Arteriovenous malformation as a cause for acute confusion and gastrointestinal bleeding in a primigravida pregnancy

2021 ◽  
Vol 14 (1) ◽  
pp. e239723
Author(s):  
Helen Clarke ◽  
Thomas McCormack ◽  
Emila Paul ◽  
Jonathan Ford
Keyword(s):  
Arteriovenous Malformation ◽  
Iron Supplementation ◽  
Healthy Population ◽  
Gi Bleeding ◽  
Term Pregnancy ◽  
Third Trimester ◽  
The Third ◽  
History Of ◽  
Acute Confusion ◽  
Protein Load

Acute confusion in pregnancy is generally uncommon, given the relatively young and healthy population obstetricians care for. We present an unusual and rare case of acute confusion in a term pregnancy with antecedent history of gastrointestinal (GI) bleeding. A primigravida with no medical history of note, was found to have a haemoglobin of 67 g/L at booking and was commenced on oral iron supplementation. In the third trimester, she presented with haematochezia and had several admissions, requiring 18 units of red blood cells during her pregnancy. At term, she was admitted with acute confusion and GI bleeding, and was subsequently delivered by caesarean section to facilitate ongoing investigation and management of her symptoms. She was diagnosed postnatally with an arteriovenous malformation in the jejunum which required interventional radiology and surgical management for symptom resolution. Her confusion was attributed to hyperammonaemic levels secondary to her high protein load.

scholarly journals HEALTH-RELATED QUALITY OF LIFE OF PREGNANT WOMEN WITH HEARTBURN AND REGURGITATION

2015 ◽  
Vol 52 (2) ◽  
pp. 100-104 ◽  
Author(s):  
Valesca DALL'ALBA ◽  
Sidia Maria CALLEGARI-JACQUES ◽  
Cláudio KRAHE ◽  
Juliana Paula BRUCH ◽  
Bruna Cherubini ALVES ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Health Related Quality ◽  
Third Trimester ◽  
The Third ◽  
Physical Problems ◽  
Related Quality ◽  
Health Related ◽  
History Of

Background Heartburn and regurgitation frequently occur in the third trimester of pregnancy, but their impact on quality of life has not been thoroughly investigated. Objective To measure health-related quality of life of third-trimester pregnant women with heartburn and regurgitation. Methods Data on obstetric history, heartburn and regurgitation frequency and intensity, history of heartburn and regurgitation and health-related quality of life were collected of 82 third-trimester pregnant women. Results Sixty-two (76%) women had heartburn, and 58 (71%), regurgitation; 20 were asymptomatic. Mean gestational age was 33.8±3.7 weeks; 35 (43%) women had a family history of heartburn and/or regurgitation, and 57 (70%) were asymptomatic before pregnancy. The following quality of life concepts were significantly reduced: physical problems and social functioning for heartburn; physical problems and emotional functioning for regurgitation. There was agreement between heartburn in present and previous pregnancies. Conclusion Heartburn and/or regurgitation affected health-related quality of life of third trimester pregnant women

The Call: Anticipatory Guidance for the Death of a Family's Newborn

1987 ◽  
Vol 8 (7) ◽  
pp. 196-199
Author(s):  
Martin J. Drell
Keyword(s):  
Past History ◽  
Phone Call ◽  
Anticipatory Guidance ◽  
Delivery Time ◽  
Third Trimester ◽  
The Third ◽  
Short Period ◽  
History Of ◽  
The One

When I arrived home, my wife told me to call a personal friend of ours who needed some advice. All my wife knew was that our friend, Mary, had just found out that the baby she was about to deliver was deformed and might not live. Mary wanted to talk with me about how to handle the matter with Barry, her son who was nearly 4 years old. Calls like this are always difficult ones, and it was with some trepidation that I called. Mary answered. Her voice quivered as she talked. The history unfolded piecemeal throughout the one-half hour phone call. From the beginning, Mary believed that something was wrong with her pregnancy, that somehow it had not "felt right" From a medical stadpoint, however, there were only minor problems. At the beginning of the third trimester, she had a short period of spotting. The obstetrician had Mary lie down and not exert herself. During this period of rest, Barry was told specifically not to jump on his mother, because it might hurt the baby. The spotting did not recur and the pregnancy progressed, supposedly without a hitch. As the delivery time approached, sonography was done to check on the health of the fetus. The test was done because of the mother's past history of having delivered Barry prematurely and having had a subsequent miscarriage.

Impact of Pregnancy On the Course of Immune Thrombocytopenic Purpura: An Observational Study On 44 Cases.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1320-1320 ◽  
Author(s):  
Lilia Baili ◽  
Mehdi Khellaf ◽  
Laetitia Languille ◽  
Philippe Bierling ◽  
Bertrand Godeau ◽  
...  
Keyword(s):  
Platelet Count ◽  
Previous History ◽  
Third Trimester ◽  
Thrombocytopenic Purpura ◽  
The Third ◽  
Short Course ◽  
History Of ◽  
The Mean ◽  
Mucosal Bleeding ◽  
Risk Of Relapse

Abstract Abstract 1320 Poster Board I-342 Backgound Adult's immune thrombocytopenic purpura (ITP), now referred as immune thrombocytopenia, is an autoimmune disease affecting preferentially women of child-bearing age. The risk of relapse or worsening of the disease during pregnancy in women with a previous history of ITP or followed for a chronic ITP is not well known and the monitoring of such patients is therefore not consensual. In order to better asses the impact of pregnancy on ITP' course and natural history, a study was initiated at the national referral center for adult's immune cytopenias at Creteil, France. Patients and Methods This was an observational single center study. To be included into the study, all women had to fulfill the following inclusion criteria: 1) A previous history of definite ITP outside pregnancy with a platelet count < 50×109/L at time of diagnosis and 2) Occurrence of at least one pregnancy within 10 years after ITP diagnosis. Patients diagnosed with secondary ITP (lupus-associated or other) or in whom ITP was diagnosed during a previous pregnancy could not be included. All available clinical and biological ITP-related data available before, during and after each pregnancy were extensively reviewed and analyzed. Results Data on 44 pregnancies in 33 women (mean age: 25 ± 7 years) were analyzed. The mean delay between ITP diagnosis and first pregnancy was 52 ± 19,8 months. At the beginning of pregnancy, ITP was considered “active” (i.e platelet count <100×109/L) in 11/44 (25%) cases, with a platelet count below 50 ×109/L in 6 cases whereas ITP was in remission (platelet count > 100 × 109/L) in 75% of the cases, either off therapy (82%) or on treatment (18% of the cases). In total, the platelet count remained stable during pregnancy In 25/44 of the cases (57%) without the need of any treatment except for one patient who received corticosteroids for an associated autoimmune hemolytic anemia diagnosed during pregnancy (Evans' syndrome). A slight decrease in the platelet count (between 50 and 100×109/L) was observed in 12 cases (27%), 6 of which occurred at the end of pregnancy. In nine of these cases, patients were given a short course of corticosteroids in preparation for delivery. Lastly, a decrease of the platelet count below 50×109/L was observed in only 7 of the 44 pregnancies (16%). In 6 of these 7 cases, patients were given corticosteroids, either alone (n=2) or in combination with intravenous immunoglobulin (n=4 cases); one patient was also given a platelet transfusion. No severe bleeding episode (mucosal bleeding or any hemorrhage) occurred in any of these cases prior to, during or after delivery. A miscarriage occurred in 6 of the 44 pregnancies (13.5%), a C-section was performed in 18% of the cases which is the usual average rate in France. In total, a treatment for ITP had been considered useful in 15 pregnancies (34%) mainly at the end of the third trimester. The mean platelet count at time of delivery was 107 ± 17 × 109/L, None of the patients had a relapse or a significant decrease of the platelet count within 6 months after delivery except for a one patient who presented with a severe (platelet count < 20 × 109/L) and symptomatic (cutaneous and mucosal bleeding) thrombocytopenia on day 2 after delivery. Conclusion Based on these preliminary data, pregnancy does not seem to have a negative impact on the course of the disease in women with chronic non-refractory ITP nor to increase the risk of relapse in those with a previous history of ITP. A significant decrease of the platelet count may occur in about 15% of the cases, mainly during the third trimester. In women with a platelet count between 50 and 100 × 109/L at term, a short course of treatment could be indicated in preparation for delivery and especially if an epidural analgesia is planned. Disclosures No relevant conflicts of interest to declare.

scholarly journals Acute Fatty Liver Disease of Pregnancy in the Second Trimester

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Faraz Afridi ◽  
Michael Feely ◽  
Raju Reddy
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Fulminant Liver Failure ◽  
Second Trimester ◽  
Third Trimester ◽  
Fetal Demise ◽  
The Third ◽  
History Of ◽  
Acute Fatty Liver

Acute fatty liver of pregnancy (AFLP) is a rare disorder that typically presents in the third trimester. We report a case of a 21-year-old woman with a history of intrauterine fetal demise at 19 weeks’ gestation who developed fulminant liver failure 1 week after the fetal demise. She was diagnosed with AFLP as per the Swansea criteria. An orthotopic liver transplant was attempted but was unsuccessful. AFLP usually presents between the 30th to 38th weeks of gestation. However, it can occur in the postpartum period after only 19 weeks of gestation as highlighted in our case.

scholarly journals Primary Aortoenteric Fistulae: What Every Surgeon Should Know About Its Diagnosis and Treatment

2021 ◽  
Author(s):  
Mohammad Hassani ◽  
Sina Zarrintan ◽  
Mohamad Moradmand ◽  
Peyman Bakhshaei Shahrbabaki
Keyword(s):  
Clinical Suspicion ◽  
The Other ◽  
Aortoenteric Fistula ◽  
Gi Bleeding ◽  
Aortic Graft ◽  
Rare Finding ◽  
The Third ◽  
High Clinical Suspicion ◽  
Artificial Graft ◽  
History Of

Aortoenteric fistula is a rare finding that is potentially fatal and is usually seen as a fistula between the aorta or an aortic graft and the third part of the duodenum. The type without the presence of an artificial graft is considered as primary and the other type as secondary. The patients usually present with the heralding symptom of minor hematemesis, which later leads to massive and mortal GI bleeding. The most important factor in the diagnosis of an aortoenteric fistula is to have a high clinical suspicion after taking an appropriate and accurate history. In hemodynamically stable patients with clinical suspicion, performing an intravenouscontrast-CT scan of the abdomen and pelvis is of assistance in diagnosis. In general, stable hemodynamics greatly reduces the suspicion for diagnosis. Treatment is often surgical, and in regard to the severity of abdominal contamination or the level of visible infection, the extra anatomical or insitu graft repair is considered as the method of choice. This article tries to transfer our experiences in two patients, each of whom presented with hematemesis and melena without a history of underlying aortic aneurysm.

scholarly journals GAMBARAN FAKTOR RESIKO IBU DENGAN TERHADAP KEJADIAN ASFIKSIA NEONATORUM DI RSUD RASIDIN PADANG TAHUN 2017

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Novria Hesti
Keyword(s):  
Risk Factors ◽  
Univariate Analysis ◽  
Maternal Risk Factors ◽  
Third Trimester ◽  
Maternal Risk ◽  
Neonatal Asphyxia ◽  
The Third ◽  
First Child ◽  
Data Editing ◽  
History Of

Tahun 2012 angka kematian neonatus di Indonesia yaitu 35 per 1.000 kelahiran, dari angka tersebut 35,9 % disebabkan oleh gangguan pernapasan/asfiksia. Faktor resiko dari ibu seperti usia, paritas, riwayat perdarahan di trimester III dan hipertensi dapat menyebabkan asfiksia pada bayi. Tujuan penelitian adalah untuk menggambarkan faktor resiko individual ibu terhadap kejadian asfiksia neonatorum di RSUD Rasidin Padang Tahun 2017. Jenis penelitian descriptif. Dilakukan di RSUD Rasidin Padang pada Tanggal 11 Juli 2018, dengan populasi seluruh ibu yang melahirkan dengan bayi asfiksia di RSUD Rasidin, dengan teknik pengambilan sampel total sampling dengan menggunakan kriteria inklusi, dengan jenis pengambilan data yaitu data sekunder, teknik pengolahan data editing, coding, entry data,tabulating, cleaning serta analisa data menggunakan analisa univariat. Dari hasil penelitian ibu yang melahirkan dengan bayi asfiksia didapatkan 22 orang ibu (66,67%) memiliki usia < 20 tahun atau > 35 tahun, sebanyak 19 orang ibu (57,57%) yang melahirkan anak pertama atau anak ke >3, sebanyak 4 orang ibu (12,12%) memiliki riwayat perdarahan timester III, sebanyak orang ibu(9,10%) memiliki riwayat hipertensi. Sebagian besar ibu yang  yang melahirkan bayi dengan asfiksia  memiliki usia < 20 tahun atau > 35 tahun. Sebagian Ibu yang melahirkan bayi dengan asfiksia merupakan anak pertama atau anak ke >3. Sebagian kecil ibu yang melahirkan dengan bayi asfiksia memiliki riwayat perdarahan timester III. Sebagian kecil ibu yang melahirkan dengan bayi asfiksia memiliki riwayat hipertensi. Diharapkan agar meningkatkan pelayanan yang lebih efektif dalam medeteksi persalinan dengan resiko sehinga keadaan ibu dan bayi dapat tertangani secara optimal.   Kata Kunci : Asfiksia Neonatorum, Usia, Paritas, Perdarahan Trimester III, Hipertensi           ABSTRAK                  In 2012 the neonatal mortality rate in Indonesia was 35 per 1,000 births, of which 35.9% were caused by respiratory / asphyxia disorders. Maternal risk factors such as age, parity, history of bleeding in the third trimester and hypertension can cause asphyxia in infants. The aim of the study was to describe the individual maternal risk factors for the incidence of neonatal asphyxia in Rasidin Padang Hospital in 2017. Descriptive research type. It was conducted at Rasidin Hospital in Padang 11 Juli 2018, with a population of all mothers giving birth to asphyxia babies in Rasidin Hospital, with a total sampling technique using inclusion criteria, with data collection types namely secondary data, editing data processing techniques, coding, data entry, tabulating, cleaning and data analysis using univariate analysis. From the results of the research, mothers who gave birth to asphyxial infants found 22 mothers (66.67%) had an age of <20 years or> 35 years, as many as 19 mothers (57.57%) who gave birth to their first child or> 3 children, as many as 4 mothers (12.12%) had a history of bleeding in the third trimester, as many as mothers (9.10%) had a history of hypertension. Most of the mothers who gave birth to asphyxial babies had <20 years or> 35 years. Some mothers who give birth to babies with asphyxia are the first child or> 3 children. A small percentage of mothers giving birth to asphyxial infants have a history of bleeding in the third trimester. A small percentage of mothers giving birth to asphyxial babies have a history of hypertension. It is expected to improve services that are more effective in detecting labor with risk so that the condition of the mother and baby can be handled optimally. Keywords: Neonatal Asphyxia, Age, Parity, Third Trimester Bleeding, Hypertension

Where There is No Ultrasound: Delay and Failure of Antenatal Diagnosis of Twin Pregnancy

2003 ◽  
Vol 33 (1) ◽  
pp. 5-7 ◽  
Author(s):  
M C Groot ◽  
E J Buchmann
Keyword(s):  
South Africa ◽  
Antenatal Care ◽  
Twin Pregnancy ◽  
Previous History ◽  
Third Trimester ◽  
Second Stage ◽  
The Third ◽  
Second Stage Of Labour ◽  
History Of ◽  
Twin Pregnancies

We investigate the problem of late diagnosis of twin pregnancy in Soweto, South Africa, where routine antenatal ultrasound is not available. One hundred consecutive pairs of twins were studied, using the notes of mothers who delivered twins at Chris Hani Baragwanath Hospital and the referring Soweto clinics. A positive history was found in 31 mothers (22 family history, nine previous history of twins). Six mothers did not attend for antenatal care. Twenty-five twin pregnancies were discovered at delivery, 15 of them in the second stage of labour, and 27 were diagnosed accidentally in the third trimester. Only 15 pregnancies were referred specifically for suspicion of twin pregnancy. Most twin pregnancies are detected only in the third trimester or at delivery. Until routine ultrasound is available to all pregnant women, the teaching of antenatal care in South Africa must give emphasis to clinical suspicion of twin pregnancy.

Sign in / Sign up

Export Citation Format

Share Document