scholarly journals Refractory Immunological Thrombocytopenia Purpura and Splenectomy in Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Santiago Bernal-Macías ◽  
Laura-Marcela Fino-Velásquez ◽  
Felipe E. Vargas-Barato ◽  
Lucio Guerra-Galue ◽  
Benjamín Reyes-Beltrán ◽  
...  
Keyword(s):  
Platelet Count ◽  
Pregnant Woman ◽  
Antiphospholipid Antibodies ◽  
First Trimester ◽  
Pharmacological Treatments ◽  
Autoimmune Thrombocytopenia ◽  
Baby Girl ◽  
Platelet Destruction ◽  
Healthy Baby ◽  
In Pregnancy

Thrombocytopenia is defined as a platelet count of less than 100,000 platelets per microlitre (mcL). Thrombocytopenia develops in approximately 6-7% of women during pregnancy and at least 3% of these cases are caused by immunological platelet destruction. Herein, we present a pregnant woman who develops at the first trimester autoimmune thrombocytopenia purpura associated with positive antiphospholipid antibodies. The disease was refractory to pharmacological treatments but had a favourable response to splenectomy. The patient carried the pregnancy to term without complication and gave birth to a healthy baby girl.

scholarly journals Predictive value of the aspartate aminotransferase to platelet ratio index and aspartate aminotransferase to alanine aminotransferase ratio in early diagnosis of intrahepatic cholestasis in pregnancy

2021 ◽  
Vol 8 (11) ◽  
pp. 650-654
Author(s):  
İbrahim Kale
Keyword(s):  
Platelet Count ◽  
Intrahepatic Cholestasis ◽  
Predictive Value ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
First Trimester ◽  
Control Group ◽  
Third Trimester ◽  
Apri Score ◽  
In Pregnancy

Objective: We aimed to investigate the predictive value of the first-trimester aspartate aminotransferase/platelet count ratio index (APRI) and aspartate aminotransferase/alanine aminotransferase ratio for intrahepatic cholestasis in pregnancy (ICP). Material and Methods: The clinical data of patients who admitted to the Obstetrics Department of Umraniye Training and Research Hospital, between 2015-2020 were analyzed retrospectively. The study group consisted of 44 patients with ICP and the control group consisted of randomly selected 92 healthy pregnant women. Results: The two groups were similar in terms of age, BMI, first and third-trimester platelet count and third-trimester hemoglobin level. Patients with ICP had a significantly higher first-trimester APRI and a lower first trimester AST/ALT ratio than the healthy controls (p <0.001, p = 0.001, respectively). According to the ROC analysis, the optimal cut-off value of the APRI to predict ICP was 0.191, with the sensitivity of 0.66 and specificity of 0.66 (AUC: 0,727), and the optimal cut-off value for AST/ALT ratio was 1.07, with the sensitivity of 0.64, and specificity of 0.62 (AUC: 0,681). Conclusion: The first-trimester APRI score and AST/ALT ratio is an easy, inexpensive, and non-invasive tool that may be useful in predicting ICP early.

Plasma Betathromboglobulin Measurement to Differentiate Types of Thrombocytopenia

1979 ◽  
Author(s):  
P. Han ◽  
A.G.G. Turpie ◽  
E. Genton
Keyword(s):  
Platelet Count ◽  
Platelet Activation ◽  
Half Life ◽  
Complete Recovery ◽  
Specific Protein ◽  
Autoimmune Thrombocytopenia ◽  
Platelet Destruction ◽  
Platelet Counts ◽  
Plasma Half Life

It is important to differentiate betwteen extravascular (autoimmune thrombocytopenia, ATP) and intravascular (thrombotic thrombocytopenia, TTP) platelet destruction in thrombocytopenia. Betathromboglobulin (BTG), a platelet-specific protein with a plasma half life of 20 minutes is released in-vivo from platelets by various stimuli and may reflect platelet activation or destruction. BTG concentration can be measured in plasma usin a radioimmunoassay to a sensitivity of 1 ng/ml., (nomal 28.0 ± 8.0 ng/ml., n = 70). Plasma BTG was measured in 3 patients with ATP (platelet counts: 17, 20, 16 x 109/L) and 2 patients with TTP (platelet counts: 20, 40 x 109/L). In ATP, BTG was normal (22, 11, 17 ng/ml.) and in TTP, BTG was elevated (80, 72 ng/ml.). Plasma BTG remained normal in ATP after treatment. BTG remained elevated in TTP (120 ng/ml.) even when the platelet count became normal (220 x 109/L) but while fragmented RBC were still present and became normal (21 ng/ml.) on complete recovery. These data suggest that plasma BTG may be useful in differenfiating extravascu1ar from intravascular platelet destruction by detecting increased concentrations of BTG in plasma.

Pregnant woman from southern Peru with rabies infection who delivered a healthy baby

2021 ◽  
pp. 004947552098605
Author(s):  
Arturo A Zarate ◽  
Moises Sanchez ◽  
Kevin Flores-Lovon ◽  
Mercedes Tello ◽  
Ericson L Gutierrez ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pregnant Woman ◽  
Respiratory Failure ◽  
Cesarean Section ◽  
High Mortality ◽  
Premature Baby ◽  
Healthy Baby ◽  
Neurological Sequelae ◽  
Emergency Cesarean ◽  
In Pregnancy

Rabies in pregnancy is rare with a high mortality. We report a pregnant woman who developed urban rabies from the bite of an infected dog. An emergency Cesarean section was performed at 31 weeks of gestation, and a premature baby was delivered who survived and did not develop rabies. The mother, however, suffered a rapid clinical deterioration and was admitted to intensive care where a Milwaukee protocol was followed. The patient survived 19 months but developed severe neurological sequelae secondary to rabies encephalitis and finally died of respiratory failure.

Immune thrombocytopenia in pregnancy

1990 ◽  
Vol 2 (2) ◽  
pp. 143-157 ◽  
Author(s):  
James Browning ◽  
David James
Keyword(s):  
Platelet Count ◽  
Intracerebral Haemorrhage ◽  
Intracranial Haemorrhage ◽  
Immune Thrombocytopenia ◽  
Autoimmune Thrombocytopenia ◽  
Reliable Test ◽  
Alloimmune Thrombocytopenia ◽  
Route Of Delivery ◽  
Abdominal Delivery ◽  
In Pregnancy

Autoimmune thrombocytopenia (ITP)1) The risks to mother and fetus have previously been overstated.2) There is no maternal test which will accurately determine fetal thrombocytopenia.3) The only reliable test for fetal thrombocytopenia is cordocentesis – this carries a higher morbidity than that of fetal intracerebral haemorrhage from ITP.4) Contrary to received wisdom, there is no evidence that, even for the most severely thrombocytopenic infant, abdominal delivery protects against intracranial haemorrhage.5) Management therefore involves keeping the maternal platelet count above 50 × 1091 and choosing the route of delivery on normal obstetric grounds.Alloimmune thrombocytopenia1) Alloimmune thrombocytopenia is commoner than hitherto believed (0.15% all neonates).2) The fetal risks are considerable: intracranial haemorrhage occurs in 4% of cases antenatally and in 10% in labour. The risks are virtually confined to those with a platelet count of less than 30 × 109l−1.3) Cordocentesis is justified for the ‘at risk’ fetus; fetal immunoglobulin or platelet therapy can be given.4) When the fetal platelet count is below 50 × 109l−1, abdominal delivery should be planned.5) A maternal screening test for neonatal alloimmune thrombocytopenia exists (lack of P1A1 antigen).

Trastuzumab exposure in early pregnancy for a young lady with locally invasive breast cancer

2016 ◽  
Vol 4 (1) ◽  
pp. 12-25
Author(s):  
Natasha Pianca ◽  
Mathew George
Keyword(s):  
Breast Cancer ◽  
Case Reports ◽  
First Trimester ◽  
Young Lady ◽  
Fetal Exposure ◽  
Negative Effects ◽  
Baby Girl ◽  
Her2 Positive ◽  
Healthy Baby ◽  
Positive Breast Cancer

The available literature on the effects of trastuzumab on pregnancy in the first trimester is limited. Case reports discuss the presence of oligohydramnios on fetal USS that result in a living baby that seemingly lacks any abnormalities. There may also be a link with higher rates of spontaneous abortion. We describe a young 32 year old on trastuzumab for a locally invasive HER2-positive breast cancer who became pregnant with fetal exposure to the treatment. After cessation of trastuzumab at 28 weeks, she delivered a healthy baby girl at 37 weeks gestation who, at 7 years of age now, still does not display any evidence of negative effects of trastuzumab exposure.

scholarly journals Acute leukemia in pregnancy: Case series from a tertiary care institute

2021 ◽  
Vol 9 (2) ◽  
pp. 85-90
Author(s):  
Peta RK ◽  
Panchal HP ◽  
Patel A ◽  
Parikh S ◽  
Agarwal A ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Tertiary Care ◽  
Case Series ◽  
First Trimester ◽  
Differential Sensitivity ◽  
Third Trimester ◽  
Unique Challenge ◽  
Healthy Baby ◽  
Medical Termination ◽  
In Pregnancy

Background: Acute leukemia in pregnancy is estimated to occur in less than one in one lakh pregnancies. Management of these patients differs by the trimester in which they present, because of the differential sensitivity of the fetus to chemotherapy during the three trimesters. Because of the rarity of this situation, there is scarcity of data on the management of these patients. Materials and method: We included patients with acute leukemia diagnosed and treated during pregnancy at our institute and reviewed 3 successive patients for this case series. Results and conclusion: Acute leukemia in pregnancy presents a unique challenge for treatment and requires multidisciplinary co-ordination for treatment. When judiciously managed, good outcomes of disease of mother and fetus can be achieved. Our three patients included one in each trimester; the first trimester patient underwent medical termination of pregnancy and has successfully completed treatment. The second trimester patient underwent induction chemotherapy and delivered a healthy baby. The patient diagnosed in the third trimester delivered a pre-term healthy baby during treatment and continues to be on chemotherapy.

Clinical Study of Gud-Amalaka Yoga in Garbhini Mutrakrichra w.s.r to Urinary Tract Infections during Pregnancy

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Sandeep Kumar Rajan ◽  
Rajnish Gautam ◽  
Pankaj Mishra
Keyword(s):  
Pregnant Woman ◽  
Urinary Tract ◽  
The Body ◽  
Premature Delivery ◽  
Healthy Baby ◽  
Patient Reported ◽  
Long Term Result ◽  
Tract Infections ◽  
Prompt Attention

Healthy mother and healthy baby are foremost aim of antenatal care. Progressive anatomical and physiological changes during pregnancy are not only confined to the genital organs however within other systems of the body too, some may be felt as discomfort by a pregnant woman. A pregnant woman having pain or burning micturition, fever with chills, nausea, vomiting and cloudy urine having bad smell can be diagnosed as having Urinary Tract Infection (UTI). UTI is most common bacterial infection encountered during Pregnancy and troublesome to the woman suffering from it. Pyelonephritis, premature delivery and other risk such as PROM, IUGR etc. can be the long term result of UTI hence prompt attention is requisite. In the present study Gud-Amalaka Yoga has been tried in 15 patients for evaluation of its clinical efficacy and adverse / side effects if any. It was observed that Gud-Amalaka Yoga showed better results (25% patients were moderately improved, 75% patients were mildly improved). None of the patient reported any adverse effect during or after the treatment.

EXPRESS: Method dependent variation in TSH and FT4 reference intervals in pregnancy: a systematic review

2021 ◽  
pp. 000456322110269
Author(s):  
O E Okosieme ◽  
Medha Agrawal ◽  
Danyal Usman ◽  
Carol Evans
Keyword(s):  
Systematic Review ◽  
Reference Interval ◽  
First Trimester ◽  
Reference Intervals ◽  
Assay Method ◽  
Specific Reference ◽  
Upper Limits ◽  
Wide Range ◽  
Assay Methods ◽  
In Pregnancy

Background: Gestational TSH and FT4 reference intervals may differ according to assay method but the extent of variation is unclear and has not been systematically evaluated. We conducted a systematic review of published studies on TSH and FT4 reference intervals in pregnancy. Our aim was to quantify method-related differences in gestation reference intervals, across four commonly used assay methods, Abbott, Beckman, Roche, and Siemens. Methods: We searched the literature for relevant studies, published between January 2000 and December 2020, in healthy pregnant women without thyroid antibodies or disease. For each study, we extracted trimester-specific reference intervals (2.5–97.5 percentiles) for TSH and FT4 as well as the manufacturer provided reference interval for the corresponding non-pregnant population. Results: TSH reference intervals showed a wide range of study-to-study differences with upper limits ranging from 2.33 to 8.30 mU/L. FT4 lower limits ranged from 4.40–13.93 pmol/L, with consistently lower reference intervals observed with the Beckman method. Differences between non-pregnant and first trimester reference intervals were highly variable, and for most studies the TSH upper limit in the first trimester could not be predicted or extrapolated from non-pregnant values. Conclusions: Our study confirms significant intra and inter-method disparities in gestational thyroid hormone reference intervals. The relationship between pregnant and non-pregnant values is inconsistent and does not support the existing practice in some laboratories of extrapolating gestation references from non-pregnant values. Laboratories should invest in deriving method-specific gestation reference intervals for their population.

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