scholarly journals Third Trimester Lower Extremity Lymphorrhea

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Kaori Morimoto ◽  
Luke O’Rourke
Keyword(s):  
Lower Extremity ◽  
Symptom Control ◽  
Diuretic Therapy ◽  
Previous History ◽  
Therapeutic Benefit ◽  
Lower Limbs ◽  
Chronic Hypertension ◽  
Lower Extremity Edema ◽  
Lifestyle Modifications ◽  
Third Trimester

Introduction. Lower extremity edema is one of the most common complaints among pregnant patients. However, there is no literature mentioning weeping edema (i.e., lymphorrhea) in a pregnant woman who has no concordant underlying renal and/or cardiac pathology. There is also a lack of evidence and recommendations regarding the therapeutic benefit and safety profile of diuretic use to treat profound pregnancy-associated edema. Herein, we present the case of 32-year-old female who presented with a significant lymphorrhea during the third trimester without cardiac or renal comorbidity and was successfully treated with torsemide. Case Report. We report a case of a 32-year-old multigravida patient pregnant with her third child and has two living full-term children (G3P2003). Her pregnancy was complicated by obesity, smoking (vape), and previous history of fetal growth restriction. The patient presented for routine prenatal care at 9-week gestation. She was diagnosed with chronic hypertension at 19 weeks of pregnancy based upon systolic blood pressure > 140 . Lifestyle modifications were recommended, but the patient did not comply. At her 31-week office visit, the patient presented with anasarca and clear, slightly viscous fluid seeping through the atraumatic skin of her lower extremities. Preeclampsia, renal, cardiac, vascular, and infectious complications were all ruled out. The patient responded positively to loop diuretic therapy. Torsemide was found to be far more beneficial than furosemide. The patient was induced at 37 weeks secondary to chronic hypertension requiring antihypertensive therapy. Delivery was uncomplicated. The patient gave birth to a healthy male with birth weight of 2,920 g via spontaneous vaginal delivery. Discussion. Pitting edema of lower limbs frequently occurs as a result of fluid overload and chronic venous insufficiency, and pregnancy is one of the known risk factors. Additionally, the blockage of lymphatic channel with the gravida uterus likely was the main contributing factor for her lymphorrhea. In this patient, the capillary hydrostatic pressure was likely accentuated due to hypertension, obesity, and vaping. Furosemide was minimally effective to alleviate her symptoms. Torsemide provided much more effective diuresis and symptom control. However, her symptoms persisted until delivery. Conclusion. Torsemide provided significant therapeutic benefit over furosemide in this patient without adverse maternal, fetal, or neonatal outcomes. Further study is needed to assess the safe use of loop diuretics in the pregnant population who suffers from significant lower extremity edema.

scholarly journals Improvement of Refractory Peripheral Edema With Multilayered Compression Bandaging: A Case Report

2018 ◽  
Vol 98 (9) ◽  
pp. 763-766 ◽  
Author(s):  
Jegy M Tennison ◽  
Jack B Fu ◽  
Eduardo Bruera
Keyword(s):  
Lower Extremity ◽  
Diuretic Therapy ◽  
Compression Therapy ◽  
Lower Extremity Edema ◽  
Compression Stockings ◽  
Peripheral Edema ◽  
Compression Bandaging ◽  
History Of ◽  
Artery Disease

Abstract Background and Purpose Lower extremity edema, which can be caused by several factors, is often poorly managed with commonly prescribed compression stockings and diuretics. Diuretics are often erroneously given in all forms of edema and may cause problems because their long-term application may induce chronicity of the edema due to disturbance of the renin-angiotensin relationship. Compression therapy, although effective against venous edema, is widely underused. Case Description A 64-year-old man with a history of hypertension, coronary artery disease, psoriasis, and multiple myeloma was admitted to the hospital for neutropenic fever, right lower extremity (RLE) cellulitis, bilateral lower extremity (BLE) weakness, RLE pain, and significant BLE edema. The patient was referred to a lymphedema-certified therapist to apply lower extremity multilayered compression bandaging and document serial limb circumference measurements. Outcomes The patient's weight decreased from 94.5 kg on day 1 of compression bandaging to 86.3 kg on day 7. The circumferences of the affected limbs also decreased. Discussion This case demonstrates the utility of multilayered compression bandaging, typically used in the management of lymphedema, in the control of peripheral edema that is refractory to diuretic therapy.

scholarly journals A Review on Impact of Lower Extremity Muscle Length

2021 ◽  
pp. 158-164
Author(s):  
Anushree Pawar ◽  
Pratik Phansopkar ◽  
Avanti Gachake ◽  
Komal Mandhane ◽  
Riddhi Jain ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Previous History ◽  
Muscle Length ◽  
Rectus Femoris ◽  
Knee Extension ◽  
Lower Limbs ◽  
Surgical Decision ◽  
Lower Extremity Muscle ◽  
History Of ◽  
Recovery Program

Muscle length is known as the length at which muscle is able to generate the maximum amount of force. This length is determined by the joint angle corresponding to that muscle. Length of muscle is an important parameter of length-tension relationship. Muscle functions and its mechanics helps in surgical decision making, to establish primary ergonomic advice recommendations and to form a structure of recovery program using the benefits of length-tension relation. Understanding the optimal muscle length as well as its comparison between the extremities is very important as a part of examination in physiotherapy, particularly in the cases of musculoskeletal disorders. Several tests are available for testing the muscle length. However standardize and reliable tests are been chosen to prevent the error while testing as such  measurement of hamstring, iliopsoas, rectus femoris and gastrocnemius length is been acquired through standard goniometer. The methods used for the assessment comprised of; active knee extension (AKE) tests the hamstrings, Thomas and modified Thomas test to evaluate iliopsoas and rectus femoris while prone, figure-four position accompanied by dorsiflexion for gastrocnemius. Many studies have done and their results had shown that there was difference in the lengths of muscle of lower extremity which was assessed in different players along with that normative data about the length of muscle was established. However there is paucity of study on the muscle length testing of individuals who are completely normal who are not having previous history of trauma to their lower limbs and those who are not an athlete.

A Pregnant Woman in the Third Trimester Diagnosed With Acute Respiratory Failure and Severe Lower-Extremity Edema

CHEST Journal ◽  
2016 ◽  
Vol 150 (4) ◽  
pp. e105-e107
Author(s):  
Mohammad A. Helwani ◽  
Julianne E. Donnelly ◽  
Majesh Makan ◽  
Charl J. De Wet
Keyword(s):  
Pregnant Woman ◽  
Respiratory Failure ◽  
Lower Extremity ◽  
Acute Respiratory Failure ◽  
Lower Extremity Edema ◽  
Third Trimester ◽  
The Third

Antithrombotic Therapy in Lower Extremity Artery Disease

2020 ◽  
Vol 18 (3) ◽  
pp. 215-222 ◽  
Author(s):  
Mislav Vrsalovic ◽  
Victor Aboyans
Keyword(s):  
Lower Extremity ◽  
Antiplatelet Therapy ◽  
Antithrombotic Therapy ◽  
Cardiovascular Events ◽  
Cardiovascular Outcomes ◽  
Lower Limbs ◽  
Stent Type ◽  
Increased Risk ◽  
Artery Disease ◽  
Lower Extremity Artery Disease

Lower extremity artery disease (LEAD) is a marker of a more advanced atherosclerotic process often affecting multiple vascular beds beyond the lower limbs, with a consequent increased risk for all-cause and cardiovascular mortality. Antithrombotic therapy is the cornerstone of management of these patients to prevent ischaemic cardiovascular and limb events and death. In patients with symptomatic LEAD, the efficacy of aspirin has been established long ago for the prevention of cardiovascular events. In the current guidelines, clopidogrel may be preferred over aspirin following its incremental ability to prevent cardiovascular events, while ticagrelor is not superior to clopidogrel in reducing cardiovascular outcomes. Dual antiplatelet therapy (DAPT, aspirin with clopidogrel) is currently recommended for at least 1 month after endovascular interventions irrespective of the stent type. Antiplatelet monotherapy is recommended after infra-inguinal bypass surgery, and DAPT may be considered in below-the-knee bypass with a prosthetic graft. In symptomatic LEAD, the addition of anticoagulant (vitamin K antagonists) to antiplatelet therapy increased the risk of major and life-threatening bleeding without benefit regarding cardiovascular outcomes. In a recent trial, low dose of direct oral anticoagulant rivaroxaban plus aspirin showed promising results, not only to reduce death and major cardiovascular events, but also major limb events including amputation. Yet, this option should be considered especially in very high risk patients, after considering also the bleeding risk. Despite all the evidence accumulated since >40 years, many patients with LEAD remain undertreated and deserve close attention and implementation of guidelines advocating the use of antithrombotic therapies, tailored according to their level of risk.

The Effect of Lower Extremity Exercise Program on Lower Extremity Edema and Pain for Women Officers

2021 ◽  
Vol 29 (3) ◽  
pp. 409-414
Author(s):  
Kyoung-Bin Min ◽  
Myung-Sung Kang ◽  
Hyun Seo ◽  
Un-Hyo Baek ◽  
Yong-Gon Seo
Keyword(s):  
Lower Extremity ◽  
Exercise Program ◽  
Lower Extremity Edema ◽  
Women Officers

THE RELATIONSHIP BETWEEN THE ONSET OF SEVERE PREECLAMPSIA AND PERINATAL COMPLICATIONS AT RUMKITAL Dr. RAMELAN IN SURABAYA

2021 ◽  
Vol 5 (2) ◽  
pp. 139
Author(s):  
Widya Retno ◽  
Ivon Diah Wittiarika ◽  
Muhammad Aldika Akbar
Keyword(s):  
Preterm Delivery ◽  
Early Onset ◽  
Late Onset ◽  
Previous History ◽  
Severe Preeclampsia ◽  
P Value ◽  
Chronic Hypertension ◽  
Perinatal Complications ◽  
Exact Test ◽  
The Relationship

 Abstract Background: Preeclampsia is one of the biggest causes of maternal-fetal morbidity and mortality. Based on the prognosis, the classification of Preeclampsia is early onset (<34 weeks) and late onset (> 34 weeks). Purpose: to investigate the relationship between the onset of severe Preeclampsia and perinatal complications. Method: This research is a quantitative study with a retrospective observational analytic study type and collected medical record data. The study population was severe Preeclampsia  patients who gave birth at RUMKITAL Dr. Ramelan Surabaya for the period January 2018 - June 2020 and has no previous history of chronic hypertension. The research sample was 79 subjects with 44 subjects early onset, and 35 subjects late onset. Perinatal complications  examined are preterm delivery, asphyxia, LBW, IUGR, stillbirth. The chi-square test or Fisher’s Exact Test was used to analyze relationships. Result: From the results of the study, the comparison of the percentage from early onset and late onset that experienced complications was 93.2% vs 48.6%, p-value = 0.000, OR = 14.5, CI = 3,764–55,635.  At preterm delivery, it was found that 75% vs 28.6%, p-value = 0.000,  OR = 7.5, CI = 2,754-20,422. . In asphyxia, it was found 41.7% vs 31.4%, p-value = 0.46. At LBW, it was found 72.7% vs 17.1%, p-value = 0,000, OR = 12.9, CI = 4,285-38,771. In IUGR, it was found that 15.9% vs 2.9%, p-value = 0.000. In stillbirth, it was found 18.2% vs 0% and p-value = 0.008. Conclusion: the onset of severe Preeclampsia is related with perinatal complications. Complications associated with the onset severe Preeclampsia are preterm, LBW, stillbirth. Meanwhile, complications that are not related with the onset severe Preeclampsia are asphyxia and IUGR  

Epidemiological Profile and Postpartum Outcome for Severe Preeclamptic Patients

2021 ◽  
pp. 45-50
Author(s):  
Suher Dafaus ◽  
Amel Morgham ◽  
Nasreen Osman
Keyword(s):  
Caesarean Section ◽  
Positive Family History ◽  
Previous History ◽  
Severe Preeclampsia ◽  
Intrauterine Fetal Death ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Adequate Treatment ◽  
History Of ◽  
The Mean

Background and objective. Preeclampsia is a multisystemic disorder, which involves the placenta, liver, blood, neurological and cardiovascular systems. It is one of the leading causes of maternal and fetal morbidity and mortality. This study aimed at describing the characteristic features for mothers who had severe preeclampsia and to know the complications during puerperium. Methods. A prospective study conducted over a period from February 2009 up to November 2009 involving 100 pre-eclampsia patients admitted and delivered in Aljalaa Maternity Hospital, Tripoli, Libya. Results. The patients mean age was 33.3 +5.9 years. The mean gestational age at admission time was 36.8+3.2 weeks and 64% of them were term. 58% of the patients with severe preeclampsia had a positive family history of chronic hypertension whereas 42% of patients had a previous history of preeclampsia. 40% of patients were primigravida. The mean systolic blood pressure at admission was 164+15.4 mmHg and the mean diastolic pressure was 113+6 mmHg. The common symptoms were headache, abdominal pain, and blurred vision (54%, 37%, and 31% respectively), whereas 9% of the patients presented with the eclamptic fit. The pregnancy in 66% patients ended by caesarean section, 78% of them were emergency caesarean section. The birth weight of 13% of new-borns was less than 1500 grams. Furthermore, 10% diagnosed with intrauterine fetal death (IUFD) antenatally and 9% died after admission to nursery intensive care unit post-delivery. Conclusion. the effects of hypertensive disorder associated with pregnancy could be prevented by close antenatal care particularly for whose had previous history of preeclampsia. In addition; early recognition and adequate treatment, and timely delivery can prevent preeclampsia and will improve maternal and neonatal outcomes.

scholarly journals Manfaat Rendaman Air Hangat dan Garam dalam Menurunkan Derajat Edema Kaki Ibu Hamil Trimester III

2020 ◽  
Vol 7 (2) ◽  
pp. 76
Author(s):  
Sawitry Sawitry ◽  
Fitria Hikmatul Ulya ◽  
Elisabet Jemsi Adepatiloy
Keyword(s):  
Pregnant Women ◽  
Quantitative Research ◽  
Mean Value ◽  
Lower Limbs ◽  
Wilcoxon Test ◽  
Warm Water ◽  
Third Trimester ◽  
Post Test ◽  
The Difference ◽  
Leg Edema

ABSTRAK Edema kaki terjadi hampir 80% dari semua kehamilan dan dapat menimbulkan ketidaknyamanan selama kehamilan seperti nyeri, merasa berat, kram pada malam hari, penebalan kulit, dan pigmentasi. Salah satu intervensi non farmakologis untuk mengurangi edema adalah rendaman air hangat dan garam yang merupakan intervensi untuk menghilangkan edema pada ekstremitas bawah  selama kehamilan. Menganalisis  pengaruh rendaman air hangat dan garam  terhadap edema kaki ibu hamil trimester III. Penelitian kuantitatif dengan metode quasy eksperimental one group pre test post test desaign. Sampel penelitian sebanyak 16 ibu hamil Trimester III dengan teknik accidental sampling. Analisis data menggunakan uji Wilcoxon. Terjadi penurunan tingkat edema kaki pada ibu hamil dengan selisih nilai tengah edema kaki sebelum 4,00 dan setelah perlakuan sebesar 0,00  .Uji Wilcoxon menunjukkan ρ value 0,000. Ada pengaruh rendaman air hangat dan garam  terhadap edema kaki ibu hamil trimester III. Kata Kunci : rendaman air hangat dan garam; edema; tungkai bawah ; ibu hamil.  THE EFFECT OF WARM WATER AND SALT IMMERSION IN DECLINING LEG EDEMA OF THIRD TRIMESTER PREGNANT WOMEN  ABSTRACT Edema of the legs occurs in almost 80% of all pregnancies and can cause discomfort during pregnancy such as pain, feeling heavy, cramps at night, skin thickening, and pigmentation. One of the non-pharmacological interventions to reduce edema is soaking in warm water and salt which is an intervention to relieve edema in the lower extremities during pregnancy. This study was to determine the effect of warm water and salt immersion in declining leg edema of third trimester pregnant women. This quantitative research used quasy experimental method one group pre test post test desaign. The total samples were 16 respondents with purposive sampling and random sampling techniques. Data analysis used the Wilcoxon test. The difference in the mean value of leg edema before 4.00 and after treatment was 0.00. The Wilcoxon test showed ρ value of 0.000. There is an effect of warm water and salt immersion on leg edema of third trimester pregnant women.   Keywords: warm water and salt soaking; edema; lower limbs; pregnant mother

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