scholarly journals Ovarian Dysgerminoma in Pregnant Women with Viable Fetus: A Rare Case Report

2021 ◽  
pp. 141-146
Author(s):  
Reda Youssef ◽  
Gamal Sayed Ahmed ◽  
Samir Alhyassat ◽  
Sanaa Badr ◽  
Ahmed Sabry ◽  
...  
Keyword(s):  
Gestational Age ◽  
Ovarian Neoplasms ◽  
Imaging Modality ◽  
Reproductive Age ◽  
Diagnostic Challenge ◽  
Short Period ◽  
Ovarian Dysgerminoma ◽  
The Impact ◽  
In Pregnancy

Dysgerminoma is an uncommon malignant tumor arising from the germ cells of the ovary. Its association with pregnancy is extremely rare, with a reported incidence of about 0.2–1 per 100,000 pregnancies. Women in the reproductive age group are more commonly affected. It can be extremely rare to conceive naturally, without assisted reproductive interventions, in cases with ovarian dysgerminoma. If a pregnancy does occur with a concurrent dysgerminoma, it is even more unusual to carry the pregnancy to viability or childbirth without fetal or maternal compromise. We report a case of right ovarian dysgerminoma in a young female with a viable intrauterine pregnancy at 10 weeks, which is rarely diagnosed and managed at this gestational age. Numerous factors played a role in her favorable outcome, including early suspicion by ultrasound and presenting history, surgery, histopathological assessment, imaging, and involvement of the multidisciplinary oncology team. Ovarian neoplasms may rapidly increase in size within a short period with little or no symptoms. This poses a diagnostic challenge for obstetricians and oncologists. Hence, we aimed to evaluate the role of imaging in pregnancy using ultrasound as an imaging modality for both early detection of ovarian neoplasms and for follow-up. In conclusion, patients with ovarian dysgerminoma in pregnancy can have favorable outcomes. Treatment should be individualized on a case-to-case basis, depending on many factors; cancer stage, previous reproductive history, the impact of imaging in staging or follow-up of tumor on the fetus, fetal gestational age, and whether termination of the pregnancy can improve survival or morbidity for the mother.

Recovering from critical illness in hospital

2016 ◽  
Author(s):  
Saxon Ridley
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
Adverse Events ◽  
General Ward ◽  
Organ Support ◽  
Icu Discharge ◽  
Short Period ◽  
P Recovery ◽  
The Impact

Recovery from critical illness may not be smooth and uneventful for the patient. Complications and adverse events may beset the patient and lead to intensive care unit (ICU) re-admission. Problems upsetting patients after discharge may be a manifestation of post-intensive care syndrome, new or recurrent organ failure. Avoiding post-ICU complications may be prevented by ensuring a well-planned transition from ICU to the general ward. This may be achieved by minimizing the impact and duration of organ support, defining a structured rehabilitation programme prior to ICU discharge. After discharge a short period spent on an intermediate care unit with higher nursing staff ratios, together with follow-up on the general ward will help identify and treat any new problems. Unfortunately, re-admission may be required to effectively treat some complications. There are recognized risk factors for ICU re-admission and these should be used to warn of the increased likelihood of adverse events to aid appropriate planning avoiding re-admission to ICU.

scholarly journals Postponing Pregnancy Through Oocyte Cryopreservation for Social Reasons: Considerations Regarding Clinical Practice and the Socio-Psychological and Bioethical Issues Involved

Medicina ◽  
2018 ◽  
Vol 54 (5) ◽  
pp. 76 ◽  
Author(s):  
Mara Simopoulou ◽  
Konstantinos Sfakianoudis ◽  
Panagiotis Bakas ◽  
Polina Giannelou ◽  
Christina Papapetrou ◽  
...  
Keyword(s):  
Reproductive Age ◽  
Future Expectations ◽  
The Social ◽  
Wide Range ◽  
Bioethical Issues ◽  
The Moment ◽  
The Impact ◽  
Complex Matter ◽  
Oocyte Freezing

Oocyte freezing for ‘social reasons’ refers to women of reproductive age who are aiming to prolong, protect and secure their fertility. The term emerged to describe application of the highly promising technique, namely vitrification on oocytes retrieved through controlled ovarian stimulation (COS) from women intending to preserve their fertility for social reasons. These women opt to cryopreserve their oocytes at a point in their life when they need to postpone childbearing on the grounds of so called ‘social’ reasons. These reasons may include a highly driven career, absence of an adequate partner, financial instability, or personal reasons that make them feel unprepared for motherhood. This is a sensitive and multifaceted issue that entails medical, bioethical and socio-psychological components. The latest trend and the apparent increase noted on oocyte freezing for ‘social reasons’ has prompted our team of fertility specialists, embryologists, obstetricians, gynecologists and psychologists to proceed with a thorough, critical and all-inclusive comprehensive analysis. The wide range of findings of this analysis involve concerns of embryology and epigenetics that shape decisions made in the IVF laboratory, issues regarding obstetric and perinatal concerns on the pregnancy concluding from these oocytes and the respective delivery management and neonatal data, to the social and bioethical impact of this trend’s application. This literature review refers to matters rising from the moment the ‘idea’ of this option is ‘birthed’ in a woman’s thoughts, to proceeding and executing it clinically, up until the point of the pediatric follow up of the children born. We aim to shed light to the controversial issue of oocyte freezing, while objectively exhibit all aspects regarding this complex matter, as well as to respectfully approach how could the prospect of our future expectations be shaped from the impact of its application.

scholarly journals 1262. Comparative Evaluation of Native and Migrant HIV+ Pregnant Women in Chile

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S454-S454
Author(s):  
macarena silva ◽  
Marcelo Wolff ◽  
Laura Orellana ◽  
Catalina Carrasco ◽  
Andrea Canals ◽  
...  
Keyword(s):  
Viral Load ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Gestational Age ◽  
Baseline Viral Load ◽  
Transmission Protocol ◽  
Pregnancy And Postpartum ◽  
Baseline Characteristics ◽  
The Impact

Abstract Background The reported data of HIV + pregnant women in Latin America (LA) is scarce. Given the political and social changes that have occurred in recent years, Chile has had to face immigration as a recent phenomenon. Based on this, the objective of this analysis was to determine the baseline characteristics, virological during pregnancy and postpartum, and the impact of immigration on adult women infected with HIV Methods The registry of HIV + pregnant women of Fundación Arriarán was analyzed since 2006. The baseline characteristics,undetectability at delivery, vertical transmission and retention were determined.Estimators as mean and median,standard deviation and interquartile range; absolute and relative frequencies were used and for the bivariate analysis the t-test and chi2,Mann–Whitney and Fisher’s exact. For follow-up, the Kaplan–Meier method was used. Results A total of 214 pregnancies in 198 HIV + women were included. A 54% of foreigners (of Haitian predominance) was found, 2/3 of the foreigners were enrolled after 2016. A 73% was diagnosed with HIV at the time of pregnancy. Average age was 28.6 years. Baseline CD4 cell count was 396 cel/mm3. A 7.7% were admitted with advanced pregnancy and 4.6% had a history of drug addiction. None of these variables had significant differences between both groups. The variables of gestational age at admission (15 vs. 21; P < 0.001), gestational age at the beginning of therapy (18 vs. 21; P < 0.001), CDC stage and baseline viral load (9750 vs. 644 copies/mL;P < 0.001) were statistically significant between Chileans and foreigners. 58% of the patients achieved undetectability at the time of delivery without differences between both groups. (55% vs. 63%; p0.42) Almost 90% of women with detectable viral load at delivery was less than 1000 copies/mL (88,9%). 93% received full vertical transmission protocol and the prematurity rate was 16.6%. The vertical transmission was 2.6% without differences between nationals and foreigners. In the postpartum follow-up,70% were retained, 73% of them undetectable on the latest follow-up visit. Conclusion Despite the cultural and language limitations, foreign patients maintained a compliance similar to those of Chile, achieving a low transmission rate vertical and good adherence to postpartum controls. Disclosures All authors: No reported disclosures.

scholarly journals Clinical Outcomes of Submicroscopic Infections and Correlates of Protection of VAR2CSA Antibodies in a Longitudinal Study of Pregnant Women in Colombia

2018 ◽  
Vol 86 (4) ◽  
Author(s):  
Kenneth Gavina ◽  
Sedami Gnidehou ◽  
Eliana Arango ◽  
Chloe Hamel-Martineau ◽  
Catherine Mitran ◽  
...  
Keyword(s):  
Birth Weight ◽  
Pregnant Women ◽  
Gestational Age ◽  
Significant Risk ◽  
Adverse Outcomes ◽  
Mixed Infections ◽  
Content Type ◽  
Delivery Outcomes ◽  
The Impact ◽  
In Pregnancy

ABSTRACTMalaria in pregnancy can cause serious adverse outcomes for the mother and the fetus. However, little is known about the effects of submicroscopic infections (SMIs) in pregnancy, particularly in areas wherePlasmodium falciparumandPlasmodium vivaxcocirculate. A cohort of 187 pregnant women living in Puerto Libertador in northwest Colombia was followed longitudinally from recruitment to delivery. Malaria was diagnosed by microscopy, reverse transcription-quantitative PCR (RT-qPCR), and placental histopathology. Gestational age, hemoglobin concentration, VAR2CSA-specific IgG levels, and adhesion-blocking antibodies were measured during pregnancy. Statistical analyses were performed to evaluate the impact of SMIs on birth weight and other delivery outcomes. Twenty-five percent of women (45/180) were positive for SMIs during pregnancy. Forty-seven percent of infections (21/45) were caused byP. falciparum, 33% were caused byP. vivax, and 20% were caused by mixedPlasmodiumspp. Mixed infections ofP. falciparumandP. vivaxwere associated with lower gestational age at delivery (P= 0.0033), while other outcomes were normal. Over 60% of women had antibodies to VAR2CSA, and there was no difference in antibody levels between those with and without SMIs. The anti-adhesion function of these antibodies was associated with protection from SMI-related anemia at delivery (P= 0.0086). SMIs occur frequently during pregnancy, and while mixed infections of bothP. falciparumandP. vivaxwere not associated with a decrease in birth weight, they were associated with significant risk of preterm birth. We propose that the lack of adverse delivery outcomes is due to functional VAR2CSA antibodies that can protect pregnant women from SMI-related anemia.

scholarly journals Recommendations of the AGG (Section Maternal Disease) for Myasthenia Gravis in Pregnancy

2021 ◽  
Vol 81 (12) ◽  
pp. 1301-1306
Author(s):  
Maritta Kühnert ◽  
Markus Schmidt ◽  
Bettina Kuschel ◽  
Ute Margaretha Schäfer-Graf
Keyword(s):  
Myasthenia Gravis ◽  
Young Women ◽  
Fetal Monitoring ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Clinical Presentations ◽  
Muscle Groups ◽  
Maternal Disease ◽  
The Impact ◽  
In Pregnancy

AbstractMyasthenia gravis is an autoimmune disease with a range of clinical presentations which manifest as combinations of weakness of the ocular, bulbar, and respiratory muscle groups and muscles of the extremities. Young women of reproductive age are most commonly affected. Preconception planning, the impact of pregnancy, prepartum management, drug therapy in pregnancy, myasthenic and cholinergic crises, fetal monitoring, peripartum management including analgesia and anesthesia during labor and cesarean section as well as neonatal management and neonatal myasthenia gravis are described here and the appropriate recommendations are given.

scholarly journals NEONATAL FOLLOW-UP IN CANADA. A NATIONAL SURVEY

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e19-e20
Author(s):  
Fawaz Albaghli ◽  
Anne Synnes ◽  
Alberta Girardi ◽  
Paige Church ◽  
Marilyn Ballantyne
Keyword(s):  
National Survey ◽  
Gestational Age ◽  
Online Survey ◽  
Current Status ◽  
National Database ◽  
P Value ◽  
Eligibility Criteria ◽  
Large Variability ◽  
The Impact

Abstract BACKGROUND The Canadian Neonatal Follow-Up Network (CNFUN) was developed in 2008 to facilitate collaboration in research by providing a national database and implemented standardized neurodevelopmental assessments at 18 and 36 months corrected ages for babies born <29-week gestational age. Previous Canadian surveys showed a large variability in neonatal follow-up practices. This is the first Canadian national survey since the establishment of CNFUN. OBJECTIVES To describe the current status of neonatal follow-up services in Canada and to evaluate the impact of CNFUN by comparing the results of the current survey to a 2006 survey. Proportions are compared using chi square, p value < 0.006 adjusted for multiple comparisons. DESIGN/METHODS All 26 Level-III University Affiliated Neonatal Follow-up programs in Canada belonged to CNFUN and were invited to participate in this comprehensive online survey. Questions were based on previous survey results, current literature and discussion amongst the investigators. RESULTS 23/26 (88%) of invited programs completed the survey. Scope of service: All programs provided neurodevelopmental screening and referral for intervention. Data collection, training and education were provided by most programs (>80%). Therapeutic interventions were offered by a smaller number of programs (>50%). Type of Assessments: The use of Bayley Scales of Infant and Toddler Development increased significantly since 2006. For speech and language, adaptive behavior, and psychological standardized assessments tools a large variation remains. Follow-Up Schedule: Most programs offer between 5 to 7 follow-up visits. There remains a great variability in the timing of visits. Eligibility Criteria: The use of gestational age eligibility criteria, the inclusion of up to 29 weeks, and the expansion to include additional neurologic, cardio-respiratory, and fetal diagnosis has increased since 2006. CONCLUSION CNFUN was associated with a clinically important, statistically non-significant standardization. Non-preterm eligibility criteria have increased. Marked variability in Neonatal follow-up practices persist. Standardized follow-up has potential benefits of including facilitating multi-centered research, site benchmarking, and continuity of care for families who move.

scholarly journals Universal screening for hypothyroidism in pregnancy: is it necessary?

2019 ◽  
Vol 8 (7) ◽  
pp. 2683
Author(s):  
Meena Priyadharshini V. ◽  
Seetha Panicker
Keyword(s):  
Pregnant Women ◽  
Universal Screening ◽  
Reproductive Age ◽  
Antenatal Visit ◽  
Endocrine Disorders ◽  
Maternal Complications ◽  
Reproductive Age Group ◽  
Ethical Clearance ◽  
In Pregnancy

Background: Thyroid diseases are one of the commonest endocrine disorders affecting women of reproductive age group, and hence constitute one important disorders complicating pregnancy. The objective of this study was to determine the importance of universal screening for hypothyroidism in pregnancy at the first antenatal visit and to formulate whether this routine screening is mandatory in our country.Methods: This retrospective study was conducted in the year 2018 at PSG IMSR Hospital for all pregnant women who attended the first antenatal visit between Jan 2012 to Dec 2012 after obtaining ethical clearance. Pregnant women who were already taking treatment for hypothyroidism, diabetes mellitus, hypertension and those pregnant women who lost their follow up were excluded from the study.Results: The incidence of subclinical hypothyroidism among antenatal women were 7.06%. In our study the maternal complications like anemia 12 (8%), preeclampsia 26 (17.3%), gestational diabetes 25 (16.7%), fetal growth restriction 8 (5.3%), Oligohydramnios 13 (8.7%), pre mature rupture of membranes 25 (16.7%), placental abruption in 2 (1.33%), APLA syndrome 2 (1.33%), low birth weight 26 (17.3%) were observed.Conclusions: Universal screening for hypothyroidism is recommended for all antenatal women especially in iodine depleted country like India.

Antibiotic Use in Pregnancy, Abnormal Fetal Growth, and Development of Gestational Diabetes Mellitus

2018 ◽  
Vol 36 (03) ◽  
pp. 243-251 ◽  
Author(s):  
Janet Catov ◽  
Tiffany Deihl ◽  
Maisa Feghali ◽  
Christina Scifres ◽  
John Mission
Keyword(s):  
Diabetes Mellitus ◽  
Birth Weight ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Age ◽  
Academic Medical Center ◽  
Antibiotic Use ◽  
Large For Gestational Age ◽  
The Impact ◽  
In Pregnancy

Objective Antibiotics are commonly used in pregnancy. Prior studies have indicated that antibiotic use in pregnancy may affect birth weight, whereas data in nonpregnant individuals suggest that antibiotic exposure may increase diabetes risk. We evaluated the impact of antibiotic prescriptions during pregnancy on the prevalence of small for gestational age (SGA) and large for gestational age (LGA) birth weight and gestational diabetes mellitus (GDM). Study Design This retrospective cohort study of 12,551 women who delivered at a large academic medical center between 2012 and 2014 assessed the number and type of antibiotic prescriptions prior to GDM testing using the electronic medical record. SGA and LGA birth weight and GDM rates were compared among women who were or were not prescribed antibiotics. Results Overall, 3,991 (31.8%) of 12,551 patients received at least one antibiotic prescription. After covariate adjustment, no differences existed in risk of SGA (adjusted odds ratio [aOR]: 1; 95% confidence interval [CI]: 0.88–1.15; p = 0.94), LGA (aOR: 1; 95% CI: 0.86–1.17; p = 0.97), or GDM (aOR: 0.90; 95% CI: 0.72–1.13; p = 0.36) between women who were or were not prescribed antibiotics. Conclusion Antibiotic use does not affect the risk of SGA or LGA birth weight or GDM in pregnant women. These results provide reassurance regarding the use of antibiotics when clinically indicated in pregnancy.

scholarly journals Waterpipe (hookah) tobacco use in pregnancy: use, preferences and perceptions of flavours

2019 ◽  
Vol 29 (Suppl 2) ◽  
pp. s62-s71
Author(s):  
Laura Stroud ◽  
Erika Werner ◽  
Kristen Matteson ◽  
Michael Carey ◽  
Gideon St Helen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Tobacco Use ◽  
Reproductive Age ◽  
Tobacco Products ◽  
Reproductive Age Women ◽  
Exposure Biomarkers ◽  
Women And Children ◽  
Carcinogen Exposure ◽  
The Impact ◽  
In Pregnancy

ObjectiveWaterpipe tobacco (WPT; hookah) use is common in pregnant and reproductive-age women. Sweet flavours contribute to the appeal of WPT and are a potential regulatory target. This study investigated use, preferences and perceptions of WPT flavours in pregnant WPT users, and the impact of flavour preferences on preconception/prenatal WPT use and exposure biomarkers.Methods58 pregnant WPT users (mean age=27 years) completed a detailed interview regarding their WPT flavours use, preferences and perceptions. Biomarkers of nicotine and carcinogen exposure (eg, cotinine, benzene, butadiene) were also collected.Results55% of participants were dual/poly WPT users (ie, reported use of one or more other tobacco products in addition to WPT). Pregnant WPT users reported nearly exclusive use of flavoured WPT, with greater use of menthol/mint (68%) followed by fruit flavours (48%) (p<0.001), and greater preferences for fruit followed by menthol/mint flavours (ps<0.05). Harm perceptions did not differ among flavours. Compared with dual/poly WPT users, WPT-only users reported more total WPT use events, greater use of and preference for menthol/mint flavoured WPT (ps<0.001), and decreased exposure biomarkers (ps≤0.040). Preference for menthol/mint and fruit flavours predicted more flavoured WPT use events during preconception and pregnancy; preference for menthol/mint predicted detectable cotinine and benzene levels but not butadiene.ConclusionsThis is the first study of WPT flavour use, preferences and perceptions in pregnant women. Use of and preference for menthol/mint and fruit WPT flavours in this vulnerable population could be considered in regulating WPT flavours to protect the health of women and children.

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