A presentation of adenovirus with hypokalemia and rhabdomyolysis in pregnancy

2020 ◽  
pp. 1753495X2097079
Author(s):  
Thomas P Kishkovich ◽  
Connie F Lu ◽  
Erica J Hardy ◽  
Melissa L Russo
Keyword(s):  
Renal Function ◽  
Supportive Care ◽  
Caesarean Delivery ◽  
Clinical Course ◽  
Fetal Monitoring ◽  
Respiratory Pathogen ◽  
Adenovirus Infection ◽  
Fetal Bradycardia ◽  
In Pregnancy ◽  
Electrolyte Abnormalities

Background Adenovirus infection is usually mild in presentation. However during pregnancy, the course can be more severe. Case A 21-year-old woman in her second pregnancy presented with abdominal pain, vomiting, and fevers at 34 weeks and 4 days of gestation. Her respiratory pathogen panel on nasopharyngeal secretions was positive for adenovirus. Electrolytes were notable for hypomagnesaemia and persistent hypokalemia (nadir of 2.6 mmol/L) despite repletion but otherwise unremarkable. During her course, she developed rhabdomyolysis. During routine fetal monitoring at 35 weeks and 6 days of gestation, prolonged fetal bradycardia was identified, and an emergency caesarean delivery was performed. The infant had no clinical or laboratory evidence of adenovirus infection. The patient had a protracted clinical course but recovered with supportive care. Conclusion Adenovirus can present with severe complications in a pregnant woman including hypokalemia and rhabdomyolysis. The mainstay of treatment is supportive care and monitoring of electrolyte abnormalities and renal function.

Neurological manifestation in severe hypothyroidism in pregnancy

2020 ◽  
Vol 13 (12) ◽  
pp. e238069
Author(s):  
Aparna Sharma ◽  
Nilofar Noor ◽  
Vatsla Dadhwal
Keyword(s):  
Peripheral Neuropathy ◽  
Facial Palsy ◽  
Caesarean Delivery ◽  
Thyroid Stimulating Hormone ◽  
Neurological Manifestations ◽  
Second Trimester ◽  
Pituitary Hyperplasia ◽  
Very High ◽  
In Pregnancy

Neurological manifestations of hypothyroidism include peripheral neuropathy and pituitary hyperplasia. However, these associations are rarely encountered during pregnancy. We report a case of a known hypothyroid with very high thyroid stimulating hormone (TSH) values (512 μIU/mL) in the second trimester. At 24 weeks she developed facial palsy and pituitary hyperplasia which responded to a combination of steroids and thyroxine. She had caesarean delivery at 35 weeks and 3 days gestation in view of pre-eclampsia with severe features and was discharged on oral antihypertensives and thyroxine. On follow-up at 5 months, TSH normalised and pituitary hyperplasia showed a greater than 50% reduction in size. To our knowledge, this is the first reported case of facial palsy and pituitary hyperplasia associated with hypothyroidism during pregnancy.

Chronic renal disease in pregnancy: obstetric outcomes and effect of pregnancy on renal function

2011 ◽  
Vol 96 (Supplement 1) ◽  
pp. Fa102-Fa102
Author(s):  
T. J. Bonnett ◽  
A. Khalid ◽  
D. Throssell ◽  
T. Farrell ◽  
R. P. Jokhi
Keyword(s):  
Renal Function ◽  
Renal Disease ◽  
Chronic Renal Disease ◽  
Obstetric Outcomes ◽  
In Pregnancy

scholarly journals Varicella meningitis in pregnancy: a clinical conundrum

2020 ◽  
Vol 9 (3) ◽  
pp. 1300
Author(s):  
Baljeet K. Gholkar ◽  
Lynda Verghese
Keyword(s):  
Lumbar Puncture ◽  
Fetal Monitoring ◽  
Complete Recovery ◽  
Subsequent Pregnancy ◽  
Structural Defects ◽  
Pcr Analysis ◽  
Intravenous Acyclovir ◽  
History Of ◽  
Clinical Dilemma ◽  
In Pregnancy

Authors present this experience of managing a case of Varicella meningitis in pregnancy in a patient presenting with headache in the third trimester. There was no history of dermatomal pain or rash. After intracranial hemorrhage and thrombosis were ruled out by imaging, a decision to perform a lumbar puncture was taken. The diagnosis was made following a PCR analysis on the cerebro-spinal fluid. Retrospective testing revealed immunity to varicella at booking, thus confirming reactivation of the infection. Treatment was done using intravenous acyclovir with complete recovery. It also created a clinical dilemma for the best possible monitoring plan for the fetus to rule out affection. A fetal medicine scan revealed no structural defects in the fetus. The subsequent pregnancy period was uneventful. A well grown normal baby was born at term. This case highlights the significance of considering a lumbar puncture in cases of intractable headache and also highlights the dilemma for fetal monitoring in such rare presentations.

The impact of renal function on the long-term clinical course of patients who underwent percutaneous coronary intervention

2007 ◽  
Vol 69 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Michail I. Papafaklis ◽  
Katerina K. Naka ◽  
Nikos D. Papamichael ◽  
Georgios Kolios ◽  
Lampros Sioros ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Renal Function ◽  
Clinical Course ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
The Impact

Obstetric management of labour, delivery, and vaginal birth after caesarean delivery

2016 ◽  
Author(s):  
Roland Devlieger ◽  
Maria-Elisabeth Smet
Keyword(s):  
Caesarean Delivery ◽  
Fetal Monitoring ◽  
Vaginal Birth ◽  
Basic Knowledge ◽  
Breech Delivery ◽  
Pathological Conditions ◽  
Third Stage ◽  
Intrapartum Fetal Monitoring ◽  
Obstetric Management ◽  
Vaginal Birth After Caesarean

This chapter describes the events surrounding normal and abnormal labour and delivery with particular relevance to the anaesthetist. The first two sections explain the course of a normal labour, delivery, and third stage. Subsequently attention is paid to obstructed labour, delivery, and prolonged third stage. Since induction of labour has become common practice in many pathological conditions, several methods of induction and their complications are then discussed. Next, some basic knowledge about intrapartum fetal monitoring is presented, followed by some specific and potentially complicated situations such as shoulder dystocia, operative vaginal delivery, caesarean delivery, breech delivery, twin birth, and vaginal birth after previous caesarean delivery.

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