scholarly journals Case series of COVID-19 infection in pregnancy complicated by ketoacidosis and symptomatic breathlessness

2021 ◽  
pp. 1753495X2110245
Author(s):  
Iona Thorne ◽  
Samantha Steele ◽  
Marcus Martineau ◽  
Joanna Girling
Keyword(s):  
Differential Diagnosis ◽  
Metabolic Acidosis ◽  
Pregnant Woman ◽  
Pregnant Women ◽  
Specific Treatment ◽  
Case Series ◽  
Metabolic Abnormalities ◽  
Shortness Of Breath ◽  
Blood Gas ◽  
In Pregnancy

Background The differential diagnosis of acute shortness of breath in a pregnant woman with COVID-19 is broad. Pregnancy is a ketosis-prone state, which can result in metabolic acidosis and tachypnoea. Methods We describe four pregnant women with COVID-19 and breathlessness where ketoacidosis was found to contribute to symptomatic tachypnoea. Results One patient did not have associated COVID-19 pneumonitis, but presented with severe tachypnoea and metabolic acidosis; three women had pneumonitis and metabolic acidosis. Corrective treatment for the metabolic abnormalities resulted in resolution of the ketoacidosis in all cases. No women had coexistent diabetes. Conclusion This is the first series of COVID-19 in pregnancy complicated by ketoacidosis and symptomatic tachypnoea. Ketoacidosis associated with COVID-19 is an important cause of tachypnoea requiring specific treatment, which should not be overlooked. Potential mechanisms for this are discussed with a framework for interpretation of blood gas results during pregnancy.

Subglottic tracheal stenosis complicating pregnancy: A case report

2021 ◽  
pp. 1753495X2199022
Author(s):  
Edward J Miller ◽  
Emily YS Huning
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Tracheal Stenosis ◽  
Multidisciplinary Management ◽  
Shortness Of Breath ◽  
Uncommon Case ◽  
In Pregnancy

The case presented details an uncommon case of subglottic tracheal stenosis exacerbated by pregnancy. We outine the multidisciplinary management involved and the outcomes for the pregnancy. The case serves as a reminder that shortness of breath in pregnancy has a broad differential diagnosis, and stridor is always abnormal.

Approach to dyspnoea in pregnancy in the COVID-19 era

2020 ◽  
Vol 19 (4) ◽  
pp. 230-234
Author(s):  
Anita Banerjee ◽  
◽  
Lindsay A Arrandale ◽  
Srividhya Sankaran ◽  
Guy W Glover ◽  
...  
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Correct Diagnosis ◽  
Case Series ◽  
Differential Diagnoses ◽  
Shared Decision ◽  
First Case ◽  
Compromise Design ◽  
A Current ◽  
In Pregnancy

Importance: Dyspnoea and hypoxia in pregnant women during the COVID-19 pandemic may be due to causes other than SARS Co-V-2 infection which should not be ignored. Shared decision-making regarding early delivery is paramount. Objective: To highlight and discuss the differential diagnoses of dyspnoea and hypoxia in pregnant women and to discuss the risks versus benefit of delivery for maternal compromise. Design, setting and participants: Case series of two pregnant women who presented with dyspnoea and hypoxia during the COVID-19 pandemic. Results: Two pregnant women presented with dyspnoea and hypoxia. The first case had COVID-19 infection in the 3rd trimester. The second case had an exacerbation of asthma without concurrent COVID-19. Only the first case required intubation and delivery. Both recovered and were discharged home. Conclusion and relevance: Our two cases highlight the importance of making the correct diagnosis and timely decision-making to consider if delivery for maternal compromise is warranted. Whilst COVID-19 is a current healthcare concern other differential diagnoses must still be considered when pregnant women present with dyspnoea and hypoxia.

scholarly journals Dyspnoea at Term in an Obese Mother

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Vicky O'Dwyer ◽  
Yvonne O'Brien ◽  
Nadine Farah ◽  
Michael J. Turner
Keyword(s):  
Differential Diagnosis ◽  
Heart Disease ◽  
Obese Woman ◽  
Peripartum Cardiomyopathy ◽  
Morbidly Obese ◽  
Shortness Of Breath ◽  
Healthy Women ◽  
Obese Mother ◽  
Life Threatening ◽  
In Pregnancy

Peripartum cardiomyopathy is a serious, potentially life-threatening heart disease of uncertain aetiology in previously healthy women. We report a morbidly obese woman who presented with peripartum shortness of breath. We discuss the differential diagnosis of dyspnoea in pregnancy and highlight the complexity of care of the morbidly obese woman.

scholarly journals Varices of the round ligament mimicking an inguinal hernia – an important differential diagnosis during pregnancy

2010 ◽  
Vol 92 (7) ◽  
pp. e10-e11 ◽  
Author(s):  
BM Dent ◽  
A Al Samaraee ◽  
PE Coyne ◽  
C Nice ◽  
M Katory
Keyword(s):  
Differential Diagnosis ◽  
Risk Factor ◽  
Inguinal Hernia ◽  
Pregnant Women ◽  
Clinical Examination ◽  
Abdominal Pressure ◽  
Emergency Repair ◽  
Important Differential Diagnosis ◽  
Ultrasound Evaluation ◽  
In Pregnancy

Pregnancy is a recognised risk factor for the development of inguinal hernias due to an increase in intra-abdominal pressure. Whilst often managed conservatively until after the pregnancy, if the hernia presents acutely as a painful or tender groin lump, urgent or emergency repair may be required. Many clinicians rely heavily on clinical examination alone in order to diagnose the presence of such a hernia. In pregnancy, however, in order to prevent unnecessary surgery, the use of ultrasound has a more important role to play in reaching this diagnosis. We report a cautionary case that highlights the need for ultrasound evaluation of all painful groin lumps in pregnant women prior to considering surgery.

A Pregnant Woman with Aphasia and Right-Sided Weakness

2017 ◽  
Author(s):  
M. Angela O’Neal
Keyword(s):  
Ischemic Stroke ◽  
Pregnant Woman ◽  
Acute Ischemic Stroke ◽  
Case Series ◽  
Intravenous Tissue Plasminogen Activator ◽  
Common Causes ◽  
Tissue Plasminogen ◽  
Multiple Trials ◽  
Iv Tpa ◽  
In Pregnancy

This chapter discusses the evaluation and management of acute ischemic stroke in pregnancy. Stroke in pregnancy is rare, but is a significant cause of morbidity. The etiologies of stroke in pregnancy are diverse. The most common causes in hospital-based studies are cardioembolic or related to eclampsia. The use of intravenous tissue plasminogen activator (IV tPA) as well as intra-arterial clot retrieval in stroke have been validated by multiple trials. Small case series support the safety of both therapies in pregnancy. Therefore, the management of stroke in pregnancy should be based on the mechanism and severity of the stroke, not on obstetrical issues.

scholarly journals COVID-19 OUTCOMES IN PREGNANCY: A REVIEW OF 275 SCREENED STUDIES

2021 ◽  
Author(s):  
Rupalakshmi Vijayan ◽  
Hanna Moon ◽  
Jasmine Joseph ◽  
Madiha Zaidi ◽  
Chhaya Kamwal ◽  
...  
Keyword(s):  
Literature Review ◽  
Pregnant Women ◽  
Direct Evidence ◽  
Case Series ◽  
Adverse Outcomes ◽  
Morbidity And Mortality ◽  
World Health ◽  
Increased Risk ◽  
Immunological Changes ◽  
In Pregnancy

In December 2019, a novel strain of severe acute respiratory syndrome (SARS-CoV-2), was declared as a cause of respiratory illness, called coronavirus 2019 (COVID-19), characterized by fever and cough. In diagnostic imaging, the afflicted population showed pathognomonic findings of pneumonia. What started out as an epidemic in China, rapidly spread across geographical locations with a significant daily increase in the number of affected cases. According to the World Health Organization (WHO) reports, the range of worldwide mortality is 3 to 4%. Maternal adaptations and immunological changes predispose pregnant women to a prolonged and severe form of pneumonia, which results in higher rates of maternal, fetal, and neonatal morbidity and mortality. There is limited data about the consequences of COVID-19 in pregnancy, thereby limiting the prevention, counseling, and management of these patients. The objective of this literature review is to explore pregnancy and perinatal outcomes of COVID-19, complications, morbidity, and mortality in this sub-population. We conducted a literature review pertaining to COVID-19 and pregnancy in databases such as: PubMed, Google Scholar, and Science Direct. The studies we chose to focus on were systematic reviews, meta-analysis, case series, and case reports. Twenty four articles were reviewed regarding COVID-19 and pregnancy, complications and their outcomes. Due to immunological changes during pregnancy as evidenced by the flaring of auto-immune diseases; pregnant women may be at an increased risk for infection. Women (19.7%) who had underlying comorbidities such as gestational DM, HTN, hypothyroidism, and autoimmune disease, COPD, or HBV infection were considered high risk. The most common maternal outcomes were premature rupture of membranes (PROM) and pre-eclampsia. Asthma was the most common comorbidity associated with maternal mortality. The most common neonatal complications were fetal distress leading to NICU admissions and preterm birth <37 weeks. The most common laboratory changes were elevated CRP and lymphocytopenia. Most patients underwent C-section due to their underlying comorbidities. Pregnant and lactating women did not shed viral particles through their vaginal mucus and milk, as evidenced by negative nucleic-acid tests of these secretions. Neonatal infections as demonstrated by positive RT-PCR were rare, but direct evidence supporting intrauterine transmission was not confirmed. Direct evidence indicating vertical transmission of COVID-19 is not available, but risk for transmission cannot be ruled out. Pregnant women should be closely monitored due to increased risk of adverse outcomes.

scholarly journals Hubungan Tekanan Darah Ibu Hamil Aterm Dengan Berat Badan Lahir di RSUP Dr. M. Djamil Padang

2013 ◽  
Vol 2 (2) ◽  
pp. 67
Author(s):  
Feby Andammori ◽  
Nur Indrawaty Lipoeto ◽  
Yusrawati Yusrawati
Keyword(s):  
Blood Pressure ◽  
Pregnant Woman ◽  
Birth Weight ◽  
Pregnant Women ◽  
Medical Record ◽  
Cross Sectional Study ◽  
T Test ◽  
Sectional Study ◽  
Cross Sectional ◽  
In Pregnancy

AbstrakTinggi rendahnya tekanan darah sistolik dan diastolik dalam kehamilan mempunyai pengaruh terhadap berat badan lahir. Penelitian ini bertujuan untuk mengidentifikasi hubungan tekanan darah ibu hamil aterm dengan berat badan lahir di RSUP dr M. Djamil Padang. Metode penelitian : Penelitian yang dilakukan merupakan survei analitik dengan menggunakan studi komparatif dengan design penelitian Cross Sectional Study. Penelitian menggunakan data sekunder yang diambil dari sub bagian Rekam Medik (Medical Record) RSUP dr. M. Djamil Padang bulan Januari 2010 – Desember 2012 dengan jumlah sampel 34 orang ibu hamil yang tidak hipertensi dan 34 orang ibu hamil yang mengalami hipertensi dalam kehamilannya. Hasil penelitian : Ditemukan rata-rata berat badan lahir bayi yang dilahirkan oleh kelompok ibu yang tidak mengalami hipertensi pada kehamilannya adalah 3.408 (SD 307) gram dan rata-rata berat badan lahir bayi yang dilahirkan oleh kelompok ibu yang mengalami hipertensi pada kehamilannya adalah 2.799 (SD 413) gram. Dari hasil uji analisis Independent Sample T-test diperoleh hasil ditemukan adanya hubungan tekanan darah ibu hamil dengan berat badan lahir di RSUP dr. M. Djamil Padang p = 0,00 (p < 0,05). Kesimpulan : Pemeriksaan kehamilan secara teratur penting untuk mengantisipasi adanya peningkatan tekanan darah ibu hamil yang dapat berpengaruh terhadap berat bayi lahir.Kata kunci: tekanan darah, berat badan lahir, ibu hamilAbstractHigh and low level of systolic and diastolic blood pressure in pregnancy has impact to birth weight. This research is purposed to identify the relation between aterm pregnant blood pressure and birth weight.Methods : This research is analytical survey which used comparative study with Cross Sectional Study design. This research used secondary data taken from Medical Record in RSUP dr. M. Djamil Padang since Januari 2010 until December 2012 with number of samples are 34 pregnant women who have not hypertension and 34 pregnant women who have hypertension in pregnancy.The results: Research found that average of birth weight from non-hypertension pregnant woman is about 3,408 (SD 307) gr and average of birth weight from hypertension pregnant woman is about 2,799 (SD 413) gr. The result from Independent sample T-test analysis found that there is a relation between blood pressure in pregnancy with birth weight at RSUP dr. M.Djamil Padang p = 0.00 (p<0.05).Conclusion: Regular antenatal care is important to anticipate an increase in maternal blood pressure can affect birth weight.Keywords: blood pressure, birth weight, pregnant women

scholarly journals An Indonesian Pregnant Woman with Lung Cancer and Liver Metastasis : A Case Report

2018 ◽  
Vol 12 (2) ◽  
pp. 67
Author(s):  
Vito Filbert Jayalie ◽  
Dimas Priantono ◽  
Zulkifli Amin
Keyword(s):  
Lung Cancer ◽  
Pregnant Woman ◽  
Multidisciplinary Approach ◽  
Stage Iv ◽  
Small Cell ◽  
Shortness Of Breath ◽  
Special Issue ◽  
Small Cell Lung ◽  
Cancer In Pregnancy ◽  
In Pregnancy

Background: Lung cancer in pregnancy is a rare disease compared to other types of cancer. However, special issue should be applied in order to maximize benefit for mother without harming the fetus.Methods: We present a case of 37-year-old, five months pregnant woman who came to the hospital with chief complain of shortness of breath. Later on, she was found to have a stage IV Non-Small Cell Lung Cancer (NSCLC) with adenocarcinoma subtype.Result: This may be the first lung cancer in pregnancy reported in Indonesia. Being a developing country, several challenges emerged before diagnosing patient of having lung cancer.Conclusion: Careful considerations along with multidisciplinary approach are necessary to provide the best care for the patient.

scholarly journals Visceral Leishmaniasis in pregnancy and vertical transmission: A systematic literature review on the therapeutic orphans

2021 ◽  
Vol 15 (8) ◽  
pp. e0009650
Author(s):  
Prabin Dahal ◽  
Sauman Singh-Phulgenda ◽  
Brittany J. Maguire ◽  
Eli Harriss ◽  
Koert Ritmeijer ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Pregnant Women ◽  
Amphotericin B ◽  
Vertical Transmission ◽  
Liposomal Amphotericin ◽  
Case Reports ◽  
Case Series ◽  
Liposomal Amphotericin B ◽  
Cochrane Central Register ◽  
In Pregnancy

Background Reports on the occurrence and outcome of Visceral Leishmaniasis (VL) in pregnant women is rare in published literature. The occurrence of VL in pregnancy is not systematically captured and cases are rarely followed-up to detect consequences of infection and treatment on the mother and foetus. Methods A review of all published literature was undertaken to identify cases of VL infections among pregnant women by searching the following database: Ovid MEDLINE; Ovid Embase; Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials; World Health Organization Global Index Medicus: LILACS (Americas); IMSEAR (South-East Asia); IMEMR (Eastern Mediterranean); WPRIM (Western Pacific); ClinicalTrials.gov; and the WHO International Clinical Trials Registry Platform. Selection criteria included any clinical reports describing the disease in pregnancy or vertical transmission of the disease in humans. Articles meeting pre-specified inclusion criteria and non-primary research articles such as textbook, chapters, letters, retrospective case description, or reports of accidental inclusion in trials were also considered. Results The systematic literature search identified 272 unique articles of which 54 records were included in this review; a further 18 records were identified from additional search of the references of the included studies or from personal communication leading to a total of 72 records (71 case reports/case series; 1 retrospective cohort study; 1926–2020) describing 451 cases of VL in pregnant women. The disease was detected during pregnancy in 398 (88.2%), retrospectively confirmed after giving birth in 52 (11.5%), and the time of identification was not clear in 1 (0.2%). Of the 398 mothers whose infection was identified during pregnancy, 346 (86.9%) received a treatment, 3 (0.8%) were untreated, and the treatment status was not clear in the remaining 49 (12.3%). Of 346 mothers, Liposomal amphotericin B (L-AmB) was administered in 202 (58.4%) and pentavalent antimony (PA) in 93 (26.9%). Outcomes were reported in 176 mothers treated with L-AmB with 4 (2.3%) reports of maternal deaths, 5 (2.8%) miscarriages, and 2 (1.1%) foetal death/stillbirth. For PA, outcomes were reported in 88 mothers of whom 4 (4.5%) died, 24 (27.3%) had spontaneous abortion, 2 (2.3%) had miscarriages. A total of 26 cases of confirmed, probable or suspected cases of vertical transmission were identified with a median detection time of 6 months (range: 0–18 months). Conclusions Outcomes of VL treatment during pregnancy is rarely reported and under-researched. The reported articles were mainly case reports and case series and the reported information was often incomplete. From the studies identified, it is difficult to derive a generalisable information on outcomes for mothers and babies, although reported data favours the usage of liposomal amphotericin B for the treatment of VL in pregnant women.

scholarly journals Analisis Konsep Kawin Hamil pada Film Dua Garis Biru Perspektif Hukum Positif Indonesia dan Hukum Islam

2020 ◽  
Vol 1 (1) ◽  
pp. 8-16
Author(s):  
Emiliya Ehsaniyah
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Islamic Law ◽  
Free Association ◽  
Men And Women ◽  
Positive Law ◽  
The Status ◽  
Legal Marriage ◽  
In Pregnancy ◽  
Husband And Wife

Nowadays, there are many cases of marriage for pregnant women, this is one of the effects of too free association between men and women. The phenomenon of pregnant marriage as a result of promiscuity among adolescents is reflected in the film Two Blue Lines. In Islamic law, people who engage in husband and wife relations outside of a legal marriage are punished as adultery. If the adultery results in pregnancy and marriage, the priests of the Madzhab have different opinions regarding the validity of the marriage and also the status of the child in the womb. Whereas in positive law (Marriage Law and KHI), the marriage of a pregnant woman is legal and the status of the child who is born later is categorized as a legal child. The purpose of this study was to determine and analyze the concept of pregnant marriage contained in the scenes of the film Dua Lines Biru to be analyzed using Law No.1 of 1974 concerning Marriage, Islamic Law, and Compilation of Islamic Law.

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