Malignant Primary Hypertension in Pregnancy Treated with Lisinopril

2000 ◽  
Vol 34 (2) ◽  
pp. 180-182 ◽  
Author(s):  
Antony J Tomlinson ◽  
James Campbell ◽  
James J Walker ◽  
Colin Morgan
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Necrotizing Enterocolitis ◽  
Ace Inhibitors ◽  
Ace Inhibitor ◽  
Neonatal Outcome ◽  
First Trimester ◽  
Successful Outcome ◽  
Chronic Hypertension ◽  
In Pregnancy

OBJECTIVE: To report a case of a patient treated with an angiotensin-converting enzyme (ACE) inhibitor with a good neonatal outcome. CASE REPORT: A 39-year-old African-Caribbean patient who had chronic hypertension presented at 18 weeks' gestation with acute hypertension. She was being treated for chronic hypertension with lisinopril, but had self-discontinued treatment. Attempts to control her hypertension with labetolol, nifedipine, and methyldopa were ineffective. She was therefore offered termination of pregnancy so treatment with lisinopril could be restarted. The patient elected to continue with the pregnancy in spite of the fetal risks associated with the use of an ACE inhibitor. She was delivered of a girl at 26 weeks' gestation. The baby initially had renal failure and also developed acute necrotizing enterocolitis. The renal failure improved simultaneously with the latter complication, and it is postulated that there was enteric excretion of lisinopril. The baby was discharged home on day 102 with no further complications. DISCUSSION: ACE inhibitors are acceptable medications to use in the first trimester of pregnancy; however, fetal malformations and neonatal complications have been associated with their use later in pregnancy, and they have a perinatal mortality rate of 97/1000. Lisinopril is excreted in urine and feces unchanged, and its half-life is prolonged in anuric neonates. Peritoneal dialysis eliminates lisinopril; however, this neonate improved after treatment for necrotizing enterocolitis and simultaneous improvement in bowel function. CONCLUSIONS: ACE inhibitors should not be used in pregnancy beyond the end of the first trimester. In exceptional cases, they may be indicated for the control of severe hypertension when the patient is refractory to other medications. The patient should be fully counseled about the adverse effect profile and neonatal outcome. This case report documents a successful outcome for mother and baby in these circumstances.

Renal failure in pregnancy due to primary renal lymphoma. Case report

1991 ◽  
Vol 98 (2) ◽  
pp. 216-217 ◽  
Author(s):  
O. SHEIL ◽  
C. W. G. REDMAN ◽  
C. PUGH
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Renal Lymphoma ◽  
In Pregnancy

Unstable Chest Surgical Management in Pregnancy: Case Report and Literature Review

2016 ◽  
Vol 5 (3) ◽  
pp. 155-160
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Surgical Management ◽  
Flail Chest ◽  
Obstetric Care ◽  
Successful Outcome ◽  
Respiratory Compromise ◽  
Sternal Fracture ◽  
Car Accident ◽  
In Pregnancy

ABSTRACT Introduction Present a review of the case, management, and progress of an obstetric patient who suffered a car accident with subsequent severe blunt thoracic trauma (BTT) resulting in flail chest (FC). Case report This is a case of Hispanic female of 44 years involved in a car accident at 14 weeks of gestation, who presented with FC, sternal fracture, and severe respiratory compromise. This woman received surgical management and care in an intensive obstetric care unit management, presenting osteomyelitis as a complication, along with physical deconditioning and prolonged hospital stay, finally with an obstetric and functional favorable outcome. Conclusion Although severe BTT in pregnant patients is uncommon, it is important to highlight the appropriate medical management required for these patients in order to achieve a successful outcome, as was in this case. This is the only case report of FC surgical management in pregnancy that we have in our institution so far. How to cite this article Nieto AJ, Velásquez M, Escobar MF, Carvajal JA, Granados M. Unstable Chest Surgical Management in Pregnancy: Case Report and Literature Review. Panam J Trauma Crit Care Emerg Surg 2016;5(3):155-160.

scholarly journals Suicide due to fear of COVID-19, in pregnancy, lead to Neonatal malformations: A case report

2021 ◽  
Author(s):  
Javad Boskabadi ◽  
Saeed Kargar-Soleiman abad ◽  
shahrokh mehrpishe ◽  
Elham Pishavar ◽  
Roya Farhadi
Keyword(s):  
Mental Health ◽  
Case Report ◽  
Antipsychotic Drugs ◽  
First Trimester ◽  
Limited Data ◽  
First Trimester Of Pregnancy ◽  
In Pregnancy

There is limited data about various effect of COVID-19 in pregnancy. The Covid-19 pandemic can increase anxiety or schizophrenia exacerbation. Neonatal malformations from antipsychotic drugs exposures during first trimester of pregnancy have been reported. However, their effect near delivery have been less studied. Keywords: Covid-19, pregnancy, mental health, neonatal malformations

scholarly journals Unstable Chest Surgical Management in Pregnancy: Case Report and Literature Review

2017 ◽  
Vol 6 (1) ◽  
pp. 52-57
Author(s):  
Mauricio Velásquez ◽  
María F Escobar ◽  
Javier A Carvajal ◽  
Albaro J Nieto
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Surgical Management ◽  
Flail Chest ◽  
Obstetric Care ◽  
Successful Outcome ◽  
Respiratory Compromise ◽  
Sternal Fracture ◽  
Car Accident ◽  
In Pregnancy

ABSTRACT Introduction We present a review of the case, management, and progress of an obstetric patient, who suffered a car accident with subsequent severe blunt thoracic trauma (BTT) resulting in flail chest (FC). Case report This is a Hispanic female of 44 years involved in a car accident at 14 weeks of gestation, who presented with FC, sternal fracture, and severe respiratory compromise. This woman received surgical management and care in an intensive obstetric care management unit, presenting with osteomyelitis as a complication, along with physical deconditioning and prolonged hospital stay, finally with an obstetric and functional favorable outcome. Conclusion Although severe BTT in pregnant patients is uncommon, it is important to highlight the appropriate medical management required for these patients to achieve a successful outcome, as was in this case. This is the only case report of a FC surgical management in pregnancy that we have had in our institution so far. How to cite this article Nieto AJ, Velásquez M, Escobar MF, Carvajal JA, Granados M. Unstable Chest Surgical Management in Pregnancy: Case Report and Literature Review. Panam J Trauma Crit Care Emerg Surg 2017;6(1):52-57.

Lysinuric protein intolerance in pregnancy: case report with successful outcome

1995 ◽  
Vol 256 (1) ◽  
pp. 49-52
Author(s):  
N. Takayama ◽  
H. Hamada ◽  
T. Kubo
Keyword(s):  
Case Report ◽  
Successful Outcome ◽  
Lysinuric Protein Intolerance ◽  
Lysinuric Protein ◽  
Protein Intolerance ◽  
In Pregnancy

scholarly journals Nephrotic syndrome in pregnancy: a case report

2020 ◽  
Vol 9 (12) ◽  
pp. 5190
Author(s):  
Ipsita Mohapatra ◽  
Subha R. Samantaray
Keyword(s):  
Nephrotic Syndrome ◽  
Case Report ◽  
Birth Weight ◽  
Multidisciplinary Approach ◽  
Fetal Outcome ◽  
Successful Outcome ◽  
Low Birth Weight Babies ◽  
Intrauterine Fetal Growth Restriction ◽  
Severity Of The Disease ◽  
In Pregnancy

Nephrotic syndrome is a spectrum of renal disorders in which proteinuria is a hallmark. When pregnancy is affected by nephrotic syndrome, the maternal and fetal outcome, as well as the required treatment, depends on the underlying cause and severity of the disease. Pregnant patients with nephrotic syndrome are more prone to develop pre-eclampsia, preterm birth, low birth weight babies and intrauterine fetal growth restriction. Here we are presenting a case report on pregnancy with nephrotic syndrome which was managed by multidisciplinary approach with successful outcome.

scholarly journals ACE Inhibitor-Induced Angioedema of the Intestine: Case Report, Incidence, Pathophysiology, Diagnosis and Management

2001 ◽  
Vol 15 (12) ◽  
pp. 827-832 ◽  
Author(s):  
Gavin Oudit ◽  
Nigel Girgrah ◽  
Johane Allard
Keyword(s):  
Case Report ◽  
Ace Inhibitors ◽  
Ace Inhibitor ◽  
Management Strategies ◽  
Angiotensin Ii Receptor ◽  
Radiological Investigation ◽  
Abdominal Symptoms ◽  
Acute Exacerbations ◽  
Gastrointestinal Complaints ◽  
Considerable Morbidity

A case report of fosinopril-induced angioedema of the intestine with a chronic course accompanied by multiple acute exacerbations is described. Angiotensin-converting enzyme (ACE) inhibitor-induced angioedema of the intestine (AIAI) occurs in a minority of patients taking an ACE inhibitor. The clinical presentation encompasses acute abdominal symptoms, pronounced bowel edema and ascites with occasional facial and/or oropharyngeal swelling. AIAI is diagnosed based on the temporal relationship between the symptomatic presentation and drug use, absence of alternative diagnoses including other causes of angioedema, and the prompt resolution of symptoms upon discontinuation of the ACE inhibitor. Prompt radiological investigation (abdominal computerized tomography and/or ultrasound) is critical in making an early diagnosis and in preventing unnecessary surgical intervention. There is a female predominance of AIAI, which may reflect the interaction of estradiol with the various pathways involved in the pathophysiology of AIAI. Management of AIAI consists mainly of conservative measures and discontinuation of the ACE inhibitor. Angiotensin II receptor antagonists should not be considered as appropriate alternatives. Awareness and knowledge of AIAI are important because of the increasing use of ACE inhibitors, current delays in making the diagnosis, obvious management strategies once the diagnosis is made and the dysutility of alternative diagnoses, which may lead to considerable morbidity. AIAI must be considered in patients taking ACE inhibitors who develop gastrointestinal complaints irrespective of the duration of the therapy.

scholarly journals An unusual presentation of ACE inhibitor-induced visceral angioedema

2019 ◽  
Vol 12 (9) ◽  
pp. e230865 ◽  
Author(s):  
Amanda Jayne Krause ◽  
Naiya Balubhai Patel ◽  
Jennifer Morgan
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Small Bowel ◽  
Ct Scan ◽  
Ace Inhibitors ◽  
Ace Inhibitor ◽  
Unusual Presentation ◽  
First Episode ◽  
Ascetic Fluid

ACE inhibitors (ACEi) are common anti-hypertensive drugs that can cause angioedema. Though classic, or facial angioedema is rare, visceral angioedema is even less common. When angioedema occurs, it typically presents early, within 30 days of initiating therapy. Visceral angioedema most commonly presents with nausea, emesis, abdominal pain and diarrhoea, and thus is often mistaken for an episode of gastroenteritis. When a CT scan is obtained, it typically shows characteristic findings, including ascetic fluid, mild mesenteric oedema and thickening of the small bowel. In this case report, we present a patient who did not experience her first episode of visceral angioedema until after she had been on ACEi therapy for 5–7 years. In addition, she experienced recurrent episodes of visceral angioedema that were separated by approximately 4 years at a time. Both of these features make for a particularly unique presentation.

scholarly journals Peritoneal dialysis throughout pregnancy with successful outcome: A case report

2017 ◽  
Vol 11 (2) ◽  
pp. 98-100 ◽  
Author(s):  
GL Malin ◽  
SVF Wallace ◽  
M Hall ◽  
A Ferraro
Keyword(s):  
Systematic Review ◽  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Residual Renal Function ◽  
Fetal Outcome ◽  
Successful Outcome ◽  
Recent Systematic Review ◽  
End Stage Renal Failure ◽  
End Stage ◽  
In Pregnancy

We present the case of a 28-year-old woman who was para 1, with end-stage renal failure secondary to reflux nephritis. She conceived after two years on peritoneal dialysis. She successfully continued this throughout pregnancy, although her antenatal course was complicated by an episode of peritonitis. Induction at 34 weeks resulted in a vaginal birth of a live boy. Her postnatal course was uncomplicated. We reviewed the literature regarding peritoneal dialysis in pregnancy. A recent systematic review identified 14 cases. When the outcomes of these women were compared with those receiving haemodialysis in pregnancy, there was a significantly higher proportion of small for gestational age fetuses, but other parameters were comparable. Two cases of peritonitis complicating peritoneal dialysis in pregnancy have been reported, both successfully treated. We conclude that peritoneal dialysis may be continued in pregnancy with successful maternal and fetal outcome, particularly in women with some residual renal function.

scholarly journals Pregnancy Outcome after Varenicline Exposure in the First Trimester

2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
Yusuf Cem Kaplan ◽  
Nihal Olgac Dündar ◽  
Burcu Kasap ◽  
Barıs Karadas
Keyword(s):  
Case Report ◽  
Unplanned Pregnancy ◽  
Fetal Echocardiography ◽  
First Trimester ◽  
Limited Data ◽  
Fetal Ultrasound ◽  
First Case ◽  
Age Appropriate ◽  
Gestational Week ◽  
In Pregnancy

To the best of our knowledge this is the first case report describing exposure to varenicline, anα4β2nicotinic acetylcholine partial receptor agonist used for smoking cessation therapy in pregnancy. A 29-year-old multiparous woman with an unplanned pregnancy has used varenicline 2 mg/day unintentionally yet regularly 4 weeks from her last menstrual period. Fetal ultrasound performed at each trimester, detailed anomaly scan, and fetal echocardiography which were performed at the 22nd gestational week showed normal fetal growth with no malformations. The patient delivered a healthy baby at the 38th week of gestation with normal Apgar score and physical examination findings. Age-appropriate physical and neurological development of the child has been observed for 6 months. Although it is not possible to draw definitive conclusions, this case report may contribute to the current available limited data regarding the safety of varenicline use in pregnancy.

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