scholarly journals Management of myasthenia gravis during pregnancy: A report of eight cases

2018 ◽  
Vol 13 (1) ◽  
pp. 28-33
Author(s):  
Beibei Shi ◽  
Linchai Zeng
Keyword(s):  
Birth Weight ◽  
Adverse Effects ◽  
Myasthenia Gravis ◽  
Potential Risk ◽  
Congenital Abnormalities ◽  
Clinical Course ◽  
The Other ◽  
Term Pregnancy ◽  
Lower Birth Weight ◽  
In Pregnancy

AbstractBackgroundThe clinical course of myasthenia gravis (MG) during pregnancy is highly variable and unpredictable. The management of MG in pregnancy has not been standardized.MethodsEight cases of MG in pregnancy, who were treated and gave birth in our hospital between 2004 and 2012, were retrospectively reviewed.ResultsIn three patients, MG deteriorated during pregnancy. Three patients discontinued their medication for MG during their pregnancy, and the other five patients continued on corticosteroid or pyridostigmine. None of the infants showed any congenital abnormalities. Interestingly, there was a trend towards lower birth weight in infants born to women who had an exacerbation of MG during pregnancy. One patient who had unstable MG before pregnancy and voluntarily discontinued the medication for MG at the beginning of pregnancy, experienced MG exacerbation at the 30th week of pregnancy and gave birth prematurely to an infant with transient neonatal MG at the 34th week. The other seven patients had uneventful full-term pregnancy.ConclusionWomen with unstable MG should postpone pregnancy to avoid potential risk of MG exacerbation and adverse effects on the fetus. Medication for MG should not be stopped abruptly during pregnancy, particularly for women with unstable MG. MG during pregnancy should be closely monitored and properly controlled.

scholarly journals The study of maternal and foetal outcome in pregnant women with thyroid disorder

2019 ◽  
Vol 8 (5) ◽  
pp. 1802
Author(s):  
Priya Maurya ◽  
Neeta Chaudhary ◽  
Natasha Tyagi ◽  
M. R. Kural ◽  
Kriti Bhatnagar
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Adverse Effects ◽  
Pregnant Women ◽  
Thyroid Dysfunction ◽  
Thyroid Peroxidase ◽  
Thyroid Disorder ◽  
Neonatal Hypothyroidism ◽  
Foetal Outcome ◽  
In Pregnancy

Background: Thyroid disorder is one of the most common disorder in pregnancy. Thyroid disorder is known to be associated with abnormal maternal and foetal outcomes and overlooked in pregnant women because of non-specific symptoms and hypermetabolic state of pregnancy of pregnancy. It is well established that not only overt, but subclinical thyroid dysfunction also has adverse effects on mother and the foetus like miscarriages, preterm delivery, pre-eclampsia, eclampsia, polyhydramnios, placental abruption, postpartum haemorrhage, low birth weight, neonatal hypothyroidism. Decreased availability of thyroid hormones may also impair neurological and intellectual development of foetus. With this background, we are conducting a study to know the effect of thyroid disorder on pregnancy and its maternal and foetal outcome.Methods: The present study was conducted in Muzaffarnagar Medical College, Uttar Pradesh, India in collaboration of department of Gynecology and Obstetrics and Pediatrics Department. It is a prospective random cross-sectional study done over 400 pregnant women which includes known cases of thyroid disorder. Serum thyroid stimulating hormone (TSH) test was apart from the routine blood sample investigations as per FOGSI-ICOG good clinical practice recommendation. fT3, fT4 and thyroid peroxidase antibody test were done in patients with a deranged TSH value. Patients were followed up till delivery, and their obstetrics and perinatal outcomes were noted and managed.Results: In present study out of 400 cases, 25 cases are hypothyroidism and 16 cases are hyperthyroidism in pregnancy. Out of these 41 patients with thyroid dysfunction, complications associated were abortions (14.63%), maternal anaemia (9.7%), pre-eclampsia (12.2%), preterm labour (9.76%), abruption placenta (4.88%), IUGR (2.4%), Still birth (7.32%). Out of 41 patients with thyroid dysfunction, foetal complications seen were hyperbilirubinemia (12.2%), Foetal distress (4.88%), NICU admission (17.07%) and low birth weight (21.95%).Conclusions: Thyroid disorder in pregnancy have adverse effects on maternal and foetal outcome emphasizing the importance of routine antenatal thyroid screening.

Prescribing in pregnancy

2020 ◽  
pp. 2706-2710
Author(s):  
Lucy MacKillop ◽  
Charlotte Frise
Keyword(s):  
Maternal Health ◽  
Adverse Effects ◽  
Pregnant Women ◽  
Potential Risk ◽  
Fetal Exposure ◽  
New Agents ◽  
In Pregnancy

Many clinicians feel uncertain about prescribing for pregnant women. Despite well-known examples of drugs that have caused serious adverse effects to the developing fetus, most medications can be used safely and effectively in this setting, provided some simple principles are followed. The first of these is that the health of the mother is the most important factor in determining the health of the fetus. Inappropriate cessation of existing medication, or failure to initiate new agents when clearly indicated, can be more harmful than the judicious use of selected medication to maintain maternal health. A medication should be prescribed in pregnancy if the benefit to the mother, and therefore indirectly to the fetus, outweighs the potential risk of fetal exposure.

HORMONE AND ENZYME ASSAYS IN PREGNANCY

1974 ◽  
Vol 77 (2) ◽  
pp. 344-355 ◽  
Author(s):  
Arne Christensen ◽  
Dag Frøyshov ◽  
Petter Fylling
Keyword(s):  
Essential Hypertension ◽  
Birth Weight ◽  
The Other ◽  
Enzyme Assays ◽  
Placental Function ◽  
Additional Information ◽  
Simultaneous Measurements ◽  
Function Test ◽  
Aminopeptidase P ◽  
In Pregnancy

ABSTRACT A comparative study of human chorionic somatomammotrophin (HCS), placental cystine-aminopeptidase (P-CAP), progesterone and total urinary oestrogens (Oe) in pregnancies complicated with essential hypertension, mild or severe pre-eclampsia was performed. No significant reduction in the 4 parameters could be demonstrated in cases complicated with essential hypertension. In cases complicated with mild pre-eclampsia, however, a significant reduction was found in the HCS (P < 0.001) and P-CAP (0.01 <P < 0.02) but not in the urinary oestrogen values (0.1 < P < 0.2). A tendency to increased progesterone values could be demonstrated. Furthermore, in those cases of mild pre-eclampsia associated with a birth weight below the 10 percentile, the HCS and P-CAP assays proved to be more sensitive than the urinary oestrogen assay. No influence upon the progesterone levels was observed in these cases. On the other hand, in pregnancies complicated with severe pre-eclampsia the HCS, P-CAP and urinary oestrogen values were significantly reduced (P < 0.001) but not the progesterone values (P > 0.5). Again, when severe pre-eclampsia was associated with low birth weight, HCS and P-CAP were the most reliable tests. Based upon the HCS, P-CAP and the urinary oestrogen readings placental and foeto-placental scores were introduced. The placental score provided valuable information concerning the viability of the infants but no additional information was obtained by the foetoplacental score. The results indicated that simultaneous measurements of HCS and P-CAP as a placental function test and total urinary oestrogens as a foeto-placental test contribute reliable information in pregnancies complicated with pre-eclampsia. The measurement of progesterone could not be recommended as a test for the placental function.

Features of the course and treatment of glaucoma during pregnancy

2020 ◽  
Vol 98 (3) ◽  
pp. 178-184
Author(s):  
T. V. Chernyakova ◽  
A. Yu. Brezhnev ◽  
I. R. Gazizova ◽  
A. V. Kuroyedov ◽  
A. V. Seleznev
Keyword(s):  
Pregnant Women ◽  
Laser Treatment ◽  
Progressive Disease ◽  
Clinical Course ◽  
The Other ◽  
Third Trimester ◽  
The Third ◽  
Chronic Progressive Disease ◽  
Hypotensive Therapy ◽  
Eye Pressure

In the review we have integrated all up-to-date knowledge concerning clinical course and treatment of glaucoma among pregnant women to help specialists choose a proper policy of treatment for such a complicated group of patients. Glaucoma is a chronic progressive disease. It rarely occurs among childbearing aged women. Nevertheless the probability to manage pregnant patients having glaucoma has been recently increasing. The situation is complicated by the fact that there are no recommendations on how to treat glaucoma among pregnant women. As we know, eye pressure is progressively going down from the first to the third trimester, so we often have to correct hypotensive therapy. Besides, it is necessary to take into account the effect of applied medicines on mother health and evaluate possible teratogenic complications for a fetus. The only medicine against glaucoma which belongs to category B according to FDA classification is brimonidine. Medicines of the other groups should be prescribed with care. Laser treatment or surgery may also be a relevant decision when monitoring patients who are planning pregnancy or just bearing a child. Such treatment should be also accompanied by medicines.

STUDY ON EFFICACY OF QUADRUPLE THERAPY RACM IN PATIENTS WITH HP- POSITIVE GASTRIC ULCER

2011 ◽  
pp. 88-99
Author(s):  
Khanh Vinh ◽  
Ngoc Doanh Pham ◽  
Van Huy Tran
Keyword(s):  
Gastric Ulcer ◽  
Adverse Effects ◽  
The Other ◽  
Healing Ulcer ◽  
Treatment Results ◽  
Quadruple Therapy ◽  
Ulcer Relapse ◽  
H Pylori ◽  
Chronis Disease ◽  
Positive Materials

Objectives: Gastric ulcer is a chronis disease with a lot of dangerous complications and H. pylori is a major cause of gastric ulcer. Eradicating H. pylori helps reducing ulcer relapse and preventing cancer. The aim of study: to evaluate the rate of H. pylori infection in gastric ulcer and efficacy of quadruple therapy RACM for 5 days in patients with gastric ulcer with H. pylori positive. Materials and methods: Total 98 patients with gastric ulcer have been performed the endoscopy and CLO-Test, treated with quadruple therapy RACM for 5 days and evaluate efficacy 4 weeks after ending treatment. Results: The rate of H. pylori in gastric ulcer is 82.65%. The rate of H. pylori eradication is 88.71%. The effect of reducing pain of therapy is 90.32%; and the rate of reducing pain: 96.37% in successfully H. pylori-eradicated group and in the other group 42.85% (p < 0.05). The effect of healing ulcer of therapy is 77.41%; and the rate of healing gastric ulcer: 83.63% in successfully H. pylori-eradicated group and in the other group 28.57% (p < 0.05). The adverse effects of therapy included tiredness: 11.29%, lose appetite: 8.06% and diarrhea: 6.45%. Conclutions: Quadruple therapy RACM for 5 days showed an effective, safe and simple regime for eradicating H. pylori and should be considered to apply as the first lines treatment for H. pylori.

scholarly journals Overt and subclinical hypothyroidism among Bangladeshi pregnant women and its effect on fetomaternal outcome

2015 ◽  
Vol 40 (2) ◽  
pp. 52-57 ◽  
Author(s):  
M Sharmeen ◽  
PA Shamsunnahar ◽  
TR Laita ◽  
SB Chowdhury
Keyword(s):  
Adverse Effects ◽  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Adequate Treatment ◽  
In Pregnancy

Objectives: Thyroid disorders are among the common endocrine problems in pregnant women. It is now well established that not only overt but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are few data from Bangladesh about the prevalence of thyroid dysfunction in pregnancy. With this background, this study aims to find out thyroid dysfunction (both overt and subclinical hypothyroidism) in pregnancy and its impact on obstetrical outcome.Methods: We studied the evaluation of 50 admitted pregnancies corresponding to 29 women with subclinical hypothyroidism and rest 21 was overt hypothyroidism. Detailed history and examination were performed. Apart from routine obstetrical investigations, Thyroid Stimulating Hormone (TSH) estimation was done. Their obstetrical and perinatal outcomes were noted.Results: Overt hypothyroidism was significantly (p<0.05) higher in 25 to 44 years age group. However two and three abortions were significantly (p<0.05) higher in overt hypothyroidism patients. In sub clinical hypothyroidism 86.2% conceived firstly within 2 years and 66.7% in overt hypothyroidism patients conceived firstly in between 3 to 5 years after marriage. Overt hypothyroids were prone to have pregnancy-induced hypertension 42.9%, intrauterine growth restriction (P=0.001) and gestational diabetes (38.1%) as compared to subclinical cases. Neonatal complications were significantly more in overt hypothyroidism group. Mean TSH level was significantly (p<0.05) higher in overt hypothyroidism patients but mean FT4 level was almost similar in both groups. Majority of the patient underwent caesarean section in both groups due to associated medical and obstetrical complications. None of the babies showed hypothyroidism by cord blood tests. In this analysis our results showed that overt hypothyroidism among Bangladeshi pregnant women are associated with more maternal complication & adverse parental outcome than subclinical hypothyroidism. The adequate treatment of hypothyroidism during gestation minimizes risks and generally, makes it possible for pregnancies to be carried to term without complications. Significant adverse effects on maternal and fetal outcome were seen emphasizing the importance of routine antenatal thyroid screening.Bangladesh Med Res Counc Bull 2014; 40 (2): 52-57

scholarly journals Analysis for Stroke Etiology in Duplicated/Accessory MCA-Related Cerebral Infarction: Two Case Report and Brief Literature Review

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 205
Author(s):  
Kou Tsuyama ◽  
Nobukazu Miyamoto ◽  
Atsuhiko Shindo ◽  
Kenichiro Hira ◽  
Yuji Ueno ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Clinical Course ◽  
The Other ◽  
Shearing Stress ◽  
Common Site ◽  
Arterial Diameter ◽  
Stroke Etiology ◽  
Proximal Site ◽  
The Media ◽  
Intracranial Arteries

Duplication and accessory of the middle cerebral artery (MCA) constitute a rare congenital variation. MCA anomalies are found at a lesser frequency than the vascular anomalies of the other major intracranial arteries. Duplicated/accessory MCA was usually noted incidentally with subarachnoid hemorrhage, due to resulted aneurysmal formation. However, duplicated/accessory MCA-related cerebral infarction is rarer. We report two cases of cerebral infarction due to dissection at the entry of the duplicate/accessory MCA. Both cases were similar in dissected site and clinical course, without headache or injury. In 20 previously reported cases and our two cases of duplicated/accessory MCA-related infarction, mean age (55.8 ± 21.2 years) was slightly younger for cerebral infarction, and stroke etiology was mainly embolism. The main etiologies of stroke were embolism and dissection. Considering embolism etiology, proximal site of arterial diameter changing lesion was a common site for embolism, as duplicated/accessory MCA was usually smaller than normal M1 segment. In cerebral dissection cases, the dissected site was similar to our cases. Numerous mechanisms of dissection were considered, but they mainly included dysfunction of the media and endothelium or shearing stress at the entry of duplication. As the detailed mechanisms of cerebral dissection remain unknown, clinicians should include a differential diagnosis for MCA dissection.

scholarly journals Secondary Myelitis in Dermal Sinus Causing Paraplegia in a Child with Previously Normal Neurological Function

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Sakina Rashid ◽  
Grace Kinabo ◽  
Marissa Kellogg ◽  
William P. Howlett ◽  
Marieke C. J. Dekker
Keyword(s):  
Congenital Anomaly ◽  
Spina Bifida ◽  
Neural Tube ◽  
Clinical Course ◽  
Acute Infection ◽  
Early Embryogenesis ◽  
The Other ◽  
Neurological Deficits ◽  
Dermal Sinus ◽  
Neurological Development

Neural tube defects result from failure of neural tube fusion during early embryogenesis, the fourth week after conception. The spectrum of severity is not uniform across the various forms of this congenital anomaly as certain presentations are not compatible with extrauterine life (anencephaly) while, on the other hand, other defects may remain undiagnosed as they are entirely asymptomatic (occult spina bifida). We report a child with previously normal neurological development, a devastating clinical course following superinfection of a subtle spina bifida defect which resulted in a flaccid paralysis below the level of the lesion and permanent neurological deficits following resolution of the acute infection and a back closure surgery.

Sign in / Sign up

Export Citation Format

Share Document