scholarly journals Spontaneous uterine vessel perforation in late pregnancy following in vitro fertilisation: a rare cause of near miss maternal morbidity and fetal death

2017 ◽  
Vol 6 (8) ◽  
pp. 3664
Author(s):  
Shalini Gainder ◽  
Tanuja Muthyala ◽  
Subhas Chandra Saha
Keyword(s):  
Late Pregnancy ◽  
Near Miss ◽  
In Vitro Fertilisation ◽  
Emergency Laparotomy ◽  
Mortality And Morbidity ◽  
Uterine Vessel ◽  
Spontaneous Hemoperitoneum ◽  
Maternal Mortality And Morbidity ◽  
In Pregnancy

Spontaneous perforation of uterine vessels causing hemoperitoneum in pregnancy is rare and is associated with high perinatal and maternal mortality and morbidity. However, for the clinician identification of aetiology with ongoing resuscitation is important in order to affect the proper treatment. Case report: We report a case of spontaneous hemoperitoneum in pregnancy following IVF conception due to ruptured uterine vein successfully managed with emergency laparotomy and repair of the uterine vessel. Conclusion: Clinicians should be aware of such rare and potentially fatal complications after IVF, because early diagnosis and management in these cases can yield a favourable maternal and perinatal outcome. 

scholarly journals Preeclampsia: Сardiotonic Steroids, Fibrosis and a Hint to Cancerogenesis

2020 ◽  
Author(s):  
Alexei Bagrov ◽  
Nikolai Kolodkin ◽  
C. David Adair ◽  
Natalia Agalakova ◽  
Alexandr Trashkov
Keyword(s):  
Inverse Relationship ◽  
Therapeutic Strategy ◽  
Transcriptional Factor ◽  
Negative Regulator ◽  
Novel Therapy ◽  
Mortality And Morbidity ◽  
Maternal Mortality And Morbidity ◽  
Leading Position

Despite prophylaxis and attempts to select a therapy, the frequency of preeclampsia does not decrease, and it still takes the leading position in the structure of maternal mortality and morbidity worldwide. In this review, we present a new theory of the etiology and pathogenesis of preeclampsia which is based on the interaction of Na/K-ATPase and its endogenous ligands including marinobufagenin. The signaling pathway of marinobufagenin involves an inhibition of transcriptional factor Fli1, a negative regulator of collagen synthesis, followed by deposition of collagen in the vascular tissues and altered vascular functions. Moreover, in vitro and in vivo neutralization of marinobufagenin is associated with restoration of Fli1. The inverse relationship between marinobufagenin and Fli1 opens new possibilities in the treatment of cancer: since Fli1 is a proto-oncogene, a hypothesis on suppression of Fli1 by cardiotonic steroids as potential anti-tumor therapeutic strategy is discussed as well. We propose a novel therapy of preeclampsia which is based on immunoneutralization of the marinobufagenin by monoclonal antibodies, which is capable to impair marinobufagenin-Na/K-ATPase interactions.

Acupuncture Prior to and at Embryo Transfer in An Assisted Conception Unit – a Case Series

2006 ◽  
Vol 24 (1) ◽  
pp. 23-28 ◽  
Author(s):  
David Johnson
Keyword(s):  
Success Rate ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Assisted Reproduction ◽  
Case Series ◽  
In Vitro Fertilisation ◽  
Assisted Conception ◽  
Before And After ◽  
In Pregnancy

Over a period of three years, acupuncture was offered to patients entering assisted reproduction therapy. Acupuncture sessions were given at varying, but usually weekly, intervals during the in vitro fertilisation (IVF) cycle, and immediately before and after embryo transfer. Twenty two patients (average age 36.2 years) were treated over a total of 26 IVF cycles and 15 pregnancies were achieved, as determined by presence of foetal heartbeat on ultrasound at four weeks post embryo transfer. This was a success rate of 57.7% compared with 45.3% for patients in the IVF unit not treated with acupuncture (P>0.05). Relaxing effects were noted following acupuncture and it is speculated that this may have contributed to the increase in pregnancy rate for the acupuncture group.

scholarly journals Spontaneous Hemoperitoneum in Pregnancy from a Ruptured Superficial Uterine Vessel

2007 ◽  
Vol 46 (1) ◽  
pp. 77-80 ◽  
Author(s):  
Cheng-Yu Wu ◽  
Jiann-Loung Hwang ◽  
Yu-Hung Lin ◽  
Bih-Chwen Hsieh ◽  
Kok-Min Seow ◽  
...  
Keyword(s):  
Uterine Vessel ◽  
Spontaneous Hemoperitoneum ◽  
In Pregnancy

scholarly journals Pregnancy-Onset Acute Severe Colitis after in vitro Fertilization Embryo Transfer

2020 ◽  
Vol 14 (3) ◽  
pp. 477-482
Author(s):  
Dora Grgić ◽  
Silvija Čuković Čavka ◽  
Vesna Elveđi Gašparović ◽  
Nikša Turk ◽  
Marko Brinar ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Biologic Therapy ◽  
Late Pregnancy ◽  
Vitro Fertilization ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Acute Severe Colitis ◽  
Severe Colitis ◽  
In Pregnancy

Inflammatory bowel diseases (IBD) usually affect women in their fertile years and, therefore, have implications for their fertility and pregnancy. The presence of IBD during pregnancy has been shown to adversely affect pregnancy outcomes, and increased rates of preterm delivery and of spontaneous abortion have been reported. An onset of acute severe colitis in pregnancy has rarely been seen. We present the case of a 42-year-old woman who conceived after 9 attempts of in vitro fertilization and whose pregnancy was the result of a donated oocyte. Shortly after conception, she was diagnosed with severe active ulcerative colitis, and biologic therapy was introduced in the 28th week of pregnancy. Although therapy for IBD in pregnancy is considered safe for most drugs, this was not very well known in 2015. We also consider our case exceptional because we now have a 5-year follow-up of our patient and her child after having begun biologic therapy during late pregnancy.

scholarly journals The Unexpected Pitter Patter: New-Onset Atrial Fibrillation in Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Sarah White ◽  
Janna Welch ◽  
Lawrence H. Brown
Keyword(s):  
Atrial Fibrillation ◽  
Late Pregnancy ◽  
Emergency Physicians ◽  
Mortality And Morbidity ◽  
Ventricular Response ◽  
Potential Risks ◽  
Onset Atrial Fibrillation ◽  
In Pregnancy ◽  
Incompetent Cervix ◽  
New Onset

Background. Atrial fibrillation is a relatively uncommon but dangerous complication of pregnancy. Emergency physicians must know how to treat both stable and unstable tachycardias in late pregnancy. In this case, a 40-year-old female with a cerclage due to incompetent cervix and previous preterm deliveries presents in new-onset atrial fibrillation.Case Report. A previously healthy 40-year-old African American G2 P1 female with a 23-week twin gestation complicated by an incompetent cervix requiring a cervical cerclage presented to the emergency department with intermittent palpitations and shortness of breath for the past two months. EMS noted the patient to have a tachydysrhythmia, atrial fibrillation with rapid ventricular response. She was placed on a diltiazem drip, which was titrated to 15 mg/hr without successful rate control. Her heart rate remained in the 130s and the rhythm continued to be atrial fibrillation with RVR. Digoxin was then added as a second agent, and discussions about the potential risks of cardioversion in pregnancy ensued. Fortunately, the patient converted to sinus rhythm before cardioversion became necessary. The digoxin was discontinued; the diltiazem was also discontinued after the patient subsequently developed hypotension.“Why Should Emergency Physicians Be Aware of This?”New-onset atrial fibrillation is rare in pregnancy but can increase the mortality and morbidity of the mother and fetus if not treated promptly.

Sepsis in obstetrics

2016 ◽  
Author(s):  
Nuala Lucas ◽  
Colleen D. Acosta ◽  
Marian Knight
Keyword(s):  
Pregnant Patient ◽  
Physiological Changes ◽  
Risk Of Infection ◽  
Surviving Sepsis Campaign ◽  
Fetal Demise ◽  
Major Morbidity ◽  
Mortality And Morbidity ◽  
Management Of Complications ◽  
Maternal Mortality And Morbidity ◽  
In Pregnancy

Sepsis in pregnancy and the puerperium remains a significant cause of maternal mortality and morbidity worldwide. Major morbidity arising as a result of obstetric sepsis includes fetal demise, organ failure, chronic pelvic inflammatory disease, chronic pelvic pain, bilateral tubal occlusion, and infertility. Sepsis may arise at any time during pregnancy and the puerperium. Prior to the advent of routine prophylactic antibiotics for caesarean delivery, endometritis used to be a major cause of postpartum infection. Diagnosis can be difficult as the physiological changes of pregnancy can overlap significantly with the pathophysiology of sepsis. The clinician must often rely on a high index of clinical suspicion rather than objective criteria. Women at risk of infection should be identified early in pregnancy. Management of the septic pregnant patient must encompass resuscitation, identification, and treatment of the source of sepsis and management of complications such as hypotension and tissue hypoxia. The Royal College of Obstetricians and Gynaecologists recommend that sepsis should be managed in accordance with the Surviving Sepsis Campaign guidelines. Anaesthetists have broad experience in all the elements required to care for a sick parturient and obstetric anaesthetists are key members of the team required to successfully manage these women.

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