Correlation of lateral placental location with development of preeclampsia

Background: Preeclampsia is a complex clinical syndrome which involves multiple organ systems and remains the principle cause of maternal and perinatal morbidity and mortality. Preeclampsia is a disease of trophoblastic tissue. Placental abnormality is one of the initial events in patients who are destined to develop pregnancy induced hypertension subsequently. Objective of this study was to evaluate the association of laterally located placenta on ultrasound with development of preeclampsia.Methods: This prospective observational study was conducted on 200 antenatal women with singleton pregnancy at 18-24 weeks of gestation who attended antenatal clinic of obstetrics and gynaecology, PGIMS Rohtak from October 2017 to October 2018. Detailed antenatal transabdominal ultrasound along with placental location was done between 18-24 weeks of gestation in women who fitted into inclusion criteria. All the antenatal women belonged to 18-24 weeks of gestation were included in the study except those women with chronic hypertension, diabetes mellitus, renal disease, severe anaemia, thyrotoxicosis, low lying placenta, previous history of preeclampsia or eclampsia.Results: Out of 200 antenatal women, 84 had lateral placenta while 116 had central placenta. Out of these 84 women who had lateral placenta, 55 women (65.5%) developed preeclampsia and out of 116 (58%) women who had central placenta, 28 women (24.1%) developed preeclampsia.Conclusions: From the above study, we concluded that women with laterally located placenta by ultrasound at 18-24 weeks of gestation have greater risk of developing preeclampsia.

Download Full-text

Epidemiological Profile and Postpartum Outcome for Severe Preeclamptic Patients

Khalij-Libya Journal of Dental and Medical Research ◽

10.47705/kjdmr.215207 ◽

2021 ◽

pp. 45-50

Author(s):

Suher Dafaus ◽

Amel Morgham ◽

Nasreen Osman

Keyword(s):

Caesarean Section ◽

Positive Family History ◽

Previous History ◽

Severe Preeclampsia ◽

Intrauterine Fetal Death ◽

Chronic Hypertension ◽

Hypertensive Disorder ◽

Adequate Treatment ◽

History Of ◽

The Mean

Background and objective. Preeclampsia is a multisystemic disorder, which involves the placenta, liver, blood, neurological and cardiovascular systems. It is one of the leading causes of maternal and fetal morbidity and mortality. This study aimed at describing the characteristic features for mothers who had severe preeclampsia and to know the complications during puerperium. Methods. A prospective study conducted over a period from February 2009 up to November 2009 involving 100 pre-eclampsia patients admitted and delivered in Aljalaa Maternity Hospital, Tripoli, Libya. Results. The patients mean age was 33.3 +5.9 years. The mean gestational age at admission time was 36.8+3.2 weeks and 64% of them were term. 58% of the patients with severe preeclampsia had a positive family history of chronic hypertension whereas 42% of patients had a previous history of preeclampsia. 40% of patients were primigravida. The mean systolic blood pressure at admission was 164+15.4 mmHg and the mean diastolic pressure was 113+6 mmHg. The common symptoms were headache, abdominal pain, and blurred vision (54%, 37%, and 31% respectively), whereas 9% of the patients presented with the eclamptic fit. The pregnancy in 66% patients ended by caesarean section, 78% of them were emergency caesarean section. The birth weight of 13% of new-borns was less than 1500 grams. Furthermore, 10% diagnosed with intrauterine fetal death (IUFD) antenatally and 9% died after admission to nursery intensive care unit post-delivery. Conclusion. the effects of hypertensive disorder associated with pregnancy could be prevented by close antenatal care particularly for whose had previous history of preeclampsia. In addition; early recognition and adequate treatment, and timely delivery can prevent preeclampsia and will improve maternal and neonatal outcomes.

Download Full-text

Hepatitis C in pregnancy: an observational study highlighting its association with maternal parameters

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195941 ◽

2019 ◽

Vol 8 (1) ◽

pp. 344

Author(s):

Bushra . ◽

Ambreen Ghori ◽

Azra Ahmed ◽

Najma Dalwani ◽

Mushtaque Ali Shah ◽

...

Keyword(s):

Risk Factors ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Previous History ◽

Cross Sectional Study ◽

University Hospital ◽

Prior History ◽

Singleton Pregnancy ◽

Cross Sectional ◽

History Of

Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.

Download Full-text

Abstract 12563: Retrospective Analysis of Cardiovascular Events With the Use of Immune Checkpoint Inhibitors

Circulation ◽

10.1161/circ.142.suppl_3.12563 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Tushar Tarun ◽

Brian P Bostick ◽

Deepa Baswaraj ◽

Nishchayjit Basra ◽

Meeshal Khan ◽

...

Keyword(s):

Heart Failure ◽

Atrial Fibrillation ◽

Retrospective Analysis ◽

Immune Checkpoint ◽

Immune Checkpoint Inhibitors ◽

Checkpoint Inhibitors ◽

Multiple Organ ◽

Fulminant Myocarditis ◽

Organ Systems ◽

History Of

Introduction: Immune checkpoint inhibitors have emerged as a promising, novel therapy for multiple malignancies. Immune-related adverse reactions pose a serious concern with use of these agents and reportedly involve multiple organ systems, notably cardiotoxicity. Early identification and management of these adverse events is essential in the prevention of morbidity and mortality. Hypothesis: Immune checkpoint inhibitors cause multiple cardiotoxic effects, and patients with prior cardiac history have a higher likelihood of cardiotoxicity. Methods: 1. A retrospective analysis of 150 patients was performed who had received immunotherapy with either the cytotoxic T lymphocyte associated antigen 4 inhibitors (CTLA4) or with the programmed cell death inhibitors (PD1) or programmed death-ligand 1 (PD-L1) inhibitors for a period of two years at a Tertiary health Care from 7/1/2016-6/30/2018. 2. Patients' cardiac diagnoses prior to the initiation of therapy were noted and included, including history of heart failure, coronary artery disease, atrial fibrillation, and sudden cardiac arrest. 3. Patients’ clinic visits and hospitalizations with admitting and discharge diagnosis, electrocardiogram, echocardiogram, troponin T, and NT-proBNP were reviewed. Results: 6% of patients had new onset heart failure (both preserved and reduced), 1.3% had evidence of myocardial infarction, 2% had new atrial fibrillation with rapid ventricular rate, and 0.6% had fulminant myocarditis. Of patients with new cardiac events, 60% had a history of cardiac disease, which was significantly higher than in patients without (p< 0.05). There were no age or sex differences between the groups with and without cardiotoxicity. Conclusion: Immunotherapy with immune checkpoint inhibitors have broadened the horizon for treatment of multiple solid and hematological malignancies. Nonetheless, new adverse effects on multiple organ systems, specifically cardiac involvement, occur with these therapies, which are important and potentially detrimental toxicities. Patients with a history of prior cardiovascular disease have higher likelihood to develop cardiotoxicity.

Download Full-text

Prevalence of some hepatitis B virus markers among pregnant women attending antenatal clinic in Specialist Hospital Sokoto Nigeria

Human Antibodies ◽

10.3233/hab-200412 ◽

2020 ◽

Vol 28 (3) ◽

pp. 233-243

Author(s):

O. Erhabor ◽

S.Y. Mohammad ◽

L. Bello ◽

F.U. Onuigwe ◽

Y. Abdulrahman ◽

...

Keyword(s):

Public Health ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Pregnant Women ◽

Previous History ◽

Public Health Problem ◽

Antenatal Clinic ◽

B Virus ◽

History Of ◽

Hepatitis B Virus Markers

BACKGROUND: Hepatitis B virus infection is a global public health problem. The virus has infected more than one-third of the global population. It has been estimated that 360 million chronic carriers are living around the world with a high risk for developing cirrhosis, hepatic carcinoma and hepatic failure. OBJECTIVE: The aim of this study was to determine the prevalence of some hepatitis B markers among pregnant women attending antenatal clinic in Sokoto Specialist Hospital, Nigeria. METHODS: The hepatitis testing was carried out using the Skytec-Rapid Diagnostic HBV-5 rapid kit (Skytec-Rapid Diagnostic, USA). The kit is based on lateral flow chromatographic immunoassay for the qualitative detection of HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in human serum or plasma. Panel format can conveniently test for five targets at once and utilizes all markers to help distinguish between acute and chronic infections. RESULTS: Out of 117 pregnant women tested, 15 were positive for HBsAg (12.8%), 6 positive for HBsAb (5.1%), 1 for HBeAg (0.9%), 14 tested positive for HBeAb (12.0%), and 14 tested for HBcAb (12.0%). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on ethnicity. HBsAb was significantly higher among the Hausa ethnic group (p= 0.001). The prevalence of HBsAb, HBeAg, HBcAb and HBcAb was not affected by ethnicity (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on age. Infection by the hepatitis B virus markers was higher among young adult and middle age groups. The difference was however not statistically significant (p> 0.05). The prevalence of HBsAg, HBsAb, HBeAg, HBcAb and HBcAb was compared based on the educational status, previous history of blood transfusion, jaundice, employment status and previous history of still births among the pregnant subjects. There were no statistically significant differences in the prevalence of Hepatitis B virus markers (p> 0.05). CONCLUSION: The study observed a high prevalence of various hepatitis B viral markers among pregnant women attending antenatal care in Specialist Hospital Sokoto. There is need for routine screening of all pregnant women and infants born to hepatitis B positive mothers. Government and non-governmental organizations should intensify efforts to enlighten the general population on the public health importance of the disease and the importance of hepatitis screening. There is also need for the development of a treatment protocol for the management of pregnant women positive for hepatitis B to prevent mother to child transmission. There is an urgent need for the implementation of evidenced-based best practice of providing universal vaccination against hepatitis B for all hepatitis B negative women of child bearing age in particular and all Nigerians in general.

Download Full-text

Development of Diabetes Type 3 After SARS-COV-2 Pancreatic B Cell Injury

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.760 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A373-A373

Author(s):

Francisco Jose Zayas ◽

Marianne Hernandez-Negron ◽

Michelle Marie Mangual Garcia

Keyword(s):

Blood Glucose ◽

Previous History ◽

Endocrine System ◽

Diabetes Type ◽

The Body ◽

C Peptide ◽

Organ Systems ◽

History Of ◽

Type 3

Abstract SARS-COV-2 has caused millions of deaths in less than one year, yet little is known about the long-term consequences survivors may suffer. The novel coronavirus uses the ACE2 receptor to infect human cells, allowing it to target organ systems with such receptors including the respiratory, cardiovascular, gastrointestinal and endocrine system. The purpose of this case report is to describe the long-term implications COVID-19 may cause in the endocrine system. A 46-year-old woman was referred to our clinic due to abrupt uncontrolled blood glucose levels ranging from 200-550mg/dL after being infected with COVID-19 for approximately 10 weeks. She has a past medical history of Diabetes Mellitus Type 2 which was diagnosed 3 years ago and was well controlled with diet. Present history reveals polyuria, polydipsia, tiredness and a decreased appetite. Laboratory values show HbA1C 12, negative islet cell antibodies/GAD antibodies, low C-peptide, high TSH, normal FT4 and positive anti-TPO antibodies/thyroglobulin antibodies. The sudden loss of blood glucose control along with low c peptide levels without evidence of autoimmunity support the diagnosis of Pancreatic Diabetes. SARS-COV-2 infection may cause Diabetes Type 3, rendering a patient dependent on insulin use for life. Covid-19 survivors, with or without a previous history of endocrinopathy, should be evaluated for possible long-term sequels of infection as the virus targets tissues throughout the body.

Download Full-text

Effect of Prior History of Dementia and a Diagnosis of COVID-19 on Delirium in the ICU

Proceedings of IMPRS ◽

10.18060/24685 ◽

2020 ◽

Vol 3 ◽

Author(s):

Amira Kupty ◽

Fen-Lei Chang

Keyword(s):

Retrospective Chart Review ◽

Multiple Organ ◽

Prior History ◽

Organ Systems ◽

Increased Risk ◽

History Of ◽

Recent Diagnosis ◽

Potential Factors ◽

Icu Delirium ◽

Severity Of Dementia

Background: Delirium occurred in nearly two out of every three patients in the ICU from prior studies. It is associated with poor health outcomes, including long-term cognitive and motor decline, increased risk of dementia, and increased mortality. In the context of COVID-19, patients are more likely to develop delirium due to the severity of the illness involving multiple organ systems. Our study evaluates factors contributing to the occurrence of delirium in the ICU for patients with or without a history of dementia and with or without a recent diagnosis of COVID-19. Methods: We performed a retrospective chart review of ICU patients in Fort Wayne, IN from January through the end of June of 2020. Patients were grouped by whether they developed delirium or not and whether they had pre-existing dementia. We recorded age, sex, race, BMI, level of education, high risk medications, comorbidities, enteric/NPO feeding, mechanical ventilation, mobility, and lab results including CBC and BMP at the onset of delirium. Additionally, we included severity of delirium, length of stay, functional status at time of discharge, and COVID-19 status. Results: We were unable to collect data at the time. However, we hypothesized that the incidence and severity of ICU delirium is associated with the severity of dementia and COVID status, among other factors. Potential Impact: This study can shed light on the contribution of dementia history to ICU delirium and potential factors contributing to delirium incidence and severity. The COVID pandemic offers opportunities to differentiate effects of neurological (dementia) versus non-neurological factors (respiratory, renal, cardiovascular, and metabolic) on ICU delirium.

Download Full-text

Treatment-resistant cough: a rare manifestation of IgG4-related disease involving the larynx

BMJ Case Reports ◽

10.1136/bcr-2020-237614 ◽

2020 ◽

Vol 13 (11) ◽

pp. e237614

Author(s):

Azfar Shahid Syed ◽

Rhonda E Colombo ◽

Bakhtiar S Syed ◽

Peter M Henning

Keyword(s):

Multiple Organ ◽

Antibody Treatment ◽

Igg4 Related Disease ◽

Organ Systems ◽

Airway Symptoms ◽

Rare Manifestation ◽

Usual Therapy ◽

Monoclonal Antibody Treatment ◽

History Of ◽

Anti Cd20

IgG4-related autoimmune diseases (IgG4 RD) are a relatively recently recognised group of disease processes that can affect multiple organ systems and result in protean symptoms. Here, we present a rare case of a 69-year-old man with a history of IgG4 RD affecting his lacrimal gland and pancreas who developed symptoms of severe laryngitis not responsive to usual therapy. He presented with non-productive cough, hoarseness and dyspnoea. Imaging findings suggestive of aortitis and laryngeal inflammation in the setting of his IgG4 RD history prompted treatment with rituximab, which resulted in resolution of his laryngeal symptoms. Subsequently, his cough returned and he required periodic rituximab infusions to stay symptom-free. IgG4 RD of the larynx is an uncommonly reported manifestation in literature. This disease is very responsive to anti-CD20 monoclonal antibody treatment. IgG4 RD should be considered in patients with airway symptoms that are especially refractory to usual therapy.

Download Full-text

Case Series of Multisystem Inflammatory Syndrome (MIS-C) in Children during the SARS-CoV-2 Pandemic in Latvia

Clinics and Practice ◽

10.3390/clinpract11020051 ◽

2021 ◽

Vol 11 (2) ◽

pp. 363-373

Author(s):

Iveta Racko ◽

Liene Smane ◽

Lizete Klavina ◽

Zanda Pucuka ◽

Ieva Roge ◽

...

Keyword(s):

Case Series ◽

Multiple Organ ◽

Special Focus ◽

Antibody Testing ◽

Median Hospital Stay ◽

Organ Systems ◽

Treatment Data ◽

History Of ◽

Inflammatory Syndrome

The total number of COVID-19 positive cases in Latvia has escalated rapidly since October 2020, peaking in late December 2020 and early January 2021. Children generally develop COVID-19 more mildly than adults; however, it can be complicated by multisystem inflammatory syndrome in children (MIS-C). This case study aims were to assess demographic characteristics and the underlying medical conditions, and clinical, investigative and treatment data among 13 MIS-C patients using electronic medical records. All 13 had acute illness or contact with someone who was COVID-19 positive two to six weeks before MIS-C onset. Only five of the 13 were symptomatic during the acute COVID-19 phase. The median age was 8.8 years; 11/13 patients were male, 10/13 had been previously healthy, and all 13 patients tested positive for SARS-CoV-2 by RT-PCR or antibody testing. The most commonly involved organ systems were the gastrointestinal (13/13), hematologic (13/13), cardiovascular (13/13), skin and mucosa (13/13), and respiratory (12/13) ones. The median hospital stay was 13 (interquartile range, 11 to 18) days; 7/13 patients received intensive care, 6/13 oxygen support, and 5/13 received inotropic support. No deaths occurred. During the current pandemic, every child with a fever should have a clearly defined epidemiological history of COVID-19, a careful clinical assessment of possible multiple organ-system involvement, with a special focus on children with severe abdominal pain and/or skin and mucocutaneous lesions.

Download Full-text

Determinants of Preeclampsia in a Tertiary Hospital in South East Nigeria

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v8i06.08 ◽

2021 ◽

Vol 8 (06) ◽

pp. 5490-5497

Author(s):

Ifeoma Anne Njelita ◽

Chinyerem Cynthia Nwachukwu ◽

Gabriel Ifeanyi Eyisi ◽

Josephat Chukwudi Akabuike Akabuike ◽

Chijioke Amara Ezenyeaku ◽

...

Keyword(s):

Family History ◽

Previous History ◽

Tertiary Hospital ◽

University Teaching ◽

Categorical Variables ◽

Chronic Hypertension ◽

Pregnancy Induced Hypertension ◽

Related Disorder ◽

Induced Hypertension ◽

History Of

Background: Preeclampsia is a pregnancy-related disorder. Symptoms commonly associated with it include elevated blood pressure, protein in the urine and leg swelling. It is one of the leading causes of maternal and fetal morbidity and mortality especially in limited resource settings. This study was aimed at determining the risk factors for preeclampsia in a tertiary hospital in south east Nigeria. Methods: This was a retrospective case-control study carried out at Chukwuemeka Odumegwu Ojukwu University teaching hospital Awka, south east of Nigeria. There were 50 cases with 100 controls. Data was retrieved from hospital case notes of both cases and controls. Tables were used to illustrate the descriptive statistics comparing the cases and controls. Categorical variables were compared using the Chi-square test. To ascertain the determinants of preeclampsia, Univariate and multivariate logistic regression analyses were conducted. Results: Maternal age less than 30 years, lower educational status, primigravida, previous history of pregnancy induced hypertension, polyhydramnios, maternal obesity, chronic hypertension, diabetes, and family history of preeclampsia were predictive of preeclampsia (Adjusted odds ratio (AOR) = 2.50, 9.08, 20.25, 76.47, 5.11, 7.53, 2.73, 10.78, and 3.57 respectively). Conclusions: The identified determinants of preeclampsia from this study especially previous history of pregnancy induced hypertension, primigravida, family history of preeclampsia among others should serve as a basis for the screening of antenatal clinic attendees for preeclampsia. This will serve to identify at risk pregnant women, and enhance early diagnosis and intervention to improve feto-maternal outcomes.

Download Full-text

Donor and recipient family histories of hypertension influence renal impairment and blood pressure during acute rejections.

Journal of the American Society of Nephrology ◽

10.1681/asn.v9112102 ◽

1998 ◽

Vol 9 (11) ◽

pp. 2102-2107

Author(s):

E Guidi ◽

M G Cozzi ◽

E Minetti ◽

G Bianchi

Keyword(s):

Family History ◽

Renal Damage ◽

Prospective Observational Study ◽

Chronic Hypertension ◽

History Of ◽

Stable Renal Function ◽

Family History Of Hypertension ◽

Kidney Impairment ◽

Double Blinded ◽

Acute Insult

A previous historical prospective observational study, double blinded for knowledge of kidney donors' family history of hypertension, included 85 transplanted patients with stable renal function, not treated with cyclosporine, who were followed-up for an average of 8 yr and carefully characterized for the presence or absence of hypertension in the donor and recipient families. The recipients without a family history of hypertension, but grafted with a kidney coming from a "hypertensive" family, developed hypertension much more frequently than recipients grafted with a kidney coming from a "normotensive" family, or recipients with familial hypertension in whom the origin of the kidney did not influence the prevalence of hypertension after transplantation. In this second study of the same patients, it was found that these recipients with a "normotensive" family and a "hypertensive" kidney showed a greater increase of diastolic BP (P = 0.005) and a greater degree of acute renal damage (P = 0.004) during acute rejections than all of the other recipients. This extension study shows that a grafted kidney can transmit not only chronic hypertension, but also susceptibility to a greater rise in BP and more severe kidney impairment after an acute insult.

Download Full-text