scholarly journals Dengue in pregnancy, maternal and fetal outcome: a case series managed at a Zonal Hospital

2020 ◽  
Vol 9 (6) ◽  
pp. 2420
Author(s):  
Tina Singh ◽  
S. M. Singh ◽  
M. M. Paprikar
Keyword(s):  
Dengue Infection ◽  
Mode Of Delivery ◽  
Laboratory Data ◽  
Case Series ◽  
Admission Rate ◽  
Obstetric Care ◽  
Fetal Monitoring ◽  
High Risk Group ◽  
Severe Thrombocytopenia ◽  
In Pregnancy

Background: Dengue is a vector borne disease with various grades of severity. Pregnancy is a high-risk group and is prone for complications of dengue haemorrhagic fever. The aim of this study was to evaluate the clinical profile of pregnant patients with dengue and to assess the maternal and fetal outcomes of dengue in pregnancy.Methods: All pregnant patients reporting to the hospital with fever and serologically confirmed dengue infection were included in the study. Clinical and laboratory data of patients were collected. The cases were followed up till their delivery to monitor the effect of dengue. An account of the mode of delivery in these patients was made. The neonates were evaluated and followed up till 6 weeks of life.Results: A total 100% patients reported with fever and serologically confirmed dengue infection. 15% had severe thrombocytopenia requiring platelet transfusion. 31% required ICU care and 15% needed mechanical respiratory support due to severe complications of dengue. NICU admission rate was 30% but there was no major neonatal complication or vertical transmission noted. A high index of suspicion should be maintained by the clinician with an aim to identify infection early, start supportive treatment and evaluate for complications. In-patient care should be provided for feto-maternal monitoring.Conclusions: The progression of dengue infection in pregnancy was rapid leading to major complications. Close materno-fetal monitoring and timely obstetric care are essential to ensure a favorable pregnancy outcome

scholarly journals Case Series of Dengue Fever in Peripartum Period: Maternal and Foetal Outcome

2020 ◽  
Vol 12 (3) ◽  
pp. 51-60
Author(s):  
Yudianto Budi Saroyo ◽  
Ali Sungkar ◽  
Rima Irwinda ◽  
Raymond Surya
Keyword(s):  
Dengue Fever ◽  
Platelet Transfusion ◽  
Dengue Infection ◽  
Case Series ◽  
Public Health Problem ◽  
Team Approach ◽  
Major Public Health Problem ◽  
Viral Virulence ◽  
Foetal Outcome ◽  
In Pregnancy

Introduction: Dengue fever is a major public health problem in tropical and subtropical areas. There are not many studies concerning the complications of dengue fever in pregnancy. We present four serial cases of dengue fever in pregnancy. Case illustration: Three of four cases were delivered by caesarean section; two of them died during post-caesarean care. All cases had the lowest platelet level below 50,000/µL and were given platelet transfusion during and after delivery; they also showed abnormal liver function tests. For foetal outcome, none tested positive for dengue. Discussion: Complication of dengue infection depends on a combination of host and viral virulence. Regardless of prophylactic platelet transfusion, some studies revealed clinical bleeding in patients with dengue infection due to an intricate effect on the haemostatic system. The adverse foetal outcome may contribute because of placental circulation caused by endothelial damage with increased vascular permeability leading to plasma leakage. There is no national guideline for dengue fever in pregnancy. Conclusions: The management of dengue fever in pregnancy at the tertiary hospital is still suboptimal. Dengue fever around peripartum presents a higher risk of morbidity and mortality for the mother and therefore needs a multidiscipline team approach.

scholarly journals Dengue infections during pregnancy: case series from a tertiary care hospital in Sri Lanka

2010 ◽  
Vol 4 (11) ◽  
pp. 767-775 ◽  
Author(s):  
Sampath Kariyawasam ◽  
Hemantha Senanayake
Keyword(s):  
Sri Lanka ◽  
Pregnant Women ◽  
Clinical Laboratory ◽  
Multiorgan Failure ◽  
Demographic Data ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
In Pregnancy

Introduction: Dengue is the most important mosquito-borne disease in Sri Lanka, leading to more than 340 deaths during the last outbreak (≈35,000 reported cases) starting in mid April 2009. The predominant dengue virus serotypes during the last few years have been DENV-2 and DENV-3. Dengue infection in pregnancy carries the risk of hemorrhage for both the mother and the newborn. Other risks include premature birth, fetal death, and vertical transmission. We report clinical and laboratory findings and outcomes in pregnant women hospitalized with dengue infection during pregnancy. Methodology: Clinical, laboratory, maternal/fetal outcomes and demographic data were collected from patients with confirmed dengue infections during pregnancy treated at De Soysa Maternity Hospital, Sri Lanka from 1 May 2009 to 31 December 2009. Results:  Fifteen seropositive dengue infected pregnant women were diagnosed in the period. Multiorgan failure leading to intrauterine fetal and maternal death occurred in one case of dengue hemorrhagic fever (DHF) IV. One patient with DHF III had a miscarriage at the 24th week of gestation. Perinatal outcomes of the other cases were satisfactory. One woman developed dengue myocarditis but recovered with supportive treatments. No cases of perinatal transmission to the neonate occurred. Conclusion: Dengue in pregnancy requires early diagnosis and treatment. A high index of clinical suspicion is essential in any pregnant woman with fever during epidemic. Further studies are mandatory as evidence-based data in the management of dengue specific for pregnancy are sparse.

Incidence and Aetiology of Thrombocytopenia in Twin Pregnancies in a Tertiary Referral Centre

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4188-4188 ◽  
Author(s):  
Anicee Danaee ◽  
Susan Robinson ◽  
Steven Okoli ◽  
Pippa Kyle ◽  
Matias Costa Vieira ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Case Series ◽  
Severe Thrombocytopenia ◽  
Electronic Patient Records ◽  
Tertiary Referral Centre ◽  
Original Cohort ◽  
Platelet Counts ◽  
Twin Pregnancies ◽  
In Pregnancy ◽  
Singleton Pregnancies

Abstract Introduction Thrombocytopenia is well described in pregnancy with an incidence of 6-10%. The majority of data with regards to platelet counts in pregnancy and aetiology of pregnancy related thrombocytopenia, however, derives from studies conducted in singletons. There is little information available on this subject in higher order pregnancies. Aim This longitudinal study aims to identify the incidence and aetiology of thrombocytopenia in twin pregnancies in order to guide investigation and management. As a reference we also investigate changes in platelet counts in a cohort of uncomplicated twin pregnancies from our population. Methods Full blood counts (FBC) and pregnancy outcome data were obtained retrospectively from electronic patient records for 676 twin pregnancies over a five year period at our institution. All women required three FBCs to be performed during their pregnancy (booking, second trimester and delivery) to be included in the study. Women with pre-existing medical co-morbidities or medication know to be associated with thrombocytopenia were excluded. A total of 381/676 women were included in the final analysis. From that original cohort, those women with uncomplicated pregnancies who delivered at term (36/40 onwards) were selected to investigate and report a reference interval for platelet count during pregnancy and compare with known reference intervals in singletons. A total of 301/676 women were included in this sub-analysis. Results The mean maternal age was 32.3 years with a mean gestational age of 36.7 weeks at delivery. We defined thrombocytopenia as mild: platelets 100-150 x 109/L, moderate: platelets 50-100 x 109/L and severe: platelets < 50 x 109/L. The table below summarises our results TableFull Blood countMild thrombocytopenia n (%)Moderate thrombocytopenia n (%)Severe thrombocytopenia n (%)1st FBC n=2566 (2.3%)002nd FBC n=38126 (6.8%)1 (0.3%)03rd FBC n=38177 (20.2%)12 (3.2%)1 (0.3%) The overall rate of thrombocytopenia was 23%. The commonest cause of thrombocytopenia in this population was gestational thrombocytopenia (75%), followed by pre-eclampsia (15%) other hypertensive disorders (5.7%) and the remaining 4.3% included other complications such as sepsis and obstetric cholestasis. The platelet ranges for our cohort of women with uncomplicated pregnancies were as shown in the table below. These results are in keeping with changes which occur in platelet counts in singleton pregnancies. TableFull Blood countMean plt count (109/L)Range95% interval1st FBC247135-390163-3262nd FBC226115-410147-3443rd FBC18526-427110-317 Conclusion This study demonstrates that while the incidence of thrombocytopenia is double the rate in twin when compared to singleton pregnancies, the overall distribution in terms of aetiology is very similar. Interestingly this differs somewhat from data in triplet pregnancies where the majority of thrombocytopenia appears to be secondary to pre-eclampsia in one case series. This is an important finding as it indicates that like in most singleton pregnancies the majority of cases are benign and as such investigation and management pathways regarding thrombocytopenia should not differ from investigation and management in singleton pregnancies. However the increased incidence of thrombocytopenia in twin pregnancies overall requires further investigation. Disclosures No relevant conflicts of interest to declare.

Severe thrombocytopenia in pregnancy: a case series from west China

2019 ◽  
Vol 19 (4) ◽  
pp. 495-503 ◽  
Author(s):  
Fan Zhou ◽  
Tingting Xu ◽  
Chunyan Deng ◽  
Haiyan Yu ◽  
Xiaodong Wang
Keyword(s):  
Case Series ◽  
Severe Thrombocytopenia ◽  
West China ◽  
In Pregnancy

CASE SERIES OF NEUROFIBROMATOSIS AND ITS VARIED MANIFESTATIONS IN PREGNANCY: AN OBSTETRICIAN’S PERSPECTIVE

2021 ◽  
pp. 68-70
Author(s):  
Shree Bharathi ◽  
Kubera N S ◽  
Niveditha Jha ◽  
Sairem Mangolnganbi Chanu
Keyword(s):  
Preterm Birth ◽  
Case Series ◽  
Obstetric Care ◽  
Neurological Manifestations ◽  
Clinical Expression ◽  
Pregnancy And Childbirth ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Neurocutaneous Disorder ◽  
In Pregnancy

Neurobromatosis (NF) type1 is a relatively common genetic neurocutaneous disorder with variable clinical expression. It has been linked with obstetric complications like preeclampsia in the mother and fetal growth restriction(FGR), preterm birth and stillbirth in the fetus. NF1 is frequently associated with bony dysplasia and neurological manifestations like seizure disorder, large disguring plexiform neurobroma and malignant nerve sheath tumors. Due to the above-mentioned concerns, pregnancy and childbirth can be challenging in women with NF1. Timely screening and regular monitoring are required for early diagnosis and treatment of these conditions, to ensure optimal obstetric care. We present in our case series, the management, maternal and fetal outcomes of 7 pregnancies in ve women with neurobromatosis.

scholarly journals Spontaneous Adrenal Hemorrhage in Pregnancy: A Case Series

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Ankita Gupta ◽  
Ruby Minhas ◽  
Hayley S. Quant
Keyword(s):  
Mode Of Delivery ◽  
Case Series ◽  
Flank Pain ◽  
Adrenal Hemorrhage ◽  
Pain Patient ◽  
Management Options ◽  
Vaginal Deliveries ◽  
The Stability ◽  
Left Flank Pain ◽  
In Pregnancy

Background. Abdominal pain during pregnancy has a broad differential diagnosis which includes spontaneous adrenal hemorrhage (SAH). There is scant literature available on optimal mode of delivery in stable patients. Cases. Patient 1 was a 35-year-old nullipara who presented at 36 weeks of gestation with left flank pain. Patient 2 was a 27-year-old multipara at 38 weeks who presented with left upper quadrant pain. Diagnosis of SAH was made by CT scan and both were managed with pain control, serial hemoglobin assessments, and abdominal exams resulting in uncomplicated vaginal deliveries. Conclusion. SAH, although rare, is an important consideration when evaluating abdominal and flank pain in pregnancy. Management options vary from conservative management to surgical intervention depending on the stability of the patient.

CASE SERIES: ERCP IN PREGNANCY- CAN WE AVOID RADIATION?

2018 ◽  
Author(s):  
F Rhodes ◽  
S Murray ◽  
R Aguilo ◽  
R Shidrawi
Keyword(s):  
Case Series ◽  
In Pregnancy

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

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