scholarly journals Case report of aplastic anaemia detected in third trimester of pregnancy: dilemmas faced

2020 ◽  
Vol 10 (1) ◽  
pp. 381
Author(s):  
Gayathri Dinesh Kamath ◽  
Sunil Prabhakar Udgire ◽  
Divya Katewa
Keyword(s):  
Immunosuppressive Therapy ◽  
Aplastic Anaemia ◽  
Blood Cells ◽  
Multidisciplinary Approach ◽  
Daily Basis ◽  
Normal Vaginal Delivery ◽  
Third Trimester ◽  
Packed Red Blood Cells ◽  
The Third ◽  
Anaemia In Pregnancy

Aplastic anaemia with pregnancy is rarely encountered. Management of aplastic anaemia in pregnancy primarily involves a multidisciplinary approach offering supportive care. Our case was challenging as she developed aplastic anaemia during the third trimester and had refractory thrombocytopenia. She required platelet transfusions on a daily basis for few weeks as well as packed red blood cells frequently. Her leucocyte count was low initially but improved quickly unlike the platelet counts. Initiation of immunosuppressive therapy turned out to be beneficial and culminated in a good outcome. After starting immunosuppressive therapy with eltrombopag and cyclosporine she drifted through term and achieved a normal vaginal delivery.

scholarly journals Multidisciplinary Approach for the Management of Complex Hepatic Injuries AAST-OIS Grades IV—V: A Prospective Study

2007 ◽  
Vol 96 (3) ◽  
pp. 214-220 ◽  
Author(s):  
J. A. Asensio ◽  
P. Petrone ◽  
L. Garcí-Núñez ◽  
B. Kimbrell ◽  
E. Kuncir
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Blood Loss ◽  
Blood Cells ◽  
Multidisciplinary Approach ◽  
Stepwise Logistic Regression ◽  
Packed Red Blood Cells ◽  
Emergency Department Thoracotomy ◽  
Estimated Blood Loss ◽  
Hepatic Injuries

Background: Complex hepatic injuries grades IV—V are highly lethal. The objective of this study is to assess the multidisciplinary approach for their management and to evaluate if survival could be improved with this approach. Study Design: Prospective 54-month study of all patients sustaining hepatic injuries grades IV—V managed operatively at a Level I Trauma Center. Main outcome measure: survival. Statistical analysis: univariate and stepwise logistic regression. Results: Seventy-five patients sustained penetrating (47/63%) and blunt (28/37%) injuries. Seven (9%) patients underwent emergency department thoracotomy with a mortality of 100%. Out of the 75 patients, 52 (69%) sustained grade IV, and 23 (31%) grade V. The estimated blood loss was 3,539±-3,040 ml. The overall survival was 69%, adjusted survival excluding patients requiring emergency department thoracotomy was 76%. Survival stratified to injury grade: grade IV 42/52–81%, grade V 10/23–43%. Mortality grade IV versus V injuries (p <0.002; RR 2.94; 95% CI 1.52–5.70). Risk factors for mortality: packed red blood cells transfused in operating room (p=0.024), estimated blood loss (p<0.001), dysryhthmia (p<0.0001), acidosis (p=0.051), hypothermia (p=0.04). The benefit of angiography and angioembolization indicated: 12% mortality (2/17) among those that received it versus a 36% mortality (21/58) among those that did not (p=0.074; RR 0.32; 95% CI 0.08–1.25). Stepwise logistic regression identified as significant independent predictors of outcome: estimated blood loss (p=0.0017; RR 1.24; 95% CI 1.08–1.41) and number of packed red blood cells transfused in the operating room (p=0.0358; RR 1.16; 95% CI 1.01–1.34). Conclusions: The multidisciplinary approach to the management of these severe grades of injuries appears to improve survival in these highly lethal injuries. A prospective multi-institutional study is needed to validate this approach.

Nuclear thyroxine and 3,5,3'-triiodothyronine receptors in human mononuclear blood cells during pregnancy

1984 ◽  
Vol 105 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Jan Kvetny ◽  
Henning Kvist Poulsen
Keyword(s):  
Blood Cells ◽  
Binding Capacity ◽  
Late Pregnancy ◽  
Normal Pregnancy ◽  
Third Trimester ◽  
Serum Free ◽  
The Third ◽  
Nuclear Binding ◽  
Mononuclear Blood Cells ◽  
Tsh Levels

Abstract. Serum free T4, free T3, TSH and maximal nuclear binding capacity for T4 and T3 in mononuclear blood cells were measured in 12 control women, in 12 normal pregnant women in the first and in 12 women in the third trimester. Serum free T4 and T3 were decreased in late pregnancy compared to control women, serum free T4: 9.1 pmol/l (mean) vs 12.9 pmol/l (mean); serum free T3: 4.0 pmol/l (mean) vs 6.2 pmol/l (mean), without any change in TSH levels: 2.2 mU/l (mean) vs 1.8 mU/l (mean). Concomitantly, the maximal nuclear binding capacity for both T4 and T3 increased, T4: 2.7 fmol T4/100 μg DNA vs 1.8 fmol T4/100 μg DNA; T3: 2.8 fmol T3/100 μg DNA vs 2.0 fmol T3/100 μg DNA. These data, obtained from healthy women during a normal pregnancy are compatible with mild compensated hypothyroidism. We suggest that euthyroidism are maintained by the increased maximal nuclear binding capacity for these hormones.

scholarly journals MOLECULAR EFFECTS OF ERYTHROPOIETIN ON THE LIPID COMPOSITION OF THE UMBILICAL CORD BLOOD ERYTHROCYTE MEMBRANES OF NEWBORNS AT CYTOMEGALOVIRUS INFECTION IN PREGNANCY

2019 ◽  
Vol 1 (71) ◽  
pp. 88-93
Author(s):  
Наталия Ишутина ◽  
Nataliya Ishutina ◽  
Ирина Андриевская ◽  
Irina Andrievskaya ◽  
Николай Дорофиенко ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Cord Blood ◽  
Red Blood Cells ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Blood Cells ◽  
Thiobarbituric Acid ◽  
Third Trimester ◽  
The Third ◽  
Molecular Effects

In order to identify the molecular effects of erythropoietin on the lipid composition and properties of the membrane of red blood cells of the umbilical cord, 35 newborn children born from cytomegalovirus seropositive women with exacerbation of infection in the third trimester of pregnancy (main group) were examined. The control group consisted of 30 newborns born from cytomegalovirus seronegative women. Plasma and red blood cells of the umbilical cord became the material for the study. In the membrane of red blood cells of the umbilical cord by spectrophotometry there were studied the products that react with thiobarbituric acid; membrane microviscosity was studied by lateral diffusion of hydrophobic fluorescent probe of pyrenes; lysophosphatidylcholine content by a thin-layer chromatography; the content of arachidonic, oleic and α-linolenic fatty acids by gas chromatography; ionized calcium content by analyzer of blood gases and electrolytes; erythropoietin in umbilical cord blood plasma by enzyme immunoassay. The number of erythrocytes was determined by an automatic hematological analyzer. The assessment of erythrocytes morphology and echinocytes counting was performed by light microscopy with further cytophotometrical data processing. In the umbilical cord blood of newborns born from cytomegalovirus seropositive women with exacerbation of infection in the third trimester of pregnancy, there was found out an increase in the level of erythropoietin by 20% (p<0.05), the number of erythrocytes by 21% (p<0.01), of products reacting with thiobarbituric acid by 60% (p<0.001), of lysophosphatidylcholine by 42% (p<0.001), of arachidonic acid by 31% (p<0.001)<0.001), of ionized calcium by 14% (p<0.05), of the amount of echinocytes by 91% (p<0.001); with a decrease in the content of oleic and α-linolenic fatty acids by 40% (p<0.001), there was an increase in the ratio of fluorescence of excimers and monomers (Fe/Fm) by 30% (p<0.001), the number of red blood cells by 21% (p<0.01). The results obtained suggested in the newborns from seropositive women to cytomegalovirus with exacerbation of the infection in the third trimester of pregnancy the development of ineffective erythropoiesis, enhancing oxidative damage of red blood cells, leading to echinocytosis and eryptosis

scholarly journals The influence of nanosized iron particles on morphological parameters of blood and reproductive ability of sows in the third trimester of gestation

2021 ◽  
Vol 285 ◽  
pp. 04011
Author(s):  
Lydia Kashirina ◽  
Vitaly Kulakov ◽  
Elman Saitkhanov ◽  
Sergey Denikin
Keyword(s):  
Red Blood Cells ◽  
Iron Powder ◽  
Blood Cells ◽  
Hematological Parameters ◽  
Physiological State ◽  
Experimental Studies ◽  
Third Trimester ◽  
The Third ◽  
Reproductive Ability ◽  
Nanosized Iron

The article presents the results of experimental studies on the use of nanosized iron powder in the third trimester of gestation on the reproduction processes of sows. The studies were carried out in the conditions of the farm. The physiological state of pregnant sows was determined by hematological parameters. It was found that iron NRP contributed to an increase in the number of red blood cells and hemoglobin in the blood of sows, compared with the control 20 days before farrowing, the content of red blood cells in the blood of experimental sows was 6.3% significantly higher compared to the control, and hemoglobin by 3.8 %. For 10 days, before farrowing, respectively, by 6.9 % and 5.2% higher. The indicators that characterize the reproductive ability of sows are: multiplicity, large fertility, the number of piglets in the nest and their average live weight. The use of ultrafine iron powder in the diets of pregnant sows in the third trimester of gestation contributed to the improvement of the overall physiological state, confirmed by the improvement of hematological parameters and had a positive effect on reproductive ability. The weight of the nest in the experimental group of sows on the day of farrowing was 4.1 % higher, the large-fruiting rate was 3.1 %, compared to the control animals.

Endogenous Heparinoids Detected by anti-Xa Activity are Present in Blood during Acute Variceal Bleeding in Cirrhosis. A Prospective Study

2014 ◽  
Vol 23 (2) ◽  
pp. 187-194 ◽  
Author(s):  
Christos Triantos ◽  
Emmanuel Louvros ◽  
Maria Kalafateli ◽  
Anne Riddell ◽  
Ulrich Thalheimer ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Variceal Bleeding ◽  
Blood Cells ◽  
Venous Pressure ◽  
White Blood Cells ◽  
International Normalized Ratio ◽  
Ulcer Bleeding ◽  
Factor X ◽  
Packed Red Blood Cells ◽  
Bacterial Peritonitis

Background & Aims: Endogenous heparinoids have been detected by thromboelastography and quantified by clotting based anti-Xa activity assays in patients with cirrhosis, but their presence in variceal bleeding has not been established yet.Methods: Clotting based anti-Xa activity was measured in A) 30 cirrhotics with variceal bleeding, B) 15 noncirrhotics with peptic ulcer bleeding, C) 10 cirrhotics without infection or bleeding, and D) 10 cirrhotics with hepatocellular carcinoma (HCC).Results: Anti-Xa activity was not detected in ulcer bleeders or in cirrhotics without infection or bleedingbut was present in seven (23%) variceal bleeders (median levels: 0.03 u/mL (0.01-0.07)) and was quantifiable for 3 days in six of seven patients. Four of seven variceal bleeders with anti-Xa activity present had HCC (p=0.023). Age, creatinine, platelet count and total infections the second day from admission were significantly correlated with the presence of measureable anti-Xa levels (p=0.014, 0.032, 0.004 and 0.019, respectively). In the HCC group, anti-Xa activity was present in three patients (30%) [median levels: 0.05 u/mL (0.01-0.06)].Conclusions: In this study, variceal bleeders and 30% of the patients with HCC had endogenous heparinoids that were detected by a clotting based anti-Xa activity assay, whereas there was no anti Xa activity present in patients with cirrhosis without infection, or bleeding or HCC, nor in those with ulcer bleeding. Thus, the anti-Xa activity is likely to be a response to bacterial infection and/or presence of HCC in cirrhosis.List of abbreviations: AFP, alpha-fetoprotein; aPTT, activated partial thromboplastin time; CP, Child-Pugh; FXa, activated factor X; GAGS, glycosaminoglycans; Hb, hemoglobin; HCC, hepatocellular carcinoma; HVPG, hepatic venous pressure gradient; INR, International normalized ratio; LMWHs, low molecular weight heparins; MELD, Model for End-stage Liver Disease; PPP, platelet-poor plasma; PRBC, packed red blood cells; PT, prothrombin time; SBP, sponataneous bacterial peritonitis; TEG, thromboelastography; WBC, white blood cells.

Correlations Between the Values of Maternal Glycemia from the Last Trimester of Pregnancy and Fetal Birth Weight

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko
Keyword(s):  
First Trimester ◽  
Mean Value ◽  
Fetal Macrosomia ◽  
Entire Group ◽  
Third Trimester ◽  
The Third ◽  
Group I ◽  
Fetal Birth Weight ◽  
First Trimester Of Pregnancy ◽  
The Mean

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.

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.

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