scholarly journals Acute abdomen in pregnancy: a case series on clinical presentation and diagnostic dilemma

2021 ◽  
Vol 10 (2) ◽  
pp. 742
Author(s):  
G. R. Abhirami ◽  
Chennaiahgari Sathyavani ◽  
Ravi N. Patil
Keyword(s):  
Pregnant Women ◽  
Acute Abdomen ◽  
Clinical Presentation ◽  
Case Series ◽  
Diagnostic Dilemma ◽  
Pain Abdomen ◽  
Fetal Complications ◽  
Magnetic Resonance Imaging Mri ◽  
Challenging Situation ◽  
In Pregnancy

Acute abdomen in pregnancy remains one of the most challenging situation in regard with the diagnosis and management. Pregnancy is a unique state in which the female body undergoes both anatomical and physiological changes which can pose a challenge in diagnosis. This may result in delay in management and increase in maternal and fetal morbidity and mortality. This study was to identify the spectrum of causes, the clinical presentation and diagnostic dilemma of acute abdomen in pregnancy. It was an observational study was done over a period of 3 years which included all the pregnant women who presented with acute abdomen. In this study, eighteen pregnant women presented with acute abdomen. Among the study group, 5.5%, 50% and 44.5% presented in first, second and third trimester respectively. The diagnosis included acute appendicitis in 11.1%, acute cholecystitis in 16.6%, acute pancreatitis in 16.6%, malrotation in 11.1%, uterine rupture 11.1%, rudimentary horn rupture in 22.4% and ovarian cyst torsion in 11.1%. The clinical presentation included pain abdomen (16.6%), pain abdomen and vomiting (44.4%), pain abdomen in shock (39%) and abdominal tenderness (33.3%). The diagnosis was confirmed with ultrasonography in 55.6%, 11.1% women required higher imaging like magnetic resonance imaging (MRI) and 33.3% women were diagnosed on table. Majority of them had good outcome, but there was one maternal mortality (6%). Diagnosis and treatment of acute abdomen in pregnancy should be individualized. Good clinical acumen is essential for ordering early diagnostic test in acute abdomen in pregnancy. Appropriate intervention should be undertaken at the earliest to reduce the maternal and fetal complications. 

Approach to dyspnoea in pregnancy in the COVID-19 era

2020 ◽  
Vol 19 (4) ◽  
pp. 230-234
Author(s):  
Anita Banerjee ◽  
◽  
Lindsay A Arrandale ◽  
Srividhya Sankaran ◽  
Guy W Glover ◽  
...  
Keyword(s):  
Decision Making ◽  
Pregnant Women ◽  
Correct Diagnosis ◽  
Case Series ◽  
Differential Diagnoses ◽  
Shared Decision ◽  
First Case ◽  
Compromise Design ◽  
A Current ◽  
In Pregnancy

Importance: Dyspnoea and hypoxia in pregnant women during the COVID-19 pandemic may be due to causes other than SARS Co-V-2 infection which should not be ignored. Shared decision-making regarding early delivery is paramount. Objective: To highlight and discuss the differential diagnoses of dyspnoea and hypoxia in pregnant women and to discuss the risks versus benefit of delivery for maternal compromise. Design, setting and participants: Case series of two pregnant women who presented with dyspnoea and hypoxia during the COVID-19 pandemic. Results: Two pregnant women presented with dyspnoea and hypoxia. The first case had COVID-19 infection in the 3rd trimester. The second case had an exacerbation of asthma without concurrent COVID-19. Only the first case required intubation and delivery. Both recovered and were discharged home. Conclusion and relevance: Our two cases highlight the importance of making the correct diagnosis and timely decision-making to consider if delivery for maternal compromise is warranted. Whilst COVID-19 is a current healthcare concern other differential diagnoses must still be considered when pregnant women present with dyspnoea and hypoxia.

scholarly journals Chikungunya neonatal: A neglected disease

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Suyen Heizer Villela ◽  
◽  
Giuliana Villela Pereira ◽  
Maria Elisabeth Lopes Moreira ◽  
◽  
...  
Keyword(s):  
Virus Infection ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Clinical Assessment ◽  
Chikungunya Virus ◽  
Clinical Presentation ◽  
Case Series ◽  
Significant Morbidity ◽  
Case Series Report ◽  
Series Report

Chikungunya virus infection is an emerging arbovirus with a global distribution that can cause significant morbidity and also death in infected fetuses and neonates. Unfortunately, there is still lack of data about the incidence of Chikungunya in pregnant women and the consequences for their fetus. This is a case series report including clinical presentation, images and clinical assessment. Keywords: Chikungunya; neonatal; vertical transmission.

scholarly journals COVID-19 OUTCOMES IN PREGNANCY: A REVIEW OF 275 SCREENED STUDIES

2021 ◽  
Author(s):  
Rupalakshmi Vijayan ◽  
Hanna Moon ◽  
Jasmine Joseph ◽  
Madiha Zaidi ◽  
Chhaya Kamwal ◽  
...  
Keyword(s):  
Literature Review ◽  
Pregnant Women ◽  
Direct Evidence ◽  
Case Series ◽  
Adverse Outcomes ◽  
Morbidity And Mortality ◽  
World Health ◽  
Increased Risk ◽  
Immunological Changes ◽  
In Pregnancy

In December 2019, a novel strain of severe acute respiratory syndrome (SARS-CoV-2), was declared as a cause of respiratory illness, called coronavirus 2019 (COVID-19), characterized by fever and cough. In diagnostic imaging, the afflicted population showed pathognomonic findings of pneumonia. What started out as an epidemic in China, rapidly spread across geographical locations with a significant daily increase in the number of affected cases. According to the World Health Organization (WHO) reports, the range of worldwide mortality is 3 to 4%. Maternal adaptations and immunological changes predispose pregnant women to a prolonged and severe form of pneumonia, which results in higher rates of maternal, fetal, and neonatal morbidity and mortality. There is limited data about the consequences of COVID-19 in pregnancy, thereby limiting the prevention, counseling, and management of these patients. The objective of this literature review is to explore pregnancy and perinatal outcomes of COVID-19, complications, morbidity, and mortality in this sub-population. We conducted a literature review pertaining to COVID-19 and pregnancy in databases such as: PubMed, Google Scholar, and Science Direct. The studies we chose to focus on were systematic reviews, meta-analysis, case series, and case reports. Twenty four articles were reviewed regarding COVID-19 and pregnancy, complications and their outcomes. Due to immunological changes during pregnancy as evidenced by the flaring of auto-immune diseases; pregnant women may be at an increased risk for infection. Women (19.7%) who had underlying comorbidities such as gestational DM, HTN, hypothyroidism, and autoimmune disease, COPD, or HBV infection were considered high risk. The most common maternal outcomes were premature rupture of membranes (PROM) and pre-eclampsia. Asthma was the most common comorbidity associated with maternal mortality. The most common neonatal complications were fetal distress leading to NICU admissions and preterm birth <37 weeks. The most common laboratory changes were elevated CRP and lymphocytopenia. Most patients underwent C-section due to their underlying comorbidities. Pregnant and lactating women did not shed viral particles through their vaginal mucus and milk, as evidenced by negative nucleic-acid tests of these secretions. Neonatal infections as demonstrated by positive RT-PCR were rare, but direct evidence supporting intrauterine transmission was not confirmed. Direct evidence indicating vertical transmission of COVID-19 is not available, but risk for transmission cannot be ruled out. Pregnant women should be closely monitored due to increased risk of adverse outcomes.

scholarly journals Visceral Leishmaniasis in pregnancy and vertical transmission: A systematic literature review on the therapeutic orphans

2021 ◽  
Vol 15 (8) ◽  
pp. e0009650
Author(s):  
Prabin Dahal ◽  
Sauman Singh-Phulgenda ◽  
Brittany J. Maguire ◽  
Eli Harriss ◽  
Koert Ritmeijer ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Pregnant Women ◽  
Amphotericin B ◽  
Vertical Transmission ◽  
Liposomal Amphotericin ◽  
Case Reports ◽  
Case Series ◽  
Liposomal Amphotericin B ◽  
Cochrane Central Register ◽  
In Pregnancy

Background Reports on the occurrence and outcome of Visceral Leishmaniasis (VL) in pregnant women is rare in published literature. The occurrence of VL in pregnancy is not systematically captured and cases are rarely followed-up to detect consequences of infection and treatment on the mother and foetus. Methods A review of all published literature was undertaken to identify cases of VL infections among pregnant women by searching the following database: Ovid MEDLINE; Ovid Embase; Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials; World Health Organization Global Index Medicus: LILACS (Americas); IMSEAR (South-East Asia); IMEMR (Eastern Mediterranean); WPRIM (Western Pacific); ClinicalTrials.gov; and the WHO International Clinical Trials Registry Platform. Selection criteria included any clinical reports describing the disease in pregnancy or vertical transmission of the disease in humans. Articles meeting pre-specified inclusion criteria and non-primary research articles such as textbook, chapters, letters, retrospective case description, or reports of accidental inclusion in trials were also considered. Results The systematic literature search identified 272 unique articles of which 54 records were included in this review; a further 18 records were identified from additional search of the references of the included studies or from personal communication leading to a total of 72 records (71 case reports/case series; 1 retrospective cohort study; 1926–2020) describing 451 cases of VL in pregnant women. The disease was detected during pregnancy in 398 (88.2%), retrospectively confirmed after giving birth in 52 (11.5%), and the time of identification was not clear in 1 (0.2%). Of the 398 mothers whose infection was identified during pregnancy, 346 (86.9%) received a treatment, 3 (0.8%) were untreated, and the treatment status was not clear in the remaining 49 (12.3%). Of 346 mothers, Liposomal amphotericin B (L-AmB) was administered in 202 (58.4%) and pentavalent antimony (PA) in 93 (26.9%). Outcomes were reported in 176 mothers treated with L-AmB with 4 (2.3%) reports of maternal deaths, 5 (2.8%) miscarriages, and 2 (1.1%) foetal death/stillbirth. For PA, outcomes were reported in 88 mothers of whom 4 (4.5%) died, 24 (27.3%) had spontaneous abortion, 2 (2.3%) had miscarriages. A total of 26 cases of confirmed, probable or suspected cases of vertical transmission were identified with a median detection time of 6 months (range: 0–18 months). Conclusions Outcomes of VL treatment during pregnancy is rarely reported and under-researched. The reported articles were mainly case reports and case series and the reported information was often incomplete. From the studies identified, it is difficult to derive a generalisable information on outcomes for mothers and babies, although reported data favours the usage of liposomal amphotericin B for the treatment of VL in pregnant women.

scholarly journals Uterine Torsion Masquerading as Abruptio Placentae: Diagnosed on Laparotomy

2020 ◽  
Author(s):  
Niranjan Mayadeo ◽  
Anusha Devalla
Keyword(s):  
Caesarean Section ◽  
Acute Abdomen ◽  
Postoperative Period ◽  
Clinical Presentation ◽  
Diagnostic Dilemma ◽  
Abruptio Placentae ◽  
Obstetric Emergency ◽  
Uterine Torsion ◽  
Life Threatening ◽  
The Right

Uterine torsion is a rare, life-threatening and unexpected obstetric emergency. It is almost always diagnosed at caesarean section. Its ill-defined clinical presentation may pose a diagnostic dilemma. Here the authors present a case of 32-year-old, Primigravida, 36 weeks pregnancy with acute abdomen and intrauterine foetal demise. Clinical features resembled Abruptio Placentae. The diagnosis of uterine torsion (180°) was established on laparotomy where the left ovarian ligament was seen on the right side anteriorly. A posterior hysterotomy was done to extract the baby which was followed by detorsion of the uterus. The postoperative period was uneventful.

scholarly journals Laparoscopic surgery for non-obstetric acute abdomen in pregnancy: A retrospective case series review

2020 ◽  
Vol 16 (1) ◽  
pp. 54
Author(s):  
SameerAshok Rege ◽  
Chiranjeev Roshan ◽  
Vairagar Siddhant ◽  
Surpam Shrinivas ◽  
Rewatkar Ajinkya
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Abdomen ◽  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
In Pregnancy

scholarly journals Acute abdomen in a term pregnancy due to isolated tubal torsion

2020 ◽  
Vol 28 (3) ◽  
pp. 217-220
Author(s):  
Güneş Topçu ◽  
Yağmur Şimşek ◽  
Şenay Çetin ◽  
Murat Muhçu ◽  
Ayşegül Özel
Keyword(s):  
Acute Abdomen ◽  
Surgical Intervention ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
Mri Findings ◽  
Obstetric Morbidity ◽  
Magnetic Resonance Imaging Mri ◽  
Early Surgical Intervention ◽  
In Pregnancy

Objective: Isolated tubal torsion in pregnancy is a rare condition we want to present this case. Case(s): In our study, we present a 23-year-old woman primigravida at 37 weeks of gestation with acute right lower abdominal pain. The clinical and Magnetic resonance imaging (MRI) findings led to diagnosis of acute appendicitis. Emergency exploratory laparotomy and cesarean section were performed. A twisted right Fallopian tube and Morgagni’s cyst was noted and right salpingectomy was performed. Conclusion: Although isolated tubal torsion during pregnancy is very rare, it should be included in the differential diagnosis of acute abdomen in pregnancy. Early surgical intervention will decrease obstetric morbidity.

scholarly journals Compassionate use of remdesivir in pregnancy: a case series

2021 ◽  
Vol 10 (10) ◽  
pp. 3950
Author(s):  
Jui R. Shah ◽  
Khushali P. Parikh ◽  
Aayushi A. Suthar ◽  
Sushma R. Shah ◽  
Supriya D. Malhotra
Keyword(s):  
Pregnant Women ◽  
Birth Defects ◽  
Treatment Options ◽  
Antiviral Drug ◽  
Case Series ◽  
Fetal Outcome ◽  
Limited Data ◽  
Compassionate Use ◽  
Healthcare Crisis ◽  
In Pregnancy

Coronavirus disease 2019 (COVID-19) has resulted in an unprecedented global healthcare crisis. One special population that poses a challenge is pregnant women with COVID-19. However, there is limited data on treatment options for severe coronavirus disease in pregnancy. Remdesivir, an antiviral drug, is currently being studied as a potential treatment of COVID-19 pneumonia. Nevertheless, pregnant women are also being excluded from various clinical trials for the disease. There are some studies mentioned in the literature which have shown no adverse effects of remdesivir during pregnancy. In this study, we present four serial cases of COVID-19 in pregnant women with moderate to severe symptoms who were treated with remdesivir. All of the them showed positive fetal outcome without any birth defects or malformations. However, further studies are necessary to evaluate the biosafety and effects of remdesivir in pregnant women.

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.

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