scholarly journals Thyroid Crisis and Septic Suspected Sepsis in the First Trimester of Pregnancy

2020 ◽  
Vol 26 (3) ◽  
Author(s):  
Mahmudah Hidayati ◽  
Banundari Rachmawati
Keyword(s):  
First Trimester ◽  
Normal Pregnancy ◽  
Final Diagnosis ◽  
Graves Disease ◽  
Hormonal Changes ◽  
Suspected Sepsis ◽  
Thyroid Crisis ◽  
Urine Examination ◽  
First Trimester Of Pregnancy ◽  
Thyroid Receptor

A normal pregnancy with physiological and hormonal changes can change thyroid function, accordingly, there are difficulties to establish the diagnosis of thyroid abnormality. The prevalence of hyperthyroidism in pregnancy is 0.6%. Approximately 1-2% of hyperthyroidism develops into a thyroid crisis. Knowledge of the diagnosis of the thyroid crisis in a pregnant female is very important to avoid complications. The 22-year-old female of thirteen weeks presented with vomiting, since two days before hospitalized, weakness, and decreased consciousness. During treatment, patients had diarrhea, melena, and was irritable. Physical examination showed blood pressure of 136/112 mmHg, pulse of 110 times/minute, respiration of 24 times/minute, and temperature of 38.3oC. Exophthalmos was found at the patient's eyes, but there was no enlargement of the thyroid and the patient often screamed hysterically. Routine urine examination showed proteinuria 1+, blood 3+, leukocytes 1+ in urinalysis, FT4 35.18 pmol/L and TSH <0.05 uIU/mL, leukocytes 15.2 x103/uL, SGOT 245 U/L, SGPT 366 U/L. The final diagnosis of this patient is a thyroid crisis and suspect sepsis in the first trimester of pregnancy. Thyroid Receptor Antibody (TRAb) examination should be performed to assure Graves disease or hyperthyroidism due to pregnancy (transient hyperthyroidism) as the cause.

scholarly journals Treatment of Graves' Disease with Antithyroid Drugs in the First Trimester of Pregnancy and the Prevalence of Congenital Malformation

2012 ◽  
Vol 97 (7) ◽  
pp. 2396-2403 ◽  
Author(s):  
Ai Yoshihara ◽  
JaedukYoshimura Noh ◽  
Takuhiro Yamaguchi ◽  
Hidemi Ohye ◽  
Shiori Sato ◽  
...  
Keyword(s):  
Congenital Malformation ◽  
First Trimester ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
First Trimester Of Pregnancy

scholarly journals Blunted erythropoietin production and decreased erythropoiesis in early pregnancy [see comments]

Blood ◽  
1991 ◽  
Vol 78 (1) ◽  
pp. 89-93
Author(s):  
Y Beguin ◽  
G Lipscei ◽  
H Thoumsin ◽  
G Fillet
Keyword(s):  
Early Pregnancy ◽  
Cell Mass ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Entire Group ◽  
Third Trimester ◽  
Serum Transferrin Receptor ◽  
Erythropoietin Production ◽  
Early Postpartum ◽  
First Trimester Of Pregnancy

After decreasing in the first trimester of pregnancy, the total red blood cell mass increases in the second and third trimesters to peak at term at about 120% to 125% of nonpregnant values, but how this is brought about by changes in the rate of erythropoiesis is not known. We evaluated erythropoiesis by measuring serum transferrin receptor (TfR) levels in 406 women during normal pregnancy (N = 317), at delivery (N = 63), or in the early postpartum (N = 27). Despite the presence of the placenta and the frequent occurrence of iron deficiency, TfR levels remained low in the first two trimesters and increased in the third trimester and at delivery. To explain why erythropoiesic activity was relatively low in early pregnancy, we also measured serum immunoreactive erythropoietin (Epo) in relation to the degree of anemia. There was a very strong correlation between serum TfR and Epo levels in the entire group (r = .59, P less than .0001) as well as in each period of pregnancy. Epo levels remained low for the degree of anemia and did not correlate with hematocrit in the first two trimesters, but recovered afterwards. In the early postpartum, Epo production and erythropoiesis were normal. We conclude that: (1) erythropoiesis is decreased in the first part of pregnancy but increases afterwards; and (2) blunted Epo production in early pregnancy could be responsible for that observation.

scholarly journals Exposure to Propylthiouracil in the First Trimester of Pregnancy and Birth Defects: A Study at a Single Institution

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Ai Yoshihara ◽  
Jaeduk Yoshimura Noh ◽  
Natsuko Watanabe ◽  
Miho Fukushita ◽  
Masako Matsumoto ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Birth Defects ◽  
Antithyroid Drug ◽  
First Trimester ◽  
Control Group ◽  
Graves Disease ◽  
Increased Risk ◽  
Group A ◽  
First Trimester Of Pregnancy ◽  
Maternal Thyroid

Abstract Context Medical treatment of Graves disease during the first trimester has been the subject of controversy ever since treatment with an antithyroid drug during the first trimester was reported to possibly be associated with an increased risk of birth defects in newborns. Objective We investigated whether the incidence of birth defects among newborns born to mothers with Graves disease (GD) treated with propylthiouracil (PTU) during the first trimester of pregnancy was higher than in a control group that was not exposed to any medication. Methods We reviewed the cases of 1913 women with GD who gave birth between January 1, 2015, and May 31, 2019. Detailed information concerning the outcome of pregnancy and the presence of birth defects was collected at the first visit after the delivery and again 1 year after delivery. We classified the mothers and infants into 3 groups according to the treatment the mother had received for GD in the first trimester of pregnancy: a group in which the mothers had been treated with PTU alone (PTU group), a group in which the mothers had not been treated with any medication (control group), and a group in which the mothers had received some other medical treatment, such as thiamazole, potassium iodide, or 2 or more drugs (other treatment group). Results The incidence of malformed infant births was 5.5% (30/541 infants) in the PTU group and 5.7% (27/ 475 infants) in the control group. There were no specific birth defects in the PTU group, and there were no significant differences between PTU dosages or maternal thyroid function according to whether mothers had delivered a child with a birth defect. Conclusion The results of our retrospective study showed that treatment with PTU during the first trimester of pregnancy did not increase the incidence of birth defects among newborns.

Plasma kisspeptin is raised in patients with gestational trophoblastic neoplasia and falls during treatment

2006 ◽  
Vol 291 (5) ◽  
pp. E878-E884 ◽  
Author(s):  
Waljit S. Dhillo ◽  
Philip Savage ◽  
Kevin G. Murphy ◽  
Owais B. Chaudhri ◽  
Michael Patterson ◽  
...  
Keyword(s):  
Reproductive Development ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Gestational Trophoblastic Neoplasia ◽  
Third Trimester ◽  
Blood Samples ◽  
Amino Acid Peptide ◽  
The Third ◽  
First Trimester Of Pregnancy ◽  
G Protein Coupled

Kisspeptin is a 54-amino acid peptide, encoded by the anti-metastasis gene KiSS-1, that activates G protein-coupled receptor 54 (GPR54). The kisspeptin-GPR54 system is critical to normal reproductive development. KiSS-1 gene expression is increased in the human placenta in normal and molar pregnancies. Circulating kisspeptin is dramatically increased in normal pregnancy, but levels in GTN have not previously been reported. The present study was designed to determine whether plasma kisspeptin levels are altered in patients with malignant GTN. Thirty-nine blood samples were taken from 11 patients with malignant GTN at presentation during and after chemotherapy. Blood was also sampled from nonpregnant and pregnant volunteers. Plasma kisspeptin IR and hCG concentrations were measured. Plasma kisspeptin IR concentration in nonpregnant ( n = 16) females was <2 pmol/l. Plasma kisspeptin IR in females was 803 ± 125 pmol/l in the first trimester of pregnancy ( n = 13), 2,483 ± 302 pmol/l in the third trimester of pregnancy ( n = 7), and <2 pmol/l on day 15 postpartum ( n = 7). Plasma kisspeptin IR and hCG concentrations in patients with malignant GTN were elevated at presentation and fell during and after treatment with chemotherapy in each patient (mean plasma kisspeptin IR: prechemotherapy 1,363 ± 1,076 pmol/l vs. post-chemotherapy <2 pmol/l, P < 0.0001; mean plasma hCG: prechemotherapy 227,191 ± 152,354 U/l vs. postchemotherapy 2 U/l, P < 0.0001). Plasma kisspeptin IR strongly positively correlated with plasma hCG levels ( r2= 0.99, P < 0.0001). Our results suggest that measurement of plasma kisspeptin IR may be a novel tumor marker in patients with malignant GTN.

Hormonal changes and somatopsychologic manifestations in the first trimester of pregnancy and post partum

2009 ◽  
Vol 105 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Fenling Fan ◽  
Yuliang Zou ◽  
Aiqun Ma ◽  
Yafei Yue ◽  
Wenjun Mao ◽  
...  
Keyword(s):  
Post Partum ◽  
First Trimester ◽  
Hormonal Changes ◽  
First Trimester Of Pregnancy

scholarly journals A Case of Intertwin Membrane Hemorrhage with Spontaneous Resolution

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Lily Criscione ◽  
Kristen Elmezzi ◽  
Saioa Torrealday ◽  
Barton C. Staat ◽  
Kimberly Hickey
Keyword(s):  
Vaginal Bleeding ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Final Diagnosis ◽  
Spontaneous Resolution ◽  
Multiple Gestation ◽  
Spontaneous Abortions ◽  
Third Trimester ◽  
The Third ◽  
Increased Risk

Vaginal bleeding during pregnancy places women at increased risk of spontaneous abortion. Etiologies for threatened and spontaneous abortions have been well studied, but there is little information on intertwin membrane hemorrhage. We present a patient with a multiple gestation pregnancy who experienced first trimester vaginal bleeding with visualization and subsequent rapid resolution of an intertwin membrane hemorrhage. The patient had an otherwise normal pregnancy until the third trimester when she developed preeclampsia with severe features and elected for a primary cesarean section at 35 + 5 weeks. The implications of an intertwin membrane hemorrhage are not well understood, although there could be a possible correlation between the hemorrhage and the ultimate progression to preeclampsia with severe features. Despite the final diagnosis, the patient did not have any noticeable complications due to the hemorrhage both when it was discovered and in the weeks following its discovery.

scholarly journals Concentrations of vitamins A and E in amniotic fluid, extraembryonic coelomic fluid, and maternal serum in the first trimester of pregnancy.

1994 ◽  
Vol 71 (1) ◽  
pp. F49-F50 ◽  
Author(s):  
J Campbell ◽  
N C Wathen ◽  
I Merryweather ◽  
R Abbott ◽  
D Muller ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
High Performance ◽  
Transvaginal Ultrasound ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Maternal Serum ◽  
Coelomic Fluid ◽  
Cholesterol Ratio ◽  
Paired Samples ◽  
First Trimester Of Pregnancy

Paired samples of amniotic fluid and coelomic fluid were obtained by transvaginal ultrasound guided amniocentesis from 15 women with an ultrasonographically normal pregnancy between 8 and 12 weeks' gestation. Vitamins A and E were measured in the two pregnancy fluids and in maternal serum by high performance liquid chromatography with detection by ultraviolet absorption and fluorimetry respectively. Concentrations of vitamins A and E were higher in maternal serum than in coelomic fluid and were generally undetectable in amniotic fluid. All differences in concentration were significant. The vitamin E/cholesterol ratio was similar in maternal serum and coelomic fluid. No correlation was shown between the vitamin concentrations in the three fluids. These findings suggest that the coelomic cavity plays a part in the maternofetal exchange of these vitamins.

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