scholarly journals Pulmonary TB in Pregnancy

2021 ◽  
Vol 5 (2) ◽  
pp. 301-308
Author(s):  
Nurmala Sari Dewi ◽  
Efriza Naldi
Keyword(s):  
High Protein Diet ◽  
Pregnant Patient ◽  
Serum Levels ◽  
X Rays ◽  
Laboratory Findings ◽  
Pulmonary Tb ◽  
Tb Treatment ◽  
History Of ◽  
Treatment Category ◽  
In Pregnancy

Objective : To report a case of pulmonary TB in pregnancyMethod : A case reportCase : Presented a case of cpulmonar TB in pregnancy on 33-year-old patient. This is fifth pregnancy with twice history of abortion, malnutrition and pulmonary TB (in treatment). The result of chest x-rays was pulmonary TB. The patient was on treatment for anti-tuberculosis drugs for second month. Patient had BMI was 16,88 kg/m2 which is underweight category. There were bronchovesicular and ronchi from both side of lung from auscultation examination. From laboratory findings there was decrease of albumin serum levels to 2,1 gr%. From ultrasound got impression 16-17 weeks of pregnancy. Patient got anti tuberculosis drugs treatment category I incentive phase (2HRZE). During hospitalization treatment, patient was given some nutrition consultation and high calories and high protein diet and also extra 3 egg whites per day. Total calories are 2250 kcal. Patient also got 1 infuse bottle of albumin and albumin supplementation.Discussion : The incidence of TB in pregnancy was 1/10,000 pregnancies. Provision of an appropriate and adequate chemotherapy regimen will improve the quality of life of the mother, reduce the side effects of anti-tuberculosis drugs (OAT) on the fetus and prevent infection in newborns. Patient got anti tuberculosis drugs treatment category I incentive phase (2HRZE) which is no difference theraphy with no-pregnant patient. Patient was not given pyridoxine as adjuvant drugs along with the anti- tuberculosis drugs. Pyridoxine supplementation must be given with the dose of 50 mg/day and is suggested for every pregnant woman who consumes isoniazid because the deficiency often happens in pregnancy than general population.Conclusion The diagnosis of this patient was correct based on anamnesis, physical examination, and supporting test . Active TB treatment in pregnancy doesn’t have any difference with non-pregnant. The management of this patient is not correct because the patient didn’t get pyridoxine supplementation, didn’t undergo sputum test in second month, and wasn’t done culture M. Tuberculosis as a gold standard.Keywords: tuberculosis, pulmonary TB, pregnancy, anti tuberculosis drugs, pyridoxine

scholarly journals A comparative study of the serum levels of antiphospholipid antibodies in hypertensive disorder of pregnancy and normotensive pregnancy

2017 ◽  
Vol 6 (2) ◽  
pp. 580
Author(s):  
Guljit Kaur ◽  
Sangeeta Pahwa ◽  
Amanbeer Kaur ◽  
Madhu Nagpal
Keyword(s):  
Antiphospholipid Antibodies ◽  
Serum Levels ◽  
Phosphatidyl Serine ◽  
Hypertensive Disorder ◽  
Blood Samples ◽  
Glycoprotein I ◽  
History Of ◽  
Hypertensive Disorder Of Pregnancy ◽  
Normotensive Pregnancy ◽  
In Pregnancy

Background: Antiphospholipid antibodies have been associated with a number of obstetric complications however their role in the pathogenesis of preeclampsia has remained uncertain Therefore, the utility of screening for antiphospholipid antibodies among women at risk for recurrent hypertensive disorder of pregnancy is still doubtful. This study is aimed to clarify relationship between hypertensive pregnancies and APLA.Methods: A prospective, randomized was conducted and, 120 patients after 20 weeks of gestation were studied. 60 patients had hypertensive disorder in pregnancy and 60 were normotensive. Blood samples were obtained from them under all asepsis, serum was separated and tested for Antiphospholipid antibodies (Anticardiolipin, anti beta 2 glycoprotein I, phosphatidyl -serine, -inositol, -ethanolamin, -choline and sphingomyelin and lupus anticoagulant), apart from other routine investigations using Aeskulsia Phospholipid-Screen-GM.Results: 4/60 and 3/60 hypertensive patients had raised IgM and IgG levels respectively. Their values came in equivocal range. 2 of the normotensive patients had equivocal range values of both IgM/IgG. Mean of IgM APLA in hypertensive and normotensive patients was 2.54 and 1.67 respectively and difference between these values was statistically non significant (p=0.081). Mean of APTT is similarly statistically non significant in two groups (p=0.817).Conclusions: No significant correlation between the hypertensive state in pregnancy and antiphospholipid antibodies, hence this test should not be recommended as a screening test in pregnancies and there was no need to assess these antibodies in the hypertensive cases of pregnancy without the history of thrombosis or autoimmune diseases.

scholarly journals When the Uterus Competes for Perfusion: Management of a Pregnant Patient with Bypass Graft Occlusion

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Sarah McGriff ◽  
Paige Percer ◽  
Iberia Sosa ◽  
Hector Mendez-Figueroa ◽  
Joseph L. Mills ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Bypass Graft ◽  
Pregnant Patient ◽  
Arterial Disease ◽  
Graft Occlusion ◽  
Left Lower Extremity ◽  
Ct Angiogram ◽  
History Of ◽  
Peripheral Arterial ◽  
In Pregnancy

Background. Peripheral arterial disease (PAD) in pregnancy has serious implications and requires multidisciplinary management. This becomes even more complicated in the setting of active disease and history of prior vascular grafts. Case. A woman presented with increasing left lower extremity pain at 18 weeks of gestation with a complex history of PAD and a previous bifurcated aorta-left femoral, -right iliac bypass. CT angiogram demonstrated known occluded bypass graft. A multidisciplinary team of providers developed guidelines for potential surgical intervention based upon clinical symptoms. Conclusion. Pelvic PAD can worsen in pregnancy in the setting of the enlarging uterus, which can potentially deplete perfusion of existing collateral vessels. Symptomatic approach to worsening disease provided an effective management strategy in this case.

scholarly journals Familial Tuberculosis Mimicking Advanced Ovarian Cancer

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Fakhrolmolouk Yassaee ◽  
Farah Farzaneh
Keyword(s):  
Family History ◽  
Positive Family History ◽  
Advanced Ovarian Cancer ◽  
Signs And Symptoms ◽  
Rapid Diagnosis ◽  
Ovarian Malignancy ◽  
Laboratory Findings ◽  
Pulmonary Tb ◽  
History Of ◽  
Mini Laparotomy

Genital TB may present as on abdominopelvic mass mimicking ovarian malignancy because clinical and laboratory findings are similar. Family history is very important and should be considered for differential diagnosis. Three cases of genital TB with presentation of abdominopelvic masses and with no signs and symptoms of TB were presented. Two of them had positive family history of pulmonary TB. Tissue diagnosis was the best method for diagnosis of genital TB, but it should be reminded that if positive family history of TB was present, mini laparotomy should be done to take biopsy and to make rapid diagnosis before treatment.

scholarly journals Unilateral Pulmonary Artery Aplasia in a Pregnant Patient

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Chitra Lal ◽  
Jim Barker ◽  
Charlie Strange
Keyword(s):  
Pulmonary Hypertension ◽  
Chest Pain ◽  
Pulmonary Artery ◽  
Case Reports ◽  
Pregnant Patient ◽  
Pregnant Female ◽  
Prospective Evaluation ◽  
Rare Anomaly ◽  
History Of ◽  
In Pregnancy

Unilateral pulmonary artery aplasia is a rare anomaly. Case reports of this condition in pregnant patients are even more uncommon and the best approach to management of such patients is still unclear. We report a patient who presented with a history of dyspnea, chest pain, and hemoptysis. Imaging established the diagnosis in a newly pregnant female. Management of the pulmonary artery aplasia patient in pregnancy requires prospective evaluation of pulmonary hypertension.

scholarly journals A Case of Babesiosis in a Pregnant Patient Treated with Red Blood Cell Exchange Transfusion

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Baruch Abittan ◽  
Aaron Nizam ◽  
Michael Oey ◽  
Felicia Callan ◽  
Lisa Simmonds ◽  
...  
Keyword(s):  
United States ◽  
Blood Cell ◽  
Gestational Age ◽  
Red Blood Cell ◽  
Exchange Transfusion ◽  
Pregnant Patient ◽  
Babesia Microti ◽  
History Of ◽  
Safe Treatment Option ◽  
In Pregnancy

Babesiosis, caused predominantly by Babesia microti, is an emerging health risk in the Northeastern and Midwestern United States. We present a case of a pregnant woman with history of splenectomy diagnosed with babesiosis at 23 5/7 weeks of gestational age refractory to antimicrobial therapy. She underwent the first reported red blood cell exchange transfusion for babesiosis in pregnancy, at 24 4/7 weeks of gestational age, which resulted in resolution of parasitemia. She had a full term, uncomplicated cesarean delivery. Exchange transfusion is potentially a safe treatment option for severe babesiosis infection in pregnancy and should be considered when other methods are poorly tolerated or ineffective.

scholarly journals Successful use of CPAP in a pregnant patient with COVID-19 pneumonia

2021 ◽  
Vol 14 (3) ◽  
pp. e238055
Author(s):  
Maxine Reindorf ◽  
Joseph Newman ◽  
Tejas Ingle
Keyword(s):  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Pregnant Patient ◽  
Shortness Of Breath ◽  
Short History ◽  
Trial Treatment ◽  
History Of ◽  
Robust Evidence ◽  
In Pregnancy

A 35-year-old nurse, who was 27 weeks pregnant at the time, was admitted to hospital with a short history of cough, fever and worsening shortness of breath. Oral and nasopharyngeal swabs were positive for SARS-CoV-2 on real-time viral PCR. During her admission, her breathing further deteriorated and she developed type 1 respiratory failure. A decision was made to trial treatment with continuous positive airway pressure (CPAP) as a means of avoiding intubation. The patient tolerated this well and made rapid improvements on this therapy. She was quickly weaned off and fully recovered before being discharged home. This case highlights the potential for CPAP to be used as a means of avoiding mechanical ventilation and iatrogenic preterm birth in COVID-19 pneumonia in pregnancy. Furthermore, it highlights the need for robust evidence to support this treatment.

scholarly journals Immunological recovery in patients with pulmonary tuberculosis after intensive phase treatment

2018 ◽  
Vol 46 (9) ◽  
pp. 3539-3551
Author(s):  
Xuejiao Luo ◽  
Furong Wu ◽  
Jun Ma ◽  
Heping Xiao ◽  
Haiyan Cui
Keyword(s):  
Interleukin 2 ◽  
Serum Levels ◽  
Sputum Smear ◽  
Intensive Phase ◽  
Pulmonary Tb ◽  
Immune Parameters ◽  
Tb Treatment ◽  
Soluble Interleukin 2 Receptor ◽  
Immunological Recovery ◽  
Factor Α

Objectives This study aimed to examine the change and significance of immune parameters in patients with sputum smear-positive pulmonary tuberculosis (TB) after 2 months of intensive phase anti-TB treatment. Methods The immune parameters of 232 cases of sputum smear-positive pulmonary TB were detected before and after 2 months of intensive phase anti-TB treatment and compared with 50 cases from healthy volunteers (controls). The T lymphocyte cell population in peripheral blood was detected using flow cytometry. Serum levels of interleukin (IL)-1β, soluble interleukin-2 receptor, IL-6, and tumour necrosis factor-α were measured by ELISA. Results After 2 months of intensive phase anti-TB treatment, a reduction in the percentage of CD4+ T cells showed a significant restoration similar to that of controls. Moreover, after intensive anti-TB treatment, serum levels of IL-1β, soluble interleukin-2 receptor, IL-6, and tumour necrosis factor-α were significantly decreased compared with before treatment. Additionally, serum levels of IL-1β and IL-6 showed a diminished recovery compared with controls. Conclusions Our findings suggest immunological recovery in patients with pulmonary TB after intensive phase treatment. Therefore, serum cytokine levels are considered potential host biomarkers for monitoring the response of treatment for pulmonary TB.

Thromboembolic disorders in pregnancy

2016 ◽  
Author(s):  
Salma Ballal ◽  
Ian A. Greer
Keyword(s):  
Risk Factors ◽  
Low Molecular Weight Heparin ◽  
Pregnant Patient ◽  
Western World ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
History Of ◽  
Problem Awareness ◽  
Deep Vein ◽  
In Pregnancy

Thromboembolism in pregnancy remains a major cause of direct maternal mortality in the Western world. Thromboembolic events in pregnancy are spread across the three trimesters but the puerperium is the time of greatest risk with a relative risk of around 20-fold compared to the non-pregnant patient. When compared to the non-pregnant population where distal deep vein thrombosis is most common, most events in pregnancy are iliofemoral and left sided. Given the multi-hit nature of the problem, awareness of risk factors is important. The two most significant single risk factors in pregnancy for thromboembolism are history of previous venous thromboembolism and thrombophilia. The identification of risk factors will guide the use of thromboprophylaxis and assist diagnosis; however, objective diagnosis is required. Prophylaxis and treatment focuses on low-molecular-weight heparin, which is considered safe in pregnancy.

Hypercalcemia-Induced Pancreatitis in Pregnancy Following Calcium Carbonate Ingestion

2017 ◽  
Vol 32 (2) ◽  
pp. 225-227 ◽  
Author(s):  
May S. Trezevant ◽  
John C. Winton ◽  
Ashley K. Holmes
Keyword(s):  
Abdominal Pain ◽  
Calcium Carbonate ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Pregnant Patient ◽  
Abdominal Ultrasound ◽  
Laboratory Findings ◽  
Emergency Cesarean ◽  
Intravenous Fluid Administration ◽  
In Pregnancy

Background: Calcium carbonate is often used to relieve Gastroesophageal Reflux Disease (GERD) in pregnant patients. This report describes a potentially serious complication. Case: A pregnant female presented at 34 weeks gestation with abdominal pain, nausea, and vomiting. Home medications included an unquantifiable amount of calcium carbonate 500 mg due to constant consumption for GERD. Laboratory findings included elevated calcium, amylase, lipase, and triglyceride level. Pancreatitis was diagnosed and abdominal ultrasound excluded gallstones. Despite hydration, lipase rose and emergency cesarean section was performed. Hypercalcemia was managed by intravenous fluid administration. After delivery, pancreatitis resolved. Conclusion: Pancreatitis developed in pregnant patient with hypercalcemia due to excessive calcium carbonate ingestion and resolved after delivery of the fetus, fluid resuscitation, and return of calcium level to normal.

Successful Treatment of Vancomycin-Resistant Enterococcus Faecium Pyelonephritis with Daptomycin During Pregnancy

2008 ◽  
Vol 42 (5) ◽  
pp. 722-725 ◽  
Author(s):  
Katherine Shea ◽  
Esther Hilburger ◽  
Allison Baroco ◽  
Edward Oldfield
Keyword(s):  
Successful Treatment ◽  
Enterococcus Faecium ◽  
Pregnant Patient ◽  
Multidrug Resistant ◽  
Successful Outcome ◽  
History Of ◽  
Vancomycin Resistant ◽  
Tract Infections ◽  
In Pregnancy ◽  
Lower Urinary

Objective: To report successful treatment using daptomycin for pyelonephritis associated with van cornycin-resistant Enterococcus faecium (VRE) in a 27-week pregnant woman. Case Summary: A 20-year-old 27-week pregnant patient with a history of spina bifida, neurogenic bladder, and multiple hospitalizations for recurrent urinary tract infections (UTIs) was diagnosed with pyelonephritis. She was treated with daptomycin 260 mg (4 mg/kg) daily for 14 days on the basis of a urine culture that revealed E. faecium resistant to ampicillin, nitrofurantoin, and vancomycin. All cultures following treatment revealed no growth, and the patient as well as the neonate displayed no adverse effects. Discussion: VRE UTIs can be treated safely in pregnancy with nitrofurantoin, if the organism is susceptible. Other viable options in the treatment of VRE, including linezolid, doxycycline, and quinupristin/dalfopristin, have lower urinary concentrations, teratogenic risk, or limited findings regarding their safety in pregnancy. Daptomycin was selected in this case due to its efficacy in the treatment of VRE, high urinary concentrations, pregnancy category B, and one case report indicating its successful use in pregnancy. Conclusions: Treatment of VRE in pregnancy can be challenging due to the teratogenicity or unknown safety of available options. The use of daptomycin in our patient enabted a successful outcome of multidrug-resistant E. faecium in a complicated pregnant patient without observed neonatal abnormalities.

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