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 P.093 Thorascopic assisted resection of dumbbell nerve sheath tumors

2017 ◽  
Vol 44 (S2) ◽  
pp. S37-S37
Author(s):  
S Sharma ◽  
R Power ◽  
K Reddy
Keyword(s):  
Length Of Stay ◽  
Case Series ◽  
Tumor Location ◽  
Neurologic Deficit ◽  
Complication Rates ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Patient Reported ◽  
Vertebral Bodies ◽  
Traditional Approaches

Background: Surgery to remove dumbbell nerve sheath tumors (NST) is complex, and is accompanied by significant operative and perioperative challenges. Historically, resection of dumbbell NST required large operations involving opening the chest and laminectomy, often accompanied by instrumentation. We describe a case series of 5 patients who underwent single stage thorascopic-guided resection of dumbbell schwannoma at our institution. Methods: 5 cases presented consisted of moderate to large NST, which contained intraforaminal components. Tumor location ranged from T3-T9, with most tumors spanning 2-3 vertebral bodies. Presentation ranged from discomfort/pain (most common) to one presentation of neurologic deficit with difficulty with ambulation. Results: Thorascopic assisted resection accomplished gross total resection in 4 of the 5 cases. In all cases there was no significant neurologic deficit, although one patient reported transient numbness following the operation and all patients made significant improvement post operatively. The length of stay for these cases ranged from 1-6 days. Conclusions: Thorascopic assisted resection of dumbbell NST can be performed safely and with good outcomes by using the corridor the tumor produces. This approach reduces the need for instrumentation, length of stay and post operative complication rates relative to traditional approaches. To perform this approach effectively, good co-operation between the neurosurgeon and thoracic surgeon needs to be present.

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 Periodontal Disease and Pregnancy Outcomes

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Dolapo A. Babalola ◽  
Folashade Omole
Keyword(s):  
Preterm Birth ◽  
Alcohol Consumption ◽  
Periodontal Disease ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Dental Health ◽  
Obstetric Care ◽  
Adverse Outcomes ◽  
Dental Screening ◽  
In Pregnancy

An increasing number of studies are confirming an association between periodontal disease (PD) and adverse outcomes in pregnancy. PD places pregnant women at greater risk for preterm birth than alcohol consumption or smoking. This underscores the importance of offering dental screening to women who are pregnant or contemplating pregnancy and the need for physicians who provide obstetric care to be aware of the possible connection between poor dental health and poor pregnancy outcomes.

scholarly journals La violencia obstétrica en el embarazo y el parto desde la perspectiva de la vulneración de derechos: autonomía y consentimiento informado = Obstetric violence as a violation of autonomy and informed consent rights in pregnancy and childbirth

2019 ◽  
pp. 241
Author(s):  
Marta Busquets Gallego
Keyword(s):  
Informed Consent ◽  
Obstetric Care ◽  
Fundamental Rights ◽  
Applicable Law ◽  
Pregnancy And Childbirth ◽  
Obstetric Violence ◽  
Legal Perspective ◽  
Pregnancy And Birth ◽  
In Pregnancy

<p class="Normal1"><strong>Resumen</strong></p><p>Este artículo explora la violencia obstétrica desde una perspectiva legal centrada en la vulneración de los derechos fundamentales de autonomía y consentimiento informado en el embarazo y el parto. Partiendo de una aproximación a la legalidad vigente aplicable, se explora qué relevancia tienen embarazo y parto a la hora de ejercer estos derechos, así como las creencias y condicionantes que afectan a su interpretación y ejercicio. También se hace un acercamiento a las dimensiones de las vulneraciones en este ámbito. Por último, se presentan distintas propuestas para promover el respeto a los derechos fundamentales en la atención obstétrica.</p><p><strong>Abstract</strong></p><p>This article explores obstetric violence from a legal perspective, focusing on the violation of the fundamental rights of autonomy and informed consent in pregnancy and childbirth. Starting from an approximation to the current applicable law , it explores how pregnancy and birth affect these rights, as well as the beliefs and conditions that affect their interpretation and excercise. There is also an approach to the dimensions of the violations in this area. Finally, different proposals are presented to promote  respect for fundamental rights in obstetric care.</p>

scholarly journals P.098 Evaluation and surgical management of pelvic peripheral nerve sheath tumors: the University of Toronto experience and review of literature

2017 ◽  
Vol 44 (S2) ◽  
pp. S38-S38
Author(s):  
S Wang ◽  
Z Merali ◽  
F Pirouzmand
Keyword(s):  
Peripheral Nerve ◽  
English Language ◽  
Case Series ◽  
Tumor Location ◽  
Presenting Symptoms ◽  
Nerve Sheath Tumors ◽  
Peripheral Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Imaging Characteristics ◽  
Surgical Technical

Background: Pelvic peripheral nerve sheath tumors (PNST), which includes neurofibroma, schwannoma, and MPNST, are rare tumors located in the retroperitoneum. Methods: The case records of a prospectively maintained database at Sunnybrook Health Sciences Center (SHSC) were reviewed to identify patients with pelvic PNST, managed between 2006 - 2016. Medical records were retrospectively reviewed for patient demographics, presentation, tumor location, symptoms, imaging characteristics, management, and outcome. The surgical technical caveats were described. An English language literature review was performed to describe previously published experiences. Results: The series consisted of 7 patients, ranging from 22 - 74 years of age at presentation. These lesions tend to be large at the time of diagnosis, and presenting symptoms include abdominal, flank, or back pain, as well as leg edema or hydronephrosis from local compression. Most patients in this cohort were managed surgically with midline abdominal transperitoneal exposures. Lastly, 5 tumors were benign schwannomas managed with gross total resection or debulking, while 2 patients had MPNSTs managed with biopsy followed by adjuvant chemoradiation therapy. Conclusions: In this case series, we describe the characteristics, evaluation, and management of 7 patients with pelvic PNST at a major healthcare institution in Toronto, Canada, highlighting the technical aspects of managing this rare and challenging entity.

The role of endocannabinoids in pregnancy

2021 ◽  
Vol 86 (5) ◽  
pp. 349-354
Author(s):  
Zdeněk Laštůvka ◽  
◽  
Josef Suchopár ◽  
Simona Mašková ◽  
Miroslava Alblová ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Enzymatic Activity ◽  
Early Pregnancy ◽  
Endocannabinoid System ◽  
Unborn Child ◽  
Substantial Impact ◽  
Pregnancy And Childbirth ◽  
Pubmed Database ◽  
In Pregnancy

Objective: In this paper, we summarize the role of the endocannabinoid system in relation to pregnancy and childbirth and its potential for dia gnosis of preterm birth. Methods: Review of articles in peer-reviewed journals using the PubMed database. Results: Endocannabinoid system plays a signifi cant role in embryo development, transport and implantation as well as in placentation. It consists of numerous endogenous ligands; however, in relation to pregnancy there are mainly two studied representatives: anandamide and 2-arachidonoylglycerol. There is increasing evidence, in addition to early pregnancy events, that anandamide plays a regulatory role in pregnancy maintenance and the timing of labour. The activity of anandamide depends on its metabolic pathway and the enzymatic activity that ensures its conversion. Ultimately, changes in anandamide concentration lead to increased production of prostaglandins or prostamides, with inverse eff ects on pregnancy. The abuse of exogenous cannabinoids in pregnancy has substantial impact on the unborn child in many ways and may result in detrimental eff ects including preterm birth. Conclusion: Measuring anandamide concentration and the prostaglandin to prostamide ratio could be a useful tool in assessing the risk of preterm birth. Key words: endocannabinoid system – pregnancy – labour

Pregnancy-associated thrombosis

Hematology ◽  
2009 ◽  
Vol 2009 (1) ◽  
pp. 277-285 ◽  
Author(s):  
Andra H. James
Keyword(s):  
Risk Factors ◽  
Postpartum Period ◽  
Case Series ◽  
Bleeding Complications ◽  
Pregnancy And Childbirth ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
History Of ◽  
Poor Pregnancy Outcome ◽  
In Pregnancy

Abstract The main reason for the increased risk of thromboembolism in pregnancy is hypercoagulability, which has likely evolved to protect women from the bleeding challenges of miscarriage and childbirth. Women are at a 4- to 5-fold increased risk of thromboembolism during pregnancy and the postpartum period compared with when they are not pregnant. Eighty percent of the thromboembolic events in pregnancy are venous, with an incidence of 0.49 to 1.72 per 1000 pregnancies. Risk factors include a history of thrombosis, inherited and acquired thrombophilia, maternal age greater than 35, certain medical conditions, and various complications of pregnancy and childbirth. Despite the increased risk of venous thromboembolism (VTE) during pregnancy and the postpartum period, most women do not require anticoagulation. Candidates include women with current VTE, a history of VTE, thrombophilia and a history of poor pregnancy outcome, or risk factors for postpartum VTE. The intensity of the anticoagulation will depend on the indication and the monitoring will depend on the intensity. At the time of delivery, anticoagulation should be manipulated to reduce the risk of bleeding complications while minimizing the risk of thrombosis. There are no large trials of anticoagulants in pregnancy, and recommendations are based on case series, extrapolations from nonpregnant patients and the opinion of experts. Nonetheless, anticoagulants are believed to improve the outcome of pregnancy for women who have, or have had, VTE.

scholarly journals Malignant Peripheral Nerve Sheath Tumors of the Head and Neck: A Case Series and Literature Review

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Brandon T. Mullins ◽  
Trevor Hackman
Keyword(s):  
Peripheral Nerve ◽  
Head And Neck ◽  
Adjuvant Radiotherapy ◽  
Case Series ◽  
Data Series ◽  
Nerve Sheath Tumors ◽  
Peripheral Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Modality Approach ◽  
Poor Outcomes

Background. Malignant peripheral nerve sheath tumors (MPNSTs) of the head and neck are rare aggressive neoplasms with a poor prognosis. This study describes the management and outcomes of 3 of our patients with MPNSTs of the head and neck.Methods. We identified 3 patients presenting with MPNST of the head and neck and treated at the University of North Carolina. We compared our results to the literature from 1963 to 2014.Results. Mean follow-up was 31 months. Average age at diagnosis was 44.7 years of age. All patients received wide-local excision and adjuvant radiotherapy. No patients recurred during the series. Recurrence-free survival time for the patients was 45, 37, and 3 months, respectively.Conclusions. Our data series confirms that a combined-modality approach with complete surgical resection and adjuvant radiotherapy leads to improved outcomes in MPNSTs of the head and neck. Nonetheless, due to historically poor outcomes, continued research into newer therapies needs to be explored.

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