Myasthenia Gravis in Pregnancy Treated With Daily Massive Vitamin D Dose

Myasthenia gravis (MG) is an autoimmune disease affecting the motor endplate of striated muscle. It is caused by antibodies that act in the cholinergic receptors at the post-synaptic portion of the neuromuscular junction, which results in asthenia and fatigue in some muscle groups. In pregnancy, it’s unpredictable, because pregnant women can present MG exacerbation, remission, stability, or even a myasthenic crisis during pregnancy. Complications are more frequent in the first trimester of pregnancy and the first 30 days of puerperium. Vitamin D and its metabolites are potent immunomodulators since their immuno-regulatory effect directly inhibits effector T cells and induces regulatory T cells (Treg) to decrease the production of inflammatory cytokines. The authors present a case report of a patient with MG who was treated throughout pregnancy with massive doses of vitamin D, obtaining good results.

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Axial torsion of Meckel’s diverticulum causing acute peritonitis in the first trimester of pregnancy: a case report

Surgical Case Reports ◽

10.1186/s40792-019-0754-y ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Hiromitsu Nagata ◽

Hiroyasu Nishizawa ◽

Susumu Mashima ◽

Yasuyuki Shimahara

Keyword(s):

Clinical Diagnosis ◽

Meckel’S Diverticulum ◽

Ileocecal Valve ◽

First Trimester ◽

Meckel's Diverticulum ◽

Ileocecal Resection ◽

Bowel Loop ◽

Axial Torsion ◽

First Trimester Of Pregnancy ◽

In Pregnancy

Abstract Background Meckel’s diverticulum is considered the most prevalent congenital anomaly of the gastrointestinal tract. Approximately 4% of patients are symptomatic with complications such as bleeding, intestinal obstruction, and inflammation, while axial torsion of Meckel’s diverticulum is rare, particularly in pregnancy. Case presentation A 31-year-old woman in week 15 of pregnancy complained of epigastric pain, nausea and vomiting. Clinical diagnosis was severe hyperemesis gravidarum. Because the symptoms persisted during hospitalization, CT was performed and revealed dilated small bowel loops with multiple air-fluid levels. In the right mid-abdomen, there was a large part of air containing a cavity connected to the small intestine, which was considered a dilated bowel loop. Emergency laparotomy was performed and axial torsion of a large Meckel’s diverticulum measuring 11 cm was found at a few centimeters proximal to the ileocecal valve. Ileocecal resection including Meckel’s diverticulum was performed. The postoperative course was uneventful. At 40 weeks gestation, she had vaginal delivery of normal baby. Conclusion The physiological and anatomical changes in pregnancy can make a straightforward clinical diagnosis difficult. Prompt diagnosis and management were needed in order to avoid significant maternal and fetal risks. The use of imaging examinations, especially CT examination, with proper timing may be helpful to prevent delay in diagnosis and surgical intervention. Here, we report the case of a patient with axial torsion of Meckel’s diverticulum in pregnancy. To our knowledge, axial torsion of Meckel’s diverticulum in the first trimester of pregnancy has not been reported in the English medical literature.

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Vitamine D en het risico op ASS

Wetenschappelijk Tijdschrift Autisme ◽

10.36254/wta.2021.2.01 ◽

2021 ◽

Vol 20 (2) ◽

Author(s):

Huub F.J. Savelkoul

Keyword(s):

Vitamin D ◽

Serum Levels ◽

First Trimester ◽

Autism Spectrum ◽

Maternal Serum ◽

Immune Reactivity ◽

Anti Oxidant ◽

First Trimester Of Pregnancy ◽

Spectrum Disorders

Autism spectrum disorders (ASD) is a heterogeneous group of behavioral disorders in which a disturbed immune reactivity can contribute to the etiology. In retrospective research we found an association between the risk to develop ASD and the month of birth with a peak in July pointing at a possible decreased exposure to sunlight during the first two semesters of pregnancy. This could point to an important role of vitamin D which has important anti-inflammatory and anti-oxidant activities and thereby regulates the proper functioning of the immune system in these individuals. Maternal serum levels of vitamin D double during the first trimester of pregnancy and therefore decreased exposure to sunlight resulting in diminished levels of vitamin D production can be an important risk factor for the development of ASD. However, there is a need for more integrated multidisciplinary studies in families where all siblings are also studied to elucidate the contribution of their genetic risk factors.

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Effectiveness of Ginger in Treating Nausea and Vomiting of Pregnancy

Eureka Herba Indonesia ◽

10.37275/ehi.v3i1.46 ◽

2021 ◽

Vol 3 (1) ◽

pp. 120-124

Author(s):

Ahmad Ramadhanu

Keyword(s):

Lifestyle Modification ◽

First Trimester ◽

Nausea And Vomiting ◽

Main Complaint ◽

Significant Burden ◽

First Trimester Of Pregnancy ◽

Cns Side Effects ◽

Possible Cause ◽

In Pregnancy

Nausea and vomiting in pregnancy (NVP) is one of the common main complaint in pregnancy. NVP can be a significant burden to the patient, make a decrease in quality of life, pregnancy threatening or even worse can lead to nutritional loss and death. NVP diagnosed when in first trimester of pregnancy and the other possible cause of NVP is excluded. Management of NVP is included maintaining hydration, nutrition, and lifestyle modification. Also avoiding the smells, food, or activity that can cause nause are necessary. There are some methods to treat NVP including pharmalogical or non-pharmalogical. The non-pharmalogical approach is change nutritional habits, lifestyle and medications. Several pharmalogical agents that can be used to relief the symptoms of NVP are pyridoxine, anti- histamines, metoclopramide, pyridoxine/doxylamine, promethazine and metoclopramide. Some patients also want to try more “natural” medications for NVP like ginger. The pharmacological activity is thought to stand in the pungent principles (gingerols and shogaols) and volatile oils (sesquiterpenes and monoterpenes). The true mechanism of action of ginger is probable to be a gastric effect, to increase tone and peristaltic due to anticholinergic and antiserotonin act. Ginger acts straight to the digestive tract and avoids the CNS side effects common to centrally acting antiemetics. Ginger is available in capsule or syrup form or in candy, cookies, beer, tinctures, teas, sodas, and jam. Nowadays, true dosing is available only if one uses standardized extracts; however, women may choose to use another form of ginger.

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Suicide due to fear of COVID-19, in pregnancy, lead to Neonatal malformations: A case report

10.22541/au.162373187.73918053/v1 ◽

2021 ◽

Author(s):

Javad Boskabadi ◽

Saeed Kargar-Soleiman abad ◽

shahrokh mehrpishe ◽

Elham Pishavar ◽

Roya Farhadi

Keyword(s):

Mental Health ◽

Case Report ◽

Antipsychotic Drugs ◽

First Trimester ◽

Limited Data ◽

First Trimester Of Pregnancy ◽

In Pregnancy

There is limited data about various effect of COVID-19 in pregnancy. The Covid-19 pandemic can increase anxiety or schizophrenia exacerbation. Neonatal malformations from antipsychotic drugs exposures during first trimester of pregnancy have been reported. However, their effect near delivery have been less studied. Keywords: Covid-19, pregnancy, mental health, neonatal malformations

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Vitamin D supplementation in the first trimester of pregnancy as an intervention to protect against adverse gestational outcomes in the third trimester

Medical Journal of Babylon ◽

10.4103/mjbl.mjbl_23_19 ◽

2019 ◽

Vol 16 (2) ◽

pp. 145

Author(s):

BanavNajeeb Muhammed ◽

ArdawanFatah Ali

Keyword(s):

Vitamin D ◽

First Trimester ◽

Vitamin D Supplementation ◽

Third Trimester ◽

The Third ◽

First Trimester Of Pregnancy

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Drug-induced cytolytic syndrome in pregnancy: clinical and biochemical diagnostic criteria

Journal of obstetrics and women s diseases ◽

10.17816/jowd65628-35 ◽

2016 ◽

Vol 65 (6) ◽

pp. 28-35

Author(s):

Irina V Borisova

Keyword(s):

Pregnant Women ◽

Hormone Therapy ◽

Clinical Manifestations ◽

First Trimester ◽

Gamma Glutamyl Transpeptidase ◽

Drug Induced ◽

Planning Stage ◽

Protein Levels ◽

First Trimester Of Pregnancy ◽

In Pregnancy

The aim of the study was evaluation of clinical and laboratory manifestations of drug-induced cytolytic syndrome in pregnancy. In the research group included 62 pregnant women with drug-induced liver injury (DILI) in the first trimester of pregnancy. These pregnant women received hormone therapy at the planning stage and/or during pregnancy for the prevention and treatment of miscarriage and had clinical and biochemical manifestations of cytolytic syndrome. Pregnancy after IVF and ovulation induction was in 60.8% of cases. Hormone therapy for pregnant patients received long-term, 85% of pregnant women used estrogen and progestin drugs. DILI during pregnancy characterized by low-symptom or asymptomatic clinical manifestations. DILI manifested cytolytic biochemical syndrome, in which there is isolated increase of transaminase levels, in some cases accompanied by increased level of gamma glutamyl transpeptidase, liver glutamate dehydrogenase and decreased total protein levels, in the first place due to the albumin fraction.

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Implementing standardised rhodes index to measure the efficacy of ginger extract (Zingiber officinale) in pregnancy induced nausea and vomiting

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20173273 ◽

2017 ◽

Vol 6 (8) ◽

pp. 1932

Author(s):

Asha P. Dass ◽

Priyadarshini Deodurg ◽

Sandhiya Rajappan

Keyword(s):

Zingiber Officinale ◽

First Trimester ◽

Nausea And Vomiting ◽

Ginger Extract ◽

Natural Signs ◽

End Of Treatment ◽

First Trimester Of Pregnancy ◽

Baseline Values ◽

Moderate Nausea ◽

In Pregnancy

Background: Although nausea and vomiting are natural signs of pregnancy affecting about half the pregnant women during their first trimester of pregnancy, it is unpleasant and difficult symptom to deal with. Considering the fact that medication during pregnancy is not advised, we decided to study the efficacy of a natural product to control nausea and vomiting during early pregnancy. Our study was directed to estimate the efficacy of ginger extract (Zingiber officinale) in pregnancy induced nausea and vomiting.Methods: A total of 30 women with pregnancy of 4-16 weeks, suffering from nausea and vomiting were included in this study (n=30). Subjects were given ginger extract 250mg, to be taken 3 times a day half an hour before food for 1 week. Severity of vomiting was assessed by Rhodes Index of Nausea and Vomiting by the patients. Baseline scores were compared with the score at the end of 7 day. The findings were analysed statistically.Results: Effect with the ginger extract in pregnancy induced nausea and vomiting was assessed at the end of treatment (day 7) and compared with the baseline values. Four patients reported symptoms of heartburn. Otherwise, there were no other reports of any adverse effects. The results showed significance (p <0.005).Conclusions: Ginger extract (Zingiber officinale) helps in reducing severity and frequency of pregnancy induced nausea and vomiting. Therefore, we conclude that ginger extract can be used for mild to moderate nausea and vomiting induced by pregnancy during first trimester.

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Pulmonary carcinoid presenting in pregnancy with an unusual radiological feature

BMJ Case Reports ◽

10.1136/bcr-2020-241231 ◽

2021 ◽

Vol 14 (4) ◽

pp. e241231

Author(s):

Anna Li ◽

Helen Crocker ◽

Brendan Dougherty ◽

Sonja Klebe ◽

Virginia Au

Keyword(s):

Healthcare Worker ◽

First Trimester ◽

Radiological Feature ◽

Clinical Heterogeneity ◽

Radiological Findings ◽

Rare Form ◽

Pulmonary Carcinoid ◽

Carcinoid Tumours ◽

First Trimester Of Pregnancy ◽

In Pregnancy

Pulmonary carcinoid tumours are a rare form of malignancy that often present with clinical heterogeneity and are challenging to diagnose. Diagnosis during pregnancy is further complicated by delays in imaging and procedures to minimise harm to the fetus. This case describes a primigravid healthcare worker who was diagnosed with pulmonary carcinoid in her first trimester of pregnancy, with particular focus on the unique radiological findings of subpleural blebs as a feature.

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Ramadan fasting and newborn's birth weight in pregnant Muslim women in The Netherlands

British Journal Of Nutrition ◽

10.1017/s0007114514002219 ◽

2014 ◽

Vol 112 (9) ◽

pp. 1503-1509 ◽

Cited By ~ 18

Author(s):

Ary I. Savitri ◽

Nasim Yadegari ◽

Julia Bakker ◽

Reyn J. G. van Ewijk ◽

Diederick E. Grobbee ◽

...

Keyword(s):

Birth Weight ◽

The Netherlands ◽

Medical Records ◽

Muslim Women ◽

First Trimester ◽

Strict Adherence ◽

Ramadan Fasting ◽

First Trimester Of Pregnancy ◽

In Pregnancy

Many Muslim women worldwide are pregnant during Ramadan and adhere to Ramadan fasting during pregnancy. In the present study, we determined whether maternal adherence to Ramadan fasting during pregnancy has an impact on the birth weight of the newborn, and whether the effects differed according to trimester in which Ramadan fasting took place. A prospective cohort study was conducted in 130 pregnant Muslim women who attended antenatal care in Amsterdam and Zaanstad, The Netherlands. Data on adherence to Ramadan fasting during pregnancy and demographics were self-reported by pregnant women, and the outcome of the newborn was retrieved from medical records after delivery. The results showed that half of all the women adhered to Ramadan fasting. With strict adherence to Ramadan fasting in pregnancy, the birth weight of newborns tended to be lower than that of newborns of non-fasting mothers, although this was not statistically significant ( − 198 g, 95 % CI − 447, 51, P= 0·12). Children of mothers who fasted in the first trimester of pregnancy were lighter at birth than those whose mothers had not fasted ( − 272 g, 95 % CI − 547, 3, P= 0·05). There were no differences in birth weight between children whose mothers had or had not fasted if Ramadan fasting had taken place later in pregnancy. Ramadan fasting during early pregnancy may lead to lower birth weight of newborns. These findings call for further confirmation in larger studies that should also investigate potential implications for perinatal and long-term morbidity and mortality.

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