scholarly journals Effective Management Of Patients With Amniotic Fluid Embolism In The Intensive Care Unit: Two Case Reports

10.3823/2527 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Leonidas Grigorakos ◽  
Nikolaos Markou ◽  
Daria Lazarescu ◽  
Katerina Tzortzopoulou ◽  
Magda Gkouni ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Case Reports ◽  
Post Partum ◽  
Rare Complication ◽  
Recovery Process ◽  
Complete Recovery ◽  
Positive Outcome ◽  
Amniotic Fluid Embolism ◽  
Short Period ◽  
Clonic Seizures

Amniotic Fluid Embolism (AFE) is a rare complication of the intra- and early post-partum period, which may also be encountered with cesarean delivery and during abortions. Its symptompatology includes respiratory distress with cyanosis, shock and possibly tonic-clonic seizures. Disseminated intravascular coagulation (DIC) frequently occurs and is usually fatal. The aim of this case report is to present the positive outcome and our gained experience from two cases suffering from AFE. Thus, we analyze the case of two patients, in the second trimester of pregnancy who presented symptoms of AFE. Our study reveals that in the case of patients with AFE, early diagnosis, prompt management and proper treatment increase survival rate and may ensure complete recovery in a relatively short period of time. However, DIC is a serious aggravating factor which makes the recovery process slower.  

scholarly journals Amniotic Fluid Embolism in Post Caesarean Section

2020 ◽  
Vol 4 (2) ◽  
pp. 161-166
Author(s):  
Defrin Defrin ◽  
Heri Farnas
Keyword(s):  
Cardiac Arrest ◽  
Cesarean Section ◽  
Amniotic Fluid ◽  
Pregnancy Termination ◽  
Post Partum ◽  
Amniotic Fluid Embolism ◽  
Initial Examination ◽  
Maternal Deaths ◽  
Obstetric Emergency ◽  
Cardiopulmonary System

Background: According to WHO, around 73% of maternal deaths globally are caused by direct obstetric causes. The amniotic fluid embolism is a life-threatening obstetric emergency characterized by sudden cardiopulmonary system failure and can be accompanied by Disseminated Intravascular Coagulation (DIC). The amniotic fluid embolism event usually occurs during labor and birth, but can also occur immediately in the post partum period or after pregnancy termination. About 56% of women will not survive for first 2 hours after the acute event. Amniotic fluid embolism is an unpredictable event, so that no prophylactic intervention can be carried out effectively and the handling and enforcement of a diagnosis that still debatable.Objective: To report maternal deaths due to amniotic fluid embolism post cesarean sectionMethod: Case ReportCase:  Reported case of a 30 years old woman with an initial diagnosis in emergency departement with decreased consciousness due to Severe hypoxia due to Pulmonary emboli due to Amniotic fluid emboli on P2A0L2 post Cesarean Section first day of puerperium. The patient experienced a sudden loss of consciousness accompanied by severe shortness of breath after 6 hours after cesarean section surgery in a private hospital. After initial examination and treatment by administering oxygen through the Nonrebreathing Mask, there was no improvement in the O2 saturation value and then the patient was intubated by the anesthetist. After intubation, the O2 saturation value still does not increase, then the patient suddenly experiences cardiac arrest and followed with cardiac resuscitation for 2 cycles accompanied by resuscitation drugs then the patient returns to spontaneous circulation. From the cardiology department, inotropic therapy was given and echocardiographic investigations were carried out. On echocardiographic examination, they found McConnel's sign which showed suspicios of pulmonary embolism. At the time the patient will be moved to the intensive care unit, the patient experiences a cardiac arrest for the second time, then resuscitation is performed again for 2 cycles, but it does not work and the patient is declared dead.Conclusion: Amniotic fluid embolism is an obstetric emergency condition that cannot be predicted and has a high mortality rate. Treatment is supportive to support the cardiopulmonary system and management of coagulopathy that may occur.Keywords: maternal mortality, amniotic fluid embolism 

scholarly journals Use of romiplostim in pregnancy for refractory idiopathic thrombocytopenic purpura: Two case reports with maternal and fetal outcomes and literature review

2018 ◽  
Vol 13 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Su J Chua ◽  
Mark R Morton ◽  
John Svigos ◽  
David M Ross ◽  
Simon Kane
Keyword(s):  
Intravenous Immunoglobulin ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Case Reports ◽  
Post Partum ◽  
Rare Complication ◽  
Cerebral Haemorrhage ◽  
Poor Response ◽  
Fetal Outcomes ◽  
Thrombocytopenic Purpura ◽  
In Pregnancy

Idiopathic thrombocytopenic purpura is a relatively rare complication occurring in pregnancy, with the potential for serious maternal and fetal outcomes. Rarely, the poor response to established first-line therapies results in consideration of second-line therapies, which may have poorly understood risks to the fetus. We report two women with severe idiopathic thrombocytopenic purpura during pregnancy unresponsive to corticosteroids and intravenous immunoglobulin who were treated with romiplostim, a thrombopoietin receptor agonist. One woman with chronic idiopathic thrombocytopenic purpura had a partial response to romiplostim and suffered a post-partum haemorrhage related to uterine atony. The second woman developed severe idiopathic thrombocytopenic purpura in pregnancy and initially responded well to romiplostim. However, a lower segment Caesarean section was performed at 37 weeks for pre-eclampsia. The newborn suffered from severe idiopathic thrombocytopenic purpura and a grade 1 cerebral haemorrhage requiring intravenous immunoglobulin and platelet transfusions. Romiplostim might be a useful therapy for severe idiopathic thrombocytopenic purpura in pregnancy but requires further study.

scholarly journals Epilepsy and syphilis: A systematic review and meta-analysis

2021 ◽  
Vol 0 ◽  
pp. 1-8
Author(s):  
Chao Zhang ◽  
Wei Yue ◽  
Shuping Hou ◽  
Wanzhen Cui ◽  
Lei Xiang
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Meta Analysis ◽  
Epileptic Seizures ◽  
Neurological Sequelae ◽  
Short Period ◽  
Syphilis Treatment ◽  
Impaired Awareness ◽  
Clonic Seizures ◽  
The Relationship

Background: Epileptic seizures were noted as one of the most overlooked manifestations in syphilis; therefore a few clinicians are concerned about the relationship between epilepsy and syphilis. Our study sought to clarify the prevalence and clinical features of epileptic seizures in patients with syphilis. Methods: We retrieved relevant articles from different databases, using the keywords “syphilis and epilepsy” and then performed statistical analysis to characterize the relationship between these diseases. Results: Forty one articles were included in this study: eight described the prevalence of syphilis and epilepsy and the remaining 33 were case reports on syphilis with epileptic seizures. The meta-analysis included 1252 patients with syphilis. The pooled estimate of proportion of prevalence (95% confidence interval) was 0.1384 (0.0955–0.2005), and the proportion and heterogeneity showed different degrees of change among three subgroups. The systematic review included 46 cases of syphilis with epileptic seizures. Thirty two (80%) patients had motor seizures, among whom 20 (62.5%) had tonic-clonic seizures. In addition, 30 (75%) patients had impaired awareness and 18 (45%) had status seizures. Twenty five (62.5%) patients were 35–55 years of age, and 77.5% of the included patients were men. Thirty seven (97.4%) patients were seizure-free after anti-syphilis treatment. Limitations: Research in this field has been conducted for a relatively short period and publication bias may exist. Furthermore, some patients with syphilis and epileptic seizures may not have recieved a clear diagnosiss. Conclusion: The proportion of prevalence was 0.1384. Most of the included patients were 35–55 years of age and had impaired awareness and motor seizures. Many patients with syphilis and epileptic seizure showed full recovery or the development of minor neurological sequelae, and nearly all patients were seizure-free after timely anti-syphilis treatment.

scholarly journals Pathological post-obstructive diuresis following obstructive uropathy due to constipation in the post-partum period: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohamed Rishard ◽  
Thalagala Kossinnage Maheeka Kossinna ◽  
Mohamed Nazar Latiff ◽  
Susantha De Silva ◽  
Mohamed Hilmy Mohamed Asmath
Keyword(s):  
Post Partum ◽  
Rare Complication ◽  
Obstructive Uropathy ◽  
Multidisciplinary Care ◽  
Complete Recovery ◽  
Fecal Impaction ◽  
Fluid Replacement ◽  
Lifestyle Modifications ◽  
Severe Constipation ◽  
Extensive Evaluation

Abstract Background Constipation during pregnancy is not uncommon. Usually, this does not warrant extensive evaluation and settles with minor interventions or lifestyle modifications. Severe fecal impaction in chronically constipated patients can rarely lead to obstructive uropathy. Relief of obstruction can result in a diuretic phase which may be self-limiting or pathological. However, occurrence of pathological post-obstructive diuresis as a result of severe constipation is an extremely rare complication during pregnancy and puerperium which can even be fatal if not promptly diagnosed and adequately monitored and timely intervened. We describe the management of a pathological post-obstructive diuresis which occurred in the immediate postpartum period after treatment of severe constipation and obstructive uropathy. Case presentation A woman who had undergone an emergency caesarean section due to deep transverse arrest 1 week ago, presented with fecal impaction and anuria. On relief of urinary obstruction which had developed secondary to fecal impaction, she developed pathological post-obstructive diuresis. Careful and timely monitoring with exact fluid replacement, correction of electrolyte imbalances and multidisciplinary care ensured complete recovery of the patient. Conclusions Despite obstructive uropathy being uncommon in obstetric practice, clinicians need to have a high index of suspicion to monitor and promptly manage the potentially life-threatening condition of post-obstructive diuresis in pregnant and puerperal women undergoing urinary tract decompression. Due to unreliability of laboratory cutoff values in pregnancy and puerperium, a more vigilant and multidisciplinary approach with lower threshold for intervention is more prudent in the management of these patients.

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