scholarly journals Antenatal follow-up, anesthesia management and perinatal outcomes in pregnancy with renal transplant

2021 ◽  
Vol 18 (2) ◽  
pp. 109-114
Author(s):  
Ezgi Turgut ◽  
Gözde İnan ◽  
Dudu Berrin Günaydın ◽  
Beyza Büyükgebiz ◽  
Sibel Konca ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Perinatal Outcomes ◽  
Anesthesia Management ◽  
In Pregnancy

scholarly journals A Review of Sars-Cov-2 Infection in Pregnancy: What We Know So Far

2020 ◽  
pp. 1-10
Author(s):  
Acevedo Gallegos Sandra ◽  
◽  
ArriagaLópez Alberto ◽  
Minjarez Corral Mariana ◽  
◽  
...  
Keyword(s):  
Vertical Transmission ◽  
Perinatal Outcomes ◽  
Diagnostic Methods ◽  
High Morbidity ◽  
Transmission Method ◽  
Coronavirus Infection ◽  
Recommended Guidelines ◽  
The Impact ◽  
In Pregnancy

Coronavirus infection (COVID-19) in pregnancy is highly relevant due to the impact on maternal and fetal health, it is caused by SARS-CoV-2, which has a high morbidity and mortality rate worldwide. It is important to evaluate pregnant patients who are identified as suspicious, to make an accurate and timely diagnosis, to implement correct follow-up and adequate therapeutic management to reduce associated complications and adverse perinatal outcomes. Objective: Execute a detailed and updated review of the causal agent, pathophysiology, diagnostic methods, treatment, maternal and fetal repercussions, via of delivery and whether there is evidence of vertical transmission. Method: A search of literature published in English and Spanish was carried out in databases such as PubMed / MEDLINE, MDconsult, HSTAT, Internet Grateful Med, using the keywords: Coronavirus, pregnancy, SARS-CoV-2, treatment, vertical transmission. From the information obtained, 88 articles were selected, which were classified and used as support to do this review. Results: Studies and available evidence, reviews, and recommended guidelines for the evaluation of patients with COVID-19 are discussed, mainly those that provide valuable data regarding the diagnosis, monitoring and management of this infection. Conclusion: Information is limited and much remains to be studied about vertical transmission and perinatal outcomes. There is no evidence to support that pregnancy increases the susceptibility to get COVID-19. More studies are necessary to know the behavior of the infection in pregnancy, for a better approach, diagnosis and treatment.

scholarly journals The efficacy and safety of non-fluoroscopic catheter ablation of arrhythmias in pregnancy after mid-long-term follow-up: a single- center experience

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Abdrakhmanov ◽  
B Ainabekova ◽  
O Nuralinov ◽  
A Bakytzhanuly ◽  
A Smagulova
Keyword(s):  
Catheter Ablation ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Mortality ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Free Wall ◽  
Efficacy And Safety ◽  
Accessory Pathways ◽  
In Pregnancy

Abstract Funding Acknowledgements Type of funding sources: None. Background Despite the incidence of arrhythmias in pregnancy data on non-fluoroscopic catheter ablation in pregnant women and perinatal outcomes is limited. Purpose the aim of this study is to prospectively assess the efficacy and safety of non-fluoroscopic catheter ablation in pregnant women with arrhythmias. Methods 44 pregnant women (mean age of 28,2 ± 4,2 years, mean gestation age 24,4 ±3,8 weeks) indicated for catheter ablation were enrolled. The ablation was performed under the guidance of CARTO (n = 20; 45%) and Ensite Precision systems (n = 24; 55%) without fluoroscopy. Ablation characteristics, procedure-related complications and clinical outcomes were evaluated during 18 months follow-up. Results all 44 cases of ablation were successful.  There were 14 (31,8%) ablation of accessory pathways - in left free wall (n = 8),  in right free wall (n = 5), posteroseptal (n = 1). 19 patients (43,2%) underwent ablation for atrioventricular nodal reentrant tachycardia. In 3 cases (6,8%) were combination of accessory pathways with slow conduction ways. Ablation of the right ventricular outflow tract was performed in 8 cases (18,2%) of frequent premature ventricular contractions and idiopathic ventricular tachycardia.  The median procedural time was 71 minutes (interquartile range 54-97). Procedural complication was documented in 1 patient (2,3%), who developed an ileofemoral thrombosis. Perinatal outcomes: spontaneus vaginal (n = 35; 79.5%) or vaginal-assisted (n = 4; 9.1%) delivery were in the majority. Five pregnancies (11.4%) were delivered by cesarean section. Mean median gestational age at delivery was 39 ± 1,12 weeks. In one case was placental abruption (2,3%).  Maternal cardiac events was none declared. There were 44 live births (in all pregnancies). Fetal birth weight was 3324,39 ± 625,1 grams, 5 minute Apgar was 8,81 ± 1,9. There were no maternal and fetal mortality. During follow-up there were no arrhythmia recurrence. Conclusions non-fluoroscopic catheter ablation of arrhythmias is feasible and can be safety performed in pregnancy. Our data suggests that these pregnancies were with good perinatal and neonatal outcomes.

Ischemic Complications of Pregnancy: Who is at Risk?

2016 ◽  
Vol 10 (1) ◽  
pp. 14
Author(s):  
Sara C Martinez ◽  
◽  
Sharonne N Hayes ◽  
Keyword(s):  
Artery Dissection ◽  
Cardiac Events ◽  
Coronary Artery Dissection ◽  
Reduction Strategies ◽  
Ischemic Complications ◽  
Substantial Risk ◽  
History Of ◽  
Invasive Management ◽  
In Pregnancy

The physiologic demands of pregnancy may either trigger or uncover ischemic heart disease (IHD) via largely unknown mechanisms, leading to an increased mortality compared with nonpregnant individuals. Risk factors for IHD in pregnancy are age, smoking, multiparity, and prior cardiac events. A multidisciplinary team at a referral center is key to coordinating medical or invasive management and inpatient observation. Etiologies may be revealed by experienced angiographers, and are predominantly spontaneous coronary artery dissection, followed by atherosclerotic disease and thrombus, while a significant percentage of women are found to have normal coronary arteries by angiogram. The management of these conditions is varied and, in general, conservative management is preferred with adequate coronary flow and stable hemodynamics. A woman with a history of IHD in pregnancy is at a substantial risk for further complications in future pregnancies and beyond; therefore, aggressive risk factor-reduction strategies and regular cardiology follow-up are imperative to decrease adverse events.

Neurological manifestation in severe hypothyroidism in pregnancy

2020 ◽  
Vol 13 (12) ◽  
pp. e238069
Author(s):  
Aparna Sharma ◽  
Nilofar Noor ◽  
Vatsla Dadhwal
Keyword(s):  
Peripheral Neuropathy ◽  
Facial Palsy ◽  
Caesarean Delivery ◽  
Thyroid Stimulating Hormone ◽  
Neurological Manifestations ◽  
Second Trimester ◽  
Pituitary Hyperplasia ◽  
Very High ◽  
In Pregnancy

Neurological manifestations of hypothyroidism include peripheral neuropathy and pituitary hyperplasia. However, these associations are rarely encountered during pregnancy. We report a case of a known hypothyroid with very high thyroid stimulating hormone (TSH) values (512 μIU/mL) in the second trimester. At 24 weeks she developed facial palsy and pituitary hyperplasia which responded to a combination of steroids and thyroxine. She had caesarean delivery at 35 weeks and 3 days gestation in view of pre-eclampsia with severe features and was discharged on oral antihypertensives and thyroxine. On follow-up at 5 months, TSH normalised and pituitary hyperplasia showed a greater than 50% reduction in size. To our knowledge, this is the first reported case of facial palsy and pituitary hyperplasia associated with hypothyroidism during pregnancy.

scholarly journals Overt and subclinical hypothyroidism among Bangladeshi pregnant women and its effect on fetomaternal outcome

2015 ◽  
Vol 40 (2) ◽  
pp. 52-57 ◽  
Author(s):  
M Sharmeen ◽  
PA Shamsunnahar ◽  
TR Laita ◽  
SB Chowdhury
Keyword(s):  
Adverse Effects ◽  
Pregnant Women ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Perinatal Outcomes ◽  
Fetal Outcome ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Adequate Treatment ◽  
In Pregnancy

Objectives: Thyroid disorders are among the common endocrine problems in pregnant women. It is now well established that not only overt but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are few data from Bangladesh about the prevalence of thyroid dysfunction in pregnancy. With this background, this study aims to find out thyroid dysfunction (both overt and subclinical hypothyroidism) in pregnancy and its impact on obstetrical outcome.Methods: We studied the evaluation of 50 admitted pregnancies corresponding to 29 women with subclinical hypothyroidism and rest 21 was overt hypothyroidism. Detailed history and examination were performed. Apart from routine obstetrical investigations, Thyroid Stimulating Hormone (TSH) estimation was done. Their obstetrical and perinatal outcomes were noted.Results: Overt hypothyroidism was significantly (p<0.05) higher in 25 to 44 years age group. However two and three abortions were significantly (p<0.05) higher in overt hypothyroidism patients. In sub clinical hypothyroidism 86.2% conceived firstly within 2 years and 66.7% in overt hypothyroidism patients conceived firstly in between 3 to 5 years after marriage. Overt hypothyroids were prone to have pregnancy-induced hypertension 42.9%, intrauterine growth restriction (P=0.001) and gestational diabetes (38.1%) as compared to subclinical cases. Neonatal complications were significantly more in overt hypothyroidism group. Mean TSH level was significantly (p<0.05) higher in overt hypothyroidism patients but mean FT4 level was almost similar in both groups. Majority of the patient underwent caesarean section in both groups due to associated medical and obstetrical complications. None of the babies showed hypothyroidism by cord blood tests. In this analysis our results showed that overt hypothyroidism among Bangladeshi pregnant women are associated with more maternal complication & adverse parental outcome than subclinical hypothyroidism. The adequate treatment of hypothyroidism during gestation minimizes risks and generally, makes it possible for pregnancies to be carried to term without complications. Significant adverse effects on maternal and fetal outcome were seen emphasizing the importance of routine antenatal thyroid screening.Bangladesh Med Res Counc Bull 2014; 40 (2): 52-57

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

scholarly journals Ovarian Dysgerminoma in Pregnant Women with Viable Fetus: A Rare Case Report

2021 ◽  
pp. 141-146
Author(s):  
Reda Youssef ◽  
Gamal Sayed Ahmed ◽  
Samir Alhyassat ◽  
Sanaa Badr ◽  
Ahmed Sabry ◽  
...  
Keyword(s):  
Gestational Age ◽  
Ovarian Neoplasms ◽  
Imaging Modality ◽  
Reproductive Age ◽  
Diagnostic Challenge ◽  
Short Period ◽  
Ovarian Dysgerminoma ◽  
The Impact ◽  
In Pregnancy

Dysgerminoma is an uncommon malignant tumor arising from the germ cells of the ovary. Its association with pregnancy is extremely rare, with a reported incidence of about 0.2–1 per 100,000 pregnancies. Women in the reproductive age group are more commonly affected. It can be extremely rare to conceive naturally, without assisted reproductive interventions, in cases with ovarian dysgerminoma. If a pregnancy does occur with a concurrent dysgerminoma, it is even more unusual to carry the pregnancy to viability or childbirth without fetal or maternal compromise. We report a case of right ovarian dysgerminoma in a young female with a viable intrauterine pregnancy at 10 weeks, which is rarely diagnosed and managed at this gestational age. Numerous factors played a role in her favorable outcome, including early suspicion by ultrasound and presenting history, surgery, histopathological assessment, imaging, and involvement of the multidisciplinary oncology team. Ovarian neoplasms may rapidly increase in size within a short period with little or no symptoms. This poses a diagnostic challenge for obstetricians and oncologists. Hence, we aimed to evaluate the role of imaging in pregnancy using ultrasound as an imaging modality for both early detection of ovarian neoplasms and for follow-up. In conclusion, patients with ovarian dysgerminoma in pregnancy can have favorable outcomes. Treatment should be individualized on a case-to-case basis, depending on many factors; cancer stage, previous reproductive history, the impact of imaging in staging or follow-up of tumor on the fetus, fetal gestational age, and whether termination of the pregnancy can improve survival or morbidity for the mother.

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