Epidemiological Profile and Postpartum Outcome for Severe Preeclamptic Patients

2021 ◽  
pp. 45-50
Author(s):  
Suher Dafaus ◽  
Amel Morgham ◽  
Nasreen Osman
Keyword(s):  
Caesarean Section ◽  
Positive Family History ◽  
Previous History ◽  
Severe Preeclampsia ◽  
Intrauterine Fetal Death ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Adequate Treatment ◽  
History Of ◽  
The Mean

Background and objective. Preeclampsia is a multisystemic disorder, which involves the placenta, liver, blood, neurological and cardiovascular systems. It is one of the leading causes of maternal and fetal morbidity and mortality. This study aimed at describing the characteristic features for mothers who had severe preeclampsia and to know the complications during puerperium. Methods. A prospective study conducted over a period from February 2009 up to November 2009 involving 100 pre-eclampsia patients admitted and delivered in Aljalaa Maternity Hospital, Tripoli, Libya. Results. The patients mean age was 33.3 +5.9 years. The mean gestational age at admission time was 36.8+3.2 weeks and 64% of them were term. 58% of the patients with severe preeclampsia had a positive family history of chronic hypertension whereas 42% of patients had a previous history of preeclampsia. 40% of patients were primigravida. The mean systolic blood pressure at admission was 164+15.4 mmHg and the mean diastolic pressure was 113+6 mmHg. The common symptoms were headache, abdominal pain, and blurred vision (54%, 37%, and 31% respectively), whereas 9% of the patients presented with the eclamptic fit. The pregnancy in 66% patients ended by caesarean section, 78% of them were emergency caesarean section. The birth weight of 13% of new-borns was less than 1500 grams. Furthermore, 10% diagnosed with intrauterine fetal death (IUFD) antenatally and 9% died after admission to nursery intensive care unit post-delivery. Conclusion. the effects of hypertensive disorder associated with pregnancy could be prevented by close antenatal care particularly for whose had previous history of preeclampsia. In addition; early recognition and adequate treatment, and timely delivery can prevent preeclampsia and will improve maternal and neonatal outcomes.

scholarly journals Characteristic of Referral Patients With Severe Preeclampsia In Surabaya

2018 ◽  
Vol 1 (1) ◽  
pp. 25
Author(s):  
Myrna Evanda Adeline ◽  
Muhammad Ardian Cahya Laksana ◽  
S Atika
Keyword(s):  
Birth Weight ◽  
Apgar Score ◽  
Previous History ◽  
Severe Preeclampsia ◽  
Hypertensive Disorder ◽  
Delivery Method ◽  
Common Cause ◽  
Number Of Patients ◽  
History Of ◽  
Almost All

Introductions: Pre-eclampsia is a hypertensive disorder of a pregnancy that remains major maternal mortality in developing country. Severe pre-eclampsia needed an advanced medical treatment since it could cause life treathening condition for both mother and fetus. The purpose of this research was to understand and got the  picture of the age, parity, complication, delivery method, referral pathway, age of pregnancy, birth weight, and Apgar score of baby from pre-eclamptic mother in dr. Soetomo General Hospital during 2011.Methods: This research is a retrospective-descriptive research which observed the age, parity, complication, delivery method, referral pathway, age of pregnancy, birth weight, and Apgar score of baby from pre-eclampsia mother This research used medical record then the data was recorded and analyzed  descriptively.Result: The number of patients who met the inclusion criteria were 239 patients. Patient’s age were distributed unimodally with a peak at productive age. Most of patients had previous history of pregnancy. Pulmonary edema was the most common cause of maternal complication and intra uterine fetal death was the most common cause of fetal complication. Most delivery were performed in Sectio Caesaria method. Almost all cases was direct refferal cases from other medical services. Then most of cases was reaching aterm periode. Most of babies were born with body weight ≥ 2500 gram. And based on Apgar score the babies were well adapted.Conclusions: Most of the patients with severe preeclampsia referrals were referred from a health care setting, only a small percentage of women were referred to relay. Most of severe preeclampsia occured in women with their gestational age has reached 37 weeks.

Pregnancy in Patients With AQP4-Ab, MOG-Ab, or Double-Negative Neuromyelitis Optica Disorder

Neurology ◽  
2021 ◽  
Vol 96 (15) ◽  
pp. e2006-e2015
Author(s):  
Nicolas Collongues ◽  
Cecilia Alves Do Rego ◽  
Bertrand Bourre ◽  
Damien Biotti ◽  
Romain Marignier ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Previous History ◽  
International Study ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Double Negative ◽  
Neuromyelitis Optica Spectrum Disorder ◽  
Pregnancy And Postpartum ◽  
History Of ◽  
Mog Antibodies ◽  
The Mean

ObjectiveTo analyze the effects of pregnancy on neuromyelitis optica spectrum disorder (NMOSD) according to patients' serostatus and immunosuppressive therapy (IST).MethodsWe performed a retrospective multicenter international study on patients with NMOSD. Patients were tested for aquaporin-4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies (Ab). Informative pregnancies were reported when NMOSD onset occurred before or during pregnancy or up to 12 months postpartum. The mean annualized relapse rate (ARR) was calculated for the 12 months before conception, for each trimester of pregnancy, and postpartum. Events such as miscarriage, abortion, and preeclampsia were reported. IST was considered if taken in the 3 months before or during pregnancy.ResultsWe included 89 pregnancies (46 with AQP4-Ab, 30 with MOG-Ab, and 13 without either Ab) in 58 patients with NMOSD. Compared to the prepregnancy period, the ARR was lower during pregnancy in each serostatus group and higher during the postpartum period in patients with AQP4-Ab (p < 0.01). Forty-eight percent (n = 31) of pregnancies occurred during IST and these patients presented fewer relapses during pregnancy and the 12 months postpartum than untreated patients (26% vs 53%, p = 0.04). Miscarriages occurred in 10 (11%) pregnancies, and were mainly in patients with AQP4-Ab (with or without IST) and a previous history of miscarriage. Preeclampsia was reported in 2 (2%) patients who were AQP4-Ab-positive.ConclusionWe found a rebound in the ARR during the first postpartum trimester that was higher than the prepregnancy period only in AQP4-Ab-positive patients. Taking IST just before or during pregnancy reduces the risk of relapses in these conditions.

THE RELATIONSHIP BETWEEN THE ONSET OF SEVERE PREECLAMPSIA AND PERINATAL COMPLICATIONS AT RUMKITAL Dr. RAMELAN IN SURABAYA

2021 ◽  
Vol 5 (2) ◽  
pp. 139
Author(s):  
Widya Retno ◽  
Ivon Diah Wittiarika ◽  
Muhammad Aldika Akbar
Keyword(s):  
Preterm Delivery ◽  
Early Onset ◽  
Late Onset ◽  
Previous History ◽  
Severe Preeclampsia ◽  
P Value ◽  
Chronic Hypertension ◽  
Perinatal Complications ◽  
Exact Test ◽  
The Relationship

 Abstract Background: Preeclampsia is one of the biggest causes of maternal-fetal morbidity and mortality. Based on the prognosis, the classification of Preeclampsia is early onset (<34 weeks) and late onset (> 34 weeks). Purpose: to investigate the relationship between the onset of severe Preeclampsia and perinatal complications. Method: This research is a quantitative study with a retrospective observational analytic study type and collected medical record data. The study population was severe Preeclampsia  patients who gave birth at RUMKITAL Dr. Ramelan Surabaya for the period January 2018 - June 2020 and has no previous history of chronic hypertension. The research sample was 79 subjects with 44 subjects early onset, and 35 subjects late onset. Perinatal complications  examined are preterm delivery, asphyxia, LBW, IUGR, stillbirth. The chi-square test or Fisher’s Exact Test was used to analyze relationships. Result: From the results of the study, the comparison of the percentage from early onset and late onset that experienced complications was 93.2% vs 48.6%, p-value = 0.000, OR = 14.5, CI = 3,764–55,635.  At preterm delivery, it was found that 75% vs 28.6%, p-value = 0.000,  OR = 7.5, CI = 2,754-20,422. . In asphyxia, it was found 41.7% vs 31.4%, p-value = 0.46. At LBW, it was found 72.7% vs 17.1%, p-value = 0,000, OR = 12.9, CI = 4,285-38,771. In IUGR, it was found that 15.9% vs 2.9%, p-value = 0.000. In stillbirth, it was found 18.2% vs 0% and p-value = 0.008. Conclusion: the onset of severe Preeclampsia is related with perinatal complications. Complications associated with the onset severe Preeclampsia are preterm, LBW, stillbirth. Meanwhile, complications that are not related with the onset severe Preeclampsia are asphyxia and IUGR  

scholarly journals Comparison of Maternal and Fetal Outcomes in Parturients With and Without a Diagnosis of Gestational Diabetes

2019 ◽  
Vol 41 (11) ◽  
pp. 647-653 ◽  
Author(s):  
Inês Carolina Siqueira Freitas ◽  
Micheli Cristiane Hintz ◽  
Larissa Chaiane Orth ◽  
Tamara Gonçalves da Rosa ◽  
Betine Moehlecke Iser ◽  
...  
Keyword(s):  
Family History ◽  
Gestational Diabetes ◽  
Statistical Significance ◽  
Positive Family History ◽  
Previous History ◽  
Diabetes Diagnosis ◽  
Fetal Outcomes ◽  
Family History Of Diabetes ◽  
Significant Difference ◽  
History Of

Abstract Objective The present study aims to compare the maternal and fetal outcomes of parturients with and without a gestational diabetes diagnosis. Methods A case-control study including parturients with (cases) and without (control) a gestational diabetes diagnosis, who delivered at a teaching hospital in Southern Brazil, between May and August 2018. Primary and secondary data were used. Bivariate analysis and a backward conditional multivariate logistic regression were used to make comparisons between cases and controls, which were expressed by odds ratio (OR), with a 95% confidence interval (95%CI) and a statistical significance level of 5%. Results The cases (n = 47) were more likely to be 35 years old or older compared with the controls (n = 93) (p < 0.001). The cases had 2.56 times greater chance of being overweight (p = 0.014), and a 2.57 times greater chance of having a positive family history of diabetes mellitus (p = 0.01). There was no significant difference regarding weight gain, presence of a previous history of gestational diabetes, height, or delivery route. The mean weight at birth was significantly higher in the infants of mothers diagnosed with diabetes (p = 0.01). There was a 4.7 times greater chance of macrosomia (p < 0.001) and a 5.4 times greater chance of neonatal hypoglycemia (p = 0.01) in the infants of mothers with gestational diabetes. Conclusion Therefore, maternal age, family history of type 2 diabetes, obesity and pregestational overweightness are important associated factors for a higher chance of developing gestational diabetes.

scholarly journals Clinical, epidemiological and autoimmune associations in childhood vitiligo in Qatar

2020 ◽  
Vol 6 (2) ◽  
pp. 151
Author(s):  
Haya Al Mannai ◽  
Mohamed Allam ◽  
Hassan Riad
Keyword(s):  
Family History ◽  
Autoimmune Diseases ◽  
Age Of Onset ◽  
Positive Family History ◽  
Thyroid Peroxidase ◽  
Base Line ◽  
Adult Onset ◽  
Prognostic Features ◽  
History Of ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Childhood vitiligo although clinically similar to adult onset vitiligo but it has distinct clinical, epidemiological and prognostic features compared to adult onset vitiligo.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective study that was carried out on 85 pediatric patients up to age of 18 years old with the diagnosis of vitiligo, where the clinical and epidemiological data  including clinical type of vitiligo, family history of autoimmune diseases like thyroid disorders and diabetes mellitus and laboratory results including anti-thyroid peroxidase antibodies (anti-TPO antibodies), anti-parietal cell antibodies, antinuclear antibodies (ANA), Vitamin D and Vitamin B12 were retrieved from the files of these patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the children affected by vitiligo was 10.4 years, the mean age of onset of vitiligo was 5.4 years, 54 (63.5%) percent were girls and 31 (36.5%) were boys. A positive family history of vitiligo was found in 44.7% of the participants, family history of DM was found in 64.7% of patients and family history of thyroid disease was found in 32.9% of the participants. The prevalence of thyroid autoimmunity was found to be in 22.4% of total participants.</p><p class="abstract"><strong>Conclusions:</strong> Childhood vitiligo has distinct clinical features, more common family history for autoimmune diseases and thyroid autoantibodies rather than overt clinical diseases, which raise the necessity to perform a routine initial immunological and thyroid screening in children with vitiligo and to repeat them at annual bases if there were abnormal values at base line or strong family history.</p>

scholarly journals Factors Affecting Tramadol-Associated Seizure

2020 ◽  
Vol 10 (4) ◽  
pp. 26674.1-26674.5
Author(s):  
Maryam Zaare Nahandi ◽  
◽  
Sayna Abbaszadeh ◽  
Mostafa Mansouri ◽  
Haniyeh Elahifard ◽  
...  
Keyword(s):  
Previous History ◽  
Health Concern ◽  
Affecting Factors ◽  
Public Health Concern ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Study Results ◽  
History Of ◽  
The Mean ◽  
Higher Doses

Background: Tramadol is a widely prescribed analgesic and due to its opioid-like effects, the potential for abuse of tramadol is noticeable. Besides, the complications of tramadol abuse have become a public health concern. This study aimed to investigate the affecting factors on the seizure, as one of the most common complications of tramadol consumption. Methods: A total number of 64 patients from 315 patients who were referred to Sina Hospital, Tabriz, Iran because of tramadol toxicity were included in this 9 months cross-sectional retrospective study. Results: There were 52 males and 12 females in the study. The seizure happened in 53.1% of the subjects and the Mean±SD time between tramadol consumption and seizure was 5.9±7.36 hours. There was no significant association between seizure and sex, age, the dose of tramadol, and previous tramadol consumption history. A significant association was seen between the dose of tramadol and the time of seizure. Conclusion: Seizure that happens due to tramadol overdose is not dependent on sex, age, and previous history of tramadol consumption. As the dose of tramadol is higher, the seizure happens later. More research is needed to understand why the seizure occurs later in higher doses.

scholarly journals Pregnancy with previous caesarean section: an overview of adverse fetomaternal sequelae

2018 ◽  
Vol 7 (5) ◽  
pp. 1817 ◽  
Author(s):  
Joyita Bhowmik ◽  
Amit Kyal ◽  
Indrani Das ◽  
Vidhika Berwal ◽  
Pijush Kanti Das ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Previous History ◽  
Successful Outcome ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Increased Risk ◽  
Fetal Complications ◽  
History Of

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.

scholarly journals Cerebral Venous Sinus Thrombosis in Women: Subgroup Analysis of the VENOST Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Derya Uluduz ◽  
Sevki Sahin ◽  
Taskin Duman ◽  
Serefnur Ozturk ◽  
Vildan Yayla ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Previous History ◽  
Epileptic Seizures ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Venous Sinus Thrombosis ◽  
History Of ◽  
The Mean

Background. Early diagnosis of cerebral venous sinus thrombosis (CVST) associated with reproductive health-related risk factors (RHRF) including pregnancy, puerperium, and oral contraceptive (OC) use can prevent severe neurological sequelae; thus, the symptoms must be documented in detail for each group. Methods. Out of 1144 patients with CVST, a total of 777 women were enrolled from a multicenter for the study of cerebral venous sinus thrombosis (VENOST). Demographic, biochemical, clinical, and radiological aspects were compared for 324 cases with RHRF and 453 cases without RHRF. Results. The mean age of the RHRF (-) group (43.2 ± 13 years) was significantly higher than of the RHRF (+) group (34±9 years). A previous history of deep venous thrombosis (3%), isolated cavernous sinus involvement (1%), cranial neuropathy (13%), comorbid malignancy (7%), and its disability scores after 12 months (9%) were significantly higher in the RHRF (-) group. The RHRF (+) group consisted of 44% cases of puerperium, 33% cases of OC users and 23% of pregnant women. The mean age was found to be higher in OC users (38±9 years). A previous history of deep venous thrombosis was slightly higher in the pregnancy subgroup (4%). Epileptic seizures were more common in the puerperium group (44%). Conclusion. The results of our study indicate that the risk of CSVT increases parallel to age, OC use, and puerperium period. In addition, when considering the frequency of findings and symptoms, epileptic seizures in the puerperium subgroup of the RHRF (+) group and malignancies in the RHRF (-) group may accompany the CSVT. In daily practice, predicting these risks for the CSVT and early recognition of the symptoms will provide significant benefits to patients.

scholarly journals Correlation of lateral placental location with development of preeclampsia

2020 ◽  
Vol 9 (3) ◽  
pp. 1017
Author(s):  
Anjali Gupta ◽  
Priyanka Bansal ◽  
Jyotsna Sen ◽  
Savita Rani Singhal
Keyword(s):  
Prospective Observational Study ◽  
Previous History ◽  
Antenatal Clinic ◽  
Severe Anaemia ◽  
Multiple Organ ◽  
Clinical Syndrome ◽  
Chronic Hypertension ◽  
Singleton Pregnancy ◽  
Organ Systems ◽  
History Of

Background: Preeclampsia is a complex clinical syndrome which involves multiple organ systems and remains the principle cause of maternal and perinatal morbidity and mortality. Preeclampsia is a disease of trophoblastic tissue. Placental abnormality is one of the initial events in patients who are destined to develop pregnancy induced hypertension subsequently. Objective of this study was to evaluate the association of laterally located placenta on ultrasound with development of preeclampsia.Methods: This prospective observational study was conducted on 200 antenatal women with singleton pregnancy at 18-24 weeks of gestation who attended antenatal clinic of obstetrics and gynaecology, PGIMS Rohtak from October 2017 to October 2018. Detailed antenatal transabdominal ultrasound along with placental location was done between 18-24 weeks of gestation in women who fitted into inclusion criteria. All the antenatal women belonged to 18-24 weeks of gestation were included in the study except those women with chronic hypertension, diabetes mellitus, renal disease, severe anaemia, thyrotoxicosis, low lying placenta, previous history of preeclampsia or eclampsia.Results: Out of 200 antenatal women, 84 had lateral placenta while 116 had central placenta. Out of these 84 women who had lateral placenta, 55 women (65.5%) developed preeclampsia and out of 116 (58%) women who had central placenta, 28 women (24.1%) developed preeclampsia.Conclusions: From the above study, we concluded that women with laterally located placenta by ultrasound at 18-24 weeks of gestation have greater risk of developing preeclampsia.

Carbohydrate metabolism in patients with Cushing disease: a glance at the incretin system

2016 ◽  
Vol 62 (5) ◽  
pp. 67-68
Author(s):  
Lubov V. Matchekhina ◽  
Ekaterina A. Shestakova ◽  
Zhanna E. Belaya ◽  
Marina V. Shestakova
Keyword(s):  
Drug Therapy ◽  
Carbohydrate Metabolism ◽  
Previous History ◽  
Pituitary Surgery ◽  
Underlying Disease ◽  
Control Group ◽  
Cushing Disease ◽  
Free Cortisol ◽  
History Of ◽  
The Mean

Introduction. The relevance of carbohydrate metabolism studying in patients with Cushing disease can be explained by frequent occurrence of glucose metabolism disturbances on the one hand, and difficulties in glucose-lowering therapy in these patients on the other. The effectiveness of hyperglycaemia treatment may be reduced due to difficulties in remission / cure of the underlying disease, as well as to the use of specific drug-therapy, leading to the hyperglycaemia. There is a growing interest in research aimed at studying the role of incretin system in the pathogenesis of secondary hyperglycemia associated with neuroendocrine diseases recently.Methods. A total of 20 patients with Cushing disease were included, (19 female and 1 male), the mean age was 37.5 years (18-69). All of the patients were diagnosed with Cushing disease for the first time (using urinary free cortisol levels and MRI-data); none of them had a history of previous drug therapy, radiotherapy or pituitary surgery. The mean HbA1c level was 5,8% (5,3-6,2). All patients underwent OGTT, during which glucose, glucagon, GLP1, GLP2, GIP, ghrelin were measured at 0, 30 and 120 min respectively. The control group included 21 patients without previous history of carbohydrate metabolism disturbances. After OGTT 57% were presented without any carbohydrate metabolism disturbances, 28,57% presented with prediabetes and 14,43% were diagnosed with diabetes.Results. After glucose levels analyzing 40% of patients were diagnosed with early carbohydrate metabolism disturbances ,15% were diagnosed with diabetes. After glucose intake a slight inrease in glucagon levels with a peak by 30’ (p=0,001) compared to gradually decreasing levels in controls was observed . The levels of GIP during OGTT were not significantly different compared to control group. GLP-1 and GLP-2 levels were significantly higher compared to controls (p=0,017 and p<0,001 respectively) with peak levels at 30’. Ghrelin levels were also significantly higher compared to controls (p=0,013)Conclusion. Incretins levels can be possible markers of specific carbohydrate metabolism disturbances in patients with Cushing disease and presumably will help to differentiate steroid diabetes from T2DM. Further investigations needed to prove these speculations.

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