scholarly journals Púrpura trombocitopénica idiopática en el embarazo: a propósito de un caso

2021 ◽  
Vol 81 (04) ◽  
pp. 411-414
Author(s):  
Claudia Milena López-López ◽  
◽  
Luis Carlos Gerena-Pallares
Keyword(s):  
Platelet Count ◽  
First Trimester ◽  
Reticuloendothelial System ◽  
Severe Thrombocytopenia ◽  
Third Trimester ◽  
Platelet Antibodies ◽  
History Of ◽  
First Trimester Of Pregnancy ◽  
Fetal Wellbeing ◽  
Time Of Admission

Idiopathic purple thrombocytopenia is a hemorrhagic pathology, characterized by a decrease in the platelet count during pregnancy, mediated by cells and anti-platelet antibodies, causing the premature destruction of platelets by the reticuloendothelial system, which during pregnancy could lead to a commitment to maternal fetal wellbeing in severe stages. This pathology occurs in 1 out of every 1,000 to 10,000 pregnancies, and corresponds to 3% of thrombocytopenic pregnancies. The goal of management is to maintain platelet counts within safe ranges, recommending starting harmacological management when a platelet count lower than 10,000 / uL is found at any time during pregnancy or 30,000 / uL in the second or third trimester. The case presented corresponds to a 40-yearold woman in the first trimester of pregnancy with a history of chronic idiopathic purple thrombocytopenic, with severe thrombocytopenia at the time of admission to the Hospital. Keywords: Idiopathic thrombocytopenic purpura. Pregnancy. Blood platlets.

Correlations Between the Values of Maternal Glycemia from the Last Trimester of Pregnancy and Fetal Birth Weight

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko
Keyword(s):  
First Trimester ◽  
Mean Value ◽  
Fetal Macrosomia ◽  
Entire Group ◽  
Third Trimester ◽  
The Third ◽  
Group I ◽  
Fetal Birth Weight ◽  
First Trimester Of Pregnancy ◽  
The Mean

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.

scholarly journals Predictive value of the aspartate aminotransferase to platelet ratio index and aspartate aminotransferase to alanine aminotransferase ratio in early diagnosis of intrahepatic cholestasis in pregnancy

2021 ◽  
Vol 8 (11) ◽  
pp. 650-654
Author(s):  
İbrahim Kale
Keyword(s):  
Platelet Count ◽  
Intrahepatic Cholestasis ◽  
Predictive Value ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
First Trimester ◽  
Control Group ◽  
Third Trimester ◽  
Apri Score ◽  
In Pregnancy

Objective: We aimed to investigate the predictive value of the first-trimester aspartate aminotransferase/platelet count ratio index (APRI) and aspartate aminotransferase/alanine aminotransferase ratio for intrahepatic cholestasis in pregnancy (ICP). Material and Methods: The clinical data of patients who admitted to the Obstetrics Department of Umraniye Training and Research Hospital, between 2015-2020 were analyzed retrospectively. The study group consisted of 44 patients with ICP and the control group consisted of randomly selected 92 healthy pregnant women. Results: The two groups were similar in terms of age, BMI, first and third-trimester platelet count and third-trimester hemoglobin level. Patients with ICP had a significantly higher first-trimester APRI and a lower first trimester AST/ALT ratio than the healthy controls (p <0.001, p = 0.001, respectively). According to the ROC analysis, the optimal cut-off value of the APRI to predict ICP was 0.191, with the sensitivity of 0.66 and specificity of 0.66 (AUC: 0,727), and the optimal cut-off value for AST/ALT ratio was 1.07, with the sensitivity of 0.64, and specificity of 0.62 (AUC: 0,681). Conclusion: The first-trimester APRI score and AST/ALT ratio is an easy, inexpensive, and non-invasive tool that may be useful in predicting ICP early.

scholarly journals Anestesi Scalp Block dan Occipital Block pada Tindakan External Ventricular Drainage (EVD) pada Kehamilan 32 Minggu

2020 ◽  
Vol 9 (2) ◽  
pp. 102-107
Author(s):  
Muhammad Arshad ◽  
Dewi Yulianti Bisri ◽  
Sri Rahardjo
Keyword(s):  
Ct Scan ◽  
First Trimester ◽  
External Ventricular Drainage ◽  
Ventricular Drainage ◽  
Third Trimester ◽  
Intrauterine Pregnancy ◽  
High Care ◽  
History Of ◽  
Scalp Block ◽  
Obstetric Surgery

Hidrosefalus adalah pembesaran ventrikel otak sebagai akibat peningkatan jumlah cairan serebrospinal (CSS) yang disebabkan oleh ketidakseimbangan antara produksi, sirkulasi dan absorbsinya. Perkiraan wanita hamil yang dilakukan operasi non obstetric sekitar 1–2%. Pasien obstetri dengan penyakit bedah saraf selalu dirawat di ICU. Insidensi operasi selama kehamilan dilaporkan 42% prosedur pembedahan terjadi pada trimester pertama, 35% pada trimester kedua, dan 23% pada trimester ketiga. Seorang wanita 35 tahun dengan usia kehamilan 32–33 minggu datang ke IGD dengan penurunan kesadaran tanpa riwayat trauma, tidak dijumpai tekanan darah tinggi. Dari pemeriksaan CT-Scan ditemukan adanya hidrosefalus, sehingga dilakukan tindakan external ventricular drainage (EVD). Anestesi untuk pasien dalam keadaan hamil harus mempertimbangkan bayi dalam kandungan sehingga dilakukan pembiusan scalp block dan occipital block. Obat yang digunakan ropivakain HCl 0,375 % (sebanyak 10cc). Setelah operasi pasien dirawat di ruang pemulihan, 2 jam kemudian dirawat di ruang high care unit (HCU). Pencegahan terhadap hipoksia dan hipotensi adalah keharusan, walaupun periode hipoksemia yang pendek masih bisa ditoleransi. Hipoksemia maternal yang berkepanjangan akan menyebabkan vasokonstriksi sirkulasi uteroplasental yang pada akhirnya menurunkan perfusi sehingga menyebabkan hipoksemia, asidosis dan kematian janin. Scalp Block and Occipital Block Anesthesia for External Ventricular Drainage (EVD) in 32-Week PregnancyAbstractHydrocephalus is enlargement of the brain ventricles as a result of an increase in the amount of cerebrospinal fluid (CSS) caused by an imbalance between production, circulation and absorption. Estimates of pregnant women in non-obstetric surgery are around 1–2%. Obstetric patients with neurosurgery disorders are always treated in the ICU. The incidence of surgery during pregnancy was reported in 42% of surgical procedures occurred in the first trimester, 35% in the second trimester, and 23% in the third trimester. A 35-year-old woman with 32-33 weeks' gestation came to the emergency room with decreased consciousness yet no history of trauma and high blood pressure. Hydrocephalus were found in CT scan, and the external ventricular drainage (EVD) is taken. The patient has intrauterine pregnancy so the anesthesia choice is scalp block and occipital block. Ropivacaine HCl 0.375% (as much 10cc) was used. After surgery the patient was treated in the recovery room for 2 hours, and discharged to the high care unit (HCU) afterwards. Hypoxia and hypotension is a challenge in short periods of hypoxemia that can still be tolerated. Prolonged maternal hypoxemia prevention will cause uteroplacental circulation vasoconstriction which ultimately reduces perfusion, causing foetal hypoxemia, acidosis and death.

scholarly journals Blunted erythropoietin production and decreased erythropoiesis in early pregnancy [see comments]

Blood ◽  
1991 ◽  
Vol 78 (1) ◽  
pp. 89-93
Author(s):  
Y Beguin ◽  
G Lipscei ◽  
H Thoumsin ◽  
G Fillet
Keyword(s):  
Early Pregnancy ◽  
Cell Mass ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Entire Group ◽  
Third Trimester ◽  
Serum Transferrin Receptor ◽  
Erythropoietin Production ◽  
Early Postpartum ◽  
First Trimester Of Pregnancy

After decreasing in the first trimester of pregnancy, the total red blood cell mass increases in the second and third trimesters to peak at term at about 120% to 125% of nonpregnant values, but how this is brought about by changes in the rate of erythropoiesis is not known. We evaluated erythropoiesis by measuring serum transferrin receptor (TfR) levels in 406 women during normal pregnancy (N = 317), at delivery (N = 63), or in the early postpartum (N = 27). Despite the presence of the placenta and the frequent occurrence of iron deficiency, TfR levels remained low in the first two trimesters and increased in the third trimester and at delivery. To explain why erythropoiesic activity was relatively low in early pregnancy, we also measured serum immunoreactive erythropoietin (Epo) in relation to the degree of anemia. There was a very strong correlation between serum TfR and Epo levels in the entire group (r = .59, P less than .0001) as well as in each period of pregnancy. Epo levels remained low for the degree of anemia and did not correlate with hematocrit in the first two trimesters, but recovered afterwards. In the early postpartum, Epo production and erythropoiesis were normal. We conclude that: (1) erythropoiesis is decreased in the first part of pregnancy but increases afterwards; and (2) blunted Epo production in early pregnancy could be responsible for that observation.

scholarly journals The Role of Routine Ultrasonography in the First Trimester of Pregnancy

2021 ◽  
pp. 950-958
Author(s):  
T. Saravanan ◽  
Hephzibah Kirubamani
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Antenatal Clinic ◽  
Specific Method ◽  
Medical College ◽  
Early Pregnancy Failure ◽  
Ultrasound Findings ◽  
History Of ◽  
First Trimester Of Pregnancy

Introduction: In the early stages of pregnancy, ultrasound is an extremely specific method for examination. This article reviews how the normal development of a baby in the first trimester of pregnancy relates to ultrasound findings. Aim: To highlight the importance of routine ultrasonography in the first trimester of pregnancy in detecting and dating gestation, its viability and early detection of anomalies and complications Methods: This descriptive study involved 100 pregnant women within 12 weeks of gestation attending antenatal clinic at Saveetha Medical college, during the study period Inclusion Criteria: Pregnant women with history of amenorrhea <12 weeks of gestation. Exclusion criteria: Individuals with history of pain abdomen and bleeding per vaginum Results: A total of 99 pregnancies were intrauterine of which 1 was anembryonic and 2 had early pregnancy failure, 15 pregnancies were redated. One ectopic and one fibroid complicating pregnancy were aslo found. Conclusion: Ultrasonography is an effective method to detect and date pregnancy, identify nonviable pregnancies, fetal abnormalities and early trimester complications. Hence it is ideal to use it routinely as screening tool during the first trimester of pregnancy.

scholarly journals Changes of Partial Pressure of Carbon Dioxide in Arterial Blood (PaCO2) and Respiratory Rate (RR) in Pregnant Women

2008 ◽  
Vol 10 (Number 1) ◽  
pp. 10-15
Author(s):  
D K Sunyal ◽  
Md. R Amin ◽  
MH Md. R ◽  
GM Kibria ◽  
G M Molla ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
Pregnant Women ◽  
Respiratory Rate ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
Arterial Blood ◽  
Significant Difference ◽  
History Of

In the present study the partial pressure of carbon dioxide in arterial blood (PaC0:1 and respiratory rate (RR) were studied in pregnant and non-pregnant women in Dhaka city. Far this purpose a total 32 women for PaCO)and 100 women for RR with age ranging front 25 ...ears le 35 years without any recent history of respiratory diseases were selected. Normal pregnant women were taken as e.yperimental group and healthy nor-pregnant ...omen as return!. Data was collected during first trimester. second trimester and third trimester in pregnant women and also nompregnant women. The PaCOrwas determined by using 'EASY BLOOD GAS .0TO INALMER" and RR was recorded. The PaCO, and RR during different trimesters of pregnant .rumen were compared with that of non-pregnant 11.1101. Statistical analysis was drum with .tudents '1' rest. The PeCOr was significantly lower in first trimester, second trimester and third (rimester of pregnant women than that of non-pregnant women. Similarly, RR was significantly higher in first trimester. second trimester and third trimester of pregnant women than that of nonpregnant women. Again RR was significantly higher in third trimester than in first trimester and second trimester of pregnant women. There were no statistically significant difference of PaCO, among first trimester. second trimester and third trimester of pregnant women. Similarly, there were no statistically significant difference of RR between first trimester and second trimester of pregnant women. It may be concluded from the study that the progressively decreased PaCO• and increased RR throughout Me pregnancy were most likely MP be related to the effect of progesterone-induced hyperventilation. Hypermfilation in pregnancy is due to hypersensitivity of respiratory centre. Due to hyperventilation there is expel out of CO, miming decrease in PaC0r and increase in RR during pregnancy.

scholarly journals Effects of Cigarette Smoke Exposure on Placental Global DNA Methylation and 8-hydroxy-2’-deoxyguanosine Levels in Mother-new-born Binomials

2021 ◽  
Author(s):  
Hector Diaz-Garcia ◽  
Jenny Vilchis-Gil ◽  
Karla Viridiana Castro-Cerritos ◽  
Pilar García-Roca ◽  
Miguel Klünder-Klünder ◽  
...  
Keyword(s):  
Cigarette Smoke ◽  
High Performance ◽  
High Resolution Mass Spectrometry ◽  
First Trimester ◽  
Cigarette Smoke Exposure ◽  
Clinical Effects ◽  
Epigenetic Alterations ◽  
History Of ◽  
Women Groups ◽  
First Trimester Of Pregnancy

Abstract Background: Smoking is practiced worldwide for both men and women, and it is associated with different diseases and deleterious effects on gestational products, chiefly during pregnancy. Epigenetic alterations induced by cigarette smoke must be related to perinatal abnormalities. Methods: 219 pregnant women, aged 16 to 34 years, with or without a history of cigarette consumption (1–5/day) during the first trimester of pregnancy and their offspring were studied in this work. A validated dietary questionnaire was used to estimate daily consumptions of macronutrients and micronutrients, including total energy, during pregnancy. As a marker of DNA damage, 8-hydroxy-2’-deoxyguanosine (8-OHdG) levels were determined in plasma of women, before delivery, in umbilical cord blood after delivery, in the new-borns. The proportion of methylated DNA in the placentas (metDNA) was determined by ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry (UPLC-HRMS). Results: Non-significant differences were observed between smoking and non-smoking women groups, or between the new-borns groups (p > 0.05). Smoking women showed up higher intakes of vitamins, lipids, proteins, and carbohydrates in comparison with non-smoking women (p < 0.01). 8-OHdG levels correlated among the mothers and new-borns (p = 5.386e-15) and were lower in the smoking binomials in comparison with non-smoking binomials (β = −1.20 to −64). Negative correlations were found between micronutrients and macronutrients but Vitamin C, and 8-OHdG levels of the women (p < 0.01). However, the new-borns 8-OHdG correlated with proteins, vitamin A, and vitamin B12 (p < 0.05). Cigarettes consumed per day correlated to the 8-8HdG levels (Rho = −0.247, p = 0.012), alcohol consumption (Rho = 0.219, p = 0.001), to macronutrients (Rho = 212 to 332, p < 0.01), micronutrients (Rho = 186 to 289, p < 0.01), and to energy (Rho = 0.286, p = 0.001). Finally, metDNA deceased in the smoking women than in the non-smoking women (β = −0.12, p < 0.05), and correlated with the number of cigarettes consumed per day (Rho = −0.229, p = 0.009). Conclusion: Cigarette smoking alters metDNA levels of the placenta, however, their clinical effects come out over years or transgenerationally.

scholarly journals A Sudden Onset of Severe Thrombocytopenia While Using Evolocumab

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ikuo Inoue ◽  
Yasuhiro Takenaka ◽  
Yoshitora Kin ◽  
Satoshi Yamazaki ◽  
Yuichi Ikegami ◽  
...  
Keyword(s):  
Platelet Count ◽  
Immunoglobulin Therapy ◽  
Sudden Onset ◽  
High Dose ◽  
Severe Thrombocytopenia ◽  
First Line Therapy ◽  
Thrombopoietin Receptor ◽  
Thrombopoietin Receptor Agonist ◽  
History Of ◽  
Coa Reductase

A 72-year-old man with a 10-year history of coronary heart disease started evolocumab treatment once a month after developing excess myalgia due to therapy with a 3-hydroxy-methylglutaryl CoA reductase inhibitor. No side effects such as myalgia symptoms had been reported during the first 14 months of evolocumab treatment; however, he suddenly presented with acute severe thrombocytopenia following the 14th treatment. His platelet count continued to decrease to a nadir of 1,000/μL. His platelet-associated immunoglobulin G level had elevated to 790 ng/107 cells. He started receiving a combination of steroid therapy, high-dose immunoglobulin therapy, and platelet transfusions, but the first-line therapy was ineffective. He was subsequently treated with a thrombopoietin receptor agonist, and his platelet count recovered to 250,000/μL.

Congenital Rubella and Thrombocytopenia: Report of Two Cases with Initial and Follow-up Viral Cultures

PEDIATRICS ◽  
1965 ◽  
Vol 36 (2) ◽  
pp. 268-270
Author(s):  
WILLIAM D. COCHRAN ◽  
MICHAEL CORNFIELD ◽  
DAVID FRIEDBERG
Keyword(s):  
Tissue Culture ◽  
Kidney Tissue ◽  
Clinical History ◽  
First Trimester ◽  
Clinical Findings ◽  
Congenital Rubella ◽  
Echo Virus ◽  
History Of ◽  
First Trimester Of Pregnancy

Recent advances have made it possible to isolate rubella virus from affected persons and to propagate the virus in tissue culture. The virus may be identified by the unique cytopathogenic changes in human amnion tissue culture by interference with ECHO virus type 11 in monkey kidney tissue culture. Thus an even closer correlation between an active rubella infection in the mother in the first trimester of pregnancy and the clinical findings of the rubella syndrome is now feasible. The rubella epidemic of 1964 can be expected to produce significant numbers of infants with the congenital rubella syndrome. This paper reports the clinical history of two cases of rubella associated with thrombocytopenia in the newborn.

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