scholarly journals Premature Birth, Management, Complications

2021 ◽  
Author(s):  
Panagiotis Tsikouras ◽  
Anastasia Bothou ◽  
Aggeliki Gerede ◽  
Ifigenia Apostolou ◽  
Fotini Gaitatzi ◽  
...  
Keyword(s):  
Premature Birth ◽  
Previous History ◽  
Premature Births ◽  
Nucleotide Polymorphisms ◽  
Mortality And Morbidity ◽  
Genes And Environment ◽  
Treatment Administration ◽  
History Of ◽  
Ultrasound Assessment ◽  
Successful Prevention

In recent years an increase in premature births (PB) rate has been noticed, as this pregnancy complication that still remain an important cause of perinatal morbidity and mortality, is multifactorial and prediction is not easy in many cases. There are many bibliographic data supporting the view that PB have also genetic predisposition. The trend of “recurrence” of PB in women as well as its increased frequency in ethnic groups suggests its association with genetic factors, either as such or as an interaction of genes and environment. Immunomodulatory molecules and receptors as well as polymorphisms of various genes and/or single nucleotides (single nucleotide polymorphisms, SNPs) now allow with advanced methods of Molecular Biology the identification of genes and proteins involved in the pathophysiology of PB. From the history of a pregnant woman, the main prognostic factor is a previous history of prematurity, while an ultrasound assessment of the cervix between 18 and 24 weeks is suggested, both in the developed and the developing world. According to the latest data, an effective method of successful prevention of premature birth has not been found. The main interventions suggested for the prevention of premature birth are the cervical cerclage, the use of cervical pessary, the use of progesterone orally, subcutaneously or transvaginally, and for treatment administration of tocolytic medication as an attempt to inhibit childbirth for at least 48 hours to make corticosteroids more effective. Despite the positive results in reducing mortality and morbidity of premature infants, the need for more research in the field of prevention, investigation of the genital code and the mechanism of initiation of preterm birth is important.

Progestogens for treatment and prevention of pregnancy disorders

2010 ◽  
Vol 3 (3) ◽  
Author(s):  
Adolf E. Schindler
Keyword(s):  
Premature Birth ◽  
Previous History ◽  
First Trimester ◽  
Study Groups ◽  
Treatment And Prevention ◽  
Maternal Immune System ◽  
Hydroxyprogesterone Caproate ◽  
History Of ◽  
Threatened Abortion ◽  
In Pregnancy

AbstractProgesterone appears to be the dominant hormone not only establishing a proper secretory endometrial development but also adequate decidualization to establish pregnancy and sustain pregnancy development. Progesterone is the natural immunoregulator to control the maternal immune system and not to reject the allogeneic fetus. There are two sources of progesterone: corpus luteum first and placenta later. Three progestogens can be used in pregnancy: (i) progesterone (per os, intravaginal and intramuscular), (ii) dydrogesterone (per os), and (iii) 17α-hydroxyprogesterone caproate (intramuscular). There are three indications, for which these progestogens can be clinically used either for treatment or prevention: (i) first trimester threatened and recurrent (habitual) abortion, (ii) premature labor/premature birth, and (iii) pre-eclampsia (hypertension in pregnancy). The available data are limited and only partially randomized. In threatened abortion the use of progesterone, dydrogesterone and 17α-hydroxyprogesterone caproate leads to a significant improved outcome, when at the time of threatened abortion a viable fetus has been ascertained by ultrasound. For prevention of recurrent abortion there are also some data indicating a significant effect compared with women without progestogen treatment. Prevention of preterm birth by progestogens (progesterone vaginally, orally and 17α-hydroxyprogesterone caproate intramuscularly) was significantly effective. The main study groups include pregnant women with a previous history of premature birth. However, also in women with shortened cervix use of progesterone seems to be helpful. The studies done so far in women with risk factors for pre-eclampsia or established pre-eclampsia were based on parenteral progesterone application. However, new studies are urgently needed.

Risk Factors for Isolated Pulmonary Embolism Are Opposite to Those for DVT-Associated PE: Results of the 7532-Patients Prospective OPTIMEV Cohort Study.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3977-3977
Author(s):  
Jean Luc Bosson ◽  
Marie Antoinette Sevestre ◽  
Jose Labarere ◽  
Joel Constans ◽  
Isabelle Quere ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Cohort Study ◽  
Diagnostic Tests ◽  
Previous History ◽  
Signs And Symptoms ◽  
Routine Practice ◽  
Early Presentation ◽  
Mortality And Morbidity ◽  
History Of

Abstract Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common clinical problem, associated with a significant mortality and morbidity. Hence, accurate diagnosis and appropriate treatment are essential for patients presenting with suspected VTE. Unfortunately, the diagnosis of VTE is challenging in routine practice because of the nonspecific signs and symptoms of this disease. A large number of epidemiologic studies have focused on VTE, contributing to better understanding of this disease and improving its management. Demonstrated risk factors for VTE have been included into clinical prediction rules derived to help physician identify patients that should be referred for objective diagnostic tests. Over the past decade, the extensive use of diagnostic tests combined with the recent advances in imaging technology have resulted in more frequent diagnosis and treatment of early presentation of VTE, including isolated distal DVT or isolated PE. However the clinical signification of various VTE presentations remains unclear, and knowledge on epidemiology of VTE needs to be improve. Therefore we prospectively investigated the relative frequency and risk factors of isolated distal DVT, proximal DVT, PE with DVT and without DVT. Between November 2004 and January 2006, all patients over 18 years old who were referred to 359 french board certified vascular physicians for a clinical suspicion of VTE were included. VTE presentations were categorized using validated clinical decision rules and objective tests including ultrasonography, lung scan and helical CT scan. Subjects without an objectively confirmed diagnosis of VTE were used as controls. We performed multivariate analysis of risk factors for each type of VTE. 8256 patients entered the study, among which 7532 were analysed. The median age for all patients was 65 years (49–77 years), 2923 (39%) were men, 2925 were inpatients (39%), and 1884 (25%) had a previous history of VTE. 933 had isolated distal DVT (12%), 710 proximal DVT (9.4%), 426 PE with DVT (5.7%), 148 PE without DVT (2.0%) and 5315 had no VTE (70.6%). Classically risk factors were comparable for all different types of DVT (distal, proximal, or associated with PE). Curiously, risk factors for isolated pulmonary embolism are opposite to those for DVT-associated PE. Specially isolated PE was not associated with age (> 75y, OR 1.2 [0.7–2.1, p 0.58), family history of VTE (OR 0.7 [0.4–1.3, p 0.26, bed confinement (OR 0.6[0.4–1.1, p 0.1),plaster (OR 0.3 [0.04–2.5, p 0.28), or acute respiratory or cardiac failure (OR 1.8 [0.9–3.3], p 0.07). Only personnal history of VTE (OR 1.7 [1.1–2.6], recent surgery (OR 1.7 [1.0–3.0], cancer [OR 1.7 [1.1–2.7, p 0.02) and contraceptive use (OR 6.3 [2.5–15.6] p< 0.01) were shwon as risk factors for isolated PE. So this multicenter prospective cohort study shows heterogeneity in the risk factor profile between different forms of VTE encountered in daily practice, providing new insight in the epidemiology of this disease. Specifically, our study underlines the specific risk factors profile of isolated PE comparing to DVT-associated PE.

scholarly journals DANDY-WALKER SYNDROME;

2017 ◽  
Vol 24 (01) ◽  
pp. 47-50
Author(s):  
Qazi Muhammad Zeeshan ◽  
Muhammad Hashim ◽  
Syed Mohammad Maroof Hashmi ◽  
Mohammad Absar Anwar
Keyword(s):  
Posterior Fossa ◽  
Previous History ◽  
Case Series ◽  
Fracture Dislocation ◽  
Common Symptom ◽  
Mortality And Morbidity ◽  
Dandy Walker Malformation ◽  
Posterior Fossa Cyst ◽  
History Of ◽  
Walker Malformation

Introduction: Dandy-Walker Malformation is an inborn condition that includesthe triumvirate of cystic enlargement of the fourth ventricle, posterior fossa distension with riseof the tentorium and agenesis of cerebellar vermis. The purpose of this study is to determinethe Clinical presentation and associated complications, mortality and morbidity of patientundergoing placement of shunt with Y- connector in Dandy Walker Malformation. StudyDesign: Case Series comprised of 85 cases. Setting: Neurosurgery Ward of Tertiary CareHospital in Karachi. Period: February 2011 to December 2015. Methodology: All patients whowere presented in OPD with complaints reminiscent of DWM with accompanied Hydrocephalusand then underwent CT scan Brain without contrast to confirm the diagnosis were admitted.The patients who have previous history of operation and other co-morbid anomalies wereomitted. These patients undergo drainage of Ventricular system and Posterior Fossa cyst wasdone mutually via Dual Shunt including Ventricular-peritoneal and Cysto-peritoneal shunt withY connector. There were few complications and mortality after this surgical intervention whichwas noted for a month. All records were recorded and evaluated by SPSS v.20. Result: Avast majority of patients included were Female. The average age of patients was 2.5 years+/- 1 Standard Deviation. The chief complaint was Hydrocephalus, existing in all patients,after that cerebellar signs in 55 (64.7%) and other signs in 10 (11.8%) patients. Others signsincludes; milestones were delayed, atypical gait and few patients were suffered from psychiatricproblems. Complications which were observed were shunt; Fracture/Dislocation in 10 (11.8%),shunt blockage in 8 (9.4%), malpositioning is also 8 (9.4%), Intracranial Hemorrhage in 7(8.24%) patients and Infection in 10 (11.8%). These complications were observed within amonth of surgery. Unfortunately, two (2.35%) patient were also expired after surgical approach.Conclusion: It is concluded that Dandy Walker Malformation is categorized by a triumvirate.Hydrocephalus is a most common symptom and principal cause of referral to hospitals. Thecommonest difficulty acknowledged after shunting is Malfunction and shunt infections. Thelowest mortality is related to Dual Shunt with Y connector when compared to other approachesfor management of shunt with Y-connector. Thus, it is found to be a worthy decision in givenDWM patients.

scholarly journals Comparison of Child Development Between Aterm and Premature Birth at Age 2-3 Years Old

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Innas Tiara Ardhiani
Keyword(s):  
Child Development ◽  
Premature Birth ◽  
Developmental Disorders ◽  
Developmental Differences ◽  
Primary Data ◽  
Premature Births ◽  
Sampling Formula ◽  
History Of ◽  
Simple Sampling ◽  
Children Development

Objective: Premature births are at risk of developing language delays, motor balance and coordination. This study aims to analyze developmental differences in children with a history of premature birth and term. Methods: The data used was primary data  through  filling  questionnaires  and  interviews  to  subjects.  This  study  was  observational analytic  with  retrospective  cohort  design.  The  population  was  all 2-3 years old children at Kabupaten Probolinggo. Sampling was using a simple sampling formula and obtained 100 children  into  2  groups.  First  group  was  50 children  who  aterm at birth.  Second  group  was  50 children  who  premature at birth.  Result: The result showed that there were there is significant different at child development between aterm and premature born childen  (p<0.05). The  relative risk (RR) analysis  showed  that  the value is significant enough. Children development  was influenced  by  type  of  born (RR=1.647x) Conclusion: The development of 2-3 years old children is very important, especially children with a history of premature birth who have a risk of developmental disorders. Parents should give more attention in providing appropriate developmental stimulation according to the child's age.

scholarly journals Prematurely delivery — observation tactics with account to gestation terms

2002 ◽  
Vol 51 (2) ◽  
pp. 13-17
Author(s):  
Vladimir I. Kulakov ◽  
Vladimir N. Serov ◽  
Vera M. Sidelnikova
Keyword(s):  
Preterm Birth ◽  
Perinatal Mortality ◽  
Gestational Age ◽  
Premature Birth ◽  
Premature Births ◽  
Mortality And Morbidity ◽  
Fetal Malformations ◽  
Complicated Course ◽  
Timely Delivery ◽  
Period Of Gestation

Some disputable matters according to the problem of prematurely labor were presented in this article. The urgency of the problem is due to the fact that preterm birth determines the level of perinatal mortality and morbidity. The management of labor is determined by the gestational age. Termination of pregnancy in the period of 22-27 weeks is most often due to infection and fetal malformations, determined by this period of gestation. With a gestational age of 28-33 weeks, the percentage of indicated premature births is extremely high due to a complicated course of pregnancy (preeclampsia, placental insufficiency) and severe extragenital diseases. Premature birth at 34-37 weeks is close to timely delivery in terms of labor outcomes.

The biology of postpartum psychosis: A hypothetical model

2014 ◽  
Author(s):  
Paola Dazzan
Keyword(s):  
Bipolar Affective Disorder ◽  
Previous History ◽  
Perinatal Period ◽  
Social Consequences ◽  
Postpartum Psychosis ◽  
Maternal Deaths ◽  
Mortality And Morbidity ◽  
Academic Settings ◽  
Mother And Child ◽  
History Of

I had the pleasure of meeting Channi Kumar as a junior psychiatry trainee at the Maudsley Hospital, when I elected to work in his clinical service as part of my rotation. It is therefore for me an honour to contribute to a book that celebrates his legacy. While working with him, I had the opportunity to seeing him in both the clinical and the academic settings. I came to know Channi as a gentle and charismatic clinician with patients, and an inspiring scientist. Channi was fascinated by the predictability of postpartum psychosis, which he used to discuss extensively with his patients, and he led seminal work on the biology of this disorder. I have been stimulated by this work and motivated to advance what remains a largely unexplored area of psychiatry. This chapter will discuss evidence on how biological factors relevant to the pathophysiology of psychoses and the perinatal period could interact in explaining the vulnerability and onset of postpartum psychosis. The role of genetic factors is extensively covered in Chapter 18, and will therefore not be discussed here. Psychiatric disorders contribute to 12% of all maternal deaths (UK Confidential Enquiry into Maternal Deaths; RCPG 2002), and puerperal (or postpartum) psychosis is the most severe psychiatric disorder associated with childbirth, with an estimated suicide rate of 2 per 1,000 sufferers (Oates 2003), and an incidence of 1–2/1,000 deliveries (Munk-Olsen et al. 2006). Although the last few decades have seen a fall in mortality and morbidity from childbirth, this has not been paralleled by a fall in the incidence of postpartum psychosis, which has remained remarkably stable at 0.5–1.0 per 1,000 deliveries (Munk-Olsen et al. 2006). Postpartum psychosis can have dramatic clinical and social consequences: child separation from the mother; lack of emotional bonding between mother and child; impaired child cognitive, physical, and psychological development; and, in some cases, suicide, infanticide, or both. This devastating impact is remarkable, especially considering that postpartum psychosis is highly predictable: in fact, between 30 and 50% of women with a history of bipolar affective disorder, or of schizoaffective disorder, will suffer postpartum psychosis after giving birth (Jones and Cradock 2001); and up to 50–70% of women with a previous history of postpartum psychosis (Jones and Craddock 2001).

405: Previous History of Bladder Cancer is an Independent Prognostic Factor for Upper Tract Transitional Cell Carcinoma

2007 ◽  
Vol 177 (4S) ◽  
pp. 135-135
Author(s):  
Eiji Kikuchi ◽  
Akira Miyajima ◽  
Ken Nakagawa ◽  
Mototsugu Oya ◽  
Takashi Ohigashi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Prognostic Factor ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Transitional Cell ◽  
Previous History ◽  
Independent Prognostic Factor ◽  
Upper Tract ◽  
History Of

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

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