11/81. Successful treatment of acute promyelocytic leukaemia during pregnancy.A case is reported of a pregnant 16-year-old-woman diagnosed with Acute promyelocytic leukaemia (APL) at 25 weeks gestation and treated with all-trans retinoic acid (ATRA) (45 mg/m2) for 25 days in combination with chemotherapy. She achieved a complete cytogenetic and molecular remission. Clinical course was complicated, with an intracerebral bleed, respiratory failure requiring ventilation and prolonged pancytopenia following initial chemotherapy. A live female infant was born at 28 weeks gestation who survived to discharge with significant pulmonary complications. She remains oxygen dependent at 6 months of age. ATRA has been used from the 3rd week of gestation, but fetal malformations are common during the first trimester. In contrast it seems to be safe in the second and third trimesters with regard to teratogenesis but can cause other side-effects. Most successful outcomes in treatment of APL during pregnancy are seen after treatment with ATRA and delivery of the baby at as late a stage as possible. Pregnancies terminated before remission has been obtained or those treated in the first trimester have a poor maternal outcome.- - - - - - - - - - ranking = 1keywords = gestation, pregnancy (Clic here for more details about this article) |
12/81. Intracerebral hemorrhage and postpartum cerebral vasculopathy.INTRODUCTION: Intracerebral hemorrhage (ICH) associated with pregnancy commonly occurs in the postpartum period in the setting of preeclampsia/eclampsia. We describe the clinical course of two patients with ICH due to postpartum cerebral vasculopathy in the absence of toxemia. methods: We reviewed two cases with ICH and postpartum vasculopathy in our hospital (1996-2001) and compared them with seven similar case reports from the literature. RESULTS: Mean age of all patients is 28.7 /-5.6 years (mean /-S.D.). toxemia of pregnancy was absent in all cases. ICHs were cortical in eight and putaminal in one patient. Erythrocyte sedimentation rate was elevated in two. Two cases rehemorrhaged during the same admission. No cerebral infarctions were reported. All patients had diffuse vasculopathy on conventional catheter angiography, with no clinical manifestations or laboratory data supportive of extracerebral or systemic vasculitis. Eight patients were treated with corticosteroids, two with additional cytotoxic agents and one with nimodipine alone. Improvement on follow-up cerebral angiography (catheter or MRA) and transcranial Doppler ultrasonography (TCD) was noted in eight cases. One did not have follow-up cerebral imaging but had an excellent clinical outcome. All cases had good to excellent functional recovery. CONCLUSIONS: Postpartum ICH in the absence of toxemia may be associated with isolated cerebral vasculopathy. The clinical course and functional outcome is good to excellent. This entity appears to be distinct from cerebral vasculitis, which is usually associated with poor outcome.- - - - - - - - - - ranking = 0.24255504290306keywords = pregnancy (Clic here for more details about this article) |
13/81. Neonatal intraventricular haemorrhage associated with maternal use of paroxetine.Selective serotonin reuptake inhibitors (SSRIs) have been reported to inhibit serotonin uptake into platelets, resulting in decreased platelet function. We report a case of a large intraventricular haemorrhage in a 6-h-old boy, whose mother used paroxetine during pregnancy.- - - - - - - - - - ranking = 0.12127752145153keywords = pregnancy (Clic here for more details about this article) |
14/81. Recent onset neurofibromatosis complicating eclampsia with maternal death: a case report.Neurofibromatosis in pregnancy has been associated with poor perinatal outcome. A 30-year-old multigravida developed peripheral lesions of neurofibromatosis during the third month of pregnancy. She had eclampsia complicated with fatal left-sided massive intracerebral haemorrhage detected on computed tomography at 8.5 months gestation. Investigations were suggestive of hellp syndrome. A still-born male baby was delivered. In spite of all supportive measures the patient died on the third postpartum day. We conclude that recent onset neurofibromatosis in current pregnancy should be considered as a predictor of potentially adverse maternal and fetal outcome and such pregnancies be managed in tertiary level referral centre.- - - - - - - - - - ranking = 0.49503669526871keywords = gestation, pregnancy (Clic here for more details about this article) |
15/81. Rostral transfontanel herniation.Upward transtentorial herniation as a result of mass effect in the posterior fossa has been described in adults by several authors. We report the case of a premature infant, small for gestational age, who experienced rostral herniation of a portion of frontal lobe through the anterior fontanel as the result of a hemorrhagic cerebellar infarction followed by a large parieto-occipital intracerebral hemorrhage.- - - - - - - - - - ranking = 0.13120413091412keywords = gestation (Clic here for more details about this article) |
16/81. Anesthetic management of intracranial hemorrhage from huge arteriovenous malformations in late pregnancy--a case report.Intracranial hemorrhage (ICH) from an arteriovenous malformation (AVM) in pregnancy is quite rare and could lead to exceedingly high maternal and fetal morbidity and mortality. We report a 26-year-old woman at 36 weeks' gestation who sustained ICH due to two huge AVMs. For preventing from progressive increased intracranial pressure (IICP), cesarean section under general anesthesia was performed successfully. Herein, we also discuss the anesthetic management after reviewing the related current literatures.- - - - - - - - - - ranking = 0.73759173817177keywords = gestation, pregnancy (Clic here for more details about this article) |
17/81. Congenital syphilis: unique clinical presentation in three preterm newborns.Three preterm newborns affected by congenital syphilis, born to mothers not adequately treated during pregnancy, are described. The clinical picture is characterized by a severe cholestatic hepatopathy and, in the two surviving patients, by an unusually wide ischemic-hemorrhagic lesion of the cerebral parenchyma. This lesion is probably due to a syphilitic endarteritis, and has rarely been described before in preterm infants.- - - - - - - - - - ranking = 0.12127752145153keywords = pregnancy (Clic here for more details about this article) |
18/81. Severe fetal cytomegalovirus infection associated with cerebellar hemorrhage.cytomegalovirus (CMV) is the most common cause of congenital infection worldwide. We report on a fatal fetal manifestation of primary maternal CMV infection including cerebellar hemorrhage and hydrops. The diagnosis was established by maternal serological tests, culture and polymerase chain reaction testing of amniotic fluid and fetal blood. The pregnancy was terminated. Postmortem examination confirmed the diagnosis.- - - - - - - - - - ranking = 0.12127752145153keywords = pregnancy (Clic here for more details about this article) |
19/81. temporal lobe hemorrhage in the full-term neonate presenting as apneic seizures.We describe a 1-day-old neonate born after 39 weeks of gestation with the unusual presentation of apneic seizures. He manifested apnea during the first 12 hours of life. Prolonged video electroencephalography (EEG) monitoring captured electrographic seizures in the right centro-temporal region, which correlated with the onset and duration of clinical bouts of apnea and oxygen desaturation. The longest event lasted more than 2 minutes, without development of bradycardia. The clinical seizures resolved after administration of phenobarbital with normalization of the EEG several days later. head ultrasound disclosed an echogenic mass in the right temporal lobe, corroborated as hemorrhage on brain magnetic resonance imaging. This report emphasizes the importance of EEG in the evaluation of full-term neonates with recurrent unexplained apnea.- - - - - - - - - - ranking = 0.13120413091412keywords = gestation (Clic here for more details about this article) |
20/81. Neonatal venous cerebral hemorrhage. Report of two cases.Intracranial pathological changes can occur as a result of impaired craniocervical venous return. thrombosis of central venous access catheters was demonstrated in two neonates born at 38 and 27 weeks' gestation. Neither infant developed hemorrhage of prematurity as confirmed on cranial ultrasonography. Clinical evidence of vena cava thrombosis and associated spontaneous intraventricular hemorrhage developed on Day 24 and 36, respectively, and these findings were confirmed on imaging studies. In one infant the hemorrhage was accompanied by communicating hydrocephalus. The cause of the intracranial disease was attributable to the retrograde cerebral venous congestion. This, together with the primitive venous bed developing in the periventricular region, was associated with the spontaneous hemorrhage in the region of the foramen of Monro. To the authors' knowledge, this is the first report in the English-language literature of spontaneous neonatal intracerebral hemorrhage, due to thrombosis of the superior or inferior vena cava. The natural history of this condition is resolution without sequelae after appropriate therapeutic intervention for the vena cava thrombosis.- - - - - - - - - - ranking = 0.13120413091412keywords = gestation (Clic here for more details about this article) |
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