1/20. Antepartum diagnosis of fetal intracranial hemorrhage due to maternal bernard-soulier syndrome.BACKGROUND: bernard-soulier syndrome, a lack of glycoprotein IB/IX, is a rare autosomal recessive bleeding disorder characterized by platelet dysfunction. women with bernard-soulier syndrome are at risk of being immunized against glycoprotein IB/IX, leading to severe isoimmune neonatal thrombocytopenia. CASE: A 26-year-old Japanese woman, gravida 1, para 0, with bernard-soulier syndrome presented at 35 weeks' gestation with changes in fetal heart rate patterns and ultrasonographic findings that strongly suggested fetal intracranial hemorrhage. Management was by cesarean hysterectomy and bilateral salpingo-oophorectomy at 36 weeks, but the neonate died 6 hours after birth. CONCLUSION: Maternal immunization to glycoprotein IB/IX during pregnancy can cause severe fetal thrombocytopenia and massive intracranial bleeding.- - - - - - - - - - ranking = 1keywords = gestation, pregnancy (Clic here for more details about this article) |
2/20. Bleeding risk and reproductive capacity among patients with factor xiii deficiency: a case presentation and review of the literature.factor xiii deficiency is an uncommon, inherited bleeding disorder that usually manifests in infancy or early childhood, involving both boys and girls. We present the case of a woman who had experienced two previous intracranial bleeding events, and was treated before and during her current pregnancy with factor XIII concentrate. Her pregnancy was successful, and she experienced an uncomplicated vaginal delivery. To better understand the issues surrounding bleeding, reproductive capacity, and management of factor xiii deficiency during pregnancy, we conducted a systematic literature review using medline from 1966 to December 1998. We also examined the bibliographic references from all articles, and included all cases, case reports, or case series of patients with factor xiii deficiency. We retrieved data on 117 patients from 37 articles, the majority of which had type II deficiency. Among untreated patients with type II factor xiii deficiency, the literature suggests an elevated mortality rate due to uncontrolled bleeding and intracranial hemorrhage. Because of its high degree of efficacy, the evidence supports the use of life long prophylactic therapy with at least monthly infusions of factor XIII concentrate, including during pregnancy. The opinion that women with type II factor xiii deficiency have inevitable recurrent abortions, or that men are sterile, is not well substantiated. No data were found on whether treatment alters male reproductive capacity. A policy of universal factor XIII replacement, starting in childhood, will likely enable more patients to attain reproductive status. The development of an international data registry would optimally address both bleeding risk and reproductive capacity among patients with factor xiii deficiency.- - - - - - - - - - ranking = 0.75567665158549keywords = pregnancy (Clic here for more details about this article) |
3/20. Persistent hypoglossal artery associated with arteriovenous malformation: a case report.A rare case of persistent hypoglossal artery in conjunction with arteriovenous malformation was presented. MRA could delineate persistent hypoglossal artery and arteriovenous malformation very clearly. The patient suffered from intracranial hemorrhage from in the 37th week of pregnancy. MRI, MRA, angiography, and CT of this rare condition are reported.- - - - - - - - - - ranking = 0.18891916289637keywords = pregnancy (Clic here for more details about this article) |
4/20. Hemorrhagic moyamoya disease during pregnancy.BACKGROUND: Intracranial hemorrhage in pregnant patients with moyamoya disease is rare. We review the case of one such patient who presented with pre-eclampsia and a catastrophic intracerebral hemorrhage in order to highlight the associated management difficulties. methods: A case of a pregnant (31 weeks) female brought to the emergency department with hypertension and a progressive decrease in her level of consciousness is presented. She rapidly developed a dilated right pupil and left extensor posturing. A CT scan of her head showed a large putamenal intracerebral hemorrhage. She was intubated, ventilated and given intravenous mannitol and magnesium sulfate. She underwent a simultaneous craniotomy and cesarean section. Post-operatively the patient's ICP and jugular venous saturation were monitored in the intensive care unit. RESULTS: The patient delivered a 1185 g infant who did well. The patient's ICP was well controlled until the tenth post-operative day when she developed malignant brain edema and died. CONCLUSION: This case highlights three important points. First, simultaneous craniotomy and cesarean section can be performed. Second, intraoperative control of bleeding Moyamoya vessels is described. Third, the difficult post-operative management of these cases is highlighted. The literature regarding moyamoya disease and pregnancy is reviewed and some recommendations for the management of this rare but potentially deadly condition are presented.- - - - - - - - - - ranking = 0.94459581448186keywords = pregnancy (Clic here for more details about this article) |
5/20. Abnormal nonstress test yet otherwise reassuring biophysical profile in a compromised fetus with severe antepartum intracranial hemorrhage.The fetal biophysical profile (BPP), a widely accepted modality of assessment of fetal well-being, significantly shortens the time required to document reassuring fetal testing and exhibits lower false-positive and false-negative rates than conventional nonstress testing. We describe a case in which a patient presenting for fetal testing due to suspected fetal growth restriction at 29 weeks of gestation with recent onset of decreased fetal movements exhibited a concerning nonreactive nonstress test. BPP assessment revealed active fetal tone, movements, breathing movements and amniotic fluid volume (BPP score 8/8). Despite the reassuring BPP, continued abnormal nonstress testing led to subsequent abdominal delivery of an acidotic infant with evidence of a massive antepartum intracranial insult consisting of frontal intraparenchymal hemorrhage and a right temporal-occipital cortical infarction. This case exhibits limitations of the BPP.- - - - - - - - - - ranking = 0.81108083710363keywords = gestation (Clic here for more details about this article) |
6/20. Intraventricular haemorrhage in a fetus with cerebral cytomegalovirus infection.cytomegalovirus (CMV) is the leading infectious cause of prenatal neurological damage, which is particularly severe when primary maternal infection occurs during the first 16 weeks of gestation, at the time of organ development and neuronal migration. Vascular involvement has been suggested to be among the possible pathogenic mechanisms of virus-induced pathology, in addition to direct viral effects. We report on a fetus with cerebral CMV infection, which had intraventricular haemorrhage, together with oligohydramnios and hyperechogenic bowel, following maternal primary CMV infection.- - - - - - - - - - ranking = 0.81108083710363keywords = gestation (Clic here for more details about this article) |
7/20. Intracranial hemorrhage and hematuria in a neonate associated with heavy maternal smoking.Maternal smoking during pregnancy is associated with greater rates of premature deliveries, low birth weight, perinatal morbidity and mortality, and impaired intellectual development. It also causes a three-fold greater risk for intracranial hemorrhage in neonates. To our knowledge no neonatal case with intracranial hemorrhage and hematuria related to heavy maternal smoking has been published to date. In this case report we present a neonate with intracranial hemorrhage and hematuria, which were associated with heavy maternal smoking, to emphasize the importance of heavy maternal smoking as a causal factor in neonatal bleeding.- - - - - - - - - - ranking = 0.18891916289637keywords = pregnancy (Clic here for more details about this article) |
8/20. Fetal cerebellar hemorrhage in a severely growth-restricted fetus: natural history and differential diagnosis from Dandy-Walker malformation.This is a report of an intracerebellar hemorrhage in a severely growth-restricted fetus with pathological Doppler findings of the fetal and uteroplacental circulations. The diagnosis was made sonographically at 22 weeks of gestation and the natural course of the hemorrhage was followed. Interestingly, the final sonographic appearance of the posterior fossa was quite similar to that of the classic form of Dandy-Walker malformation: absence of the vermis and an enlarged fourth ventricle. However, careful sonographic examination showed that the enlargement of the fourth ventricle was actually caused by a porencephalic cystic lesion of the left cerebellar lobe. Pathological examination revealed complete absence of the vermis and cerebellar hypoplasia.- - - - - - - - - - ranking = 0.81108083710363keywords = gestation (Clic here for more details about this article) |
9/20. prenatal diagnosis of fetal intracranial hemorrhage at 25 weeks of gestation.OBJECTIVE: To determine whether magnetic resonance imaging (MRI) can give further information for the prenatal diagnosis of intracranial hemorrhage, when ultrasound (US) is not conclusive. methods: We report on a fetus in the 26th week of gestation with a grade-III hemorrhage in the right cerebral hemisphere, which was suspected on US examination and specified by MRI examination in a patient with pre-eclampsia. RESULTS: Doppler measurement of the umbilical artery, which showed the absence of end diastolic velocity, was indicative of placental insufficiency. The MRI specified the findings found by US examination and confirmed the poor outcome of the fetus. Labor was induced by prostaglandins in the 27th week of gestation. Postmortem examination showed a female fetus with a grade-III intracranial hemorrhage in the center of the right hemisphere with a diameter of 4 cm. A hemorrhage was also found in the subarachnoid space and in the occipital region of the left hemisphere. CONCLUSION: We suggest that fetuses at high risk of developing hypoxia should be sonographically evaluated and MRI should be considered when intracranial echogenicities are seen.- - - - - - - - - - ranking = 4.8664850226218keywords = gestation (Clic here for more details about this article) |
10/20. warfarin-associated fetal intracranial hemorrhage: a case report.A 27-yr-old woman who had been taking warfarin for 10 yr after mitral valve replacement became pregnant. After knowing her pregnancy, she received heparinization for nine weeks instead of warfarin, and took oral anticoagulant again. At 24 weeks of gestation, fetal ultrasound and MRI showed a left subdural hematoma, and the pregnancy was terminated. Subdural hematoma was demonstrated on autopsy. Fatal bleeding of the fetus is a rare complication of maternal warfarin medication, occurring mostly in the second or third trimester. There is no alternative regimen available, so that regular monitoring by fetal ultrasound and strict control of warfarin dose with regular measurement of prothrombin time are the best way to prevent intrauterine fetal death due to bleeding.- - - - - - - - - - ranking = 1.1889191628964keywords = gestation, pregnancy (Clic here for more details about this article) |
| | Next -> |