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1/117. Postpartum cerebral angiopathy associated with the administration of sumatriptan and dihydroergotamine--a case report.

    Cerebral angiopathy of the postpartum period is a rare entity, sometimes promoted by vasoconstrictives drug prescription. Its clinical presentation includes headaches, seizures and focal neurological deficits, which develop shortly after a normal pregnancy. The diagnosis is based on clinical findings and angiography, showing multiple narrowing of the intracranial cerebral arteries. This neurological feature is reversible and the clinical outcome is good. We report a case of benign cerebral angiopathy in a 20-year-old woman in the postpartum period, occurring after administration of sumatriptan and ergot derivates.
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ranking = 1
keywords = pregnancy
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2/117. Primary malignant lymphoma of the cervix in pregnancy. A case report.

    BACKGROUND: Malignant lymphoma arising from the uterine cervix is a very rare entity. Only two such patients have been reported as pregnant at the time of diagnosis. CASE: A 35-year-old woman (negative Pap smear at antenatal clinics) was referred because of the accidental finding of a huge cervical mass during labor. The patient underwent cesarean section because of arrest of cervical dilatation and persistent floating of the fetal head. The final diagnosis of this cervical mass was malignant lymphoma, low grade B cell, after radical abdominal hysterectomy. CONCLUSION: Although labor obstructed by a tumor of the pelvic organs is a relatively rare event and the majority of cases are benign leiomyomas of the uterus or cervix, the risk of pelvic malignancies should be considered. Bimanual examination and pelvic ultrasound and/or color Doppler ultrasound should be applied without hesitancy in any uncertain situation during pregnancy or labor.
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ranking = 5
keywords = pregnancy
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3/117. fetus papyraceous: an unusual cause of obstructed labour.

    fetus papyraceous is a relatively rare complication in twin pregnancy. The occurrence of fetus papyraceous is frequently associated with perinatal morbidity in the other twin, making antenatal diagnosis of this condition desirable. Ultrasound detection is not always possible due to anatomical position and technical difficulties. A case of fetus papyraceous, found during Caesarean section for obstructed labour is reported and the implications of antenatal detection are discussed.
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ranking = 1
keywords = pregnancy
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4/117. Acute intrapartum fetoplacental transfusion in monochorionic twin pregnancy.

    BACKGROUND: The risk of antenatal fetofetal transfusion in monochorionic twin pregnancies has been noted, but possible acute intrapartum transfusion has not been studied extensively. Acute fetoplacental transfusion after the birth of the first twin can be disastrous to the second twin, so it deserves description. CASES: We present three cases of acute intrapartum fetoplacental transfusion after successful deliveries of first twins. After the births of their cotwins, the second twins rapidly deteriorated and were born severely hypovolemic and anemic. CONCLUSION: The risk of acute intrapartum transfusion should be kept in mind when planning delivery of monochorionic twins.
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ranking = 4
keywords = pregnancy
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5/117. fetal heart rate during a maternal grand mal epileptic seizure.

    Although maternal ingestion of antiepileptic drugs is strongly suspected of causing congenital defects, particularly oral clefts, the effect of epilepsy itself or a combined effect of drug intake and epilepsy have not been excluded as etiological factors. Very little is known about fetal oxygenation during a maternal grand mal epileptic seizure. We describe two cases in which fetal heart rate was recorded during a maternal epileptic seizure during labor. The first fetus became clearly asphyctic as judged from the fetal heart rate recording: immediately after the epileptic seizure there was a 13-minute continuous bradycardia wave with decreased short-term variability. After the bradycardia a phase of tachycardia with decreased short-term and long-term variability occurred. In the other fetus there was only a short period of bradycardia, which was followed by a phase of tachycardia and decreased short-term and long-term variability. Both fetuses were vigorous at birth 43 and 87 minutes, respectively, after the epileptic seizures of their mothers. We conclude that a maternal grand mal epileptic seizure can be ominous to the fetus. It is therefore important that epileptic seizures are controlled by optimal medication throughout pregnancy.
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ranking = 1
keywords = pregnancy
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6/117. Precipitate delivery and postpartum hemorrhage after term induction with 200 micrograms misoprostol.

    misoprostol has been widely applied in early pregnancy termination and term pregnancy induction. However, the upper dosage limit of misoprostol through vaginal route has not been firmly established. Most popular dosages of vaginal misoprostol recommended are 25, 50 or 100 micrograms. There are no reports on the dangers of high-dosage misoprostol 200 micrograms as used in term labor induction. We present a primiparaous woman who was administered 200 micrograms misoprostol vaginally for term labor induction. The following precipitate delivery resulted in multiple lacerations of the isthmus, cervix and vagina, postpartum hemorrhage and disseminated intravascular coagulopathy. Inevitably, a hysterectomy was performed. A postsurgical check of the uterus confirmed lacerations of the isthmus and internal cervix. This rare complication suggests the possible dangers of vaginal misoprostol doses as high as 200 micrograms for term induction of labor at term.
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ranking = 2
keywords = pregnancy
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7/117. Variations in maternal serum zinc during pregnancy and correlation to congenital malformations, dysmaturity, and abnormal parturition.

    serum zinc concentrations in 234 gravidae showed a gradual fall during the first and second trimesters. From the 25th week of gestation until delivery there is a levelling out of mean zinc values. No correlations between serum zinc, serum HCS, or urinary excretion of oestriol were found. women with mature infants born by normal delivery showed significantly higher serum zinc during pregnancy than women with abnormal deliveries and/or abnormally developed infants (p less than 0.001). Eight infants showed congenital malformations. Five of the 8 mothers showed the lowest serum zinc concentrations recorded during respective week of pregnancy. A diabetic woman gave birth to an immature infant with multiple skeletal malformations. She showed the lowest serum zinc in the 21st week, and at the same time a very low alkaline phosphatase activity. Her serum proteins and serum HCS were normal. women with dysmature infants showed significantly lower zinc values during pregnancy (p less than 0.02) than women with mature infants born by normal delivery. Data from studies on zinc metabolism show that there is a requirement of at least 375 mg of zinc during pregnancy in order to meet the demands of normal weight gain. Teenagers, women with multiple pregnancies, women with impaired intestinal absorption due to disease or drugs and in particular women with a low-protein, high-phytate diet seem to risk developing zinc deficiency during pregnancy.
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ranking = 9.3888873763894
keywords = pregnancy, gestation
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8/117. pregnancy and delivery in young woman affected by isthmic coarctation of the aorta.

    Coarctation of aorta is a rare cause of hypertension in pregnancy and the case material reported in literature is limited without a univocal line of clinical conduct. A case association between isthmic coarctation of the aorta and pregnancy in a 17 year-old primigravida woman is described.
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ranking = 2
keywords = pregnancy
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9/117. postpartum hemorrhage and intrauterine balloon tamponade. A report of three cases.

    BACKGROUND: postpartum hemorrhage can become rapidly catastrophic. If medical management fails, then, according to recent reports, the use of an intrauterine inflated Foley catheter balloon for tamponade gives excellent results and can help avoid invasive procedures. CASE: We present one case of profuse hemorrhage following evacuation of the fetus after intrauterine fetal death at 17 weeks' gestation controlled with intrauterine balloon tamponade and two cases of severe postpartum hemorrhage (one immediate and one late) following normal vaginal deliveries, both controlled with Foley catheters. In either case the patient required no blood transfusions, and major surgery was avoided. CONCLUSION: Intrauterine balloon tamponade is highly effective. The catheter is readily available, is not expensive, does not require special training for insertion and, extremely important, can avoid major surgery.
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ranking = 0.38888737638943
keywords = gestation
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10/117. Vaginal delivery in a woman with limb-girdle muscular dystrophy. A case report.

    BACKGROUND: Limb-girdle muscular dystrophy is a muscular disease determined genetically. Few papers have been published on this disorder in pregnancy. Several authors reported on delivery by cesarean section because of the risk of dystocia. CASE: A woman with limb-girdle muscular dystrophy had two pregnancies with normal vaginal delivery and follow-up. No obstetric complications related to the disease occurred. CONCLUSION: A trial of labor is possible in patients with limb-girdle muscular dystrophy if no obstetric contraindications exist.
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ranking = 1
keywords = pregnancy
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