1/359. The loss of Peyton.Eclampsia, a convulsive disorder usually occurring near the end of pregnancy and more often than not occurring with primigravida mothers, represents a serious toxic condition that endangers the life of both the mother and child. Because of this possibility it is very important for women to receive prenatal care. Most obstetricians believe that the causes of eclampsia are unknown. However, midwives usually believe that good nutrition in combination with the reduction of stress prevents eclampsia. Eclampsia can be insidious and can present itself with little warning.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/359. pre-eclampsia and the hellp syndrome still cause maternal mortality in The netherlands and other developed countries; can we reduce it?maternal mortality in developed countries does not seem to have decreased during the past decade, despite good prenatal care. Hypertensive disorders of pregnancy are the main cause of maternal mortality in most countries. In more than half of these cases, the hellp syndrome is involved. In this article attention is drawn again to the life-threatening complications that might occur in cases of pre- eclampsia and the hellp syndrome. Two case histories with fatal outcomes are described to provide extra emphasis. The literature indicates that some cases of maternal mortality might be avoidable. From a review of the literature, suggestions and recommendations are made about how to achieve a decrease in maternal mortality from pre-eclampsia/the hellp syndrome. The most important are the making of an early, correct diagnosis, anticipating the possibilities of serious complications, and, if necessary, early referral to a regional centre with special expertise.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
3/359. Infiltration block for caesarean section in a morbidly obese parturient.We report a case of a morbidly obese parturient (150 kg and 150 cm) for emergency lower segment caesarean section for dead foetus. Her pregnancy had been unsupervised. She presented with severe pre-eclampsia, generalized oedema and acute respiratory failure. Caesarean section was performed under infiltration block using lidocaine 0.5-1.0%. Her status improved postoperatively with aggressive physiotherapy, nursing in a semirecumbent position and oxygen supplementation.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
4/359. Spinal haematoma following epidural anaesthesia in a patient with eclampsia.A patient with a twin pregnancy required a Caesarean section for severe pre-eclampsia. Her platelet count was 71 x 10(9).l-1. Epidural anaesthesia was performed after platelet transfusion. A spinal epidural haematoma was diagnosed postoperatively. A generalised tonic-clonic seizure sparing the lower limbs enabled early diagnosis to be made. The patient recovered with no permanent neurological damage after laminectomy and clot removal. The risks and benefits of regional techniques require careful consideration, and postoperative monitoring for recovery of neural blockade is essential.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
5/359. Anaesthetic management of Caesarean section in an elderly parturient with pre-eclampsia.The number of women over 40 years of age becoming pregnant has increased over recent years. They suffer a high incidence of hypertensive complications, and require more frequent operative interventions. We present a case report of a 51-year-old woman having a Caesarean section for a twin pregnancy complicated by pre-eclampsia. We discuss the effects of age on pregnancy and the implications for anaesthetic management.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
6/359. Anaesthesia for caesarean section in a patient with recent subarachnoid haemorrhage and severe pre-eclampsia.Subarachnoid haemorrhage is a leading 'indirect' cause of maternal death in the UK. We describe the case of a 43-year-old woman who presented with headache, photophobia and neck stiffness of sudden onset at 32 weeks' gestation. Cerebral computed tomography demonstrated subarachnoid blood in the cisterns around the midbrain, and oral nimodipine was started to prevent vasospasm. Preparations were made for endovascular coil embolisation in the event of identification of a posterior circulation aneurysm. However, angiography under general anaesthesia failed to reveal any vascular abnormality. On emergence from anaesthesia, headache persisted, and over the next 24 h severe pre-eclampsia developed. magnesium sulphate was started, and urgent Caesarean section performed under general anaesthesia without incident. The rationale for the neuroradiological, obstetric and anaesthetic management is discussed.- - - - - - - - - - ranking = 0.43545378616775keywords = gestation (Clic here for more details about this article) |
7/359. Severe early onset preeclampsia secondary to bilateral ureteral obstruction reversed by stenting.BACKGROUND: Severe early onset preeclampsia might be reversed by correction of an underlying pathophysiologic condition. CASE: A 22-year-old nullipara with a history of antivesicoureteral reflux surgery in childhood presented at 23 weeks' gestation with severe headaches, hypertension, proteinuria, edema, and acute renal failure. Severe preeclampsia was diagnosed, and bilateral distal ureteral obstruction was documented by cystoscopy, fluoroscopy, and retrograde pyelography. Bilateral ureteral stent placement completely resolved the preeclampsia and prolonged pregnancy until term. CONCLUSION: pregnant women with a history of antireflux surgery in childhood might be at risk for acute renal failure and severe preeclampsia caused by bilateral ureteral obstruction. Ureteral stent placement might reverse obstruction, renal failure, and preeclampsia.- - - - - - - - - - ranking = 1.4354537861678keywords = pregnancy, gestation (Clic here for more details about this article) |
8/359. splenic rupture associated with severe preeclampsia. A case report.BACKGROUND: splenic rupture is a very rare event complicating pregnancy. Approximately 5% of cases reported have involved the postpartum period. Unrecognized, this complication is universally fatal. CASE: Preeclampsia and pulmonary edema complicated a 42-year-old woman's intrapartum care. After cesarean delivery she was supported with mechanical ventilation, blood products and invasive monitoring. Shortly thereafter, she became hypotensive and developed disseminated intravascular coagulation. During exploratory laparotomy a splenic capsular rupture was identified. splenectomy and continued intensive care support ultimately reversed the severe end-organ consequences. CONCLUSION: It is extremely important that this condition be maintained in the diagnostic differential of post-operative hemodynamic instability. Failure to identify it is invariably fatal. awareness and intervention are essential to ensure a good outcome.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
9/359. retinal detachment in postpartum preeclampsia and eclampsia: report of two cases.retinal detachment is an unusual complication of hypertensive disorder in pregnancy. It has been reported in 1% to 2% of patients with severe preeclampsia and in 10% of patients with eclampsia. Choroidal ischemia may be the cause of retinal detachment. We know that mild arteriolar spasm involving the bulbar conjunctival vessels has been observed in the normal pregnancy, but in pregnancy-induced hypertension the vasospasm may be severe and result in choroidal ischemia. Most patients with retinal detachment in pregnancy-induced hypertension have had full spontaneous resolution within a few weeks, and they did not have any sequelae. Medical treatment with antihypertensive drugs and steroids may be helpful. We report two rare cases of retinal detachment and persistent hypertension in association with postpartum eclampsia and post-cesarean section preeclampsia. These patients had normotension throughout pregnancy. Preeclampsia or eclampsia developed after delivery, and blurred vision, headache, and reduced vision accompanied serous retinal detachment. The serous retinal detachment disappeared within 3 weeks. Good outcomes were found in the follow-up examinations in both of these cases. For women who had been normotensive at the time of delivery and then complained in the postpartum period of blurred vision, headaches, nausea and vomiting, we should consider the possibility of retinal detachment and perform fundoscopy.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
10/359. May-Hegglin anomaly and pregnancy.A hypertensive patients with thrombocytopenia is reported who had two pregnancies complicated by preeclampsia and cesarean deliveries without hemorrhage. During her first pregnancy corticosteroids were given for presumed autoimmune thrombocytopenia. Thereafter she was splenectomised. Ten years later May-Hegglin anomaly and renal failure were diagnosed. One of her children had easy bruising.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
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