1/22. The risk of birth defects: Jacobs v. Theimer and parents' right to know.This Article discusses the texas Supreme Court's holding in Jacobs v. Theimer that the parents of a defective child had a cause of action for damages against a physician for alleged negligent failure to inform the mother during pregnancy that she had contracted rubella and therefore might have a defective child, thereby causing her to lose the opportunity to have an abortion. The Article raises a number of questions that post-Jacobs courts probably will confront concerning the duty of physicians and genetic counselors to keep their clients informed; describes some social and medical developments--including recent progress in medical genetics and prenatal diagnosis--which are likely to make Jacobs a significant precedent; evaluates the court's decision to allow a damage suit only for the costs of treating and caring for the child's defects; and briefly addresses the question of whether the Jacobs case comes within the sphere of suits for what has come to be known as "wrongful birth" and "wrongful life."- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/22. Infections in pregnant women: the need to assess and possibly treat the fetus and the sexual partner as well.Assessing and treating pregnant women in the emergency department for complaints unrelated to pregnancy are complex processes at best. Obtaining a consultation from an obstetrician is always prudent, even if it is simply by telephone. Careful attention to laboratory and other diagnostic test results is imperative, and communication with the patient's primary care physician and/or obstetrician is a must. Assessment of fetal well-being should be documented, and implications for the fetus of all treatments and/or omitted treatments should be considered. With infections in pregnant women, remember to think about implications for the baby and the woman's sexual partner; both may need to be assessed and treated.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
3/22. Perinatal tuberculosis.Perinatal tuberculosis is insufficiently understood. Its early diagnosis is essential but often difficult as the initial manifestations may be delayed. Improved screening of women at risk and sensitivity of the medical community are necessary. A coherent system of cooperation between the hospital and community services and between pediatricians and adult physicians is indispensable to find the index adult case to break the chain of contagion as well as to offer prophylactic therapy to the children at risk. We hereby report a baby with perinatal tuberculosis who was not offered any prophylactic therapy inspite of the mother being diagnosed to have pulmonary tuberculosis.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/22. Fetal meconium peritonitis in the infant of a woman with fulminant hepatitis b. A case report.BACKGROUND: Simultaneous fulminant maternal hepatitis b infection and fetal meconium peritonitis has never been reported before in the English-language literature. CASE REPORT: Fetal meconium peritonitis was detected at 32 weeks' gestation in a 21-year-old woman suffering from fulminant hepatitis. Fulminant hepatitis b was confirmed by clinical observation and serologic examination results. The course was also complicated with preterm labor. The fetus was diagnosed with meconium peritonitis prenatally. Because of failed tocolytic treatment, the fetus was delivered vaginally. Both the mother and fetus received intensive care, and the mother recovered. In contrast, the fetus's course worsened due to progressive abdominal distension. Although exploratory laparotomy was attempted, the operation was not successful. The infant died five days after birth. CONCLUSION: Recognition of the predisposing factors in fetal meconium peritonitis and immediate referral to a tertiary medical center, where specialists are available, could help physicians determine an accurate diagnosis and might improve prognosis.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
5/22. Epidural anaesthesia for caesarean section in a patient with extreme cardiovascular and respiratory disease.A 24-year old booked primigravida, with rheumatic heart disease in heart failure and lobar pneumonia presented in active labour. She was stabilized and prepared for an emergency Caesarean section that was successfully managed with Epidural Anaesthesia. She was admitted into the intensive care unit where the pneumonia and heart failure were managed by the physicians. The importance of proper follow up and treatment and, the need to perform more epidural techniques to meet the ever increasing challenges to the Anaesthetist are highlighted.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
6/22. Imported malaria in pregnancy: report of four cases and review of management.malaria is a common infection worldwide. Increased travel by pregnant women makes it likely that physicians in the united states will see cases of malaria in this population. We observed four cases of malaria during pregnancy over an 8-month period at a general hospital in the united states. These cases illustrate the association between pregnancy and severe malaria in the mother and congenital infection in the newborn. We also noted delays in diagnosis because malaria was mistaken for other common illnesses. Therapy was complicated by concerns about the safety of antimalarial agents for the fetus and newborn as well as drug resistance. While chloroquine is safe for use in pregnancy, drug resistance is now common, especially when the etiologic organism is plasmodium falciparum. There are concerns about the safety of administering other antimalarial agents during pregnancy (e.g., mefloquine). Concerns about the safety and availability of these agents limit options for prophylaxis.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
7/22. Poststreptococcal glomerulonephritis: a rare complication in pregnancy.streptococcus pyogenes rarely causes glomerulonephritis in pregnant women. The family physician must consider this nonsuppurative cause, however, in the differential diagnosis of a pregnant patient with edema, abnormal urinalysis, and declining renal function, as this case study demonstrates.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
8/22. Human parvovirus B-19: not just a pediatric problem.Parvoviruses have long been associated with disabling and even fatal illnesses in animals. The discovery of the human parvovirus B-19 in 1975 (1) and subsequent studies of its effects in humans identified this virus as the causative agent of erythema infectiosum ("fifth disease") in children. (2). erythema infectiosum (EI) is a common, self-limited infectious disorder in children, easily recognized by the classic "slapped cheek" facial erythema and fine reticular rash. Only in the 1980s have further investigations linked HPV B-19 infection with more significant clinical syndromes, among which is an adult polyarthropathy. This presentation in adults is more common than is currently understood and is easily confused with other symmetric polyarthropathies. Recognition and conservative treatment of this disorder are important for the emergency physician, to whom these patients may present.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
9/22. mumps mistaken for rubella in the first trimester of pregnancy. The role of the microbiology laboratory in the diagnosis of the infection. A case report.A case of mumps with an exanthema is described. However, the parotid swelling was mistaken for enlarged lymph nodes, and the case was described as one of "typical rubella". As the patient was pregnant in her first trimester, an induced abortion was considered. serum specimens for rubella antibody testing had been taken, but the information given by the consulting physician was incorrect and led to testing for past infection and immunity. After re-examination of the patient by a gynaecologist, mumps was suspected and the diagnosis verified serologically. The present case shows that in certain situations adequate information must be given to the laboratory in order to ensure a meaningful interpretation of the results of the serological examination.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
10/22. Maternal herpes infection complicated by prolonged premature rupture of membranes.Three cases of patients who developed genital herpes virus infections after prolonged, premature rupture of membranes (PROM) at 28-31 weeks gestation are reported. These patients were expectantly managed without immediate intervention at the time of diagnosis of the genital herpes virus infection. In all three cases, there was no evidence of neonatal herpes virus infection at the time of delivery or before hospital discharge. The spectrum of decisions facing the physician managing a patient with prolonged PROM and a genital herpes virus infection is discussed, and a rational approach to management presented.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
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