1/12. Living-related right lobe liver transplantation for a patient with fulminant hepatic failure during the second trimester of pregnancy: report of a case.A 28-year-old pregnant Japanese woman developed fulminant hepatic failure (FHF) with coma grade IV at 15 weeks' gestation and underwent emergency orthotopic living-related liver transplantation (LRLT) using the right hepatic lobe of her father. blood type was identical. On postoperative day 2, she regained consciousness and was extubated. For fear of possible negative effects of exposure to various drugs and from x-ray examinations on the fetus as well as the maternal burden of a continuing pregnant state on the patient, artificial abortion was a treatment choice in this woman on posttransplant day 31. The patient was discharged and is currently doing well. Until the present, 11 pregnant women were reported to have liver transplantation during the second trimester of pregnancy, including 2 pregnant women with LRLT. This is the third case of LRLT, and the first successful case in which the right hepatic lobe was used for graft.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
2/12. Management of voiding difficulties associated with pregnancy.The purpose of this paper is to share the lessons learnt from a clinical experience that involved a woman who developed difficulties passing urine after the birth of her second child. Maximising learning is a crucial aspect of health professionals' work in an increasingly litigious society where the NHS regularly receives negative publicity and staff fear prosecution (Department of health, 2001).- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
3/12. Operative treatment of acetabular fracture during pregnancy: a case report.We present a case of operative treatment of an acetabular fracture in a pregnant patient in her third trimester. The natural fear of causing harm to the pregnancy or fetus is understandable in such situations, but should not lead to withholding appropriate care. Successful treatment of these rare cases is possible with careful pre-, peri-, and postoperative evaluation of the mother and fetus by a multidisciplinary team.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
4/12. Acute renal failure due to mesangial proliferative glomerulonephritis in a pregnant woman with primary sjogren's syndrome.The most common form of renal involvement in sjogren's syndrome (SS) is tubulointerstitial nephritis. Renal dysfunction is usually mild and subclinical. glomerulonephritis (GMN) is rare in patients with SS. We report a 28-year-old multigravida patient with primary sjogren's syndrome (pSS) and associated manifestations, who presented with acute renal failure in the 20th week of her fifth pregnancy. The complaints and clinical findings, positive Schirmer's test, findings of dry eye on ophthalmologic examination, and the salivary gland biopsy were compatible with SS. The patient exhibited no other clinical or laboratory findings indicative of other collagenous disease and/or rheumatoid arthritis. She refused renal biopsy, hesitating for fear of fetal loss; thus, based on the clinical and laboratory findings indicating rapidly progressive GMN and vasculitis, prednisolone, plasmapheresis, and one dose of cyclophosphamide were administered during the pregnancy. Hemodialysis five times weekly was performed. At the 28th week of gestation, she underwent a cesarean section due to early rupture of membranes and fetal distress. A healthy male boy was delivered. The renal biopsy performed 2 weeks after labor revealed mesangial proliferative glomerulonephritis. After the fourth cyclophosphamide treatment, her urinary output increased and she was discharged from the hemodialysis program. She remains in follow-up at our outpatient clinic free of hemodialysis for 4 months. This is the first report of mesangial proliferative GMN requiring dialysis in a pregnant pSS patient that has featured good maternal and fetal outcomes.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
5/12. Needle phobia during pregnancy.The objective of this study was to understand the experience of a pregnant woman with needle phobia and examine its impact on her antepartum, intrapartum, and postpartum experience. A case study format was employed. A 21-year-old primiparous woman with diagnosed needle phobia was interviewed, and her prenatal and delivery records were reviewed. Three tasks during pregnancy were identified: seeking trusting relationships with health care providers; establishing and maintaining control and understanding; and coping with fear of needles, pain, and invasion. As frequent caregivers during childbearing, nurses with an understanding of needle phobia can help to establish trusting relationships with women with this phobia and support them and their families during childbearing and their encounters with needles.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
6/12. obsessive-compulsive disorder exacerbated during pregnancy: a case report.An established obsessive compulsive disorder (OCD) in a twenty-six-year-old woman, characterized by obsessional fear of rat germs and ritualistic cleansing, was observed to worsen during pregnancy. The patient's OCD had followed a fluctuating course for three years but she had not previously experienced a decompensation of such duration and severity. During her pregnancy she became depressed and suicidal, was unable to care for her family and spent the majority of her confinement in the hospital. Several mechanisms are discussed which might explain the exacerbation.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
7/12. Pulmonary imaging in pregnancy. Maternal risk and fetal dosimetry.A Tc-99m macroaggregated albumin (MAA) perfusion lung scan and a Tc-99m DTPA aerosol ventilation scan were performed for suspicion of pulmonary embolism (PE) in a patient who was ten weeks pregnant. There was considerable reluctance on the part of the obstetricians to permit this study. Standard MIRD dose estimates to the fetus were performed, which showed a maximum fetal exposure of about 50 mrem. It was concluded that the risk to mother and fetus from undiagnosed and untreated PE is much greater than the negligible risk to the fetus from the radiation exposure; fear of fetal radiation damage should not be a deterrent to performing these scans.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
8/12. Laparoscopic oophoropexy for recurrent adnexal torsion.Torsion of the adnexa has traditionally been treated by adnexectomy because of the fear of emboli departing from thrombosed ovarian veins. Several recent reports have described successful conservative management with unwinding of the twisted adnexa. As the trend toward conservative management progresses, the incidence of recurrent adnexal torsion may increase. We present a case of a 33 year old gravida 3, para 2 Caucasian female who presented at 7 weeks gestation complaining of symptoms similar to those experienced during an episode of right ovarian torsion treated by laparoscopic unwinding 6 years earlier. Colour Doppler sonography revealed absent flow in the right adnexa. The twisted right adnexa containing the presumed corpus luteum of pregnancy was laparoscopically unwound. Using an extracorporeal suturing technique, a laparoscopic oophoropexy was performed to prevent any further rotatory movement. This appears to be the first reported case of laparoscopic oophoropexy for a recurrent ovarian torsion; we encourage the use of this simple, minimally invasive procedure in cases of recurrent adnexal torsion.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
9/12. pseudoxanthoma elasticum and pregnancy.Reports of complications of pseudoxanthoma elasticum occurring during pregnancy have dissuaded some women with the disorder from attempting to conceive for fear of exacerbating the disease. The actual risks of serious complications during pregnancy, however, may be overstated. We report a 40-year-old woman with pseudoxanthoma elasticum who delivered a healthy male infant after an uneventful pregnancy. At the time of delivery, the placenta was noted to be heavily calcified. The effects of pregnancy on pseudoxanthoma elasticum and the effects of maternal pseudoxanthoma elasticum on a developing fetus are reviewed, with a review of the relevant medical literature.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
10/12. Laparoscopic surgery during pregnancy.BACKGROUND: Laparoscopic surgery is known for its many advantages, but the use of this modality during pregnancy is still under discussion. methods: The subjects in this discussion are the unknown influence of the pneumoperitoneum and the fear of damaging the uterus while inserting the Veress needle and trocars. In a review of recent literature describing laparoscopic surgery during pregnancy, no complications were seen. We performed four laparoscopic appendectomies and three laparoscopic cholecystectomies between 12 and 33 weeks estimated gestational age (EGA). RESULTS: All pregnancies passed without complications and ended in at-term deliveries of healthy babies. CONCLUSIONS: The risks, precautions to avoid them, and the safety of laparoscopic surgery during pregnancy are discussed in the light of our experience and reports in recent literature.- - - - - - - - - - ranking = 1keywords = fear (Clic here for more details about this article) |
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