1/13. Fracture and fortified breast milk in an extremely preterm infant.Metabolic bone disease (MBD) in the newborn predominantly affects preterm infants. The risk of MBD is inversely proportional to gestational age and birthweight, and directly related to postnatal complications. Poor bone mineralization has been shown in 55% of infants born at less than 1000 g. Optimal nutrition for very preterm infants is thought to be mother's own milk but supplementation is required to meet dietary requirements. However, there is insufficient evidence to determine that supplementation of human milk with commercial fortifiers has an effect on bone mineral content. We report a case of severe MBD with fractures in an extremely preterm infant who was fed with fortified mother's milk.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
2/13. Thrombotic thrombocytopenic purpura and pregnancy: a review of ten cases.BACKGROUND AND OBJECTIVES: A series of women with pregnancy-associated thrombotic thrombocytopenic purpura, is presented. This study will focus on the relationship between thrombotic thrombocytopenic purpura and pregnancy and on maternal and neonatal outcomes. MATERIALS AND methods: Among forty-six consecutive patients with thrombotic thrombocytopenic purpura, nine pregnant patients were identified. RESULTS: Seven patients presented an acute single episode associated with pregnancy and two patients had a chronic relapsing form of the disease. None of these two patients were diagnosed during pregnancy or in the postpartum period. There was one maternal death. fetal mortality was 33%. CONCLUSIONS: The recurrence is rare in women who had the prior episode related to pregnancy. The risk of death for these patients seems not higher than that of the remaining patients in the series. Preterm delivery and intrauterine fetal death were frequent complications of these pregnancies.- - - - - - - - - - ranking = 16.578332125115keywords = pregnancy (Clic here for more details about this article) |
3/13. sjogren's syndrome diagnosed in pregnancy: a case report.BACKGROUND: As in most other autoimmune diseases, sjogren's syndrome is seen predominantly in women. Since the peak age is around the late reproductive and early postmenopausal period, the obstetric aspect has not been well studied. CASE: A 28-years-old woman, pregnant for 22 weeks and 5 days, was admitted with worsening general status, skin lesions, arthralgias, and oral and ocular symptoms typical of sjogren's syndrome. She underwent hemodialysis for renal insufficiency. To prevent autoantibody formation, progression of the disease, therapy with methyl prednisolone, 100 mg/d intravenously; cyclophosphamide, 500 mg/month in a single intravenous application; hemodialysis 3 times a week; and plasmapheresis 7 times was instituted. An 1,100-g, male infant at 27 weeks and 5 days was delivered by cesarean section because of premature preterm rupture of membranes and severe late decelerations on cardiotocography. The infant was discharged from the neonatal intensive care unit after 30 days, weighing 1,800 g. Postnatal echocardiographic examination of the infant revealed neither cardiac malformations nor arrhythmias. CONCLUSION: Since the presence of autoantibodies against SS-A and SS-B are reported to accompany congenital heart block, the primary goal of therapy should be preventing this untoward effect of the disease. Close monitoring during pregnancy is mandatory to detect preeclampsia, intrauterine growth retardation and preterm labor.- - - - - - - - - - ranking = 9.2101845139529keywords = pregnancy (Clic here for more details about this article) |
4/13. Neonatal effects of breast cancer chemotherapy administered during pregnancy.A human fetus is most susceptible to teratogenic agents during the first trimester of pregnancy. cyclophosphamide and doxorubicin are pregnancy category D agents; however, potential benefits may warrant treatment with these agents during pregnancy under special circumstances. During her first trimester of pregnancy, a 37-year-old Caucasian woman was diagnosed with stage IIB infiltrating ductal carcinoma in situ (breast cancer) that was estrogen and progesterone receptor negative and human epidermal growth factor receptor-2 positive. The patient was treated with doxorubicin and cyclophosphamide in the second and third trimesters and delivered a premature baby boy at 31 weeks' gestation. The neonate was intubated on delivery because of respiratory distress and failure; however, no physical anomalies were observed. He had neutropenia and anemia, quite possibly as a result of his mother's chemotherapy 1 week before delivery. He was prophylactically treated for sepsis, but all cultures were negative. The infant grew and developed normally during his first year of life and remained in good health. An objective causality assessment revealed that it was probable that the infant's adverse events (prematurity, neutropenia, and anemia) were related to his mother's doxorubicin and cyclophosphamide therapy; however, these were the only adverse events potentially linked to in utero exposure to chemotherapy during the second and third trimesters. Due to the special considerations of both mother and infant, optimal treatment for patients with pregnancy-associated breast cancer requires the expert opinion of a multidisciplinary care team.- - - - - - - - - - ranking = 17.578332125115keywords = pregnancy, gestation (Clic here for more details about this article) |
5/13. Autosomal dominant polycystic kidney disease in pregnancy complicated by twin gestation and severe preeclampsia: a case report.BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD), an autosomal dominant genetic disorder with a reported prevalence of 1 in 1,000, may be associated with hypertensive disease in pregnancy. The evaluation of a pregnant woman with an adult-onset genetic disorder is complex and involves counseling about inheritance, prenatal diagnosis and management of the current pregnancy. CASE: A 33-year-old woman presented for obstetric care with a history of hypertension and ADPKD for 6 years. The patient had secondary infertility, which was treated by in vitro fertilization. The case was complicated by twin gestation and superimposed severe preeclampsia, leading to preterm cesarean delivery at 26 weeks' estimated gestational age. CONCLUSION: Because of the heritable nature of ADPKD and the long-term risk of end-stage renal disease requiring dialysis and/or renal transplantation, the evaluation and counseling of women with ADPKD who are pregnant or considering pregnancy should include a discussion of the modes of inheritance, natural history, available prenatal diagnostic options, and pregnancy risks and management options. Specific counseling issues in this case include the genetic concepts of variable expression and penetrance and the medical management of chronic hypertension and preeclampsia.- - - - - - - - - - ranking = 20.736295222325keywords = pregnancy, gestation (Clic here for more details about this article) |
6/13. Peripartum disseminated extrapulmonary tuberculosis simulating ovarian carcinoma.Disseminated extrapulmonary tuberculosis is an uncommon complication of pregnancy. We present a 26-year-old multiparous immigrant from haiti who was admitted following an extramural preterm delivery. Marked ascites was confirmed by computerized tomography, which also revealed a thickened greater omentum. These findings were considered suggestive of advanced ovarian carcinoma, although extrapulmonary tuberculosis was also considered despite negative tuberculin skin test screening. Image-guided omental biopsy demonstrated caseating granulomas substantiating the diagnosis of abdominal tuberculosis, which was later confirmed by cultures. The patient responded well to antituberculosis medications. This case describes the unusual peripartum presentation of abdominal tuberculosis simulating advanced ovarian carcinoma, and demonstrates the importance of considering extrapulmonary tuberculosis when encountering ascites and omental thickening during pregnancy despite negative tuberculin skin test screening.- - - - - - - - - - ranking = 3.6840738055811keywords = pregnancy (Clic here for more details about this article) |
7/13. pregnancy affected by isoimmunisation caused by a unique haemolytic rhesus type antibody in a Somali woman.Clinical suspicion and biochemical evidence of isoimmunisation in pregnancy have from contemporary times led to clinical curiousity and intervention at various stages of pregnancy for the sake of the fetus. Some of these interventions only found unnecessary after the causative antibodies have been properly identified and characterised. Hundreds of these antibodies were identified accidentally or by planned clinical and biochemical investigation. Here we present a unique case of isoimmunisation in pregnancy caused by a unique haemolytic antibody.- - - - - - - - - - ranking = 5.5261107083717keywords = pregnancy (Clic here for more details about this article) |
8/13. carnitine palmitoyltransferase deficiency in pregnancy.carnitine palmitoyltransferase (CPT) deficiencies are among the most common causes of inherited fatty acid oxidation disorders characterized by hypoglycemia-induced rhabdomyolysis. There is limited experience with the management of this condition in pregnancy. We report a case and management of a woman with CPT deficiency type II during pregnancy.- - - - - - - - - - ranking = 11.052221416743keywords = pregnancy (Clic here for more details about this article) |
9/13. Sporadic Larsen syndrome in a preterm female originally diagnosed as positional deformities due to oligohydramnios.Few reports describe incidental prenatal diagnosis of sporadic Larsen syndrome by ultrasound, but none of these discuss coincidental oligohydramnios or an association with fetal growth restriction. A 28-year-old woman had prolonged rupture of membranes causing marked oligohydramnios at 32 weeks gestation in her first pregnancy. Labor was induced by vaginal prostaglandins and oxytocin infusion after dexamethasone administration because of concern about placental abruption. She delivered vaginally a live female infant weighing 1960 g (< 10th percentile) with multiple skeletal malformations and characteristic facies originally suspected as positional. Newborn x-rays, however, established the diagnosis of Larsen syndrome with bilateral dislocations of the hips, knees (genu recurvatum), and ankles (club foot). The neonatal karyotype was 46,XX. Parental examination and family history were unremarkable. The newborn did well with bilateral lower extremities cast. Postnatal diagnosis of Larsen syndrome should be suspected in neonates with multiple skeletal abnormalities following oligohydramnios.- - - - - - - - - - ranking = 2.8420369027906keywords = pregnancy, gestation (Clic here for more details about this article) |
10/13. umbilical cord prolapse.prolapse of the umbilical cord is a rare obstetric emergency that in the viable fetus necessitates an expeditious delivery. A case of a periviable pregnancy complicated by preterm premature rupture of membranes and overt umbilical cord prolapse was prolonged 2 weeks with expectant management is described. An extensive review of the literature regarding the etiology, risk factors, and management options for umbilical cord prolapse in both viable and previable pregnancies accompanies this report.- - - - - - - - - - ranking = 1.8420369027906keywords = pregnancy (Clic here for more details about this article) |
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