11/291. Spontaneous recovery from pathologically confirmed lymphocytic adenohypophysitis with a dramatic reduction of hypophyseal size.A pituitary mass compressing the optic nerve was revealed by magnetic resonance imaging (MRI) in a 35-year-old woman complaining of visual disturbance in the post-partum period. Responses of plasma gonadotropin and corticotropin-cortisol levels to respective hypothalamic hormones were delayed or blunted, but the response of plasma prolactin to thyrotropin-releasing hormone was exaggerated. diabetes insipidus was not associated. biopsy revealed lymphocytic adenohypophysitis, and no hypophysectomy was performed. Only five weeks later, the pituitary mass spontaneously disappeared on MRI. The pituitary function was normalized. Anti-thyroidal and anti-pituitary antibodies were negative throughout the clinical course. Pituitary masses developing during late pregnancy or the post-partum period should be carefully observed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
12/291. A case of dermatomyositis that developed after delivery: the involvement of pregnancy in the induction of dermatomyositis.A relationship between dermatomyositis (DM) and pregnancy has rarely been documented, and most cases have been reported from the viewpoint of the management of high-risk pregnancy. We report a patient with DM which developed after the delivery of a healthy infant. This case, with support from a literature review, suggests that pregnancy could be a trigger for the development of DM. Furthermore, it is suggested that there are at least two types of pregnancy related DM: in one type, the disease activity is provoked during pregnancy and tends to improve after delivery, while the other type (including the present case) has onset in the postpartum period.- - - - - - - - - - ranking = 9keywords = pregnancy (Clic here for more details about this article) |
13/291. 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) |
14/291. Postpartum dissecting aneurysm of the superior cerebellar artery--case report.A 37-year-old female with toxemia of pregnancy suffered sudden headache and loss of consciousness on the day following a cesarean delivery. Computed tomography revealed subarachnoid hemorrhage (SAH). Vertebral angiography revealed a fusiform dilatation near the origin of the right superior cerebellar artery (SCA) with distal luminal narrowing. She underwent surgery within 24 hours of the ictus. A SAH clot was carefully removed from the prepontine cistern, and subadventitial discoloration was seen in the wall of the right SCA just distal to the aneurysmal protuberance (rupture site). The dissecting aneurysm was treated with body clipping by directly clipping the rupture site and with additional wrapping of the proximal SCA, including the aneurysmal protuberance and discolored site. The postoperative clinical course was uneventful. Postoperative angiography revealed complete obliteration of the aneurysm and patency of the SCA. Therapeutic intervention should be considered for patients with ruptured dissecting aneurysm who present with recurrent SAH.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
15/291. A case of postpregnancy osteoporosis.A puerperant woman, who was previously healthy and had no disease known to affect bone metabolism, experienced lower back pain and lumbar vertebral fractures during lactation. Both bone formation markers and resorption markers were markedly elevated. Bone mineral density of the lumbar spine as measured by dual energy X-ray absorptiometry was extremely low. She stopped lactation through the use of bromocriptine because of the large volume of milk secretion. After treatment with calcitonin injections and the use of a corset, her back pain gradually disappeared. This case appears to be postpregnancy osteoporosis.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
16/291. Primary aldosteronism as a cause of severe postpartum hypertension in two women.Two women who first had the clinical features of primary aldosteronism in the postpartum period are described. Their gestations were virtually uneventful. After delivery, however, progressively severe hypertension (Joint National Committee VI, stage 3) with hypokalemia developed. pregnancy may conceal the clinical symptoms of primary aldosteronism that causes unexpected severe hypertension in the postpartum period.- - - - - - - - - - ranking = 0.042692031010102keywords = gestation (Clic here for more details about this article) |
17/291. Post partum splenic artery aneurysm rupture.Ruptured splenic artery aneurysm during pregnancy is a rare event with high maternal and fetal mortality rate. A case of ruptured splenic artery aneurysm in the post partum period is presented. The literature is reviewed on pathophysiology, clinical presentation and management of this rare and potentially fatal entity.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
18/291. case reports: postpartum cerebral angiopathy in a patient with chronic migraine with aura.A 25-year-old woman with a history of chronic severe migraine with aura presented in an apoplectic state 1 week after the delivery of her third child. She developed a severe headache and within hours lapsed into a coma. A CT scan of the brain showed cerebral edema and an occipital hemorrhage. A four-vessel angiogram showed diffuse arterial narrowing of all the intracranial vessels with segmental narrowing of the suprasellar portion of the internal carotid arteries bilaterally. She had no risk factors for stroke or vasculitis. Her pregnancy and delivery were uneventful with no preeclampsia or eclampsia. Apart from ergometrine at the time of the delivery, no vasoconstrictor drugs were used. She recovered spontaneously. Serial CT scans of the brain demonstrated resolution of the edema and hemorrhage with the development of cortical and watershed infarcts. A repeat cerebral angiogram was normal. She was, therefore, diagnosed as having suffered from postpartum cerebral angiopathy, a form of reversible cerebral vasoconstriction, called the Call or Call-Fleming syndrome. The relationship between migraine and postpartum angiopathy in the development of reversible cerebral vasoconstriction is discussed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
19/291. First presentation of polymyositis postpartum following intrauterine fetal death.We present a case of polymyositis (PM) following intrauterine fetal death. The first presentation of PM in the patient was during postpartum. The patient was referred to our hospital because of a fever of unknown cause 13 d after delivery of dead fetus at 32 weeks' gestation. PM was diagnosed based on the increased serum creatine phosphokinase level, typical electromyogram findings and characteristic muscle biopsy findings.- - - - - - - - - - ranking = 0.042692031010102keywords = gestation (Clic here for more details about this article) |
20/291. Previously undiagnosed congenital vascular ring presenting as dysphagia in a six-week post-partum female.We report the first case of dysphagia due to engorgement of a congenital vascular ring as a result of the haemodynamic changes of pregnancy. The clinician should be aware of this in the differential diagnosis. Spontaneous recovery may occur six months post partum as the haemodynamic changes resolve, but if further pregnancies are planned surgery is effective.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
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