1/72. A case of peripartum eosinophilic myocarditis.A 19-year-old postpartum patient with a previous history of asthma and eosinophilic myocarditis is described. Eosinophilic myocarditis is thought to be caused by exacerbation of the idiopathic hypereosinophilic syndrome by pregnancy. The diagnosis was made by a right ventricular endomyocardial biopsy, which showed an eosinophilic infiltrate with a few scattered foci of myonecrosis, but no fibrosis, vasculitis or granulomas. The patient's myocardial function continued to decline over a two-year follow-up period, despite normal levels of eosinophils. She developed echocardiographic evidence of diastolic and systolic dysfunction.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/72. 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) |
3/72. Acute hypermagnesemia and respiratory arrest following infusion of MgSO4 for tocolysis.Hypermagnesemia (6.95 mmol/l) and respiratory arrest occurred to a 20-year-old female (G3P2002) at 26 weeks of gestation during tocolytic treatment with MgSO4.7H2O (density greater than plasmalyte) injected into an i.v. infusion bag containing 1 l of plasmalyte without mixing. The patient was rescued with calcium gluconate and normal pregnancy continued. It is important to adequately mix an i.v. solution after adding a drug particularly when the drug-containing solution has greater density than the parent i.v. solution.- - - - - - - - - - ranking = 1.5797382519502keywords = pregnancy, gestation (Clic here for more details about this article) |
4/72. Respiratory failure in pregnancy.A case of respiratory failure in pregnancy associated with old poliomyelitis is presented and the available methods of treatment described.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
5/72. nitric oxide in the treatment of fulminant pulmonary failure in a young pregnant woman with varicella pneumonia.extracorporeal membrane oxygenation is the recommended treatment for fulminant pulmonary failure due to varicella pneumonia. However, in pregnancy fetal viability during extracorporeal membrane oxygenation is generally poor resulting in either therapeutic or spontaneous abortion. The present case is to our knowledge the first report on the treatment with nitric oxide to improve oxygenation in a pregnant woman with fulminant pulmonary failure due to varicella pneumonia. Adding 20 parts per million nitric oxide to the inspiratory gas increased arterial oxygen saturation from 75 to 88%, and it could be kept at this level. Due to a vaginal bleeding, an emergency Caesarean section was performed with successful outcome for the fetus. The mother started to improve after delivery and could be weaned from nitric oxide after 5 days. We conclude that inhalation of nitric oxide may be a good alternative to extracorporeal membrane oxygenation in the treatment of fulminant pulmonary failure due to varicella pneumonia in pregnancy.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
6/72. extracorporeal membrane oxygenation in pregnancy.We describe the use of extracorporeal membrane oxygenation in pregnancy. There were no major complications, and the outcome was successful for mother and baby.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
7/72. Central hemodynamic monitoring in a woman with acute respiratory insufficiency after evacuation of a complete molar pregnancy. A case report.BACKGROUND: The incidence of hydatiform moles in the united states is approximately 1 in 1,200 pregnancies. Acute respiratory insufficiency is a known complication of molar pregnancies, occurring in 8-11%. While there have been numerous case reports and retrospective studies describing respiratory complications following evacuation of hydatiform moles, only a limited number of reports provide data from central hemodynamic monitoring in patients with this complication. CASE: A 16-year-old, Hispanic woman, gravida 1, para 0, presented to the emergency room at 13 weeks' gestational age by menstrual dating with complaints of vaginal bleeding for two days. The serum quantitative beta-hCG level was 1 x 10(6) mIU/mL, and a bedside sonogram was consistent with hydatiform mole. After informed consent was obtained, the patient underwent dilation and suction curettage. Approximately five minutes after evacuation of the uterus was begun, the patient developed pulmonary edema in the setting of oliguria. A pulmonary artery catheter was inserted to determine the etiology of the edema. The initial pulmonary capillary wedge pressure was > 18 mm Hg, consistent with hydrostatic pulmonary edema. Volume overload in association with a reduced colloid osmotic pressure to wedge pressure gradient was primarily responsible for the pulmonary edema in this patient. CONCLUSION: The majority of case reports of pulmonary complications after evacuation of a hydatidiform mole were either presumed or documented to be due to trophoblastic pulmonary embolism. thyrotoxicosis, fluid overload with dilutional anemia, preeclampsia, sepsis, hypoalbuminemia or a combination of these factors may be more common than trophoblastic embolization.- - - - - - - - - - ranking = 4.5797382519502keywords = pregnancy, gestation (Clic here for more details about this article) |
8/72. Impact of pregnancy on respiratory capacity in women with muscular dystrophy and kyphoscoliosis. A case report.BACKGROUND: Restriction of the chest wall in pregnancy prevents adaptive physiologic hyperventilation. This in turn might gradually promote respiratory insufficiency. CASE: Two consecutive pregnancies occurred in a woman with severe kyphoscoliosis due to juvenile muscular dystrophy. The patient died postpartum. CONCLUSION: Pregnancies with restrictive lung diseases, including severe scoliosis and kyphoscoliosis, should be considered high risk and thus should be monitored and managed carefully.- - - - - - - - - - ranking = 5keywords = pregnancy (Clic here for more details about this article) |
9/72. Course and outcome of a pregnancy with a giant fetal cervical teratoma diagnosed prenatally.We report the course and outcome of a pregnancy involving a giant fetal neck teratoma which was diagnosed at 23 weeks of gestation. Sonographic surveillance of the fetal neck revealed continuing growth of the tumor with development of polyhydramnios. Three-dimensional ultrasound provided additional detailed information on the external extent of the lesion. color Doppler ultrasound showed intense arterial and venous flow with low resistance indices. cesarean section under general anesthesia was planned in close cooperation with the neonatologist, pediatric surgeon and anesthesiologist because the size of the neck mass precluded vaginal delivery. cesarean section was performed at 34 weeks of gestation following preterm rupture of the membranes. Orotracheal intubation was not successful because of compression of the airway and a tracheostomy could not be performed because of the risk of severe fetal hemorrhage from the tumor. The neonate died from respiratory insufficiency 66 min after birth.- - - - - - - - - - ranking = 6.1594765039004keywords = pregnancy, gestation (Clic here for more details about this article) |
10/72. Congenital mediastinal immature teratoma: a case report with autopsy findings.A full-term newborn with karyotype 46, XX was delivered by cesarean section. She had severe respiratory distress and substernal retraction, and underwent emergency operation, but she died on the same day due to respiratory failure. The mother, 26-year-old prima gravida with no history of twinning, had been examined with ultrasonography at the 34th week of her pregnancy, which revealed a fetus with edema of head and neck region, a probable diaphragmatic hernia, polyhydramnios, and a large mediastinal mass with solid and multicystic parts with hypoplasia of the lungs. autopsy revealed a 9 x 5 x 3 cm lobulated mediastinal mass with both solid and cystic areas, displacing the lungs and the heart postero-inferiorly and thymus anteriorly. The lungs were hypoplasic. Microscopically, the mass showed mature epithelial and mesenchymal tissues with primitive mesenchyme and immature neuroepithelium. All these findings led to the diagnosis of an immature teratoma. Mediastinal teratomas are rare and life-threatening, but early diagnosis and surgical intervention in a newborn with sufficient lung maturation may provide a long survival.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
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