1/4. Thyroid storm during pregnancy. A medical emergency.Thyroid storm is the major risk to pregnant women with thyrotoxicosis. This life-threatening condition is more likely to occur with another precipitating factor such as labor and delivery, surgical delivery, infection, or trauma. Thyroid storm most often occurs in patients with undertreated or undiagnosed hyperthyroidism. As many as 20% to 30% of cases can end in maternal and fetal mortality. Therefore, critical care nurses must be able to recognize and initiate proper medical and nursing interventions promptly.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/4. plasma-exchange in the treatment of severe thyrotoxicosis in pregnancy.Three female patients with severe thyrotoxicosis, two of them pregnant 22 and 16 wk, respectively, were treated with plasma-exchange (PE) combined with anti-thyroid drugs. In both pregnant patients PE was an effective adjunct to therapy with low-dose carbimazol. They were both delivered of normal babies at 37 and 40 wk, respectively. One newborn was euthyroid, the other had transient neonatal thyrotoxicosis. In the non-pregnant patient an ominous situation of thyrotoxic crisis was rapidly reversed by a single PE. During PE an influx of thyroid hormones occurs from the extra- to the intravascular compartment, which increases the efficacy of PE. The 5% albumin solution derived from human donor plasma, used as replacement fluid, contained substantial amounts of thyroid hormones. A 5% albumin solution from human placental origin lacks these hormones and is therefore recommended as replacement fluid for PE in thyrotoxicosis. There are no valid arguments for advocating replacement with donor plasma.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
3/4. hyperemesis gravidarum due to thyrotoxicosis.A case of hyperemesis gravidarum at 9 weeks' gestation is described for which no cause could initially be found. Intravenous feeding was needed as a life preserving measure and following improvement on this regime the patient went into a thyrotoxic crisis which was successfully diagnosed and treated. The continuing pregnancy and its outcome is described. The need for practitioners to remember vomiting as a presenting sign of thyrotoxicosis is stressed.- - - - - - - - - - ranking = 0.25keywords = pregnancy (Clic here for more details about this article) |
4/4. Papillary thyroid carcinoma manifesting as thyroid storm of pregnancy: case report.A patient with known hyperthyroidism was seen at 25 weeks' gestation with a rapidly growing neck mass. She was initially in thyroid storm and received aggressive medical therapy. Two subsequent episodes of thyrotoxicosis occurred during pregnancy in spite of large doses of propylthiouracil. Post partum the patient was diagnosed with a locally advanced thyroid malignancy.- - - - - - - - - - ranking = 1.25keywords = pregnancy (Clic here for more details about this article) |