1/886. safety of antiarrhythmics during pregnancy: case report and review of the literature.A young woman is reported with intractable sustained ventricular tachycardia thought to originate in the right ventricle, which was treated successfully with encainide after failure to respond to beta-blockers and several class IA antiarrhythmic agents. She became pregnant twice while on encainide and gave birth to two healthy children. This is the first report of pregnancy during treatment with encainide. A literature review showed no other reported case of encainide taken during pregnancy, but several reports of the safe use of flecainide, a similar class IC drug, during pregnancy. Other antiarrhythmics are also reviewed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/886. Anaesthesia for caesarean section in a patient with an intracranial arteriovenous malformation.Intracranial haemorrhage from an arteriovenous malformation (AVM) during pregnancy is rare but may result in significant maternal and fetal morbidity and mortality. In the untreated patient with an AVM, the best mode of delivery remains debatable with most obstetricians preferring a caesarean section in order to avoid Valsalva manoeuvres associated with vaginal delivery. We describe the administration of epidural anaesthesia for such a parturient undergoing Caesarean section and the anaesthetic implications.- - - - - - - - - - ranking = 0.14285714285714keywords = pregnancy (Clic here for more details about this article) |
3/886. Catheter-directed thrombolysis for thromboembolic disease during pregnancy: a viable option.Anticoagulation with intravenous heparin has been the standard treatment for the management of gestational thromboembolic complications. Catheter-directed thrombolysis is an encouraging approach for the treatment of thromboembolic disease and has not been previously reported during pregnancy. One gravid woman with pulmonary embolism, critically ill, and hemodynamically compromised, and two gravid women with iliofemoral venous thrombosis, who failed to respond to standard treatment with intravenous heparin, were treated with catheter-directed urokinase. All three patients experienced rapid resolution of symptoms and successful pregnancy outcomes. In our three patients, catheter-directed thrombolysis for thromboembolic disease during pregnancy allowed rapid resolution of hemodynamic abnormalities and/or resolution of thrombus. Catheter-directed thrombolysis offered a reasonably safe alternative to prolonged medical management in these young, otherwise healthy, patients. Long-term, it may prevent the postphlebitic syndrome.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
4/886. Crack-cocaine-associated aortic dissection in early pregnancy--a case report.Even though uncommon in pregnancy, aortic dissection is a potentially catastrophic vascular complication, occurring mainly in the late stages of pregnancy. Vascular events, including aortic dissection are recognized complications of crack-cocaine use. The authors report a case of aortic dissection in early pregnancy related to crack-cocaine use. They believe that the combined effects of pregnancy and crack cocaine on the vasculature create the requisite milieu potentiating such catastrophic events as aortic dissection. This paper reviews the possible underlying pathophysiologic mechanisms and the available diagnostic, therapeutic, and management options.- - - - - - - - - - ranking = 1.1428571428571keywords = pregnancy (Clic here for more details about this article) |
5/886. Implantation of permanent dual chamber pacemaker in a pregnant woman by transesophageal echocardiographic guidance.A 37-year-old woman complained of fatigue and dizziness because of intermittent sinus arrest and asystole up to 5.2 seconds. She was 3 months into her pregnancy and a dual chamber permanent pacemaker was implanted by transesophageal echocardiographic guidance.- - - - - - - - - - ranking = 0.14285714285714keywords = pregnancy (Clic here for more details about this article) |
6/886. Inhaled nitric oxide therapy in pregnancy complicated by pulmonary hypertension.The use of nitric oxide as an agent to reduce pulmonary artery pressure in a pregnancy complicated by pulmonary hypertension is reported for the first time. This therapy can reduce pulmonary vascular resistance and therefore potentially enable the right ventricle to better compensate for the physiologic changes of pregnancy.- - - - - - - - - - ranking = 0.85714285714286keywords = pregnancy (Clic here for more details about this article) |
7/886. moyamoya disease: long term follow-up including a normal pregnancy.We present a woman with moyamoya disease. The patient was born by prolonged vaginal delivery after a long pregnancy lasting 43 weeks. During her first years of life she depicted poor psychomotor development. When she was 9 years old a diagnosis of moyamoya disease was made. Annual neurologic evaluations have revealed moderate motor deficiency, slurred speech and borderline mental capacity. At 26 years of age she became pregnant and was prophylactically treated with 40 mg/day oral nicardipine. She had a healthy child after an uncomplicated 40 week pregnancy. When she was 33 years old a magnetic resonance (MR) study disclosed a zone of ischemic parenchyma. MR angiography yielded results similar to those of conventional arteriography. At present, the patient is 36 years old, lives a normal life and works in a factory.- - - - - - - - - - ranking = 0.85714285714286keywords = pregnancy (Clic here for more details about this article) |
8/886. Doppler echocardiography as a predictor of pregnancy outcome in the presence of aortic stenosis: A case report.Aortic stenosis in pregnancy can be a life-threatening condition, but fortunately it is rare. In the modern era, careful obstetric and cardiologic monitoring, particularly through echocardiography, have improved fetal and maternal outcomes. However, a test that could predict outcome has not been available for patients with aortic stenosis who seek prepregnancy counseling. We report a case in which exercise Doppler echocardiography was used to predict cardiac function and maximal gradients in a woman with a bicuspid aortic valve who wished to become pregnant.- - - - - - - - - - ranking = 0.85714285714286keywords = pregnancy (Clic here for more details about this article) |
9/886. cesarean section in a mother with uncorrected congenital coronary to pulmonary artery fistula.PURPOSE: We report a case of a 33 yr old woman with pulmonary hypertension secondary to uncorrected right coronary artery to pulmonary artery fistula who underwent two successful operative deliveries under general anesthesia. CLINICAL FEATURES: This woman underwent an emergency Caesarean section at 32 wk gestation because she presented in NYHA Class IV, heart failure and premature labour. She did not have antenatal follow-up. For her second pregnancy, she was managed from the first trimester of pregnancy by the cardiologist, obstetrician and anesthesiologist. She received oral furosemide and digoxin from eight weeks gestation. Pregnancy was managed to term before she progressed to NYHA Class IV and cardiac failure at 37 wk gestation. She had a Caesarean section under general anesthesia. She received rapid sequence induction of anesthesia and tracheal intubation with 0.1 mg x kg(-1) etomidate, 2 mg x kg(-1) succinylcholine and maintenance with nitrous oxide 50% in oxygen, isoflurane 1% and 0.1 mg x kg(-1) vecuronium. fentanyl, 2 microg x kg(-1) helped to obtund the hypertensive response to intubation. analgesia was provided with 1 mg x kg(-1) morphine. Glyceryl trinitrate infusion, 10-30 microg x min(-1) was used in addition to the anti-heart failure therapy. End-tidal capnography, electrocardiogram, pulse oximetry, continuous arterial blood pressure and pulmonary arterial catheter provided hemodynamic monitoring. The lungs were mechanically ventilated for 24 hr postoperatively. She received anti-heart failure therapy which she continued after discharge. She was NYHA class II upon discharge. She defaulted from further follow-up. CONCLUSION: Although the literature advocates, in this situation, controlled vaginal delivery utilising epidural analgesia, we describe the successful outcome for operative delivery under general anesthesia in a patient with secondary pulmonary hypertension and heart failure.- - - - - - - - - - ranking = 0.28571428571429keywords = pregnancy (Clic here for more details about this article) |
10/886. The use of pulsatile perfusion during aortic valve replacement in pregnancy.Cardiac operations are occasionally required during pregnancy. Despite a low maternal mortality, fetal mortality remains high. Previous reports have suggested maintenance of high perfusion pressure and flow rate as protective measures to maintain fetal viability. Recent experimental data suggest pulsatile perfusion may help preserve placental hemodynamic function. The successful use of pulsatile bypass to replace the aortic valve in a 25-year-old female at 14 weeks gestation, with both maternal and fetal survival, is presented.- - - - - - - - - - ranking = 0.71428571428571keywords = pregnancy (Clic here for more details about this article) |
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