1/55. Preterm labor and accidental hemorrhage after disopyramide therapy in pregnancy. A case report.BACKGROUND: Treatment of arrhythmias during pregnancy is complicated by concerns about the safety of antiarrhythmic therapy. This is the first case report of preterm labor and abruptio placentae following the administration of disopyramide during pregnancy. CASE: A 26-year-old woman, gravida 2, para 1, was diagnosed as having wolff-parkinson-white syndrome during the third trimester of pregnancy. Recurrent episodes of supra-ventricular tachycardia were refractory to medical therapy and required repeated direct current cardioversion. Administration of disopyramide led to the initiation of painful uterine contractions and accidental hemorrhage. CONCLUSION: Caution must be exercised during the use of disopyramide during pregnancy, and intensive monitoring should be instituted to avoid adverse maternal and fetal effects.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/55. Twin pregnancy in a uterus didelphys, with unilateral placental abruption and onset of labour.A dizygotic twin pregnancy with a fetus in each side of a uterus didelphys is described. An antepartum haemorrhage at 26 weeks' gestation, with subsequent onset of contractions in the right-sided uterus, precipitated delivery by Caesarean section.- - - - - - - - - - ranking = 0.625keywords = pregnancy (Clic here for more details about this article) |
3/55. Primary aldosteronism in pregnancy.Aldosteronism is a rare complication of pregnancy. We report a case of a 26-year-old woman who became pregnant soon after a diagnosis of primary aldosteronism due to left adrenal adenoma was made. Only oral potassium supplementation was required in addition to routine prenatal care until 36 weeks' gestation. Subsequently, antihypertensive medication was needed to control elevated blood pressure. A healthy male infant was delivered by cesarean section because of abruptio placentae. The postoperative course was uneventful. Left adrenalectomy was conducted eight months after delivery under laparoscopic visualization. In this case report, we discuss management of aldosteronism in pregnancy and review the literature.- - - - - - - - - - ranking = 0.75keywords = pregnancy (Clic here for more details about this article) |
4/55. Hypovolaemic shock.Measured blood loss up to 1000 ml is well tolerated by healthy pregnant women. This is partly due to physiological increases in plasma volume and red cell mass during pregnancy. Nevertheless, hypovolaemic shock is a major cause of maternal mortality. Management requires teamwork, co-ordination, speed and adequate facilities to be life-saving. The first priority is rapid fluid replacement. Evidence from randomized trials has established that crystalloids are the fluids of choice over colloids and particularly albumen, which was associated with increased mortality. Rapid access to blood or blood products for transfusion is necessary, as well as laboratory back-up. Further management includes accurate assessment of the site of bleeding; control of the bleeding; diagnosis and management of the underlying condition; supportive therapy; and monitoring of the clinical, haematological and biochemical response to treatment. Bedside diagnostic ultrasound has several applications in the evaluation of obstetric hypovolaemic shock.- - - - - - - - - - ranking = 0.125keywords = pregnancy (Clic here for more details about this article) |
5/55. pregnancy complicated by Evan's syndrome.Evan's syndrome was initially diagnosed in a 26-year-old pregnant patient. Following the introduction of high dose steroid therapy, the patient developed possible disseminated gonococcal infection which was followed by preterm labor and abruptio placentae. A cesarean delivery was performed at the 34th week of pregnancy following platelet infusion. While the infant survived, the mother had delayed postpartum hemorrhage.- - - - - - - - - - ranking = 0.125keywords = pregnancy (Clic here for more details about this article) |
6/55. tetany following resuscitation after abruptio placentae.BACKGROUND: serum ionized calcium and magnesium are normally decreased during later stages of pregnancy. A further rapid decline may be caused by the rapid infusion of blood bank products in which citrate is used as an anticoagulant/preservative. tetany, as reported here, may be precipitated by such infusions.CASE: A gravid woman presented in hemorrhagic shock due to abruptio placentae. Rapid infusion of packed red blood cells and fresh frozen plasma precipitated signs of tetany, muscle rigidity, posturing, high airway pressure during mechanical ventilation, etc. Ionized calcium and magnesium blood levels were very low (0.58 mmol/L and 1.0 mg/dL, respectively), but responded to rapid electrolyte administration.CONCLUSION: Binding of calcium and magnesium by citrate may lead to hypo-ionized calcemic and hypomagnesemic tetany after rapid replacement of blood products in the pregnant patient. This consequence is worsened when extreme alkalemia due to respiratory or metabolic causes is also present.- - - - - - - - - - ranking = 0.125keywords = pregnancy (Clic here for more details about this article) |
7/55. Initial presentation of Crohn's disease in pregnancy: report of a case.PURPOSE: This study evaluates the current morbidity and mortality of Crohn's disease presenting for the first time in pregnancy. methods: A review of the English-language literature was performed to collect all reported cases of Crohn's disease presenting in pregnancy. RESULTS: This review demonstrates a maternal mortality of 4 percent and morbidity of 40 percent and a fetal mortality of 38 percent, with 24 percent normal outcome of pregnancy. CONCLUSIONS: This study shows improved maternal and fetal outcome compared with earlier data.- - - - - - - - - - ranking = 0.875keywords = pregnancy (Clic here for more details about this article) |
8/55. Successful term pregnancy after bilateral uterine artery embolization for postpartum hemorrhage.BACKGROUND: Selective bilateral uterine artery embolization has been used since the 1970s for the conservative treatment of postpartum hemorrhage. The fertility rate after the embolization procedure is yet to be determined. CASE: A 30-year-old woman presented with placental abruption and subsequently delivered preterm at 29 weeks' gestation. Her delivery was complicated by postpartum hemorrhage, for which selective bilateral uterine artery embolization was performed with successful cessation of the hemorrhage. Three months later, the patient presented with a spontaneous pregnancy. Her pregnancy resulted in an appropriately grown fetus delivered at 39 weeks' gestation. CONCLUSION: This is one of the earliest reported successful pregnancies after a bilateral uterine artery embolization procedure performed for postpartum hemorrhage. This case adds to a growing literature demonstrating that pregnancy after embolization is possible, and can occur soon after the procedure.- - - - - - - - - - ranking = 0.875keywords = pregnancy (Clic here for more details about this article) |
9/55. Malignant placental site trophoblastic tumor associated with placental abruption, fetal distress, and elevated CA-125.The second pregnancy of 27-year-old woman, gravida 2, para 2 was complicated by a low alpha-fetoprotein and symptoms of chronic placental abruption. She delivered by cesarean section at 35 weeks for fetal distress at which time a biopsy of the uterus revealed a placental site trophoblastic tumor (PSTT). She rapidly developed intraabdominal spread of the neoplasm which did not respond to chemotherapy and she died 10 weeks later. Her CA-125 was elevated to 5360 mu/ml and this decreased after hysterectomy. This patient is reported to highlight a very malignant course of PSTT that was associated with a live-born male infant.- - - - - - - - - - ranking = 0.125keywords = pregnancy (Clic here for more details about this article) |
10/55. hemoperitoneum from a tubal pregnancy mimicking abruptio placentae: an obstetrical enigma.A case of simultaneous intrauterine and extrauterine pregnancy with hemoperitoneum during labor is presented. The hemoperitoneum from the tubal pregnancy occurred sufficiently late during pregnancy to mimic a placental abruption. The difficulty of diagnosing heterotopic pregnancy is stressed.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
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