1/5. uterine rupture in a multiparous woman during labor induction with oral misoprostol.A multigravida with gestational diabetes, mild pregnancy-induced hypertension and a previous curettage received four doses of misoprostol (100 microg) at three hourly intervals for induction of labor at term. Vaginal delivery of a live healthy baby occurred 1 h after the fourth dose. Hindwaters were bloodstained. Three hours later, she had excessive bleeding. Examination showed that the left lateral uterine wall had ruptured. She recovered after hysterectomy and blood transfusions.- - - - - - - - - - ranking = 1keywords = pregnancy-induced, hypertension (Clic here for more details about this article) |
2/5. Twin pregnancy following gonadotrophin therapy in a patient with Sheehan's syndrome.A case of Sheehan's syndrome presented with secondary amenorrhea and was put on L-thyroxine, prednisolone and cyclical estrogen and progestin. ovulation induction with gonadotrophins and intrauterine insemination with husband's semen resulted in a twin pregnancy. Antepartum course was complicated by bronchial asthma, gestational diabetes and pregnancy-induced hypertension. Cesarian section was done at 34 weeks gestation for preterm rupture of membranes and breech presentation. Both babies and their mother were doing well at 6 months of follow-up.- - - - - - - - - - ranking = 1keywords = pregnancy-induced, hypertension (Clic here for more details about this article) |
3/5. Diabetes, hypertension and birth injuries: a complex interrelationship.Seemingly coincidental occurrence of various pathological conditions may derive from common etiologic denominators. While reviewing 240 malpractice claims involving shoulder dystocia related fetal injuries, we found two antenatal complications in the background conspicuously often. Chronic or pregnancy induced hypertension was identifiable in 80 instances (33%). pregnancy induced or preexisting diabetes was diagnosed 48 times (20%). Many of these patients were poorly controlled. The blood pressure was usually checked during the antenatal visits. However, about one-half of all patients received no diabetic screening. Therefore, this study may underestimate the actual incidence of diabetes. It has been calculated that the frequency of diabetes in pregnancy and that of hypertension, is about 5% in the united states. Thus, the rates of these complications in this selected group of gravidas was severalfold higher than in the general population. Since hypertension causes retarded fetal growth, it cannot be a direct cause of arrest of the shoulders at delivery. The likely common denominator is maternal diabetes a known predisposing factor both for preeclampsia and shoulder dystocia at birth. In the course of litigations for fetal injuries, demonstration of the predisposing role of seemingly unrelated shortcomings of the medical management may profoundly influence the outcome. This principle is demonstrated by the presentation of an actual malpractice action which resulted in a substantial settlement.- - - - - - - - - - ranking = 0.0033376850846437keywords = hypertension (Clic here for more details about this article) |
4/5. Complete large bowel duplication with paraduodenal cyst: prenatal sonographic features.OBJECTIVES: To illustrate diagnostic dilemmas while considering a diagnosis of complete large bowel duplication and duodenal duplication cysts. methods: A case of large bowel dilatation with a peripancreatic cyst was identified sonographically in a 27-year-old gravida 3 at 35 weeks of gestation, suffering from gestational diabetes and pregnancy-induced hypertension. RESULTS: On the basis of sonographic findings of dilated, hyperperistaltic large bowel loops, and a large cyst with echo-free contents near the pancreas, a diagnosis of large bowel obstruction with a paraduodenal cyst was considered. The findings were confirmed after postnatal ultrasonography. At the time of surgery, it proved to be a completely duplicated large bowel with a paraduodenal cyst. CONCLUSION: Prenatal findings of a hugely dilated, hyperperistaltic large bowel should lead one to suspect/consider large bowel duplication. Associated cysts are likely to be bowel duplication cysts. Timely intervention can thus obviate potentially serious complications.- - - - - - - - - - ranking = 1keywords = pregnancy-induced, hypertension (Clic here for more details about this article) |
5/5. A case of isolated peripartum elevation of alkaline phosphatase in pregnancy complicated by gestational diabetes.Several isoenzymes of alkaline phosphatase are present in pregnancy, the most common are of liver, bone, and placental origin. We report a case of pregnancy complicated by hypertension and gestational diabetes, in which an extremely high elevation in bone isoenzyme was noted during labor. The enzyme level returned to normal by six weeks postpartum. Elevations in total serum alkaline phosphatase during pregnancy or labor cannot be assumed to arise from the placenta, and should be further investigated to determine the specific isoenzyme.- - - - - - - - - - ranking = 0.0004768121549491keywords = hypertension (Clic here for more details about this article) |