Cases reported "Pre-Eclampsia"

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1/4. Spontaneous hepatic hemorrhage in preeclampsia: treatment with hepatic arterial embolization.

    Four patients with spontaneous rupture of the liver due to preeclampsia of pregnancy underwent diagnostic angiography followed by successful transcatheter embolization of the hepatic artery with gelatin particles. All patients stopped bleeding and were discharged in good condition. Transcatheter embolization of the hepatic artery may be an attractive alternative to surgery for control of spontaneous rupture of the liver in preeclampsia.
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2/4. Hepatic rupture associated with pregnancy: treatment with transcatheter embolotherapy.

    Spontaneous rupture of the liver associated with pregnancy is a rare and very serious complication, usually occurring in association with eclampsia or preeclampsia. survival has generally been dependent on early recognition of characteristic signs and symptoms and prompt surgical intervention. Even with surgery, maternal mortality approaches 40% and fetal mortality is even higher. The diagnosis can usually be firmly established based on the clinical and radiographic findings presented in this article. Reported is a patient with hepatic rupture successfully treated by transcatheter embolization of the hepatic artery. It is the authors' belief that if such a patient is clinically stable enough to undergo angiography, then transcatheter embolotherapy is a reasonable alternative to surgery.
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3/4. Treatment of severe pre-eclampsia by plasma exchange.

    Three women will with pre-existing renal disease developed severe pre-eclampsia with renal failure during the midtrimester of pregnancy. plasma exchange was commenced at 23, 26 and 29 weeks of gestation and continued, initially daily then second daily, until delivery at 32, 29 and 32 weeks, respectively. During this period, signs of pre-eclampsia regressed and renal function stabilised or improved. One baby with severe hyaline membrane disease died at 6 days; the other 2, now aged 7 months and 4 months, are in good health. plasma exchange may offer an alternative to termination of pregnancy in the management of patients with severe pre-eclampsia when fetal maturity is insufficient for viability.
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4/4. Continuous spinal anesthesia for cesarean section in a parturient with severe preeclampsia.

    Epidural anesthesia is a widely accepted technique for cesarean section in the preeclamptic patient with normal coagulation. Regional anesthetic techniques avoid the hazards associated with tracheal intubation in the preeclamptic or eclamptic patient. To date, continuous spinal anesthesia in the preeclamptic parturient has not been described. We present a case in which continuous spinal anesthesia was administered for cesarean section in a morbidly obese parturient with severe preeclampsia. Continuous spinal anesthesia was successfully administered without significant hemodynamic consequences or maternal or fetal morbidity. This case suggests that continuous spinal anesthesia may be a viable alternative anesthetic technique for operative delivery in the preeclamptic parturient when epidural anesthesia cannot be established.
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