Cases reported "pre-eclampsia"

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1/536. The loss of Peyton.

    Eclampsia, a convulsive disorder usually occurring near the end of pregnancy and more often than not occurring with primigravida mothers, represents a serious toxic condition that endangers the life of both the mother and child. Because of this possibility it is very important for women to receive prenatal care. Most obstetricians believe that the causes of eclampsia are unknown. However, midwives usually believe that good nutrition in combination with the reduction of stress prevents eclampsia. Eclampsia can be insidious and can present itself with little warning. ( info)

2/536. liver rupture postpartum associated with preeclampsia and hellp syndrome.

    liver rupture is a rare perinatal complication with high maternal mortality. In a multiparous woman with preeclampsia and hemolysis, Elevated liver enzymes, and Low platelet count (HELLP) syndrome, liver rupture was suspected 10 h after a cesarean section. laparotomy revealed liver rupture which was treated by perihepatic packing. Eventually, the mother was discharged with her baby 88 days after admission. Clinical symptoms, maternal hemodynamics by Swan-Ganz monitoring, and laboratory findings were not predictive until the emergency situation and the consecutive complications required multidisciplinary management. ( info)

3/536. Use of a pulmonary artery catheter in the management of the severe preeclamptic patient.

    The perioperative management of the parturient with severe preeclampsia can be challenging with reference to fluid and antihypertensive therapy. A pulmonary artery catheter should be used when necessary to provide accurate information concerning the patient's hemodynamic status and to provide additional information regarding the effectiveness of the therapeutic modalities employed. ( info)

4/536. Hereditary elliptical stomatocytosis: a case report.

    The case described demonstrates the development of elliptical stomatocytosis in a neonate and the appearance of elliptical stomatocytes in her mother whose blood film, before delivery, showed elliptocytosis. Further investigations on both individuals indicated a mild haemolytic anaemia. To our knowledge this is the second reported case of elliptical stomatocytosis. ( info)

5/536. pre-eclampsia and the hellp syndrome still cause maternal mortality in The netherlands and other developed countries; can we reduce it?

    maternal mortality in developed countries does not seem to have decreased during the past decade, despite good prenatal care. Hypertensive disorders of pregnancy are the main cause of maternal mortality in most countries. In more than half of these cases, the hellp syndrome is involved. In this article attention is drawn again to the life-threatening complications that might occur in cases of pre- eclampsia and the hellp syndrome. Two case histories with fatal outcomes are described to provide extra emphasis. The literature indicates that some cases of maternal mortality might be avoidable. From a review of the literature, suggestions and recommendations are made about how to achieve a decrease in maternal mortality from pre-eclampsia/the hellp syndrome. The most important are the making of an early, correct diagnosis, anticipating the possibilities of serious complications, and, if necessary, early referral to a regional centre with special expertise. ( info)

6/536. Infiltration block for caesarean section in a morbidly obese parturient.

    We report a case of a morbidly obese parturient (150 kg and 150 cm) for emergency lower segment caesarean section for dead foetus. Her pregnancy had been unsupervised. She presented with severe pre-eclampsia, generalized oedema and acute respiratory failure. Caesarean section was performed under infiltration block using lidocaine 0.5-1.0%. Her status improved postoperatively with aggressive physiotherapy, nursing in a semirecumbent position and oxygen supplementation. ( info)

7/536. Massive ascites and bilateral hydrothorax complicating severe pre-eclampsia.

    Massive ascites and hydrothorax as additional complications of pre-eclampsia are rare. The case reported is one of ascites and bilateral hydrothorax in a patient with severe pre-eclampsia. Careful antenatal assessment may help in detecting more cases with this complication, which is often misunderstood and the diagnosis missed. ( info)

8/536. Profound ECG abnormalities during emergency cesarean section in a patient with pre-eclampsia.

    A case of severe ECG abnormalities occurring during pre-eclampsia is presented. Although these electrocardiographic changes were indicative of severe alterations of coronary flow, neither structural nor functional abnormalities could be documented during subsequent diagnostic workup. The pathogenetic pathways potentially involved in this case including coronary spasms are briefly discussed. ( info)

9/536. Acute oligohydramnios and deteriorating fetal biophysical profile associated with severe preeclampsia.

    Acute changes in fetal biophysical profile (BPP) status usually include rapid cessation of all nonessential acute biophysical activities, yet not necessarily an acute decrease in the amniotic fluid volume, or oligohydramnios. A 36-year-old para 3 with early third-trimester severe preeclampsia, mild placental abruption, and fetal growth restriction, with a reassuring BPP of 8/8, was managed expectantly with intravenous magnesium sulfate, hydralazine, and intramuscular corticosteroids. Within 20 h of admission a marked change in the BPP was noted, with a score of 0/8. amniotic fluid index (AFI), which on admission had been 20.1, progressively became 0, despite a stable normovolemic maternal status. At immediate cesarean, a mildly acidotic and hypoxic fetus was delivered which subsequently did well. This case supports the concept that acute oligohydramnios may develop rapidly in the presence of acute fetal hypoxemia. ( info)

10/536. Spinal haematoma following epidural anaesthesia in a patient with eclampsia.

    A patient with a twin pregnancy required a Caesarean section for severe pre-eclampsia. Her platelet count was 71 x 10(9).l-1. Epidural anaesthesia was performed after platelet transfusion. A spinal epidural haematoma was diagnosed postoperatively. A generalised tonic-clonic seizure sparing the lower limbs enabled early diagnosis to be made. The patient recovered with no permanent neurological damage after laminectomy and clot removal. The risks and benefits of regional techniques require careful consideration, and postoperative monitoring for recovery of neural blockade is essential. ( info)
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