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21/232. rupture of splenic artery aneurysm during pregnancy and posterior evolution of gestation.

    We present a case of splenic artery aneurysm rupture in a 26 weeks pregnant patient. Facing to the maternal collapse and after the ultrasonographical diagnosis of massive hemoperitoneum, the rapid intervention proved to be crucial in controlling the hemorrhage and allowed for the continuation of gestation and successful delivery.
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ranking = 1
keywords = artery
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22/232. Ruptured renal artery aneurysm during pregnancy: successful ex situ repair and autotransplantation.

    rupture of a renal artery aneurysm during pregnancy is a rare event, with a high mortality rate for both mother and fetus. Until now, 25 cases have been reported in the English medical literature. Renal salvage with in situ repair of the renal artery has been documented in only four cases, and successful ex situ repair and autotransplantation in only one case. We report the case of a mother and fetus who both survived acute rupture of a renal artery aneurysm after treatment with ex situ repair and autotransplantation.
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ranking = 1.4
keywords = artery
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23/232. Spontaneous rupture of a splenic artery aneurysm in pregnancy: report of two cases.

    The spontaneous rupture of a splenic artery aneurysm during pregnancy is a rare but catastrophic event. Two cases are reported, both involving fetal death and one maternal death as well. A review of the literature covering this condition shows that mortality amongst pregnant women remains high at 75% with 95% fetal loss, which compares with a 25% mortality rate amongst non-pregnant women. Clinical presentation is often non-specific, with good haemodynamic compensation, followed by a rapid deterioration. The best investigation appears to be a diagnostic laparotomy. The discussion stresses the importance of early diagnosis faced with this serious condition, as well as the potential benefits of a prompt lower mid-line incision in terms of statistical survival for both mother and fetus.
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ranking = 1
keywords = artery
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24/232. Coronary artery dissection during pregnancy and the postpartum period: two case reports and review of literature.

    Spontaneous coronary dissection is a rare event occurring particularly in women during the peripartum and postpartum period. Two cases related to the early postpartum period with a successful outcome are described, together with a comprehensive review of all the previously published cases. Diagnostic and therapeutic considerations of this unique clinical entity are discussed and reviewed.
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ranking = 0.8
keywords = artery
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25/232. A case of renovascular hypertension due to bilateral renal artery microaneurysm who succeeded in baby delivery.

    We report the case of a young pregnant woman with bilateral renovascular hypertension due to renal microaneurysms from an unknown cause, who had a successful delivery. Pregnancy did not affect the disease activity even in the postpartum period. Her blood pressure was maintained within the normal range by administration of labetalol. Although the angiographic appearance of the symmetrical aneurysms in both renal artery beds from the interlobular to arcuate artery levels suggested polyarteritis nodosa of multiple microaneurysms in the bilateral interlobular arteries, the clinical features suggested other causes of renovascular hypertension, such as fibromuscular dysplasia and/or congenital microaneurysms. We were thus unable to reach a definitive diagnosis.
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ranking = 1.2
keywords = artery
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26/232. Longitudinal observation of deterioration of Doppler parameters, computerized cardiotocogram and clinical course in a fetus with growth restriction.

    We report on a fetus with intrauterine growth restriction detected at 27 weeks' gestation, who was longitudinally followed up until delivery by cesarean section 33 days later (31 5 weeks) due to severe decelerations in CTG. Longitudinal Doppler assessment of the umbilical artery (UA), the middle cerebral artery (MCA) and the main branch of the right pulmonary artery (RPA), the ductus venosus (DV) and the left coronary artery was compared to clinical course and computerized CTG. At first presentation (day--33) increased resistance in both the UA and uterine arteries with bilateral notches was found. Absent enddiastolic flow (AED) in the UA was found at day--19 and reverse flow (RED) at day--11. The MCA showed a decreased pulsatility first at day--19 and again at day--11 together with RED in the UA. The RPA initially (day--33) showed increased PI which returned to normal values at day--19 but increased again at day--1, when the DV showed RED and the coronary arteries became visible. The DV was normal until day--11, then its PI began to increase together with occurence of RED in the UA, but reverse flow in the DV occurred only on the eve (day--1) of severe decelerations in CTG. Short-term variability in computerized CTG was stable at 6 to 7 ms, except for an intermediate drop to 4 ms at day--10. Maternal hypertension was found at day--19 and mild preeclampsia developed at day--12. A reduction of fetal movements was noticed at day--5. This report shows that at 29 weeks gestation despite detection of AED resp. RED in the UA a prolongation of pregnancy for 19 resp. 11 days is possible. In addition to abnormal CTG, late signs of fetal deterioration are reverse flow in the DV and visibility of the coronary arteries. The role of increased resistance in the main branches of the pulmonary arteries should be examined in the future.
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ranking = 3.8225192031257
keywords = umbilical artery, umbilical, artery
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27/232. pulmonary artery aneurysm in a pregnant woman.

    We present a patient with a pulmonary artery (PA) aneurysm who has none of the documented causes of PA aneurysm but who is pregnant. We believe that this patient represents a case of primary pregnancy-associated PA aneurysm.
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ranking = 1
keywords = artery
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28/232. Successful pregnancy outcome with cardiac and severe restrictive lung disease requiring mechanical ventilation: a case report and literature review.

    The prognosis for pulmonary hypertension as a single entity is poor, but when it is superimposed on the physiological changes of pregnancy, it produces a lethal condition, with maternal mortality rates greater than 50%. We present a successfully managed case followed by a review and discussion of the available literature on this subject. A 24-year-old woman, a primigravida, was mechanically ventilated for severe restrictive lung disease. Her pregnancy required close surveillance of her labile cardiopulmonary status as well as fetal well-being. Her delivery was scheduled for induction at 34 weeks' gestation, but she required an emergency cesarean section, which was productive of a healthy infant. Her recovery was complicated by recurrent fever. There is limited literature on restrictive lung disease and pulmonary hypertension with regards to their management during pregnancy. Nevertheless, successful pregnancy outcomes may result with careful multidisciplinary management.
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ranking = 0.00054873978546771
keywords = single
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29/232. Hereditary hemorrhagic telangiectasia with pulmonary arteriovenous malformations.

    BACKGROUND: Most congenital pulmonary arteriovenous malformations are associated with hereditary hemorrhagic telangiectasia. During pregnancy, pulmonary hemorrhage can occur, compromising maternal and fetal health. CASES: We studied three pregnancies in two women with hemorrhagic telangiectasia complicated by pulmonary arteriovenous malformations. A 28-year-old primigravida's fetus died at 25 weeks' gestation, and she had embolotherapy with coil springs, which corrected the hypoxemic state. In a subsequent pregnancy she delivered a healthy 2315-g infant at 38 weeks' gestation. A 19-year-old primigravida had spontaneous hemothorax at 26 weeks' gestation with severe hypoxemia and a growth-restricted fetus without umbilical artery diastolic flow. Pulmonary arteriovenous malformation was diagnosed by computed tomography of the maternal lung. She had continued pulmonary bleeding, so emergency lung lobectomy was done. Maternal hypoxemia and umbilical diastolic flow improved, and she had term delivery of a healthy 2250-g infant. CONCLUSION: Antenatal diagnosis and treatment of women with hereditary hemorrhagic telangectasia and pulmonary arteriovenous malformations might prevent potentially life-threatening fetomaternal complications.
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ranking = 3.4984567512986
keywords = umbilical artery, umbilical, artery
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30/232. Primary dissecting hepatic artery aneurysm in pregnancy.

    A 32-year-old 32 weeks pregnant primigravida presented with acute abdomen and died 13 h later. She was normotensive during her antenatal period and on admission. At postmortem, a primary dissecting aneurysm of the main hepatic artery extending into its intrahepatic right branch was found. The cause of the dissection was presumably pregnancy-related.
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ranking = 1
keywords = artery
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