Cases reported "Pregnancy Complications"

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11/26. Fetal outcome following intrauterine amantadine exposure.

    amantadine hydrochloride is a well-known antiviral agent that has been used for the prevention of influenza A2, the treatment of parkinson disease, and, more recently, multiple sclerosis. However, very few data exist about its use in pregnant women. We report a 34-year-old woman who had used amantadine to prevent relapse of her multiple sclerosis throughout two of her pregnancies who subsequently delivered two normal infants. We review the available animal data and two other human pregnancy exposure reports.
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keywords = animal
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12/26. Cardiovascular anomalies associated with prenatal exposure to theophylline.

    theophylline has been shown to be a potent cardiovascular teratogen in animals, but there has been no evidence linking theophylline with congenital anomalies in infants. The cardiovascular anomalies in our three patients were aortic anomalies, double-outlet right ventricle, transposition of the great arteries, total anomalous pulmonary venous connection, and hypoplasia of the left ventricle. Some of these rare defects were also induced frequently in animal experiments with theophylline, which suggests that this drug can be a cardiovascular teratogen in a susceptible human fetus.
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ranking = 2
keywords = animal
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13/26. Should hyperbaric oxygen be used to treat the pregnant patient for acute carbon monoxide poisoning? A case report and literature review.

    Carbon monoxide (CO) is the leading cause of death due to poisoning. Although uncommon, CO poisoning does occur during pregnancy and can result in fetal mortality and neurological malformations in fetuses who survive to term. uncertainty arises regarding the use of hyperbaric oxygen (HBO) as a treatment for the pregnant patient because of possible adverse effects on the fetus that could be induced by oxygen at high partial pressures. While the dangers of hyperoxia to the fetus have been demonstrated in animal models, careful review of animal studies and human clinical experience indicates that the short duration of hyperoxic exposure attained during HBO therapy for CO poisoning can be tolerated by the fetus in all stages of pregnancy and reduces the risk of death or deformity to the mother and fetus. A case is presented of acute CO poisoning during pregnancy that was successfully treated with HBO. Recommendations are suggested for the use of HBO during pregnancy.
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ranking = 2
keywords = animal
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14/26. Primary reconstruction of a major loss of lower jaw by an animal bite using a "rib sandwich" pectoralis major island flap.

    A 20 weeks pregnant woman was bitten by a wild bear which took away the central portion of her jaw. A single stage primary reconstruction was performed using a composite pedicled pectoralis major "rib sandwich" island flap. This provided continence of the mouth, allowing her to feed herself within 3 weeks of the operation and to speak reasonably by 6 weeks.
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ranking = 4
keywords = animal
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15/26. lymphedema in noonan syndrome: clues to pathogenesis and prenatal diagnosis and review of the literature.

    The noonan syndrome (NS) is a true multiple congenital anomalies (MCA) syndrome with numerous manifestations. An association with lymphedema has been noted, but its pathogenesis is not fully understood. Nine new cases and a review of the literature explore the role of lymphedema in NS, including its pathogenesis, presentations, and phenotypic effects. Consideration is given to developmental stage at time of onset, chronicity, resolution, and anatomic site. It appears likely that lymphedema is a much more frequent concomitant in NS than previously realized. The major source of lymphedema in NS appears to be a presently undefined dysplasia of lymphatic vessels of unknown cause. Further study of lymphedema may provide an understanding of its role in shaping the NS phenotype. Comparison with other MCA syndromes and animal models is made in this regard. Relevance to prenatal diagnosis and treatment is discussed.
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ranking = 1
keywords = animal
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16/26. Serious envenomation by the Northern Australian box-jellyfish (Chironex fleckeri).

    Serious envenomation of an adult pregnant woman by a box-jellyfish (Chironex flecteri) in North queensland is reported. Quick thinking and resuscitation by bystanders which was followed by early hospital treatment resulted in a successful outcome both for mother and for fetus. A brief review of the historic background of box-jellyfish envenomation is given, and some specific problems concerning the management and prevention of envenomation from this unique animal are described. On-the-spot resuscitation takes absolute priority, and the advent of specific antivenom is a major advance. Avoidance of fetal stings in the future is possible by simple preventive measures. The role of the Surf life Saving association of australia in the prevention and treatment of such problems is highlighted, and, as a result of recent research, possible changes in the management of box-jellyfish envenomations are predicted.
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ranking = 1
keywords = animal
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17/26. teratogens associated with congenital contractures in humans and in animals.

    An evaluation of over 350 patients in a study of congenital contractures of the joints (arthrogryposis) included a review of family, pregnancy, and delivery histories for teratogenic exposures. Fifteen out of the total 350 patients studied had a possible teratogenic exposure: an infectious agent (viral or bacterial), maternal drug or toxin ingestion, chronic maternal neurologic or muscular illness, or a direct physical insult such as a structural uterine anomaly. literature was reviewed for all human and animal cases reported with congenital contractures of the joints with an associated teratogenic insult. Those findings are discussed here.
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ranking = 5
keywords = animal
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18/26. azathioprine teratogenicity: review of the literature and case report.

    An infant born with preaxial polydactyly to a mother taking azathioprine throughout pregnancy is described. Experimental studies in animals reveal a teratogenic role for azathioprine and its main metabolite, 6-mercaptopurine. The skeletal system appears to be the primary tissue target for such action of these drugs. Although no direct cause-effect relationship can be established from the single case presented, the similarity of this anomaly to experimental azathioprine teratogenesis suggests the necessity for further surveillance.
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ranking = 1
keywords = animal
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19/26. risk assessment of drug use in pregnancy: prevention of birth defects.

    Some developmental disorders are preventable by primary prevention, i.e. by avoiding exposure to microorganisms or chemicals that cause developmental disorders. This is not only important for physicians prescribing drugs, midwives monitoring pregnancies, but especially for parents taking the responsibility of having a baby; moreover, this fact is of importance for teratogen information services and public health authorities, both having preventive roles to play. knowledge of the different pre- and postnatal developmental stages and the reproductive cycle is essential to understand this statement. The basic principle in reproductive toxicology and teratology is that the response of an organism to a teratogen depends upon the nature and the dosage of the substance, the stage of development of the embryo/fetus and its genetic make up. Chemical agents of different nature can induce developmental disorders either via the mother and perhaps via the father. The common consent that the vulnerable stage of development is only the first trimester of pregnancy is not correct. From oogenesis and spermatogenesis to at least the first years of life the developing organism is susceptible to harmful effects of chemical agents, including drugs. Developmental disorders include not only malformations visible at birth, but also spontaneous abortions, fetal death and functional deficits including behavioural defects. Studies both in the human and in laboratory animals make it possible to select substances to avoid exposure to developmental toxicants which are already on the market or still under development. This implicates a multi-step procedure leading from risk-evaluation, risk-assessment, and risk-communication to risk-perception and the according action (risk-management).
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ranking = 1
keywords = animal
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20/26. Preaxial ray reduction defects as part of valproic acid embryofetopathy.

    It is well known that prenatal exposure of valproic acid (VPA) may be associated with the occurrence of neural tube defects (Robert and Gibaud, 1982). Additional adverse effects related to VPA exposure include craniofacial abnormalities, skeletal defects, brain defects, cardiovascular defects, and urogenital defects (DiLiberti et al., 1984; Winter et al., 1987; Huot et al., 1987; Jager-Roman et al., 1986; Martinez-Frias, 1990). Recently, radial ray reduction has been reported as a severe type of skeletal defect associated with VPA exposure (Jager-Roman et al., 1986; Huot et al., 1987; Verloes et al., 1990). We report two additional cases of this severe limb reduction defect as part of a broader pattern of altered morphogenesis in fetuses exposed to VPA and to confirm an association between such severe specific skeletal defects and VPA exposure. We briefly review teratologic studies in experimental animals which document the biologic plausibility of this association, and suggest that fetuses exposed to VPA undergo detailed prenatal ultrasonographic evaluation of the limbs.
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ranking = 1
keywords = animal
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