1/33. Severe cardiac dysrhythmia in patients using bromocriptine postpartum.Used worldwide since 1980 for the prevention of breast engorgement in the puerperium, in 1994 bromocriptine mesylate was withdrawn from the American market as an agent suitable for ablactation. The relevant recommendation of the food and Drug Administration rested on case reports that described severe vasospastic reactions among users of the drug. Some patients so affected suffered stroke, intracranial bleeding, cerebral edema, convulsions, myocardial infarction, and puerperal psychosis. More recently, it has been suggested that the side effects of the drug may also include circulatory collapse secondary to cardiac dysrhythmia. This report describes two additional cases in this category. The antepartum clinical evaluation of these women suggested that they were predisposed to arrhythmias.- - - - - - - - - - ranking = 1keywords = lactation (Clic here for more details about this article) |
2/33. A case of postpregnancy osteoporosis.A puerperant woman, who was previously healthy and had no disease known to affect bone metabolism, experienced lower back pain and lumbar vertebral fractures during lactation. Both bone formation markers and resorption markers were markedly elevated. Bone mineral density of the lumbar spine as measured by dual energy X-ray absorptiometry was extremely low. She stopped lactation through the use of bromocriptine because of the large volume of milk secretion. After treatment with calcitonin injections and the use of a corset, her back pain gradually disappeared. This case appears to be postpregnancy osteoporosis.- - - - - - - - - - ranking = 2keywords = lactation (Clic here for more details about this article) |
3/33. iodine-131 elimination from breast milk: a case report.This case report describes the management of a breastfeeding mother who had been given radioactive iodine and technetium for diagnosis of thyroid disease. The mother requested to submit weekly milk samples for monitoring of radioactivity. Once activity fell below measurable counts, the mother resumed lactation.- - - - - - - - - - ranking = 1keywords = lactation (Clic here for more details about this article) |
4/33. Severe postpartum hypertension and reversible cerebral angiopathy associated with ergot derivative (methergoline) administration.A 36-year-old woman (gravida 2, para 2) delivered a healthy child by cesarean section at the 37th week of an unremarkable gestation. blood pressure remained within normal range throughout the pregnancy, surgery, and for the 9 following days. On day 10, about 36 hours after the initiation of oral methergoline to suppress lactation, the patient complained of severe posterior headache, flashing scotomata, hypertension, tonico-clonic seizures and then homonymous left hemianopsia and hemiparesis. blood pressure monitoring confirmed intermittent and severe hypertension. angiography demonstrated diffuse narrowing of the small and medium cerebral arteries. Transcranial Doppler ultrasound examination disclosed a bilateral increase in mean flow velocity. Progressive normalization of blood pressure, obtained with labetalol and oral clonidine, was accompanied by amelioration of the neurological deficits until a complete recovery and normalization of transcranial Doppler flow velocity occurred. This case provides further evidences that hypertension might play a major pathogenetic role in reversible cerebral angiopathy. Some ergot derivatives (including methergoline) might trigger the initial rise in blood pressure.- - - - - - - - - - ranking = 1keywords = lactation (Clic here for more details about this article) |
5/33. The role of hypertension in bromocriptine-related puerperal intracranial hemorrhage.The spate of medicolegal inquiries following the disqualification of Parlodel (bromocriptine mesylate) by the food and Drug Administration for postpartum ablactation, uncovered previously unreported side effects associated with its postpartum administration. In 1994, bromocriptine mesylate was withdrawn from the market as a milk suppressant. Since this time, over a dozen cases of postpartum intracranial hemorrhages associated with its use have been reported. We describe three additional cases of postpartum intracranial hemorrhage related to bromocriptine usage. One patient, previously normotensive, developed hypertension and a headache; initial CT was normal, but CT 24 h later demonstrated intracranial hemorrhage. This suggests that the blood-pressure elevation was drug-induced and was the cause, rather than the consequence, of bromocriptine-related intracranial hemorrhage.- - - - - - - - - - ranking = 1keywords = lactation (Clic here for more details about this article) |
6/33. optic neuritis with transient total blindness during lactation(1).BACKGROUND: lactation-induced blindness is a rare but devastating puerperal complication. There are few reported cases and no consistent associated disease processes historically identified. This case illustrates lactation-associated optic neuritis as an early identifier of multiple sclerosis. CASE: A nulliparous woman underwent a term vaginal delivery complicated only by chorioamnionitis. She was treated with intravenous antibiotics, which included spontaneous bacterial endocarditis prophylaxis. Her postpartum course was uncomplicated, and she was discharged on postpartum day 2 with her infant. She was readmitted on postpartum day 16 completely blind. Evaluation revealed bilateral optic neuritis. Symptoms were initiated and exacerbated during nursing. Transitory waxing and waning of her visual deficits were noted after aggressive steroid therapy and discontinuing nursing. The patient was subsequently diagnosed with multiple sclerosis of relapsing-remitting type. CONCLUSION: multiple sclerosis must be considered as an etiology for acute puerperal lactation-associated blindness when there is no clear anatomic or infectious cause.- - - - - - - - - - ranking = 6keywords = lactation (Clic here for more details about this article) |
7/33. Breast milk activity during early lactation following maternal 99Tcm macroaggregated albumin lung perfusion scan.A breast feeding infant may receive a radiation dose from ingestion of breast milk following the administration of a radiopharmaceutical to the mother. The Administration of Radioactive Substances Advisory Committee recommendation to interrupt breast feeding may not necessarily apply in the period of early lactation when colostrum is being produced. Following a lung scan using 99Tcm macroaggregated albumin (MAA) on a patient approximately 15 h post partum, radioactivity within breast milk was measured. milk was expressed approximately every 4 h during the day and samples were counted. The sample radioactivity concentration peaked at 15 h and decayed monoexponentially (half clearance time was approximately 4.8 h). The estimated effective dose to the infant from ingestion alone, had breast feeding not been interrupted, was approximately 0.02 mSv. These data suggest that interruption to breast feeding may not be necessary following administration of up to the diagnostic reference level of 99Tcm MAA during early lactation.- - - - - - - - - - ranking = 6keywords = lactation (Clic here for more details about this article) |
8/33. Post-partum hypocalcemia: idiopatic hypoparathyroidism manifested early in lactation.hypocalcemia associated with labor and lactation is a rare condition reported previously in patients with hypovitaminosis D. We here describe a case of a young woman in whom symptomatic severe hypocalcemia appeared after her second delivery, early in lactation. At the end of lactation the condition worsened. We review all previously reported cases and suggest a possible physiologic explanation for the association between pregnancy, lactation and the appearance of symptomatic hypocalcemia.- - - - - - - - - - ranking = 8keywords = lactation (Clic here for more details about this article) |
9/33. Lactational atrophic vaginitis.atrophic vaginitis is typically associated with the hypoestrogenic state of menopause. However, lactation also decreases estrogen levels and can cause symptomatic urogenital atrophy. Discussion of this clinical phenomenon in the literature is minimal. A case report of atrophic vaginitis at 13 months postpartum is presented. Mechanisms of action, evaluation, and treatments for lactational atrophic vaginitis are reviewed with recommendations for further research on this topic.- - - - - - - - - - ranking = 2keywords = lactation (Clic here for more details about this article) |
10/33. Use of bromocriptine to prevent puerperal lactation during neuroleptic treatment of chronic schizophrenia.bromocriptine, the ergotamine alkaloid 2-bromo-alpha-ergocriptine, is known as a dopamine D-2 receptor agonist with strong prolactin-lowering actions and potential mental side-effects. The case reported here involves a female chronic schizophrenic patient in childbed who was treated both with neuroleptics and with bromocriptine; the latter was given in order to prevent inappropriate puerperal lactation. The described therapeutic regimen succeeded in preventing puerperal lactation without exacerbating schizophrenic symptoms. The simultaneous use of neuroleptics and bromocriptine was accompanied by monitoring for changes in mental status and plasma prolactin level. The high prolactin plasma levels that persisted in spite of treatment with bromocriptine would seem to be a reason to carry out further research into the mechanism of action of the drug.- - - - - - - - - - ranking = 6keywords = lactation (Clic here for more details about this article) |
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