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Sample records for advanced abdominal pregnancy

  1. Conservative Management of an Advanced Abdominal Pregnancy at 22 Weeks

    PubMed Central

    Marcellin, Louis; Ménard, Sophie; Lamau, Marie-Charlotte; Mignon, Alexandre; Aubelle, Marie Stephanie; Grangé, Gilles; Goffinet, François

    2014-01-01

    Objective We report an uneventful conservative approach of an advanced abdominal pregnancy discovered at 22 weeks of gestation. Study Design This study is a case report. Results Attempting to extend gestation of an advanced abdominal pregnancy is not a common strategy and is widely questioned. According to the couple's request, the management consisted in continuous hospitalization, regular ultrasound scan, and antenatal corticosteroids. While the woman remained asymptomatic, surgery was planned at 32 weeks, leading to the birth of a preterm child without any long-term complications. Placenta was left in situ with a prophylactic embolization, and its resorption was monitored. Conclusion Depending on multidisciplinary cares and agreement of the parents, when late discovered, prolonging advanced abdominal pregnancy appears to be a reasonable option. PMID:25032062

  2. [Abdominal pregnancy, institutional experience].

    PubMed

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy.

  3. Conservative Management and Planned Surgery for Periviable Advanced Extrauterine Abdominal Pregnancy with Favorable Outcome: Report of Two Cases

    PubMed Central

    Harirah, Hassan M.; Smith, J. Michael; Dixon, C. Luke; Hankins, Gary D. V.

    2016-01-01

    Advanced abdominal pregnancy is an extremely rare condition that poses diagnostic and management challenges. A high index of suspicion and careful assessment of the patient's symptoms, supplemented with obstetric ultrasound, and magnetic resonance imaging, are crucial for timely diagnosis and management to prevent life-threatening complications. The presence of periviable fetuses in advanced abdominal pregnancies increases the challenge to achieve a balance between maternal and fetal benefits and risks. Early diagnosis and management decisions via a multidisciplinary approach and planned delivery are of paramount importance to minimize complications and achieve favorable maternal and fetal outcomes. Even in the setting of oligohydramnios and suspected preterm premature rupture of membranes, in-patient conservative management and an individualized planned surgical approach that includes removing or leaving the placenta in place are appropriate for managing the periviable abdominal pregnancy. PMID:27595049

  4. [Late primary abdominal pregnancy. Case report].

    PubMed

    Farías, Emigdio Torres; Gómez, Luis Guillermo Torres; Allegre, René Márquez; Higareda, Salvador Hernández

    2008-09-01

    Abdominal advanced pregnancy is an obstetric complication that put at risk maternal and fetal life. We report a case of advanced abdominal pregnancy with intact ovaries and fallopian tubes, without ureteroperitoneal fistulae and, late prenatal diagnosis, in a multiparous patient without risk factors, with alive newborn, and whose pregnancy was attended at Unidad Medica de Alta Especialidad, Hospital de Gineco-Obstetricia, Centro Medico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México.

  5. Abdominal emergencies during pregnancy.

    PubMed

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management.

  6. Abdominal pregnancy- a case report.

    PubMed

    Okafor, Ii; Ude, Ac; Aderibigbe, Aso; Amu, Oc; Udeh, Pe; Obianyo, Nen; Ani, Coc

    2011-01-01

    A case of abdominal pregnancy in a 39 year old female gravida 4, para 0(+3) is presented. Ultrasonography revealed a viable abdominal pregnancy at 15 weeks gestational age. She was initially managed conservatively. Surgical intervention became necessary at 20 weeks gestational age following Ultrasound detection of foetal demise. The maternal outcome was favourable. This case is presented to highlight the dilemma associated with diagnosis and management of abdominal pregnancy with a review of literature.

  7. [Abdominal pregnancy care. Case report].

    PubMed

    Morales Hernández, Sara; Díaz Velázquez, Mary Flor; Puello Tamara, Edgardo; Morales Hernández, Jorge; Basavilvazo Rodríguez, Maria Antonia; Cruz Cruz, Polita del Rocío; Hernández Valencia, Marcelino

    2008-10-01

    Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.

  8. Why Do Abdominal Muscles Sometimes Separate during Pregnancy?

    MedlinePlus

    ... Lifestyle Pregnancy week by week Why do abdominal muscles sometimes separate during pregnancy? Answers from Roger W. ... D. During pregnancy, the growing uterus stretches the muscles in the abdomen. This can cause the two ...

  9. Robot-Assisted Abdominal Cerclage During Pregnancy

    PubMed Central

    Zeybek, Burak; Hill, Amanda; Menderes, Gulden; Borahay, Mostafa A.; Azodi, Masoud

    2016-01-01

    Background and Objectives: Cervical insufficiency is a difficult condition to diagnose and can lead to preterm birth, miscarriage, or perinatal infant morbidity and mortality. We conducted this retrospective case study and literature review to evaluate the safety and efficacy of robot-assisted abdominal cerclage during pregnancy. Methods: We conducted a case series and a systematic review that included patients who underwent robot-assisted abdominal cerclage during pregnancy from January 2010 through March 2016. Results: Six patients met the criteria for the case series. Median age was 34 years (range, 28–37) at the time of the procedure. In 5 cases, the indication for transabdominal cerclage was a failed vaginal cerclage in a previous pregnancy, whereas a scarred and shortened cervix caused by a previous dilatation and curettage–induced cervical laceration was the indication in the remaining case. Median operating time was 159.5 minutes (range, 124–204), and median estimated blood loss was 25 mL (range, 10–25). No surgeries were converted to laparotomies; all patients were discharged on postoperative day 1. The median gestational age at delivery was 37.5 weeks (range, 22–39). Five patients delivered between 36 and 39 weeks. No patients had chorioamnionitis or preterm premature rupture of membranes. One patient went into preterm labor at 22 weeks, and the cerclage was removed via minilaparotomy. Eight articles met the criteria for systematic review. Sixteen patients underwent robot-assisted abdominal cerclage during pregnancy. Median age was 31.5 years (range, 25–37). The major indication in most articles was previous failed transvaginal cerclage. The median gestational ages at time of procedure and delivery were 12 weeks (range, 10–15) and 37 weeks (range, 33–39), respectively. Conclusion: Robot-assisted abdominal cerclage is safe and effective during pregnancy. PMID:27904309

  10. [Abdominal ectopic pregnancy. A case report and literature review].

    PubMed

    Puch-Ceballos, Eduardo Erik; Vázquez-Castro, Rosbel; Osorio-Pérez, Ana Isabel; Ramos-Ayala, Montserrat; Villarreal-Sosa, Conrado Otoniel; Ruvalcaba-Rivera, Everardo

    2015-07-01

    Abdominal ectopic pregnancy is an extremely rare entity, which represents 1% of all ectopic pregnancies and is associated with high maternal and fetal morbidity and mortality. The maternal mortality risk of an abdominal ectopic pregnancy is seven to eight times greater than the risk of a tubal ectopic pregnancy and is 90 times greater than the risk of intrauterine pregnancy. This is a disease of difficult diagnosis that often takes place late. We report the case of a patient with an abdominal ectopic pregnancy, which was diagnosed by abdominal ultrasound in the second trimester; the patient was suc- cessfully treated with exploratory laparotomy with complete removal of the fetus and placenta. We provide a review of the literature on the risk factors for abdominal ectopic pregnancy, diagnostic tests and therapeutic options.

  11. Secondary abdominal pregnancy in human immunodeficiency virus-positive woman

    PubMed Central

    Manyanga, Hudson; Lwakatare, Flora

    2016-01-01

    We report on an abdominal pregnancy in human immunodeficiency virus-positive mother, currently on antiretroviral therapy, which was discovered incidentally while training the obstetric ultrasound capacity building program. Although abdominal pregnancy is a rare form of ectopic pregnancy, it may be more common in women with HIV infection because they tend to have a higher rate of sexually transmitted diseases than the general population. The positive diagnosis of abdominal pregnancy is difficult to establish and is usually missed during prenatal assessment particularly in settings that lack routine ultrasound examination as is the case in most developing countries. For the management of abdominal pregnancy, surgical intervention is recommended and removal of the placenta is a key controversy. Ultrasonography is considered the front-line and most effective imaging method and an awareness with a high index of suspicion of abdominal pregnancy is vital for reducing associated high maternal and even higher perinatal mortality. PMID:27896258

  12. Advances in abdominal MR imaging.

    PubMed

    Ferrucci, J T

    1998-01-01

    Major technical advances in MR imaging have led to its wider use in the evaluation of abdominal disease. The principle new pulse sequence is the RARE sequence for T2-weighted imaging. Multishot and breath-hold single-shot RARE techniques are now widely used, and both have performed as well as conventional spin-echo imaging with far shorter acquisition times. The most notable improvements have been in the detection and characterization of hepatic lesions. Two liver-specific contrast agents received FDA approval during 1997: SPIO particles or ferumoxide and mangafodipir trisodium, a hepatocyte-specific agent. Both of these agents provide considerable benefit in the detection and characterization of hepatic lesions. Manganese enhancement has also proved useful in MR imaging of the pancreas, although fat-suppressed T1-weighted imaging with dynamic gadolinium enhancement has also yielded results comparable with those of contrast-enhanced CT. MR hydrography, a generic term for static fluid imaging, is another derivative of RARE fast T2-weighted imaging. MRCP, the best known example of MR hydrography, has been rapidly and widely employed as a primary method for imaging the biliary and pancreatic ducts and has become competitive with ERCP. MR vascular imaging, especially portal venography, has been used for noninvasive imaging of portal venous disease in Budd Chiari disease, before placement of transjugular intrahepatic portosystemic shunts, and for pancreatic cancer staging. Finally, the development of conventional phased-array body coils and endorectal coils has enabled high-quality MR imaging of perirectal disease (including Crohn disease, fistula in ano, and postpartum sphincter dysfunction). Future abdominal applications of MR imaging will involve second-generation MR interventional techniques, including use of open systems, functional or diffusion-weighted imaging exploiting the molecular activity of tissues, and virtual MR endoscopy. Although CT continues to evolve

  13. Term Live Secondary Abdominal Pregnancy: A Case Report

    PubMed Central

    Pannu, Deepika; Bharti, Rekha; Anand, HP; Sharma, Manjula

    2016-01-01

    Term, live abdominal pregnancy secondary to rupture of a uterine rudimentary horn is a rare condition. Pregnancies conceived in the rudimentary horn of the uterus usually rupture during early gestation and present as a catastrophic event. However, rarely, after rupture of the uterine horn the foetus may continue to grow in the abdominal cavity and reach term gestation. A primigravida with a term pregnancy was referred to our centre for caesarean section with ultrasonography findings of transverse lie and placenta previa. During surgery, a live baby was extracted from the abdominal cavity, revealing a bicornuate uterus with rupture of the rudimentary horn. The early peroperative diagnosis and prompt control of the bleeding with excision of the rudimentary horn and transfusion of multiple blood products saved the patient’s life. The case is presented for its rarity and to highlight the importance of a high index of suspicion in cases presenting with abnormal foetal presentation. PMID:27904431

  14. Laparoscopic management of primary abdominal pregnancy: a case report.

    PubMed

    Altay, Mehmet Metin; Dündar, Betül; Erol, Ahmet Okyar; Kurtaran, Volkan; Gelişen, Orhan

    2010-01-01

    This is a case report of a primary abdominal pregnancy managed by laparoscopic intervention. A 22 year old, gravida 1, woman was admitted to our emergency room with vaginal bleeding and pain in lower abdomen. She was 4 weeks pregnant according to her last menstrual period. She had undergone right salpingoophorectomy previously. Pelvic examination revealed cervical motion tenderness, bilateral adnexal tenderness and rebound tenderness. Her vital signs were normal. Beta hCG was 15826 IU/ml and hemoglobin was 10.0 g/dl. Transvaginal sonography showed an endometrium of 3 mm thickness and free fluid in the pelvis. Upon admission to the Early Pregnancy Clinic, abdominal pain became worse and hemoglobin decreased to 8.0 g/dL. Therefore, we performed a laparoscopy which showed that the uterus, left tube and ovary were completely normal with absence of the right ovary and tube. Approximately 500 cc blood was aspirated from the pelvis. Between the right sacrouterine ligament and rectum, there was a bleeding area 2 cm in width which was removed with forceps and sent for frozen pathological examination,which revealed 'placental tissue fragments'. Endometrial sampling was reported to be 'secretory endometrium'. A rapid decrease in the beta HCG post operative titer confirmed the resolution of the pregnancy. Primary abdominal pregnancy is extremely rare. The diagnosis is confirmed according to Studdiford's criteria. In the literature, there only a few cases of abdominal pregnancy in which laparoscopic procedure has been used effectively as treatment. However, laparoscopic procedure is usually successful in treatment of abdominal pregnancy if the gestational age is early enough.

  15. Term Abdominal Pregnancy Revealed by Amnioperitoneum in Rural Area

    PubMed Central

    Kenfack, Bruno

    2017-01-01

    Abdominal pregnancy (AP) accounts for 1% of ectopic implantations. In sub-Saharan Africa, the high prevalence of sexually transmitted infections explains the increasing frequency of this pathology. In Cameroon it rose from 1/10000 deliveries (1995) to 3.3/10000 (2015). Authors herein report a case of a viable abdominal pregnancy discovered at term during emergency laparotomy for suspected uterine rupture. The 24-year-old G2P0 patient was HIV-positive, under antiretrovirals, though AP exceptionally occurs in HIV patients. She did only two antenatal consultations: her main complaint was abdominal pain but five echographies concluded to normal intrauterine pregnancy. Findings at laparotomy were as follows: amnioperitoneum, a live female baby weighing 3.4 kilogrammes without deformities and a placenta deeply inserted on the uterine fundus. Removal of the placenta triggered massive bleeding (2400 milliliters) with shock managed with a tourniquet on the lower uterine segment and fluid resuscitation. Outcome was favourable for the mother and child. Prevention of vertical transmission of HIV was successful with antiretroviral therapy. PMID:28331644

  16. Advanced tubal pregnancy at 30 weeks.

    PubMed

    Koçak, Idris; Dagdemir, Aynur; Yilmaz, Mustafa Sadi; Ustün, Cazip

    2005-08-01

    A case of advanced tubal pregnancy at 30 weeks is described. The placenta was implanted on the salpinx. Most tubal pregnancies become symptomatic within the first 12 weeks. A small number of tubal pregnancies have progressed beyond this. We present this unusual case of a 30-week tubal pregnancy situated in the proximal half of the tube that created a diagnostic dilemma.

  17. Viable abdominal pregnancy: a case report in Yaoundé (Cameroon)

    PubMed Central

    Fouelifack, Florent Ymele; Fouogue, Jovanny Tsuala; Fouedjio, Jeanne Hortence; Sando, Zacharie

    2014-01-01

    We herein report a case of abdominal pregnancy managed in Yaounde (Cameroon). The 33 year old G5P2022 woman was referred to our setting for management of an abdominal pregnancy of 34 weeks diagnosed during the first routine obstetrical ultrasonography done two days earlier. This ultrasonography revealed a live foetus within intestinal loops with a severe oligoamnios. After two days of lung maturation, laparotomy was carried out and the live male baby weighed 2 600 grammes. The placenta was left on its implantation sites: omentun, uterine fundus and intestinal loops. The mother did well post-operatively and the resorption of the placenta took 11 months. The newborn presented compression deformities and died three days later of respiratory distress. This case illustrates that intra-abdominal fetuses can reach viability. Though rare, abdominal pregnancy remains a threat to mothers. Practitioners should therefore know the traps in its management. PMID:25419308

  18. Advancements in identifying biomechanical determinants for abdominal aortic aneurysm rupture.

    PubMed

    Kontopodis, Nikolaos; Metaxa, Eleni; Papaharilaou, Yannis; Tavlas, Emmanouil; Tsetis, Dimitrios; Ioannou, Christos

    2015-02-01

    Abdominal aortic aneurysms are a common health problem and currently the need for surgical intervention is determined based on maximum diameter and growth rate criteria. Since these universal variables often fail to predict accurately every abdominal aortic aneurysms evolution, there is a considerable effort in the literature for other markers to be identified towards individualized rupture risk estimations and growth rate predictions. To this effort, biomechanical tools have been extensively used since abdominal aortic aneurysm rupture is in fact a material failure of the diseased arterial wall to compensate the stress acting on it. The peak wall stress, the role of the unique geometry of every individual abdominal aortic aneurysm as well as the mechanical properties and the local strength of the degenerated aneurysmal wall, all confer to rupture risk. In this review article, the assessment of these variables through mechanical testing, advanced imaging and computational modeling is reviewed and the clinical perspective is discussed.

  19. Acute Intestinal Obstruction Complicating Abdominal Pregnancy: Conservative Management and Successful Outcome

    PubMed Central

    Udigwe, Gerald Okanandu; Ihekwoaba, Eric Chukwudi; Udegbunam, Onyebuchi Izuchukwu; Egeonu, Richard Obinwanne; Okwuosa, Ayodele Obianuju

    2016-01-01

    Background. Acute intestinal obstruction during pregnancy is a very challenging and unusual nonobstetric surgical entity often linked with considerable fetomaternal morbidity and mortality. When it is synchronous with abdominal pregnancy, it is even rarer. Case Presentation. A 28-year-old lady in her second pregnancy was referred to Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, at 27 weeks of gestation due to vomiting, constipation, and abdominal pain. Examination and ultrasound scan revealed a single live intra-abdominal extrauterine fetus. Plain abdominal X-ray was diagnostic of intestinal obstruction. Conservative treatment was successful till the 34-week gestational age when she had exploratory laparotomy. At surgery, the amniotic sac was intact and the placenta was found to be adherent to the gut. There was also a live female baby with birth weight of 2.3 kg and Apgar scores of 9 and 10 in the 1st and 5th minutes, respectively, with the baby having right clubbed foot. Adhesiolysis and right adnexectomy were done. The mother and her baby were well and were discharged home nine days postoperatively. Conclusion. To the best of our knowledge, this is the first report of abdominal pregnancy as the cause of acute intestinal obstruction in the published literature. Management approach is multidisciplinary. PMID:27313923

  20. Advanced case of glioblastoma multiforme and pregnancy

    PubMed Central

    Al-Rasheedy, Intisar M.; Al-Hameed, Fahad M.

    2015-01-01

    Glioblastoma multiforme (GBM) is the most common and malignant form of the glial tumors. Advanced and treated GBM is rarely associated with pregnancy for many reasons. Glioblastoma multiforme presenting during pregnancy carries unique challenges to the patient, baby, family, and health care providers. We describe an unusual case of advanced GBM that was treated with maximum doses of chemotherapy and radiations, and she became pregnant and presented at eighteenth weeks of gestation. Her medical management was associated with a significant ethical dilemma. We managed to deliver the baby safely through cesarean section at week 28 despite the critical condition of the mother. Unfortunately, the mother died 2 weeks post delivery. We concluded that although recurrent and treated GBM is rarely associated with pregnancy and carries dismal prognosis, but if it occurs, it can still be carried, and a multidisciplinary team work is the key for successful outcome. PMID:26492122

  1. Spontaneous uterine rupture after abdominal myomectomy at the gestational age of 20 weeks in pregnancy: A case report

    PubMed Central

    Pakniat, Hamideh; Soofizadeh, Nasrin; Khezri, Marzieh Beigom

    2016-01-01

    Background: Uterine rupture in pregnancy is rare and often could be life threatening and catastrophic. Myomectomy is one of very common surgeries in gynecology, performed as the vaginal, abdominal and laparoscopic surgeries. Pregnancies occured after abdominal and laparoscopic myomectomy are high risk for uterine rapture. Case: Patient was a 28 Years old female, pregnant woman at the 20 wks of gestational age with abdominal pain and a history of abdominal myomectomy 6 yrs ago. Uterus was ruptured and fetus in amniotic sac was found in abdominal cavity. Conclusion: Early diagnosis of uterine rupture after myomectomy can save patients from death. PMID:27525334

  2. Placental localization in abdominal pregnancy using technetium-99m-labeled red blood cells

    SciTech Connect

    Martin, B.; Payan, J.M.; Jones, J.S.; Buse, M.G. )

    1990-06-01

    In a patient with third trimester abdominal pregnancy with fetal demise, technetium-99m-labeled erythrocytes ({sup 99m}Tc-RBCs) localized the placenta preoperatively, after nonvisualization by ultrasonography and arteriography. Extrauterine placental localization by blood-pool imaging may be useful when ultrasound fails.

  3. Abdominal visceral adiposity influences CD4+ T cell cytokine production in pregnancy.

    PubMed

    Ozias, Marlies K; Li, Shengqi; Hull, Holly R; Brooks, William M; Petroff, Margaret G; Carlson, Susan E

    2015-02-01

    Women with pre-gravid obesity are at risk for pregnancy complications. While the macrophage response of obese pregnant women categorized by body mass index (BMI) has been documented, the relationship between the peripheral CD4(+) T cell cytokine profile and body fat compartments during pregnancy is unknown. In this study, third trimester peripheral CD4(+) T cell cytokine profiles were measured in healthy pregnant women [n=35; pre-pregnancy BMI: 18.5-40]. CD4(+) T cells were isolated from peripheral blood mononuclear cells and stimulated to examine their capacity to generate cytokines. Between 1 and 3weeks postpartum, total body fat was determined by dual-energy X-ray absorptiometry and abdominal subcutaneous and visceral fat masses were determined by magnetic resonance imaging. Pearson's correlation was performed to assess relationships between cytokines and fat mass. Results showed that greater abdominal visceral fat mass was associated with a decrease in stimulated CD4(+) T cell cytokine expression. IFN-gamma, TNF-alpha, IL-12p70, IL-10 and IL-17A were inversely related to visceral fat mass. Chemokines CCL3 and IL-8 and growth factors G-CSF and FLT-3L were also inversely correlated. Additionally, total body fat mass was inversely correlated with FGF-2 while abdominal subcutaneous fat mass and BMI were unrelated to any CD4(+) T cell cytokine. In conclusion, lower responsiveness of CD4(+) T cell cytokines associated with abdominal visceral fat mass is a novel finding late in gestation.

  4. Abdominal echinococcosis during pregnancy: clinical aspects and management of a series of cases in Chile.

    PubMed

    Manterola, Carlos; Espinoza, Rodolfo; Muñoz, Sergio; Vial, Manuel; Bustos, Luis; Losada, Héctor; Barroso, Manuel

    2004-07-01

    Twelve pregnant women with hydatid disease are presented with median age of 29; 11 (91.7%) had a liver cyst and one (8.3%) had a kidney cyst as the primary disease location. Four (33.3%) had additional cysts located in the pelvis, peritoneal cavity and/or spleen; eight (66.7%) had two or more abdominal cysts. Three patients (25.0%) had surgery at the 3rd month after delivery and nine (75.0%) during their pregnancy. There was no histological evidence of hydatid disease in placentas, and no serological evidence of echinococcosis in the newborns was confirmed. One patient died after surgery. After a mean follow-up time of 39.5 months, we found one recurrent case of pelvic hydatid disease. Management of abdominal echinococcosis during pregnancy is an uncommon and difficult problem owing to the serious potential risks for mother and child.

  5. The medical antigravity suit for management of surgically uncontrollable bleeding associated with abdominal pregnancy.

    PubMed

    Sandberg, E C; Pelligra, R

    1983-07-01

    Three patients with abdominal pregnancy have been treated at Stanford University Hospital in recent years. Common to each was surgically uncontrolled hemorrhage for which circumferential pneumatic compression (supplied by a medical antigravity suit) was used to stop the bleeding. In each patient, the hemostatic effect of treatment was dramatic. In published accounts of the use of the garment in other severely hemorrhaging patients, the effects have been similarly dramatic and equally successful. These observations lead to a compelling consideration in regard to optimum management of patients with abdominal pregnancy. If our experience is confirmed by others, optimum management in abdominal pregnancy hereafter should regularly and routinely include removal of the placenta at the primary operation. This approach would anticipate use of the medical antigravity suit to provide hemostasis if surgically uncontrollable bleeding is encountered. Theoretically, the complications and long-term morbidity associated with retention of the placenta would be eliminated by this means while the previous disadvantage of placental removal, the potential for exsanguinating hemorrhage, would be circumvented.

  6. Advances in surgery for abdominal wall defects: gastroschisis and omphalocele.

    PubMed

    Islam, Saleem

    2012-06-01

    Abdominal wall defects (AWDs) are a common congenital surgical problem in fetuses and neonates. The incidence of these defects has steadily increased over the past few decades due to rising numbers of gastroschisis. Most of these anomalies are diagnosed prenatally and then managed at a center with available pediatric surgical, neonatology, and high-risk obstetric support. Omphaloceles and gastroschisis are distinct anomalies that have different management and outcomes. There have been a number of recent advances in the care of patients with AWDs, both in the fetus and the newborn, which will be discussed in this article.

  7. Antepartum uterine rupture in previous caesarean sections presenting as advanced extrauterine pregnancies: lessons learnt.

    PubMed

    Ramphal, Surandhra R; Moodley, Jagidesa

    2009-03-01

    In present day obstetric practice, rupture of a previously scarred uterus should be uncommon. It occurs in <1% of previous caesarean sections and most cases occur during labour and have evidence of abnormal fetal heart rate patterns, vaginal bleeding and continuous abdominal pains. Clinicians are alert to these symptoms and signs, and therefore immediate action is taken to prevent further maternal morbidity and mortality. However, rupture of a previously scarred uterus may occur occasionally in the antepartum period. In such circumstances, the patients may be haemodynamically stable and present with loss of fetal movements and vague abdominal pains, and are treated expectantly for a period of time because an initial diagnosis of advanced extra-uterine pregnancy is made. We present a series of 7 cases, all of whom had one or more previous caesarean sections, were haemodynamically stable and were being managed expectantly, to illustrate the fact that ruptured uterus should be strongly considered in the differential diagnosis, even when the clinical signs and sonography are suggestive of an advanced extra-uterine pregnancy. The lessons in these cases fall into the following categories: 1. Ruptured uteri can occur in non-labouring women with previous lower segment caesarean sections. 2. Absence of signs of peritonism is possibly due to the fact that the pregnancy is extruded through the uterine rupture with the amniotic sac being intact and there is little or no bleeding into the abdominal cavity or vaginally. 3. Imaging techniques should focus on the size of the uterus, as an enlarged uterus in the background of an advanced extra-uterine pregnancy in a previously scarred uterus is highly suggestive of uterine rupture. Clinicians must strongly consider ruptured uteri in non labouring women with previous caesarean sections even when imaging modalities suggest an advanced extrauterine pregnancy. This will lead to earlier surgical treatment and appropriate information

  8. Hepatic fat and abdominal adiposity in early pregnancy together predict impaired glucose homeostasis in mid-pregnancy

    PubMed Central

    De Souza, L R; Berger, H; Retnakaran, R; Vlachou, P A; Maguire, J L; Nathens, A B; Connelly, P W; Ray, J G

    2016-01-01

    Hepatic fat and abdominal adiposity individually reflect insulin resistance, but their combined effect on glucose homeostasis in mid-pregnancy is unknown. A cohort of 476 pregnant women prospectively underwent sonographic assessment of hepatic fat and visceral (VAT) and total (TAT) adipose tissue at 11–14 weeks' gestation. Logistic regression was used to assess the relation between the presence of maternal hepatic fat and/or the upper quartile (Q) of either VAT or TAT and the odds of developing the composite outcome of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or gestational diabetes mellitus at 24–28 weeks' gestation, based on a 75 g OGTT. Upon adjusting for maternal age, ethnicity, family history of DM and body mass index (BMI), the co-presence of hepatic fat and quartile 4 (Q4) of VAT (adjusted odds ratio (aOR) 6.5, 95% CI: 2.3–18.5) or hepatic fat and Q4 of TAT (aOR 7.8 95% CI 2.8–21.7) were each associated with the composite outcome, relative to women with neither sonographic feature. First-trimester sonographic evidence of maternal hepatic fat and abdominal adiposity may independently predict the development of impaired glucose homeostasis and GDM in mid-pregnancy. PMID:27643724

  9. A 15-year-old female with amenorrhea, abdominal distention, and elevated human chorionic gonadotropin: pregnancy, right? Not so fast….

    PubMed

    Aggarwal, Arun; Ocon, Anthony J; Nibhanipudi, Kumara

    2012-10-01

    Nongestational choriocarcinoma, a rare ovarian tumor, may present in young women with amenorrhea, abdominal distention, and elevated urine human chorionic gonadotropin (hCG), all of which may be mistaken for pregnancy. A 15-year-old Hispanic female, who reported no sexual activity, presented with 6 months of amenorrhea, abdominal pain, and progressive abdominal distension. Initially, suspicion of pregnancy was considered. Physical examination was significant for abdominal distension, but no uterine fundus or fetal anatomy could be palpated, and auscultation did not reveal any fetal heart sounds or bruits. Laboratory values showed elevated urine hCG, cancer antigen 125, and cancer antigen 19.9 levels but normal serum hCG level and was inconsistent with pregnancy. Computed tomographic scans revealed a large abdominal heterogeneous mass and pleural effusions. Salpingo-oophorectomy with total omentectomy and inversion appendectomy removed a 21 × 20.5 × 16.5-cm tumor. Pathological testing determined it to be a nongestational choriocarcinoma. This rare tumor is more common in the pediatric adolescent population than in adults. Surgical resection and chemotherapy often result in a positive prognosis. In female adolescent patients presenting with elevated hCG level, amenorrhea, and abdominal distention, choriocarcinoma should be considered, especially in those with no history of sexual activity or before menarche.

  10. Fertility and Pregnancy Outcome After Abdominal Irradiation That Included or Excluded the Pelvis in Childhood Tumor Survivors

    SciTech Connect

    Sudour, Helene; Chastagner, Pascal; Claude, Line; Desandes, Emmanuel; Klein, Marc; Carrie, Christian; Bernier, Valerie

    2010-03-01

    Purpose: To evaluate fertility after abdominal and/or pelvic irradiation in long-term female survivors. Methods and Materials: Puberty and pregnancy outcome were analyzed in female survivors of childhood cancer (aged <18 years) treated with abdominal and/or pelvic radiotherapy (RT) at one of two French centers (Nancy and Lyon) between 1975 and 2004. Data were obtained from medical records and questionnaires sent to the women. Results: A total of 84 patients who had received abdominal and/or pelvic RT during childhood and were alive and aged more than 18 years at the time of the study made up the study population. Of the 57 female survivors treated with abdominal RT that excluded the pelvis, 52 (91%) progressed normally through puberty and 23 (40%) had at least one recorded pregnancy. Of the 27 patients treated with pelvic RT, only 10 (37%) progressed normally through puberty and 5 (19%) had at least one recorded pregnancy. Twenty-two women (seventeen of whom were treated with pelvic RT) had certain subfertility. A total of 50 births occurred in 28 women, with one baby dying at birth; one miscarriage also occurred. There was a high prevalence of prematurity and low birth weight but not of congenital malformations. Conclusions: Fertility can be preserved in patients who undergo abdominal RT that excludes the pelvis, taking into account the other treatments (e.g., chemotherapy with alkylating agents) are taken into account. When RT includes the pelvis, fertility is frequently impaired and women can have difficulty conceiving. Nevertheless, pregnancies can occur in some of these women. The most important factor that endangers a successful pregnancy after RT is the total dose received by the ovaries and uterus. This radiation dose has to be systematically recorded to improve our ability to follow up patients.

  11. Advanced Gastric Cancer Perforation Mimicking Abdominal Wall Abscess

    PubMed Central

    Cho, Jinbeom; Park, Ilyoung; Lee, Dosang; Sung, Kiyoung; Baek, Jongmin

    2015-01-01

    Surgeons occasionally encounter a patient with a gastric cancer invading an adjacent organ, such as the pancreas, liver, or transverse colon. Although there is no established guideline for treatment of invasive gastric cancer, combined resection with radical gastrectomy is conventionally performed for curative purposes. We recently treated a patient with a large gastric cancer invading the abdominal wall, which was initially diagnosed as a simple abdominal wall abscess. Computed tomography showed that an abscess had formed adjacent to the greater curvature of the stomach. During surgery, we made an incision on the abdominal wall to drain the abscess, and performed curative total gastrectomy with partial excision of the involved abdominal wall. The patient received intensive treatment and wound management postoperatively with no surgery-related adverse events. However, the patient could not receive adjuvant chemotherapy and expired on the 82nd postoperative day. PMID:26468420

  12. Intra-Abdominal Pressure Measurements in Term Pregnancy and Postpartum: An Observational Study

    PubMed Central

    Staelens, Anneleen S. E.; Van Cauwelaert, Stefan; Tomsin, Kathleen; Mesens, Tinne; Malbrain, Manu L. N.; Gyselaers, Wilfried

    2014-01-01

    Objective To determine intra-abdominal pressure (IAP) and to evaluate the reproducibility of IAP-measurements using the Foley Manometer Low Volume (FMLV) in term uncomplicated pregnancies before and after caesarean section (CS), relative to two different reference points and to non-pregnant values. Design Observational cohort study. Setting Secondary level referral center for feto-maternal medicine. Population Term uncomplicated pregnant women as the case-group and non-pregnant patients undergoing a laparoscopic assisted vaginal hysterectomy (LAVH) as control group. Methods IAP was measured in 23 term pregnant patients, before and after CS and in 27 women immediately after and 1 day after LAVH. The midaxillary line was used as zero-reference (IAPMAL) in all patients and in 13 CS and 13 LAVH patients, the symphysis pubis (IAPSP) was evaluated as additional zero-reference. Intraobserver correlation (ICC) was calculated for each zero-reference. Paired student's t-tests were performed to compare IAP values and Pearson's correlation was used to assess correlations between IAP and gestational variables. Main outcome measures ICC before and after surgery, IAP before and after CS, IAP after CS and LAVH. Results The ICC for IAPMAL before CS was lower than after (0.71 versus 0.87). Both mean IAPMAL and IAPSP were significantly higher before CS than after: 14.0±2.6 mmHg versus 9.8±3.0 mmHg (p<0.0001) and 8.2±2.5 mmHg versus 3.5±1.9 mmHg (p = 0.010), respectively. After CS, IAP was not different from values measured in the LAVH-group. Conclusion IAP-measurements using FMLV is reproducible in pregnant women. Before CS, IAP is increased in the range of intra-abdominal hypertension for non-pregnant individuals. IAP significantly decreases to normal values after delivery. PMID:25117778

  13. High-risk pregnancy in rhesus monkeys (Macaca mulatta): a case of ectopic, abdominal pregnancy with birth of a live, term infant, and a case of gestational diabetes complicated by pre-eclampsia

    PubMed Central

    Krugner-Higby, Lisa; Luck, Melissa; Hartley, Deborah; Crispen, Heather M.; Lubach, Gabriele R.; Coe, Christopher L.

    2009-01-01

    Several cases of abdominal pregnancy have been described in nonhuman primates. These previous occurrences have been mummified fetuses found in the abdominal cavity. This report describes a case of abdominal pregnancy in a timed-bred rhesus monkey with delivery of a live term infant. The mother died 14 days later from complications of septic peritonitis. At necropsy, the monkey had an intestinal adenocarcinoma that may have allowed leakage of intestinal contents into the abdomen. The second case of pregnancy complication was a rhesus monkey found to have gestational diabetes that later developed pre-eclampsia. She was treated for 5 days with a regimen similar to that used in women, and a live infant was delivered at day 157 of gestation by Caesarian section. These cases of high-risk pregnancy underscore the value of timed-breeding and careful monitoring of pregnant monkeys and the similarities between pregnancy complications in women and in nonhuman primates. PMID:19490364

  14. Advanced nurse practitioner-led abdominal therapeutic paracentesis.

    PubMed

    Aplin, Neal

    2017-03-10

    Liver disease is a common cause of death in England and Wales, and ascites is associated with a 50% mortality rate. Most patients who present with ascites have underlying liver cirrhosis, and often require therapeutic paracentesis for symptomatic relief. This article describes a competency framework that was developed to enable advanced nurse practitioners to perform therapeutic paracentesis in an ambulatory care unit.

  15. Comparing the diagnostic performance of MRI versus CT in the evaluation of acute nontraumatic abdominal pain during pregnancy.

    PubMed

    Baron, Keren Tuvia; Arleo, Elizabeth Kagan; Robinson, Christopher; Sanelli, Pina C

    2012-12-01

    The objectives of this study were to document the utilization of MRI compared with CT in pregnant patients presenting with acute nontraumatic abdominal pain at our institution and to compare the diagnostic performance of the two modalities. A retrospective review identified all pregnant patients at our institution who had MRI or CT exams of the abdomen and/or pelvis for acute nontraumatic abdominal pain over a 3-year period from January 2008 through December 2010. The imaging diagnoses were compared with pathologic data or operative findings as the primary reference standard or with clinical follow-up and laboratory data as the secondary reference standard. Patients without surgically proven diagnoses were followed clinically until delivery, when possible. Ninety-four pregnant patients were included in this study: 61 MRI exams were performed in 57 patients, 44 CT exams were performed in 43 patients (including six patients who had both), and 72 patients (77 %) had ultrasound prior to cross-sectional imaging, with the appendix specifically assessed in 25 patients but visualized in only two of them. Of 61 MRI exams, 24 were considered positive for imaging diagnoses, 33 were negative, and 4 were equivocal. Of 44 CT exams, 24 were positive and 20 were negative. The test characteristics for MRI and CT in the diagnosis of acute abdominal pain were as follows: sensitivity 91 and 88 %, specificity 85 and 90 %, positive predictive value 81 and 91 %, negative predictive value 94 and 8 5 %, and diagnostic accuracy 88 and 88 %, respectively. Differences were not statistically significant (p value = 1). The majority of MRIs (34/61 = 56 %) were read by emergency radiologists. MRI and CT performed equally well in the evaluation of acute nontraumatic abdominal pain during pregnancy. Given its lack of ionizing radiation, MRI may be preferable. Given that the majority of MRIs were read by radiologists specializing in emergency imaging, this is a technique that emergency

  16. Obstetric triage revisited: update on non-obstetric surgical conditions in pregnancy.

    PubMed

    Angelini, Diane J

    2003-01-01

    New findings and diagnostic advances warrant revisiting key features of acute non-obstetric abdominal pain in pregnancy. Four of the most frequently seen conditions warranting surgical intervention are: appendicitis, cholecystitis, pancreatitis, and bowel obstruction. Because pregnancy often masks abdominal complaints, effectively assessing and triaging abdominal pain in pregnant women can be difficult. Working in obstetric triage settings and triaging obstetric phone calls demand continual updating of abdominal assessment knowledge and clinical skills.

  17. Surgical management of a large peritoneal pseudocyst causing acute kidney injury secondary to abdominal compartment syndrome in a rare case of congenital absence of omentum during pregnancy.

    PubMed

    Jones, Benjamin P; Hunjan, Tia; Terry, Jayne

    2016-09-01

    Complete congenital absence of the omentum is very rare with only one previously reported case. We present a unique case of the management of a pregnant woman with a large pelvic pseudocyst caused by complications related to congenital absence of omentum, resulting in acute kidney injury, likely secondary to acute compartment syndrome. This case highlights the importance of considering acute compartment syndrome in critically unwell pregnant women and reiterates the need to measure intra-abdominal pressure when clinically indicated. Given that pregnancy is in itself a state of intra-abdominal hypertension, obstetricians should maintain a high index of suspicion in the context of additional risk factors.

  18. Pulmonary function in advanced uncomplicated singleton and twin pregnancy* **

    PubMed Central

    Siddiqui, Anwar Hasan; Tauheed, Nazia; Ahmad, Aquil; Mohsin, Zehra

    2014-01-01

    Objective: Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Methods: Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups), as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. Results: All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Conclusions: Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy. PMID:25029647

  19. Ruptured subcapsular hematoma of the liver due to pre-eclampsia presenting as interstitial pregnancy and the role of intra-abdominal packing.

    PubMed

    Ngene, N C; Amin, N; Moodley, J

    2015-01-01

    Ruptured subcapsular hematoma of the liver (RSHL) can mimic ruptured interstitial pregnancy because each of these conditions occasionally presents at the same gestational period and both do manifest hemodynamic instability. The similarities between the two conditions pose a diagnostic challenge, especially in an un-booked patient. We report a case of an un-booked primigravida, at 21 weeks of gestation, who arrived at a regional hospital with evidence of intra-abdominal bleeding and hypovolemic shock. She was diagnosed as potentially having a ruptured interstitial pregnancy. During the ensuing emergency laparotomy, RSHL was discovered, the area around the ruptured liver capsule was packed with large abdominal swabs, and the patient recovered. This case report illustrates the need to consider RSHL in patients presenting with features of ruptured interstitial pregnancy, as this will assist in the planning of intraoperative care. We also describe abdominal packing and highlight the need for this essential surgical intervention to be taught to doctors practising in low-resource settings.

  20. Translational Relevance and Recent Advances of Animal Models of Abdominal Aortic Aneurysm.

    PubMed

    Sénémaud, Jean; Caligiuri, Giuseppina; Etienne, Harry; Delbosc, Sandrine; Michel, Jean-Baptiste; Coscas, Raphaël

    2017-03-01

    Human abdominal aortic aneurysm (AAA) pathophysiology is not yet completely understood. In conductance arteries, the insoluble extracellular matrix, synthesized by vascular smooth muscle cells, assumes the function of withstanding the intraluminal arterial blood pressure. Progressive loss of this function through extracellular matrix proteolysis is a main feature of AAAs. As most patients are now treated via endovascular approaches, surgical AAA specimens have become rare. Animal models provide valuable complementary insights into AAA pathophysiology. Current experimental AAA models involve induction of intraluminal dilation (nondissecting AAAs) or a contained intramural rupture (dissecting models). Although the ideal model should reproduce the histological characteristics and natural history of the human disease, none of the currently available animal models perfectly do so. Experimental models try to represent the main pathophysiological determinants of AAAs: genetic or acquired defects in extracellular matrix, loss of vascular smooth muscle cells, and innate or adaptive immune response. Nevertheless, most models are characterized by aneurysmal stabilization and healing after a few weeks because of cessation of the initial stimulus. Recent studies have focused on ways to optimize existing models to allow continuous aneurysmal growth. This review aims to discuss the relevance and recent advances of current animal AAA models.

  1. Integrating trans-abdominal ultrasonography with fecal steroid metabolite monitoring to accurately diagnose pregnancy and predict the timing of parturition in the red panda (Ailurus fulgens styani).

    PubMed

    Curry, Erin; Browning, Lissa J; Reinhart, Paul; Roth, Terri L

    2017-02-23

    Red pandas (Ailurus fulgens styani) exhibit a variable gestation length and may experience a pseudopregnancy indistinguishable from true pregnancy; therefore, it is not possible to deduce an individual's true pregnancy status and parturition date based on breeding dates or fecal progesterone excretion patterns alone. The goal of this study was to evaluate the use of transabdominal ultrasonography for pregnancy diagnosis in red pandas. Two to three females were monitored over 4 consecutive years, generating a total of seven profiles (four pregnancies, two pseudopregnancies, and one lost pregnancy). Fecal samples were collected and assayed for progesterone (P4) and estrogen conjugate (EC) to characterize patterns associated with breeding activity and parturition events. Animals were trained for voluntary transabdominal ultrasound and examinations were performed weekly. Breeding behaviors and fecal EC data suggest that the estrus cycle of this species is 11-12 days in length. Fecal steroid metabolite analyses also revealed that neither P4 nor EC concentrations were suitable indicators of pregnancy in this species; however, a secondary increase in P4 occurred 69-71 days prior to parturition in all pregnant females, presumably coinciding with embryo implantation. Using ultrasonography, embryos were detected as early as 62 days post-breeding/50 days pre-partum and serial measurements of uterine lumen diameter were documented throughout four pregnancies. Advances in reproductive diagnostics, such as the implementation of ultrasonography, may facilitate improved husbandry of pregnant females and allow for the accurate prediction of parturition.

  2. Advances in understanding and treating liver diseases during pregnancy: A review.

    PubMed

    Kamimura, Kenya; Abe, Hiroyuki; Kawai, Hirokazu; Kamimura, Hiroteru; Kobayashi, Yuji; Nomoto, Minoru; Aoyagi, Yutaka; Terai, Shuji

    2015-05-07

    Liver disease in pregnancy is rare but pregnancy-related liver diseases may cause threat to fetal and maternal survival. It includes pre-eclampsia; eclampsia; haemolysis, elevated liver enzymes, and low platelets syndrome; acute fatty liver of pregnancy; hyperemesis gravidarum; and intrahepatic cholestasis of pregnancy. Recent basic researches have shown the various etiologies involved in this disease entity. With these advances, rapid diagnosis is essential for severe cases since the decision of immediate delivery is important for maternal and fetal survival. The other therapeutic options have also been shown in recent reports based on the clinical trials and cooperation and information sharing between hepatologist and gynecologist is important for timely therapeutic intervention. Therefore, correct understandings of diseases and differential diagnosis from the pre-existing and co-incidental liver diseases during the pregnancy will help to achieve better prognosis. Therefore, here we review and summarized recent advances in understanding the etiologies, clinical courses and management of liver disease in pregnancy. This information will contribute to physicians for diagnosis of disease and optimum management of patients.

  3. Abdominal Pain Syndrome

    MedlinePlus

    ... or cancer Infection of the tubes (salpingitis) Ectopic pregnancy Fibroid tumors of the uterus (womb) Malignant tumors of the uterus or cervix Endometriosis Adhesions (scars) Screening and Diagnosis How is the cause of abdominal pain determined? ...

  4. Perforated duodenal ulcer in pregnancy-a rare cause of acute abdominal pain in pregnancy: a case report and literature review.

    PubMed

    Essilfie, Papa; Hussain, M; Bolaji, I

    2011-01-01

    Medical and surgical disorders in pregnancy can be can be quite challenging for the obstetrician gynaecologist even in resource rich countries. Reaching an accurate diagnosis and admininstering appropriate management can be difficult in the presence of an on-going pregnancy. The importance of involving specialist from other disciplines (multidisciplinary care) cannot be overemphasized. We present an interesting case of perforated duodenal ulcer in a pregnant patient, review the literature ,discuss the differential diagnosis and evaluate the management principles for this rare condition.

  5. Maternal macronutrient intake during pregnancy is associated with neonatal abdominal adiposity: the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study1-4

    PubMed Central

    Chen, Ling-Wei; Tint, Mya-Thway; Fortier, Marielle V.; Aris, Izzuddin M.; Bernard, Jonathan Y.; Colega, Marjorelee; Gluckman, Peter D.; Saw, Seang-Mei; Chong, Yap-Seng; Yap, Fabian; Godfrey, Keith M.; Kramer, Michael S.; van Dam, Rob M.; Chong, Mary Foong-Fong; Lee, Yung Seng

    2016-01-01

    Background Infant body composition has been associated with later metabolic risk, but few studies have examined the association between maternal macronutrient intake and neonatal body composition. Furthermore, most of those studies have used proxy measures of body composition that may not reflect body fat distribution, particularly abdominal internal adiposity. Objective We investigated the relation between maternal macronutrient intake and neonatal abdominal adiposity measured using magnetic resonance imaging (MRI) in a multi-ethnic Asian mother-offspring cohort. Methods Macronutrient intakes of mothers were ascertained using a 24-h dietary recall at 26-28 weeks gestation. Neonatal abdominal adiposity was assessed using MRI in the second week of life. Mother-offspring dyads with complete macronutrient intake and adiposity information (n= 320) were included in the analysis. Associations were assessed by both substitution and addition models using multivariable linear regressions. Results Mothers [mean age: 30 y; 44% Chinese, 38% Malay, 18% Indians] consumed 15.5 ± 4.3% (mean ± SD) of their energy intakes from protein, 32.4 ± 7.7% from fat, and 52.1 ± 9.0% from carbohydrate. A higher protein, lower carbohydrate/fat diet during pregnancy was associated with lower abdominal internal adipose tissue (IAT) in the neonates [β (95% CI): -0.18 (-0.35, -0.001) mL per 1% protein to carbohydrate substitution and -0.25 (-0.46, -0.04) mL per 1% protein to fat substitution]. These associations were stronger in boys than in girls (P-interactions <0.05). Higher maternal intake of animal protein [-0.26 (-0.47, -0.05) mL for fat substitution], but not plant protein, was associated with lower offspring IAT. In contrast, maternal macronutrient intake was not consistently associated with infant anthropometric measurements, including abdominal circumference and subscapular skinfold thickness. Conclusions Higher maternal protein intake (at the expense of carbohydrate or fat intake

  6. Pregnancy

    MedlinePlus

    ... each trimester are described below. 1 First Trimester (Week 1 to Week 12) The events that lead to pregnancy begin ... and oxygen to the fetus. 2 Second Trimester (Week 13 to Week 28) At 16 weeks, and ...

  7. Pregnancy

    MedlinePlus

    ... also be tired and need more rest. Your body will change as your baby grows during the nine months of your pregnancy. Don't hesitate to call your health care provider if you think you have a problem or something is bothering or worrying you.

  8. Pregnancy week by week

    MedlinePlus

    ... Pregnancy > Prenatal care > Pregnancy week by week Pregnancy week by week Week by week Videos Swipe to advance Learn ... grows each week during pregnancy. Pick your week. Weeks 1-2 Conception (also called fertilization) usually happens ...

  9. Characterizing the Propagation of Uterine Electrophysiological Signals Recorded with a Multi-Sensor Abdominal Array in Term Pregnancies.

    PubMed

    Escalona-Vargas, Diana; Govindan, Rathinaswamy B; Furdea, Adrian; Murphy, Pam; Lowery, Curtis L; Eswaran, Hari

    2015-01-01

    The objective of this study was to quantify the number of segments that have contractile activity and determine the propagation speed from uterine electrophysiological signals recorded over the abdomen. The uterine magnetomyographic (MMG) signals were recorded with a 151 channel SARA (SQUID Array for Reproductive Assessment) system from 36 pregnant women between 37 and 40 weeks of gestational age. The MMG signals were scored and segments were classified based on presence of uterine contractile burst activity. The sensor space was then split into four quadrants and in each quadrant signal strength at each sample was calculated using center-of-gravity (COG). To this end, the cross-correlation analysis of the COG was performed to calculate the delay between pairwise combinations of quadrants. The relationship in propagation across the quadrants was quantified and propagation speeds were calculated from the delays. MMG recordings were successfully processed from 25 subjects and the average values of propagation speeds ranged from 1.3-9.5 cm/s, which was within the physiological range. The propagation was observed between both vertical and horizontal quadrants confirming multidirectional propagation. After the multiple pairwise test (99% CI), significant differences in speeds can be observed between certain vertical or horizontal combinations and the crossed pair combinations. The number of segments containing contractile activity in any given quadrant pair with a detectable delay was significantly higher in the lower abdominal pairwise combination as compared to all others. The quadrant-based approach using MMG signals provided us with high spatial-temporal information of the uterine contractile activity and will help us in the future to optimize abdominal electromyographic (EMG) recordings that are practical in a clinical setting.

  10. Intensity-Modulated Whole Abdominal Radiotherapy After Surgery and Carboplatin/Taxane Chemotherapy for Advanced Ovarian Cancer: Phase I Study

    SciTech Connect

    Rochet, Nathalie; Sterzing, Florian; Jensen, Alexandra D.; Dinkel, Julien; Herfarth, Klaus K.; Schubert, Kai; Eichbaum, Michael H.; Schneeweiss, Andreas; Sohn, Christof; Debus, Juergen; Harms, Wolfgang

    2010-04-15

    Purpose: To assess the feasibility and toxicity of consolidative intensity-modulated whole abdominal radiotherapy (WAR) after surgery and chemotherapy in high-risk patients with advanced ovarian cancer. Methods and Materials: Ten patients with optimally debulked ovarian cancer International Federation of Gynecology and Obstetrics Stage IIIc were treated in a Phase I study with intensity-modulated WAR up to a total dose of 30 Gy in 1.5-Gy fractions as consolidation therapy after adjuvant carboplatin/taxane chemotherapy. Treatment was delivered using intensity-modulated radiotherapy in a step-and-shoot technique (n = 3) or a helical tomotherapy technique (n = 7). The planning target volume included the entire peritoneal cavity and the pelvic and para-aortal node regions. Organs at risk were kidneys, liver, heart, vertebral bodies, and pelvic bones. Results: Intensity-modulated WAR resulted in an excellent coverage of the planning target volume and an effective sparing of the organs at risk. The treatment was well tolerated, and no severe Grade 4 acute side effects occurred. Common Toxicity Criteria Grade III toxicities were as follows: diarrhea (n = 1), thrombocytopenia (n = 1), and leukopenia (n = 3). Radiotherapy could be completed by all the patients without any toxicity-related interruption. Median follow-up was 23 months, and 4 patients had tumor recurrence (intraperitoneal progression, n = 3; hepatic metastasis, n = 1). Small bowel obstruction caused by adhesions occurred in 3 patients. Conclusions: The results of this Phase I study showed for the first time, to our knowledge, the clinical feasibility of intensity-modulated whole abdominal radiotherapy, which could offer a new therapeutic option for consolidation treatment of advanced ovarian carcinoma after adjuvant chemotherapy in selected subgroups of patients. We initiated a Phase II study to further evaluate the toxicity of this intensive multimodal treatment.

  11. The Value of Restaging With Chest and Abdominal CT/MRI Scan After Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer.

    PubMed

    Liu, Guo-Chen; Zhang, Xu; Xie, E; An, Xin; Cai, Pei-Qiang; Zhu, Ying; Tang, Jing-Hua; Kong, Ling-Heng; Lin, Jun-Zhong; Pan, Zhi-Zhong; Ding, Pei-Rong

    2015-11-01

    Little was known with regard to the value of preoperative systemic restaging for patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (CRT). This study was designed to evaluate the role of chest and abdominal computed tomography (CT) scan or magnetic resonance imaging (MRI) on preoperative restaging in LARC after neoadjuvant CRT and to assess the impact on treatment strategy.Between January 2007 and April 2013, 386 newly diagnosed consecutive patients with LARC who underwent neoadjuvant CRT and received restaging with chest and abdominal CT/MRI scan were included. Imaging results before and after CRT were analyzed.Twelve patients (3.1%) (6 liver lesions, 2 peritoneal lesions, 2 distant lymph node lesions, 1 lung lesions, 1 liver and lung lesions) were diagnosed as suspicious metastases on the restaging scan after radiotherapy. Seven patients (1.8%) were confirmed as metastases by pathology or long-term follow-up. The treatment strategy was changed in 5 of the 12 patients as a result of restaging CT/MRI findings. Another 10 patients (2.6%) who present with normal restaging imaging findings were diagnosed as metastases intra-operatively. The sensitivity, specificity accuracy, negative predictive value, and positive predictive values of restaging CT/MRI was 41.4%, 98.6%, 58.3%, and 97.3%, respectively.The low incidence of metastases and minimal consequences for the treatment plan question the clinical value of routine restaging of chest and abdomen after neoadjuvant CRT. Based on this study, a routine restaging CT/MRI of chest and abdomen in patients with rectal cancer after neoadjuvant CRT is not advocated, carcino-embryonic antigen (CEA) -guided CT/MRI restaging might be an alternative.

  12. Endoscopic Ultrasound-Guided Drainage of Intra-Abdominal Abscess after Gastric Perforation in a Patient Receiving Ramucirumab and Paclitaxel for Advanced Gastric Cancer.

    PubMed

    Mandai, Koichiro; Shirakawa, Atsushi; Uno, Koji; Yasuda, Kenjiro

    2017-01-01

    Gastrointestinal perforation is a serious adverse event that occurs in approximately 1% of patients receiving ramucirumab and paclitaxel. A 67-year-old man with unresectable advanced gastric cancer was admitted to our hospital and treated with ramucirumab and paclitaxel. Gastric perforation occurred during the second cycle of chemotherapy. Although the patient's condition improved without surgery, an abscess developed in the intra-abdominal fluid collection resulting from the perforation. We performed endoscopic ultrasound-guided abscess drainage. The patient improved and was discharged in satisfactory condition. Endoscopic ultrasound-guided drainage is a treatment option for patients with intra-abdominal abscess following gastric perforation due to ramucirumab.

  13. Endoscopic Ultrasound-Guided Drainage of Intra-Abdominal Abscess after Gastric Perforation in a Patient Receiving Ramucirumab and Paclitaxel for Advanced Gastric Cancer

    PubMed Central

    Mandai, Koichiro; Shirakawa, Atsushi; Uno, Koji; Yasuda, Kenjiro

    2017-01-01

    Gastrointestinal perforation is a serious adverse event that occurs in approximately 1% of patients receiving ramucirumab and paclitaxel. A 67-year-old man with unresectable advanced gastric cancer was admitted to our hospital and treated with ramucirumab and paclitaxel. Gastric perforation occurred during the second cycle of chemotherapy. Although the patient's condition improved without surgery, an abscess developed in the intra-abdominal fluid collection resulting from the perforation. We performed endoscopic ultrasound-guided abscess drainage. The patient improved and was discharged in satisfactory condition. Endoscopic ultrasound-guided drainage is a treatment option for patients with intra-abdominal abscess following gastric perforation due to ramucirumab. PMID:28203161

  14. [Myxofibrosarcoma in the abdominal cavity].

    PubMed

    Janů, F

    2016-01-01

    A number of benign and malignant tumors may develop in the abdominal cavity. Sarcomas are rather rare tumors of the abdominal cavity. They are often diagnosed at advanced growth stages as their local growth can cause clinical problems to the patients. The author presents a case report of myxofibrosarcoma in the abdominal cavity.Key words: myxofibrosarcoma.

  15. Acute abdominal pain.

    PubMed

    Stone, R

    1998-01-01

    Abdominal pain is among the most frequent ailments reported in the office setting and can account for up to 40% of ailments in the ambulatory practice. Also, it is in the top three symptoms of patients presenting to emergency departments (ED) and accounts for 5-10% of all ED primary presenting ailments. There are several common sources for acute abdominal pain and many for subacute and chronic abdominal pain. This article explores the history-taking, initial evaluation, and examination of the patient presenting with acute abdominal pain. The goal of this article is to help differentiate one source of pain from another. Discussion of acute cholecystitis, pancreatitis, appendicitis, ectopic pregnancy, diverticulitis, gastritis, and gastroenteritis are undertaken. Additionally, there is discussion of common laboratory studies, diagnostic studies, and treatment of the patient with the above entities.

  16. Abdominal ultrasound

    MedlinePlus

    ... Kidney - blood and urine flow Abdominal ultrasound References Chen L. Abdominal ultrasound imaging. In: Sahani DV, Samir ... the Health on the Net Foundation (www.hon.ch). The information provided herein should not be used ...

  17. Abdominal tap

    MedlinePlus

    ... tap; Cirrhosis - abdominal tap; Malignant ascites - abdominal tap Images Digestive system Peritoneal sample References Garcia-Tiso G. ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  18. Abdominal Pain

    MedlinePlus

    ... call your doctor. In Spanish— Dolor abdominal en niños menores de 12 años What is recurrent abdominal ... Functional abdominal pain (FAP) typically affects kids ages 4-12, and is quite common, affecting up to ...

  19. Monitoring fetal heart rate during pregnancy: contributions from advanced signal processing and wearable technology.

    PubMed

    Signorini, Maria G; Fanelli, Andrea; Magenes, Giovanni

    2014-01-01

    Monitoring procedures are the basis to evaluate the clinical state of patients and to assess changes in their conditions, thus providing necessary interventions in time. Both these two objectives can be achieved by integrating technological development with methodological tools, thus allowing accurate classification and extraction of useful diagnostic information. The paper is focused on monitoring procedures applied to fetal heart rate variability (FHRV) signals, collected during pregnancy, in order to assess fetal well-being. The use of linear time and frequency techniques as well as the computation of non linear indices can contribute to enhancing the diagnostic power and reliability of fetal monitoring. The paper shows how advanced signal processing approaches can contribute to developing new diagnostic and classification indices. Their usefulness is evaluated by comparing two selected populations: normal fetuses and intra uterine growth restricted (IUGR) fetuses. Results show that the computation of different indices on FHRV signals, either linear and nonlinear, gives helpful indications to describe pathophysiological mechanisms involved in the cardiovascular and neural system controlling the fetal heart. As a further contribution, the paper briefly describes how the introduction of wearable systems for fetal ECG recording could provide new technological solutions improving the quality and usability of prenatal monitoring.

  20. Monitoring Fetal Heart Rate during Pregnancy: Contributions from Advanced Signal Processing and Wearable Technology

    PubMed Central

    Signorini, Maria G.

    2014-01-01

    Monitoring procedures are the basis to evaluate the clinical state of patients and to assess changes in their conditions, thus providing necessary interventions in time. Both these two objectives can be achieved by integrating technological development with methodological tools, thus allowing accurate classification and extraction of useful diagnostic information. The paper is focused on monitoring procedures applied to fetal heart rate variability (FHRV) signals, collected during pregnancy, in order to assess fetal well-being. The use of linear time and frequency techniques as well as the computation of non linear indices can contribute to enhancing the diagnostic power and reliability of fetal monitoring. The paper shows how advanced signal processing approaches can contribute to developing new diagnostic and classification indices. Their usefulness is evaluated by comparing two selected populations: normal fetuses and intra uterine growth restricted (IUGR) fetuses. Results show that the computation of different indices on FHRV signals, either linear and nonlinear, gives helpful indications to describe pathophysiological mechanisms involved in the cardiovascular and neural system controlling the fetal heart. As a further contribution, the paper briefly describes how the introduction of wearable systems for fetal ECG recording could provide new technological solutions improving the quality and usability of prenatal monitoring. PMID:24639886

  1. Peritoneal tuberculosis in pregnancy mimicking advanced ovarian cancer: a plea to avoid hasty, radical and irreversible surgical decisions.

    PubMed

    Sakorafas, George H; Ntavatzikos, Anastasions; Konstantiadou, Ioanna; Karamitopoulou, Eva; Kavatha, Dimitra; Peros, George

    2009-09-01

    Tuberculous peritonitis is rare in most Western counties, and can cause significant diagnostic and therapeutic problems. A 28-year-old pregnant female presented with nausea and vomiting, right lower quadrant abdominal pain, fever and intra-abdominal fluid. During surgery for presumed complicated acute appendicitis, many small masses (considered to be 'implants') were found within the peritoneal cavity, with a larger mass in the pelvis, mainly on the right. The clinical intra-operative diagnosis was advanced ovarian cancer and multiple biopsies were taken. The histological diagnosis was peritoneal tuberculosis. The patient was successfully treated conservatively. Hasty decisions to undertake radical and irreversible surgery should be avoided; this type of surgery should be performed only after histological confirmation.

  2. Long-Term Efficacy and Tolerability of Abdominal Once-Yearly Histrelin Acetate Subcutaneous Implants in Patients with Advanced Prostate Cancer

    PubMed Central

    Woolen, Sean; Holzmeyer, Cameron; Nesbitt, Emily; Siami, Paul F.

    2014-01-01

    Objectives. Long-term assessment of the efficacy and tolerability of subcutaneous abdominal histrelin acetate implants that have been inserted for more than two years. Materials and Methods. Retrospective data collected over a six-year period at a single center from charts of 113 patients who received the subcutaneous abdominal histrelin acetate implant. Results. Following insertion of the first implant, 92.1% and 91.8% of patients had a serum testosterone level of ≤30 ng/dL at 24 and 48 weeks, respectively. Serum testosterone levels remained at <30 ng/dL for 96% of patients at two years and for 100% of patients at 3, 4, and 5 years. The testosterone levels remained significantly less than baseline (P < 0.05). Six patients (5.3%) had androgen-independent progression when followed up on the long term, increasing the mean serum PSA at 3, 4, and 5 years to 35.0 µg/L (n = 22), 30.7 µg/L (n = 13), and 132.9 µg/L (n = 8), respectively. The mean serum PSA was significantly greater than baseline during these years (P < 0.05). Eight patients (7.1%) experienced minor, but not serious, adverse events from the histrelin acetate. Conclusion. Subcutaneous abdominal histrelin acetate implants are an effective long-term and well-tolerated administration method for treating patients with advanced prostate cancer. PMID:25548680

  3. [Abdominal paracentesis].

    PubMed

    Glauser, Frédéric; Barras, Anne-Catherine; Pache, Isabelle; Monti, Matteo

    2008-10-29

    Abdominal paracentesis is frequently performed in the clinical setting. Every newly developed ascites need to be investigated by abdominal paracentesis. Any clinical or biological deterioration in patients with chronic ascites also requires a new paracentesis. Therapeutically abdominal paracentesis is performed for refractory or symptomatic ascites. As other invasive procedures, it is critical to master its indications, contra-indications and complications. The aim of this article is to review the basics of abdominal paracentesis in order to help physicians to carry out this technical skill.

  4. Effect of advanced uncomplicated pregnancy on pulmonary function parameters of North Indian subjects.

    PubMed

    Neeraj; Sodhi, Candy; Pramod, John; Singh, Joydeep; Kaur, Vaneet

    2010-01-01

    The study was conducted on 100 pregnant women in third trimester of uncomplicated pregnancy (Test group) and 100 age-matched non-pregnant women (Control group) in the age group of 25 to 35 years. Pulmonary function test parameters FVC, FEV1, PEFR and FEF25-75% recorded using Medspiror. The FEV1/FVC ratio was calculated. All parameters except FEV1/ FVC ratio were found to decline in the Test group as compared to the Control group. The decrease in FEV1 with pregnancy was not of such amplitude as decrease in FVC, and hence FEV1/FVC ratio was seen to increase. This study validates the physiological changes in pulmonary function brought by pregnancy and highlights the need to compile expected and accepted alterations in predicted values of PFT in comparison with the non gravid states for safer outcome of the pregnancy.

  5. Anxious women do not show the expected decrease in cardiovascular stress responsiveness as pregnancy advances.

    PubMed

    Braeken, M A K A; Jones, A; Otte, R A; Widjaja, D; Van Huffel, S; Monsieur, G J Y J; van Oirschot, C M; Van den Bergh, B R H

    2015-10-01

    Altered stress responsiveness is a risk factor for mental and physical illness. In non-pregnant populations, it is well-known that anxiety can alter the physiological regulation of stress reactivity. Characterization of corresponding risks for pregnant women and their offspring requires greater understanding of how stress reactivity and recovery are influenced by pregnancy and women's anxiety feelings. In the current study, women were presented repeatedly with mental arithmetic stress tasks in the first and third pregnancy trimester and reported their trait anxiety using the state trait anxiety inventory. Cardiovascular stress reactivity in late pregnancy was lower than reactivity in the first pregnancy trimester (heart rate (HR): t(197)=4.98, p<.001; high frequency heart rate variability (HF HRV): t(196)=-2.09, p=.04). Less attenuation of stress reactivity occurred in more anxious women (HR: b=0.15, SE=0.06, p=.008; HF HRV: b=-10.97, SE=4.79, p=.02). The study design did not allow the influence of habituation to repeated stress task exposure to be assessed separately from the influence of pregnancy progression. Although this is a limitation, the clear differences between anxious and non-anxious pregnant women are important, regardless of the extent to which differing habituation between the groups is responsible. Less dampened stress reactivity through pregnancy may pose long-term risks for anxious women and their offspring. Follow-up studies are required to determine these risks.

  6. Perforated Duodenal Ulcer in Pregnancy—A Rare Cause of Acute Abdominal Pain in Pregnancy: A Case Report and Literature Review

    PubMed Central

    Essilfie, Papa; Hussain, M.; Bolaji, I.

    2011-01-01

    Medical and surgical disorders in pregnancy can be can be quite challenging for the obstetrician gynaecologist even in resource rich countries. Reaching an accurate diagnosis and admininstering appropriate management can be difficult in the presence of an on-going pregnancy. The importance of involving specialist from other disciplines (multidisciplinary care) cannot be overemphasized. We present an interesting case of perforated duodenal ulcer in a pregnant patient, review the literature ,discuss the differential diagnosis and evaluate the management principles for this rare condition. PMID:22567500

  7. Clostridial abdominal gas gangrene masquerading as a bowel perforation in an advanced-stage ovarian cancer patient.

    PubMed

    Abaid, L N; Thomas, R H; Epstein, H D; Goldstein, B H

    2013-08-01

    The coexistence of clostridial gas gangrene and a gynecologic malignancy is extremely rare, with very few cases involving ovarian cancer. A patient originally presented to our gynecologic oncology service with stage IV ovarian cancer; she underwent a diagnostic laparoscopy and neoadjuvant chemotherapy. On postoperative day 6, the patient developed severe abdominal pain, nausea, and emesis, suggestive of a bowel perforation. Further evaluation confirmed that her symptoms were attributed to Clostridium perfringens-related gas gangrene. Despite immediate surgical intervention, the patient succumbed to her disease. Clostridial gas gangrene is associated with an extremely high mortality rate. Therefore, accurate detection and prompt management are indispensable to ensuring a favorable patient outcome.

  8. Fertility after abdominal myomectomy.

    PubMed

    Connolly, G; Doyle, M; Barrett, T; Byrne, P; De Mello, M; Harrison, R F

    2000-07-01

    This study aimed to evaluate the morbidity and pregnancy outcome of myomectomy in infertile women with uterine fibroids. This was a cross-sectional study. Records were reviewed for 100 consecutive women in the Rotunda Hospital who underwent myomectomy in the years 1995-1996. A questionnaire regarding subsequent fertility was sent. The study was carried out in the infertility unit at the Rotunda Hospital, Dublin, Ireland. Seventy-five women responded. Multiple myomectomy was performed in 52 (70%). Mean fibroid size was 6.8 cm (range 2-14.5 cm). Nine women (12%) developed complications; five had menstrual problems, two had wound discomfort and two had abdominal discomfort. Twenty-five women (33%) became pregnant. Seven (28%) were IVF pregnancies. Overall six (24%) miscarried. In 19 of 25, pregnancy occurred where fibroids were the only identifiable cause of infertility. We conclude that abdominal myomectomy is associated with a favourable outcome in infertile women particularly if no other confounding variable is present.

  9. Advanced Poincaré plot analysis differentiates between hypertensive pregnancy disorders.

    PubMed

    Seeck, A; Baumert, M; Fischer, C; Khandoker, A; Faber, R; Voss, A

    2011-10-01

    Hypertensive pregnancy disorders affect 6% to 8% of all pregnancies and can result in severe complications for the mother and the foetus of which pre-eclampsia (PE) has the worst perinatal outcome. Several studies suggested that the autonomic nervous system plays an important role in the process of developing hypertensive pregnancy disorders, especially PE. The aim of this retrospective study was to investigate whether women with PE could be differentiated from women with various other hypertensive pregnancy disorders, by employing an enhanced Poincaré plot analysis (PPA), the segmented Poincaré plot analysis (SPPA), to their beat-to-beat interval and blood pressure signals. Sixty-nine pregnant women with hypertensive disorders (29 PE, 40 with chronic or gestational hypertension) were included. The SPPA as well as the traditional PPA found significant differences between PE and other hypertensive disorders of diastolic blood pressure (p < 0.001 versus p < 0.001) but only the SPPA method revealed significant differences (p < 0.001) also of the systolic blood pressure. Further on, linear discrimination analysis demonstrated that indices derived from SPPA are more suitable for differentiation between chronic and gestational hypertension and PE than those from traditional PPA (area under the ROC curve 0.85 versus 0.69). Therefore this procedure could contribute to the differential diagnosis of hypertensive pregnancy disorders.

  10. Limits to sustained energy intake. XVI. Body temperature and physical activity of female mice during pregnancy.

    PubMed

    Gamo, Yuko; Bernard, Amelie; Mitchell, Sharon E; Hambly, Catherine; Al Jothery, Aqeel; Vaanholt, Lobke M; Król, Elzbieta; Speakman, John R

    2013-06-15

    Lactation is the most energy-demanding phase of mammalian reproduction, and lactation performance may be affected by events during pregnancy. For example, food intake may be limited in late pregnancy by competition for space in the abdomen between the alimentary tract and fetuses. Hence, females may need to compensate their energy budgets during pregnancy by reducing activity and lowering body temperature. We explored the relationships between energy intake, body mass, body temperature and physical activity throughout pregnancy in the MF1 mouse. Food intake and body mass of 26 females were recorded daily throughout pregnancy. Body temperature and physical activity were monitored every minute for 23 h a day by implanted transmitters. Body temperature and physical activity declined as pregnancy advanced, while energy intake and body mass increased. Compared with a pre-mating baseline period, mice increased energy intake by 56% in late pregnancy. Although body temperature declined as pregnancy progressed, this served mostly to reverse an increase between baseline and early pregnancy. Reduced physical activity may compensate the energy budget of pregnant mice but body temperature changes do not. Over the last 3 days of pregnancy, food intake declined. Individual variation in energy intake in the last phase of pregnancy was positively related to litter size at birth. As there was no association between the increase in body mass and the decline in intake, we suggest the decline was not caused by competition for abdominal space. These data suggest overall reproductive performance is probably not constrained by events during pregnancy.

  11. Abdominal pain

    MedlinePlus

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

  12. [Abdominal pain].

    PubMed

    Gschossmann, J M; Holtmann, G; Netzer, P; Essig, M; Balsiger, B M; Scheurer, U

    2005-10-01

    Abdominal pain can result from a variety of different intra- and extra-abdominal disorders. Given the wide variety of etiological triggers for this pain, the primary task during the first stage of the diagnostic work-up is to determine as soon as possible the underlying cause and the degree of emergency. The aim of this evaluation is to adapt the therapeutic measures which are necessary for a causal treatment to the individual situation. Contrary to somatic causes of abdominal pain, the availability of such a causal therapy for functional bowel disorders is still very limited. Given this dilemma, the therapeutic focus of abdominal pain associated with these functional syndromes has to be placed on symptom-oriented treatment.

  13. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy.

  14. Abdominal Adhesions

    MedlinePlus

    ... Adhesions 1 Ward BC, Panitch A. Abdominal adhesions: current and novel therapies. Journal of Surgical Research. 2011;165(1):91–111. Seek Help for ... and how to participate, visit the NIH Clinical Research Trials and You website ... Foundation for Functional Gastrointestinal Disorders 700 West Virginia ...

  15. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  16. [Specific dermatoses of pregnancy].

    PubMed

    Teixeira, Vera; Coutinho, Inês; Gameiro, Rita; Vieira, Ricardo; Gonçalo, Margarida

    2013-01-01

    During pregnancy immunological, metabolic, hormonal and vascular changes occur, and can cause specific skin diseases. The specific dermatoses of pregnancy have undergone numerous changes in nomenclature and classification, partly due to advances in the knowledge of the pathogenesis of these skin diseases. Currently the following diseases are considered specific dermatoses of pregnancy: pemphigoid gestations, polymorphic eruption of pregnancy, intrahepatic cholestasis of pregnancy and atopic eruption of pregnancy. Timely diagnosis and specific and safe treatment are essential to prevent complications which, although rare, may be associated with significant maternal-fetal comorbidity.

  17. Pregnancy Complications

    MedlinePlus

    ... To receive Pregnancy email updates Enter email Submit Pregnancy complications Complications of pregnancy are health problems that ... pregnancy. Expand all | Collapse all Health problems before pregnancy Before pregnancy, make sure to talk to your ...

  18. Abdominal surgical emergencies in the puerperium.

    PubMed Central

    Munro, A; Jones, P F

    1975-01-01

    Since surgical emergencies in the puerperium are rare, surgeons and obstetricians amass little experience of them. There may be considerable delay in making a diagnosis, firstly, because the abdominal symptoms are thought to be related to the pregnancy, and, secondly, because the signs are rarely convincing in contrast to the symptoms. Any of the common surgical emergencies may occur in pregnancy and the puerperium and there are some others that appear to be a particullar problem of the puerperium. PMID:1203726

  19. Intra-abdominal bleeding in appendicitis.

    PubMed

    Thongprayoon, C; Pasa-Arj, S

    1991-08-01

    A 34-year-old woman, gravida 6 with 10 weeks of gestation was admitted because of abdominal pain and fainting. On physical examination she had hypotension, was pale with abdominal tenderness and guarding. Culdocentesis yielded unclotted blood. Immediate laparotomy was performed, because a diagnosis of ectopic pregnancy was made. About 2,500 ml of fresh blood was found in the abdominal cavity. Appendicular artery tear caused active arterial bleeding. The torn appendicular artery was observed to be the consequence of perforated appendicitis, which, in turn, was caused by a faecalith. Appendectomy was performed and she made a good recovery.

  20. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... is a hoodlike device used to reduce pressure on the pregnant patient's abdomen for the relief of abdominal pain during pregnancy or labor. (b) Classification. Class III (premarket approval). (c) Date...

  1. 21 CFR 884.5225 - Abdominal decompression chamber.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... is a hoodlike device used to reduce pressure on the pregnant patient's abdomen for the relief of abdominal pain during pregnancy or labor. (b) Classification. Class III (premarket approval). (c) Date...

  2. Demonstration of the route of embryo migration in retroperitoneal ectopic pregnancy using contrast-enhanced computed tomography.

    PubMed

    Liang, Changhu; Li, Xueli; Zhao, Bin; Du, Yinglin; Xu, Shifeng

    2014-03-01

    Retroperitoneal abdominal pregnancy is exceptionally rare. An unusual retroperitoneal pregnancy has a high risk of severe bleeding. Abdominal ultrasonography and whole abdominal computerized tomography scanning should be performed for the early diagnosis of ectopic pregnancy. A case of retroperitoneal ectopic pregnancy located very close to large retroperitoneal blood vessels and treated with resection is presented. Many unusual features of retroperitoneal ectopic pregnancy were highlighted as providing further evidence in support of the main proposed embryo migration mechanism via lymphatic vessels.

  3. Vertically transmitted hypoplasia of the abdominal wall musculature.

    PubMed

    Chan, Yuin-Chew; Bird, Lynne M

    2004-01-01

    The prune belly syndrome (OMIM 100100) is an association of bladder dilation with hypoplasia of the abdominal wall muscles. This malformation sequence is due to early urethral obstruction. We report a family with abdominal wall muscular hypoplasia as an isolated defect, not associated with the urethral obstruction sequence. The proband is a q3-year-old male who presented with abdominal wall laxity and severe constipation. His mother, maternal grandmother and younger brother had varying degrees of abdominal wall muscular deficiency and constipation. His mother's condition was aggravated by her 2 pregnancies. This family shows vertical transmission (compatible with autosomal dominant or mitochondrial inheritance) of the abdominal phenotype of prune belly sequence without any evidence of urinary tract or renal pathology. The expression in the sons may remain incomplete because abdominal distention due to pregnancy will not occur.

  4. Abdominal Adhesions

    MedlinePlus

    ... History Research Resources Research at NIDDK Meetings & Events Technology Advancement & Transfer Health Information Diabetes Digestive Diseases Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition ...

  5. Pregnancy and liver disease.

    PubMed

    Westbrook, Rachel H; Dusheiko, Geoffrey; Williamson, Catherine

    2016-04-01

    Pregnancy associated liver diseases affect up to 3% of pregnant women and are the most frequent cause of liver dysfunction in pregnancy. When severe, they are associated with significant morbidity and mortality for both mother and infant. A rapid evaluation to distinguish them from non-pregnancy related liver dysfunction is essential, in order to facilitate appropriate management. Liver disease unrelated to pregnancy can present de novo in pregnancy, or pregnancy can occur in women with preexisting liver pathology (Table 1). Research and subsequent advances in medical care have resulted in improved but still not satisfactory maternal and fetal outcomes. In this review we provide an overview of the liver diseases specific to the pregnant state and an update on their pathogenesis, treatment and outcomes. The risks of pregnancy in women with pre-existent liver pathology is detailed and recent advances in our understanding of specific risks and outcomes are discussed.

  6. [Management of pregnant women with advanced cervical cancer].

    PubMed

    Vincens, C; Dupaigne, D; de Tayrac, R; Mares, P

    2008-04-01

    The purpose of this study is to update the management of pregnant women with advanced cervical cancer, thanks to a literature review indexed in Medline((R)) (from 1980 till 2006 using those keywords: advanced cervix cancer, neoadjuvant chemotherapy and pregnancy), ScienceDirect (from 1990 till 2006) and the French Encyclopédie Médico-Chirurgicale. It occurs that pregnancy is a privileged period to diagnose cervical cancer, particularly in early stages. We ought to beware of symptoms such as vaginal bleeding, which could be underestimated during pregnancy. Colposcopically selected biopsies are reference techniques to confirm the diagnostic. The assessment of extension includes an abdominal and pelvic MRI and echography and a radiography of the chest for locally advanced stages. The decision to interrupt pregnancy should be based on a collegial evaluation and depends on state and histology of disease, patient's desire for pregnancy, as well as gestational age and disease evolution. Cesarean is preferred to natural delivery even though survival rates are the same. The cesarean section prevents from short-term complications and recurrence on the episiotomy, but the hysterotomy type is controversial throughout literature. The prognosis of cervical cancer does not seem to be influenced by pregnancy. Management is the same, even though we have to adapt the treatment from the pregnancy state. No study could show the benefit and the safety of neoadjuvant chemotherapy during pregnancy, due to few cases, but it could be a solution with patients suffering from an advanced cancer and not willing to stop pregnancy. To conclude, the detection by cervical smears should be systematic during pregnancy. When cancer is diagnosed, cesarean section is the favourite way to deliver. Pregnancy does not modify disease's prognosis and the therapeutic choice depends on the stage of the disease.

  7. Abdominal tuberculosis.

    PubMed Central

    Kapoor, V. K.

    1998-01-01

    Tuberculosis has staged a global comeback and forms a dangerous combination with AIDS. The abdomen is one of the common sites of extrapulmonary involvement. Patients with abdominal tuberculosis have a wide range and spectrum of symptoms and signs; the disease is therefore a great mimic. Diagnosis, mainly radiological and supported by endoscopy, is difficult to make and laparotomy is required in a large number of patient. Management involves judicious combination of antitubercular therapy and surgery which may be required to treat complications such as intestinal obstruction and perforation. The disease, though potentially curable, carries a significant morbidity and mortality. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 PMID:9926119

  8. Advanced paternal age and stillbirth rate: a nationwide register-based cohort study of 944,031 pregnancies in Denmark.

    PubMed

    Urhoj, Stine Kjaer; Andersen, Per Kragh; Mortensen, Laust Hvas; Davey Smith, George; Nybo Andersen, Anne-Marie

    2017-03-01

    Advanced paternal age has been associated with a variety of rare conditions and diseases of great public health impact. An increased number of de novo point mutations in sperm with increasing age have been suggested as a mechanism, which would likely also affect fetal viability. We examined the association between paternal age and stillbirth rate in a large nationwide cohort. We identified all pregnancies in Denmark from 1994 to 2010 carried to a gestational age of at least 22 completed weeks (n = 944,031) as registered in national registers and linked to individual register data about the parents. The hazard ratio of stillbirth according to paternal age was estimated, adjusted for maternal age in 1-year categories, year of outcome, and additionally parental educational levels. The relative rate of stillbirth (n = 4946) according to paternal age was found to be J-shaped with the highest hazard ratio for fathers aged more than 40 years when paternal age was modelled using restricted cubic splines. When modelled categorically, the adjusted hazard ratios of stillbirth were as follows: <25, 1.16 (95% confidence interval, CI 1.01-1.34); 25-29, 1.03 (95% CI 0.95-1.11); 35-39, 1.16 (95% CI 1.07-1.26); 40-44, 1.41 (95% CI 1.26-1.59); 45-49, 1.20 (95% CI 0.97-1.49); 50+, 1.58 (95% CI 1.18-2.11), compared with fathers aged 30-34 years. These estimates attenuated slightly when further adjusted for parental education. Our study showed that paternal age was associated with the relative rate of stillbirth in a J-shaped manner with the highest hazard ratios among fathers aged more than 40 years.

  9. 2013 WSES guidelines for management of intra-abdominal infections

    PubMed Central

    2013-01-01

    Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections. PMID:23294512

  10. Teenage pregnancy.

    PubMed

    Molina Cartes, Ramiro; González Araya, Electra

    2012-01-01

    Teen pregnancy is a social problem not resolved in developing and some developed countries. Adolescent fecundity has become the most exact bio-demographic and health indicator of development. In developing countries that are expected to follow the sexual behaviour patterns of developed countries, without offering the levels of education and services for adolescents, the consequences will be adolescent fecundity and STI prevalence increase. The ignorance about sexuality and reproduction both in parents, teachers and adolescents increases the early initiation of coital relations and of unwanted pregnancies. Extreme poverty and being the son or daughter of an adolescent mother are risk factors of repeating the early pregnancy model. The application of predictive risk criteria in pregnant adolescents to facilitate the rational use of Health Services to diminish the maternal and perinatal mortality is discussed as well as the social factors associated with adolescent pregnancy as socioeconomic levels, structure - types and characteristics of the family, early leaving school, schooling after delivery, female employment, lack of sexual education, parental and family attitudes in different periods of adolescent pregnancy, adolescent decisions on pregnancy and children, unstable partner relationship and adoption as an option. Social consequences are analyzed as: incomplete education, more numerous families, difficulties in maternal role, abandonment by the partner, fewer possibilities of having a stable, qualified and well-paid job, greater difficulty in improving their socioeconomic level and less probability of social advancement, lack of protection of the recognition of the child. Finally, based on evidence, some measures that can reduce adverse consequences on adolescent mothers, fathers and their children are suggested.

  11. Ectopic Pregnancy

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old Ectopic Pregnancy KidsHealth > For Parents > Ectopic Pregnancy Print A A ... lower back pain continue What Causes an Ectopic Pregnancy? An ectopic pregnancy usually happens because a fertilized ...

  12. Ectopic pregnancy

    MedlinePlus

    Tubal pregnancy; Cervical pregnancy; Tubal ligation - ectopic pregnancy ... In most pregnancies, the fertilized egg travels through the fallopian tube to the womb (uterus). If the movement of the egg ...

  13. Pregnancy Tests

    MedlinePlus

    ... Us Home A-Z Health Topics Pregnancy tests Pregnancy tests > A-Z Health Topics Pregnancy test fact ... To receive Publications email updates Enter email Submit Pregnancy tests If you think you may be pregnant , ...

  14. Ectopic Pregnancy

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old Ectopic Pregnancy KidsHealth > For Parents > Ectopic Pregnancy A A A ... lower back pain continue What Causes an Ectopic Pregnancy? An ectopic pregnancy usually happens because a fertilized ...

  15. Ultrasound pregnancy

    MedlinePlus

    Pregnancy sonogram; Obstetric ultrasonography; Obstetric sonogram; Ultrasound - pregnancy; IUGR - ultrasound; Intrauterine growth - ultrasound; Polyhydramnios - ultrasound; Oligohydramnios - ultrasound; ...

  16. Using technology to advance type 1 diabetes care among women during the reproductive years and in pregnancy.

    PubMed

    Polsky, Sarit; Giordano, Dominique; Voelmle, Mary K; Garcetti, Rachel; Garg, Satish K

    2016-05-01

    The prevalence of diabetes is increasing globally. Technology to improve care among individuals with diabetes is constantly being developed. Women living with Type 1 Diabetes Mellitus (T1DM) have unique challenges affecting their glucose control relating to menstrual cycles, pregnancy, and menopause. The purpose of this review is to examine the literature related to the use of technology to help women with T1DM manage their diabetes during the reproductive years, pregnancy, and beyond. Continuous subcutaneous insulin infusion (CSII) therapy can provider equivalent or better glucose control when compared with multiple daily injections (MDI), with less hypoglycemia, diabetic ketoacidosis, and weight gain. The CSII therapy has features that could help improve glucose control over the menstrual cycle, menopause, and pregnancy, although the most studied of these stages is pregnancy. Continuous glucose monitoring (CGM) can be combined with any insulin delivery system (MDI or CSII) to provide data on glucose values every few minutes and show glucose trends over time. CGM introduction can highlight glucose variability for women with T1DM, may be beneficial during pregnancy, and can reduce hypoglycemia. Sensor-augmented pump therapy and hybrid artificial pancreas (closed-loop) systems are promising tools that improve outcomes among individuals with diabetes. The use of modern technology to improve glucose and metabolic control among menopausal women with diabetes has not been well studied. Internet and phone-based technologies are emerging as important tools that may help with diabetes self-care for women living with diabetes.

  17. Pregnancy and Thyroid Disease

    MedlinePlus

    ... can lead to congestive heart failure preeclampsia—a dangerous rise in blood pressure in late pregnancy thyroid ... Development Research Resources Research at NIDDK Meetings & Events Technology Advancement & Transfer Health Information Diabetes Digestive Diseases Kidney ...

  18. Cervical ectopic pregnancy.

    PubMed

    Samal, Sunil Kumar; Rathod, Setu

    2015-01-01

    Cervical pregnancy is a rare type of ectopic pregnancy and it represents <1% of all ectopic pregnancies. Early diagnosis and medical management with systemic or local administration of methotrexate is the treatment of choice. If the pregnancy is disturbed, it may lead to massive hemorrhage, which may require hysterectomy to save the patient. We report three cases of cervical pregnancy managed successfully with different approaches of management. Our first case, 28 years old G3P2L2 with previous two lower segment cesarean sections, presented with bleeding per vaginum following 6 weeks of amenorrhea. Clinical examination followed by transvaginal ultrasound confirmed the diagnosis of cervical pregnancy. Total abdominal hysterectomy was done in view of intractable bleeding to save the patient. The second case, a 26-year-old second gravida with previous normal vaginal delivery presented with pain abdomen and single episode of spotting per vaginum following 7 weeks of amenorrhea. Transvaginal ultrasound revealed empty endometrial cavity, closed internal os with gestational sac containing live fetus of 7 weeks gestational age in cervical canal and she was treated with intra-amniotic potassium chloride followed by systemic methotrexate. Follow up with serum beta human chorionic gonadotropin level revealed successful outcome. Our third case, a 27-year-old primigravida with history of infertility treatment admitted with complaints of bleeding per vaginum for 1 day following 8 weeks amenorrhea. She was diagnosed as cervical pregnancy by clinical examination, confirmed by transvaginal ultrasonography and subsequently managed by dilation and curettage with intracervical Foleys' ballon tamponade.

  19. Pregnancy and the kidney.

    PubMed

    Maynard, Sharon E; Thadhani, Ravi

    2009-01-01

    Nephrologists are frequently called on to diagnose and treat renal disorders in pregnant women. In this review, we update recent literature pertinent to pregnancy and renal disease. We initially begin by describing the application of common clinical estimators of GFR and proteinuria in pregnancy and then summarize recent studies regarding pregnancy in women with chronic kidney disease and the latest information on the use of common renal medications in pregnancy. In the final section, we describe advances in our understanding of the pathophysiology of preeclampsia and the potential clinical implications of these discoveries for screening, prevention, and treatment of preeclampsia.

  20. Effect of laparoscopic abdominal surgery on splanchnic circulation: historical developments.

    PubMed

    Hatipoglu, Sinan; Akbulut, Sami; Hatipoglu, Filiz; Abdullayev, Ruslan

    2014-12-28

    With the developments in medical technology and increased surgical experience, advanced laparoscopic surgical procedures are performed successfully. Laparoscopic abdominal surgery is one of the best examples of advanced laparoscopic surgery (LS). Today, laparoscopic abdominal surgery in general surgery clinics is the basis of all abdominal surgical interventions. Laparoscopic abdominal surgery is associated with systemic and splanchnic hemodynamic alterations. Inadequate splanchnic perfusion in critically ill patients is associated with increased morbidity and mortality. The underlying pathophysiological mechanisms are still not well understood. With experience and with an increase in the number and diversity of the resulting data, the pathophysiology of laparoscopic abdominal surgery is now better understood. The normal physiology and pathophysiology of local and systemic effects of laparoscopic abdominal surgery is extremely important for safe and effective LS. Future research projects should focus on the interplay between the physiological regulatory mechanisms in the splanchnic circulation (SC), organs, and diseases. In this review, we discuss the effects of laparoscopic abdominal surgery on the SC.

  1. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis or plaque buildup causes the ... weak and bulge outward like a balloon. An AAA develops slowly over time and has few noticeable ...

  2. Abdominal aortic aneurysm

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000162.htm Abdominal aortic aneurysm To use the sharing features on this page, ... blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ...

  3. Heterotopic pregnancy: discovery of ectopic pregnancy after elective abortion.

    PubMed

    DeFrancesch, F; DiLeo, L; Martinez, J

    1999-03-01

    We report a case of combined intrauterine and tubal pregnancy in a 23-year-old woman. The patient came to the emergency department complaining of lower abdominal pain after having had an elective abortion 2 weeks earlier. Her physician had done pelvic ultrasonography, noting an intrauterine pregnancy before the abortion. Our working diagnosis in the emergency department was retained products of conception versus postabortion endometritis. Pelvic ultrasonography in the emergency department revealed an ectopic pregnancy without evidence of retained products of conception, and the patient had a right salpingotomy with removal of the ectopic fetus without complications.

  4. Peritoneal pregnancy with massive hemoperitoneum in early gestation: two case reports

    PubMed Central

    Miyauchi, Azumi; Yamada, Mitsutoshi; Furuya, Masataka; Matsumura, Satoko; Murayama, Shinji; Yoshimura, Yasunori; Tanaka, Mamoru

    2015-01-01

    Key Clinical Message Peritoneal pregnancy may cause severe abdominal bleeding without genital bleeding as early as the fifth week of gestation. Awareness that pregnancy can exist in unusual locations is imperative. PMID:26185643

  5. Progress in Fully Automated Abdominal CT Interpretation

    PubMed Central

    Summers, Ronald M.

    2016-01-01

    OBJECTIVE Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. CONCLUSION This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation. PMID:27101207

  6. Spontaneous bilateral tubal ectopic pregnancy.

    PubMed

    Marasinghe, Jeevan P; Condous, George; Amarasinghe, W I

    2009-03-01

    A 28-year-old woman presented at eight weeks and four days of gestation, according to her menstrual dates, complaining of painless vaginal bleeding for three days. Her urinary pregnancy test was positive. Initial transvaginal ultrasound demonstrated an irregular complex structure with a fluid filled centre in the right adnexum. Despite the diagnosis of a possible underlying unruptured right tubal ectopic pregnancy, she declined surgical intervention and was managed expectantly as an inpatient. When she complained of increasing abdominal pain with haemodynamic instability, an emergency laparotomy was performed and a diagnosis of bilateral tubal ectopic pregnancy was made.

  7. Use of prediction equations to determine the accuracy of whole-body fat and fat-free mass and appendicular skeletal muscle mass measurements from a single abdominal image using computed tomography in advanced cancer patients.

    PubMed

    Kilgour, Robert D; Cardiff, Katrina; Rosenthall, Leonard; Lucar, Enriqueta; Trutschnigg, Barbara; Vigano, Antonio

    2016-01-01

    Measurements of body composition using dual-energy X-ray absorptiometry (DXA) and single abdominal images from computed tomography (CT) in advanced cancer patients (ACP) have important diagnostic and prognostic value. The question arises as to whether CT scans can serve as surrogates for DXA in terms of whole-body fat-free mass (FFM), whole-body fat mass (FM), and appendicular skeletal muscle (ASM) mass. Predictive equations to estimate body composition for ACP from CT images have been proposed (Mourtzakis et al. 2008; Appl. Physiol. Nutr. Metabol. 33(5): 997-1006); however, these equations have yet to be validated in an independent cohort of ACP. Thus, this study evaluated the accuracy of these equations in estimating FFM, FM, and ASM mass using CT images at the level of the third lumbar vertebrae and compared these values with DXA measurements. FFM, FM, and ASM mass were estimated from the prediction equations proposed by Mourtzakis and colleagues (2008) using single abdominal CT images from 43 ACP and were compared with whole-body DXA scans using Spearman correlations and Bland-Altman analyses. Despite a moderate to high correlation between the actual (DXA) and predicted (CT) values for FM (rho = 0.93; p ≤ 0.001), FFM (rho = 0.78; p ≤ 0.001), and ASM mass (rho = 0.70; p ≤ 0.001), Bland-Altman analyses revealed large range-of-agreement differences between the 2 methods (29.39 kg for FFM, 15.47 kg for FM, and 3.99 kg for ASM mass). Based on the magnitude of these differences, we concluded that prediction equations using single abdominal CT images have poor accuracy, cannot be considered as surrogates for DXA, and may have limited clinical utility.

  8. [Early diagnosis of ectopic pregnancy].

    PubMed

    Belics, Zoran; Gérecz, Balázs; Csákány, M György

    2014-07-20

    Ectopic pregnancy is a high-risk condition that occurs in 2% of reported pregnancies. This percentage is fivefold higher than that registered in the 1970s. Since 1970 there has been a two-fold increase in the ratio of ectopic pregnancies to all reported pregnancies in Hungary and in 2012 7.4 ectopic pregnancies per thousand registered pregnancies were reported. Recently, the majority (80%) of cases can be diagnosed in early stage, and the related mortality objectively decreased in the past few decades to 3.8/10,000 ectopic pregnancies. If a woman with positive pregnancy test has abdominal pain and/or vaginal bleeding the physician should perform a work-up to safely exclude the possibility of ectopic pregnancy. The basis of diagnosis is ultrasonography, especially vaginal ultrasound examination and measurement of the β-subunit of human chorionic gonadotropin. The ultrasound diagnosis is based on the visualization of an ectopic mass rather than the inability to visualize an intrauterine pregnancy. In some questionable cases the diagnostic uterine curettage or laparoscopy may be useful. The actuality of this topic is justified by practical difficulties in obtaining correct diagnosis, especially in the early gestational time.

  9. Efficacy of Transcerebellar Diameter/Abdominal Circumference Versus Head Circumference/Abdominal Circumference in Predicting Asymmetric Intrauterine Growth Retardation

    PubMed Central

    Bhimarao; Bhat, Venkataramana; Gowda, Puttanna VN

    2015-01-01

    Background The high incidence of IUGR and its low recognition lead to increasing perinatal morbidity and mortality for which prediction of IUGR with timely management decisions is of paramount importance. Many studies have compared the efficacy of several gestational age independent parameters and found that TCD/AC is a better predictor of asymmetric IUGR. Aim To compare the accuracy of transcerebellar diameter/abdominal circumference with head circumference/abdominal circumference in predicting asymmetric intrauterine growth retardation after 20 weeks of gestation. Materials and Methods The prospective study was conducted over a period of one year on 50 clinically suspected IUGR pregnancies who were evaluated with 3.5 MHz frequency ultrasound scanner by a single sonologist. BPD, HC, AC and FL along with TCD were measured for assessing the sonological gestational age. Two morphometric ratios- TCD/AC and HC/AC were calculated. Estimated fetal weight was calculated for all these pregnancies and its percentile was determined. Statistical Methods The TCD/AC and HC/AC ratios were correlated with advancing gestational age to know if these were related to GA. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy (DA) for TCD/AC and HC/AC ratios in evaluating IUGR fetuses were calculated. Results In the present study, linear relation of TCD and HC in IUGR fetuses with gestation was noted. The sensitivity, specificity, PPV, NPV & DA were 88%, 93.5%, 77.1%, 96.3% & 92.4% respectively for TCD/AC ratio versus 84%, 92%, 72.4%, 95.8% & 90.4% respectively for HC/AC ratio in predicting IUGR. Conclusion Both ratios were gestational age independent and can be used in detecting IUGR with good diagnostic accuracy. However, TCD/AC ratio had a better diagnostic validity and accuracy compared to HC/AC ratio in predicting asymmetric IUGR. PMID:26557588

  10. Teenage pregnancy

    MedlinePlus

    Prenatal care - teenage pregnancy ... the baby. If you decide to continue the pregnancy, it is important to have good prenatal care. ... trimester is the first 3 months of your pregnancy. During this time, you will have a prenatal ...

  11. What Health Problems Can Develop during Pregnancy?

    MedlinePlus

    ... Who is at risk for complications? How does stress affect pregnancy? NICHD Research Information Research Goals Activities and Advances ... Who is at risk for complications? How does stress affect pregnancy? NICHD Research Information Clinical Trials Resources and Publications ...

  12. Comparison of foetomaternal circulation in normal pregnancies and pregnancy induced hypertension using color Doppler studies.

    PubMed

    Gupta, Shikha; Misra, R; Ghosh, U K; Gupta, V; Srivastava, D

    2014-01-01

    The aim of present study was to assess fetomaternal blood flows in normal and abnormal pregnancies using color Doppler indices. Subjects were divided into two groups as: Group A of 25 subjects of normal pregnancy as controls and group B of 25 subjects of pregnancy induced hypertension. All the subjects were lying in the age-group of 25-35 years and having 28 to 34 weeks of gestation; the patients were evaluated by detailed history and were subjected to complete general examination. Blood pressure was taken on two occasions at least 6 hours apart. Systemic examination and obstetrical examination was done in all subjects. All cases were subjected to pathological tests- Haemogram, Test for proteins in urine. Ultrasound assessment of fetal growth was done by measuring BPD (Biparietal diameter), HC (Head circumference), FL (Femur length) and AC (Abdominal circumference): Average gestational age and effective fetal weight was then calculated by ultrasound machine. Color Doppler was used to assess the various Doppler indices indices: Pulsatility index (PI), Resistive index (RI) and Systolic diastolic ratio (S/D ratio) in bilateral uterine, umbilical and middle cerebral arteries and compared to the standard normograms. Percentage of subjects having abnormal Doppler indices were calculated. Assessment of percentage of SGA (small for gestational age) fetuses was done in all the three groups. Decline in mean values of all Doppler indices was found with advancing gestational age in normal pregnancy suggesting decreased vascular resistance and increased blood flow in fetomaternal circulation. In pregnancy induced hypertensives, the mean values of Doppler indices showed a decline as in normal pregnancy but showed an increase (more than 2 S.D. of the mean) for that gestational age in comparison to the control group suggesting increased impedance to blood flow in uteroplacental and fetomaternal circulation. Umbilical artery Doppler indices were found to be the most sensitive

  13. Desmoid tumor of the abdominal wall: a case report

    PubMed Central

    2011-01-01

    Introduction Desmoid tumors are rare lesions without any metastatic potential but a strong tendency to invade locally and to recur. These tumors are associated with women of fertile age, especially during and after pregnancy. Case presentation The case of a desmoid tumor of the anterior abdominal wall in a 40-year-old Caucasian man with no relevant family history is presented, describing its appearance on computed tomography and ultrasonography. The patient, who presented with a painless mass in the left anterolateral abdomen, had a history of previous urgent abdominal surgery after a shotgun injury two years earlier. Radical resection of the affected abdominal wall musculature was performed, and the defect was reconstructed with polypropylene mesh. Conclusion The diagnosis of desmoid tumor should be strongly considered even in male patients with an abdominal mass and a history of previous abdominal surgery. The goal of its treatment is complete tumor excision and avoidance of the development of complications such as hernia. PMID:21787413

  14. [Denial of pregnancy].

    PubMed

    Rott, Peter

    2016-12-01

    With an incidence of 1:500, denial of pregnancy is a rather frequent incident in obstetrics. Strikingly, in our society, this issue is placed under a taboo. Reasons might be our moral values and socialization. Since pregnancy and motherhood have to be associated with joy, other sensations are often perceived as socially not accepted and thus denied. A similar phenomenon exists e. g. with postnatal depression.In all existing studies on denial of pregnancy, it was proven that there are no significant at-risk groups. Instead, it occurs in all social and educated classes and no association with parity was shown.Psychologically, the denial can be understood as an adaptive or anxiety disorder. Unconsciously, it serves as a defense mechanism against intrapsychic conflicts. Reinterpretation of physical changes allow sustained unconscious and thus conflict even in the presence of fetal movements and while body weight and abdominal girth are increasing.Lacking and insufficient preventive examinations increase risks for mother and child. Especially, when delivery takes place without professional help.The earlier the pregnant woman realizes her condition, if necessary with help from a reference person or medical personnel, the lower the risks. This implies to train detection and overcome fear of addressing the woman. After the pregnancy is revealed, the woman needs to be integrated into a social network, which conveys that denial of pregnancy is not a psychotic symptom and occurs more often than assumed. If this succeeds, the perspective for mother and child is favorable.

  15. Revisiting Ectopic Pregnancy: A Pictorial Essay

    PubMed Central

    Petrides, Artemis; Dinglas, Cheryl; Chavez, Martin; Taylor, Sharon; Mahboob, Sabrina

    2014-01-01

    Ectopic pregnancies occur in approximately 1.4% of all pregnancies and account for 15% of pregnancy-related deaths. Considering the high degree of mortality, recognizing an ectopic pregnancy is important. Signs and symptoms of an ectopic pregnancy are nonspecific and include pain, vaginal bleeding, and an adnexal mass. Therefore, imaging can play a critical role in diagnosis. There are different types of ectopic pregnancies, which are tubal, cornual, cesarean scar, cervical, heterotopic, abdominal, and ovarian. Initial imaging evaluation of pregnant patients with pelvic symptoms is by ultrasonography, transabdominal, transvaginal or both. We review the sonographic appearance of different types of ectopic pregnancies that will aid in accurate and prompt diagnosis. PMID:25161806

  16. Ovarian ectopic pregnancy: A rare case

    PubMed Central

    Ghasemi Tehrani, Hatav; Hamoush, Zaynab; Ghasemi, Mojdeh; Hashemi, Leila

    2014-01-01

    Background: Ovarian pregnancy is a rare form of the non-tubal ectopic pregnancy. It ends with rupture before the end of the first trimester. One of the important risk factors for ovarian pregnancy is in the use of Intra uterine devices (IUD). Case: We report here one such uncommon case of ovarian ectopic pregnancy. Our patient is a 30 years old multiparous woman with two previous cesarean sections with severe hypogastric abdominal pain. During laparotomy, ruptured ovarian ectopic pregnancy was diagnosed, and wedge resection of the ovary was only done. Histopathological examination confirmed it to be an ovarian ectopic pregnancy. Conclusion: IUD is one of contraceptive methods which prevents intra-uterine implantation in 99.5%, if implant occurs with IUD, it is tubal implantation in 95% of cases, and it is very rare in other places such as ovary. The most important risk factor of ovarian ectopic pregnancy is IUD as in this study it was showed. PMID:24976824

  17. Unilateral twin tubal pregnancy and subsequent heterotopic pregnancy in a patient following in vitro fertilization.

    PubMed

    Kasum, Miro

    2009-09-01

    Unilateral twin tubal gestations are extremely rare with a reported incidence of 1 per 200 ectopic pregnancies. In recent years, the incidence of heterotopic pregnancy associated with in vitro fertilization and embryo transfer (IVF-ET) has risen to 1%-3% of achieved pregnancies. We report a very rare case of a 32-year-old woman with 6-year primary infertility with unilateral twin tubal pregnancy and subsequent heterotopic pregnancy following two IVF treatments. Her gynecologic history was notable for previous distal occlusion of the left fallopian tube treated by laparoscopic reconstructive surgery. After ovulation induction and IVF with ET of two embryos, transvaginal sonography at 6 weeks revealed two separate gestational sacs in the left adnexal mass. Emergency laparoscopy showed unruptured ampullar pregnancy and salpingectomy was carried out. On second IVF two years later, after ovulation induction and ET of three embryos, endovaginal sonography at 6 weeks revealed only one intrauterine sac. One week later, the patient complained of intermittent episodes of lower abdominal pain in the right quadrant. Ultrasound confirmed intrauterine pregnancy and revealed right tubal gestational sac. Laparoscopy showed unruptured right ampullar pregnancy and salpingectomy was performed. Histology of salpingectomy specimens showed signs of chronic infection in both tubes. The intrauterine pregnancy progressed to term when a healthy infant was delivered vaginally. Gynecologists should always consider the possibility of ectopic pregnancy in pregnancies following IVF-ET, particularly in cases with tubal disease and abdominal pain.

  18. Cervical ectopic pregnancy

    PubMed Central

    Samal, Sunil Kumar; Rathod, Setu

    2015-01-01

    Cervical pregnancy is a rare type of ectopic pregnancy and it represents <1% of all ectopic pregnancies. Early diagnosis and medical management with systemic or local administration of methotrexate is the treatment of choice. If the pregnancy is disturbed, it may lead to massive hemorrhage, which may require hysterectomy to save the patient. We report three cases of cervical pregnancy managed successfully with different approaches of management. Our first case, 28 years old G3P2L2 with previous two lower segment cesarean sections, presented with bleeding per vaginum following 6 weeks of amenorrhea. Clinical examination followed by transvaginal ultrasound confirmed the diagnosis of cervical pregnancy. Total abdominal hysterectomy was done in view of intractable bleeding to save the patient. The second case, a 26-year-old second gravida with previous normal vaginal delivery presented with pain abdomen and single episode of spotting per vaginum following 7 weeks of amenorrhea. Transvaginal ultrasound revealed empty endometrial cavity, closed internal os with gestational sac containing live fetus of 7 weeks gestational age in cervical canal and she was treated with intra-amniotic potassium chloride followed by systemic methotrexate. Follow up with serum beta human chorionic gonadotropin level revealed successful outcome. Our third case, a 27-year-old primigravida with history of infertility treatment admitted with complaints of bleeding per vaginum for 1 day following 8 weeks amenorrhea. She was diagnosed as cervical pregnancy by clinical examination, confirmed by transvaginal ultrasonography and subsequently managed by dilation and curettage with intracervical Foleys’ ballon tamponade. PMID:25810679

  19. Diagnosis and management of ectopic pregnancy.

    PubMed

    Barash, Joshua H; Buchanan, Edward M; Hillson, Christina

    2014-07-01

    Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination, and imaging with transvaginal ultrasonography can usually confirm the diagnosis. When ultrasonography does not clearly identify the pregnancy location, the physician must determine whether the pregnancy is intrauterine (either viable or failing) or ectopic. Use of the beta subunit of human chorionic gonadotropin (ß-hCG) discriminatory level, the ß-hCG value above which an intrauterine pregnancy should be visualized by transvaginal ultrasonography, may be helpful. Failure to visualize an intrauterine pregnancy when ß-hCG is above the discriminatory level suggests ectopic pregnancy. In addition to single measurements of ß-hCG levels, serial levels can be monitored to detect changes. ß-hCG values in approximately 99% of viable intrauterine pregnancies increase by about 50% in 48 hours. The remaining 1% of patients have a slower rate of increase; these patients may have pregnancies that are misdiagnosed as nonviable intrauterine or ectopic. After an ectopic pregnancy has been confirmed, treatment options include medical, surgical, or expectant management. For patients who are medically unstable or experiencing life-threatening hemorrhage, a surgical approach is indicated. For others, management should be based on patient preference after discussion of the risks, benefits, and monitoring requirements of all approaches.

  20. Pregnancy with Portal Hypertension

    PubMed Central

    Aggarwal, Neelam; Negi, Neha; Aggarwal, Aakash; Bodh, Vijay; Dhiman, Radha K.

    2014-01-01

    Even though pregnancy is rare with cirrhosis and advanced liver disease, but it may co-exist in the setting of non-cirrhotic portal hypertension as liver function is preserved but whenever encountered together is a complex clinical dilemma. Pregnancy in a patient with portal hypertension presents a special challenge to the obstetrician as so-called physiological hemodynamic changes associated with pregnancy, needed for meeting demands of the growing fetus, worsen the portal hypertension thereby putting mother at risk of potentially life-threatening complications like variceal hemorrhage. Risks of variceal bleed and hepatic decompensation increase many fold during pregnancy. Optimal management revolves round managing the portal hypertension and its complications. Thus management of such cases requires multi-speciality approach involving obstetricians experienced in dealing with high risk cases, hepatologists, anesthetists and neonatologists. With advancement in medical field, pregnancy is not contra-indicated in these women, as was previously believed. This article focuses on the different aspects of pregnancy with portal hypertension with special emphasis on specific cause wise treatment options to decrease the variceal bleed and hepatic decompensation. Based on extensive review of literature, management from pre-conceptional period to postpartum is outlined in order to have optimal maternal and perinatal outcomes. PMID:25755552

  1. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  2. Hand-assisted laparoscopic splenectomy for idiopathic thrombocytopenic purpura during pregnancy.

    PubMed

    Iwase, K; Higaki, J; Yoon, H E; Mikata, S; Tanaka, Y; Takahashi, T; Hatanaka, K; Tamaki, T; Hori, S; Mitsuda, N; Kamiike, W

    2001-02-01

    A successful case of a hand-assisted laparoscopic splenectomy with low-pressure pneumoperitoneum for autoimmune thrombocytopenic purpura in a patient at 23 weeks' gestation is reported. Preoperative splenic arterial embolization was performed on the same day as the operation using painless contour embolic material and super-absorbent polymer microspheres. The abdominal wall retraction method first was applied to avoid the effects of pneumoperitoneum on systemic hemodynamic alterations. However, a sufficient surgical view could not be obtained, as the intra-abdominal organs were elevated because of the enlarged uterus. A surgical view with 4 to 6-mm Hg pneumoperitoneum was available for the hand-assisted splenectomy. The postoperative course was uneventful, and the patient vaginally delivered a healthy infant. A hand-assisted laparoscopic splenectomy with low-pressure pneumoperitoneum after splenic arterial embolization would be feasible for patients with autoimmune thrombocytopenic purpura during a relatively advanced pregnancy.

  3. [Appendicitis during pregnancy].

    PubMed

    Bonfante Ramírez, E; Estrada Altamirano, A; Bolaños Ancona, R; Juárez Garcia, L; Castelazo Morales, E

    1998-03-01

    Acute appendicitis es the most common cause of lapparotomy during pregnancy. The differential diagnosis in the pregnant woman becomes a challenge due to the anatomic changes that take place during the maternal adjustment to pregnancy. We have done a retrospective study between january 1989 and december 1994, at Instituto Nacional de Perinatologia. We found in that period of time 35,080 deliveries reported and 4 cases of acute appendicitis during pregnancy. The maternal age was between 16 and 42 years old, 26 years in average. Three patients were in the 3 trimester at the time of diagnosis, and the most important clinical sign was found to be diffuse abdominal pain. In 3 cases diagnosis was attributed to obstetric pathology rather than appendicitis in first place. Laparotomy and appendicectomy was done to all patients, with on block hysterectomy in only one case, having this particular patient an abscess as a postquirurgical complication. Just one case reported a healthy newborn delivered at term. It is obvious that early diagnosis and quirurgical treatment are important factors for the mother and the fetus prognosis. Appendicectomy as well as cholecystectomy are the two most common causes of laparotomy during pregnancy.

  4. Molar Pregnancy

    MedlinePlus

    ... cysts. In a complete molar pregnancy, there's no embryo or normal placental tissue. In a partial molar pregnancy, there's an abnormal embryo and possibly some normal placental tissue. The embryo ...

  5. Ectopic Pregnancy

    MedlinePlus

    ... woman is pregnant. If you have an ectopic pregnancy, the fertilized egg grows in the wrong place, ... tubes. The result is usually a miscarriage. Ectopic pregnancy can be a medical emergency if it ruptures. ...

  6. Pregnancy care

    MedlinePlus

    ... with you about how to manage common pregnancy complaints such as: Morning sickness Backaches, leg pain, and ... getting prenatal care You cannot manage common pregnancy complaints without medicines You might have been exposed to ...

  7. [The abdominal catastrophe].

    PubMed

    Seiler, Christian A

    2011-08-01

    Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.

  8. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  9. Abdominal and Pelvic CT

    MedlinePlus Videos and Cool Tools

    ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as ... injuries to abdominal organs such as the spleen, liver, kidneys or other internal organs in cases of ...

  10. Abdominal wall surgery

    MedlinePlus

    ... the results of abdominoplasty. Many feel a new sense of self-confidence. Alternative Names Cosmetic surgery of the abdomen; Tummy tuck; Abdominoplasty Images Abdominoplasty - series Abdominal muscles References McGrath MH, Pomerantz J. Plastic surgery. In: Townsend ...

  11. Interventional radiology and endovascular surgery in the treatment of ectopic pregnancies

    PubMed Central

    Fornazari, Vinicius Adami Vayego; Szejnfeld, Denis; Elito, Julio; Goldman, Suzan Menasce

    2015-01-01

    The advent of interventional radiology enabled remarkable advances in diagnosis and treatment of several situations in obstetrics and gynecology. In the field of obstetrics, these advances include temporary occlusion of the iliac arteries to the management of placenta accreta and/or prior, arteriovenous fistulas after embolization of uterine curettage and management of ectopic uterine and extra-uterine pregnancies. The non-tubal ectopic pregnancy, either cervical, abdominal, ovarian or in a cesarean scar, often represents major therapeutic challenge, especially when exists a desire to maintain fertility. Despite the systemic methotrexate therapy and surgical resection of the ectopic gestational sac be the most used therapeutic options, the interventionist approach of non-tubal ectopic pregnancies, direct injection of methotrexate in the gestational sac and intra-arterial chemoembolization of uterine arteries constitute in the currently literature viable, safe, effective modalities with low morbidity, shorter hospital stay, and rapid clinical recovery. Because of little variety of materials used, and the increase in training of specialists in the area, the radiological intervention as a treatment option in ectopic pregnancies is financially viable and present considerable accessibility in the world and at most of Brazilian medical centers. PMID:25993085

  12. Abdominal involvement in tuberculosis.

    PubMed

    Neyman, Edward G; Georgiades, Christos S; Fishman, Elliot K

    2002-10-01

    Rising incidence of disseminated and extrapulmonary tuberculosis (TB), especially in immunocompromised hosts and patients with multi-drug-resistant tuberculosis, has resulted in an increase of unusual clinical and radiographic presentations of TB. With CT being a common part of emergency room (ER) evaluation of abdominal pain, it is imperative that radiologists be able to recognize abdominal presentations of TB. We discuss and illustrate typical and less common CT manifestations of tuberculosis in the abdomen to help ER radiologists in this task.

  13. Ectopic molar pregnancy: a case report.

    PubMed

    Bousfiha, Najoua; Erarhay, Sanaa; Louba, Adnane; Saadi, Hanan; Bouchikhi, Chahrazad; Banani, Abdelaziz; El Fatemi, Hind; Sekkal, Med; Laamarti, Afaf

    2012-01-01

    The incidence of hydatidiform moles is 1 per 1,000 pregnancies. Ectopic pregnancy occurs in 20 per 1,000 pregnancies. Thus, the incidence of the ectopic molar gestation is very rare. We report a case of tubal molar pregnancy diagnosed at the systematic histology exam of an ectopic pregnancy. We report the case of 32 years old nulliparus women who presented a vaginal bleeding, lower abdominal pain and 6 weeks amenorrhea corresponding to the last menstrual period. At the clinical examination, the arterial pressure was 100/60 mmHG. The gynecological examination was difficult because of lower abdominal pain. Serum gonadotropin activity was 3454 ui/l. Pelvic ultrasound revealed an irregular echogenic mass in the left adnexa. Diagnostic laparoscopy revealed a left-sided unruptured ampullary ectopic pregnancy. A left laparoscopic salpingectomy was performed. The systematic histologic test identified an ectopic partial molar pregnancy, which was confirmed by DNA ploidy image analysis. The patient was followed with weekly quantitative B-hCG titers until three successive B-hCG levels were negative. It is pertinent that clinicians take routine histological examination of tubal specimens in ectopic pregnancy very seriously in order to diagnose cases of ectopic molar gestations early and mount appropriate post treatment surveillance.

  14. Inflammatory abdominal aortic aneurysm.

    PubMed

    Savarese, R P; Rosenfeld, J C; DeLaurentis, D A

    1986-05-01

    Between January 1976 and December 1982, 181 patients with abdominal aortic aneurysms were treated surgically, and in 13 patients the aneurysms were found to be inflammatory. Inflammatory aneurysms of the abdominal aorta (IAAA) share important characteristics with typical atherosclerotic abdominal aortic aneurysms. Diagnosis and surgical management of IAAA are distinctive which suggests that IAAA should be considered separately, as a varient of typical abdominal aortic aneurysms. IAAA occur predominantly in males. The presenting symptoms are often idiosyncratic and include severe abdominal or back pain, or both, and ureteral obstruction; the diagnosis of IAAA should be considered when these symptoms are present. Although grossly and microscopically, the perianeurysmal fibrosis resembles idiopathic retroperitoneal fibrosis, the two conditions can be differentiated. At the present time, ultrasonography and computed tomography appear to offer reliable means for diagnosing IAAA. The presence of IAAA, whether established preoperatively or discovered unexpectedly at operation, necessitate certain modifications in the surgical approach, in order to avoid injuring the duodenum and the venous structures. Most patients can be successfully treated by resection and graft replacement. Rupture of the aneurysm in IAAA appears to be less frequent than in typical atherosclerotic abdominal aortic aneurysm.

  15. Influence of Electrode Placement on Signal Quality for Ambulatory Pregnancy Monitoring

    PubMed Central

    Rooijakkers, M. J.; Song, S.; Rabotti, C.; Oei, S. G.; Bergmans, J. W. M.; Cantatore, E.; Mischi, M.

    2014-01-01

    Noninvasive fetal health monitoring during pregnancy has become increasingly important in order to prevent complications, such as fetal hypoxia and preterm labor. With recent advances in signal processing technology using abdominal electrocardiogram (ECG) recordings, ambulatory fetal monitoring throughout pregnancy is now an important step closer to becoming feasible. The large number of electrodes required in current noise-robust solutions, however, leads to high power consumption and reduced patient comfort. In this paper, requirements for reliable fetal monitoring using a minimal number of electrodes are determined based on simulations and measurement results. To this end, a dipole-based model is proposed to simulate different electrode positions based on standard recordings. Results show a significant influence of bipolar lead orientation on maternal and fetal ECG measurement quality, as well as a significant influence of interelectrode distance for all signals of interest. PMID:24639888

  16. Intermittent hepatic porphyria in pregnancy with good perinatal outcome.

    PubMed

    Vidosavljević, Domagoj; Sijanović, Siniša; Rubin, Mirjana; Košuta Petrović, Maja; Abičić Žuljević, Kristina; Simić, Ivana

    2012-02-01

    Porphyrias are rare metabolic diseases caused by enzymatic defects of the haeme biosynthesis. Association of pregnancy and acute porphyria is rare, but mortality rate among pregnant women from acute attack has been reported up to 42%. This paper presents a patient with pregnancy complicated by intermittent hepatic porphyria with good perinatal outcome. The pattern of the attack in pregnancy varies individually and it makes porphyric pregnancies a challenge. Previously diagnosed porphyria patients should be closely monitored during pregnancy and diagnosis of acute porphyria must be also considered in all pregnant women with unexplained abdominal pain.

  17. Rare ectopic pregnancies after in-vitro fertilization: one unilateral twin and four bilateral tubal pregnancies.

    PubMed

    Rizk, B; Morcos, S; Avery, S; Elder, K; Brinsden, P; Mason, B; Edwards, R

    1990-11-01

    Between 1985 and 1989, one unilateral twin and four bilateral tubal pregnancies were encountered among 124 extrauterine pregnancies and 1648 intrauterine pregnancies following in-vitro fertilization and embryo transfer. The two factors associated with this high incidence of single and multiple extrauterine pregnancies were tubal damage and multiple embryo transfer. Embryos at different stages of development appear to have the capacity to implant ectopically. Despite advances in diagnostic capabilities, ectopic pregnancy remains a major cause of maternal mortality. Early diagnosis prior to rupture must be made if mortality and morbidity are to be abolished. The use of transvaginal sonography has improved the diagnosis of ectopic pregnancy and should be routinely used in all pregnancies following assisted conception. The identification of an intrauterine pregnancy should not be sufficient to rule out the possibility of an extrauterine pregnancy or even bilateral tubal pregnancies.

  18. Imaging the Abdominal Manifestations of Cystic Fibrosis

    PubMed Central

    McDermott, S.; Chan, V. O.; Ridge, C. A.

    2017-01-01

    Cystic fibrosis (CF) is a multisystem disease with a range of abdominal manifestations including those involving the liver, pancreas, and kidneys. Recent advances in management of the respiratory complications of the disease has led to a greater life expectancy in patients with CF. Subsequently, there is increasing focus on the impact of abdominal disease on quality of life and survival. Liver cirrhosis is the most important extrapulmonary cause of death in CF, yet significant challenges remain in the diagnosis of CF related liver disease. The capacity to predict those patients at risk of developing cirrhosis remains a significant challenge. We review representative abdominal imaging findings in patients with CF selected from the records of two academic health centres, with a view to increasing familiarity with the abdominal manifestations of the disease. We review their presentation and expected imaging findings, with a focus on the challenges facing diagnosis of the hepatic manifestations of the disease. An increased familiarity with these abdominal manifestations will facilitate timely diagnosis and management, which is paramount to further improving outcomes for patients with cystic fibrosis. PMID:28250993

  19. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  20. Functional involvement of protein kinase C, Rho-kinase and TRPC3 decreases while PLC increases with advancement of pregnancy in mediating oxytocin-induced myometrial contractions in water buffaloes (Bubalus bubalis).

    PubMed

    Sharma, Abhishek; Nakade, Udayraj P; Choudhury, Soumen; Garg, Satish Kumar

    2017-04-01

    Present study unravels the involvement of different calcium signaling pathways in oxytocin-induced contractions in myometrium of non-pregnant and pregnant buffaloes during early and mid-pregnancy stages. Uteri of pregnant animals were more sensitive than of non-pregnant buffaloes. Phasic contractions and frequency of contraction significantly increased with advancement of pregnancy, while tonic contractions non-significantly and amplitude significantly decreased from six months pregnancy onward. Oxytocin produced concentration-dependent-contraction on isolated myometrial strips of pregnant and non-pregnant buffaloes and the dose response curves (DRCs) of oxytocin were significantly (P < 0.05) shifted to right in the presence of nifedipine (1 μM), in Ca(2+)-free Ringer Locke solution (RLS), ruthenium red (30 μM), ruthenium red + nifedipine, cyclopiazonic acid (CPA; Ca(2+) free RLS as well as RLS), CPA (10 μM)+nifedipine, U-73122 (1 μM) + nifedipine and SKF96365 (25 μM) on uteri of non-pregnant and pregnant (early and mid) animals. The DRCs were also significantly shifted towards right in the presence of Y-27632 (10 μM), GF109203X (5 μM) and Pyr3 (10 μM) on uteri of non-pregnant and early pregnancy stage buffaloes while only in the presence of U-73122 (1 μM) on uteri of mid-pregnancy stage buffaloes. Our finding suggest that and L-type Ca(2+) channels, IP3-RyR-gated, and store-operated calcium channels including transient receptor potential channel (TRPC) pathways play significant role in mediating oxytocin-induced contractions in myometrium of pregnant and non-pregnant buffaloes. SERCA plays major role only during early-pregnancy while functional role of protein kinase C (PKC), Rho-kinase and TRPC3 pathways decreased and role of G-protein coupled receptor-phospholipase C (GPCR-PLC) pathway increased with advancement of pregnancy.

  1. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Mikami, Y; Kyogoku, M

    1994-08-01

    Inflammatory abdominal aortic aneurysm (IAAA) is a distinct clinicopathological entity, characterized by: (1) clinical presentation, such as back pain, weight loss, and increased ESR, (2) patchy and/or diffuse lymphoplasmacytic infiltration, and (3) marked periaortic fibrosis resulting in thickening of the aneurysmal wall and occasional retroperitoneal fibrosis. Its pathogenesis is unknown, but some authors support the theory that IAAA is a subtype of atherosclerotic abdominal aortic aneurysm because of close relationship between IAAA and atherosclerotic change. In this article, we describe clinical and histological features of IAAA on the basis of the literature and our review of 6 cases of IAAA, emphasizing the similarity and difference between IAAA and atherosclerotic abdominal aortic aneurysm. Our review supports that marked lamellar fibrosis completely replacing the media and adventitia, patchy lymphocytic infiltration (mostly B cells) and endarteritis obliterans are characteristic features of IAAA.

  2. Spontaneous live unilateral twin ectopic pregnancy – A case presentation

    PubMed Central

    Mahsood, Shazia; Shelton, Hannah; Zaedi, Khaled; Economides, DL

    2014-01-01

    The incidence of ectopic pregnancy has increased in recent years and now is around one in 100 pregnancies. However, the incidence of live twin ectopic pregnancy in a spontaneous conception is still quite rare. A 34-year-old gravida 3, para 0 presented in the Early Pregnancy Unit with a positive pregnancy test, lower abdominal pain and vaginal spotting. Her quantitative serum Beta hCG was high, and the transvaginal scan revealed an empty uterine cavity with a twin ectopic pregnancy in the left adnexa with cardiac activity in both embryos. The patient was taken for laparoscopic surgery and a left ampullary twin pregnancy was confirmed. She underwent a left salpingectomy and is well on a one-year follow-up. This case report discusses the incidence, diagnoses and treatment of ectopic pregnancies in general. PMID:27433227

  3. [Thyroid dysfunctions and pregnancy].

    PubMed

    Caron, Philippe

    2011-12-01

    Advances in understanding the physiology of the thyroid function in normal pregnancy have highlighted the importance of the consequences of abnormal thyroid function on mother and fetal outcomes. Thyroid diseases are common in young women of childbearing age while management of thyroid diseases is relatively straightforward. For each thyroid dysfunction (hypothyroxinemia, hypothyroidism, hyperthyroidism, postpartum thyroiditis), the issues with the obstetric complications of the mother and the fetus are considered. Indeed, early recognition of thyroid diseases during pregnancy and appropriate management has the potential to improve outcome for the mother and the fetus.

  4. [Abdominal actinomycosis with IUD].

    PubMed

    Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A

    1997-01-01

    We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

  5. Risks of Myrrh usage in pregnancy

    PubMed Central

    Al-Jaroudi, Dania; Kaddour, Ouhoud; Al-Amin, Nahla

    2016-01-01

    Recurrent miscarriage places a huge psychological burden on a woman who is trying to conceive. Meanwhile, the use of traditional medicine still plays an important role within the Saudi Arabian culture, where many patients still seek alternative forms of therapy. However, this traditional way of treatment might expose patients to many hazards. We present a case of a 32-year-old pregnant woman with a history of infertility and recurrent miscarriages. She used large amounts of myrrh herbs for 2 months, since a traditional healer told her that her current pregnancy would progress safely by its use. However, her pregnancy was complicated with an acute abdominal pain. Her symptom was relieved as soon as she stopped taking myrrh. We assume that myrrh acted as a uterine stimulant causing acute abdominal pain. Scientific studies should be carried out to evaluate the safety of Myrrh intake during pregnancy. PMID:28050964

  6. Abdominal exploration - slideshow

    MedlinePlus

    ... anatomy URL of this page: //medlineplus.gov/ency/presentations/100049.htm Abdominal exploration - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  7. Vaccination During Pregnancy.

    PubMed

    Moniz, Michelle H; Beigi, Richard H

    2016-03-01

    Active immunization during pregnancy for maternal and neonatal benefit is a remarkably promising strategy to reduce infectious morbidity in both women and infants. The aim of this review is to present current clinical guidelines for vaccination during pregnancy and review evidence-based strategies for the implementation of maternal immunization recommendations. Observational studies, clinical trials, cost-effectiveness analyses, systematic reviews, and meta-analyses were evaluated to generate the evidence base for this review. In addition, recommendations from major national professional and public health organizations were examined. We present current clinical recommendations for vaccination during pregnancy and review medical and public health strategies to implement these guidelines. We also discuss a research agenda to advance the field of maternal immunization and achieve further improvements in maternal and child health.

  8. An efficient unsupervised fetal QRS complex detection from abdominal maternal ECG.

    PubMed

    Varanini, M; Tartarisco, G; Billeci, L; Macerata, A; Pioggia, G; Balocchi, R

    2014-08-01

    Non-invasive fetal heart rate is of great relevance in clinical practice to monitor fetal health state during pregnancy. To date, however, despite significant advances in the field of electrocardiography, the analysis of abdominal fetal ECG is considered a challenging problem for biomedical and signal processing communities. This is mainly due to the low signal-to-noise ratio of fetal ECG and difficulties in cancellation of maternal QRS complexes, motion and electromyographic artefacts. In this paper we present an efficient unsupervised algorithm for fetal QRS complex detection from abdominal multichannel signal recordings combining ICA and maternal ECG cancelling, which outperforms each single method. The signal is first pre-processed to remove impulsive artefacts, baseline wandering and power line interference. The following steps are then applied: maternal ECG extraction through independent component analysis (ICA); maternal QRS detection; maternal ECG cancelling through weighted singular value decomposition; enhancing of fetal ECG through ICA and fetal QRS detection. We participated in the Physionet/Computing in Cardiology Challenge 2013, obtaining the top official scores of the challenge (among 53 teams of participants) of event 1 and event 2 concerning fetal heart rate and fetal interbeat intervals estimation section. The developed algorithms are released as open-source on the Physionet website.

  9. Incision for abdominal laparoscopy (image)

    MedlinePlus

    Abdominal laparoscopy is a useful aid in diagnosing disease or trauma in the abdominal cavity with less scarring than ... as liver and pancreatic resections may begin with laparoscopy to exclude the presence of additional tumors (metastatic ...

  10. Who Is at Increased Risk of Health Problems during Pregnancy?

    MedlinePlus

    ... Who is at risk for complications? How does stress affect pregnancy? NICHD Research Information Research Goals Activities and Advances ... Who is at risk for complications? How does stress affect pregnancy? NICHD Research Information Clinical Trials Resources and Publications ...

  11. Travel during Pregnancy

    MedlinePlus

    ... Events Advocacy For Patients About ACOG Travel During Pregnancy Home For Patients Search FAQs Travel During Pregnancy ... Pregnancy FAQ055, February 2016 PDF Format Travel During Pregnancy Pregnancy When is the best time to travel ...

  12. Multiple Extrauterine Pregnancy with Early and Near Full-Term Mummified Fetuses in a New Zealand White Rabbit (Oryctolagus cuniculus)

    PubMed Central

    Tena-Betancourt, Eduardo; Tena-Betancourt, Carlos A; Zúniga-Muñoz, Alejandra M; Hernández-Godínez, Braulio; Ibáñez-Contreras, Alejandra; Graullera-Rivera, Verónica

    2014-01-01

    Extrauterine pregnancy (EP) is infrequent in mammalian species and occurs when fertilized ova implant and develop outside the uterus. A common outcome is abdominal pregnancy resulting in mummified fetuses (lithopedia). Here we describe an unusual case of abdominal pregnancy with early and near full-term lithopedia. Macroscopic findings supported the diagnosis of lithopedia with distinct age differences and facilitated further characterization of primary ectopia and risk factors leading to this occurrence. PMID:24602549

  13. Pregnancy Loss

    MedlinePlus

    ... and painful this loss can be. You might wonder if you'll ever have a baby to hold and call your own. But surviving the emotional impact of pregnancy loss is possible. And many women go on to have successful pregnancies. Expand all | ...

  14. Teenage Pregnancy.

    ERIC Educational Resources Information Center

    McClellan, Mary C.

    1987-01-01

    Reviews the problems of teenage pregnancy, including the costs to society, the challenge to educators, and the types of preventive programs developing across the country. Programs dealing strictly with reproduction and contraception are the least effective deterrents to teenage pregnancy. (MD)

  15. Pregnancy, cardiomyopathies, and genetics.

    PubMed

    Van Tintelen, J Peter; Pieper, Petronella G; Van Spaendonck-Zwarts, Karin Y; Van Den Berg, Maarten P

    2014-03-15

    Although familial forms of cardiomyopathy such as hypertrophic or dilated cardiomyopathy have been recognized for decades, it is only recently that much of the genetic basis of these inherited cardiomyopathies has been elucidated. This has provided important insights into the pathophysiological mechanisms underlying the disease phenotype. This increased knowledge and the availability of genetic testing has resulted in increasing numbers of mutation carriers who are being monitored, including many who are now of child-bearing age. Pregnancy is generally well tolerated in asymptomatic patients or mutation carriers with inherited cardiomyopathies. However, since pregnancy leads to major physiological changes in the cardiovascular system, in women with genetic cardiomyopathies or who carry a mutation pre-disposing to a genetic cardiomyopathy, pregnancy entails a risk of developing heart failure and/or arrhythmias. This deterioration of cardiac function may occur despite optimal medical treatment. Advanced left ventricular dysfunction, poor functional class (NYHA class III or IV), or prior cardiac events appear to increase the risk of maternal cardiac complications. However, there are no large series of cardiomyopathy patients who are regularly evaluated for cardiac complications during pregnancy and for certain types of inherited cardiomyopathy, only case reports on individual pregnancies are available. Pre-conception cardiologic evaluation and genetic counselling are important for every woman with a cardiomyopathy or a cardiomyopathy-related mutation who is considering having a family. In this article, we give an overview of the basic clinical aspects, genetics, and pregnancy outcome in women with different types of inherited cardiomyopathies. We also discuss the genetic aspects of pregnancy-associated cardiomyopathy, including peripartum cardiomyopathy.

  16. Pregnancy and delivery in Leyden-Möbius muscular dystrophy. Case Report.

    PubMed

    Vavrinkova, Blanka; Binder, Tomas

    2015-01-01

    Leyden-Möbius muscular dystrophy is an autosomal recessive hereditary disease of unknown aetiology; it is a congenital disorder of protein metabolism primarily affecting proximal muscle groups leading to progressive muscular dystrophy. It later spreads to the muscles of the pelvic floor and lower extremities. The estimated incidence is 1:200,000. This paper describe a case of pregnancy and delivery in woman with progressive Leyden-Moebius muscular dystrophy. Cesarean section was performed due to progression of the underlying disease. First postoperative day DIC occure and surgical revision of abdominal cavity was performed. Although the uterine suture was strong, diffuse bleeding was present. Blood was not coagulating. Supravaginal amputation of the uterus was performed including left-sided adnexectomy due to bleeding from the left ovarium. Due to the severity of the condition and assumed necessity of long-term controlled ventilation, the patient was transferred to the intensive medicine department. She was dismissed home after 91 days of hospitalisation. Gravidity in advanced muscular dystrophy is rare and associated with a high risk. Due to muscle weakness, diaphragm weakness, atrophy of individual muscle groups, spine deformities and often dislocation of thoracic organs, these patients cannot avoid the caesarean section to end their pregnancy, followed by prolonged intubation and controlled ventilation. During pregnancy, the growing uterus elevates the diaphragm and impairs breathing. Therefore, pregnancies in such patients will probably always have to be ended prematurely.

  17. Black widow spider (Latrodectus mactans) envenomation in a term pregnancy.

    PubMed

    Sherman; Groll; Gonzalez; Aerts

    2000-07-01

    Description of a black widow spider (Latrodectus mactans) envenomation in a term pregnancy.Case report conducted at an Air Force tertiary care hospital of a 27-year-old primigravida at 38 1/7 weeks pregnancy.Latrodectus mactans antivenin can be given to treat symptoms of black widow envenomation.Black widow envenomations can cause symptoms associated with acute intra-abdominal processes. In pregnancy, envenomations can result in symptoms and signs similar to those seen in preeclampsia (abdominal pain, headache, hypertension, and proteinuria). Latrodectism should be considered in patients complaining of these symptoms in association with a spider bite. If latrodectism is considered to be the underlying origin for these symptoms, appropriate treatment should be administered. In cases of pregnancy, treatment should include L. mactans antivenin if believed to be clinically indicated. There is no current evidence that this antivenin is contraindicated in pregnancy. (Curr Surg 57:346-348)

  18. Pregnancy in acromegaly

    PubMed Central

    Laway, Bashir A.

    2015-01-01

    With advances in surgical and medical treatment and the availability of assisted reproductive techniques, pregnancy in women with acromegaly is more frequently encountered. Diagnosis of acromegaly during pregnancy is difficult because of changes in growth hormone and insulin like growth factor-1 (IGF-1) axis secondary to placental production of growth hormone. The difficulty is compounded by the inability of routine hormone assays to detect placental growth hormone. In the majority of patients with acromegaly, pregnancy does not have an adverse effect on mother or fetus and pituitary mass does not increase in size. The level of IGF-1 usually remains stable because of the effect of estrogen causing a growth hormone resistant state. In patients with pituitary macroadenoma, the possibility of an increase in size of the pituitary mass needs to be kept in mind and more frequent monitoring is required. In case of tumor enlargement, pituitary surgery can be considered in the mid trimester. Experience with the use of medical treatment for acromegaly during pregnancy is increasing. Dopamine agonists, somatostatin analogs or growth hormone receptor antagonists have been used without any adverse consequences on mother or fetus. At present, it is advisable to stop any medical treatment after confirmation of pregnancy till more data are available on the safety of these drugs. PMID:26623004

  19. Practical Approaches to Definitive Reconstruction of Complex Abdominal Wall Defects.

    PubMed

    Latifi, Rifat

    2016-04-01

    With advances in abdominal surgery and the management of major trauma, complex abdominal wall defects have become the new surgical disease, and the need for abdominal wall reconstruction has increased dramatically. Subsequently, how to reconstruct these large defects has become a new surgical question. While most surgeons use native abdominal wall whenever possible, evidence suggests that synthetic or biologic mesh needs to be added to large ventral hernia repairs. One particular group of patients who exemplify "complex" are those with contaminated wounds, enterocutaneous fistulas, enteroatmospheric fistulas, and/or stoma(s), where synthetic mesh is to be avoided if at all possible. Most recently, biologic mesh has become the new standard in high-risk patients with contaminated and dirty-infected wounds. While biologic mesh is the most common tissue engineered used in this field of surgery, level I evidence is needed on its indication and long-term outcomes. Various techniques for reconstructing the abdominal wall have been described, however the long-term outcomes for most of these studies, are rarely reported. In this article, I outline current practical approaches to perioperative management and definitive abdominal reconstruction in patients with complex abdominal wall defects, with or without fistulas, as well as those who have lost abdominal domain.

  20. Pregnancy associated breast cancer and pregnancy after breast cancer treatment.

    PubMed

    Doğer, Emek; Calışkan, Eray; Mallmann, Peter

    2011-01-01

    Breast cancer is one of the most common cancers diagnosed during pregnancy and its frequency is increasing as more women postpone their pregnancies to their thirties and forties. Breast cancer diagnosis during pregnancy and lactation is difficult and complex both for the patient and doctors. Delay in diagnosis is frequent and treatment modalities are difficult to accept for the pregnant women. The common treatment approach is surgery after diagnosis, chemotherapy after the first trimester and radiotherapy after delivery. Even though early stage breast cancers have similar prognosis, advanced stage breast cancers diagnosed during pregnancy and lactation have poorer prognosis than similar stage breast cancers diagnosed in non-pregnant women. Women who desire to become pregnant after treatment of breast cancer will have many conflicts. Although the most common concern is recurrence of breast cancer due to pregnancy, the studies conducted showed that pregnancy has no negative effect on breast cancer prognosis. In this review we search for the frequency of breast cancer during pregnancy, the histopathological findings, risk factor, diagnostic and treatment modalities. We reviewed the literature for evidence based findings to help consult the patients on the outcome of breast cancer diagnosed during pregnancy and lactation, and also inform the patients who desire to become pregnant after breast cancer according to current evidences.

  1. Predicting Pregnancy and Pregnancy Attrition

    DTIC Science & Technology

    1985-07-01

    Test Married Single Pregnancy Prediction Multivariate test for traditionality variables Significant univariate tests ...college students. Journal of Consulting and Clinical Psychology, 36, 27-32. Olson, M. S . &: Stumpf, S . S . (September 1978). Pregnancy in the Navy; Impact...public release; distribution unlimited. 4 PERFORMING ORGANIZATION REPORT NUMBER( S ) NPRDC TR 85-32 5. MONITORING ORGANIZATION REPORT NUMBER( S )

  2. Population dynamics of arterial cells during atherogenesis. XIII. Mitogenic and cytotoxic effects of a hyperlipidemic (HL) diet on cells in advanced lesions in the abdominal aortas of swine fed an HL diet for 270-345 days.

    PubMed

    Thomas, W A; Kim, D N; Lee, K T; Reiner, J M; Schmee, J

    1983-12-01

    The abdominal aortas of five groups of young male Yorkshire swine were studied: (1) 0-day baseline group; (2) hyperlipidemic (HL) group with ballooning; (3) mash group with ballooning; (4) mash group without ballooning; and (5) HL group without ballooning. The last four groups were injected with [3H]thymidine at 270 days and sacrificed subsequently in subsets at intervals up to 75 days in order to study births and deaths (or loss by migration) among cells over the period 270-345 days. However, only in the HL-ballooned group were there enough swine for the isotopic data to be useful for most purposes. In the 0-day baseline group there were 6 +/- 2 X 10(6) cells in intimal cell masses (ICM); in the 270- to 345-day mash group without ballooning the number was 10 +/- 2 X 10(6), which is not a statistically significant increase over 0-day. This supports the hypothesis that in the normal state births and deaths (or loss by migration) among cells in ICM are nearly balanced at least up to 1 year of age. In the 270- to 345-day mash group with ballooning there were 61 +/- 12 X 10(6) cells in the ICM. Thus a single episode of deendothelialization results in tremendous hyperplasia of ICM. However, even the largest ICM (atherosclerotic lesion) in this group showed essentially no necrosis. In the 270- to 345-day HL group with ballooning there were 108 +/- 17 X 10(6) cells in the ICM turned atherosclerotic lesions. In addition an average of one-third of the lesion volume was occupied by lipid-rich, calcific necrotic debris. Thus the HL diet appears to have associated with it both mitogenic and cytotoxic influences on ICM cells. In the 270- to 345-day HL group not ballooned there were 130 +/- 30 X 10(6) lesion cells and lesions were somewhat more extensive and necrotic than in the HL-ballooned group, probably because the former group included by chance more hyperresponders (as regards serum cholesterol values) to the HL diet than the latter. Regardless of this, the data suggest

  3. Ruptured abdominal aortic aneurysm.

    PubMed

    Sachs, T; Schermerhorn, M

    2010-06-01

    Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.

  4. The Abdominal Circulatory Pump

    PubMed Central

    Aliverti, Andrea; Bovio, Dario; Fullin, Irene; Dellacà, Raffaele L.; Lo Mauro, Antonella; Pedotti, Antonio; Macklem, Peter T.

    2009-01-01

    Blood in the splanchnic vasculature can be transferred to the extremities. We quantified such blood shifts in normal subjects by measuring trunk volume by optoelectronic plethysmography, simultaneously with changes in body volume by whole body plethysmography during contractions of the diaphragm and abdominal muscles. Trunk volume changes with blood shifts, but body volume does not so that the blood volume shifted between trunk and extremities (Vbs) is the difference between changes in trunk and body volume. This is so because both trunk and body volume change identically with breathing and gas expansion or compression. During tidal breathing Vbs was 50–75 ml with an ejection fraction of 4–6% and an output of 750–1500 ml/min. Step increases in abdominal pressure resulted in rapid emptying presumably from the liver with a time constant of 0.61±0.1SE sec. followed by slower flow from non-hepatic viscera. The filling time constant was 0.57±0.09SE sec. Splanchnic emptying shifted up to 650 ml blood. With emptying, the increased hepatic vein flow increases the blood pressure at its entry into the inferior vena cava (IVC) and abolishes the pressure gradient producing flow between the femoral vein and the IVC inducing blood pooling in the legs. The findings are important for exercise because the larger the Vbs the greater the perfusion of locomotor muscles. During asystolic cardiac arrest we calculate that appropriate timing of abdominal compression could produce an output of 6 L/min. so that the abdominal circulatory pump might act as an auxiliary heart. PMID:19440240

  5. Lateral Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Lateral abdominal wall (LAW) defects can manifest as a flank hernias, myofascial laxity/bulges, or full-thickness defects. These defects are quite different from those in the anterior abdominal wall defects and the complexity and limited surgical options make repairing the LAW a challenge for the reconstructive surgeon. LAW reconstruction requires an understanding of the anatomy, physiologic forces, and the impact of deinnervation injury to design and perform successful reconstructions of hernia, bulge, and full-thickness defects. Reconstructive strategies must be tailored to address the inguinal ligament, retroperitoneum, chest wall, and diaphragm. Operative technique must focus on stabilization of the LAW to nonyielding points of fixation at the anatomic borders of the LAW far beyond the musculofascial borders of the defect itself. Thus, hernias, bulges, and full-thickness defects are approached in a similar fashion. Mesh reinforcement is uniformly required in lateral abdominal wall reconstruction. Inlay mesh placement with overlying myofascial coverage is preferred as a first-line option as is the case in anterior abdominal wall reconstruction. However, interposition bridging repairs are often performed as the surrounding myofascial tissue precludes a dual layered closure. The decision to place bioprosthetic or prosthetic mesh depends on surgeon preference, patient comorbidities, and clinical factors of the repair. Regardless of mesh type, the overlying soft tissue must provide stable cutaneous coverage and obliteration of dead space. In cases where the fasciocutaneous flaps surrounding the defect are inadequate for closure, regional pedicled flaps or free flaps are recruited to achieve stable soft tissue coverage. PMID:23372458

  6. [Abdominal catastrophe--surgeon's view].

    PubMed

    Vyhnánek, F

    2010-07-01

    Abdominal catastrophe is a serious clinical condition, usually being a complication arising during treatment of intraabdominal nontraumatic disorders or abdominal injuries. Most commonly, inflamation- secondary peritonitis, is concerned. Abdominal catastrophe also includes secondary signs of sepsis, abdominal compartment syndrome and enterocutaneous fistules. Most septic abdominal disorders which show signs of abdominal catastrophy, require surgical intervention and reinterventions--planned or "on demand" laparotomies. During the postoperative period, the patient requires intensive care management, including steps taken to stabilize his/hers condition, management of sepsis and metabolic and nutritional support measures, as well as adequate indication for reoperations. New technologies aimed at prevention of complications in laparostomies and to improve conditions for final laparotomy closure are used in phase procedures for surgical management of intraabdominal infections. Despite the new technologies, abdominal catastrophe has higher morbidity and lethality risk rates.

  7. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  8. Functional abdominal pain

    PubMed Central

    Matthews, P; Aziz, Q

    2005-01-01

    Functional abdominal pain or functional abdominal pain syndrome (FAPS) is an uncommon functional gut disorder characterised by chronic or recurrent abdominal pain attributed to the gut but poorly related to gut function. It is associated with abnormal illness behaviour and patients show psychological morbidity that is often minimised or denied in an attempt to discover an organic cause for symptoms. Thus the conventional biomedical approach to the management of such patients is unhelpful and a person's symptom experience is more usefully investigated using a biopsychosocial evaluation, which necessarily entails a multidisciplinary system of healthcare provision. Currently the pathophysiology of the disorder is poorly understood but is most likely to involve a dysfunction of central pain mechanisms either in terms of attentional bias, for example, hypervigilance or a failure of central pain modulation/inhibition. Although modern neurophysiological investigation of patients is promising and may provide important insights into the pathophysiology of FAPS, current clinical management relies on an effective physician-patient relationship in which limits on clinical investigation are set and achievable treatment goals tailored to the patient's needs are pursued. PMID:15998821

  9. Adolescent Pregnancy.

    PubMed

    Leftwich, Heidi K; Alves, Marcus Vinicius Ortega

    2017-04-01

    Adolescent pregnancy, although on the decline, represents a significant public health concern. Often adolescents present late to prenatal care, either from lack of knowledge, fear of consequences, limited access, stigma, or all of the above. Although multifaceted, there are many risks both to mother and child that are increased in adolescent pregnancy. Many are unintended and are at risk for repeat adolescent pregnancy, especially within the first 2 years. Risks include but are not limited to: low birth weight, preterm delivery, stillbirth, and preeclampsia, as well as feelings of social isolation, delayed or neglected educational goals, and maternal depression.

  10. Broad Ligament Pregnancy – Success Story of a Laparoscopically Managed Case

    PubMed Central

    Nair, Sobha S.

    2016-01-01

    Abdominal pregnancies constitute 1% of ectopic pregnancies, among which broad ligament pregnancy is a rare form. The maternal mortality rate has been reported to be as high as 20%. The diagnosis is seldom established before surgery. Laparoscopic management of broad ligament ectopic pregnancy is the ideal form of treatment in appropriately selected patients. We present the case report of successful laparoscopic treatment of a 3x3.5cm broad ligament pregnancy. A search of literature shows that ours is the 6th case report of such a rare ectopic pregnancy managed endoscopically successfully. PMID:27630914

  11. Abdominal tumors in children

    PubMed Central

    Oh, Chaeyoun; Youn, Joong Kee; Han, Ji-Won; Kim, Hyun-Young; Jung, Sung-Eun

    2016-01-01

    Abstract The use of minimally invasive surgery (MIS) in pediatric patients has been steadily increasing in recent years. However, its use for diagnosing and treating abdominal tumors in children is still limited compared with adults, especially when malignancy is a matter of debate. Here, we describe the experience at our center with pediatric abdominal tumors to show the safety and feasibility of MIS. Based on a retrospective review of patient records, we selected for study those pediatric patients who had undergone diagnostic exploration or curative resection for abdominal tumors at a single center from January 2010 through August 2015. Diagnostic exploration for abdominal tumors was performed in 32 cases and curative resection in 173 cases (205 operations). MIS was performed in 11 cases of diagnostic exploration (34.4%) and 38 cases of curative resection (21.9%). The mean age of the children who underwent MIS was 6.09 ± 5.2 years. With regard to diagnostic exploration, patient characteristics and surgical outcomes were found to be similar for MIS and open surgery. With regard to curative resection, however, the mean age was significantly lower among the patients who underwent open surgery (4.21 ± 4.20 vs 6.02 ± 4.99 for MIS, P = 0.047), and the proportion of malignancies was significantly higher (80% vs 39.4% for MIS, P < 0.001). MIS compared favorably with open surgery with respect to the rate of recurrence (6.7% vs 35.1%, P = 0.035), the rate of intraoperative transfusions (34.2% vs 58.5%, P = 0.01), the median amount of blood transfused (14 vs 22 mL/kg, P = 0.001), and the mean number of hospital days (4.66 ± 2.36 vs 7.21 ± 5.09, P < 0.001). Complication rates did not differ significantly between the MIS and open surgery groups. The operation was converted to open surgery in 3 cases (27.2%) of diagnostic MIS and in 5 cases (13.1%) of curative MIS. MIS was found to be both feasible and effective for the

  12. Care during pregnancy and childbirth for migrant women: How do we advance? Development of intervention studies--the case of the MAMAACT intervention in Denmark.

    PubMed

    Villadsen, Sarah Fredsted; Mortensen, Laust Hvas; Andersen, Anne-Marie Nybo

    2016-04-01

    The increased risk of adverse pregnancy and childbirth outcomes demonstrated for many non-Western migrants in Europe, Australia and North America may be due to inadequate use and suboptimal quality of care. It is indicated that a poor user-provider interaction leads to inequity of pregnancy and delivery care. This review demonstrated that there is no evidence of best practice antenatal care for migrant women. Health system interventions for improved maternal and child health among migrants should be based on thorough needs assessments, contextual understanding and involvement of the target group and health-care providers. We present the Danish MAMAACT study as a strategic perspective on how to move forward, and we describe methodological steps in intervention development. Based on a mixed method needs assessment, the MAMAACT study aimed to enhance the communication between migrant women and midwives during antenatal care regarding warning signs of pregnancy and how to access acute care.

  13. Pregnancy test

    MedlinePlus

    ... eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 25. Read More Ectopic pregnancy HCG blood test - qualitative HCG blood test - quantitative HCG in urine Miscarriage ...

  14. Pregnancy Complications

    MedlinePlus

    ... and Alaska Native Activities Building Tribal MCH Epidemiologic Capacity Improving Surveillance Systems and Collecting American Indian and ... Selected Recommendations for Contraceptive Use Providing Quality Family Planning Services Training for Providers Unintended Pregnancy Women’s Reproductive ...

  15. Uterine torsion in second trimester of pregnancy followed by a successful-term pregnancy

    PubMed Central

    Fatih, Farah Farouq; Gowri, Vaidyanathan; Rao, Kuntal

    2012-01-01

    Uterine torsion is defined as rotation of the uterus of more than 45° on its long axis. It is an unusual complication of pregnancy and for most obstetricians it probably represents a ‘once-in-a-lifetime’ diagnosis. Fetal mortality up to 12% and occasional maternal mortality are reported. A 22-year-old second gravida presented at 22+ weeks gestation with severe abdominal pain and shock. Laparotomy was done for suspected abruptio placenta, when torsion of the uterus to 180° was diagnosed. Posterior hysterotomy was performed. She conceived the next year and was delivered at term by caesarean section. Uterine torsion is a rare complication of pregnancy and obstetricians should have this complication in mind when performing a caesarean section for undiagnosed severe abdominal pain in pregnancy. Anatomical landmarks should be defined if possible, prior to uterine incision during a caesarean section, to avoid posterior hysterotomy PMID:22914233

  16. Color Doppler ultrasonography of the abdominal aorta.

    PubMed

    Battaglia, S; Danesino, G M; Danesino, V; Castellani, S

    2010-09-01

    Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations.

  17. Abdominal perfusion computed tomography.

    PubMed

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-02-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.

  18. Abdominal Perfusion Computed Tomography

    PubMed Central

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M. Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-01-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis. PMID:25610249

  19. Recurrent pneumothorax following abdominal paracentesis.

    PubMed Central

    Stafford, P. J.

    1990-01-01

    A 62 year old man presented with abdominal ascites, without pleural effusion, due to peritoneal mesothelioma. He had chronic obstructive airways disease and a past history of right upper lobectomy for tuberculosis. On two occasions abdominal paracentesis was followed within 72 hours by pneumothorax. This previously unreported complication of abdominal paracentesis may be due to increased diaphragmatic excursion following the procedure and should be considered in patients with preexisting lung disease. PMID:2385561

  20. Abdominal Tuberculosis in Cairo, Egypt

    DTIC Science & Technology

    1994-01-01

    COW 03 PUBLICATION REPORT 94-30227 * ABDOMINAL TUBERCULOSIS IN CAIRO, BY RWIavni 0. IHibbs6 M. Kuanmm ad Z. Fun .Y .~ ... W I Form ApprovedREPORT...Leave blank) 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED 8 April 1993 4. TITLE AND SUBTITLE S. FUNDING NUMBERS Abdominal Tuberculosis in Cairo...abdominal tuberculosis patients seen at Abbassia Fever Hospital in Cairo, Egypt from January 1990 to August 1992 are described; their mean age was 21.5

  1. Prosthetics and Techniques in Repair of Animal's Abdominal Wall

    PubMed Central

    Karrouf, Gamal; Zaghloul, Adel; Abou-Alsaud, Mohamed; Barbour, Elie; Abouelnasr, Khaled

    2016-01-01

    The management of abdominal wall repair continues to present a challenging problem, especially in the repair of major defects. Many abdominal wall defects can be repaired by primary closure; however, if the defect is large and there is a tension on the closure of the wound, the use of prosthetic materials becomes indispensable. Many studies have been performed with various materials and implant techniques, without the comparison of their degrees of success, based on sound meta-analysis and/or inclusive epidemiologic studies. This review covered the effectiveness of recent advances in prosthetic materials and implant procedures used in repair of abdominal wall, based on biomechanical properties and economic aspects of reconstructed large abdominal wall defects and hernias in animals. The presented results in this review helped to reach treatment algorithms that could maximize outcomes and minimize morbidity. PMID:27293982

  2. Prosthetics and Techniques in Repair of Animal's Abdominal Wall.

    PubMed

    Karrouf, Gamal; Zaghloul, Adel; Abou-Alsaud, Mohamed; Barbour, Elie; Abouelnasr, Khaled

    2016-01-01

    The management of abdominal wall repair continues to present a challenging problem, especially in the repair of major defects. Many abdominal wall defects can be repaired by primary closure; however, if the defect is large and there is a tension on the closure of the wound, the use of prosthetic materials becomes indispensable. Many studies have been performed with various materials and implant techniques, without the comparison of their degrees of success, based on sound meta-analysis and/or inclusive epidemiologic studies. This review covered the effectiveness of recent advances in prosthetic materials and implant procedures used in repair of abdominal wall, based on biomechanical properties and economic aspects of reconstructed large abdominal wall defects and hernias in animals. The presented results in this review helped to reach treatment algorithms that could maximize outcomes and minimize morbidity.

  3. Acute Pancreatitis and Pregnancy

    MedlinePlus

    ... Pancreatitis Acute Pancreatitis and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as ... pancreatitis in pregnancy. Reasons for Acute Pancreatitis and Pregnancy While acute pancreatitis is responsible for almost 1 ...

  4. Back Pain During Pregnancy

    MedlinePlus

    ... Education & Events Advocacy For Patients About ACOG Back Pain During Pregnancy Home For Patients Search FAQs Back ... During Pregnancy FAQ115, January 2016 PDF Format Back Pain During Pregnancy Pregnancy What causes back pain during ...

  5. Street Drugs and Pregnancy

    MedlinePlus

    ... premature birth Zika virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how ... Is it safe? > Street drugs and pregnancy Street drugs and pregnancy E-mail to a friend Please ...

  6. Early Pregnancy Loss

    MedlinePlus

    ... is called early pregnancy loss , miscarriage , or spontaneous abortion . How common is early pregnancy loss? Early pregnancy ... testes that can fertilize a female egg. Spontaneous Abortion: The medical term for early pregnancy loss. Trimester: ...

  7. Alcohol during Pregnancy

    MedlinePlus

    ... Home > Pregnancy > Is it safe? > Alcohol during pregnancy Alcohol during pregnancy E-mail to a friend Please ... and fetal alcohol spectrum disorders. How does drinking alcohol during pregnancy affect your baby's health? Drinking alcohol ...

  8. Sex during Pregnancy

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Sex During Pregnancy KidsHealth > For Parents > Sex During Pregnancy ... satisfying and safe sexual relationship during pregnancy. Is Sex During Pregnancy Safe? Sex is considered safe during ...

  9. Having a Healthy Pregnancy

    MedlinePlus

    ... Week of Healthy Breakfasts Shyness Having a Healthy Pregnancy KidsHealth > For Teens > Having a Healthy Pregnancy A ... or she can help you to get treatment. Pregnancy Discomforts Pregnancy can cause some uncomfortable side effects. ...

  10. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Siebenmann, R; Schneider, K; von Segesser, L; Turina, M

    1988-06-11

    348 cases of abdominal aortic aneurysm were reviewed for typical features of inflammatory aneurysm (IAAA) (marked thickening of aneurysm wall, retroperitoneal fibrosis and rigid adherence of adjacent structures). IAAA was present in 15 cases (14 male, 1 female). When compared with patients who had ordinary aneurysms, significantly more patients complained of back or abdominal pain (p less than 0.01). Erythrocyte sedimentation rate was highly elevated. Diagnosis was established in 7 of 10 computed tomographies. 2 patients underwent emergency repair for ruptured aneurysm. Unilateral ureteral obstruction was present in 4 cases and bilateral in 1. Repair of IAAA was performed by a modified technique. Histological examination revealed thickening of the aortic wall, mainly of the adventitial layer, infiltrated by plasma cells and lymphocytes. One 71-year-old patient operated on for rupture of IAAA died early, and another 78-year-old patient after 5 1/2 months. Control computed tomographies revealed spontaneous regression of inflammatory infiltration after repair. Equally, hydronephrosis due to ureteral obstruction could be shown to disappear or at least to decrease. IAAA can be diagnosed by computed tomography with high sensitivity. Repair involves low risk, but modification of technique is necessary. The etiology of IAAA remains unclear.

  11. [Intra-abdominal mycoses].

    PubMed

    Boos, C; Kujath, P; Bruch, H-P

    2005-01-01

    The incidence of invasive mycoses in patients undergoing abdominal surgery amounts to approximately 8% and shows an upward trend in epidemiological studies. The lethality of these systemic mycoses, which are mostly based on Candida infections constitutes up to 60%. The development of a sytemic mycosis is marked by exogenic, endogenic and iatrogenic risk factors and typically displays tissue invasion after an initial fungal contamination or systemic dissemination via fungal sepsis. Fungal peritonitis is generally a monoinfection with Candida spp., where Candida albicans outweighs in 70% of cases. Aspergillus spp. are only detected abdominally in rare cases. The histological verification of a fungal invasion is regarded as proof of the existence of an invasive mycosis, but typical macroscopic findings with corresponding cultural findings can also confirm the diagnosis. Systemic mycosis requires an early initiation of a consistent antimycotic therapy as well as definitive surgical eradication of the focus in order to reduce high lethal rate. Resistances or incorrect dosages can be validated objectively by means of histological monitoring of the antimycotic therapy, thus affording early recognition of the need to change the substance class.

  12. Teenage pregnancy.

    PubMed

    Murdock, N H

    1998-03-01

    Pregnancy among women under age 15 years is unusual, but not rare. About one third of the approximately 3 million total pregnancies which occur each year in the US are to teenagers. However, only about 30% of all pregnant adolescents receive adequate prenatal care, even though it is women in that age group who most need such care. Teen mothers have a higher rate of anemia and pregnancy-induced hypertension, most probably related to diet. Infants born to teen mothers are more likely to be premature and of low birth weight. Infants born to teen mothers are also more predisposed to mental retardation, brain damage, and birth injuries. Teen mothers are more likely to have poor weight gain, premature labor, abruptio placentae, and preeclampsia. The psychosocial reasons why teenage women become pregnant are considered, as well as the relevant media influences. While teenage pregnancy remains a major problem in the US, 1996 statistics indicate an overall 4% decline to 54.7 births/1000 among women aged 15-19 years. Teenage women need to be taught that there are many options in life other than pregnancy.

  13. Transgender men and pregnancy

    PubMed Central

    Obedin-Maliver, Juno

    2015-01-01

    Transgender people have experienced significant advances in societal acceptance despite experiencing continued stigma and discrimination. While it can still be difficult to access quality health care, and there is a great deal to be done to create affirming health care organizations, there is growing interest around the United States in advancing transgender health. The focus of this commentary is to provide guidance to clinicians caring for transgender men or other gender nonconforming people who are contemplating, carrying, or have completed a pregnancy. Terms transgender and gender nonconforming specifically refer to those whose gender identity (e.g., being a man) differs from their female sex assigned at birth. Many, if not most transgender men retain their female reproductive organs and retain the capacity to have children. Review of their experience demonstrates the need for preconception counseling that includes discussion of stopping testosterone while trying to conceive and during pregnancy, and anticipating increasing experiences of gender dysphoria during and after pregnancy. The clinical aspects of delivery itself fall within the realm of routine obstetrical care, although further research is needed into how mode and environment of delivery may affect gender dysphoria. Postpartum considerations include discussion of options for chest (breast) feeding, and how and when to reinitiate testosterone. A positive perinatal experience begins from the moment transgender men first present for care and depends on comprehensive affirmation of gender diversity. PMID:27030799

  14. Transgender men and pregnancy.

    PubMed

    Obedin-Maliver, Juno; Makadon, Harvey J

    2016-03-01

    Transgender people have experienced significant advances in societal acceptance despite experiencing continued stigma and discrimination. While it can still be difficult to access quality health care, and there is a great deal to be done to create affirming health care organizations, there is growing interest around the United States in advancing transgender health. The focus of this commentary is to provide guidance to clinicians caring for transgender men or other gender nonconforming people who are contemplating, carrying, or have completed a pregnancy. Terms transgender and gender nonconforming specifically refer to those whose gender identity (e.g., being a man) differs from their female sex assigned at birth. Many, if not most transgender men retain their female reproductive organs and retain the capacity to have children. Review of their experience demonstrates the need for preconception counseling that includes discussion of stopping testosterone while trying to conceive and during pregnancy, and anticipating increasing experiences of gender dysphoria during and after pregnancy. The clinical aspects of delivery itself fall within the realm of routine obstetrical care, although further research is needed into how mode and environment of delivery may affect gender dysphoria. Postpartum considerations include discussion of options for chest (breast) feeding, and how and when to reinitiate testosterone. A positive perinatal experience begins from the moment transgender men first present for care and depends on comprehensive affirmation of gender diversity.

  15. Abdominal contributions to cardiorenal dysfunction in congestive heart failure.

    PubMed

    Verbrugge, Frederik H; Dupont, Matthias; Steels, Paul; Grieten, Lars; Malbrain, Manu; Tang, W H Wilson; Mullens, Wilfried

    2013-08-06

    Current pathophysiological models of congestive heart failure unsatisfactorily explain the detrimental link between congestion and cardiorenal function. Abdominal congestion (i.e., splanchnic venous and interstitial congestion) manifests in a substantial number of patients with advanced congestive heart failure, yet is poorly defined. Compromised capacitance function of the splanchnic vasculature and deficient abdominal lymph flow resulting in interstitial edema might both be implied in the occurrence of increased cardiac filling pressures and renal dysfunction. Indeed, increased intra-abdominal pressure, as an extreme marker of abdominal congestion, is correlated with renal dysfunction in advanced congestive heart failure. Intriguing findings provide preliminary evidence that alterations in the liver and spleen contribute to systemic congestion in heart failure. Finally, gut-derived hormones might influence sodium homeostasis, whereas entrance of bowel toxins into the circulatory system, as a result of impaired intestinal barrier function secondary to congestion, might further depress cardiac as well as renal function. Those toxins are mainly produced by micro-organisms in the gut lumen, with presumably important alterations in advanced heart failure, especially when renal function is depressed. Therefore, in this state-of-the-art review, we explore the crosstalk between the abdomen, heart, and kidneys in congestive heart failure. This might offer new diagnostic opportunities as well as treatment strategies to achieve decongestion in heart failure, especially when abdominal congestion is present. Among those currently under investigation are paracentesis, ultrafiltration, peritoneal dialysis, oral sodium binders, vasodilator therapy, renal sympathetic denervation and agents targeting the gut microbiota.

  16. [Abdominal approaches and drainages of the abdominal cavity].

    PubMed

    Hagel, C; Schilling, M

    2006-04-01

    Appropriate access to the abdominal cavity is the first and crucial step for successful abdominal surgical intervention. In planning the incision, several variables have to be considered, such as anatomy of the abdominal wall, localization of the target organ, and individual conditions (previous incisions, minimal access surgery, etc). Medial laparotomy is the preferred incision for emergency cases and ill-defined pathologies, allowing access and hence exploration to all quadrants. Transverse laparotomies give superior access to the dorsal and right aspects of the liver and cause less pain in patients unfit for regional anesthetic procedures. Draining of the abdominal cavity is used after various resective and reconstructive procedures, but there is little evidence for its use in a number of operations such as gastric, hepatic, and colorectal resections. Advantages and disadvantages of different abdominal wall incisions and drainages are discussed.

  17. Postural balance and the risk of falling during pregnancy.

    PubMed

    Cakmak, Bulent; Ribeiro, Ana Paula; Inanir, Ahmet

    2016-01-01

    Pregnancy is a physiological process and many changes occur in a woman's body during pregnancy. These changes occur in all systems to varying degrees, including the cardiovascular, respiratory, genitourinary, and musculoskeletal systems. The hormonal, anatomical, and physiological changes occurring during pregnancy result in weight gain, decreased abdominal muscle strength and neuromuscular control, increased ligamentous laxity, and spinal lordosis. These alterations shift the centre of gravity of the body, altering the postural balance and increasing the risk of falls. Falls during pregnancy can cause maternal and foetal complications, such as maternal bone fractures, head injuries, internal haemorrhage, abruption placenta, rupture of the uterus and membranes, and occasionally maternal death or intrauterine foetal demise. Preventative strategies, such as physical exercise and the use of maternity support belts, can increase postural stability and reduce the risk of falls during pregnancy. This article reviews studies that have investigated changes in postural balance and risk of falling during pregnancy.

  18. [Ovarian pregnancy: about 3 cases and review of the literature].

    PubMed

    Ranaivoson, Haingo Voahangy Rabetafika; Ranaivomanana, Volahasina Françine; Nomenjanahary, Lalaina; Andriamampionona, Tsitohery Francine; Randrianjafisamindrakotroka, Nantenaina Soa

    2016-01-01

    Ovarian pregnancy is a rare event among women with ectopic pregnancy in whom the ovary is the site of implantation. Its diagnosis requires a well codified approach. The peculiarities of the determining factors, of the histopathological and evolutionary features typical of ovarian pregnancies led us to focus on this form of ectopic pregnancy. We report 3 cases of ovarian pregnancy diagnosed in our Department. The three women were between 30 and 42 years, at 13 to 37 weeks of amenorrhea. All women had abdominal pain of varying intensity associated with shock. Anatomopathological examination of the right annex, normal site of implantation of ovarian pregnancies, confirmed the diagnosis. All women had juxtaposition ovarian cortical pregnancy. Ovarian pregnancy is a rare event among women with ectopic pregnancy, having specific peculiarities. Its diagnosis is difficult and is based on preoperative findings. The identification of the ovarian implantation on histopathological examination is ideal for confirming the diagnosis. Currently, it is assumed that ovarian pregnancy is the form of ectopic pregnancy which can develop to term or even result in a live birth.

  19. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  20. [The 454th case: a 29-week pregnant woman with abdominal pain, hyperlipemia and multiorgan dysfunction].

    PubMed

    Wu, D; Xu, J; Peng, J M; Ma, L K; Chen, S; Li, X G; Zhang, T P; Qian, J M

    2017-02-01

    A 32 year-old woman in the third trimester of pregnancy was admitted for severe acute pancreatitis due to hypertriglyceridemia. During hospitalization she developed multiorgan dysfunction, infected pancreatic necrosis, abdominal compartment syndrome and intrauterine fetal death. She was successfully treated by multidisciplinary team including department of emergency medicine, ICU, gastroenterology, obstetrics, endocrinology, ultrasonography, radiology, infectious disease, nutrition and surgery.

  1. CT of abdominal tuberculosis

    SciTech Connect

    Epstein, B.M.; Mann, J.H.

    1982-11-01

    Intraabdominal tuberculosis (TB) presents with a wide variety of clinical and radiologic features. Besides the reported computed tomographic (CT) finding of high-density ascites in tuberculous peritonitis, this report describes additional CT features highly suggestive of abdominal tuberculosis in eight cases: (1) irregular soft-tissue densities in the omental area; (2) low-density masses surrounded by thick solid rims; (3) a disorganized appearance of soft-tissue densities, fluid, and bowel loops forming a poorly defined mass; (4) low-density lymph nodes with a multilocular appearance after intravenous contrast administration; and (5) possibly high-density ascites. The differential diagnosis of these features include lymphoma, various forms of peritonitis, peritoneal carcinomatosis, and peritoneal mesothelioma. It is important that the CT features of intraabdominal tuberculosis be recognized in order that laparotomy be avoided and less invasive procedures (e.g., laparoscopy, biopsy, or a trial of antituberculous therapy) be instituted.

  2. Vaccines and pregnancy: past, present, and future.

    PubMed

    Rasmussen, Sonja A; Watson, Amelia K; Kennedy, Erin D; Broder, Karen R; Jamieson, Denise J

    2014-06-01

    Vaccination during pregnancy with certain vaccines can prevent morbidity and mortality in pregnant women and their infants. However, previous recommendations often focused on the potential risks of vaccines to the fetus when used during pregnancy. In recent years, additional data have become available on the absence of increased risks for adverse events associated with vaccines when administered during pregnancy and on their benefits to mothers and infants. Currently two vaccines - (i) inactivated influenza, and (ii) tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) - are recommended for use by all pregnant women by the United States Advisory Committee on Immunization Practices. Here we review the history of vaccination during pregnancy, the current status of recommendations for vaccination during pregnancy in the USA, and the potential for future advances in this area, including key barriers that must be overcome to accommodate these advances.

  3. Economics of abdominal wall reconstruction.

    PubMed

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias.

  4. A bizarre abdominal cystic lesion.

    PubMed

    Zucchini, Giorgia; Pezzilli, Raffaele; Ricci, Claudio; Casadei, Riccardo; Santini, Donatella; Calculli, Lucia; Corinaldesi, Roberto

    2010-09-06

    In spite of careful intraoperative precautions and gauze counts, mistakes can still occur during surgery. In the case reported, a retained gauze leaved during a surgical approach for removing a solid-cystic papillary tumor localized in the pancreatic tail, caused both persistent abdominal discomfort and the presence of an abdominal cystic lesion at imaging techniques. When a previous operative history is present, a foreign body should be taken into account in the differential diagnosis of a patient with an intra-abdominal cystic mass. Finally, radio-opaque marker should be routinely used by surgeons in order to reach a correct diagnosis in operated patients having retained gauze.

  5. [Teenage pregnancy].

    PubMed

    Mora-Cancino, María; Hernández-Valencia, Varcelino

    2015-05-01

    In Mexico, 20% of the annual births are presented in women younger than 20 years old. Pregnancy in adolescents puts at risk mother and child health. This risk is major while the woman is younger, especially when the social and economic conditions are not favorable, which is decisive in later psychosocial development. It has been pointed out that the youths with low education, with minor academic and laboral expectations, with low self-esteem and assertiveness, tend to begin early their active sexual life, to use less frequently contraceptives, and in the case of younger women, to be pregnant, with the risk of abortion because they cannot to make the best decision. It is important to take into account the social context and the special characteristics of the family to understand situation of adolescent at risk of pregnancy.

  6. [Penetrating abdominal injuries].

    PubMed

    Nesbakken, A; Pillgram-Larsen, J; Naess, F; Gerner, T; Solheim, K; Stadaas, J O; Gjøra, O

    1990-02-28

    We have reviewed the medical records of 111 patients treated for abdominal stab wounds during the period 1980-87. Our two hospitals serve a catchment area of about 450,000 people. Exploratory laparotomy was performed in 89 patients with suspected peritoneal penetration. In 16 patients the laparotomy was negative, and in 15 patients only minor injuries were noted. There were no serious complications in these 31 patients. Twenty-seven patients had thoracic wounds below the fourth intercostal space, 15 with intraabdominal injuries. The most common injuries were lacerations of the liver, the small bowel and the diaphragm. The mortality in the series was 2%. Stab wounds are infrequent in Norway, and most surgeons have limited experience of such injuries. We discuss whether to employ immediate exploratory laparotomy or selective management when the peritoneum has been penetrated. When there is no evidence of evisceration or omental protrusion, local exploration of the wound should be performed in order to confirm or exclude peritoneal penetration. Injury to the diaphragm and intraabdominal viscera should always be suspected in thoracic stab wounds below the fourth intercostal space.

  7. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-11-14

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  8. Rupture rudimentary horn pregnancy at 31 week

    PubMed Central

    Al Qarni, Abdullah A.; Al-Braikan, Nawal; Al-Hanbali, Moh’d M.; Alharmaly, Abdullah H.

    2017-01-01

    Rudimentary horn could be a rare congenital uterine anomalies result from incomplete fusion of the 2 Müllerian ducts throughout embryo-genesis. Pregnancy in an exceedingly rudimentary horn is rare and typically terminates in rupture throughout the late of first or second trimester of pregnancy. We tend to present a rare case of a gravida within the trimester (31 weeks) presented with complain of abdominal pain, nausea, and vomit for 3 days. On presentation, the patient was pale and irritable. Ultrasound scan showed fetus at (30 weeks) with cardiac activity. Cardiotocography reactive. Incision showed horned uterus with pregnancy in rudimentary left horn that was ruptured. Alive fetus was delivered. The rudimentary left horn was excised. The patient was advised to not get pregnant for 3 years. Within one year, the patient came to hospital in active labor at (37 weeks). This case emphasizes the importance of fine antepartum care to avoid morbidity and mortality. PMID:28133695

  9. Rupture rudimentary horn pregnancy at 31 week.

    PubMed

    Al Qarni, Abdullah A; Al-Braikan, Nawal; Al-Hanbali, Moh'd M; Alharmaly, Abdullah H

    2017-02-01

    Rudimentary horn could be a rare congenital uterine anomalies result from incomplete fusion of the two Müllerian ducts throughout embryo-genesis. Pregnancy in an exceedingly rudimentary horn is rare and typically terminates in rupture throughout the late of first or second trimester of pregnancy. We tend to present a rare case of a gravida within the trimester (31 weeks) presented with complain of abdominal pain, nausea, and vomit for 3 days. On presentation, the patient was pale and irritable. Ultrasound scan showed fetus at (30 weeks) with cardiac activity. Cardiotocography reactive. Incision showed horned uterus with pregnancy in rudimentary left horn that was ruptured. Alive fetus was delivered. The rudimentary left horn was excised. The patient was advised to not get pregnant for 3 years. Within one year, the patient came to hospital in active labor at (37 weeks). This case emphasizes the importance of fine antepartum care to avoid morbidity and mortality.

  10. Laparoscopic Treatment of Cesarean Scar Ectopic Pregnancy

    PubMed Central

    Felsingerová, Zuzana; Felsinger, Michal; Jandakova, Eva

    2014-01-01

    Abstract Background: An ectopic pregnancy within a Cesarean scar represents a rare type of extrauterine pregnancy in which the fertilized egg nidates in the myometrium of the uterine wall within a scar left from a previous Cesarean delivery. An unrecognized growing Cesarian scar pregnancy may result in uterine rupture, uncontrollable metrorrhagia, and bleeding into the abdominal cavity; therefore, early diagnosis and therapy are necessary to prevent the development of severe complications. Case: A 34-year-old woman after a previous Cesarean delivery presented with amenorrhoa of 7 weeks' duration. Transvaginal ultrasonography revealed an ectopic pregnancy in the Cesarean scar, and a laparoscopic removal of the gestational sac was performed with no complications. Results: Three months later, another laparoscopy with chromopertubation showed no signs of penetration in the suture, both the Fallopian tubes being bilaterally passable. The patient was advised that she could try to achieve pregnancy through spontaneous conception, after which monitoring of the gestational development and a careful assessment of the nidation site would be needed. Conclusions: Laparoscopic surgical management of a viable ectopic pregnancy is technically simple, and is followed by a good recovery. (J GYNECOL SURG 30:309) PMID:25336858

  11. The unanticipated pregnancy: a preliminary study.

    PubMed

    Bluestein, D

    1990-01-01

    To guide clinical judgements regarding possible pregnancy in women seen for nonpregnancy concerns, 75 pregnant women tested for pregnancy confirmation were compared to 31 women with pregnancies diagnosed when tested to clarify undifferentiated symptoms. Symptom clarification patients were more often unmarried (74.2% vs 37.3%, P less than 0.001), unemployed (54.8% vs 14.7%, P less than 0.0001), uninsured (54.8% vs 25.3%, P less than 0.004), black (67.8% vs 45.3%, P less than 0.04), using contraception (45.2% vs 22.7%, P less than 0.02), and carrying unwanted gestations (77.4% vs 34.7%, P less than 0.0001). Symptom clarification patients had a median 2 pregnancy symptoms versus 3 for pregnancy confirmation patients (P less than 0.001), less often reported amenorrhea (25.8% vs 6.7%, P less than 0.01) or breast tenderness (38.7% vs 66.7%, P less than 0.01), but more often experienced abdominal pain (45.2% vs 17.3%, P less than 0.003). Thus, symptom clarification patients are often earlier in gestation with fewer pregnancy symptoms, or may differ in how they perceive and interpret such symptoms when present, findings consistent with a tentative hypothesis that symptom clarification patients may not have anticipated being pregnant.

  12. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    ... signs or symptoms of an abdominal aortic aneurysm (AAA). The final recommendation statement summarizes what the Task ... the potential benefits and harms of screening for AAA: (1) Men ages 65 to 75 who smoke ...

  13. Children's (Pediatric) Abdominal Ultrasound Imaging

    MedlinePlus Videos and Cool Tools

    ... not use ionizing radiation, has no known harmful effects, and is particularly valuable for evaluating abdominal, pelvic ... of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and ...

  14. Incentive spirometry after abdominal surgery.

    PubMed

    Davis, Suja P

    Patients face various possible complications after abdominal surgery. This article examines best practice in guiding and teaching them how to use an incentive spirometer to facilitate recovery and prevent respiratory complications.

  15. Recurrent abdominal pain in children: a clinical approach

    PubMed Central

    Quak, Seng Hock

    2015-01-01

    The term ‘recurrent abdominal pain’, or RAP, refers mainly to the duration of painful period and frequency of pain. The commonly accepted duration is at least three months in the preceding period, and over this three-month period, there are at least three episodes of pain that are severe enough to affect the daily activities of the affected patients. Over the years, with advances in medical technology and better understanding of the pathophysiology of abdominal pain, more and more organic causes have been identified. However, the most common cause of RAP in children is still functional in origin. PMID:25820843

  16. [METHODS IN ABDOMINAL OBESITY].

    PubMed

    Savchenko, O; Zavalskaya, T; Lizogub, V; Kuzhel, O; Baitser, M; Zapeka, Y

    2015-01-01

    This article describes the anatomical and physiological, histological and topographic features of adipose tissue on the relationship of metabolic syndrome, insulin resistance and cardiovascular disease. An advanced diagnostic techniques of total body fat and visceral fat content quantification as the most metabolically active are described.

  17. Abdominal Complications after Severe Burns

    DTIC Science & Technology

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease, peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease, peptic lcer disease and gastritis, large...70%); 13 for other compli- ations, such as biliary or perineal conditions (26%); and 4 or feeding access (8%). For the civilians, 2 had trauma

  18. Common abdominal emergencies in children.

    PubMed

    D'Agostino, James

    2002-02-01

    Because young children often present to EDs with abdominal complaints, emergency physicians must have a high index of suspicion for the common abdominal emergencies that have serious sequelae. At the same time, they must realize that less serious causes of abdominal symptoms (e.g., constipation or gastroenteritis) are also seen. A gentle yet thorough and complete history and physical examination are the most important diagnostic tools for the emergency physician. Repeated examinations and observation are useful tools. Physicians should listen carefully to parents and their children, respect their concerns, and honor their complaints. Ancillary tests are inconsistent in their value in assessing these complaints. Abdominal radiographs can be normal in children with intussusception and even malrotation and early volvulus. Unlike the classic symptoms seen in adults, young children can display only lethargy or poor feeding in cases of appendicitis or can appear happy and playful between paroxysmal bouts of intussusception. The emergency physician therefore, must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints. Eventually, all significant abdominal emergencies reveal their true nature, and if one can be patient with the child and repeat the examinations when the child is quiet, one will be rewarded with the correct diagnosis.

  19. [Ectopic pregnancy: Its current interest in Primary Health Care].

    PubMed

    López-Luque, P R; Bergal-Mateo, G J; López-Olivares, M C

    2014-01-01

    An ectopic pregnancy is the implantation and development of the ovum fertilized outside the endometrial cavity. Its incidence has increased in the last 30 years, and although its morbimortality has decreased, it is still the first cause of mortality in the first trimester of the pregnancy. Early suspicion is important, particularly in women of fertile age and with risk factors indicative of an extrauterine gestation. The symptomatology is usually amenorrhea, abdominal pain, metrorrhagia, general pregnancy symptoms, and even syncope and shock. The diagnosis of ectopic pregnancy is based on the clinical information, analytical results on mother blood and urine, ultrasound examination, transvaginal culdocentesis, laparoscopic or laparotomic inspection, and a histological study. The treatment can be surgical (salpingostomy or salpingectomy), medical (methotrexate) or expectant, depending on the factors of the ectopic pregnancy: early diagnosis, presence of acute complications, clinical condition of the patient, etc.

  20. Visceral scalloping on abdominal computed tomography due to abdominal tuberculosis

    PubMed Central

    Sharma, Vishal; Bhatia, Anmol; Malik, Sarthak; Singh, Navjeet; Rana, Surinder S.

    2017-01-01

    Objective: Scalloping of visceral organs is described in pseudomyxoma peritonei, malignant ascites, among other conditions, but not tuberculosis. Methods: We report findings from a retrospective study of patients with abdominal tuberculosis who had visceral scalloping on abdominal computed tomography (CT). Diagnosis of abdominal tuberculosis was made on the basis of combination of clinical, biochemical, radiological and microbiological criteria. The clinical data, hematological and biochemical parameters, and findings of chest X-ray, CT, Mantoux test, and HIV serology were recorded. Results: Of 72 patients with abdominal tuberculosis whose CT scans were included, seven patients had visceral scalloping. The mean age of these patients was 32.14 ± 8.43 years and four were men. While six patients had scalloping of liver, one had splenic scalloping. The patients presented with abdominal pain (all), abdominal distension (five patients), loss of weight or appetite (all), and fever (four patients). Mantoux test was positive in five, while none had HIV infection. The diagnosis was based on fluid (ascitic or collections) evaluation in four patients, ileo-cecal biopsy in one patient, fine needle aspiration from omental thickening in one patient, and sputum positivity for acid fast bacilli (AFB) in one patient. On CT examination, four patients had ascites, five had collections, one had lymphadenopathy, four had peritoneal involvement, three had pleural effusion, and two had ileo-cecal thickening. All except one patient received standard ATT for 6 months or 9 months (one patient). Pigtail drainage for collections was needed for two patients. Discussion: This report is the first description of visceral scalloping of liver and spleen in patients with abdominal tuberculosis. Previously, this finding has been reported primarily with pseudomyxoma peritonei and peritoneal carcinomatosis. Conclusion: Visceral scalloping may not conclusively distinguish peritoneal

  1. Pregnancy and Fifth Disease

    MedlinePlus

    ... Cheek Rash Parvovirus B19 and Other Illnesses References Pregnancy and Fifth Disease Recommend on Facebook Tweet Share ... half of pregnancy. Testing for Parvovirus B19 during Pregnancy A blood test for parvovirus B19 can show ...

  2. Pregnancy and IBD

    MedlinePlus

    ... Center Home > Resources > Pregnancy and IBD Go Back Pregnancy and IBD Email Print + Share If you have ... on the developing fetus or newborn. EFFECT OF PREGNANCY ON WOMEN WITH IBD Women should be well ...

  3. Nutrition during Pregnancy

    MedlinePlus

    ... being overweight or obese affect my pregnancy? • Can caffeine in my diet affect my pregnancy? • What are ... with possible birth injury, and childhood obesity. Can caffeine in my diet affect my pregnancy? Although there ...

  4. Ending a Pregnancy

    MedlinePlus

    ... Share Ending a Pregnancy Ending a PregnancyWhat is abortion?Abortion means ending a pregnancy early. In some cases, ... This is called a miscarriage, or a spontaneous abortion. In other cases, a woman chooses to end ...

  5. Gestational Diabetes and Pregnancy

    MedlinePlus

    ... Arrives Trouble Getting Pregnant Avoiding Pregnancy Articles Gestational Diabetes and Pregnancy Language: English Español (Spanish) Recommend ... diabetes must also take insulin. Problems of Gestational Diabetes in Pregnancy Blood sugar that is not well ...

  6. [Bilateral tubal pregnancy with intrauterine device -- a case report].

    PubMed

    Peixoto, R M; Aleixo Neto, A; Guimaraes, O; Portugal, E S

    1988-05-01

    Ectopic pregnancy occurs in Brazil in 1/300 cases. 99% are in the ovarian tubes and are almost always unilateral. The incidence rate for bilateral ectopic pregnancy has been described in literature to be 1/1,580 ectopic pregnancies. The article reports a case history at the maternity hospital of the Federal University in the Minas Gerais region. A 31 year-old leukodermatous patient in December 1980 began using an IUD (Lippes loop), followed by episodes of menorrhagia accompanied by abdominal colics of medium intensity during the following months. After the 3rd cycle menstrual delay occurred with abdominal pains localized mostly in the hypogastrium, but also in the lumbar and anal regions. After the diagnosis of ectopic pregnancy, the IUD was removed, resulting in minor bleeding a few days later. Subsequent ultrasonographic tests exposed a posterior pelvic tumorous mass at the uterus, 5.0x6.5 cm in diameter, and absence of uterine abnormalities, suggesting an ectopic pregnancy on the left. Following a complete physical examination including specular examination of the inner genitals it was decided to perform a diagnostic peritoneoscopy. It revealed an abdominal cavity presenting a large quantity of blood spread diffusely, uterus of normal size, and a cystic mass to the left+-6 cm in diameter apparently with hemorrhagic content. Laparotomy with transversal suprapubic incision was then performed. Final examinations indicated a bilateral tubal pregnancy ruptured on the left. The patient had a normal postoperative period and was discharged from the hospital after 6 days. Diagnosis is generally difficult since the unsuspected opposite tube may be infected and edematized due to bilateral endosalpingitis. For IUD users 2 etiological aspects of tubal pregnancies may be involved: Greater incidence rate of pelvic infection, modified tubal motility altering contractibility and possibly reversal of peristaltic wave. The necessity for examining both tubes when suspecting tubal

  7. Simulated spaceflight effects on mating and pregnancy of rats

    NASA Technical Reports Server (NTRS)

    Sabelman, E. E.; Chetirkin, P. V.; Howard, R. M.

    1981-01-01

    The mating of rats was studied to determine the effects of: simulated reentry stresses at known stages of pregnancy, and full flight simulation, consisting of sequential launch stresses, group housing, mating opportunity, diet, simulated reentry, and postreentry isolation of male and female rats. Uterine contents, adrenal mass and abdominal fat as a proportion of body mass, duration of pregnancy, and number and sex of offspring were studied. It is found that: (1) parturition following full flight simulation was delayed relative to that of controls; (2) litter size was reduced and resorptions increased compared with previous matings in the same group of animals; and (3) abdominal fat was highly elevated in animals that were fed the Soviet paste diet. It is suggested that the combined effects of diet, stress, spacecraft environment, and weightlessness decreased the probability of mating or of viable pregnancies in the Cosmos 1129 flight and control animals.

  8. Mechanics, Mechanobiology, and Modeling of Human Abdominal Aorta and Aneurysms

    PubMed Central

    Humphrey, J.D.; Holzapfel, G.A.

    2011-01-01

    Biomechanical factors play fundamental roles in the natural history of abdominal aortic aneurysms (AAAs) and their responses to treatment. Advances during the past two decades have increased our understanding of the mechanics and biology of the human abdominal aorta and AAAs, yet there remains a pressing need for considerable new data and resulting patient-specific computational models that can better describe the current status of a lesion and better predict the evolution of lesion geometry, composition, and material properties and thereby improve interventional planning. In this paper, we briefly review data on the structure and function of the human abdominal aorta and aneurysmal wall, past models of the mechanics, and recent growth and remodeling models. We conclude by identifying open problems that we hope will motivate studies to improve our computational modeling and thus general understanding of AAAs. PMID:22189249

  9. Pregnancy Loss and Miscarriage

    MedlinePlus

    ... Overview Condition Information What are common symptoms? How many people are ... Pregnancy Loss: Condition Information Skip sharing on social media links Share this: Page Content What is pregnancy ...

  10. The 2015 Pregnancy Summit, London, UK.

    PubMed

    Johansson, Cherynne

    2016-01-01

    Pregnancy Summit, Cineworld, The O2, London, UK, 29 September to 1 October 2015 The 2015 Pregnancy Summit was held over 3 days from 29 September to 1 October at Cineworld, The O2, London, UK. The event brings together a multidisciplinary faculty of international researchers and clinicians to discuss both scientific and clinical aspects of pregnancy-related issues in an informal setting. The goal of the meeting was to provide delegates with an update of recent advances in management of pregnancy-related conditions, to present research data and to discuss the current attitudes and practices in relevant topics. An extensive range of topics were discussed, from preeclampsia and treatment of hypertension, to the psychological impact of termination of pregnancy and feticide. This report will summarize a selection of the lectures presented.

  11. Recovery after abdominal wall reconstruction.

    PubMed

    Jensen, Kristian Kiim

    2017-03-01

    Incisional hernia is a common long-term complication to abdominal surgery, occurring in more than 20% of all patients. Some of these hernias become giant and affect patients in several ways. This patient group often experiences pain, decreased perceived body image, and loss of physical function, which results in a need for surgical repair of the giant hernia, known as abdominal wall reconstruction. In the current thesis, patients with a giant hernia were examined to achieve a better understanding of their physical and psychological function before and after abdominal wall reconstruction. Study I was a systematic review of the existing standardized methods for assessing quality of life after incisional hernia repair. After a systematic search in the electronic databases Embase and PubMed, a total of 26 studies using standardized measures for assessment of quality of life after incisional hernia repair were found. The most commonly used questionnaire was the generic Short-Form 36, which assesses overall health-related quality of life, addressing both physical and mental health. The second-most common questionnaire was the Carolinas Comfort Scale, which is a disease specific questionnaire addressing pain, movement limitation and mesh sensation in relation to a current or previous hernia. In total, eight different questionnaires were used at varying time points in the 26 studies. In conclusion, standardization of timing and method of quality of life assessment after incisional hernia repair was lacking. Study II was a case-control study of the effects of an enhanced recovery after surgery pathway for patients undergoing abdominal wall reconstruction for a giant hernia. Sixteen consecutive patients were included prospectively after the implementation of a new enhanced recovery after surgery pathway at the Digestive Disease Center, Bispebjerg Hospital, and compared to a control group of 16 patients included retrospectively in the period immediately prior to the

  12. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  13. Abdominal Bloating: Pathophysiology and Treatment

    PubMed Central

    Seo, A Young; Oh, Dong Hyun

    2013-01-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  14. [Gallstone ileus. Abdominal CT usefulness].

    PubMed

    Sukkarieh, F; Brasseur, P; Bissen, L

    2004-06-01

    The authors report the case of a 93-year old woman referred to the emergency department and presenting with an intestinal obstruction. Abdominal CT reveals a biliary ileus caused by the migration and the impaction of a 3 cm gallstone in the small bowel. Surgical treatment by enterolithotomy was successful. In over 90% of cases, gallstone ileus is a complication of cholelithiasis and accounts for 25% of intestinal obstruction in patients over 65 years. To reduce morbidity and mortality, early diagnosis and prompt treatment are essential. Abdominal CT-scan is the gold standard technique.

  15. Abdominal obesity and metabolic syndrome.

    PubMed

    Després, Jean-Pierre; Lemieux, Isabelle

    2006-12-14

    Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease risk. But abdominal obesity - the most prevalent manifestation of metabolic syndrome - is a marker of 'dysfunctional adipose tissue', and is of central importance in clinical diagnosis. Better risk assessment algorithms are needed to quantify diabetes and cardiovascular disease risk on a global scale.

  16. Abdominal surgery in neonatal foals.

    PubMed

    Bryant, James E; Gaughan, Earl M

    2005-08-01

    Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.

  17. Acute Fatty Liver of Pregnancy and its Differentiation from Other Liver Diseases in Pregnancy.

    PubMed

    Maier, J T; Schalinski, E; Häberlein, C; Gottschalk, U; Hellmeyer, L

    2015-08-01

    Background: There are a number of threatening liver diseases that occur during pregnancy. Acute fatty liver of pregnancy is a rare disease associated with high maternal and foetal mortality. Case Report: We report on a young gravida 1 woman who presented to our level 1 perinatal centre in the 36 + 5 week of pregnancy with an isolated elevation of transaminases together with diffuse upper abdominal complaints. After comprehensive diagnostic work-up we performed an emergency delivery by Caesarean section. This was followed by interdisciplinary management. Discussion: The differentiation from other liver diseases seems not to be obvious in all cases. Here we consider the following differential diagnoses: hyperemesis gravidarum, intrahepatic gestational cholestasis, preeclampsia, HELLP syndrome. Conclusion: Rapid diagnosis and delivery as well as interdisciplinary aftercare are necessary in order to reduce maternal and foetal mortality.

  18. Electrochemical vaginal potential during the estral cycle and pregnancy in the rat.

    PubMed

    Zipper, J; Angelo, S

    1980-01-01

    Potentials were measured with nonpolarizable salt electrodes (agar KCl-AgCl) during the estral cycle and pregnancy of the rat. The vaginal fundus is positive in regard to the external end of the vagina and does not present changes associated with the estral cycle. Vaginal-tongue potentials present biphasic cyclic changes associated with the estral cycle, the vagina being (-) during estro and (+) during diestro. Vaginal-abdominal skin potentials present monophasic modifications associated with the estral cycle. Vaginal-tongue potentials registered during pregnancy were (-) on the first day of pregnancy, (+) throughout pregnancy, and (-) on the first day postpartum.

  19. THE DERMATOSES OF PREGNANCY

    PubMed Central

    Sachdeva, Silonie

    2008-01-01

    The skin changes in pregnancy can be either physiological (hormonal), changes in pre-existing skin diseases or development of new pregnancy specific dermatoses. Pregnancy-specific skin dermatoses include an ill-defined heterogeneous group of pruritic skin eruptions which are seen only in pregnancy. These include atopic eruption of pregnancy, polymorphic eruption of pregnancy, pemphigoid gestationis and intrahepatic cholestasis of pregnancy. Atopic eruption of pregnancy is the most common of these disorders. Most skin eruptions resolve postpartum and require only symptomatic treatment. Antepartum surveillance is recommended for patients with pemphigoid gestationis and intrahepatic cholestasis of pregnancy as they carry fetal risk. This article deals with the classification, clinical features and treatment of the specific dermatoses of pregnancy. PMID:19882004

  20. [Kidney diseases in pregnancy].

    PubMed

    Kolesárova, Eva; Sirotiaková, Jana; Kozárová, Miriam

    2010-01-01

    Knowledge of important morphological, functional and hemodynamic changes occurring in the kidneys during physiological pregnancy is a prerequisite for proper diagnostics and therapy of renal diseases in pregnancy. Kidney diseases may be kidney diseases complicating pregnancy in previously healthy women, or pre-existing or superposed kidney diseases. Knowledge of renal insufficiency management in pregnancy, including haemodialysis treatment and management of pregnancy in patients who have undergone transplantation, is also important.

  1. Early Parental and Child Predictors of Recurrent Abdominal Pain at School Age: Results of a Large Population-Based Study

    ERIC Educational Resources Information Center

    Ramchandani, Paul G.; Stein, Alan; Hotopf, Matthew; Wiles, Nicola J.

    2006-01-01

    Objective: To assess whether parental psychological and physical factors and child factors measured in the first year of life were associated with recurrent abdominal pain (RAP) in children at age 6 3/4 years. Method: A longitudinal cohort study (the Avon Longitudinal Study of Parents and Children), followed 8,272 children from pregnancy to age 6…

  2. Leptin in pregnancy.

    PubMed

    Henson, M C; Castracane, V D

    2000-11-01

    Leptin is a polypeptide hormone that aids in the regulation of body weight and energy homeostasis and is linked to a variety of reproductive processes in both animals and humans. Thus, leptin may help regulate ovarian development and steroidogenesis and serve as either a primary signal initiating puberty or as a permissive regulator of sexual maturation. Perhaps significantly, peripheral leptin concentrations, adjusted for adiposity, are dramatically higher in females than in males throughout life. During primate pregnancy, maternal levels that arise from adipose stores and perhaps the placenta increase with advancing gestational age. Proposed physiological roles for leptin in pregnancy include the regulation of conceptus growth and development, fetal/placental angiogenesis, embryonic hematopoiesis, and hormone biosynthesis within the maternal-fetoplacental unit. The specific localization of both leptin and its receptor in the syncytiotrophoblast implies autocrine and/or paracrine relationships in this endocrinologically active tissue. Interactions of leptin with mechanisms regulating pre-eclampsia and maternal diabetes have also been suggested. Collectively, therefore, reports suggest that a better understanding of the regulation of leptin and its role(s) throughout gestation may eventually impact those causes of human perinatal morbidity and mortality that are exacerbated by intrauterine growth retardation, macrosomia, placental insufficiency, or prematurity.

  3. Functional Abdominal Pain in Children

    MedlinePlus

    ... the child’s mood and emotions, and in turn cause depression and anxiety. Screening/Diagnosis Detailed information regarding the location of abdominal pain, the frequency (number of times per week) and ... about the cause, and will guide further testing. Other important pieces ...

  4. Endoscopic ultrasound for chronic abdominal pain and gallbladder disease.

    PubMed

    Dill, B; Dill, J E; Berkhouse, L; Palmer, S T

    1999-01-01

    Endoscopic ultrasound (EUS) is a major advance in gastrointestinal endoscopy. EUS, which is invaluable in the diagnosis and staging of gastrointestinal cancer, is now being used in the diagnosis of chronic upper abdominal pain. EUS combined with stimulated biliary drainage (EUS/SBD) aids in the diagnosis of choledocholithiasis, cholecystitis, microlithiasis, and various conditions of the upper gastrointestinal tract. This article describes the EUS/SBD procedure and nursing care. Two case histories illustrating potential benefits to patients are presented.

  5. Abdominal Pain (Stomach Pain), Short-Term

    MedlinePlus

    ... myhealthfinder Immunization Schedules Nutrient Shortfall Questionnaire Abdominal Pain (Stomach Pain), Short-termJust about everyone has had a " ... time or another. But sudden severe abdominal pain (stomach pain), also called acute pain, shouldn't be ...

  6. Imaging of gastrointestinal and abdominal tuberculosis.

    PubMed

    Vanhoenacker, F M; De Backer, A I; Op de, Beeck B; Maes, M; Van Altena, R; Van Beckevoort, D; Kersemans, P; De Schepper, A M

    2004-03-01

    This article discusses the range of manifestations of tuberculosis (TB) of the abdomen, including involvement of the gastrointestinal tract, the peritoneum, mesentery, omentum, abdominal lymph nodes, solid abdominal organs, the genital system and the abdominal aorta. Abdominal TB is a diagnostic challenge, particularly when pulmonary TB is absent. It may mimic many other abdominal diseases, both clinically and radiologically. An early correct diagnosis, however, is important in order to ensure proper treatment and a favorable outcome. Modern imaging is a cornerstone in the early diagnosis of abdominal TB and may prevent unnecessary morbidity and mortality. Generally, CT appears to be the imaging modality of choice in the detection and assessment of abdominal tuberculosis, other than gastrointestinal TB. Barium studies remain superior for demonstrating mucosal intestinal lesions. Ultrasound may be used for follow-up to monitor therapy response. The diagnosis of abdominal TB should be considered if suggestive imaging findings are found in patients with a high index of suspicion.

  7. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe ... kinds of pain: Generalized pain or pain over more than half ...

  8. Blunt traumatic abdominal wall disruption with evisceration

    PubMed Central

    McDaniel, Ellen; Stawicki, Stanislaw PA; Bahner, David P

    2011-01-01

    Blunt traumatic abdominal wall disruptions associated with evisceration are very rare. The authors describe a case of traumatic abdominal wall disruption with bowel evisceration that occurred after a middle-aged woman sustained direct focal blunt force impact to the lower abdomen. Abdominal exploration and surgical repair of the abdominal wall defect were performed, with good clinical outcome. A brief overview of literature pertinent to this rare trauma scenario is presented. PMID:22229144

  9. Spontaneous live recurrent ectopic pregnancy after ipsilateral partial salpingectomy leading to tubal rupture

    PubMed Central

    Abraham, Cynthia; Seethappan, Vanitha

    2014-01-01

    Introduction Ectopic pregnancy accounts for 1–2% of all pregnancies in the United States. The most common site of implantation for an ectopic pregnancy is the fallopian tube. We present the first case describing a recurrent ectopic pregnancy with a fetal heartbeat after ipsilateral salpingectomy that led to tubal rupture. Presentation of case The patient presented with abdominal pain approximately six weeks after her last menstrual period. Seven years prior to presentation, a laparoscopic partial right salpingectomy had been performed for a tubal ectopic pregnancy. Physical exam was significant for diffuse abdominal tenderness and guarding. Ultrasonography revealed a right tubal pregnancy with a fetal pole and a fetal heart rate that was calculated to be 108 beats per minute. Free fluid was also noted. 1.5 l of hemoperitoneum was subsequently evacuated and the right fallopian tube remnant with the ectopic pregnancy was removed. Pathology of the tubal remnant showed immature chorionic villi and fetal parts. Discussion The mechanism by which a recurrent ectopic pregnancy after ipsilateral salpingectomy occurs is unclear, but is theorized to be secondary to contralateral fertilization and/or tubal recanalization that may occur due to inadequate diathermy. Conclusion Physicians should be aware that ectopic pregnancies may not only occur repeatedly but may also present a typically. We recommend when performing a salpingectomy that efforts be undertaken to minimize the length of the tubal remnant and to assure adequate coagulation of tissue so as to reduce the risk of recurrence. PMID:25594734

  10. [A case of bilateral tubal pregnancy after IVF - ET].

    PubMed

    Kovachev, E; Kozovski, I; Ivanov, S; Kornovski, Y; Mircheva, N; Koleva, P; Tsonev, A; Ismail, E; Kisyov, S; Kolev, N

    2013-01-01

    The authors describe a rare case of bilateral tubal pregnancy after IVF. The patient is with secondary infertility. The preceding diagnostic laparoscopy excluded the presence of tubal factor. The results of the spermogram show average to severe form of Oligoasthenozoospermia. Short protocol with GnRH-antagonist was performed and two embryos were transferred on the third day. On the 36th day after the embryo transfer the patient was hospitalized with abdominal pain in the right hypogastric region, clinical and ultrasound indications for hemoperitoneum. Urgent laparotomy was performed followed by salpingectomy dextra due to hemoperitoneum caused by tubal abortion. The examination of the left adnexa reveals uruptured tubal pregnancy in the isthmic part of the tube and the decision for salpingectomy sinistra was taken. Histological examinations confirmed the diagnosis of ectopic pregnancy in both tubes. The frequency of some rare forms and localizations of ectopic as well as heterotopic pregnancies increase after ART.

  11. [Acute fatty liver of pregnancy].

    PubMed

    Bacq, Y; Constans, T; Body, G; Choutet, P; Lamisse, F

    1986-01-01

    The authors analyse 115 cases of acute fatty liver of pregnancy, proven histologically. Characteristics of the condition is the finding of central nuclei in the hepatocytes containing microvesicular droplets. The disease occurs more frequently in primiparous women (54 per cent) and usually occurs in the third trimester of the pregnancy. A pre-icteric phase usually precedes the jaundice and during that time there is usually vomiting and/or nausa with abdominal pain or anarexia. In 92 per cent of case there is transient loss of consciousness with hepatic encephalopathy. Further tests show that there is more defective liver function than would be expected from the extent of cell lysis; and there is defective renal function. The worst complications are intestinal haemorrhages (48 per cent of cases)--genital bleeding (43 per cent of cases)--shock--diffuse intravascular coagulation and complications associated with coma. Maternal mortality at present runs at 25 per cent and fetal mortality at 60 per cent. The condition does not recur. Early evacuation of the uterus is recommended by most authors and does probably improve the outlook. The various hypotheses concerning the aetiology are discussed.

  12. Uncommon Implantation Sites of Ectopic Pregnancy: Thinking beyond the Complex Adnexal Mass.

    PubMed

    Chukus, Anjeza; Tirada, Nikki; Restrepo, Ricardo; Reddy, Neelima I

    2015-01-01

    Ectopic pregnancy occurs when implantation of the blastocyst takes place in a site other than the endometrium of the uterine cavity. Uncommon implantation sites of ectopic pregnancy include the cervix, interstitial segment of the fallopian tube, scar from a prior cesarean delivery, uterine myometrium, ovary, and peritoneal cavity. Heterotopic and twin ectopic pregnancies are other rare manifestations. Ultrasonography (US) plays a central role in diagnosis of uncommon ectopic pregnancies. US features of an interstitial ectopic pregnancy include an echogenic interstitial line and abnormal bulging of the myometrial contour. A gestational sac that is located below the internal os of the cervix and that contains an embryo with a fetal heartbeat is indicative of a cervical ectopic pregnancy. In a cesarean scar ectopic pregnancy, the gestational sac is implanted in the anterior lower uterine segment at the site of the cesarean scar, with thinning of the myometrium seen anterior to the gestational sac. An intramural gestational sac implants in the uterine myometrium, separate from the uterine cavity and fallopian tubes. In an ovarian ectopic pregnancy, a gestational sac with a thick hyperechoic circumferential rim is located in or on the ovarian parenchyma. An intraperitoneal gestational sac is present in an abdominal ectopic pregnancy. Intra- and extrauterine gestational sacs are seen in a heterotopic pregnancy. Two adnexal heartbeats suggest a live twin ectopic pregnancy. Recognition of the specific US features will help radiologists diagnose these uncommon types of ectopic pregnancy.

  13. PET/CT detects abdominal wall and port site metastases of colorectal carcinoma.

    PubMed

    Goshen, E; Davidson, T; Aderka, D; Zwas, S T

    2006-07-01

    Abdominal wall metastases from colorectal cancer (CRC) may be resected with curative results. Such lesions, often indicators of additional intra-abdominal lesions, may appear in surgical scars, stomas and port site metastases after laparoscope-assisted surgery (LAS). Post-operative changes, primarily surgical scars, alter local physical findings making early detection of small lesions challenging. The purpose of this study was to retrospectively evaluate the contribution of PET/CT to the diagnosis of recurrent colorectal cancer in the post-operative abdominal wall. 120 patients were referred for PET/CT with suspected recurrent CRC based on clinical, radiological or laboratory findings. All underwent whole body PET/CT imaging. 12 of these 120 (10%), were found to have abdominal wall lesions. A total of 16 abdominal wall lesions were detected, located to surgical scars, stomas, drain and laparoscope ports. Additional findings on PET/CT in this group included liver metastases, intra-abdominal lesions and retroperitoneal lymph node involvement. In general, the patients in this small group were young with high grade tumours presenting in advanced stages. In conclusion, PET/CT appears to be a sensitive tool for the diagnosis of abdominal wall recurrence of CRC. The accuracy of localization afforded by the fused functional and anatomic images makes PET/CT a likely tool for diagnosing abdominal wall lesions, including port site metastases of other aetiologies.

  14. Spontaneous Unilateral Adrenal Hemorrhage in Pregnancy

    PubMed Central

    Ebrahem, Rawaa; Munguti, Cyrus; Mortada, Rami

    2017-01-01

    Spontaneous adrenal hemorrhage (SAH) is a serious medical condition associated with variable clinical presentation depending on the extent of the hemorrhage. Pregnancy-induced adrenal hemorrhage is poorly understood. A low cortisol level in the peripartum period with radiological findings is sufficient to establish the diagnosis. Prompt hormone replacement and supportive care to ensure good clinical outcomes is crucial. Due to the potentially life-threatening complications, physicians should have a high suspicion for adrenal hemorrhage when they evaluate patients with hypotension, fatigue, and abdominal pain during the peripartum period. PMID:28191381

  15. Salmonella enterica Serotype Typhi Bacteremia Complicating Pregnancy in the Third Trimester

    PubMed Central

    Patel, Krunal; Gittens-Williams, Lisa; Apuzzio, Joseph J.; Martimucci, Kristina; Williams, Shauna F.

    2017-01-01

    Background. Salmonella enterica serotype Typhi (S. Typhi) is an anaerobic gram-negative enteric rod that causes infection when contaminated food or water is ingested and may cause illness in pregnancy. Case. This is a patient who presented at 31 weeks' gestation with abdominal pain and fever and was diagnosed with S. Typhi bacteremia. Conclusion. S. Typhi should be considered in febrile patients with recent travel presenting with abdominal discomfort with or without elevated liver enzymes. PMID:28203469

  16. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

    PubMed Central

    Oguejiofor, Njideka; Al-Abayechi, Sarah; Njoku, Emmanuel

    2017-01-01

    Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms. PMID:28299215

  17. Antibiotics and Pregnancy: What's Safe?

    MedlinePlus

    Healthy Lifestyle Pregnancy week by week Is it safe to take antibiotics during pregnancy? Answers from Roger W. Harms, M. ... 2014 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/antibiotics-and-pregnancy/ ...

  18. Outcome of pregnancy in survivors of Wilms' tumor

    SciTech Connect

    Li, F.P.; Gimbrere, K.; Gelber, R.D.; Sallan, S.E.; Flamant, F.; Green, D.M.; Heyn, R.M.; Meadows, A.T.

    1987-01-09

    Outcome of pregnancy was reported by 99 patients who were cured of childhood Wilms' tumor at seven pediatric cancer centers during 1931 to 1979. These patients carried or sired 191 singleton pregnancies of at least 20 weeks in duration. Among the 114 pregnancies in women who had received abdominal radiotherapy for Wilms' tumor, an adverse outcome occurred in 34 (30%). There were 17 perinatal deaths (five in premature low-birth-weight infants) and 17 other low-birth-weight infants. Compared with white women in the United States, the irradiated women had an increased perinatal mortality rate (relative risk, 7.9) and an excess of low-birth-weight infants (relative risk, 4.0). In contrast, an adverse outcome was found in two (3%) of the 77 pregnancies in nonirradiated female patients with Wilms' tumor and wives of male patients. The high risk of adverse pregnancy outcome should be considered in the counseling and prenatal care of women who have received abdominal radiotherapy for Wilms' tumor.

  19. Management of hypertensive disorders in pregnancy.

    PubMed

    Moussa, Hind N; Arian, Sara E; Sibai, Baha M

    2014-07-01

    Hypertensive disorders are the most common medical complication of pregnancy, with an incidence of 5-10%, and a common cause of maternal mortality in the USA. Incidence of pre-eclampsia has increased by 25% in the past two decades. In addition to being among the lethal triad, there are likely up to 100 other women who experience 'near miss' significant maternal morbidity that stops short of death for every pre-eclampsia-related mortality. The purpose of this review is to present the new task force statement and novel definitions, as well as management approaches to each of the hypertensive disorders in pregnancy. The increased understanding of the pathophysiology of hypertension in pregnancy, as well as advances in medical therapy to minimize risks of fetal toxicity and teratogenicity, will improve our ability to prevent and treat hypertension in pregnancy. Fetal programming and fetal origins of adult disease theories extrapolate the benefit of such therapy to future generations.

  20. Colorectal cancer diagnosed during pregnancy: systematic review and treatment pathways.

    PubMed

    Pellino, Gianluca; Simillis, Constantinos; Kontovounisios, Christos; Baird, Daniel L; Nikolaou, Stella; Warren, Oliver; Tekkis, Paris P; Rasheed, Shahnawaz

    2017-03-01

    The aim of this study was to identify the mode of presentation and incidence of colorectal cancer in pregnancy (CRC-p), assess the outcomes of the mother and foetus according to gestational age, treatment delivered and cancer features and location. A systematic review of the literature was carried out to identify studies reporting on CRC-p and pooled analysis of the reported data. Seventy-nine papers reporting on 119 patients with unequivocal CRC-p were included. The calculated pooled risk is 0.002% and age at diagnosis has decreased over time. The median age at diagnosis was 32 (range, 17-46) years. Twelve per cent, 41 and 47% of CRC-p were diagnosed during the first, second and third trimester. The CRC-p site was the colon in 53.4% of cases, the rectum in 44% and multiple sites in 2.6%. Bleeding occurred in 47% of patients, abdominal pain in 37.6%, constipation in 14.1%, obstruction in 9.4% and perforation in 2.4%. Out of 82 patients whose treatment was described, 9.8% received chemotherapy during pregnancy. None of their newborns developed permanent disability, one developed hypothyroidism and 72% of newborns were alive. Vaginal delivery was possible in 60% of cases. Anterior resection was performed in 30% of patients and abdominoperineal excision of the rectum in 14.9%. Five patients had either synchronous (60%) or metachronous liver resection (40%). The median survival in these patients was 42 (0-120) months. Fifty-five per cent of patients were alive at the last available follow-up. The median survival of the mother was 36 (0-360) months. Patients with rectal cancer had longer survival compared with patients with colon cancer (P=0.0072). CRC-p is rare, leading to symptoms being overlooked, and diagnosis made at advanced stages. Cases described in the literature include patients who had cancer before pregnancy or developed it after delivery. Survival has not increased over time and the management of these patients requires collaboration between specialties and

  1. Sex during Pregnancy

    MedlinePlus

    ... results. Health care providers sometimes also recommend avoiding anal sex during pregnancy. If significant complications with your ... October 2016 previous 1 • 2 For Teens For Kids For Parents MORE ON THIS TOPIC Pregnancy & Newborn ...

  2. Teen Pregnancy and Childbearing

    MedlinePlus

    ... Development Healthy Relationships has sub items, Healthy Relationships Bullying Dating Dating Violence Healthy Friendships LGBTQ Youth Mental ... Pregnancy & Childbearing Teen Pregnancy Prevention Program Trends Negative Impacts Strategies & Approaches for Prevention Engaging Adolescent Males in ...

  3. Marijuana and Pregnancy

    MedlinePlus

    Marijuana and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of having ... risk. This sheet talks about whether exposure to marijuana may increase the risk for birth defects over ...

  4. Tumors and Pregnancy

    MedlinePlus

    Tumors during pregnancy are rare, but they can happen. Tumors can be either benign or malignant. Benign tumors aren't cancer. Malignant ones are. The most common cancers in pregnancy are breast cancer, cervical cancer, lymphoma, and melanoma. ...

  5. Pregnancy and Nutrition

    MedlinePlus

    ... calcium, and folic acid than you did before pregnancy. You also need more calories. But "eating for ... baby. You should gain weight gradually during your pregnancy, with most of the weight gained in the ...

  6. Problems sleeping during pregnancy

    MedlinePlus

    ... sleeping References Balserak BI, Lee KA. Sleep and sleep disorders associated with pregnancy. In: Kryger M, Roth T, ... Elsevier; 2017:chap 156. Ibrahim S, Foldvary-Shaefer N. Sleep disorders in pregnancy: implications, evaluation, and treatment. Neurologic Clinics . ...

  7. Alcohol and pregnancy

    MedlinePlus

    Drinking alcohol during pregnancy; Fetal alcohol syndrome - pregnancy; FAS - fetal alcohol syndrome ... group of defects in the baby known as fetal alcohol syndrome. Symptoms can include: Behavior and attention problems Heart ...

  8. Ectopic pregnancy (image)

    MedlinePlus

    An ectopic pregnancy is one in which the fertilized egg implants in tissue outside of the uterus and the placenta ... common site is within a Fallopian tube, however, ectopic pregnancies can occur in the ovary, the abdomen, and ...

  9. Asthma Medications and Pregnancy

    MedlinePlus

    ... Associated Conditions Asthma and Pregnancy Asthma Medications Asthma Medications Make an Appointment Refer a Patient Ask a ... for both mother and child. Making Decisions about Medication During Pregnancy It is important that your asthma ...

  10. Gaucher Disease in Pregnancy

    MedlinePlus

    ... as soon as you learn you are pregnant. Assessing your bone disease before pregnancy or as soon as you find out you’re pregnant is important because pregnancy increases the risk for severe bone pain (bone crisis). Your treatment ...

  11. Sleeping during Pregnancy

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old Sleeping During Pregnancy KidsHealth > For Parents > Sleeping During Pregnancy ... have trouble getting enough deep, uninterrupted sleep. Why Sleeping Can Be Difficult The first and most pressing ...

  12. Pesticides and Pregnancy

    MedlinePlus

    Pesticides and Pregnancy In every pregnancy, a woman starts out with a 3-5% chance of having ... risk. This sheet talks about whether exposure to pesticides may increase the risk for birth defects over ...

  13. Exercise during Pregnancy

    MedlinePlus Videos and Cool Tools

    ... premature birth Zika virus and pregnancy Folic acid Medicine safety and pregnancy Birth defects prevention Learn how ... a healthy weight and avoiding alcohol and street drugs . Featured articles March of Dimes Premature Birth Report ...

  14. MRI Safety during Pregnancy

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z MRI Safety During Pregnancy Magnetic resonance imaging (MRI) Illness ... during the exam? Contrast material MRI during pregnancy Magnetic resonance imaging (MRI) If you are pregnant and your doctor ...

  15. Anemia and Pregnancy

    MedlinePlus

    ... Advocacy Toolkit Home For Patients Blood Disorders Anemia Anemia and Pregnancy Your body goes through significant changes ... becoming anemic. back to top Is Pregnancy-Related Anemia Preventable? Good nutrition is the best way to ...

  16. Acute Pancreatitis and Pregnancy

    MedlinePlus

    ... and Pregnancy Acute Pancreatitis and Pregnancy Timothy Gardner, MD Acute pancreatitis is defined as the sudden inflammation ... the incidence of recurrent attacks minimized. Timothy Gardner, MD is Director of Pancreatic Disorders at Dartmouth-Hitchcock ...

  17. Pregnancy Complications: Liver Disorders

    MedlinePlus

    ... X Home > Complications & Loss > Pregnancy complications > Liver disorders Liver disorders Now playing: E-mail to a friend ... have blood on them (razors, toothbrushes). Acute fatty liver of pregnancy What is acute fatty liver of ...

  18. Cancer during Pregnancy

    MedlinePlus

    ... Cancer is Treated Side Effects Dating, Sex, and Reproduction Dating and Intimacy Sexuality and Cancer Treatment: Men ... here Home > Navigating Cancer Care > Dating, Sex, and Reproduction > Cancer During Pregnancy Request Permissions Cancer During Pregnancy ...

  19. Prevent Infections in Pregnancy

    MedlinePlus

    ... before and during pregnancy: Protect yourself from Zika virus. Zika virus can be passed from a pregnant woman to ... to her baby around the time of birth. Zika virus infection during pregnancy can cause microcephaly (a birth ...

  20. Yeast Infection during Pregnancy

    MedlinePlus

    ... OK? What's the best way to treat a yeast infection during pregnancy? Answers from Yvonne Butler Tobah, M.D. You can safely treat a yeast infection during pregnancy with various over-the-counter ...

  1. Folic Acid and Pregnancy

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old Folic Acid and Pregnancy KidsHealth > For Parents > Folic Acid and ... before conception and during early pregnancy . About Folic Acid Folic acid, sometimes called folate, is a B ...

  2. Current management of molar pregnancy.

    PubMed

    Hancock, Barry W; Tidy, John A

    2002-05-01

    Molar pregnancy remains an uncommon and still not fully understood disorder. The clinical presentation has changed over recent decades. In developed countries complete moles are now usually diagnosed early (on clinical and/or ultrasound scan criteria) so that the more severe clinical presentations are much less commonly seen. The important differences between complete and partial moles and their risk factors are now well recognized. Common protocols for managing persistent gestational trophoblastic disease are being derived, and molecular genetic studies are advancing our understanding of molar pregnancy and its sequelae. Cure rates approaching 100% should now be the rule rather than the exception. There is a strong case for formal registration and monitoring of all cases through specialist centers.

  3. Vanishing tumor in pregnancy

    PubMed Central

    Vimal, M. V.; Budyal, Sweta; Kasliwal, Rajeev; Jagtap, Varsha S.; Lila, Anurag R.; Bandgar, Tushar; Menon, Padmavathy; Shah, Nalini S.

    2012-01-01

    A patient with microprolactinoma, who had two successful pregnancies, is described for management issues. First pregnancy was uneventful. During the second pregnancy, the tumor enlarged to macroprolactinoma with headache and blurring of vision which was managed successfully with bromocriptine. Post delivery, complete disappearance of the tumor was documented. PMID:23226664

  4. Infections complicating pregnancy.

    PubMed

    Reilly, K; Clemenson, N

    1993-09-01

    Common infectious disease problems that occur in pregnancy are outlined, including implications for pregnancy, appropriate diagnostic techniques, treatments, and methods for prevention of disease in mother and infant. Also included is general information about the use of immunizations and antibiotics in pregnancy.

  5. Liver disease in pregnancy

    PubMed Central

    Lee, Noel M; Brady, Carla W

    2009-01-01

    Liver diseases in pregnancy may be categorized into liver disorders that occur only in the setting of pregnancy and liver diseases that occur coincidentally with pregnancy. Hyperemesis gravidarum, preeclampsia/eclampsia, syndrome of hemolysis, elevated liver tests and low platelets (HELLP), acute fatty liver of pregnancy, and intrahepatic cholestasis of pregnancy are pregnancy-specific disorders that may cause elevations in liver tests and hepatic dysfunction. Chronic liver diseases, including cholestatic liver disease, autoimmune hepatitis, Wilson disease, and viral hepatitis may also be seen in pregnancy. Management of liver disease in pregnancy requires collaboration between obstetricians and gastroenterologists/hepatologists. Treatment of pregnancy-specific liver disorders usually involves delivery of the fetus and supportive care, whereas management of chronic liver disease in pregnancy is directed toward optimizing control of the liver disorder. Cirrhosis in the setting of pregnancy is less commonly observed but offers unique challenges for patients and practitioners. This article reviews the epidemiology, pathophysiology, diagnosis, and management of liver diseases seen in pregnancy. PMID:19248187

  6. Hypertensive disorders in pregnancy

    PubMed Central

    Berry, Casey; Atta, Mohamed G

    2016-01-01

    Renal injury or failure may occur in the context of pregnancy requiring special considerations with regard to fetal and maternal health. The condition of pregnancy itself may be a major factor in such injuries. In addition, for many young women previously known to be healthy, pregnancy may be the first presentation for routine urine and blood testing which may yield previously subclinical renal disease. As such, pregnancy may add complexity to considerations in the management of renal disease presenting coincidentally requiring knowledge of the physiologic changes and potential renal disorders that may be encountered during pregnancy. PMID:27648405

  7. Anemia in pregnancy.

    PubMed

    Horowitz, Kari M; Ingardia, Charles J; Borgida, Adam F

    2013-06-01

    Hemodynamic changes occur in pregnancy to prepare for expected blood loss at delivery. Physiologic anemia occurs in pregnancy because plasma volume increases more quickly than red cell mass. Anemia is most commonly classified as microcytic, normocytic, or macrocytic. Iron deficiency anemia accounts for 75% of all anemias in pregnancy. Oral iron supplementation is the recommended treatment of iron deficiency anemia in pregnancy. Parenteral iron and erythropoietin can also be used in severe or refractory cases. Outcomes and treatments for other forms of inherited and acquired anemias in pregnancy vary by disease, and include nutritional supplementation, corticosteroids, supportive transfusions, and splenectomy.

  8. Liver Failure in Pregnancy.

    PubMed

    Bacak, Stephen J; Thornburg, Loralei L

    2016-01-01

    Acute liver failure is a rare but life-threatening medical emergency in pregnancy whose true incidence remains unknown. Many cases of acute liver failure are caused by pregnancy-related conditions such as acute fatty liver of pregnancy and HELLP syndrome. However, acute deterioration in liver function can also be caused by drug overdose, viral infections, and an exacerbation of underlying chronic liver disease. This article provides an overview of the normal liver changes that occur during pregnancy, and summarizes the most common conditions and general management strategies of liver failure during pregnancy.

  9. Spontaneous bilateral tubal pregnancy.

    PubMed

    Wali, Aisha Syed; Khan, Rozilla Sadia

    2012-02-01

    With the increase in incidence of ectopic pregnancy over the decades, bilateral ectopic pregnancy is also increasing. It is usually associated with assisted reproductive techniques (ART) but in recent years few cases of spontaneous bilateral ectopic pregnancy have been reported. Gynaecologists should be aware of this and that ultrasonography has limitations in diagnosis. In cases of ectopic pregnancy where contralateral adnexa is not clearly identified on ultrasound and fertility needs to be conserved, patient should be managed by experts in well equipped centres. A case of spontaneous bilateral tubal pregnancy that remained undiagnosed till laparotomy, is described.

  10. Hypertensive disorders in pregnancy.

    PubMed

    Berry, Casey; Atta, Mohamed G

    2016-09-06

    Renal injury or failure may occur in the context of pregnancy requiring special considerations with regard to fetal and maternal health. The condition of pregnancy itself may be a major factor in such injuries. In addition, for many young women previously known to be healthy, pregnancy may be the first presentation for routine urine and blood testing which may yield previously subclinical renal disease. As such, pregnancy may add complexity to considerations in the management of renal disease presenting coincidentally requiring knowledge of the physiologic changes and potential renal disorders that may be encountered during pregnancy.

  11. Adolescent pregnancy options.

    PubMed

    Resnick, M D

    1992-09-01

    The range of pregnancy options available to adolescents each have significant ramifications for future educational and economic achievement. The changing societal context of adolescent pregnancy decision-making are described, and the characteristics of adolescents who choose to terminate their pregnancy, parent their child, or place for adoption are examined. The role of significant others in decision-making and the implications of mandatory parental involvement in pregnancy decision-making is discussed, as well as the roles of schools in promoting the well-being and potential of adolescents considering pregnancy decisions.

  12. A review of abdominal organ transplantation in cystic fibrosis.

    PubMed

    Lu, Brandy R; Esquivel, Carlos O

    2010-12-01

    With advances in medical treatments, patients with CF are having improved quality of life and living longer. Although pulmonary disease is still the leading cause of morbidity and mortality, this longevity has allowed for the development of other organ dysfunction, mainly liver and pancreas. This review discusses the abdominal organ complications and the role of abdominal organ transplantation in CF. Liver failure and portal hypertension complications are the most common indicators for liver transplantation in CF, and five-yr survival for isolated liver transplantation is >80%. Deficiency of pancreatic enzymes is almost universal and up to 40% of patients with CF can develop insulin-dependent diabetes, although the role of pancreas transplantation is less clear and needs further research. Finally, the need for lung transplantation should always be assessed and considered in combination with liver transplantation on a case-by-case basis.

  13. Birth control and pregnancy management in pulmonary hypertension.

    PubMed

    Olsson, Karen M; Jais, Xavier

    2013-10-01

    Pregnancies in patients with pulmonary arterial hypertension (PAH) are associated with serious complications and mortality rates of more than 50%. Advanced medical therapies for PAH have been developed during the past years resulting in improved hemodynamics, exercise capacity, quality of life, and outcome. However, despite these advances, pregnancy in women with PAH is still associated with excessive maternal mortality. Consequently, all current guidelines strongly discourage pregnancy and recommend an effective method of contraception in women of childbearing age. If this fails, early pregnancy termination is advised. Those patients who choose to continue pregnancy should be treated with targeted PAH therapies including prostacyclin analogues and/or phosphodiesterase type 5 inhibitors. The care of the pregnant women with PAH requires a planned, multidisciplinary approach, preferably in a dedicated pulmonary hypertension referral center, focusing on close monitoring before, during and after delivery.

  14. Diabetes insipidus and pregnancy.

    PubMed

    Chanson, Philippe; Salenave, Sylvie

    2016-06-01

    Diabetes insipidus (DI) is a rare complication of pregnancy. It is usually transient, being due to increased placental production of vasopressinase that inactivates circulating vasopressin. Gestational, transient DI occurs late in pregnancy and disappears few days after delivery. Acquired central DI can also occur during pregnancy, for example in a patient with hypophysitis or neuroinfundibulitis during late pregnancy or postpartum. Finally, pre-existing central or nephrogenic DI may occasionally be unmasked by pregnancy. Treatment with dDAVP (desmopressin, Minirin(®)) is very effective on transient DI of pregnancy and also on pre-existing or acquired central DI. Contrary to vasopressin, dDAVP is not degraded by vasopressinase. Nephrogenic DI is insensitive to dDAVP and is therefore more difficult to treat during pregnancy if fluid intake needs to be restricted.

  15. Pruritic folliculitis of pregnancy*

    PubMed Central

    Delorenze, Lilian Mathias; Branco, Letícia Guedes; Cerqueira, Luiza Fiszon; Vasques, Wellington Batista; Salles, Simone de Abreu Neves; Vilar, Enoi Guedes

    2016-01-01

    Pruritic folliculitis of pregnancy is a rare disease of unknown etiology. It occcurs primarily during pregnancy, usually with spontaneous resolution postpartum. It is characterized by a benign dermatosis, with papular and pustular follicular lesions that first appear on the torso and occasionally spread throughout the body. We report the case of a patient in the 27th week of pregnancy, with a two-month evolution of pruritic and papular erythematous lesions on her lower back. Differential diagnosis includes other pregnancy-specific dermatoses: gestational pemphigoid, pruritic urticarial papules and plaques of pregnancy (PUPPP), prurigo of pregnancy, and (PUPPP) and prurigo of pregancy. Histopathological tests showed changes consistent with pruritic folliculitis of pregnancy. This case is relevant due to its rare nature and its clinical and histopathological characteristics. PMID:28300898

  16. Hypopituitarism and successful pregnancy

    PubMed Central

    Du, Xue; Yuan, Qing; Yao, Yanni; Li, Zengyan; Zhang, Huiying

    2014-01-01

    Hypopituitarism is a disorder characterized by the deficiency of one or more of the hormones secreted by the pituitary gland. Hypopituitarism patients may present the symptoms of amenorrhea, poor pregnancy potential, infertility, and no production of milk after delivery. Successful pregnancy in hypopituitarism patient is rare because hypopituitarism is associated with an increased risk of pregnancy complications, such as abortion, anemia, pregnancy-induced hypertension, placental abruption, premature birth, and postpartum hemorrhage. Hypopituitarism during pregnancy and perinatal period should be managed carefully. The hormone levels should be restored to normal before pregnancy. GH and HMG-hCG are combined to improve follicular growth and the success rate of pregnancy. Hypopituitary patients must be closely monitored as changes may need to be made to their medications, and serial ultrasound measurements are also necessary for fetal growth assessment. PMID:25663963

  17. [Dirofilaria in the abdominal cavity].

    PubMed

    Révész, Erzsébet; Markovics, Gabriella; Darabos, Zoltán; Tóth, Ildikó; Fok, Eva

    2008-10-01

    Number of cases of filariasis have been recently reported in the Hungarian medical literature, most of them caused by Dirofilaria repens . Dirofilaria repens is a mosquito-transmitted filarioid worm in the subcutaneous tissue of dogs and cats. Human infection manifests as either subcutaneous nodules or lung parenchymal disease, which may even be asymptomatic. The authors report a human Dirofilaria repens infection of the abdominal cavity in a 61-year-old man,who underwent laparotomy for acute abdomen. Intraoperatively, local peritonitis was detected caused by a white nemathhelminth, measured 8 cm in size. Histocytology confirmed that the infection was caused by Dirofilaria repens.

  18. Technical aspects of abdominal stomas.

    PubMed

    Link, Brian A; Kropp, Bradley; Frimberger, Dominic

    2007-01-01

    Continent urinary diversion has gained increasing popularity in the pediatric population during the last few decades. In adults, continent diversions are usually needed to replace a bladder after cystectomy for invasive carcinoma. Subsequently, the creation of functional and cosmetically hidden urinary and cecal abdominal stomas has become an integral part of many urinary reconstructive procedures. These techniques, originally developed for pediatric urinary reconstruction have gained increasing popularity for adult patients in need of a continence procedure. In the current manuscript, we review the technical aspects of site selection, mucocutaneous anastomosis, cosmetic appearance, and management of associated complications.

  19. Skin and hair changes during pregnancy

    MedlinePlus

    ... pregnancy; Polymorphic eruption of pregnancy; Melasma - pregnancy; Prenatal skin changes ... during pregnancy may have other effects on your skin. Some women get brownish or yellowish patches around ...

  20. Abdominal Compartment Syndrome After Hip Arthroscopy

    DTIC Science & Technology

    2010-01-01

    K. Intra- abdominal compartment syndrome as a complication of ruptured abdomi- nal aortic aneurysm repair. Am Surg 1989;55:396-402. 6. Sugrue M...00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Abdominal Compartment Syndrome After Hip Arthroscopy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Author’s personal copy Case Report Abdominal Compartment Syndrome After

  1. Abdominal Mass Secondary to Human Toxocariasis

    PubMed Central

    Ghoroobi, Javad; Khoddami, Maliheh; Mirshemirani, Alireza; Sadeghian, Naser; Mahdavi, Alireza; Hatefi, Sayeh

    2017-01-01

    Toxocariasis is an extensive helminthic infection that leads to visceral larva migrans in humans. A 2.5-year-old girl referred for abdominal mass. She had history of pharyngitis for two weeks. There were no other symptoms. Abdominal examination revealed an irregular solid mass in right lower quadrant (RLQ). Abdominal ultrasonography revealed an echohetrogenic large mass in RLQ, liver, and retroperitoneal area. Abdominal CT scan showed a huge mass. At laparotomy a large retroperitoneal mass that involved right liver lobe, bladder, ileocecal valve, small and large intestines was found. At histopathology diagnosis of toxocariasis was made. PMID:28164001

  2. [Diagnostic imaging and acute abdominal pain].

    PubMed

    Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-19

    Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.

  3. Empyema following intra-abdominal sepsis.

    PubMed

    Ballantyne, K C; Sethia, B; Reece, I J; Davidson, K G

    1984-09-01

    Over the past 9 years, ten patients have presented to the Thoracic Unit, Glasgow Royal Infirmary, with 12 empyemas secondary to intra-abdominal sepsis. In eight patients, the presenting signs and symptoms were wrongly attributed to primary intra-thoracic pathology. All were subsequently found to have intra-abdominal sepsis. The presence of empyema after recent abdominal surgery or abdominal pain strongly suggests a diagnosis of ipsilateral subphrenic abscess. Adequate surgical drainage is essential. In our experience, limited thoracotomy with subdiaphragmatic extension offers the best access to both pleural and subphrenic spaces and provides the greatest chance of eradicating infection on both sides of the diaphragm.

  4. Mechanical ventilation in abdominal surgery.

    PubMed

    Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

    2014-01-01

    One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery.

  5. Nutrition and multifetal pregnancy.

    PubMed

    Brown, J E; Carlson, M

    2000-03-01

    Largely because of assisted reproduction, the rate of multifetal pregnancy is rising rapidly in the United States. Accordingly, dietitians are increasingly being called upon to provide nutrition services for these high-risk pregnancies. This article gives an overview of the incidence of and risks associated with multifetal pregnancy and reviews studies that contribute to our knowledge of nutrition and multifetal pregnancy. Practice guidelines for promoting healthy outcomes based on the best available scientific data are suggested. Guidelines for weight gain for twin and triplet pregnancy, dietary intake, and supplement use are included. Suggested practice guidelines for multifetal pregnancy include a positive rate of weight gain early in pregnancy, the use of prepregnancy weight status to determine total weight gain goals in twin pregnancy, a 50-lb weight gain goal for triplet pregnancy, and higher minimal number of servings of foods from several of the Food Guide Pyramid groups. The need for additional information on the effects of nutritional status on the course and outcome of multifetal pregnancy is critical. Preliminary evidence of the benefits of nutrition services suggests that both the incorporation of dietetics services into care programs and additional research on nutrition and multifetal gestation are warranted.

  6. Hepatobiliary diseases during pregnancy and their management: An update

    PubMed Central

    Lata, Indu

    2013-01-01

    Liver diseases in pregnancy although rare but they can seriously affect mother and fetus. Signs and symptoms are often not specific and consist of jaundice, nausea, vomiting, and abdominal pain. Although any type of liver disease can develop during pregnancy or pregnancy may occur in a patient already having chronic liver disease. All liver diseases with pregnancy can lead to increased maternal and fetal morbidity and mortality. It is difficult to identify features of liver disease in pregnant women because of physiological changes. Physiological changes of normal pregnancy can be confounding with that of sign and symptoms of liver diseases. Telangiectasia or spider angiomas, palmar erythema, increased alkaline phosphatase due to placental secretion, hypoalbuminemia due to hemodilution. These normal alterations mimic physiological changes in patients with decompensated chronic liver disease. Besides all these pathological changes however, blood flow to the liver remains constant and the liver usually remains impalpable during pregnancy. The diagnosis of liver disease in pregnancy is challenging and relies on laboratory investigations. The underlying disorder can have a significant effect on morbidity and mortality in both mother and fetus, and a diagnostic workup should be initiated promptly. If we see the spectrum of liver disease in pregnancy, in mild form there occur increase in liver enzymes to severe form, where liver failure affecting the entire system or maternal mortality and morbidity. It can not only complicate mother's life but also poses burden of life of fetus to growth restriction. Most of the times termination is only answer to save life of mother but sometimes early detection of diseases, preventive measures and available active treatment is helpful for both of the life. Extreme vigilance in recognizing physical and laboratory abnormalities in pregnancy is a prerequisite for an accurate diagnosis. This could lead to a timely intervention and

  7. Monocytes and macrophages in abdominal aortic aneurysm.

    PubMed

    Raffort, Juliette; Lareyre, Fabien; Clément, Marc; Hassen-Khodja, Réda; Chinetti, Giulia; Mallat, Ziad

    2017-04-13

    Abdominal aortic aneurysm (AAA) is a life-threatening disease associated with high morbidity, and high mortality in the event of aortic rupture. Major advances in open surgical and endovascular repair of AAA have been achieved during the past 2 decades. However, drug-based therapies are still lacking, highlighting a real need for better understanding of the molecular and cellular mechanisms involved in AAA formation and progression. The main pathological features of AAA include extracellular matrix remodelling associated with degeneration and loss of vascular smooth muscle cells and accumulation and activation of inflammatory cells. The inflammatory process has a crucial role in AAA and substantially influences many determinants of aortic wall remodelling. In this Review, we focus specifically on the involvement of monocytes and macrophages, summarizing current knowledge on the roles, origin, and functions of these cells in AAA development and its complications. Furthermore, we show and propose that distinct monocyte and macrophage subsets have critical and differential roles in initiation, progression, and healing of the aneurysmal process. On the basis of experimental and clinical studies, we review potential translational applications to detect, assess, and image macrophage subsets in AAA, and discuss the relevance of these applications for clinical practice.

  8. Intrauterine fallopian tube incarceration: an uncommon complication of termination of pregnancy by vacuum aspiration.

    PubMed

    Deffieux, Xavier; Kane, Aminata; Faivre, Erika; Gervaise, Amélie; Frydman, René; Fernandez, Hervé

    2008-11-01

    A 34-year-old woman presented with an intermittent abdominal pain 5 years after voluntary vacuum aspiration for interruption of a first-trimester pregnancy. Magnetic resonance imaging demonstrated complete septate uterus and a cystic mass that infiltrated the posterior myometrial wall of the right side of the uterus. Laparoscopy and hysteroscopy revealed an intra uterine fallopian tube incarceration.

  9. [Timing, place and method of delivery in twin pregnancy].

    PubMed

    Nikolov, A

    2011-01-01

    Over the past years, rate and number of twin births have increased, in general, due to innovations in infertility treatment. Delivery in twin pregnancy has its own specifics in the three periods of delivery. Contemporary tendencies in twin pregnancy management and elective birth timing are been reviewed in this article. The general rules defining the place of delivery and general organizational and diagnostic problems are outlined. The methods of delivery are discussed in detail whereby types of incisions and anesthesiological specifics for abdominal operative delivery are focused. Contemporary possibilities for vaginal delivery are described as well as methods and specifics of the anesthesia. The knowledge of the specifics of twin pregnancy delivery as well as the definition of time and place of delivery is of high significance for successful perinatal outcome and long-term prognosis.

  10. [Denial of pregnancy and neonaticide: psychopathological and clinical features].

    PubMed

    Seigneurie, A-S; Limosin, F

    2012-11-01

    Pregnancy denial and neonaticide have recently received media coverage following a series of French cases of neonatal killing. Although it has been known for a long time that some women deny their pregnancy and may kill their newborns, there is still no consensus on the etiopathogenic factors involved in the denial of pregnancy occurrence. Even though neonaticide is often committed by young, poor, unmarried women with little or no prenatal care, it appears that denial of pregnancy is a heterogeneous condition associated with different psychological features. Societies are ambivalent with regard to mothers who killed their children and tend to lay the entire blame on them. Furthermore, there is a widespread lack of understanding among the public on these affairs, when birth control techniques and methods are widely available. The purpose of this article is to describe the different types of pregnancy denial and neonaticide and to review the still debated etiopathogenic hypotheses. The absence of the physical changes of pregnancy at the time of the denial such as cessation of menstruation, abdominal swelling or perception of foetal movements is also discussed.

  11. Ectopic tubal pregnancy after hysterectomy and tubal ligation.

    PubMed

    Rosa, Marilin; Mohammadi, Amir; Monteiro, Carmela

    2009-01-01

    Posthysterectomy ectopic pregnancy is an unusual condition that may present soon after hysterectomy or several years later. Similarly, although tubal ligation is a widespread method of contraception, tubal pregnancy after tubal ligation is not common either. If any of these conditions are rare, having an ectopic pregnancy after hysterectomy and tubal ligation is even more infrequent and only one of such cases was found in our review of the literature. We describe the case of a 35-year-old patient, with history of bilateral tubal ligation and vaginal hysterectomy that looked for medical attention due to abdominal pain. A pregnancy test was positive and a transvaginal ultrasound demonstrated the presence of a gestational sac at the vaginal cuff, adjacent to the ovary. An exploratory laparotomy showed a ruptured ectopic pregnancy located in the distal portion of the left fallopian tube. The occurrence of an ectopic pregnancy several years following tubal ligation and vaginal hysterectomy is a rare phenomenon that appears to be secondary to a fistulous connection into the peritoneal cavity.

  12. Bilateral tubal ectopic pregnancies: a report of two cases.

    PubMed

    Eze, Justus N; Obuna, Johnson A; Ejikeme, Brown N

    2012-01-01

    Bilateral tubal ectopic pregnancies are rare occurrences. Two recently managed cases are discussed. The first was a single, sexually active 23-year-old nullipara with family history of twinning who presented with eight weeks amenorrhea, positive pregnancy test, lower abdominal discomfort and other clinical and ultrasound findings suggestive of unruptured left tubal pregnancy. Intra-operatively, unruptured bilateral tubal pregnancies were found and bilateral salpingotomy performed with uneventful recovery. Histology of the specimens confirmed the intra-operative diagnosis. She was appropriately counseled. Case 2, a 30-year-old multiparous housewife who had been on clomid for secondary infertility, presented with signs and symptoms of ruptured tubal ectopic. Intra-operatively, ruptured left and unruptured right tubal pregnancies were found and salpingectomy and salpingotomy were done respectively, with uneventful recovery. The diagnosis was also confirmed histologically and counseling given as in case 1. Bilateral tubal ectopic pregnancies appear to be increasing with twin proneness and use of fertility drugs as risk factors. Whether spontaneous or induced, the hallmarks of good management include early presentation, high index of suspicion, meticulous ultrasound scanning, good case selection, judicious intra-operative inspection of the contralateral tube, histology of specimens and appropriate patient counseling.

  13. Chemotherapy in pregnancy.

    PubMed

    Ngu, Siew-Fei; Ngan, Hextan Y S

    2016-05-01

    Cancer diagnosed during pregnancy is uncommon, complicating between 0.02% and 0.1% of all pregnancies. Nonetheless, due to increasing age of childbearing, the incidence of cancer during pregnancy is likely to increase due to higher incidence of several age-dependent malignancies. The most common malignancies include breast cancer, cervical cancer, malignant melanoma and lymphoma. One of the key challenges in the management of cancer in pregnancy is treating the women with standard chemotherapy regimen, without compromising the safety of the developing foetus. Exposure of chemotherapy in the first trimester is associated with an increased risk of major birth defects, whereas use in the second and third trimesters is associated with intrauterine growth restriction, low birthweight and stillbirth. In this article, we review available data regarding the use of chemotherapeutic agents in pregnancy, and we summarise the neonatal outcomes, including malformations, perinatal complications and long-term follow-up. In addition, the management plan during pregnancy is also discussed.

  14. Liver abnormalities in pregnancy.

    PubMed

    Than, Nwe Ni; Neuberger, James

    2013-08-01

    Abnormalities of liver function (notably rise in alkaline phosphatase and fall in serum albumin) are common in normal pregnancy, whereas rise in serum bilirubin and aminotransferase suggest either exacerbation of underlying pre-existing liver disease, liver disease related to pregnancy or liver disease unrelated to pregnancy. Pregnant women appear to have a worse outcome when infected with Hepatitis E virus. Liver diseases associated with pregnancy include abnormalities associated hyperemesis gravidarum, acute fatty liver disease, pre-eclampsia, cholestasis of pregnancy and HELLP syndrome. Prompt investigation and diagnosis is important in ensuring a successful maternal and foetal outcome. In general, prompt delivery is the treatment of choice for acute fatty liver, pre-eclampsia and HELLP syndrome and ursodeoxycholic acid is used for cholestasis of pregnancy although it is not licenced for this indication.

  15. Herbal medicine in pregnancy.

    PubMed

    Pinn, Graham; Pallett, Linda

    2002-05-01

    The objective of the study was to assess the frequency of alternative medical usage in an antenatal population. A survey of alternative medicine usage was carried out among 305 consecutive patients over 2 months at their registration in mid-pregnancy at an Australian Antenatal Clinic. The study showed that something like 40% of patients used alternative medical therapy, including 12% herbal therapy. No specific study of pregnancy outcome was carried out, but it is of concern that some herbs taken had the potential to adversely affect pregnancy outcome. The herbal therapies commonly used in pregnancy are reviewed with their potential complications; examples of toxicity are also discussed. It is important to obtain a herbal medicine history at any time but particularly in pregnancy. Herbs may have unrecognised effects on pregnancy or labour, have interactions with prescribed medications and have potentially serious complications for the foetus.

  16. Pregnancy in adolescents.

    PubMed

    Black, Amanda Y; Fleming, Nathalie A; Rome, Ellen S

    2012-04-01

    Adolescent pregnancy remains a public health issue with significant medical, emotional, and societal consequences for the adolescent mother, her child, and her family. Teenage pregnancies are at higher risk of many adverse outcomes, including preterm delivery, low birth weight, and neonatal and infant mortality. Teen pregnancy and motherhood may have detrimental effects on the teen mother and her child; antenatal and postpartum care need to be adapted to meet the special needs of pregnant adolescents because standard obstetrical environments may not do so. This comprehensive review of adolescent pregnancy will highlight global statistics, factors contributing to adolescent pregnancy, social implications of adolescent pregnancy, obstetrical and neonatal outcomes, and the importance of multidisciplinary antenatal and postnatal care.

  17. Pregnancy and the Eye

    PubMed Central

    Yenerel, Nursal Melda; Küçümen, Raciha Beril

    2015-01-01

    Pregnancy causes significant changes in all systems of the body. Although most of them are physiological, they may also lead to pathological consequences. The resulting pathological changes may occur for the first time or existing diseases affected by pregnancy can become more serious or change course. Diseases specific only to pregnancy may arise. Like all systems of the body, the visual system is also affected by pregnancy, developing a wide range of physiological and pathological changes. Knowing the ocular physiological changes and diagnosing eye diseases that may develop during pregnancy, and preventing and treating these diseases is crucial to ensure the baby’s healthy development. Therefore, we have reviewed the conditions that an ophthalmologist should recognize, follow-up, and pay attention to during treatment and summarized them under the topic “pregnancy and the eye”. PMID:27800235

  18. [Antiphospholipid syndrome and pregnancy].

    PubMed

    Schreiber, Karen; Lykke, Jacob Alexander; Langhoff-Roos, Jens; Nielsen, Henriette Svarre; Jacobsen, Søren

    2016-01-18

    Antiphospholipid syndrome (APS) is the association of antiphospholipid antibodies with thromboses and/or obstetric morbidity. Obstetric morbidity includes recurrent first trimester loss, stillbirth, intrauterine death, preeclam-psia, premature birth and fetal growth restriction. Although current treatment regimens including aspirin and low-molecular weight heparin have improved pregnancy outcomes, 30% of affected women have pregnancy complica-tions. Women with APS are therefore high-risk pregnancies who should be monitored in specialist centres according to international standards.

  19. Treating Hypertension in Pregnancy.

    PubMed

    Schlembach, Dietmar; Homuth, Volker; Dechend, Ralf

    2015-08-01

    Hypertension is present in about 10 % of all pregnancies. The frequency of chronic hypertension and that of gestational hypertension is increasing. The management of pregnant women with hypertension remains a significant, but controversial, public health problem. Although treatment of hypertension in pregnancy has shown to reduce maternal target organ damage, considerable debate remains concerning treatment. We review current evidence regarding treatment goals, the ideal treatment starting time, and which drugs are available for the treatment of hypertension in pregnancy.

  20. Hypertension and pregnancy.

    PubMed

    Deak, Teresa M; Moskovitz, Joshua B

    2012-11-01

    Hypertension in pregnancy is increasing in prevalence and incidence and its treatment becoming more commonplace. Associated complications of pregnancy, including end-organ damage, preeclampsia, eclampsia, and postpartum eclampsia, are leading sources of maternal and fetal morbidity and mortality, requiring an emergency physician to become proficient with their identification and treatment. This article reviews hypertension in pregnancy as it relates to outcomes, with special emphasis on preeclampsia, eclampsia, and postpartum eclampsia.

  1. Renal disease in pregnancy.

    PubMed

    Sanders, C L; Lucas, M J

    2001-09-01

    Women with renal disease who conceive and continue a pregnancy are at significant risk for adverse maternal and fetal outcomes. Risk is inversely related to the degree of renal insufficiency. Pregnancy-induced changes in the urinary tract can temporarily increase renal function compromise, such as nephrosis, but most often results in no net increase in dysfunction. Common complications of pregnancy--such as hypertension and hypovolemia--can be associated with acute renal injury or aggravation of pre-existing disease.

  2. Outcomes of abdominal surgery in patients with liver cirrhosis

    PubMed Central

    Lopez-Delgado, Juan C; Ballus, Josep; Esteve, Francisco; Betancur-Zambrano, Nelson L; Corral-Velez, Vicente; Mañez, Rafael; Betbese, Antoni J; Roncal, Joan A; Javierre, Casimiro

    2016-01-01

    Patients suffering from liver cirrhosis (LC) frequently require non-hepatic abdominal surgery, even before liver transplantation. LC is an important risk factor itself for surgery, due to the higher than average associated morbidity and mortality. This high surgical risk occurs because of the pathophysiology of liver disease itself and to the presence of contributing factors, such as coagulopathy, poor nutritional status, adaptive immune dysfunction, cirrhotic cardiomyopathy, and renal and pulmonary dysfunction, which all lead to poor outcomes. Careful evaluation of these factors and the degree of liver disease can help to reduce the development of complications both during and after abdominal surgery. In the emergency setting, with the presence of decompensated LC, alcoholic hepatitis, severe/advanced LC, and significant extrahepatic organ dysfunction conservative management is preferred. A multidisciplinary, individualized, and specialized approach can improve outcomes; preoperative optimization after risk stratification and careful management are mandatory before surgery. Laparoscopic techniques can also improve outcomes. We review the impact of LC on surgical outcome in non-hepatic abdominal surgeries required in this cirrhotic population before, during, and after surgery. PMID:26973406

  3. Outcomes of abdominal surgery in patients with liver cirrhosis.

    PubMed

    Lopez-Delgado, Juan C; Ballus, Josep; Esteve, Francisco; Betancur-Zambrano, Nelson L; Corral-Velez, Vicente; Mañez, Rafael; Betbese, Antoni J; Roncal, Joan A; Javierre, Casimiro

    2016-03-07

    Patients suffering from liver cirrhosis (LC) frequently require non-hepatic abdominal surgery, even before liver transplantation. LC is an important risk factor itself for surgery, due to the higher than average associated morbidity and mortality. This high surgical risk occurs because of the pathophysiology of liver disease itself and to the presence of contributing factors, such as coagulopathy, poor nutritional status, adaptive immune dysfunction, cirrhotic cardiomyopathy, and renal and pulmonary dysfunction, which all lead to poor outcomes. Careful evaluation of these factors and the degree of liver disease can help to reduce the development of complications both during and after abdominal surgery. In the emergency setting, with the presence of decompensated LC, alcoholic hepatitis, severe/advanced LC, and significant extrahepatic organ dysfunction conservative management is preferred. A multidisciplinary, individualized, and specialized approach can improve outcomes; preoperative optimization after risk stratification and careful management are mandatory before surgery. Laparoscopic techniques can also improve outcomes. We review the impact of LC on surgical outcome in non-hepatic abdominal surgeries required in this cirrhotic population before, during, and after surgery.

  4. Reduced dermis thickness and AGE accumulation in diabetic abdominal skin.

    PubMed

    Niu, Yiwen; Cao, Xiaozan; Song, Fei; Xie, Ting; Ji, Xiaoyun; Miao, Mingyuan; Dong, Jiaoyun; Tian, Ming; Lin, Yuan; Lu, Shuliang

    2012-09-01

    Dermatological problems in diabetes might play an important role in the spontaneous ulcers and impaired wound healing that are seen in diabetic patients. Investigation of the cause of diabetic skin disorders is critical for identifying effective treatment. The abdominal full-thickness skin tissues of 33 patients (14 nondiabetic and 19 diabetic) were analyzed. The cell viability and malondialdehyde (MDA) production of fibroblasts were measured after advanced glycosylation end product (AGE)-bovine serum albumin (BSA) exposure. Cutaneous histological observation showed reduced thickness of the diabetic abdominal dermis with morphological characteristics of obscured multilayer epithelium and shortened, thinned, and disorganized collagen fibrils with focal chronic inflammatory cell infiltration when compared with controls of the same age. Accumulation of AGEs in diabetic skin was prominent. Less hydroxyproline, higher myeloperoxidase activity, and increased MDA content were detected in diabetic skin. In vitro, the time- and dose-dependent inhibitory effects of AGE-BSA on fibroblast viability as well as the fact that AGE-BSA could promote MDA production of fibroblasts were shown. It is shown that the accumulation of AGEs in diabetic skin tissue induces an oxidative damage of fibroblasts and acts as an important contributor to the thinner diabetic abdominal dermis. The authors believe that diabetic cutaneous properties at baseline may increase the susceptibility to injury, and diabetic wounds possess atypical origin in the repair process.

  5. Pituitary gland and pregnancy.

    PubMed

    Foyouzi, Nastaran; Frisbaek, Yr; Norwitz, Errol R

    2004-12-01

    The hypothalamic-pituitary-adrenal axis is central to mammalian reproductive function, including conception, pregnancy maintenance, parturition, and breastfeeding. Pregnancy is associated with substantial physiologic changes within this endocrine axis to meet the demands of pregnancy, which include support of the fetus (volume support, nutritional and oxygen supply, clearance of fetal waste), protection of the fetus (from starvation, drugs, toxins), preparation of the uterus for labor, and protection of the mother from potential cardiovascular injury at delivery. This article reviews the anatomy, embryology, and physiology of the pituitary. The effect of pregnancy on pituitary structure and function, in health and disease, also is discussed.

  6. [Hypertension and pregnancy].

    PubMed

    Rosas, Martín; Lomelí, Catalina; Mendoza-González, Celso; Lorenzo, José Antonio; Méndez, Arturo; Férez Santander, Sergio Mario; Attie, Fause

    2008-01-01

    Increasing evidence indicates that hypertension in pregnancy is an under recognized risk factor for cardiovascular disease (CVD). Compared with women who have had normotensive pregnancies, those who are hypertensive during pregnancy are at greater risk of cardiovascular and cerebrovascular events and have a less favorable overall risk profile for CVD years after the affected pregnancies. One factor that might underlie this relationship is that hypertensive disorders of pregnancy (pre-eclampsia, in particular) and CVD share several common risk factors (e.g. obesity, diabetes mellitus and renal disease). Alternatively, hypertension in pregnancy could induce long-term metabolic and vascular abnormalities that might increase the overall risk of CVD later in life. In both cases, evidence regarding risk-reduction interventions specific to women who have had hypertensive pregnancies is lacking. While awaiting results of large-scale studies, hypertensive disorders of pregnancy should be screened for during assessment of a woman's overall risk profile for CVD. Women at high risk must be monitored closely for conventional risk factors that are common to both CVD and hypertensive disorders of pregnancy and treated according to current evidence-based national guidelines.

  7. Hyperthyroidism and pregnancy.

    PubMed

    Gargallo Fernández, Manuel

    2013-11-01

    Association of hyperthyroidism and pregnancy is not an unusual event, and has an impact on both the mother and fetus. After delivery, it may also affect the newborn and the nursing mother. Clinical management of this situation is quite different from that required by non-pregnant hyperthyroid women and poses significant diagnostic and therapeutic challenges. This review addresses aspects related to the unique characteristics of biochemical assessment of thyroid function in pregnancy, the potential causes of hyperthyroidism in pregnancy, and the clinical and therapeutic approach in each case. Special attention is paid to pregnancy complicated with Graves' disease and its different the maternal, fetal, neonatal, and postnatal consequences.

  8. Pregnancy and Lupus Nephritis.

    PubMed

    Kattah, Andrea G; Garovic, Vesna D

    2015-09-01

    The management of lupus nephritis in pregnancy presents a diagnostic and therapeutic challenge for providers. Pregnancy creates a series of physiologic changes in the immune system and kidney that may result in an increased risk of disease flare and adverse maternal and fetal outcomes, such as preeclampsia, fetal loss, and preterm delivery. Conception should be delayed until disease is in remission to ensure the best pregnancy outcomes. Maternal disease activity and fetal well-being should be monitored closely by an interdisciplinary team, including obstetricians, rheumatologists, and nephrologists throughout pregnancy. Careful attention must be paid to the dosing and potential teratogenicity of medications.

  9. [Liver diseases and pregnancy].

    PubMed

    Guettrot-Imbert, G; Plessier, A; Hillaire, S; Delluc, C; Leroux, G; Le Guern, V; Costedoat-Chalumeau, N

    2015-03-01

    Liver disease can be observed in pregnant women whether or not related to pregnancy. Liver disorders can be revealed by pruritus, vomiting, jaundice or abnormal liver blood tests during pregnancy. These liver manifestations can lead to the diagnosis of liver disease specifically associated to pregnancy as intrahepatic pregnancy, intrahepatic cholestasis of pregnancy, Hyperemesis gravidarum, acute fatty liver of pregnancy and preeclampsia-induced liver injury. Pregnancy may also be a risk factor for other liver diseases coincident with pregnancy as viral hepatitis, thrombosis, drug toxicity or gallstone. Finally, pre-existing liver disease must be taken into account given the risk of fœto-maternal transmission risk as well as the risk of decompensation of underlying cirrhosis secondary to the hemodynamic changes caused by pregnancy. The aim of this revue is to perform an update on the various situations that can be observed, the principles of management of these liver diseases, in order to reduce the risk of complications and to ensure the best maternal and fetal prognosis.

  10. Neuromuscular disorders in pregnancy.

    PubMed

    Guidon, Amanda C; Massey, E Wayne

    2012-08-01

    Preexisting and coincident neuromuscular disorders in pregnancy are challenging for clinicians because of the heterogeneity of disease and the limited data in the literature. Many questions arise regarding the effect of disease on the pregnancy, delivery, and newborn in addition to the effect of pregnancy on the course of disease. Each disorder has particular considerations and possible complications. An interdisciplinary team of physicians is essential. This article discusses the most recent literature on neuromuscular disorders in pregnancy including acquired root, plexus, and peripheral nerve lesions; acquired and inherited neuropathies and myopathies; disorders of the neuromuscular junction; and motor neuron diseases.

  11. Hypertensive Emergencies in Pregnancy.

    PubMed

    Olson-Chen, Courtney; Seligman, Neil S

    2016-01-01

    The prevalence of hypertensive disorders in pregnancy is increasing. The etiology and pathophysiology of hypertensive disorders in pregnancy remain poorly understood. Hypertensive disorders are a major cause of maternal and perinatal morbidity and mortality. Treatment of hypertension decreases the incidence of severe hypertension, but it does not impact rates of preeclampsia or other pregnancy complications. Several antihypertensive medications are commonly used in pregnancy, although there is a lack of randomized controlled trials. Severe hypertension should be treated immediately to prevent maternal end-organ damage. Appropriate antepartum, intrapartum, and postpartum management is important in caring for patients with hypertensive disorders.

  12. Venous thromboembolism and pregnancy

    PubMed Central

    D’Uva, Maristella; Di Micco, Pierpaolo; Strina, Ida; De Placido, Giuseppe

    2010-01-01

    In recent decades, the association between a hypercoagulable state and its causes and adverse pregnancy outcome, in particular recurrent pregnancy loss (RPL) has been studied extensively. Although the first studies were focused only on the association between thrombophilia and RPL, subsequent studies underlined also a potential role of antithrombotic treatment to prevent vascular complication such as venous thromboembolism (VTE) during pregnancy. Thromboprophylaxis should be considered also for pregnant subjects carriers of molecular thrombophilia or that previously experienced VTE, in order to prevent VTE during pregnancy, while antithrombotic treatment for VTE should be performed during all pregnant periods. PMID:22282678

  13. Renal disease in pregnancy.

    PubMed

    Thorsen, Martha S; Poole, Judith H

    2002-03-01

    Anatomic and physiologic adaptations within the renal system during pregnancy are significant. Alterations are seen in renal blood flow and glomerular filtration, resulting in changes in normal renal laboratory values. When these normal renal adaptations are coupled with pregnancy-induced complications or preexisting renal dysfunction, the woman may demonstrate a reduction of renal function leading to an increased risk of perinatal morbidity and mortality. This article will review normal pregnancy adaptations of the renal system and discuss common pregnancy-related renal complications.

  14. Abdominal aortic aneurysms in women

    PubMed Central

    Lo, Ruby C.; Schermerhorn, Marc L.

    2015-01-01

    Abdominal aortic aneurysm (AAA) has long been recognized as a condition predominantly afflicting males, with sex-associated differences described for almost every aspect of the disease from pathophysiology and epidemiology to morbidity and mortality. Women are generally spared from AAA formation by the immunomodulating effects of estrogen but once they develop, the natural history of AAAs in women appears to be more aggressive, with more rapid expansion, a higher tendency to rupture at smaller diameters, and higher mortality following rupture. However, simply repairing AAA at smaller diameters in women is a debatable solution, as even elective endovascular AAA repair (EVAR) is fraught with higher morbidity and mortality in women compared to men. The goal of this review is to summarize what is currently known about the effect of gender on AAA presentation, treatment, and outcomes. Additionally, we aim to review current controversies over screening recommendations and threshold for repair in women. PMID:26747679

  15. Acute fatty liver of pregnancy associated with severe acute pancreatitis: A case report.

    PubMed

    de Oliveira, Cássio Vieira; Moreira, Alecsandro; Baima, Julio P; Franzoni, Leticia de C; Lima, Talles B; Yamashiro, Fabio da S; Coelho, Kunie Yabuki Rabelo; Sassaki, Ligia Y; Caramori, Carlos Antonio; Romeiro, Fernando G; Silva, Giovanni F

    2014-07-27

    Acute fatty liver of pregnancy is a rare disease that affects women in the third trimester of pregnancy. Although infrequent, the disease can cause maternal mortality. The diagnosis is not always clear until the pregnancy is terminated, and significant complications, such as acute pancreatitis, can occur. Pancreatic involvement typically only occurs in severe cases after the development of hepatic and renal impairment. To date, little knowledge is available regarding how the disease causes pancreatitis. Treatment involves supportive measures and pregnancy interruption. In this report, we describe a case of a previously healthy 26-year-old woman at a gestational age of 27 wk and 6 d who was admitted with severe abdominal pain and vomiting. This case illustrates the clinical and laboratory overlap between acute fatty liver of pregnancy and pancreatitis, highlighting the difficulties in differentiating each disease. Furthermore, the hypothesis for this overlapping is presented, and the therapeutic options are discussed.

  16. Pulmonary complications of abdominal wall defects.

    PubMed

    Panitch, Howard B

    2015-01-01

    The abdominal wall is an integral component of the chest wall. Defects in the ventral abdominal wall alter respiratory mechanics and can impair diaphragm function. Congenital abdominal wall defects also are associated with abnormalities in lung growth and development that lead to pulmonary hypoplasia, pulmonary hypertension, and alterations in thoracic cage formation. Although infants with ventral abdominal wall defects can experience life-threatening pulmonary complications, older children typically experience a more benign respiratory course. Studies of lung and chest wall function in older children and adolescents with congenital abdominal wall defects are few; such investigations could provide strategies for improved respiratory performance, avoidance of respiratory morbidity, and enhanced exercise ability for these children.

  17. The Flu Vaccine and Pregnancy

    MedlinePlus

    ... Events Advocacy For Patients About ACOG The Flu Vaccine and Pregnancy Home For Patients Search FAQs The ... Spanish FAQ189, October 2015 PDF Format The Flu Vaccine and Pregnancy Pregnancy What is influenza (the flu)? ...

  18. Understanding Pregnancy and Birth Issues

    MedlinePlus

    ... Navigation Bar Home Current Issue Past Issues Understanding Pregnancy and Birth Issues Past Issues / Winter 2008 Table ... turn Javascript on. What is a High-Risk Pregnancy? All pregnancies involve a certain degree of risk ...

  19. Glucose screening tests during pregnancy

    MedlinePlus

    Oral glucose tolerance test - pregnancy; OGTT - pregnancy; Glucose challenge test - pregnancy; Gestational diabetes - glucose screening ... first step, you will have a glucose screening test: You DO NOT need to prepare or change ...

  20. Percutaneous transhepatic drainage of inaccessible abdominal abscesses following abdominal surgery under real-time CT-fluoroscopic guidance.

    PubMed

    Yamakado, Koichiro; Takaki, Haruyuki; Nakatsuka, Atsuhiro; Kashima, Masataka; Uraki, Junji; Yamanaka, Takashi; Takeda, Kan

    2010-02-01

    This study evaluated the safety, feasibility, and clinical utility of transhepatic drainage of inaccessible abdominal abscesses retrospectively under real-time computed tomographic (CT) guidance. For abdominal abscesses, 12 consecutive patients received percutaneous transhepatic drainage. Abscesses were considered inaccessible using the usual access route because they were surrounded by the liver and other organs. The maximum diameters of abscesses were 4.6-9.5 cm (mean, 6.7 +/- 1.4 cm). An 8-Fr catheter was advanced into the abscess cavity through the liver parenchyma using real-time CT fluoroscopic guidance. Safety, feasibility, procedure time, and clinical utility were evaluated. Drainage catheters were placed with no complications in abscess cavities through the liver parenchyma in all patients. The mean procedure time was 18.8 +/- 9.2 min (range, 12-41 min). All abscesses were drained. They shrank immediately after catheter placement. In conclusions, this transhepatic approach under real-time CT fluoroscopic guidance is a safe, feasible, and useful technique for use of drainage of inaccessible abdominal abscesses.

  1. Rare case of primary peritoneal pregnancy infiltrated into the Gerota's fascia of the right kidney.

    PubMed

    Chishima, Fumihisa; Kato-Suzuki, Erina; Ichikawa, Go; Hayashi, Chuyu; Ohni, Sumie; Yamamoto, Tatsuo

    2013-05-01

    A 33-year-old, gravida 3, para 2, woman was transferred to our hospital, with acute abdominal pain. Abdominal computed tomography (CT) revealed a cystic lesion accompanied by ring-enhancement between the liver and right kidney with fluid collection in the pelvic cavity. Serum hCG value was 3100 mIU/mL. Transvaginal sonography revealed a pseudo-gestational sac in a thickened endometrium. With a preoperative diagnosis of ectopic pregnancy at 7 weeks of gestation, laparotomy was performed. Following careful removal of clots between the liver and right kidney that contained a gestational sac, continuous bleeding from a defect in the Gerota's fascia of the right kidney was noted. The postoperative course was uneventful and the serum hCG concentration decreased markedly. This case demonstrates that the Gerota's fascia is a possible site of ectopic pregnancy, and that CT can identify a pregnancy in the Gerota's fascia as well as in the liver and spleen.

  2. Pregnancy in women with congenital heart disease.

    PubMed

    Greutmann, Matthias; Pieper, Petronella G

    2015-10-01

    Congenital heart defects are the most common birth defects. Major advances in open-heart surgery have led to rapidly evolving cohorts of adult survivors and the majority of affected women now survive to childbearing age. The risk of cardiovascular complications during pregnancy and peripartum depends on the type of the underlying defect, the extent and severity of residual haemodynamic lesions and comorbidities. Careful individualized, multi-disciplinary pre-pregnancy risk assessment and counselling, including assessment of risks in the offspring and estimation on long-term outcomes of the underlying heart defect, will enable informed decision making. Depending on the estimated risks, a careful follow-up plan during pregnancy as well as a detailed plan for delivery and postpartum care can reduce the risks and should be made by the multi-disciplinary team.

  3. The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper.

    PubMed

    Sartelli, Massimo; Abu-Zidan, Fikri M; Ansaloni, Luca; Bala, Miklosh; Beltrán, Marcelo A; Biffl, Walter L; Catena, Fausto; Chiara, Osvaldo; Coccolini, Federico; Coimbra, Raul; Demetrashvili, Zaza; Demetriades, Demetrios; Diaz, Jose J; Di Saverio, Salomone; Fraga, Gustavo P; Ghnnam, Wagih; Griffiths, Ewen A; Gupta, Sanjay; Hecker, Andreas; Karamarkovic, Aleksandar; Kong, Victor Y; Kafka-Ritsch, Reinhold; Kluger, Yoram; Latifi, Rifat; Leppaniemi, Ari; Lee, Jae Gil; McFarlane, Michael; Marwah, Sanjay; Moore, Frederick A; Ordonez, Carlos A; Pereira, Gerson Alves; Plaudis, Haralds; Shelat, Vishal G; Ulrych, Jan; Zachariah, Sanoop K; Zielinski, Martin D; Garcia, Maria Paula; Moore, Ernest E

    2015-01-01

    The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual infection, control any persistent source of infection, and remove more effectively infected or cytokine-loaded peritoneal fluid, preventing abdominal compartment syndrome and deferring definitive intervention and anastomosis until the patient is appropriately resuscitated and hemodynamically stable and thus better able to heal. However, the OA may require multiple returns to the operating room and may be associated with significant complications, including enteroatmospheric fistulas, loss of abdominal wall domain and large hernias. Surgeons should be aware of the pathophysiology of severe intra-abdominal sepsis and always keep in mind the option of using open abdomen to be able to use it in the right patient at the right time.

  4. Primary aldosteronism and pregnancy.

    PubMed

    Landau, Ester; Amar, Laurence

    2016-06-01

    Hypertension (HT) is a complication of 8% of all pregnancies and 10% of HT cases are due to primary aldosteronism (PA). There is very little data on PA and pregnancy. Given the changes in the renin angiotensin system during pregnancy, the diagnosis of PA is difficult to establish during gestation. It may be suspected in hypertensive patients with hypokalemia. A comprehensive literature review identified reports covering 40 pregnancies in patients suffering from PA. Analysis of these cases shows them to be high-risk pregnancies leading to maternal and fetal complications. Pregnancy must be programmed, and if the patient has a unilateral form of PA, adrenalectomy should be performed prior to conception. It is customary to stop spironolactone prior to conception and introduce antihypertensive drugs that present no risk of teratogenicity. When conventional antihypertensive drugs used during pregnancy fail to control high blood pressure, diuretics, including potassium-sparing diuretics may be prescribed. Adrenalectomy can be considered during the second trimester of pregnancy exclusively in cases of refractory hypertension. A European retrospective study is currently underway to collect a larger number of cases.

  5. Epilepsy and Pregnancy

    MedlinePlus

    ... Birth Control Family HealthInfants and Toddlers Kids and Teens Pregnancy and Childbirth Women Men SeniorsIn The NewsYour Health ... Birth Control Family HealthInfants and Toddlers Kids and Teens Pregnancy and Childbirth Women Men SeniorsIn The NewsYour Health ...

  6. Bisphosphonate Treatment and Pregnancy

    MedlinePlus

    ... splenectomy, bisphosphonate therapy, use of biomarkers and bone disease monitoring. J Inherit Metab Dis. 31: 319-336. Djokanovic N et al. 2008. Does treatment with Bisphosphonates endanger the human pregnancy? J ... pregnancy in Gaucher disease. Thromb Haemost, 156:3-8. Green SB, Pappas ...

  7. Pregnancy and Healthy Weight

    MedlinePlus

    ... Profiles Multimedia Pregnancy & Healthy Weight Skip sharing on social media links Share this: Page Content New research shows that maintaining a healthy weight before and during pregnancy can reduce the likelihood of negative effects for mothers and babies We’ve heard the ...

  8. Prolactinomas, cabergoline, and pregnancy.

    PubMed

    Glezer, Andrea; Bronstein, Marcello D

    2014-09-01

    Hyperprolactinemia, frequently caused by a prolactinoma, is an important cause of infertility among young women. Dopamine agonists (DA) are the treatment of choice. Although cabergoline (CAB) is currently considered the gold standard DA, bromocriptine (BRC) remains the drug of choice for women desiring pregnancy, as it was proven to be safe in more than 6,000 pregnancies. The purpose of this review is to perform a critical evaluation of CAB safety in pregnancy, as it is used by most patients harboring prolactinomas. Although the number of CAB-induced pregnancies (about 800) is still reduced as compared with those under BRC treatment, data in the literature do not point to increase risk of preterm delivery or fetal malformations, comparing to pregnancies induced by BRC and those in the general population. Moreover, CAB use throughout pregnancy was reported in about ten cases, without evidence of any harm to fetal development. Therefore, even though BRC still remains the recommended DA drug for pregnancy induction or use during pregnancy in women with prolactinomas, increasing evidences point to the safety of CAB for this purpose.

  9. Pregnancy and IBD

    MedlinePlus

    ... toxic effects on the developing fetus or newborn. EFFECT OF PREGNANCY ON WOMEN WITH IBD Women should be well before becoming ... resections do not appear to have any negative effects on pregnancy in women with Crohn’s disease. Women also have had successful ...

  10. Ultrasound imaging in the management of bleeding and pain in early pregnancy.

    PubMed

    Knez, Jure; Day, Andrea; Jurkovic, Davor

    2014-07-01

    Bleeding and pain are experienced by 20% of women during the first trimester of pregnancy. Although most pregnancies complicated by pain and bleeding tend to progress normally, these symptoms are distressing for woman, and they are also associated with an increased risk of miscarriage and ectopic pregnancy. Ultrasound is the first and often the only diagnostic modality that is used to determine location of early pregnancy and to assess its health. Ultrasound is an accurate, safe, painless and relatively inexpensive diagnostic tool, which all contributed to its widespread use in early pregnancy. Pain and bleeding in early pregnancy are sometimes caused by concomitant gynaecological, gastrointestinal, and urological problems, which could also be detected on ultrasound scan. In women with suspected intra-abdominal bleeding, ultrasound scan can be used to detect the presence of blood and provide information about the extent of bleeding. In this chapter, we comprehensively review the use of ultrasound in the diagnosis and management of early pregnancy complications. We include information about the diagnosis of gynaecological and other pelvic abnormalities, which could cause pain or bleeding in pregnancy. We also provide a summary of the current views on the safety of ultrasound in early pregnancy.

  11. Intestinal injury mechanisms after blunt abdominal impact.

    PubMed

    Cripps, N P; Cooper, G J

    1997-03-01

    Intestinal injury is frequent after non-penetrating abdominal trauma, particularly after modern, high-energy transfer impacts. Under these circumstances, delay in the diagnosis of perforation is a major contributor to morbidity and mortality. This study establishes patterns of intestinal injury after blunt trauma by non-penetrating projectiles and examines relationships between injury distribution and abdominal wall motion. Projectile impacts of variable momentum were produced in 31 anaesthetised pigs to cause abdominal wall motion of varying magnitude and velocity. No small bowel injury was observed at initial impact velocity of less than 40 m/s despite gross abdominal compression. At higher velocity, injury to the small bowel was frequent, irrespective of the degree of abdominal compression (P = 0.00044). Large bowel injury was observed at all impact velocities and at all degrees of abdominal compression. This study confirms the potential for intestinal injury in high velocity, low momentum impacts which do not greatly compress the abdominal cavity and demonstrates apparent differences in injury mechanisms for the small bowel and colon. Familiarity with injury mechanisms may reduce delays in the diagnosis of intestinal perforation in both military and civilian situations.

  12. Traumatic abdominal hernia complicated by necrotizing fasciitis.

    PubMed

    Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa

    2014-11-01

    Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption.

  13. The prognosis of childhood abdominal migraine

    PubMed Central

    Dignan, F; Abu-Arafeh, I; Russell, G

    2001-01-01

    AIMS—To determine the clinical course of childhood abdominal migraine, seven to 10 years after the diagnosis.
METHODS—A total of 54 children with abdominal migraine were studied; 35 were identified from a population survey carried out on Aberdeen schoolchildren between 1991 and 1993, and 19 from outpatient records of children in the same age group who had attended the Royal Aberdeen Children's Hospital. Controls were 54 children who did not have abdominal pain in childhood, matched for age and sex, obtained from either the population survey or the patient administration system. Main outcome measures were presence or resolution of abdominal migraine and past or present history of headache fulfilling the International Headache Society (IHS) criteria for the diagnosis of migraine.
RESULTS—Abdominal migraine had resolved in 31 cases (61%). Seventy per cent of cases with abdominal migraine were either current (52%) or previous (18%) sufferers from headaches that fulfilled the IHS criteria for migraine, compared to 20% of the controls.
CONCLUSIONS—These results support the concept of abdominal migraine as a migraine prodrome, and suggest that our diagnostic criteria for the condition are robust.

 PMID:11316687

  14. [Cervical pregnancy. Three cases].

    PubMed

    Plascencia Moncayo, Norberto; Hernández, María de la Paz; Guadarrama Sánchez, Rafael; Guerra Becerra, Leticia; Salmón Vélez, J Fernando G; Galván Aguilera, Alejandro

    2008-12-01

    We describe cervical pregnancy concept and its rareness. Its frequency is one in 2,550 to 98,000 intrauterine pregnancies. Predisposing factors are related with endometrial damage due to uterine curettages and previous cesarian section. Clinical picture was nonspecific and diagnosis was based in endovaginal ultrasonography. It can cause massive bleeding and put life in risk. During 2007 we attend 829 intrauterine pregnancies at Hospital San José de Querétaro: 11 tubal, and 3 cervical, this represents an extraordinarily high frequency of cervical pregnancy. Here we report three cases of cervical pregnancies treated with total hysterectomy, two as urgency and one elective. We remark early diagnosis importance to perform conservative treatment and maintain reproductive function.

  15. Diabetic nephropathy and pregnancy.

    PubMed

    Landon, Mark B

    2007-12-01

    Diabetic nephropathy, the most common etiology for end-stage renal disease, complicates approximately 5% of insulin-dependent diabetic pregnancies. Assessment for vasculopathy is important before pregnancy because nephropathy can increase perinatal risks including potential for preeclampsia and preterm birth. Counseling women receiving renoprotective medications including angiotensin converting enzyme inhibitors has recently become complicated in light of new information suggesting a teratogenic risk for these agents. Most reproductive age women with overt diabetic nephropathy have preserved renal function and do not seem to have the progression of their disease affected by pregnancy. Perinatal outcomes are excellent for these women who have received care in tertiary institutions. However, there are relatively few women with significant renal impairment included in case series of pregnancies complicated by diabetic nephropathy. For these women, adverse perinatal outcomes are more common, and the effect of pregnancy on the course of their disease is less certain.

  16. [Ectopic pregnancy in Senegal].

    PubMed

    Cissé, Cheikh A Tidiane; Bernis, Luc De; Faye, El Hadj Ousseynou; Diadhiou, Fadel

    2002-01-01

    The objective of this prospective study was to analyse the epidemiology and prognosis of ectopic pregnancy in Senegal. From January 1 to December 31, 1996, 255 ectopic pregnancies were registered. The national rate of ectopic pregnancy was 0.6%. of expected pregnancies. However, rates differed greatly between areas in Senegal, with extremes ranging from 0.85%. in Dakar to 0.32%. in Thiès. The epidemiological profile was that of a young woman-mean age: 23 years old, mean parity=3, admitted with broken ectopic pregnancy (95%). A salpingectomy was performed in all cases. The maternal mortality rate was 1.20%, while morbidity, mainly due to post-operative infection, was found in 2.7% of the cases.

  17. Hypertension in pregnancy.

    PubMed

    Vest, Amanda R; Cho, Leslie S

    2014-03-01

    Hypertensive disorders of pregnancy represent the second commonest cause of direct maternal death and complicate an estimated 5-10 % of pregnancies. Classification systems aim to separate hypertension similar to that seen outside pregnancy (chronic and gestational hypertension) from the potentially fatal pregnancy-specific conditions. Preeclampsia, HELLP syndrome, and eclampsia represent increasing severities of this disease spectrum. The American College of Obstetricians and Gynecologists' 2013 guidelines no longer require proteinuria as a diagnostic criterion, because of its variable appearance in the disease spectrum. The cause involves inadequate cytotrophoblastic invasion of the myometrium, resulting in placental hypoperfusion and diffuse maternal endothelial dysfunction. Changes in angiogenic and antiangiogentic peptide profiles precede the onset of clinical preeclampsia. Women with preeclampsia should be closely monitored and receive magnesium sulfate intravenously if severe features, HELLP syndrome, or eclampsia occur. Definitive therapy is delivery of the fetus. Hypertension in pregnancy increases future maternal risk of hypertension and cardiovascular disorders.

  18. Primary aldosteronism and pregnancy.

    PubMed

    Morton, Adam

    2015-10-01

    Primary aldosteronism is the most common cause of secondary hypertension. Less than 50 cases of pregnancy in women with primary aldosteronism have been reported, suggesting the disorder is significantly underdiagnosed in confinement. Accurate diagnosis is complicated by physiological changes in the renin-angiotensin-aldosterone axis in pregnancy, leading to a risk of false negative results on screening tests. The course of primary aldosteronism during pregnancy is highly variable, although overall it is associated with a very high risk of fetal and maternal morbidity and mortality. The optimal management of primary aldosteronism during pregnancy is unclear, with uncertainty regarding the safety of mineralocorticoid antagonists and amiloride, their relative efficacy compared with the antihypertensive medications commonly used during pregnancy, and as to whether prognosis is improved by laparoscopic adrenalectomy where an adrenal adenoma can be demonstrated.

  19. Thrombocytopenia in pregnancy.

    PubMed

    Palta, A; Dhiman, P

    2016-01-01

    Thrombocytopenia during pregnancy is quite common. Evaluation of blood counts of pregnant women has shown that thrombocytopenia is the second most common haematological problem in pregnancy, after anaemia. While mostly thrombocytopenia has no consequences for either the mother or the foetus, in some cases it is associated with substantial maternal and/or neonatal morbidity and mortality. It may result from a number of diverse aetiologies. Adequate knowledge of these causes will help the clinicians in making proper diagnosis and management of thrombocytopenia in pregnancy. The evaluation of thrombocytopenia is essential to rule out any systemic disorders that may affect pregnancy management as thrombocytopenia can present as an isolated finding or in combination with underlying conditions. In this concise review, we have provided the overview of thrombocytopenia diagnosed during pregnancy.

  20. Management of intra-abdominal hypertension and abdominal compartment syndrome: a review

    PubMed Central

    2014-01-01

    Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Aim: This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function. PMID:24499574

  1. A comprehensive review of hypertension in pregnancy.

    PubMed

    Mustafa, Reem; Ahmed, Sana; Gupta, Anu; Venuto, Rocco C

    2012-01-01

    Hypertension is the most common medical disorder encountered during pregnancy. Hypertensive disorders are one of the major causes of pregnancy-related maternal deaths in the United States. We will present a comprehensive update of the literature pertinent to hypertension in pregnancy. The paper begins by defining and classifying hypertensive disorders in pregnancy. The normal vascular and renal physiological changes which occur during pregnancy are detailed. We will summarize the intriguing aspects of pathophysiology of preeclampsia, emphasizing on recent advances in this field. The existing diagnostic tools and the tests which have been proposed for screening preeclampsia are comprehensively described. We also highlight the short- and long-term implications of preeclampsia. Finally, we review the current management guidelines, goals of treatment and describe the potential risks and benefits associated with various antihypertensive drug classes. Preeclampsia still remains an enigma, and the present management focuses on monitoring and treatment of its manifestations. We are hopeful that this in depth critique will stimulate the blossoming research in the field and assist practitioners to identify women at risk and more effectively treat affected individuals.

  2. Pregnancy in end stage renal disease.

    PubMed

    Hladunewich, Michelle; Hercz, Adam Engel; Keunen, Johannes; Chan, Christopher; Pierratos, Andreas

    2011-01-01

    The ovulatory menstrual cycle is known to be affected on multiple levels in women with advanced renal disease. Menstrual irregularities, sexual dysfunction, and infertility worsen in parallel with the renal disease. Pregnancy in women with ESRD on dialysis is therefore uncommon. Furthermore, when pregnancy does occur, it can prove hazardous to both mother and baby owing to a multitude of potential complications including accelerated hypertension and preeclampsia, poor fetal growth, anemia, and polyhydramnios. Data are emerging, however, to suggest that pregnancy while on intensified renal replacement regimens may result in better pregnancy outcomes, and emerging trends include the decreased rate of therapeutic abortions probably reflecting a change in counseling practices over time. Nevertheless, a pregnant woman on intensive dialysis requires meticulous follow-up by a dedicated team including nephrology, obstetrics, and a full multidisciplinary staff. In this article, we will address fertility issues in young women with ESRD, review pregnancy outcomes in women on both hemodialysis and peritoneal dialysis, and provide suggestions for the management of the pregnant women on intensive hemodialysis.

  3. Torsion of an intra-abdominal testis.

    PubMed

    Lewis; Roller; Parra; Cotlar

    2000-09-01

    To present a case of torsion of a nonneoplastic intra-abdominal testis with an unusual clinical presentation.A 26-year-old active duty Navy Petty Officer presented to the emergency department on 3 occasions over a 5-day period with lower abdominal pain. Physical examination demonstrated acute tenderness in the left lower quadrant with sugestion of a normal spermatic cord and atrophic testis in the left scrotum. Computed tomography scan demonstrated an intra-abdominal lesion near the internal inguinal ring. The patient underwent surgical exploration through an inguinal incision. Torsion of a nonviable intra-abdominal testis was present. The scrotum contained only the vas deferens and cremasteric muscle. An orchiectomy was performed with removal of the vas deferens and other cord structures.The unusual clinical finding of acute torsion of an intra-abdominal testis, associated with an apparent atrophic scrotal testis, presented a confusing clinical picture. Computed tomography scan did not clarify the issue sufficiently to establish a definite preoperative diagnosis. Clinical suspicion prompted early surgical intervention. Review of the current literature produced 60 reported cases of torsion of an intra-abdominal testis. Two thirds of these involved testicular neoplasm, usually seminoma. Although the clinical presentation varied, most patients had recent onset of lower abdominal pain associated with tenderness and, in half the cases, a mass. Patients almost always presented with an absent scrotal testis on the involved side, and not infrequently reported previous surgery thought to be an orchiectomy.Diagnosis of an intra-abdominal testicular torsion is rare, particularly when no neoplasm is present. A high index of suspicion must be maintained whenever there is abdominal pain and undescended testis. The surgical history and imaging studies may not clarify a confusing clinical picture.

  4. [Laparoscopic abdominal drainage by sterile destructive pancreatitis].

    PubMed

    Kuznetsov, N A; Rodoman, G V; Shalaeva, T I; Trefilova, O I; Sosikova, N L

    2009-01-01

    90 patients with acute pancreatitis were observed, in 60 of them laparoscopic drainage was performed. The procedure by sterile pancreatonecrosis is indicated only in presence of extent amount of exudate in abdominal cavity. Duration of draining the abdominal cavity should be strictly limited because of the high risk of septic complications. Contraindications for the abdominal drainage by acute necrotic pancreatitis are not only adhesions in the abdomen and shock state of the patient at the moment of procedure necessity, but also unstable hemodynamics in anamnesis and even by the arterial pressure downtrend.

  5. Soft tissue coverage in abdominal wall reconstruction.

    PubMed

    Baumann, Donald P; Butler, Charles E

    2013-10-01

    Abdominal wall defects requiring soft tissue coverage can be either partial-thickness defects or full-thickness composite defects. Soft tissue flap reconstruction offers significant advantages in defects that cannot be closed primarily. Flap reconstruction is performed in a single-stage procedure obviating chronic wound management. If the defect size exceeds the availability of local soft tissue for coverage, regional pedicled flaps can be delivered into the abdominal wall while maintaining blood supply from their donor site. Microsurgical free tissue transfer increases the capacity to provide soft tissue coverage for abdominal wall defects that are not amenable to either local or regional flap coverage.

  6. Laparoscopic repair of abdominal incisional hernia

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Abdominal incisional hernia is a common complication after open abdominal operations. Laparoscopic procedures have obvious mini-invasive advantages for surgical treatment of abdominal incisional hernia, especially to cases with big hernia defect. Laparoscopic repair of incisional hernia has routine mode but the actual operations will be various according to the condition of every hernia. Key points of these operations include design of the position of trocars, closure of defects and fixation of meshes. The details of these issues and experiences of perioperative evaluation and treatment will be talked about in this article. PMID:27761446

  7. Abdominal wall defects: prenatal diagnosis, newborn management, and long-term outcomes.

    PubMed

    Gamba, Piergiorgio; Midrio, Paola

    2014-10-01

    Omphalocele and gastroschisis represent the most frequent congenital abdominal wall defects a pediatric surgeon is called to treat. There has been an increased reported incidence in the past 10 years mainly due to the diffuse use of prenatal ultrasound. The early detection of these malformations, and related associated anomalies, allows a multidisciplinary counseling and planning of delivery in a center equipped with high-risk pregnancy assistance, pediatric surgery, and neonatology. At present times, closure of defects, even in multiple stages, is always possible as well as management of most of cardiac-, urinary-, and gastrointestinal-associated malformations. The progress, herein discussed, in the care of newborns with abdominal wall defects assures most of them survive and reach adulthood. Some aspects of transition of medical care will also be considered, including fertility and cosmesis.

  8. Postoperative Adhesion Development Following Cesarean and Open Intra-Abdominal Gynecological Operations

    PubMed Central

    Awonuga, Awoniyi O.; Fletcher, Nicole M.; Saed, Ghassan M.; Diamond, Michael P.

    2011-01-01

    In this review, we discuss the pathophysiology of adhesion development, the impact of physiological changes associated with pregnancy on markers of adhesion development, and the clinical implications of adhesion development following cesarean delivery (CD). Although peritoneal adhesions develop after the overwhelming majority of intra-abdominal and pelvic surgery, there is evidence in the literature that suggests that patients having CD may develop adhesions less frequently. However, adhesions continue to be a concern after CD, and are likely significant, albeit on average less than after gynecological operations, but with potential to cause significant delay in the delivery of the baby with serious, lifelong consequences. Appreciation of the pathophysiology of adhesion development described herein should allow a more informed approach to the rapidly evolving field of intra-abdominal adhesions and should serve as a reference for an evidence-based approach to consideration for the prevention and treatment of adhesions. PMID:21775773

  9. Obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART compared with spontaneous pregnancy

    PubMed Central

    Pourali, Leila; Ayati, Sedigheh; Jelodar, Shahrzad; Zarifian, Ahmadreza; Sheikh Andalibi, Mohammad Sobhan

    2016-01-01

    Introduction: Regarding to the recent advances in assisted reproductive techniques (ART), twin and multiple pregnancies have increased during past years. Objective: This study was performed to compare obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART with spontaneous pregnancy. Materials and Methods: In this cross-sectional study which was performed in Ghaem Hospital, Mashhad University of Medical Sciences, 107 dichorionic twin pregnancy were enrolled in two groups: spontaneous group (n=96) and ART group (n=31). Basic criteria and obstetrics and neonatal outcomes information including demographic data, gestational age, mode of delivery, pregnancy complications (preeclampsia, gestational diabetes, preterm labor, and intrauterine growth retardation (IUGR), postpartum hemorrhage), neonatal outcomes (weight, first and fifth minute Apgar score, Neonatal Intensive Care Unit (NICU) admission, mortality, respiratory distress, and icterus) were recorded using a questionnaire. Results: Preterm labor, gestational diabetes, and preeclampsia were significantly higher in ART group compared to spontaneous pregnancy group. However, other factors such as anemia, IUGR, postpartum hemorrhage, and intrauterine fetal death (IUFD) were not significantly different between groups. There were no significant differences between groups in terms of neonatal outcomes (weight, 1st and 5th min Apgar score <7, NICU hospitalization, mortality, respiratory distress, and icterus). Conclusion: With regard of significantly higher poor outcomes such as preeclampsia, gestational diabetes and preterm labor in ART group, the couples should be aware of these potential risks before choosing ART. PMID:27326416

  10. [Churg-Strauss abdominal manifestation].

    PubMed

    Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo

    2014-01-01

    Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.

  11. The Tribolium homeotic gene Abdominal is homologous to abdominal-A of the Drosophila bithorax complex

    NASA Technical Reports Server (NTRS)

    Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)

    1993-01-01

    The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.

  12. Hydatidiform mole presentation as a tubal ectopic pregnancy.

    PubMed

    Nakeer, Tabassum; Shahid, Muhammad; Ansari, Muhammad Asad; Nakeer, Rooham

    2014-05-01

    Presentation of hydatidiform mole as tubal ectopic pregnancy is very rare. These patients usually present with ectopic pregnancy and are later diagnosed with hydatidiform mole on the basis of histological examination following surgery. We present the case of a 32-year-old female who presented with abdominal pain and vaginal bleed since 2 days of presentation. She was vitally stable. There was mild tenderness in hypogastrium and left iliac fossa. Pelvic examination showed mild bleeding per vaginum and fullness in both fornices. The patient was suspected of having an ectopic pregnancy. Ultrasonography of pelvis revealed fluid in cul-de-sac and a sac like mass of 1.8 cm attached to the left ovary. On laparotomy, there was a left sided tubal ectopic pregnancy and subsequently left salpingectomy was done. Histopathology of the tissue sample showed features of partial hydatidiform mole. Ectopic pregnancy can present as hydatidiform mole in rare cases for which histological examination of the tissue is required to establish the diagnosis.

  13. Advance Provision of Emergency Contraception for Adolescents

    ERIC Educational Resources Information Center

    Adamji, Jehan-Marie; Swartwout, Kathryn

    2010-01-01

    Emergency contraception is most effective at preventing unintended pregnancy when taken as early as possible following unprotected sexual intercourse. Advance provision of this medication supports more timely and effective use. In the midst of rising teen pregnancy rates, current policies often limit access to emergency contraception for…

  14. Exercise in Pregnancy

    PubMed Central

    Hinman, Sally K.; Smith, Kristy B.; Quillen, David M.; Smith, M. Seth

    2015-01-01

    Context: Health professionals who care for pregnant women should discuss potential health benefits and harms of exercise. Although most pregnant women do not meet minimal exercise recommendations, there are a growing number of physically active women who wish to continue training throughout pregnancy. Evidence Acquisition: A search of the Web of Science database of articles and reviews available in English through 2014. The search terms exercise pregnancy, strenuous exercise pregnancy, and vigorous exercise pregnancy were used. Study Design: Clinical review. Level of Evidence: Level 3. Results: With proper attention to risk stratification and surveillance, exercise is safe for the mother and fetus. Benefits of exercise in pregnancy include reduction in Cesarean section rates, appropriate maternal and fetal weight gain, and managing gestational diabetes. Exercise as a means of preventing gestational diabetes, preeclampsia, or perinatal depression cannot be reliably supported. Overall, the current evidence suffers from a lack of rigorous study design and compliance with physical activity interventions. Conclusion: Research thus far has been unable to consistently demonstrate proposed benefits of exercise in pregnancy, such as preventing gestational diabetes, preeclampsia, or perinatal depression. However, moderate- and high-intensity exercise in normal pregnancies is safe for the developing fetus and clearly has several important benefits. Thus, exercise should be encouraged according to the woman’s preconception physical activity level. PMID:26502446

  15. Pregnancy in endurance athletes.

    PubMed

    Penttinen, J; Erkkola, R

    1997-08-01

    The purpose of the present study was to examine pregnancy and delivery among Finnish endurance athletes at the national top level. A questionnaire concerning first pregnancy was sent to 30 Finnish endurance athletes who had been at national top level in cross-country skiing, running, speed-skating or orienteering. Data on labour were collected retrospectively through a questionnaire and from the diaries in the hospital concerned. The next primipara in the diaries formed a member of the control group. Twenty-three athletes (77%) had regular menstrual cycles, seven (23%) had irregularities, and four of them had received hormonal treatment for this. Seven athletes (23%) had experienced spontaneous abortion during the first trimester in previous pregnancy. Sixteen (53%) did not notice any change in their exercise performance, three (10%) subjectively felt themselves to be in a better physical condition, and seven (23%) felt themselves to be in a worse condition than before the pregnancy. Four did not respond on the question. After delivery, 18 athletes continued to compete, the median interval being 8.2 months (range 2-24 months). Two of them (11%) achieved a better condition than before the pregnancy, 11 (61%) reached the same level and five (28%) did not achieve the same performance level. There were no significant differences in labour parameters between the athletes and controls. Endurance training had no harmful side-effects on the pregnancies or deliveries of the athletes. The effect of pregnancy on exercise performance is individual.

  16. Managing Prolactinomas during Pregnancy

    PubMed Central

    Almalki, Mussa Hussain; Alzahrani, Saad; Alshahrani, Fahad; Alsherbeni, Safia; Almoharib, Ohoud; Aljohani, Naji; Almagamsi, Abdurahman

    2015-01-01

    Prolactinomas are the most prevalent functional benign pituitary tumors due to a pituitary micro- or macroadenoma. The majority of patients presents with infertility and gonadal dysfunction. A dopamine agonist (DA) (bromocriptine or cabergoline) is the treatment of choice that can normalize prolactin levels, reduce tumor size, and restore ovulation and fertility. Cabergoline generally preferred over bromocriptine because of its higher efficacy and tolerability. Managing prolactinomas during pregnancy may be challenging. During pregnancy, the pituitary gland undergoes global hyperplasia due to a progressive increase in serum estrogens level that may lead to increase of the tumor volume with potential mass effect and visual loss. The risk of tumor enlargement may occur in 3% of those with microadenomas, 32% in those with macroadenomas that were not previously operated on, and 4.8% of those with macroadenomas with prior ablative treatment. Though both drugs appear to be safe during pregnancy, the data on fetal exposure to DAs during pregnancy have been reported with bromocriptine far exceeds that of cabergoline with no association of increased risk of pregnancy loss and premature delivery. It is advisable to stop the use of DAs immediately once pregnancy is confirmed, except in the case of women with invasive macroprolactinomas or pressure symptoms. This review outlines the therapeutic approach to prolactinoma during pregnancy, with emphasis on the safety of available DA therapy. PMID:26074878

  17. Anaemia in pregnancy.

    PubMed

    Goonewardene, Malik; Shehata, Mishkat; Hamad, Asma

    2012-02-01

    Anaemia in pregnancy, defined as a haemoglobin concentration (Hb) < 110 g/L, affects more than 56 million women globally, two thirds of them being from Asia. Multiple factors lead to anaemia in pregnancy, nutritional iron deficiency anaemia (IDA) being the commonest. Underlying inflammatory conditions, physiological haemodilution and several factors affecting Hb and iron status in pregnancy lead to difficulties in establishing a definitive diagnosis. IDA is associated with increased maternal and perinatal morbidity and mortality, and long-term adverse effects in the new born. Strategies to prevent anaemia in pregnancy and its adverse effects include treatment of underlying conditions, iron and folate supplementation given weekly for all menstruating women including adolescents and daily for women during pregnancy and the post partum period, and delayed clamping of the umbilical cord at delivery. Oral iron is preferable to intravenous therapy for treatment of IDA. B12 and folate deficiencies in pregnancy are rare and may be due to inadequate dietary intake with the latter being more common. These vitamins play an important role in embryo genesis and hence any relative deficiencies may result in congenital abnormalities. Finding the underlying cause are crucial to the management of these deficiencies. Haemolytic anaemias rare also rare in pregnancy, but may have life-threatening complications if the diagnosis is not made in good time and acted upon appropriately.

  18. Thrombophilia, thrombosis and pregnancy.

    PubMed

    Eldor, A

    2001-07-01

    The risk of venous thromboembolism (VTE) in pregnancy is 0.05-1.8%, six times greater than in the non-pregnant state, and pulmonary embolism remains the most common cause of maternal death. Maternal age, previous history of VTE, Caesarean section and the presence of thrombophilia, significantly increase the risk of VTE. Acquired or hereditary thrombophilia occur in almost two-thirds of women presenting with recurrent miscarriages, pre-eclampsia, intrauterine growth restriction, abruptio placentae, or stillbirth, which are associated with microvascular thrombosis in placental blood vessels. Women with VTE during pregnancy and especially those with thrombophilia require individualized management, based on the type of defect, the family history and the presence of additional risk factors. These factors are important in determining the dose and duration of antithrombotic therapy during pregnancy and the puerperium, and the thromboprophylactic strategy for future pregnancies. Oral anticoagulants are now seldom used during pregnancy because of their significant side effects. Low-molecular-weight heparins (LMWHs) are increasingly replacing unfractionated heparin in the prevention and treatment of VTE during pregnancy. LMWHs have also been shown to be effective in improving the outcome of pregnancy in women with previous obstetric complications.

  19. [Inflammatory aneurysms of the abdominal aorta].

    PubMed

    Tovar Martín, E; Acea Nebril, B

    1993-01-01

    Approximately 10 per cent of abdominal aneurysms have an excessively thick wall that sometimes involve duodenum, cava or colon by an inflammatory process. Between February 1986 and December 1992, 147 patients with abdominal aortic aneurysm (AAA) were treated surgically and in 13 (8.8%) the aneurysms were found to be inflammatory. Their mean age was 67.3 years (70.1 years in non inflammatory group) and all were symptomatics initially (abdominal pain in 53%, rupture in 23%, mass in 15%). The operative mortality for elective resection was 37% in patients with inflammatory abdominal aortic aneurysms (IAAA) decreasing to 9% in the AAA group without inflammatory involvement. We conclude that surgery is indicated in these patients to prevent rupture and to hasten the subsidense of inflammatory process ever with postoperative morbi-mortality increased.

  20. Intravenous dihydroergotamine therapy for pediatric abdominal migraines.

    PubMed

    Raina, Madiha; Chelimsky, Gisela; Chelimsky, Thomas

    2013-10-01

    Abdominal migraines present with debilitating symptoms in adolescence. At our institution, the gastroenterology, neurology, and autonomic departments collaborated in treating patients with such presentations. This case series describes 6 patients who were given intravenous dihydroergotamine (DHE) for presumed abdominal migraines. DHE was only used when other agents like amitriptyline, verapamil, topiramate, or depakote had proved ineffective. DHE was started at 0.5 mg dose and on average 7 to 9 mg were given on each hospitalization. Patient ages ranged from 13 to 19 years with the majority being female. One patient did not respond to treatment. One patient was admitted 4 times for symptoms of abdominal migraines resolving with DHE. The average time between symptom relapse was about 5 to 12 months. Five of our 6 patients responded to the infusion without significant side effects. Based on these case series, DHE may be a treatment option in children with intractable abdominal migraine.

  1. Abdominal miliary tuberculosis in a patient with AIDS: a case report.

    PubMed

    Pop, Monica; Pop, Cezar; Homorodean, Daniela; Itu, Corina; Man, Milena; Goron, Monica; Gherasim, Ruxandra; Coroiu, Georgiana

    2003-09-01

    We present a 34 year old patient, intravenous drug user, hospitalized with fever, distortion of general status, dry irritating cough, abdominal colicative pains, and we established the diagnosis of HIV infection advanced stage/AIDS; his antecedents revealed (August 2000) abdominal tuberculosis not treated during the last 3 months. He presented a pneumonia with Pneumocystis carinii during hospitalization. Death was due to a colon perforation with secundary peritonitis. Miliary tuberculous lesions in liver, spleen and colon were revealed at necropsy and cytomegalovirus was identified in necrotic samples also.

  2. Ovarian ectopic pregnancy in adolescence

    PubMed Central

    Andrade, Ana Gonçalves; Rocha, Sara; Marques, Catarina O; Simões, Mafalda; Martins, Isabel; Biscaia, Isabel; F Barros, Carlos

    2015-01-01

    Key Clinical Message Ovarian pregnancy is one of the rarest types of extrauterine pregnancy. Its preoperative diagnosis remains a challenge since it presents quite similarly to tubal pregnancy and complicated ovarian cysts. Although in most cases, histology is necessary to confirm the diagnosis, we present an ovarian pregnancy in a teenager, correctly diagnosed during ultrasound examination. PMID:26576271

  3. Pregnancy complicated with agranulocytosis

    PubMed Central

    Wang, Hai; Sun, Jiang-Li; Zhang, Zheng-Liang; Pei, Hong-Hong

    2016-01-01

    Abstract Rationale: Pregnancy is a complicated physiological process. Physiological leukocytosis often takes place and it is primarily related to the increased circulation of neutrophils, especially during the last trimester of pregnancy. Noncongenital agranulocytosis during pregnancy is rare and reported only occasionally, while in most of the cases, the agranulocytosis has already occurred prior to pregnancy or induced by identified factors such as antibiotics, antithyroid agents, or cytotoxic agents. Gestation-induced agranulocytosis has not been reported, so we present a case of gestation-induced agranulocytosis in this article. Patients concern: In this case, we present a Chinese woman (aged 25) in her 38th week of the first gestation who had the complication of agranulocytosis. No abnormality was detected in regular examinations before pregnancy and in the first trimester. Since the last trimester of pregnancy, the patient began to suffer from agranulocytosis and intermittent fever, the maximum being temperature 38.8°C. At admission, the neutrophil granulocytes were 0.17 × 109 L−1 and the bone marrow biopsy showed that agranulocytosis was detected, but the levels of red blood cell and megalokaryocyte were normal. In addition, antinuclear antibodies were detected at a dilution of 1:40, but anti-dsDNA, antiphospholipid antibody, and neutrophil granulocyte antibody were negative. Diagnoses: The patient was empirically treated as having pneumonia. Interventions: We tried to use granulocyte colony-stimulating factor, γ-globulin, glucocorticoids, antibiotics, and antifungi agents to treat the patient, but her symptoms were not alleviated until the patient had a cesarean section. Outcomes: After 24 hours of cesarean section, the temperature and neutrophil granulocyte returned to normal. After a year of follow-up, we found that the patient and the baby were healthy. Lessons: Agranulocytosis during pregnancy seems to be associated with immunosuppression

  4. Selective Nonoperative Management of Abdominal Stab Wounds.

    PubMed

    Murry, Jason S; Hoang, David M; Ashragian, Sogol; Liou, Doug Z; Barmparas, Galinos; Chung, Rex; Alban, Rodrigo F; Margulies, Daniel R; Ley, Eric J

    2015-10-01

    Stab wounds (SW) to the abdomen traditionally require urgent exploration when associated with shock, evisceration, or peritonitis. Hemodynamically stable patients without evisceration may benefit from serial exams even with peritonitis. We compared patients taken directly to the operating room with abdominal SWs (ED-OR) to those admitted for serial exams (ADMIT). We retrospectively reviewed hemodynamically stable patients presenting with any abdominal SW between January 2000 and December 2012. Exclusions included evidence of evisceration, systolic blood pressure ≤110 mm Hg, or blood transfusion. NON-THER was defined as abdominal exploration without identification of intra-abdominal injury requiring repair. Of 142 patients included, 104 were ED-OR and 38 were ADMIT. When ED-OR was compared with ADMIT, abdominal Abbreviated Injury Score was higher (2.4 vs 2.1; P = 0.01) and hospital length of stay was longer (4.8 vs 3.3 days; P = 0.04). Incidence of NON-THER was higher in ED-OR cohort (71% vs 13%; P ≤ 0.001). In a regression model, ED-OR was a predictor of NON-THER (adjusted odds ratio 16.6; P < 0.001). One patient from ED-OR expired after complications from NON-THER. There were no deaths in the ADMIT group. For those patients with abdominal SWs who present with systolic blood pressure ≥110 mm Hg, no blood product transfusion in the emergency department and lacking evisceration, admission for serial abdominal exams may be preferred regardless of abdominal exam.

  5. Abdominal apoplexy resulting in small bowel obstruction

    PubMed Central

    Le, Don; Guileyardo, Joseph; Casanova, Mark

    2016-01-01

    Abdominal apoplexy is a rare hemorrhagic condition involving the small arteries or veins within the abdominal cavity. A high degree of clinical suspicion, followed by appropriate diagnostic workup and therapeutic intervention, is critical, as nonoperative mortality approaches 100%. Contrary to most previously reported cases, which were associated with hemoperitoneum, we present a patient in which gastroduodenal artery dissection resulted in an organized retroperitoneal hematoma with local compression of the duodenum and subsequent bowel obstruction, resulting in vomiting, aspiration, and death. PMID:27695177

  6. Pregnancy across the spectrum of chronic kidney disease.

    PubMed

    Hladunewich, Michelle A; Melamad, Nir; Bramham, Kate

    2016-05-01

    Management of the pregnant woman with chronic kidney disease is difficult for both nephrologists and obstetricians. Prepregnancy counselling with respect to risk stratification, optimization of maternal health prior to pregnancy, as well as management of the many potential pregnancy-associated complications in this complex patient population remains challenging due to the paucity of large, well-designed clinical studies. Furthermore, the heterogeneity of disease and the relative infrequency of pregnancy, particularly in more advanced stages of chronic kidney disease, leaves many clinicians feeling ill prepared to manage these pregnancies. As such, counselling is imprecise and management varies substantially across centers. All pregnancies in women with chronic kidney disease can benefit from a collaborative multidisciplinary approach with a team that consists of nephrologists experienced in the management of kidney disease in pregnancy, maternal-fetal medicine specialists, high-risk pregnancy nursing staff, dieticians, and pharmacists. Further access to skilled neonatologists and neonatal intensive care unit support is essential given the risks for preterm delivery in this patient population. The goal of this paper is to highlight some of the data that currently exist in the literature, provide management strategies for the practicing nephrologist at all stages of chronic kidney disease, and explore some of the knowledge gaps where future multinational collaborative research efforts should concentrate to improve pregnancy outcomes in women with kidney disease across the globe.

  7. Ovarian hyperstimulation syndrome in a spontaneous singleton pregnancy

    PubMed Central

    Cabar, Fábio Roberto

    2016-01-01

    ABSTRACT The ovarian hyperstimulation syndrome is the combination of increased ovarian volume, due to the presence of multiple cysts and vascular hyperpermeability, with subsequent hypovolemia and hemoconcentration. We report a case of spontaneous syndrome in a singleton pregnancy. This was a spontaneous pregnancy with 12 weeks of gestational age. The pregnancy was uneventful until 11 weeks of gestational age. After that, the pregnant woman complained of progressive abdominal distention associated with abdominal discomfort. She did not report other symptoms. In the first trimester, a routine ultrasonography showed enlarged ovaries, multiples cysts and ascites. Upon admission, the patient was hemodynamically stable, her serum β-hCG was 24,487mIU/mL, thyroid-stimulating hormone was 2.2µUI/mL and free T4 was 1.8ng/dL. All results were within normal parameters. However, levels of estradiol were high (10,562pg/mL). During hospitalization, she received albumin, furosemide and prophylactic dose of enoxaparin. The patient was discharged on the sixth hospital day. PMID:27223308

  8. Urolithiasis in pregnancy.

    PubMed

    Pais, Vernon M; Payton, Alice L; LaGrange, Chad A

    2007-02-01

    The presentation of urolithiasis is often dramatic, but rarely is it more anxiety provoking than during pregnancy. The evaluation and the intervention are often approached with trepidation as the health of the mother and the fetus must be taken into account. The typical diagnostic course and surgical management used in the nonpregnant population must be reevaluated in the expectant mother. Failure to promptly diagnose and manage urolithiasis during pregnancy may have adverse consequences for mother and child. The authors present a review of the relevant anatomic and physiologic changes of pregnancy as they affect stone disease and outline options for radiologic evaluation and surgical management.

  9. Sugar substitutes during pregnancy

    PubMed Central

    Pope, Eliza; Koren, Gideon; Bozzo, Pina

    2014-01-01

    Abstract Question I have a pregnant patient who regularly consumes sugar substitutes and she asked me if continuing their use would affect her pregnancy or child. What should I tell her, and are there certain options that are better for use during pregnancy? Answer Although more research is required to fully determine the effects of in utero exposure to sugar substitutes, the available data do not suggest adverse effects in pregnancy. However, it is recommended that sugar substitutes be consumed in moderate amounts, adhering to the acceptable daily intake standards set by regulatory agencies. PMID:25392440

  10. Sleep disorders in pregnancy.

    PubMed

    Oyiengo, Dennis; Louis, Mariam; Hott, Beth; Bourjeily, Ghada

    2014-09-01

    Sleep disturbances are common in pregnancy and may be influenced by a multitude of factors. Pregnancy physiology may predispose to sleep disruption but may also result in worsening of some underlying sleep disorders, and the de novo development of others. Apart from sleep disordered breathing, the impact of sleep disorders on pregnancy, fetal, and neonatal outcomes is poorly understood. In this article, we review the literature and discuss available data pertaining to the most common sleep disorders in perinatal women. These include restless legs syndrome, insomnia, circadian pattern disturbances, narcolepsy, and sleep-disordered breathing.

  11. Renal Failure in Pregnancy.

    PubMed

    Balofsky, Ari; Fedarau, Maksim

    2016-01-01

    Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause.

  12. Hypertension in pregnancy.

    PubMed

    Solomon, Caren G; Seely, Ellen W

    2011-12-01

    Hypertension is a common complication of pregnancy. Preeclampsia, in particular, is associated with substantial risk to both the mother and the fetus. Several risk factors have been recognized to predict risk for preeclampsia. However, at present no biomarkers have sufficient discriminatory ability to be useful in clinical practice, and no effective preventive strategies have yet been identified. Commonly used medications for the treatment of hypertension in pregnancy include methyldopa and labetalol. Blood pressure thresholds for initiating antihypertensive therapy are higher than outside of pregnancy. Women with prior preeclampsia are at increased risk of hypertension, cardiovascular disease, and renal disease.

  13. Sleep disorders during pregnancy.

    PubMed

    Pien, Grace W; Schwab, Richard J

    2004-11-01

    This paper reviews the topic of sleep disorders in pregnant women. We describe changes in sleep architecture and sleep pattern during pregnancy, discuss the impact of the physical and biochemical changes of pregnancy on sleep in pregnant women and examine whether maternal-fetal outcomes may be adversely affected in women with disordered sleep. The literature on common sleep disorders affecting pregnant women, including insomnia, sleep-disordered breathing and restless legs syndrome, is reviewed and recommendations are made for the management of these disorders during pregnancy.

  14. Factors associated with abdominal obesity in children

    PubMed Central

    Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

    2015-01-01

    Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. PMID:26298655

  15. Abdominal aortic aneurysm: A comprehensive review

    PubMed Central

    Aggarwal, Sourabh; Qamar, Arman; Sharma, Vishal; Sharma, Alka

    2011-01-01

    An arterial aneurysm is defined as a focal dilation of a blood vessel with respect to the original artery. The risk of abdominal aortic aneurysms (AAAs) increases dramatically in the presence of the following factors: age older than 60 years, smoking, hypertension and Caucasian ethnicity. The likelihood that an aneurysm will rupture is influenced by the aneurysm size, expansion rate, continued smoking and persistent hypertension. The majority of AAAs are asymptomatic and are detected as an incidental finding on ultrasonography, abdominal computed tomography or magnetic resonance imaging performed for other purposes. It can also present with abdominal pain or complications such as thrombosis, embolization and rupture. Approximately 30% of asymptomatic AAAs are discovered as a pulsatile abdominal mass on routine physical examination. Abdominal ultrasonography is considered the screening modality of choice for detecting AAAs because of its high sensitivity and specificity, as well as its safety and relatively lower cost. The decision to screen for AAAs is challenging. The United States Preventive Services Task Force recommended that men between the age of 65 to 75 years who have ever smoked should be screened at least once for AAAs by abdominal ultrasonography. Management options for patients with an asymptomatic AAA include reduction of risk factors such as smoking, hypertension and dyslipidemia; medical therapy with beta-blockers; watchful waiting; endovascular stenting; and surgical repair depending on the size and expansion rate of the aneurysm and underlying comorbidities. PMID:21523201

  16. Ectopic pregnancy with associated gestational choriocarcinoma in a California sea lion (Zalophus californianus).

    PubMed

    Fravel, Vanessa A; Lowenstine, Linda J; Koehne, Amanda

    2016-07-07

    A wild-born, captive-reared, 14 yr old, primiparous female California sea lion Zalophus californianus presented for anorexia of 14 d duration and abdominal distention. Routine complete blood cell count revealed leukocytosis with a neutrophilia, and serum chemistry revealed hypoalbumenemia and hyponatremia. Treatment with broad spectrum antibiotics and non-steroidal anti-inflammatories were started, but the animal continued to decline. Abdominal radiographs revealed a mature mineralized fetal skull and spine in the caudal abdomen and abdominal ultrasound revealed ascites but could not confirm the fetus. The patient was taken to surgery where a full term fetus was found outside of the uterus but within the fetal membranes, representing a secondary ectopic pregnancy. The patient passed away during surgery and was taken to necropsy. Gross necropsy revealed a diffuse peritonitis with yellow deposits over the serosal surfaces of the abdominal organs. The uterus appeared intact grossly and the ovaries appeared abnormal. The mesenteric, renal, and sub-lumbar nodes were enlarged and edematous. Histopathology revealed choriocarcinoma in the right uterine horn with evidence of chronic uterine rupture and protrusion of the placental tissue into the abdomen. The choriocarcinoma had metastasized locally as well as to the liver, spleen and lung. Choriocarcinoma is a highly malignant trophoblastic neoplasm that is rare in domestic animals. This case represents, to the authors' knowledge, the first report of gestational choriocarcinoma causing secondary ectopic pregnancy in a California sea lion and presents questions regarding pregnancy monitoring and management in a population of captive, minimally trained California sea lions.

  17. Heterotopic pregnancy in HIV women

    PubMed Central

    Savasi, Valeria; Antonazzo, Patrizio; Personeni, Carlo

    2016-01-01

    Heterotopic pregnancy occurs when intrauterine and ectopic pregnancy are concomitant; overall rate rises from 1/30.000 to 1.5/1000 in assisted reproductive technology pregnancies. HIV (human immunodeficiency virus) patients are at increased risk of heterotopic pregnancies due to the greater frequency of assisted reproductive technology and pelvic inflammatory disease. We report the first case of heterotopic pregnancy in HIV woman. PMID:27928504

  18. Chronic Hypertension in Pregnancy

    MedlinePlus

    ... AGE Downloaded from http:// circ. ahajournals. org/ by guest on April 13, 2017 Chronic Hypertension in Pregnancy ... e189 Downloaded from http:// circ. ahajournals. org/ by guest on April 13, 2017 TABLE 1. Types of ...

  19. Vaccines and Pregnancy

    MedlinePlus

    ... best live chat Live Help Fact Sheets Share Vaccines and Pregnancy Thursday, 01 September 2016 In every ... risk. This sheet talks about whether exposure to vaccines may increase the risk for birth defects over ...

  20. Bupropion (Wellbutrin) and Pregnancy

    MedlinePlus

    ... There is very little known about long term effects on children exposed to bupropion during pregnancy. One study has suggested an association between prenatal exposure to bupropion and attention deficit hyperactivity disorder (ADHD). There are many factors that contribute to ...

  1. Planning for Pregnancy

    MedlinePlus

    ... of life, including during pregnancy. The number of violent deaths experienced by women tells only part of ... lifelong physical and emotional scars. If someone is violent toward you or you are violent toward your ...

  2. Zika and Pregnancy

    MedlinePlus

    ... Digital Press Kit Read the MMWR Science Clips Zika and Pregnancy What you should know Language: English ... Infographics What Can Be Done Issue Details Overview Zika virus disease (Zika) spreads to people mainly through ...

  3. Pregnancy Complications: Preeclampsia

    MedlinePlus

    ... youth volunteer leader Partner Spotlight Become a partner World Prematurity Day What's happening in your area Find ... serious health problem for pregnant women around the world. It affects 2 to 8 percent of pregnancies ...

  4. Ciprofloxacin and Pregnancy

    MedlinePlus

    ... J Gynecol Obstet 77:293-295. Berkovitch M, et al. 1994. Safety of the new quinolones in ... Obstet Gynecol 84(4):535-538. Bomford JAL, et al. 1993. Ciprofloxacin use during pregnancy. Drugs 45( ...

  5. Metronidazole (Flagyl) and Pregnancy

    MedlinePlus

    ... sheets/ paternal- exposures- pregnancy/ . Selected References: Beard CM, et al. 1988. Cancer after expsoure to metronidazole. Mayo Clinic Proceedings 63(2):147-153. Beard CM, et al. 1979. Lack of evidence for cancer due ...

  6. [Selenium deficiency in pregnancy?].

    PubMed

    Lechner, W; Jenewein, I; Ritzberger, G; Sölder, E; Waitz-Penz, A; Schirmer, M; Abfalter, E

    1990-07-15

    Selenium content was investigated by atomic absorbtion spectroscopy in 32 normal pregnant women in the 38th-42, week of pregnancy. In congruence with other investigations from middle and northern Europe, selenium deficiency was stated in all of the patients.

  7. Radiation Exposure and Pregnancy

    MedlinePlus

    ... Gynecol 200(1):4-24; 2009. International Atomic Energy Agency. Pregnancy and radiation protection in diagnostic radiology, radiotherapy and nuclear medicine. 2010. Available at: http: / / rpop. iaea. org/ ...

  8. Thrombocytopenic syndromes in pregnancy

    PubMed Central

    Yan, Matthew; Malinowski, Ann K

    2015-01-01

    The physiological changes in pregnancy result in platelet counts that are lower than in nonpregnant women. Consequently, thrombocytopenia is a common finding occurring in 7–12% of pregnant women. Gestational thrombocytopenia, the most common cause of low platelet counts, tends to be mild in most women and does not affect maternal, fetal or neonatal outcomes. Gestational thrombocytopenia needs to be distinguished from other less common causes of isolated thrombocytopenia, such as immune thrombocytopenia, which affects approximately 3% of thrombocytopenic pregnant women and can lead to neonatal thrombocytopenia. Hypertensive disorders of pregnancy and thrombotic microangiopathies are both associated with thrombocytopenia. They share a considerable number of similar characteristics and are associated with significant maternal and neonatal morbidity and rarely mortality. Accurate identification of the aetiology of thrombocytopenia and appropriate management are integral to optimizing the pregnancy, delivery and neonatal outcomes of this population. Clinical cases are described to illustrate the various aetiologies of thrombocytopenia in pregnancy and their treatment. PMID:27512485

  9. Medical Care during Pregnancy

    MedlinePlus

    ... Feeding Your 1- to 2-Year-Old Medical Care During Pregnancy KidsHealth > For Parents > Medical Care During ... médica durante el embarazo The Importance of Prenatal Care Millions of American women give birth every year, ...

  10. Medical problems in pregnancy.

    PubMed

    Narayan, Bhaskar; Nelson-Piercy, Catherine

    2016-12-01

    The prevalence of medical problems in pregnancy is increasing because of a complex interplay between demographic and lifestyle factors, and developments in modern medicine. Maternal mortality and morbidity resulting from treatable medical conditions, such as venous thromboembolism, epilepsy and autoimmune disease, have not decreased in recent years. This is despite a marked decrease in overall maternal mortality. It is vital that all physicians acquire a basic knowledge and understanding of medical problems in pregnancy. This includes prepregnancy measures such as counselling and optimisation of medical therapy, as well as multidisciplinary management throughout pregnancy and the postpartum period. Prompt recognition and treatment of acute and chronic illness is of clear benefit, and most drugs and many radiological investigations may be used in pregnancy.

  11. Docusate Sodium and Pregnancy

    MedlinePlus

    ... live chat Live Help Fact Sheets Share Docusate Sodium Friday, 01 April 2016 In every pregnancy, a ... This sheet talks about whether exposure to docusate sodium may increase the risk for birth defects over ...

  12. [Liver transplantation and pregnancy].

    PubMed

    Goarin, A-C; Homer, L

    2010-11-01

    Management during their sexual life of patients with a liver transplantation is a more or less common situation depending centers. Based on literature review, a focus on management of recipient women was conducted, from contraception to pregnancy, describing the complications related to the status of transplant recipient, but also those that may be related to immunosuppressive agents. If fertility and access to contraception are only slightly modified by graft, complications related to graft or immunosuppressive drugs can affect the pregnancy. On the maternal side, hypertension and preeclampsia are more common, as well as renal dysfunction, iatrogenic diabetes and bacterial or viral infections, acute rejection and graft loss do not appear to be influenced by pregnancy. The fetus is also exposed to risks such as induced prematurity and IUGR. Pregnancy in recipients of hepatic grafts therefore requires joint follow-up by transplant specialist and perinatologist, which leads in most cases to successful outcome for mother and child.

  13. Cardiac arrhythmias in pregnancy.

    PubMed

    Knotts, Robert J; Garan, Hasan

    2014-08-01

    As more women with repaired congenital heart disease survive to their reproductive years and many other women are delaying pregnancy until later in life, a rising concern is the risk of cardiac arrhythmias during pregnancy. Naturally occurring cardiovascular changes during pregnancy increase the likelihood that a recurrence of a previously experienced cardiac arrhythmia or a de novo arrhythmia will occur. Arrhythmias should be thoroughly investigated to determine if there is a reversible etiology, and risks/benefits of treatment options should be fully explored. We discuss the approach to working up and treating various arrhythmias during pregnancy with attention to fetal and maternal risks as well as treatment of fetal arrhythmias. Acute management in stable patients includes close monitoring and intravenous pharmacologic therapy, while DC cardioversion should be used to terminate arrhythmias in hemodynamically unstable patients. Long-term management may require continued oral antiarrhythmic therapy, with particular attention to fetal safety, to prevent complications associated with arrhythmias.

  14. Loratadine and Pregnancy

    MedlinePlus

    ... body, loratadine breaks down into another compound called desloratadine (Clarinex®). The similarities between these compounds suggest that ... would be helpful in predicting the effects of desloratadine on a pregnancy. I just found out I ...

  15. Methotrexate and Pregnancy

    MedlinePlus

    Methotrexate In every pregnancy, a woman starts out with a 3-5% chance of having a baby ... risk. This sheet talks about whether exposure to methotrexate may increase the risk for birth defects over ...

  16. Cocaine and Pregnancy

    MedlinePlus

    ... my baby’s body too? Yes. Cocaine crosses the placenta and enters the developing baby. Cocaine can be ... Later in pregnancy, cocaine use can cause the placenta to pull away from the wall of the ...

  17. Medication Use during Pregnancy

    MedlinePlus

    ... What's this? Submit Button Past Emails CDC Features Medication Use During Pregnancy Recommend on Facebook Tweet Share ... are taking only medications that are necessary. What Medications Can Cause Birth Defects? We know that taking ...

  18. Lithium and Pregnancy

    MedlinePlus

    ... use during pregnancy and the development of a goiter (enlarged thyroid gland in the neck) in the ... in the mother, this can lead to a goiter in the baby. The mother’s thyroid function should ...

  19. Group B streptococcus - pregnancy

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000511.htm Group B streptococcus - pregnancy To use the sharing features on this page, please enable JavaScript. Group B streptococcus (GBS) is a type of bacteria that some ...

  20. Pemphigus vulgaris in pregnancy.

    PubMed

    Salzberg, Kelsey W; Gero, Melanie J; Ragsdale, Bruce D

    2014-10-01

    We report the case of a 34-year-old woman who was diagnosed with pemphigus vulgaris (PV) during pregnancy. The patient presented with widespread blistering dermatitis and associated burning and pruritus. At 6 weeks' gestation the patient was admitted to the hospital to expedite her diagnosis and initiate treatment. A skin biopsy revealed suprabasal acantholysis, and direct immunofluorescence demonstrated diffuse intercellular IgG in the epidermis and basal intercellular C3, which confirmed the diagnosis of PV. Treatment with corticosteroids was instituted after discussions with the patient about possible adverse effects to the fetus. Pemphigus vulgaris is rare in pregnancy and active PV presents potential threats of fetal spread and transient lesion production, which is associated with increased mortality and morbidity in the fetus. Our patient had active PV and required treatment throughout her pregnancy. The pregnancy progressed to premature delivery of the neonate without skin lesions or apparent complications.

  1. Ultrasound in pregnancy (image)

    MedlinePlus

    The ultrasound has become a standard procedure used during pregnancy. It can demonstrate fetal growth and can detect increasing ... abnormalities, hydrocephalus, anencephaly, club feet, and other ... does not produce ionizing radiation and is considered ...

  2. Ectopic/Tubal Pregnancy

    MedlinePlus

    ... miscarriage? The medical term for miscarriage is “spontaneous abortion”, but it’s not the same thing as a therapeutic or planned abortion. A spontaneous abortion is when a pregnancy ends “ ...

  3. Listeriosis and Pregnancy

    MedlinePlus

    Listeria Infection (Listeriosis) In every pregnancy, a woman starts out with a 3-5% chance of having ... is listeriosis? Listeriosis is an infection caused by Listeria monocytogenes bacteria, often called just Listeria. Listeriosis is ...

  4. Pregnancy Complications: Anemia

    MedlinePlus

    ... Close X Home > Complications & Loss > Pregnancy complications > Anemia Anemia E-mail to a friend Please fill in ... anemia at a prenatal care visit . What causes anemia? Usually, a woman becomes anemic (has anemia) because ...

  5. Carbamazepine (Tegretol) and Pregnancy

    MedlinePlus

    ... pregnancy. The most common neural tube defect is spina bifida. The general population’s risk for having a baby with a neural tube defect, such as spina bifida (an opening in the spine or brain), is ...

  6. Fluoxetine (Prozac) and Pregnancy

    MedlinePlus

    ... belongs to the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). I am taking fluoxetine, but I would ... Studies have begun to look at the possible long-term effects on infants exposed to fluoxetine during pregnancy. Fluoxetine ...

  7. Benzodiazepines and Pregnancy

    MedlinePlus

    ... suggested a higher rate of preterm deliveries and low birth weight in infants when women take benzodiazepines during ... benzodiazepine during breastfeeding, watch your baby for sleepiness, low ... increased risk of birth defects or pregnancy complications is not expected when ...

  8. Pregnancy and travel

    MedlinePlus

    ... Disease Control and Prevention's (CDC) website at: www.cdc.gov/zika/ . ... Prevention. Pregnant women. Updated October 17, 2016. www.cdc.gov/zika/pregnancy/protect-yourself.html . Accessed December 10, 2016. ...

  9. MRI Safety during Pregnancy

    MedlinePlus

    ... 20 to 40 minutes. top of page Contrast material For some MRI exams, a contrast material called gadolinium will need to be injected into a vein in the arm. While contrast material sometimes improves the MRI images, during pregnancy the ...

  10. Hyperthermia and Pregnancy

    MedlinePlus

    ... been associated with adverse pregnancy outcomes. Ultrasound uses sound waves to create an image of a fetus on a screen. Although this procedure can slightly increase body temperature, even a lengthy ultrasound exposure is unlikely to ...

  11. Diabetes and Pregnancy

    MedlinePlus

    ... Statistics Diabetes A-Z Pregnancy if You Have Diabetes If you have diabetes and plan to have ... are pregnant, you have gestational diabetes . How can diabetes affect my baby? A baby’s organs, such as ...

  12. Vaccinations during Pregnancy

    MedlinePlus

    ... get is safe. Make sure your vaccinations are up to date before you get pregnant. What is a vaccination? ... are recommended before pregnancy? It’s best to be up to date on all your routine adult vaccinations before you ...

  13. Depression and Pregnancy

    MedlinePlus

    ... best live chat Live Help Fact Sheets Share Depression Thursday, 01 September 2016 In every pregnancy, a ... risk. This sheet talks about whether exposure to depression may increase the risk for birth defects over ...

  14. Pregnancy, Childbirth, and Anesthesia

    MedlinePlus

    ... and Anesthesia Share this Page Preparing For Surgery Effects of Anesthesia Children and Anesthesia Pregnancy, Childbirth and Anesthesia Seniors and Anesthesia Surgery Risks Anesthesia Awareness Obesity and Anesthesia Sleep Apnea and Anesthesia Smoking and Anesthesia Outpatient Surgery ...

  15. Pregnancy and herpes

    MedlinePlus

    ... sharing features on this page, please enable JavaScript. Newborn infants can become infected with herpes virus during pregnancy, during labor or delivery, or after birth. Causes Newborn infants can become infected with herpes virus: In the ...

  16. Stages of Pregnancy

    MedlinePlus

    ... three stages. Expand all | Collapse all First trimester (week 1–week 12) During the first trimester your body undergoes ... is different, so is each pregnancy. Second trimester (week 13–week 28) Most women find the second ...

  17. Valproic Acid and Pregnancy

    MedlinePlus

    ... live chat Live Help Fact Sheets Share Valproic Acid and Pregnancy Wednesday, 01 July 2015 In every ... This sheet talks about whether exposure to valproic acid may increase the risk for birth defects over ...

  18. Living donor liver transplantation with abdominal wall reconstruction for hepatocellular carcinoma with needle track seeding

    PubMed Central

    Yang, Horng-Ren; Thorat, Ashok; Gesakis, Kanellos; Li, Ping-Chun; Kiranantawat, Kidakorn; Chen, Hung Chi; Jeng, Long-Bin

    2015-01-01

    Malignant cell seeding in subcutaneous tissues along the needle track and/or percutaneous biliary drainage catheters is rare complication, but pose various technical issues in planning surgical treatment of such patients. If underlying primary hepatic malignancy can be treated, an aggressive resection of subcutaneous tissue bearing cancer cell with subsequent abdominal wall reconstruction has been sporadically reported. But, when hepatic resection is not possible due to underlying advanced cirrhosis, liver transplantation along with abdominal wall resection and subsequent reconstruction remains only feasible option. Herein, we describe our successful experience of living donor liver transplantation for hepatocellular carcinoma with full-thickness abdominal wall resection bearing the tumor seeding followed by reconstruction in single stage surgery. PMID:26722665

  19. Acromegaly and pregnancy.

    PubMed

    Caron, P

    2011-09-01

    In women with acromegaly due to growth hormone (GH)-secreting pituitary adenomas, the occurrence of pregnancy warrants consideration of: (1) the consequences of pregnancy on the pituitary adenoma including the tumor syndrome and GH/IGF-1 secretion, (2) the consequence of GH/IGF-1 hypersecretion on the pregnant woman and the fetus, (3) the consequences of pituitary surgery and medical treatment (dopamine agonists, somatostatin analogs, GH receptor antagonist) on the pregnant woman and the developing fetus.

  20. Hay fever in pregnancy.

    PubMed

    Wiseberg, Max

    2014-05-01

    Spring and summer can bring misery to millions who suffer from allergic reactions to pollen. Hay fever can cause runny noses, streaming eyes and sore throats. Sadly, many treatments for this distressing condition are not recommended during pregnancy because of fears surrounding the effect on the unborn child. This article presents the causes and treatments of hay fever and explores the alternatives for use during pregnancy which may be able to relieve or minimise the unpleasant symptoms without harming the baby.

  1. Urolithiasis and pregnancy.

    PubMed

    Korkes, Fernando; Rauen, Eduardo Costa; Heilberg, Ita Pfeferman

    2014-01-01

    The diagnosis of urolithiasis during pregnancy is common, even though no additional measures are required in asymptomatic cases. Renal colic or complications of urinary lithiasis occur more frequently during the last months of pregnancy, and there are several particularities for the diagnosis and treatment of this subset of women. The present manuscript aim to review the current knowledge concerning this subject and present authors personal experience.

  2. Marijuana Use in Pregnancy.

    PubMed

    Roth, Cheryl K; Satran, Lori A; Smith, Shauna M

    2015-01-01

    With the legalization of both medical and recreational use of marijuana in some U.S. states, nurses and other clinicians should be prepared to care for pregnant women who have used marijuana during pregnancy. This column describes the prevalence of cannabis use among women, the effect cannabis has on the body and the potential maternal, fetal and neonatal effects of marijuana use during pregnancy.

  3. Reducing teenage pregnancy.

    PubMed

    Fallon, Debbie

    2011-03-01

    The Teenage Pregnancy Independent Advisory Group (TPIAG) was established in 2000 to advise the government about reducing teenage pregnancy rates and supporting teenage parents to continue with their education. The group reached the end of its tenure in December 2010. This short article highlights some of the key issues from the final report and provides some insights into past achievements and future directions from an interview with Gill Frances, TPIAG's chair.

  4. [Post-rape pregnancy].

    PubMed

    Muhlstein, J; Martrille, L; Guillet-May, F; Routiot, T; Coudane, H; Judlin, P

    2013-02-01

    A rape is a traumatizing circumstance for the victim. This aggression often has, regrettably, immediate repercussions, and then medium and long-term ones. Its complications are psychological, but also sometimes somatic, like pregnancy. Through an international literature review, and the study of the national legislation, we will summarize the main essential elements of the medical and forensic care of a pregnancy arising after a rape.

  5. Challenges of Twin Pregnancy

    PubMed Central

    Wilson, Lynn M.; Hose, Patricia M.

    1991-01-01

    Family physicians have an important role in the diagnosis and management of twin pregnancies. Optimal antepartum management begins with early detection. Provision of patient education about the risks of the pregnancy is important. Intrapartum management is dependent on gestation age, placentation, fetal presentation, and fetal well-being. Anticipatory guidance and ongoing support should be provided for postpartum issues, such as breast-feeding and family adjustment. PMID:21229108

  6. Thrombophilia and Pregnancy Complications.

    PubMed

    Simcox, Louise E; Ormesher, Laura; Tower, Clare; Greer, Ian A

    2015-11-30

    There is a paucity of strong evidence associated with adverse pregnancy outcomes and thrombophilia in pregnancy. These problems include both early (recurrent miscarriage) and late placental vascular-mediated problems (fetal loss, pre-eclampsia, placental abruption and intra-uterine growth restriction). Due to poor quality case-control and cohort study designs, there is often an increase in the relative risk of these complications associated with thrombophilia, particularly recurrent early pregnancy loss, late fetal loss and pre-eclampsia, but the absolute risk remains very small. It appears that low-molecular weight heparin has other benefits on the placental vascular system besides its anticoagulant properties. Its use is in the context of antiphospholipid syndrome and recurrent pregnancy loss and also in women with implantation failure to improve live birth rates. There is currently no role for low-molecular weight heparin to prevent late placental-mediated complications in patients with inherited thrombophilia and this may be due to small patient numbers in the studies involved in summarising the evidence. There is potential for low-molecular weight heparin to improve pregnancy outcomes in women with prior severe vascular complications of pregnancy such as early-onset intra-uterine growth restriction and pre-eclampsia but further high quality randomised controlled trials are required to answer this question.

  7. Mammary cancers and pregnancy.

    PubMed Central

    Anderson, J M

    1979-01-01

    Uncertainties persist about management and prognosis of mammary cancers that occur during and after pregnancy and during lactation. Pathological features of mammary cancers occurring during pregnancy are the same as those in non-pregnant women and survival rates are comparable. Management should be the same as in non-pregnant patients. Termination of pregnancy does not improve survival but it should be advised if the prognosis is poor. Mastectomy apparently presents little danger to the fetus, though treatment such as chemotherapy and irradiation should be avoided. Women who have received treatment for mammary cancer need not be advised against subsequent pregnancy. Routine ovarian radiation in non-pregnant premenopausal women is not generally to be recommended, since it does not prolong survival and would deprive some of the chance of further pregnancy. In lactating women who develop mammary cancers survival is apparently not adversely affected. Lactation should be suppressed initially and followed by mastectomy. Regimens of immunotherapy, chemotherapy, or radiotherapy may then be begun. Until results of current trials of combined treatments of mammary cancers associated with pregnancy are available, management should be neither aggressive nor tentative. It should be based on a well-balanced concept of applying all available treatments, as in non-pregnant patients. PMID:376044

  8. Pregnancy and kidney transplantation.

    PubMed

    Josephson, Michelle A; McKay, Dianne B

    2011-01-01

    Despite decades of experience with child bearing in women with kidney transplants, these pregnancies remain high risk with an increased prevalence of hypertension and pre-eclampsia. Infertility, common in women with end-stage renal disease, is rapidly restored after transplant although pregnancy rates appear lower in transplant recipients than the general public. Many unanswered questions exist, some old questions such as what is the optimal timing of pregnancy after transplant, whether breast feeding is safe, the long-term impact if any on the offspring, and whether pregnancy negatively affects the kidney graft; and some new questions such as whether to modify immunosuppression in a patient taking a mycophenolic acid-containing drug, whether kidney donation has a deleterious impact on future pregnancies, whether to use erythropoietin-stimulating agents, and the role of BK virus. Counseling about contraception and pregnancy after transplant should be initiated during the pretransplant evaluation process. It is important because of the rapid restoration of fertility that occurs after transplant as well as the many risks and unanswered questions that remain.

  9. Hematologic Complications of Pregnancy

    PubMed Central

    Townsley, Danielle M.

    2013-01-01

    Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This paper specifically reviews the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations,; however care must be taken not to miss other causes of anemia, such as sickle cell disease. Thrombocytopenia is also a common reason for consulting the hematologist and distinguishing gestational thrombocytopenia from immune thrombocytopenia (ITP), preeclampsia, HELLP syndrome, or thrombotic thrombocytopenic purpura (TTP) is essential since the treatment differs widely. Occasionally the management of mother and infant involves the expeditious recognition of neonatal alloimmune thrombocytopenia (NAIT), a condition that is responsible for severe life-threatening bleeding of the newborn. Additionally, inherited and acquired bleeding disorders affect pregnant women disproportionately and often require careful monitoring of coagulation parameters in order to prevent bleeding in the puerperium. Finally, venous thromboembolism (VTE) during pregnancy is still largely responsible for mortality during pregnancy and the diagnosis, treatment options and guidelines for prevention of VTE during pregnancy are explored. PMID:23953339

  10. Pregnancy with autoimmune hepatitis

    PubMed Central

    Braga, António Costa; Vasconcelos, Carlos; Braga, Jorge

    2016-01-01

    Aim: The aim of this study was to review our experience with gestations in autoimmune hepatitis patients. Background: There are only limited data describing pregnancy in patients with autoimmune hepatitis. Patients and methods: Retrospective analysis of pregnancies with autoimmune hepatitis followed in Centro Hospitalar do Porto, Portugal in the last ten years. Results: We reported nine pregnancies in seven patients with autoimmune hepatitis. Two patients had documented liver cirrhosis prior to the pregnancy. In this study, 66.7% of patients were treated with azathioprine and 88.9% with prednisolone. Clinical improvements were observed in 11.1% of pregnancies and 22.2% exacerbations were diagnosed. There were six live births and two preterm deliveries (preterm delivery rate of 33%). We also report three first trimester miscarriages (early gestation miscarriage rate of 33%). There were no neonatal or maternal deaths. Conclusion: The favorable obstetric outcome is a realistic expectation in patients with autoimmune hepatitis. Tight monitoring and control of asymptomatic and unpredictable exacerbations, which are unrelated to the severity of the underlying disease, are essential to the prognosis of the current pregnancy. PMID:27458515

  11. Thyroid disorders in pregnancy

    PubMed Central

    Ramprasad, Menaka; Bhattacharyya, Shaila Shamanur; Bhattacharyya, Arpandev

    2012-01-01

    Thyroid disorders are common in pregnancy and the most common disorder is subclinical hypothyroidism. Due to the complex hormonal changes during pregnancy, it is important to remember that thyroxine requirements are higher in pregnancy. According to recent American Thyroid Association (ATA) guidelines, the recommended reference ranges for TSH are 0.1 to 2.5 mIU/L in the first trimester, 0.2 to 3.0 mIU/L in the second trimester, and 0.3 to 3.0 mIU/L in the third trimester. Maternal hypothyroidism is an easily treatable condition that has been associated with increased risk of low birth weight, fetal distress, and impaired neuropsychological development. Hyperthyroidism in pregnancy is less common as conception is a problem. Majority of them are due to Graves’ disease, though gestational hyperthyroidism is to be excluded. Preferred drug is propylthiouracil (PTU) with the target to maintain free T4 in upper normal range. Doses can be reduced in third trimester due to the immune-suppressant effects of pregnancy. Early and effective treatment of thyroid disorder ensures a safe pregnancy with minimal maternal and neonatal complications. PMID:23565370

  12. Hyperthyroidism in pregnancy.

    PubMed

    Cooper, David S; Laurberg, Peter

    2013-11-01

    Changes in thyroid hormone concentrations that are characteristic of hyperthyroidism must be distinguished from physiological changes in thyroid hormone economy that occur in pregnancy, especially in the first trimester. Approximately one to two cases of gestational hyperthyroidism occur per 1000 pregnancies. Identification of hyperthyroidism in a pregnant woman is important because adverse outcomes can occur in both the mother and the offspring. Graves' disease, which is autoimmune in nature, is the usual cause; but hyperthyroidism in pregnancy can be caused by any type of hyperthyroidism--eg, toxic multinodular goitre or solitary autonomously functioning nodule. Gestational transient thyrotoxicosis is typically reported in women with hyperemesis gravidarum, and is mediated by high circulating concentrations of human chorionic gonadotropin. Post-partum thyroiditis occurs in 5-10% of women, and many of those affected ultimately develop permanent hypothyroidism. Antithyroid drug treatment of hyperthyroidism in pregnant women is controversial because the usual drugs--methimazole or carbimazole--are occasionally teratogenic; and the alternative--propylthiouracil--can be hepatotoxic. Fetal hyperthyroidism can be life-threatening, and needs to be recognised as soon as possible so that treatment of the fetus with antithyroid drugs via the mother can be initiated. In this Review, we discuss physiological and pathophysiological changes in thyroid hormone economy in pregnancy, the diagnosis and management of hyperthyroidism during pregnancy, severe life-threatening thyrotoxicosis in pregnancy, neonatal thyrotoxicosis, and post-partum hyperthyroidism.

  13. Reconstruction of complex abdominal wall defects.

    PubMed

    Leppäniemi, A; Tukiainen, E

    2013-01-01

    Complex abdominal wall defects refer to situations where simple ventral hernia repair is not feasible because the defect is very large, there is a concomitant infection or failed previous re-pair attempt, or if there is not enough original skin to cover the repair. Usually a complex abdominal wall repair is preceded by a period of temporary abdominal closure where the short-term aims include closure of the catabolic drain, protection of the viscera and preventing fistula formation, preventing bowel adherence to the abdominal wall, and enabling future fascial and skin closure. Currently the best way to achieve these goals is the vacuum- and mesh-mediated fascial traction method achieving close to 90% fascial closure rates. The long-term aims of an abdominal closure following a planned hernia strategy include intact skin cover, fascial closure at midline (if possible), good functional outcome with innervated abdominal musculature, no pain and good cosmetic result. The main methods of abdominal wall reconstruction include the use of prosthetic (mesh) or autologous material (tissue flaps). In patients with original skin cover over the fascial defect (simple ventral hernia), the most commonly used method is hernia repair with an artificial mesh. For more complex defects, our first choice of reconstruction is the component separation technique, sometimes combined with a mesh. In contaminated fields where component separation alone is not feasible, a combination with a biological mesh can be used. In large defects with grafted skin, a free TFL flap is the best option, sometimes reinforced with a mesh and enhanced with components separation.

  14. Ruptured ectopic pregnancy with a negative urine pregnancy test.

    PubMed

    Hughes, Mallory; Lupo, Andrew; Browning, Adrianne

    2017-01-01

    Ectopic pregnancy is commonly seen as a differential diagnosis of first-trimester vaginal bleeding. Often the diagnosis is made based on a combination of exam findings, transvaginal ultrasound, and a positive pregnancy test. Our case describes a patient with a history of ectopic pregnancy treated with methotrexate and serial human chorionic gonadotropin measurements that were decreasing appropriately. At the time of evaluation, her urine pregnancy test was negative; however, she was confirmed to have a ruptured tubal ectopic pregnancy. This case highlights the variable presentation of ectopic pregnancies and the importance of combining exam findings with ultrasound and laboratory results.

  15. Ruptured ectopic pregnancy with a negative urine pregnancy test

    PubMed Central

    Hughes, Mallory; Lupo, Andrew

    2017-01-01

    Ectopic pregnancy is commonly seen as a differential diagnosis of first-trimester vaginal bleeding. Often the diagnosis is made based on a combination of exam findings, transvaginal ultrasound, and a positive pregnancy test. Our case describes a patient with a history of ectopic pregnancy treated with methotrexate and serial human chorionic gonadotropin measurements that were decreasing appropriately. At the time of evaluation, her urine pregnancy test was negative; however, she was confirmed to have a ruptured tubal ectopic pregnancy. This case highlights the variable presentation of ectopic pregnancies and the importance of combining exam findings with ultrasound and laboratory results. PMID:28127150

  16. A case of spontaneous hemoperitoneum by uterine vessel rupture in pregnancy

    PubMed Central

    Jang, Jeong Hui; Lee, Seolmin; Hong, Seung-Hwa; Ji, Ilwoon; Jeong, Eun-Hwan

    2016-01-01

    A 27-year-old pregnant woman, para 1, was transferred to our hospital at 29+3 weeks of gestation complaining of abdominal pain. She was diagnosed with hemoperitoneum based on ultrasonography. An emergency laparotomy was performed, and the bleeding was confirmed to be caused by ruptured surface blood vessels on the uterine fundus. Hemostasis with compression was successfully performed to sustain the pregnancy, and the patient delivered a full-term baby. Spontaneous hemoperitoneum during pregnancy caused by rupture of uterine blood vessels is very rare. It requires rapid diagnosis and surgical treatment because it increases the morbidity of the fetus and mother. In most incidences of spontaneous hemoperitoneum during pregnancy, a cesarean delivery is performed along with a simultaneous emergency laparotomy. However, in this case, the pregnancy was maintained to full term after surgical hemostasis, which prevented neonatal complications due to premature birth. PMID:27896257

  17. Rare Site of Ectopic Pregnancy in a Patient with Bicornuate Uterus

    PubMed Central

    El Namoury, Mohamed; Heider, Mostafa

    2016-01-01

    Ectopic pregnancy occurs in about 1-2% in normal cycles but in IVF cycles the rate jumps to 4%. No definite cause for ectopic pregnancy was detected, but many risk factors were described as abnormal tube, pelvic infection, or surgery. In this case report we found 2 abnormalities in eight-year infertile woman; the first abnormality was bicornuate uterus and the second abnormality was the site of ectopic pregnancy which was in between the two horns of uterus. ‎This is the only case reported with primary abdominal pregnancy with bicornuate uterus and both healthy ovaries and tubes.‎ The case was unstable and managed by laparotomy and repair of ectopic site after enucleation of sac using Vicryl 2/0. The case was discharged 24 hours after operation in good health. PMID:28042488

  18. Intra-abdominal pressure: an integrative review.

    PubMed

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

    2016-01-01

    There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do

  19. Intra-abdominal pressure: an integrative review

    PubMed Central

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

    2016-01-01

    ABSTRACT There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. PMID:26958978

  20. Functional bowel disorders and functional abdominal pain

    PubMed Central

    Thompson, W; Longstreth, G; Drossman, D; Heaton, K; Irvine, E; Muller-Lissner, S

    1999-01-01

    The Rome diagnostic criteria for the functional bowel disorders and functional abdominal pain are used widely in research and practice. A committee consensus approach, including criticism from multinational expert reviewers, was used to revise the diagnostic criteria and update diagnosis and treatment recommendations, based on research results. The terminology was clarified and the diagnostic criteria and management recommendations were revised. A functional bowel disorder (FBD) is diagnosed by characteristic symptoms for at least 12 weeks during the preceding 12 months in the absence of a structural or biochemical explanation. The irritable bowel syndrome, functional abdominal bloating, functional constipation, and functional diarrhea are distinguished by symptom-based diagnostic criteria. Unspecified FBD lacks criteria for the other FBDs. Diagnostic testing is individualized, depending on patient age, primary symptom characteristics, and other clinical and laboratory features. Functional abdominal pain (FAP) is defined as either the FAP syndrome, which requires at least six months of pain with poor relation to gut function and loss of daily activities, or unspecified FAP, which lacks criteria for the FAP syndrome. An organic cause for the pain must be excluded, but aspects of the patient's pain behavior are of primary importance. Treatment of the FBDs relies upon confident diagnosis, explanation, and reassurance. Diet alteration, drug treatment, and psychotherapy may be beneficial, depending on the symptoms and psychological features.


Keywords: functional bowel disorder; functional constipation; functional diarrhea; irritable bowel syndrome; functional abdominal pain; functional abdominal bloating; Rome II PMID:10457044

  1. Creation of Abdominal Adhesions in Mice.

    PubMed

    Marshall, Clement D; Hu, Michael S; Leavitt, Tripp; Barnes, Leandra A; Cheung, Alexander T M; Malhotra, Samir; Lorenz, H Peter; Longaker, Michael T

    2016-08-27

    Abdominal adhesions consist of fibrotic tissue that forms in the peritoneal space in response to an inflammatory insult, typically surgery or intraabdominal infection. The precise mechanisms underlying adhesion formation are poorly understood. Many compounds and physical barriers have been tested for their ability to prevent adhesions after surgery with varying levels of success. The mouse and rat are important models for the study of abdominal adhesions. Several different techniques for the creation of adhesions in the mouse and rat exist in the literature. Here we describe a protocol utilizing abrasion of the cecum with sandpaper and sutures placed in the right abdominal sidewall. The mouse is anesthetized and the abdomen is prepped. A midline laparotomy is created and the cecum is identified. Sandpaper is used to gently abrade the surface of the cecum. Next, several figure-of-eight sutures are placed into the peritoneum of the right abdominal sidewall. The abdominal cavity is irrigated, a small amount of starch is applied, and the incision is closed. We have found that this technique produces the most consistent adhesions with the lowest mortality rate.

  2. Abdominal sarcoidosis: cross-sectional imaging findings

    PubMed Central

    Gezer, Naciye Sinem; Başara, Işıl; Altay, Canan; Harman, Mustafa; Rocher, Laurence; Karabulut, Nevzat; Seçil, Mustafa

    2015-01-01

    Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%–70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis. PMID:25512071

  3. Mother-daughter in vitro fertilization triplet surrogate pregnancy.

    PubMed

    Michelow, M C; Bernstein, J; Jacobson, M J; McLoughlin, J L; Rubenstein, D; Hacking, A I; Preddy, S; Van der Wat, I J

    1988-02-01

    A successful triplet pregnancy has been established in a surrogate gestational mother following the transfer of five embryos fertilized in vitro. The oocytes were donated by her biological daughter, and the sperm obtained from the daughter's husband. The daughter's infertility followed a total abdominal hysterectomy performed for a postpartum hemorrhage as a result of a placenta accreta. Synchronization of both their menstrual cycles was obtained using oral contraceptive suppression for 2 months, followed by stimulation of both the surrogate gestational mother and her daughter such that embryo transfer would occur at least 48 hr after the surrogate gestational mother's own ovulation. This case raises a number of medical, social, psychological, and ethical issues.

  4. Choriocarcinoma developed in a tubal pregnancy - a case report.

    PubMed

    Petre, Izabella; Bernad, Elena; Mureşan, Anca; Bordianu, Anca; Bernad, Sandor I; Băcean, Onuţ; Folescu, Roxana; Milulescu, Amelia; Pantea, Stelian

    2015-01-01

    Carcinoma of the Fallopian tube is the least frequent tumor of the female genital tract. The diagnosis is difficult but could be made more frequently if the causes of abnormal bleeding were thoroughly investigated by means of cytology and endometrial curettage. Treatment is by resection of the tumor, total hysterectomy, and bilateral salpingo-oophorectomy followed by chemotherapy. A 25-year-old patient, presented herself at the emergency room, accusing intense lower abdominal pains, accompanied by vaginal bleeding. The histological aspect corroborated with the Ki-67 index is strongly suggestive for a choriocarcinoma developed in a tubal ectopic pregnancy.

  5. [Spontaneous splenic rupture in the second quarter of pregnancy].

    PubMed

    Brocas, E; Tenaillon, A

    2002-03-01

    We report the case of a 33 year-old woman at the second quarter of pregnancy, with known brain aneurysm admitted in intensive care unit for sudden coma. The coma was not related to a rupture of the brain aneurysm but to a serious haemorrhagic shock caused by a spontaneous splenic rupture. This case report illustrates the difficulty of this unrecognized diagnosis and reminds us to suspect a spontaneous splenic rupture in front of any pregnant woman with atypic abdominal pain and haemorrhagic shock.

  6. Cystic fibrosis in pregnancy.

    PubMed Central

    Kent, N E; Farquharson, D F

    1993-01-01

    OBJECTIVE: To review the outcomes of pregnancies in women with cystic fibrosis (CF) and to address issues pertinent to the obstetric care of such women. DATA SOURCES: English-language case reports and case series published from 1960 to 1991 identified through a search of MEDLINE and Index Medicus. The terms of reference were "cystic fibrosis" and "pregnancy". Not all the reports reviewed addressed all the outcomes under consideration. STUDY SELECTION: A total of 20 reports citing cases of pregnancy in women with CF. DATA EXTRACTION: Outcomes included the number of spontaneous abortions, pregnancies continued beyond 20 weeks, preterm deliveries, maternal deaths at 6 months and 2 years after delivery and perinatal deaths. Breast-feeding was addressed. Measures to assess the severity of maternal disease included the mean age at diagnosis of CF, weight gain during pregnancy, pulmonary function studies if available and the need for pancreatic enzyme replacement therapy. DATA SYNTHESIS: Of 217 pregnancies in 162 women spontaneous abortion occurred in 10 (4.6%). Pregnancy progressed beyond 20 weeks in 81.6% of cases; 24.3% of the deliveries were preterm. The maternal death rate did not exceed that among age-related women with CF who were not pregnant. The rate of perinatal death was 7.9%. Breast milk was not hypernatremic. Poor outcomes were associated with a weight gain of less than 4.5 kg and a forced vital capacity of less than 50% of the predicted value. CONCLUSIONS: Premature labour and delivery remain a significant risk for pregnant women with CF, contributing to a high rate of perinatal death. Maternal illness and death result from deteriorating pulmonary function. Breast-feeding is not contraindicated. Attention to energy intake and pulmonary function is important. PMID:8374843

  7. [Pregnancy and antiphospholipid syndrome].

    PubMed

    Costedoat-Chalumeau, N; Guettrot-Imbert, G; Leguern, V; Leroux, G; Le Thi Huong, D; Wechsler, B; Morel, N; Vauthier-Brouzes, D; Dommergues, M; Cornet, A; Aumaître, O; Pourrat, O; Piette, J-C; Nizard, J

    2012-04-01

    Antiphospholipid syndrome (APS) is associated with a risk of obstetrical complications, affecting both the mother and the fetus. Obstetrical APS is defined by a history of three consecutive spontaneous miscarriages before 10 weeks of gestation (WG), an intra-uterine fetal death after 10 WG, or a premature birth before 34 WG because of severe pre-eclampsia, eclampsia or placental adverse outcomes (intrauterine growth retardation, oligohydramnios). Pregnancy in women with a diagnosis of obstetric APS is at increased risk for placental abruption, HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome and thrombosis that may be part of a catastrophic antiphospholipid syndrome (CAPS). A previous thrombosis and the presence of a lupus anticoagulant are risk factors for pregnancy failure. A multidisciplinary approach, associating the internist, the anesthesiologist and the obstetrician, is recommended for these high-risk pregnancies. Preconception counseling is proposed to identify pregnancy contraindications, and to define and adapt the treatment prior and during the upcoming pregnancy. Heparin and low-dose aspirin are the main treatments. The choice between therapeutic or prophylactic doses of heparin will depend on the patient's medical history. The anticoagulant therapeutic window for delivery should be as narrow as possible and adapted to maternal thrombotic risk. There is a persistent maternal risk in the postpartum period (thrombosis, HELLP syndrome, CAPS) justifying an antithrombotic coverage during this period. We suggest a monthly clinical and biological monitoring which can be more frequent towards the end of pregnancy. The persistence of notches at the Doppler-ultrasound evaluation seems to be the best predictor for a higher risk of placental vascular complications. Treatment optimization and multidisciplinary antenatal care improve the prognosis of pregnancies in women with obstetric APS, leading to a favorable outcome most of the time.

  8. [Detecting high risk pregnancy].

    PubMed

    Doret, Muriel; Gaucherand, Pascal

    2009-12-20

    Antenatal care is aiming to reduce maternal land foetal mortality and morbidity. Maternal and foetal mortality can be due to different causes. Their knowledge allows identifying pregnancy (high risk pregnancy) with factors associated with an increased risk for maternal and/or foetal mortality and serious morbidity. Identification of high risk pregnancies and initiation of appropriate treatment and/or surveillance should improve maternal and/or foetal outcome. New risk factors are continuously described thanks to improvement in antenatal care and development in biology and cytopathology, increasing complexity in identifying high risk pregnancies. Level of risk can change all over the pregnancy. Ideally, it should be evaluated prior to the pregnancy and at each antenatal visit. Clinical examination is able to screen for intra-uterin growth restriction, pre-eclampsia, threatened for preterm labour; ultrasounds help in the diagnosis of foetal morphological anomalies, foetal chromosomal anomalies, placenta praevia and abnormal foetal growth; biological exams are used to screen for pre-eclampsia, gestational diabetes, trisomy 21 (for which screening method just changed), rhesus immunisation, seroconversion for toxoplasmosis or rubeola, unknown infectious disease (syphilis, hepatitis B, VIH). During pregnancy, most of the preventive strategies have to be initiated during the first trimester or even before conception. Prevention for neural-tube defects, neonatal hypocalcemia and listeriosis should be performed for all women. On the opposite, some measures are concerning only women with risk factors such as prevention for toxoplasmosis, rhesus immunization (which recently changed), tobacco complications and pre-eclampsia and intra-uterine growth factor restriction.

  9. Being Well Born: Preventive Health Practices in Pregnancy and Delivery. Matrix No. 6.

    ERIC Educational Resources Information Center

    Iams, Jay D.

    Some of the principal research advances of the 1970s related to pregnancy and newborn infants and consequent changes in obstetrical practice are summarized in this report. The process of infant-parent attachment (bonding), adolescent pregnancy, and the reproductive hazards of tobacco, alcohol, and poor nutrition have been investigated and, in…

  10. Necrotizing Fasciitis of the Abdominal Wall Caused by Serratia Marcescens.

    PubMed

    Lakhani, Naheed A; Narsinghani, Umesh; Kumar, Ritu

    2015-04-15

    In this article, we present the first case of necrotizing fasciitis affecting the abdominal wall caused by Serratia marcescens and share results of a focused review of S. marcescens induced necrotizing fasciitis. Our patient underwent aorto-femoral bypass grafting for advanced peripheral vascular disease and presented 3 weeks postoperatively with pain, erythema and discharge from the incision site in the left lower abdominal wall and underwent multiple debridement of the affected area. Pathology of debrided tissue indicated extensive necrosis involving the adipose tissue, fascia and skeletal muscle. Wound cultures were positive for Serratia marcescens. She was successfully treated with antibiotics and multiple surgical debridements. Since necrotizing fasciitis is a medical and surgical emergency, it is critical to examine infectivity trends, clinical characteristics in its causative spectrum. Using PubMed we found 17 published cases of necrotizing fasciitis caused by Serratia marcescens, and then analyzed patterns among those cases. Serratia marcescens is prominent in the community and hospital settings, and information on infection presentations, risk factors, characteristics, treatment, course, and complications as provided through this study can help identify cases earlier and mitigate poor outcomes. Patients with positive blood cultures and those patients where surgical intervention was not provided or delayed had a higher mortality. Surgical intervention is a definite way to establish the diagnosis of necrotizing infection and differentiate it from other entities.

  11. Heart Conditions and Pregnancy: Know the Risks

    MedlinePlus

    ... week by week Pregnancy stresses your heart and circulatory system, but many women who have heart conditions deliver ... conditions and pregnancy. Pregnancy stresses your heart and circulatory system. During pregnancy, your blood volume increases by 30 ...

  12. Pregnancy and Obesity: Know the Risks

    MedlinePlus

    ... Pregnancy week by week Concerned about pregnancy and obesity? Understand the risks of obesity during pregnancy — plus steps to promote a healthy ... you can do to promote a healthy pregnancy. Obesity is defined as having an excessive amount of ...

  13. Aspirin during Pregnancy: Is It Safe?

    MedlinePlus

    Healthy Lifestyle Pregnancy week by week Is it safe to take aspirin during pregnancy? Answers from Yvonne Butler Tobah, M. ... 2015 Original article: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/aspirin-during-pregnancy/ ...

  14. [Duodenal perforation after blunt abdominal trauma].

    PubMed

    Schneider, R; Moebius, C; Thelen, A; Jonas, S

    2009-12-01

    Duodenal perforation after a blunt abdominal trauma is a rare emergency situation that can result in life-threatening complications. We report on a woman who had a perforation of the duodenum after a supposed mild blunt abdominal trauma. Unremarkable at the initial presentation, the patient presented with acute abdominal pain and a retroperitoneal abscess five days after the initial trauma. The duodenal repair was performed with a Roux-Y anastomosis. Difficulties in diagnosis are very common, but the early recognition of the rupture is essential. The contrast-enhanced CT scan is the gold standard for diagnosis. Surgical management depends on the severity of the trauma and must be chosen on an individual basis.

  15. Electromyographic analysis of four popular abdominal exercises.

    PubMed

    Piering, A W; Janowski, A P; Wehrenberg, W B; Moore, M T; Snyder, A C

    1993-01-01

    This study was designed to evaluate the effects of four specific sit-up exercises on muscular activity of the rectus abdominis. Pairs of surface electrodes were placed unilaterally on four quadrants of the rectus abdominis, delimited by tendinous inscriptions, in four male subjects. Electromyographic (EMG) recordings were taken while the subjects performed four different abdominal exercises. Each abdominal exercise was hypothesized to have a specific effect on one of the four quadrants of the rectus abdominis. The four exercises analyzed were: 1) long lying crunch, 2) bent knee crunch, 3) leg raise, and 4) vertical leg crunch. Analysis of the standardized EMG recordings demonstrated no significant differences in the mean muscle activity between the four different quadrants, in the mean muscle activity between the four different exercises, and in interactions between the exercises and the quadrants of the rectus abdominis. We conclude that none of the four abdominal exercises studied are specific for strengthening individual muscle quadrants of the rectus abdominis.

  16. [Pregnancy and vaccinoprevention].

    PubMed

    Galev, A; Nacheva, A

    2014-01-01

    Vaccinations protect woman and her fetus against different infectious diseases, but their application on pregnant should be extremely responsible. In this review I present information about some infectious diseases and vaccines during pregnancy. Women, planning to get pregnant should be advised to do serological tests in order to find out their immune status against some infections, leading to fetal congenital malformations (rubella, chicken pox, hepatitis B) and if necessary to get vaccinated at least a month before pregnancy. Despite the lack of vaccines against Cytomegalovirus (CMV), parvovirus 19 and Toxoplasma gondii it is good to know woman's immune status against these infections in order to clarify the clinical approach in case of future contact with sick or carriers. Parvovirus 19 could cause fetal death, while CMV could be transmitted to the child. Immune women wouldn't get sick and wouldn't transmit Toxoplasmagondii to the fetus during pregnancy. Recommended vaccines before pregnancy include vaccines against flu, human papilloma virus, MMR (morbilli, measles, rubella), Tdap (tetanus, diphtheria, whooping cough), chicken pox. CDC-Atlanta recommends during pregnancy two vaccines--against flu, in case it wasn't done before pregnancy, and Tdap during every pregnancy between 27-th and 36-th gestation week. Whooping cough is very dangerous for the baby during the first two months after birth, while it is not yet vaccinated. From this point of view it is of best interest of the mother to have strong immunity in order to transfer antibodies during breastfeeding, as well as for the father and the rest who will take care for the newborn child to be vaccinated against whooping cough. During pregnancy vaccinations against tuberculosis, morbilli, measles, rubella, meningococcal disease, typhoid fever and chicken pox are contraindicated. In case of contact vaccinations against rabies, anthrax, small pox, poliomyelitis and yellow fever should be taken into

  17. Methamphetamines and Pregnancy Outcomes

    PubMed Central

    Wright, Tricia E.; Schuetter, Renee; Tellei, Jacqueline; Sauvage, Lynnae

    2014-01-01

    Introduction Methamphetamine (MA) is one of the most commonly used illicit drugs in pregnancy, yet studies on MA-exposed pregnancy outcomes have been limited because of retrospective measures of drug use, lack of control for confounding factors: other drug use, including tobacco; poverty; poor diet; and lack of prenatal care. This study presents prospective collected data on MA use and birth outcomes, controlling for most confounders. Materials and Methods This is a retrospective cohort study of women obtaining prenatal care from a clinic treating women with substance use disorders, on whom there are prospectively obtained data on MA and other drug use, including tobacco. MA-exposed pregnancies were compared with non-MA exposed pregnancies as well as non-drug exposed pregnancies, using univariate and multivariate analysis to control for confounders. Results One hundred forty-four infants were exposed to MA during pregnancy, 50 had first trimester exposure only, 45 had continuous use until the second trimester, 29 had continuous use until the third trimester, but were negative at delivery and 20 had positive toxicology at delivery. There were 107 non MA-exposed infants and 59 infants with no drug exposure. Mean birth weights were the same for MA-exposed and non-exposed infants (3159 g vs. 3168 g p=0.9), though smaller than those without any drug exposure (3159 vs. 3321 p=0.04), Infants with positive toxicology at birth (meconium or urine) were smaller than infants with first trimester exposure only (2932 g vs. 3300 g p=0.01). Gestation was significantly shorter among the MA-exposed infants compared to non-exposed infants (38.5 vs. 39.1 weeks p=0.045) and those with no drug exposure (38.5 vs. 39.5 p=0.0011), The infants with positive toxicology at birth had a clinically relevant shortening of gestation (37.3 weeks vs. 39.1 p=0.0002). Conclusions MA use during pregnancy is associated with shorter gestational ages and lower birth weight, especially if used continuously

  18. Reactive-homeostasis as a cybernetic model of the silhouette effect of denial of pregnancy.

    PubMed

    Sandoz, P

    2011-11-01

    In a woman presenting a pervasive denial of pregnancy, it happens that abdominal swelling is significantly reduced if not completely absent. In such cases, the announcement of the pregnancy to the unaware woman by a physician is often sufficient to trigger the spontaneous appearance of a normal silhouette of pregnancy with abdominal prominence. The pregnancy announcement acts as an input signal applied to the regulation mechanisms of the body with the consequence that the output signal; i.e. the silhouette of the pregnant woman; turns spontaneously from an abnormal shape to a normal one. By applying a system-based analysis to these observations, the brain appears clearly to be responsible for this disorder through instructions sent to the body by the nervous system. The silhouette effect is thus shown to be a cybernetic disorder as opposed to a functional one. The existence of unexpected information-and-semantic pathways throughout the human body is also revealed by this spontaneous transition. A reactive-homeostasis model is then proposed in which symptoms result from an abnormal but coherent regulation of the functioning of the body caused by an unconscious mechanism by the brain to escape paradoxical realities. Spontaneous recovery is then a consequence of the paradoxical situation dissolution induced by the pregnancy announcement. This concept of reactive-homeostasis prompts us to investigate human disorders in complementary categories; i.e. cybernetic versus functional. Such an enlarged point of view may improve our knowledge of aetiology and suggest new perspectives for therapeutics research.

  19. Early Pregnancy Diagnosis in Bovines: Current Status and Future Directions

    PubMed Central

    Gupta, Meenakshi; Singh, Surender; Mohanty, Ashok K.; Singh, Inderjeet

    2013-01-01

    An early and accurate diagnosis of reproductive dysfunctions or aberrations is crucial to better reproductive management in livestock. High reproductive efficiency is a prerequisite for high life-time production in dairy animals. Early pregnancy diagnosis is key to shorten the calving interval through early identification of open animals and their timely treatment and rebreeding so as to maintain a postpartum barren interval close to 60 days. A buffalo, the most important dairy animal in the Indian subcontinent, is known for problems related to high calving interval, late puberty, and high incidence of anestrus. Lack of reliable cow-side early pregnancy diagnosis methods further aggravates the situation. Several methods of pregnancy diagnosis are being practiced in bovine species, yet none qualifies as the ideal pregnancy diagnosis method due to the inherent limitations of sensitivity, accuracy, specificity, speed, and ease of performing the test. The advancement of molecular techniques like proteomics and their applications in animal research has given a new hope to look for pregnancy biomarker molecules in these animals. This review attempts to examine common pregnancy diagnosis methods available for dairy animals, while assessing the usefulness of the modern technologies in detecting novel pregnancy markers and designing future strategies for research in this area. PMID:24382949

  20. Pregnancy and scleroderma.

    PubMed

    Silman, A J

    1992-01-01

    Scleroderma is a rare disease with a marked female excess in incidence. The pattern of age of onset, together with the effects of the disease, are such that the majority of women with scleroderma experience pregnancy prior to diagnosis. There are three questions of interest: (1) Does pregnancy adversely affect the prognosis of scleroderma? Isolated case reports suggest that renal disease, and in particular hypertensive crises, are associated with pregnancy in the absence of any renal abnormality before pregnancy. However, such events are rare. (2) Does scleroderma adversely affect either fertility or the outcome of pregnancy? Women with established scleroderma, again in case series, have a high rate of spontaneous miscarriage which is not found consistently in epidemiological studies. Prematurity and low birth rates are more frequent problems. (3) Does reproductive history influence disease and particularly Raynaud's phenomenon may antedate diagnosis by many years and might influence reproductive outcome, in general reproductive outcome is similar to that seen after diagnosis, although fertility appears to be reduced.

  1. Diving and pregnancy.

    PubMed

    Camporesi, E M

    1996-08-01

    Scuba diving during pregnancy has increased in incidence as a result of substantial growth in the number of young females attracted to sport diving. This review summarizes the physiological changes induced by immersion, diving and decompression, on male and female divers. Furthermore, it extends to literature review, in animal models, of the susceptibility of a pregnant animal to diving decompression injury. Publications regarding reports of diving injury in pregnant humans are also reviewed, comprising very recent material from the sport diving community. It is concluded that there is no countraindication to diving for the normal, healthy, nonpregnant female. However, pregnant females should refrain from diving, because the fetus is not protected from decompression problems and is at risk of malformation and gas embolism after decompression disease. It is prudent to advise pregnant patients of the increased risk of diving problems for the fetus during pregnancy. However, should a woman have completed a dive during early pregnancy because she was unaware she was pregnant, the present evidence is not to recommend an abortion, because several normal pregnancies have been documented even if diving is continued. Snorkeling can still be practiced during pregnancy, but scuba diving should be discontinued until after the birth period.

  2. Pregnancy and Antiphospholipid Syndrome.

    PubMed

    Schreiber, Karen; Hunt, Beverley J

    2016-10-01

    Antiphospholipid syndrome (APS) is classified as the association of thrombotic events and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies (aPL). APS is also the most frequently acquired risk factor for a treatable cause of recurrent pregnancy loss and increases the risk of conditions associated with ischemic placental dysfunction, such as stillbirth, intrauterine death, preeclampsia, premature birth, and fetal growth restriction. The use of low-dose aspirin and heparin has improved the pregnancy outcome in obstetric APS and approximately 70% of pregnant women with APS will deliver a viable live infant. However, current management does not prevent all maternal, fetal, and neonatal complications of APS and the current treatment fails in 20 to 30% of APS pregnancies, raising the need to explore other treatments to improve obstetrical outcome. Two clinical studies of retrospective design have suggested that the immunomodulator hydroxychloroquine (HCQ) may play a role in the prevention of pregnancy complications in women with aPL and APS. The randomized controlled multicenter trial of hydroxychloroquine versus placebo during pregnancy in women with antiphospholipid antibodies (HYPATIA) of HCQ versus placebo will provide scientific evidence on the use of HCQ in pregnant women with aPL.

  3. Antecedents of teenage pregnancy.

    PubMed

    Klein, L

    1978-12-01

    Antecedent factors operative in the causation of adolescent pregnancy include: The sexuality of contemporary society, especially the media. Prolongation of educational any vocational preparation in industrialized western society. Normal physical maturation at an early age. Peer and social pressure. Low expectations of life among minority and economically poor individuals. The conspiracy of silence surrounding sexuality and the inability of society to admit and deal realistically with the sexual activity of adolescents. Failure to provide sex education, clarification of values, family-life education, preparation for parenthood, and knowledge of birth-control and family-planning services targeted to teenagers, including adolescent males. Psychological and emotional problems. Failure to provide available and accessible early pregnancy-detection services with adequate counseling and support services. Failure to provide abortion services. Failure to provide supportive services to adolescents who have a child in order to prevent repeated pregnancy. Pregnancy, childbearing, and motherhood represent ultimate feminine fulfillment to many in our society, and unless attainable expectations and desirable alternatives are available, adolescents will continue to see little reason to postpone pregnancy and childbearing.

  4. Decompressive laparotomy for abdominal compartment syndrome

    PubMed Central

    Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.

    2016-01-01

    Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380

  5. Acute fatty liver of pregnancy with hypoglycaemia, diabetes insipidus and pancreatitis, preceded by intrahepatic cholestasis of pregnancy.

    PubMed

    English, Nicola; Rao, Jegajeeva

    2015-04-15

    We present the case of a 33-year-old woman in her first pregnancy. She presented with pruritus at 34 weeks gestation. A diagnosis of intrahepatic cholestasis of pregnancy was made based on elevated bile acids and elevated liver transaminases. She re-presented 4 days later, jaundiced with abdominal pain and nausea, and was hypertensive. Her bilirubin was now elevated and her creatinine had doubled. The differential diagnosis-included pre-eclampsia and Hemolysis Elevated Liver enzymes Low Platelet count (HELLP) syndrome, and delivery was expedited. Postnatally, the patient became coagulopathic, though not thrombocytopaenic; she had persistent hypoglycaemia, hyponatraemia, developed acute pancreatitis and had profound ascites and peripheral oedema. Management was supportive with multidisciplinary care and over a period of 3 weeks she made a full clinical and biochemical recovery.

  6. Progress in abdominal organ transplantation

    PubMed Central

    Kosieradzki, Maciej; Lisik, Wojciech; Rowiński, Wojciech; Małkowski, Piotr

    2011-01-01

    Summary The excellent results of vascularized organ transplantation have resulted in an increasing number of end-stage organ failure patients seeking such treatment. The results of organ transplantation depend on a number of factors – the quality of the donor (and an organ), living vs. deceased donation, magnitude of ischemic injury (and its prevention), and recipient-dependent factors. Ischemia/reperfusion injury in organ transplantation is a multifactorial process, which may lead to delayed graft function. In addition, surgical and preservation techniques, type of immunosuppressive regimens, complications after transplantation and post-transplant management may also have a significant impact on short- and long-term results of transplantation. In this paper we describe advances in transplantation in recent years, with particular emphasis on kidney, liver, intestines, whole pancreas and pancreatic islets. PMID:22129915

  7. Imaging for chronic abdominal pain in adults.

    PubMed

    Mendelson, Richard

    2015-04-01

    Diagnostic imaging is often not indicated in chronic abdominal pain. In particular, undifferentiated abdominal pain is rarely an indication for a CT scan. CT scanning is overused even when imaging is required. Other modalities may be preferable. A normal CT scan does not rule out cancer. Alarm symptoms, including anaemia, blood in the stool, waking at night with gastrointestinal symptoms, and weight loss, should be investigated. The most appropriate modality depends on the symptoms. Clinical information on request forms for CT scans should be specific and include the suspected condition as this helps the radiologist to determine an appropriate imaging protocol.

  8. [Penetrating abdominal wounds. Apropos of 330 cases].

    PubMed

    Nejjar, M; Bennani, S; Zerouali, O N

    1991-01-01

    Penetrating abdominal wounds are frequent and serious. 330 cases have been treated in the Department of Emergencies and visceral Surgery at Averroes Hospital of Casablanca from 1980 to 1990. The predominance of male sex is noted, and these wounds are always the result of aggression by white arm. All patients have been operated, the white laparotomy rate is of 36%. The classic interventionist attitude is still recommended in spite of this high rate, because our present conditions can't permit us a rigorous watching. According to abdominal lesions, the different interventions are reviewed, and their indications are detailed.

  9. Hypovolemic shock in children: abdominal CT manifestations.

    PubMed

    Taylor, G A; Fallat, M E; Eichelberger, M R

    1987-08-01

    The authors describe a "hypoperfusion complex," seen on abdominal computed tomography, which consists of marked, diffuse dilatation of the intestine with fluid; abnormally intense contrast enhancement of the bowel wall, mesentery, kidneys, and/or pancreas; decreased caliber of the abdominal aorta and inferior vena cava; and moderate to large peritoneal fluid collections. This complex was present in three patients less than 2 years of age and was associated with severe injury and a poor outcome. Recognition of this constellation of findings may help direct attention to the patient's serious hemodynamic abnormality as much as to individual organ defects.

  10. [Intraabdominal hypertension and abdominal compartment syndrome].

    PubMed

    Sonne, Morten; Hillingsø, Jens

    2008-02-11

    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various medical and surgical conditions increase the intraabdominal volume. When the content exceeds the compliance of the abdominal wall, the IAP rises. Increased IAP affects the functioning of the brain, lungs, circulation, kidneys, and bowel. The treatment of ACS is a reduction of IAP.

  11. Abdominal Migraine in a Middle-aged Woman

    PubMed Central

    Kunishi, Yosuke; Iwata, Yuri; Ota, Mitsuyasu; Kurakami, Yuichi; Matsubayashi, Mao; Kanno, Masatomo; Kuboi, Yoriko; Yoshie, Koichiro; Kato, Yoshio

    2016-01-01

    A 52-year-old woman presented with recurrent, severe abdominal pain. Laboratory tests and imaging were insignificant, and treatment for functional dyspepsia was ineffective. The poorly localized, dull, and severe abdominal pain, associated with anorexia, nausea, and vomiting, was consistent with abdominal migraine. The symptoms were relieved by loxoprofen and lomerizine, which are used in the treatment of migraine. We herein report a case of abdominal migraine in a middle-aged woman. Abdominal migraine should be considered as a cause of abdominal pain as it might easily be relieved by appropriate treatment. PMID:27725538

  12. Doppler findings in chronic ectopic pregnancy: case report.

    PubMed

    Abramov, Y; Nadjari, M; Shushan, A; Prus, D; Anteby, S O

    1997-05-01

    Chronic ectopic pregnancy is an uncommon form of tubal pregnancy manifested as a pelvic mass with minimal symptoms and a low or absent titer of human chorionic gonadotropin. For this reason, most of the reported cases have been diagnosed only after explorative laparotomy. The value of Doppler ultrasonography for preoperative diagnosis of this entity has not yet been established. We report on a 36-year-old patient who was admitted for intermittent right lower quadrant abdominal pain of 3 months' duration, and a right adnexal mass found on pelvic examination. On Doppler ultrasonography, a right complex adnexal mass was demonstrated, characterized by extensive external vascularization, aberrant vessels and arteriovenous shunting, but with no internal blood flow. Explorative laparotomy revealed a right tubal mass adherent to the omentum, and covered by numerous enlarged and tortuous blood vessels originating in the omentum. Pathological examination of the mass revealed a chronic ectopic pregnancy. The possible contribution of Doppler-specific characteristics for the diagnosis of chronic ectopic pregnancy is described and discussed.

  13. High Blood Pressure in Pregnancy

    MedlinePlus

    ... of the baby. Controlling your blood pressure during pregnancy and getting regular prenatal care are important for ... your baby. Treatments for high blood pressure in pregnancy may include close monitoring of the baby, lifestyle ...

  14. Pregnancy, Breastfeeding, and Bone Health

    MedlinePlus

    ... supported by your browser. Home Osteoporosis Women Pregnancy, Breastfeeding, and Bone Health Publication available in: PDF (63 ... to get enough calcium during pregnancy and breastfeeding. Breastfeeding and Bone Health Breastfeeding also affects a mother’s ...

  15. Pregnancy Loss: How to Cope

    MedlinePlus

    ... J, et al. A national survey on public perceptions of miscarriage. Obstetrics & Gynecology. 2015;125:1313. Kropmans ... mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/in-depth/pregnancy-loss/art-20047983 . Mayo Clinic Footer Legal ...

  16. Diagnostic imaging of abdominal fluid collections and abscesses.

    PubMed

    Baker, M E; Blinder, R A; Rice, R P

    1986-01-01

    With today's advanced technology, the clinician and radiologist have a number of techniques with which to evaluate the abdomen for fluid collections and/or abscesses. Three points are clear from the plethora of literature concerning this subject: the need to individualize the clinical and imaging approach to each patient suspected of an abnormal fluid collection or abscess, the need to individualize the imaging procedure based upon what is done best at the institution, and the need for percutaneous aspiration of all fluid collections for diagnosis. No single imaging test is totally sensitive or specific for the detection of an infected fluid collection. Overall, CT probably does provide the most accurate means to detect an intra-abdominal abscess. Because of this, and because it is less operator dependent than ultrasound, CT is used most often as the procedure of choice at our institution.

  17. [Pregnancy and kidney diseases].

    PubMed

    Siekierka-Harreis, M; Rump, L C

    2011-10-01

    The prevalence of chronic kidney disease in women of childbearing age reaches approximately 0.2%. Under physiological conditions pregnancy results in important hemodynamic changes on the maternal organism. In the case of chronic kidney disease these adaptations often are only partial. Physiological changes of immune response during pregnancy may contribute to the progress of renal disease. Regardless of the underlying kidney disease, one can assume that the better the glomerular filtration rate and blood pressure are the more favorable the course of pregnancy will be with the chance for a healthy child and stable renal function. To achieve this goal, a close interaction is required between gynecologist, nephrologist, and other specialists in a center with appropriate experience.

  18. Anorectal abscess during pregnancy.

    PubMed

    Koyama, Shinsuke; Hirota, Masaki; Kobayashi, Masaki; Tanaka, Yusuke; Kubota, Satoshi; Nakamura, Ryo; Isobe, Masanori; Shiki, Yasuhiko

    2014-02-01

    Anorectal symptoms and complaints caused by hemorrhoids or anal fissures are common during pregnancy. It is known that one-third of pregnant women complain of anal pain in the third trimester. Anal pain may be caused by a wide spectrum of conditions, but if it begins gradually and becomes excruciating within a few days it may indicate anorectal abscess. We experienced a case of anorectal abscess during pregnancy which was diagnosed by magnetic resonance imaging and treated by incision and seton drainage at 36 weeks of gestation, followed by a normal spontaneous delivery at 38 weeks of gestation. To our knowledge, this is the first case report of anorectal abscess during pregnancy in the English-language published work. The clinical course of our case and clinical considerations of anorectal abscesses are discussed.

  19. Orthopedic trauma in pregnancy.

    PubMed

    Desai, Pratik; Suk, Michael

    2007-11-01

    Trauma sustained during pregnancy can trigger uncertainty and anxiety for patient and orthopedic surgeon alike. In particular, orthopedic-related injuries raise concerns about preoperative, intraoperative, and postoperative care. In this article, we review common concerns about radiation exposure, leukemia, pain management, anticoagulation, and anesthesia. One finding is that radiation risk is minimal when obtaining x-rays for operative planning, provided that the cumulative dose is within 5 rad. We also address safety concerns about patient positioning and staff radiation exposure. In addition, we found that most anesthetics used in pregnancy are category C (ie, safe). Perioperative opioid use for pain management is recommended with little risk. Regarding anticoagulation, low-molecular-weight heparin and fondaparinux are the safest choices. Last, pregnancy is not a contraindication to operative management of pelvic and acetabular fractures.

  20. Eisenmenger Syndrome in Pregnancy

    PubMed Central

    Yuan, Shi-Min

    2016-01-01

    Eisenmenger syndrome is very rare in pregnant women. Debates remain concerning the management of Eisenmenger syndrome in this patient population and the prognosis is unclear in terms of maternal and fetoneonatal outcomes. Epidural analgesia is preferred for Cesarean section as it alleviates perioperative pain and reduces the pulmonary and systemic vascular resistances. Maternal mortality in the presence of Eisenmenger syndrome is reported as 30-50% and even up to 65% in those with Cesarean section. The major causes of death could be hypovolemia, thromboembolism and preeclampsia. Pregnancy should ideally be avoided in a woman with Eisenmenger syndrome concerning the high maternal mortality rate and probable poor prognosis of the baby. A short labour and an atraumatic delivery under epidural block are preferred in the women with a strong desire of pregnancy. The purpose of this article is to discuss the debates of Eisenmenger syndrome in pregnancy and the possible resolutions. PMID:27849306