PURPOSE OF REVIEW: There is increasing awareness within obstetric services of the importance of treating maternal mental illness due to the association with increased maternal mortality, morbidity and poorer child outcomes. However, there is limited research on the risks and benefits of pharmacological treatment of women in pregnancy. This review ...

A phaeochromocytoma in a pregnant patient is one of the most threatening medical conditions for both mother, fetus and physician. Although extraordinarily rare with a frequency of 0.002% of all pregnancies, this tumour is notorious for its devastating consequences. As in non-pregnant patients, signs and symptoms are quite variable but ...

Dietary iodine intake is required for thyroid hormone production. The impact of pregnancy on iodine metabolism and homeostasis and the impact of maternal dietary iodine status and supplementation on maternal thyroid volume and function are reviewed. The effects of iodine status on fetal and neonatal neurodevelopment during pregnancy and lactation ...

Both mood disorders and thyroid dysfunction are common in pregnancy and the postpartum period and have significant short and long-term implications to the mothers and their infants. Thyroid hormones have a multitude of effects on the central nervous system, undergo significant changes during pregnancy, and it is now widely recognized ...

Cytokines are involved in almost all processes during the menstrual cycle, the fertilization period and pregnancy. They are expressed in numerous reproduction-related body fluids and tissues. Disorders of cytokine expression patterns may cause pregnancy pathologies. Therefore, cytokines have the potential as new biomarkers in different body compartments for a variety ...

Establishment of pregnancy in pigs requires continuous function of corpora lutea and endometrial preparation for embryo implantation. Progesterone regulates expression of many proteins necessary for endometrial remodelling and embryo-maternal communications. Attaining the uterine receptivity involves progesterone priming and loss of progesterone receptors in the uterine epithelium before days 10-12 after ...

Morbidly adherent placenta is a grave complication of pregnancy referring to a pathological adherence of placenta to uterine wall with a reported incidence of 1:2500 deliveries. Women with previous two caesarean sections and placenta previa are at greater risk and also those with previous damage to uterine wall. This commentary ...

Clin Microbiol Infect 2011; 17: 1312-1322 ABSTRACT: This review considers the role of intracellular bacteria in adverse pregnancy outcomes, such as miscarriage, stillbirths, and preterm labour. The cause of miscarriage, stillbirth and preterm labour often remains unexplained. Intracellular bacteria that grow either poorly or not at all on media used ...

Overt thyroid disease is a well-established risk factor for adverse pregnancy and perinatal outcomes. Whether or not subclinical thyroid dysfunction carries these same risks has been a matter of controversy. There is inconsistent evidence on the association of subclinical thyroid dysfunction (ie, subclinical hypothyroidism or isolated hypothyroxinemia) with a woman's ...

The placenta and umbilical cord play important roles in the development of the growing fetus. The placenta can be clearly identified by the 14th gestational week and should be evaluated during each obstetric ultrasound examination.This article reviews the formation of the placenta and its expected sonographic appearance throughout gestation along ...

U.S. servicewomen's ability to plan pregnancies is of concern to the military in terms of troop readiness and cost and is an important public health issue. Contraception access and use are crucial, particularly given the high prevalence of sexual assault in the military and the benefits of menstrual suppression for ...

During pregnancy, steroids are usually used in maternal diseases such as adrenal failure or other autoimmune diseases, e.g. idiopathic thrombocytopenic purpura (ITP), Crohn's disease, systemic lupus erythematosus, dermatomyositis, scleroderma, Addison's disease and hyperemesis gravidarum, HELLP syndrome. Endogenous or exogenousmaternal steroids are metabolized by the placental enzyme 11 beta-hydroxy steroid dehydrogenase ...

Management of prolactinoma in pregnancy is a big challenge for the treating obstetrician as prolactin levels are normally raised in pregnancy and this creates a possibility of missing the diagnosis of prolactinoma. Women with micro adenomas and intrasellar macro adenomas do not require serial magnetic resonance imaging (MRI) or visual ...

Valvular heart disease is common in pregnancy. Maternal physiology changes significantly during gestation with substantial increases in cardiac output and blood volume; this can cause unmasking or worsening of cardiac disease. Acquired valvular lesions most frequently arise from rheumatic fever, especially in patients who have emigrated from developing nations. Congenital ...

Pregnancy is associated with physiological and pathological changes in platelet numbers and function, which can be of clinical concern because of risks for maternal and fetal or neonatal bleeding. Thrombocytopenia in pregnancy is frequently encountered and may be due to increased platelet turnover and plasma dilution, immune-mediated mechanisms, or a ...

Pregnancy can be associated with a wide variety of neurologic problems, resulting from alterations in physiology of the pregnant state. The pregnant patient presenting with neurologic symptoms poses both diagnostic and therapeutic challenges. The physician will often require some form of neuroimaging as part of their ongoing evaluation. This review ...

The benefits of rigorous physical activity have long been proclaimed by the medical community. However, consensus regarding exercise duration and intensity in pregnancy has been more difficult to achieve. Conservative exercise guidelines for pregnant women were issued broadly in the 1980s due to limited evidence regarding safety. More recent evidence ...

Successful pregnancy and delivery is dependent upon normal function of the pituitary gland. Benign tumors of the pituitary are relatively common and may interfere with normal pregnancy in a variety of ways. Symptoms related to pituitary tumors can include headache, fatigue, and visual loss. Some may present dramatically with pituitary ...

Selective serotonin reuptake inhibitor (SSRI) medications are the most common antidepressant treatment used during pregnancy and the postpartum period. Up to 10% of pregnant women are prescribed SSRIs. Serotonin plays an integral part in neurodevelopment, and questions have been raised about the placental transfer of SSRIs and the effects of ...

PURPOSE OF REVIEW: The stubborn epidemic of teen pregnancy remains a major public health problem in the United States. This review discusses the use of intrauterine devices (IUDs) in United States teens as a potential strategy to reduce teen pregnancy. Traditionally, the IUD was not thought of as an appropriate ...

The combination of 200mg of mifepristone followed by 25μg to 800μg (depending on gestational age) of misoprostol has been shown to be effective for the termination of pregnancy throughout gestation. The dose of misoprostol should be reduced as gestational age increases. Mifepristone is not indicated for induction of labor with ...

BACKGROUNDCurrent routine semen preparation techniques do not inclusively target all intrinsic sperm characteristics that may impact the fertilization potential. In order to address these characteristics, several methods have been recently developed and applied to sperm selection. The objective of this study was to systematically review the literature describing these advanced ...

During pregnancy, maternal and fetal Ca demands are met through increased intestinal Ca absorption. Increased Ca absorption may be more dependent on oestrogen's up-regulation of Ca transport genes than on vitamin D status. Numerous studies, however, have found that severe vitamin D deficiency with secondary hyperparathyroidism during pregnancy leads to ...

Asthma is probably the most common serious medical disorder that may complicate pregnancy. A third of pregnant women with asthma will experience worsening of their symptoms, a third will see improvement of their symptoms and a third will see no change. The primary goal is to maintain optimal control of ...

The global pandemic of maternal obesity presents a major challenge for healthcare providers, and has significant short- and long-term implications for both maternal and fetal health. Currently, the evidence-base underpinning many of the interventions either currently in use or recommended to improve pregnancy outcome in obese women is limited. The ...

The primary embryonic signal in primates is chorionic gonadotropin (CG, designated hCG in humans), that is classically associated with corpus luteum rescue and progesterone production. However, research over the past decade has revealed the presence of the hCG receptor in a variety of extragonadal tissues. Additionally, discoveries of the multiple ...

Emergency contraception and medical abortion are options, but education about them is vital.

INTRODUCTION:: Granulosa cell tumors (GCTs) are extremely rare tumors and are divided into 2 types: adult (AGCT) and juvenile (JGCT). The JGCTs represent only 5% of all cases. The incidence of ovarian carcinoma diagnosed during pregnancy varies about 0.0179 to 0.11 per 1000 pregnancies. CASE:: A 24-year-old woman at 12 ...

PURPOSE OF REVIEW: Induced abortion is widely believed - by the public, healthcare professionals, and policy-makers - to lead to adverse mental health sequelae. This belief is false, as it applies both to adult women and adolescents. However, it has been used to rationalize, and been quoted in, restrictive and ...

Recent research in the USA has shown the advantages for children's welfare of open fetal surgery over postnatal treatment for myelomeningocele. However, a balance must be struck between complications of premature birth risked by prenatal surgery and the long-term advantages for affected children's health, including mobility and neurologic capacity. Risks ...

Autoimmune blistering disease (AIBD) in pregnancy raises several complex management issues associated with underlying pathogenesis and treatment options. This article considers the effects of the disease as well as its treatment for both mother and fetus. All AIBDs can occur in pregnancy but are relatively rare. Pemphigoid gestationis is a ...

Treating coma in the mother also means treating the fetus. Pregnant women are subject to causes of coma that may also arise from the effects of pregnancy on organ systems: vascular, cardiac, pulmonary, renal, endocrine, and others. With coma, no investigations are categorically excluded when the mother's health and life ...

BACKGROUND Complete asthenozoospermia, i.e. 100% immotile spermatozoa in the ejaculate, is reported at a frequency of 1 of 5000 men. Its diagnosis implies a poor fertility prognosis even with ICSI. It is extremely important to distinguish between two different groups of patients with complete asthenozoospermia, i.e. virtual or absolute asthenozoospermia. ...

Women who lose desired pregnancies by miscarriage, stillbirth, genetic termination, or unsuccessful in vitro fertilization are at risk of suffering from grief, anxiety, guilt, and self-blame that may even present in subsequent pregnancies. A review of the literature reveals the dilemmas about effective means of helping women deal with these ...

The specific dermatoses of pregnancy represent a heterogeneous group of pruritic skin diseases that have been recently reclassified and include pemphigoid (herpes) gestationis, polymorphic eruption of pregnancy (syn. pruritic urticarial papules and plaques of pregnancy), intrahepatic cholestasis of pregnancy, and atopic eruption of pregnancy. They are associated with severe pruritus ...

This is a retrospective analysis of vaginal breech delivery from January 2006 to December 2008 at a maternity hospital in New Delhi. The hospital has approximately 6,000 deliveries per year, and serves a low income population. Most patients are unbooked, have had no antenatal care and attend in an advanced ...

Preeclampsia, a hypertensive pregnancy-specific disorder, has long been analyzed for its association with cellular stress. It still remains one of the most serious complications of pregnancy. It is a multi-system disorder that affects maternal vascular function and fetal growth. The physiopathology of preeclampsia is still unclear, but an imbalance between ...

Once a woman is delivered by cesarean, her options in a subsequent pregnancy are either a planned trial of labor or a planned elective repeat cesarean. There are no randomized trials comparing these two choices to definitively guide patients and physicians. The primary cesarean rate is increasing and vaginal birth ...

Frequency-related parameters derived from the uterine electromyogram (EMG) signals are widely used in many pregnancy monitoring and preterm delivery prediction studies. Although they are classical parameters, they are well suited for quantifying uterine EMG signals and have many advantages over amplitude-related parameters. The present work aims to compare various frequency-related ...

Selective serotonin reuptake inhibitors (SSRIs) are increasingly used during pregnancy and lactation, with 1.8-2.8% exposed pregnancies. Given the risks of untreated maternal depression for both mother and child, adequate treatment is essential. If pharmacological treatment with SSRIs is indicated, the fetal and neonatal effects of SSRIs have to be considered, ...

An increasing body of evidence suggests that poor nutrition at the very beginning of life - even before birth - leads to large and long term negative consequences for both mental and physical health. This paper reviews the evidence from studies on the Dutch famine, which investigated the effects of ...

To review the literature regarding the diagnosis and management of acromegaly during pregnancy. A systematic literature search was performed using MEDLINE including hand-searching reference lists from original articles. The diagnosis of acromegaly during pregnancy is made difficult due to the physiologic changes in pituitary GH secretion and IGF-1 production resulting ...

Preterm labor (PTL) is a major cause of neonatal morbidity and mortality worldwide. Among the available tocolytics, indomethacin, a prostaglandin synthetase inhibitor, has been in use since the 1970s. Recent studies have suggested that prostaglandin synthetase inhibitors are superior to other tocolytics in delaying delivery for 48 hours and 7 ...

A consideration of teratogenic exposures includes not only an agent (chemical, radiation, biologic) but an exposure level and timing of exposure. There are criteria by which exposures are evaluated for a causal connection with an abnormal outcome. We here review some teratogenic exposures and discuss how they were initially described ...

Several studies indicate that impaired fetal growth, and in utero exposure to risk factors, especially maternal hypercholesterolemia, may be relevant for the early onset of cardiovascular damage. The exact molecular mechanisms of such fetal programming are still unclear. Epigenetics may represent one of the possible scientific explanations of the impact ...

Pregnant women should have access to medications that have been adequately studied for use to facilitate evidence-based risk-benefit discussions with their health care providers. Pregnant women experience acute medical emergencies, have existing conditions that require continued medical treatment or may develop pregnancy-induced conditions, making drug use during pregnancy unavoidable. Drug ...

Abstract Why is induced abortion common in environments in which modern contraception is readily available? This study analyses qualitative data collected from focus group discussions and in-depth interviews with women and men from low-income areas in five countries - the United States, Nigeria, Pakistan, Peru and Mexico - to better ...

Teratology Information Services (TIS) located throughout the world have long played a key role in screening for potential new human teratogens. Using a basic prospective cohort study design, TIS recruit pregnant women from among callers to the Services who have had an exposure of interest and at the same time ...

Urea cycle enzymes deficiencies are rare metabolic disorders. Ornithine transcarbamylase (OTC) deficiency is the most common type. The syndrome results from a deficiency of the mitochondrial enzyme OTC which catalyses the conversion of ornithine and carbamoyl phosphate to citrulline. It shows X-linked inheritance and typically remains asymptomatic until late infancy ...

BACKGROUND: Pregnancy complicated by cancer is relatively rare but, as women in western societies tend to delay childbearing to the third and fourth decade of life, this phenomenon is going to be encountered more often in the future. MATERIAL AND METHODS: Review of the literature and description of the different ...