Most drugs are not tested for use during pregnancy, consequently, labeling, which may include information about fetal safety, includes nothing about dosing, efficacy, or maternal safety. Yet these are concerns of health care providers considering treatment of disease during pregnancy. Therefore, the practitioner treats the pregnant woman with the same ...

It is estimated there are 350-400 million people worldwide chronically infected with HBV. Many of these are women and of reproductive age. As such, they may face therapeutic decisions regarding antiviral therapy and the implication this may have on future or current pregnancies. This article reviews the data of all ...

Acquired hemophilia A is a rare but often life-threatening hemorrhagic disorder characterized by an autoantibody directed against coagulation factor VIII. Fifty per cent of cases are idiopathic whereas the remaining 50% are associated with pregnancy, autoimmune conditions, malignancies and drugs. In this review the actual knowledge on diagnostic and therapeutic ...

Iron deficiency, the most common cause of anaemia in pregnancy worldwide, can be mild, moderate or severe. Severe anaemia can have very serious consequences for mothers and babies, but there is controversy about whether treating mild or moderate anaemia provides more benefit than harm. To assess the effects of different ...

All the elective surgeries are to be avoided during pregnancy and pregnant women should undergo only emergency surgical interventions. Pregnancy is associated with different physiological changes in the organism, which should be taken into account in preparative preparation of the pregnant women. Expanded body fluid volume leads to dilutional anemia, ...

The incidence of pre-eclampsia ranges from 3% to 7% for nulliparas and 1% to 3% for multiparas. Pre-eclampsia is a major cause of maternal mortality and morbidity, preterm birth, perinatal death, and intrauterine growth restriction. Unfortunately, the pathophysiology of this multisystem disorder, characterized by abnormal vascular response to placentation, is ...

Fetal medicine covers a broad spectrum of conditions that can be diagnosed before birth. Different disorders will require different treatment strategies and there is often an important ontogenetic aspect on how and when treatment can be implemented. Due to the limited availability there is a general lack of knowledge on ...

The prevalence of overt and subclinical hypothyroidism during pregnancy is estimated to be 0.3-0.5% and 2-3%, respectively. Thyroid autoantibodies are found in 5-18% of women in the childbearing age. The aim of this review is to underscore the clinical significance of these findings on the health of both the mother ...

MANAGEMENT OF FIRST TRIMESTER PREGNANCY LOSS HAS CONVENTIONALLY INVOLVED TWO OPTIONS: expectant management or dilation and curettage in the operating room. New options in the outpatient setting are providing women with alternatives that can be less expensive and performed in more private settings. This review discusses the available approaches to ...

Combination antiretroviral therapy (CART) dramatically decreases mother-to-child HIV-1 transmission (MTCT), but maternal adverse events are not infrequent. A review of 117 locally followed pregnancies revealed 7 grade ≥3 AEs possibly related to antiretrovirals, including 2 hematologic, 3 hepatic, and 2 obstetric cholestasis cases. A fetal demise was attributed to obstetric ...

The human placenta expresses the genes for proopiomelanocortin and the major stress hormone, corticotropin-releasing hormone (CRH), profoundly altering the "fight or flight" stress system in mother and fetus. As pregnancy progresses, the levels of these stress hormones, including maternal cortisol, increase dramatically. These endocrine changes are important for fetal maturation, ...

Pregnancy and the postpartum period have an increased incidence of venous thromboembolism (VTE). The condition is unique during this period for several reasons. Primarily, because there is complexity in diagnosing this condition in view of altered physiology and preexisting edema in pregnancy and also because there are restrictions on the ...

Maternal euthyroidism during pregnancy is crucial for normal development and, in particular, neurodevelopment of the foetus. Up to 3.5 percent of pregnant women suffer from hypothyroidism. Industrial use of various chemicals-endocrine disrupting chemicals (EDCs)-has been shown to cause almost constant exposure of humans with possible harmful influence on health and ...

Pregnancy places increased demands on the mother to provide adequate nutrition to the growing conceptus. A number of micronutrients function as essential cofactors for or themselves acting as antioxidants. Oxidative stress is generated during normal placental development; however, when supply of antioxidant micronutrients is limited, exaggerated oxidative stress within both ...

Nanoparticles (NP) are organic or inorganic substances, the size of which ranges from 1 to 100 nm, and they possess specific properties which are different from those of the bulk materials in the macroscopic scale. In a recent decade, NP were widely applied in biomedicine as potential probes for imaging, ...

In pharmacokinetics drug absorption, distribution, clearance, and bioequivalence are usually considered, but during pregnancy the most important variable is adherence or compliance. Pharmacokinetic changes during pregnancy that may lead to changes in maternal drug use are described through presentation of cases highlighting the relevance of these changes. Non-invasive methods of ...

Although most drugs are used to treat chronic or pregnancy-induced conditions during pregnancy and lactation, very few are studied in pregnant or breastfeeding women. The information we have on drugs taken during pregnancy and lactation is usually obtained after market approval through published case reports or case series and from ...

The uterine cervix plays a vital role in maintaining pregnancy and an equally important role in allowing parturition to occur. Progesterone, either endogenously produced or supplied exogenously, supports the function of the cervix in sustaining intrauterine pregnancy, and the withdrawal of progesterone, either through natural processes or pharmacologic intervention, leads ...

Intervention trials have demonstrated conclusively that oral ingestion of extra folic acid can prevent the majority of cases of spina bifida and other neural tube defects (NTDs). Data from these studies offer conclusive evidence that the intake of 400 μg/day folic acid provides this benefit. The big problem has remained ...

Severe liver disease in pregnancy is generally considered to have a favorable prognosis. The limited data available have not yielded disease-specific prognostic criteria or guidance on who should undergo liver transplantation (LT). We retrospectively evaluated 54 admissions with pregnancy-related liver disease to (1) evaluate if any admission parameters were associated ...

Ascending amniotic fluid bacterial infection is a cause of perinatal morbidity and mortality. A diagnosis of amniotic cavity infection can be inferred by documenting maternal (acute chorioamnionitis) and/or fetal (chorionic plate vasculitis; umbilical vasculitis/funisitis) inflammatory response. A definitive diagnosis of intrauterine/neonatal sepsis as a cause of stillbirth requires positive blood ...

The purpose of this presentation is to review the role of sonography in evaluation of acute abdomen during pregnancy. Illustrative cases were collected from gravid patients who presented with signs and symptoms suspicious for acute abdomen and subsequently underwent sonography. This presentation shows sonographic findings of various maternal complications that ...

To study the causes, burden, and impact of pregnancy-related acute renal failure (PRARF) in a low-resource setting. A prospective observational study of consecutive women admitted to the Seth Sukhlal Karnani Memorial Hospital, Kolkata, India, with PRARF between February 1, 2007, and May 31, 2009, was conducted. The information collected included ...

Acute pyelonephritis is one of the most common indications for antepartum hospitalization. When acute pyelonephritis is diagnosed, conventional treatment includes intravenous fluid and parenteral antibacterial administration. There are limited data by which to assess the superiority of one antibacterial regimen over the other in terms of efficacy, patient acceptance and ...

We report our experience with three cases of acute fatty liver of pregnancy. Case 1 complained of hydrodipsia 4 days before delivery. Case 2 presented with nausea, vomiting and dizziness 6 days before delivery. Case 3 developed loss of appetite and general fatigue with jaundice 10 days before delivery. They ...

Acute lymphocytic leukemia (ALL) is a rare occurrence in pregnancy and can be rapidly fatal if left untreated. The need for immediate treatment of ALL, coupled with the maternal-fetal risks from the chemotherapy regimen render a therapeutic dilemma in pregnant women with ALL. We report a case of ALL diagnosed ...

BACKGROUND: Acute, persistent abdominal pain due to ruptured pancreatic carcinoma and perforated stomach is extremely rare during pregnancy. CASE: We evaluated a woman at 34 weeks of gestation presenting with uterine contractions. Computed tomography scanning revealed a large retroperitoneal mass, and her blood carbohydrate antigen 19-9 level was elevated. Immediately ...

To determine the clinical presentation, biochemical findings, complications, clinical diagnosis and management of patients with acute fatty liver of pregnancy (AFLP). The influence of the mode of delivery on maternal-perinatal mortality is analyzed and two methods of diagnostic imaging are compared. Eleven cases of AFLP identified at the West China ...

A survey was posted to 27 women with acute porphyria about complications and outcome of pregnancy. Fifteen women returned the completed questionnaire and the pregnancies were characterised depending on the timing of diagnosis of porphyria. Four women were diagnosed with porphyria before the first pregnancy, five during a pregnancy and ...

An acute intracranial haemorrhage during delivery or pregnancy is a rare complication and usually observed in connection with risk factors. We present the clinical course of a 32-year-old primigravida in the 40th week of gestation delivered in general anaesthesia by Caesarean section after premature rupture of the membranes and obstructed ...

The maternal respiratory tract undergoes significant anatomic and physiologic changes during pregnancy, which increase maternal susceptibility to respiratory failure. Respiratory failure in pregnancy is relatively rare, but it remains one of the leading conditions requiring intensive care unit admission in pregnancy and carries a high risk of maternal and fetal ...

To evaluate the demographics, clinical presentations, laboratory findings, and maternal and fetal outcomes in patients with acute fatty liver of pregnancy. A retrospective review was conducted of the records of pregnant patients with a diagnosis of acute fatty liver in a tertiary medical center over a 22-year period. Eighteen patients ...

Acute fatty liver of pregnancy (AFLP) is a potentially fatal metabolic disorder that manifests during the third trimester. Early diagnosis, termination of pregnancy, and treatment of complications associated with AFLP significantly reduce maternal morbidity and mortality. While most cases of AFLP occur before delivery, some may occur after vaginal delivery. ...

To report our experience about a woman with acute promyelocytic leukemia (APL) during pregnancy. We focus on the obstetric treatment of our patient. Case report. University Hospital. A 32-year-old-woman, gravida 2, para 1, at the 25th week of pregnancy with a diagnosis of APL. Multidisciplinary approach to the problem with ...

Management of acute pancreatitis in pregnancy is based on expert opinion only, due to geographic and ethic variations. Nonbiliary causes should be sought as they are associated with worse outcomes. Alcohol as a cause of acute pancreatitis is not rare. Hemoconcentration as a marker of fluid deficit and severity should ...

Acute fatty liver of pregnancy is a rare cause of jaundice and liver failure associated with high maternal and fetal mortality. We analysed five consecutive cases of acute fatty liver of pregnancy, along with the associated morbidity, mortality and complications. Between January 1999 and January 2008, a total of 68,524 ...

Long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency is a mitochondrial fatty acid beta-oxidation defect characterized by accumulation of long-chain hydroxyacylcarnitine intermediates and female carriers of this disorder are in risk for pregnancy complications. We found elevated blood long-chain hydroxyacylcarnitine species in a carrier of LCHAD deficiency at 31weeks of pregnancy with a ...

Pregnancy complicated by pancreatitis is a rare and difficultly managed clinical situation. Gallstones are the most frequent cause of pancreatitis in pregnancy. Non-gallstone pancreatitis in pregnancy has been shown to be significantly more prone to premature delivery and pseudocyst formation. Cystic lesions as a cause of pancreatitis in pregnancy have ...

BACKGROUND: Pregnancy-associated acute biliary pancreatitis is a rare but challenging clinical entity in terms of diagnosis and management. We report our institutional medical data of pregnancy-associated acute biliary pancreatitis. METHODS: Medical records of 27 patients admitted to our clinics for pregnancy-associated acute biliary pancreatitis between January 2005 and January 2010 ...

Pregnancy is a time of great maternal physiological and metabolic changes. This affects the biochemical and haematological parameters used in the assessment of liver disease, and it is important to appreciate the different reference ranges in pregnancy to facilitate recognition of liver disorders in pregnancy. Due to the increased physiological ...

Low maternal vitamin D levels during pregnancy have been linked to various health outcomes in the offspring, ranging from periconceptional effects to diseases of adult onset. Maternal and infant cord 25(OH)D levels are highly correlated. Here, we review the available evidence for these adverse health effects. Most of the evidence ...

With the constant advent of new developments and modifications in immunosuppressive regimens, clinicians are responsible for providing pregnancy counseling to all pre and posttransplant recipients of childbearing age. As individual physicians and centers accrue experience with these major therapeutic decisions, it is critical that both positive and negative outcomes be ...

OBJECTIVE: To evaluate the safety, feasibility, and pregnancy outcomes of laparoscopic appendectomy (LA) during pregnancy. STUDY DESIGN: A retrospective review of eight pregnant women who underwent LA from January 2007 to December 2008. RESULTS: The median age of the patients and median parity were 29.5 years (range, 25-34 years) and ...

To study the clinical profile, management and outcome of the patients with pregnancy-related acute renal failure (PRARF). All patients with PRARF admitted between January 2006 and January 2009 were analyzed. The total number of women with PRARF was 75. Age range of women with PRARF was 21 to 46 years ...

INTRODUCTION: The data directly evaluating acute renal failure (ARF) in third trimester of pregnancy from Indian subcontinent are scanty. This study analyzes the clinical spectrum of ARF with respect to total birth in third trimester of pregnancy. MATERIAL: All pregnant women after the 28th week of pregnancy or in early ...

African American and Latino teenagers and communities are frequently assumed to have weaker norms against teenage pregnancy than whites. Despite their importance, adolescents' norms about teenage pregnancy have not been measured or their correlates and consequences documented. This study examines individual-level and contextual variation in adolescents' embarrassment at the prospect ...

Acute pancreatitis (AP) is a rare event in pregnancy, occurring in approximately 3 in 10,000 pregnancies. The spectrum of AP in pregnancy ranges from mild pancreatitis to serious pancreatitis associated with necrosis, abscesses, pseudocysts and multiple organ dysfunction syndromes. Pregnancy related hematological and biochemical alterations influence the interpretation of diagnostic ...

Acute abdominal pain in pregnancy may be attributable to a broad range of nonobstetrical causes. The evaluation of an acute abdomen during pregnancy must include in the differential diagnosis appendicitis and cholecystitis, which are 2 of the most common reasons for nonobstetric surgical intervention in pregnancy. Both conditions may be ...

Suboptimal developmental environments program offspring to lifelong metabolic problems. The aim of this study was to determine the impact of protein restriction in pregnancy on maternal liver lipid metabolism at 19 days of gestation (dG) and its effect on fetal brain development. Control (C) and restricted (R) mothers were fed ...

Treatment of acutely ruptured intracranial aneurysms in pregnancy represents a clinical challenge requiring a meticulously selected strategy. We report eight cases of ruptured cerebral aneurysms in eight pregnant patients treated safely and effectively via an endovascular approach.