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 ...

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 ...

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 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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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 ...

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.

OBJECTIVE: To determine the etiology and outcome of Acute Renal Failure (ARF) in pregnancy. STUDY DESIGN: A case series. PLACE AND DURATION OF STUDY: Nephrology Department of the Jinnah Postgraduate Medical Centre, Karachi, from August 2007 to July 2008. METHODOLOGY: Pregnant women who were healthy previously and had developed ARF, ...

Acute eosinophilic pneumonia is a disease of unknown etiology characterized by peripheral blood eosinophilia and pulmonary infiltrative shadows on radiography. Acute eosinophilic pneumonia follows an acute course within 1 week and the symptoms include fever, dyspnea, and cough. Acute eosinophilic pneumonia has a good prognosis and responds promptly to steroid ...

Acute aortic dissection is a rare life-threatening event. No further pregnancies in women who had a previous acute aortic dissection have been reported. We present the case of a chronic hypertensive woman, who in her previous gestation was submitted to an acute aortic dissection repair at 28 weeks of gestation ...

Orthotopic liver transplantation (OLT) for acute liver failure (ALF) during pregnancy is an uncommon occurrence with variable outcomes. In pregnancy-related liver failure, prompt diagnosis and immediate delivery are essential for a reversal of the underlying process and for maternal and fetal survival. In rare cases, the reason for ALF during ...

BACKGROUND & AIMS: Acute pancreatitis is rare during pregnancy; limited data are available about maternal and fetal outcomes. We investigated the effects of acute pancreatitis during pregnancy on fetal outcome. METHODS: This retrospective cohort study, performed at a single academic center, included consecutive pregnant women who presented with (n = ...

OBJECTIVE: We sought to compare maternal and neonatal morbidity as well as obstetric outcomes associated with pyelonephritis in pregnancy during the first compared to the second/third trimester. STUDY DESIGN: A retrospective cohort analysis was performed of all pregnant women admitted to a single tertiary care hospital between January 2004 and ...

Acute pancreatitis is rare cause in pregnancy and gallstones are clearly the most common cause of pancreatitis during pregnancy. Only a small percentage of women with acute pancreatitis are associated with hypertriglyceridemia and it is most often noted during the last two trimesters of pregnancy. Hypertriglyceridemia is a rare cause ...

A 33-year old pregnant patient (pregnancy week 15) with a past medical history of ulcerative colitis with onset of the disease following the birth of her first child was admitted to the hospital with symptoms of weight loss, pyrexia, leukocytosis and bloody and mucous diarrhoea. Total ileocolonoscopy revealed an acute ...

BACKGROUND: Pregnancies after orthotropic liver transplantation (OLT) have demonstrated favorable perinatal outcomes. However, obstetrical complications in OLT recipients are more common than those in a normal population. In countries where the number of cadaveric donors is limited, living-related liver transplantation (LRLT) is a valuable procedure, but few pregnancies after LRLT ...

Chloroacetonitrile (CAN) is a disinfection by-product of chlorination of drinking water. The present study was designed to investigate the potential adverse effects of maternal exposure to CAN on fetal liver in mice. Based on an initial dose-response experiment, CAN (25mg/(kgday)) was given orally to pregnant mice at gestation day (GD) ...

Viral infections in pregnancy are a major cause of morbidity and mortality for both mother and fetus. Viral STIs occur as surface infection and then gradually infect immunologically protected sites. Therefore, these are asymptomatic, hidden and hence underdiagnosed, persistent and difficult to treat. HSV, HPV, HBV, HIV and CMV (cytomegalovirus) ...

Acute Q fever in pregnancy is uncommon, but is probably underrecognized. It results in a significant risk of adverse pregnancy outcome and also predisposes to the development of chronic Q fever in the mother. Here, we review the clinical features, epidemiology, treatment and follow-up of acute Q fever in pregnancy. ...

BACKGROUND: The possible association between maternal appendicitis/appendectomy during pregnancy and congenital abnormalities in the offspring was studied. CASES: Two cases with primary microcephaly were born to mothers who had complicated appendicitis owing to the delay of appendectomy resulting in abscess/peritonitis associated with septicemia and fever in the second trimester of ...

Acute pancreatitis complicating pregnancy is rare and has previously been associated with high mortality rates. We report a case of repeated hypertriglyceridemia during pregnancy. During the patient's first pregnancy, acute pancreatitis was elicited in the third trimester by pregnancy-induced hypertriglyceridemia. The patient was treated successfully with a conservative treatment course. ...

BACKGROUND: Intussusception occurs when a segment of bowel and its associated mesentery telescopes into the lumen of the adjacent distal bowel. Appendiceal intussusception is a rare form of ileocoloc intussusception, is rarely diagnosed preoperatively, can mimic appendicitis and has not been previously reported during pregnancy. CASE: A 31-year-old gravid woman ...

INTRODUCTION: Ectopic pregnancy may lead to massive haemorrhage, infertility or death. Prompt diagnosis and treatment are crucial to save patients who would otherwise die. Serum amylase and lipase measurements are known biochemical markers of pancreatic inflammation and a recognized finding that may help diagnose acute pancreatitis. To the best of ...

Amphetamine is one of the most common substances abused in pregnancy and one of the most potent sympathomimetic amines with respect to stimulatory effects on the central nervous system. I present a case of an amphetamine abusing parturient who developed postpartum convulsions and acute hemodynamic instability initially mistaken for eclampsia.

BACKGROUND: Appendicitis is the most common surgical problem in pregnancy, however the particular dangers of appendicitis in pregnancy lie in the varied presentation of symptoms and the higher chance of delayed diagnosis. The aim of this study was to determine the risk factors associated with prenatal outcome in acute appendicitis ...

The physiological changes in liver function in pregnancy are commonly transient, rarely permanent. Disorders arising in pregnancy, such as pre-eclampsia and eclampsia, acute fatty liver of pregnancy (AFLP), haemolysis, elevated liver enzyme and low platelets (HELLP) syndrome, cholestasis, hyperemesis gravidarum and isolated cases of raised liver enzymes can have serious ...

The most important causes of acute collapse in pregnancy are pulmonary embolism, amniotic fluid embolism, acute coronary syndrome, thrombosed mechanical prosthetic heart valves, acute aortic dissection, cerebrovascular incidents and anaesthetic complications like failed intubation, anaphylaxis, and problems relating to regional or local anaesthetic agents. The management is based on supporting ...

BACKGROUND: We present a case of a 27-year-old woman who was found to have an appendiceal ectopic pregnancy, a carcinoid tumour of the appendix and acute appendicitis existing concurrently. This triad of pathology has never been reported previously. CONCLUSIONS: This case highlights the importance of performing a pregnancy test in ...

The unique physiology of pregnancy poses several problems for clinicians charged with caring for critically ill pregnant patients. This focused review summarizes two problems encountered in critically ill pregnant patients: pregnancy-related sepsis and acute renal failure. Common causes, and the effects of pregnancy on diagnosis and treatment are discussed.

BACKGROUND: Illnesses coincident with pregnancy may present similarly to preeclampsia or may be mistaken for severe preeclampsia or hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. Distinguishing these imitators from preeclampsia is important to allow for appropriate treatment and to avoid unnecessary delivery. CASE: A primigravida at 32 2/7 weeks ...

Acute aortic dissection is a life-threatening disease. To increase the awareness of this diagnosis as a cause of feto-maternal mortality during pregnancy, we have analyzed risk factors using information from five pregnant women admitted for acute aortic dissection to the Karolinska University Hospital over an eight-year period (1999-2007). Four of ...

The acute abdomen in pregnancy is a surgical emergency. Ectopic pregnancy and appendicitis are two causes of acute abdomen in pregnancy. Difficulties in correctly identifying the cause of the pain can be hazardous to the patient and care needs to be taken in obtaining a prompt and accurate diagnosis enabling ...

A 32-year-old pregnant woman in the 13th gestational week was brought to Severance Hospital with gum bleeding and easy bruising. Initial laboratory results revealed anemia and thrombocytopenia. In a peripheral blood smear, 81% of leukocytes were large, abnormal promyelocytes. Bone marrow aspiration showed a hypercellular marrow with packed leukemic promyelocytes, ...

Contraception is recommended during imatinib therapy based on the teratogenicity data in rats. However, patients may become pregnant and here we describe a successful pregnancy and labor without any congenital anomaly in a patient with chronic myeloid leukemia (CML) under treatment with imatinib. The patient had received imatinib for 53 ...

Acute coronary syndrome (ACS) in pregnancy has traditionally been considered to be a rare event, but the combination of normal physiological changes of pregnancy and more prevalent cardiovascular risk factors are increasing its incidence in this population. The present report describes a 39 year-old woman that is seven weeks pregnant ...

BACKGROUND: Acute biliary diseases during pregnancy have been classically managed conservatively. Advances in minimally invasive surgery and the high recurrence rate of symptoms observed changed this management. METHODS: This is a prospective observational study. Initial management was medical. Unresponsive patients were treated with minimally invasive techniques including gallbladder percutaneous aspiration ...

A 24-year-old female at 34-week gestation, presented with malaise, nausea, vomiting, jaundice, and absent foetal movements. A clinical diagnosis of acute fatty liver of pregnancy was made. Although early caesarean section was performed, postoperative course was complicated by acute respiratory distress syndrome (ARDS) sepsis, and continuing coagulopathy. Supportive management in ...