Spontaneous rupture of the liver during pregnancy seems to represent an extreme vascular complication of toxemia. The very high mortality rate has generally been attributable to uncontrolled hemorrhage. However, control of the hemorrhage may not be sufficient to achieve recovery. Hepatic dysfunction may proceed to necrosis associated with multiple organ ...

Prolongation of pregnancy for 1.5 days by the injection of progesterone leads to a decrease in maternal liver glycogen content and an increase in blood ketones without alteration in the activity of hepatic hydroxymethylglutaryl-CoA synthase, an enzyme of ketogenesis. Fetal hepatic mitochondrial hydroxymethylglutaryl-CoA synthase activity increases with increasing postmaturity in ...

A 30-year-old woman developed pruritic urticarial papules and plaques of pregnancy (PUPPP). The eruption, characterized by generalized edematous, erythematous plaques and nonexcoriated papules, began in the third trimester of pregnancy and was responsive to oral corticosteroids. While the etiology of PUPPP is unknown and the clinical features (urticarial plaques) sometimes ...

The effect of administration of cholestyramine on plasma cholesterol level and hepatic cholesterol and bile acid synthesis was investigated in pregnant and nonpregnant rats. Rates of cholesterol and bile acid synthesis were reduced by pregnancy in both control and cholestyramine-treated rats. Administration of cholestyramine throughout gestation and pregnancy failed either ...

The terminology of the specific dermatoses of pregnancy has become increasingly confusing, with several names in use for identical clinical disorders. On the basis of our own study of sixty-four patients and a review of the literature, we propose a simplified classification: (1) herpes gestationis (pemphigoid gestationis); (2) polymorphic eruption ...

Hypercholesterolemia occurs during pregnancy in rats and human beings, beginning in the second trimester and increasing progressively throughout the remainder of pregnancy. The present study quantified de novo cholesterol synthesis in vivo and in vitro in pregnant animals using 3H2O as the substrate for measuring cholesterogenesis. In the third trimester, ...

A new case of Budd-Chiari syndrome following pregnancy is reported. The patient, shortly after her second normal delivery, showed clinical evidence of hepatic venous outflow impairment. The diagnosis of Budd-Chiari syndrome was supported by angiographic studies, computed tomography, liver scanning and histology. Because of the poor results reported in the ...

Papular dermatitis of pregnancy is a rare pruritic eruption of widespread urticarialike papules. The eruption developed in a 31-year-old woman during the third trimester of her second pregnancy. Urine chorionic gonadotropin (UCG) levels were elevated. A biopsy specimen of an involved papule showed spongiosis and a perivascular lymphocytic infiltrate in ...

The course and outcome of pregnancy in two adolescents with chronic active hepatitis is described. Pregnancy was uneventful in both patients apart from mild biochemical deterioration in one patient. Both infants are entirely normal. One mother died 4 1/2 months after delivery from primary pulmonary hypertension, an extrahepatic manifestation of ...

Female Wistar rats received cadmium (Cd) in drinking water at a concentration of 100 ppm before and during pregnancy, prior to gestation only, and during gestation only. For the quantitative determination of metallothionein, the 203Hg-saturation method was used. Each of the 3 exposure treatments led to a decrease of the ...

A review of the case histories of 53 patients with established cirrhosis who had 83 pregnancies and 38 noncirrhotic patients with varices who had 77 pregnancies suggests that conception may occur in patients with varying degrees of hepatic decompensation, that sustaining gestation to term and delivery is unlikely to overtax ...

Epidemiological, clinical and laboratory data were obtained relating to 89 pregnant women who suffered from viral hepatitis during the period 1967-1977 in Israel. The obstetrical data, course of labor and details about the newborn, were all compared with the accepted obstetrical standards in Israel and abroad. A follow-up study was ...

The ontogeny of hepatic metallothioneins (Mt) in fetal tissue as related to dietary and hepatic Zn was investigated. Sixty 6-month-old female rats were divided into two groups and given either double-distilled water or water containing 700 mug of Zn per milliliter. Dams from each group were killed on 16, 19, ...

To test the hypothesis that intrahepatic cholestasis of pregnancy represent an abnormal reaction to estrogens in genetically predisposed individuals, the sulfobromophthalein disappearance curve from blood was compared before and after ethinyl estradiol administration (0.1 mg/day, during 6 days) in multiparous women with or without a past history of intrahepatic cholestasis ...

Pruritic urticarial papules and plaques of pregnancy is a self-limiting disease generally seen in the first pregnancy during the third trimester. Lesions are frequently present centrally and are intensely pruritic. Mucous membranes are usually not involved. Histology shows a normal epidermis with mild perivascular lymphohistiocytic infiltrate. Blood vessels, cutaneous appendages, ...

A 19-year-old mother had pruritic urticarial papules and plaques of pregnancy. Similar eruptions were found on her newborn son. This recently recognized eruption of pregnancy, characterized by pruritic papules, papulovesicles, and urticarial plaques, has been seen previously only in mothers. The histologic findings are nonspecific and may include spongiosis, a ...

A prospective field study was carried out during an epidemic of non-A non-B hepatitis for determining the incidence and severity of hepatitis in pregnant women, nonpregnant women of child bearing age and men (15 to 45 years old). In 36 (17.3 percent) of 208 pregnant women viral hepatitis developed, as ...

Thirty women with detrusor instability (27 cases idiopathic, and three secondary to multiple sclerosis) completed a double-blind, cross-over trial of the prostaglandin synthetase inhibitor flurbiprofen and a placebo, results being evaluated by questionnaire and cystometry. Frequency, urgency, and urge incontinence were all significantly reduced with flurbiprofen (P less than 0.001, ...

The aim of the present study was to determine whether pregnancy complications themselves influence the conversion rate of dehydroepiandrosterone sulphate (DHAS) to oestrogens during pregnancy. 100 mg DHAS was given intravenously to seven women with intrahepatic cholestasis of pregnancy, nine women with preeclampsia, nine diabetics, ten with twins and eight ...

Radioimmunoassay has been used to quantitate the conjugates of cholic and chenodeoxycholic acid in venous blood from women in different stages of normal pregnancy and in patients with recurrent intrahepatic cholestasis of pregnancy (RCP). The levels of cholic and chenodeoxycholic acid were shown to be within normal limits throughout uncomplicated ...

The outcome of pregnancy in chronic active hepatitis (CAH) was studied retrospectively, together with a survival analysis of patients and a comparison of fertility with that expected from controls drawn from the normal Australian population. Clinical records of 73 cases of CAH included 37 women who were potentially fertile (aged ...

The course and possible risks of pregnancy in 7 women between the ages of 20 and 30 yr with chronic-persistent hepatitis (CPH) were evaluated. Ten pregnancies occurred in these women during the follow-up period which ranged from 3 to 8 yr. Four of the fetuses were aborted electively for nonmedical ...

Concentrations of numerous sulfate steroids were checked in the plasma of 10 women in normal pregnancy (NP), 21 women with intrahepatic cholestasis of pregnancy (ICP) and 10 pregnant women suffering from viral hepatitis with jaundice (VHP). A considerable increase in 5 alpha pregnane and 5 beta pregnane 3 alpha, 20 ...

We report an intensely pruritic cutaneous eruption that occurs in the third trimester of pregnancy. The clinical manifestations include erythematous urticarial papules and plaques that begin on the abdomen and spread to involve the thighs and occasionally the buttocks and arms. This dermatosis appears to be clinically distinct from previously ...

A case is presented in which pregnancy occurred after jejunoileal bypass for treatment of obesity. The pregnancy was complicated by coagulation defects apparently on the basis of liver damage secondary to the bypass. Pertinent literature is reviewed, and the conclusion is reached that although the majority of patients becoming pregnant ...

A woman who developed hepatitis B during the 3rd trimester of pregnancy gave birth to a preterm, small-for-gestational-age infant whose blood also contained hepatitis B antigen. The effects of viral hepatitis on the fetus are reviewed and an approach to the management of such pregnancies is formulated.

Sixteen cases of pruritic papules of pregnancy were collected during a 32-month period. This dermatosis was introduced to the literature in 1962 but no histopathologic study of it has been published. Histopathologic presentation of pruritic papules of pregnancy is that of toxic dermatitis. This finding is not characteristic of this ...

The prevalence of intrahepatic cholestasis of pregnancy was studied immediately postpartum in 869 women from three distant Chilean cities differing in climate and food supply. Cholestatic jaundice of pregnancy was detected in 2.4% and pruritus gravidarum in 13.2%, without significant differences between the three cities. Every woman was then ethnically ...

A case of a 26-year-old woman who presented at 38 weeks of gestation with severe hepatitis B complicated by disseminated intravascular coagulation (DIC) and hypoglycemia is reported. The clinical features of the illness suggested acute fatty liver of pregnancy. Cesarean section was followed by resolution of the coagulopathy and the ...

Erythroid progenitor cells in +/+ and Sl/Sld fetal livers manifested as burst-forming units-erythroid (BFU-E) and colony-forming units-erythroid (CFU-E) were assayed in vitro during early development. The proportion of BFU-E was higher as mutant than in normal fetal livers. On the other hand, the proportion of CFU-E was less in the ...

The clinical features of hepatitis during pregnancy and the effect of this complication on the mother and the fetus were evaluated in 45 patients with jaundice who were treated at the University College Hospital, Ibadan, Nigeria, from July 1976 to January 1978. Viral hepatitis was the cause of jaundice in ...

Serum mitochondrial, nuclear and smooth-muscle antibodies were assayed by the immunofluorescence method in a series of 42 patients with intrahepatic cholestasis of pregnancy and a control series of 15 normal pregnant subjects. None of the subjects examined had mitochondrial antibodies, and nuclear antibodies were only found in one patient with ...

Three patients with serum hepatitis during pregnancy are described. The first patient was delivered of an infant in whom hepatitis B surface antigen (HBsAg) was detected at 3 months of age; the second patient had a child who became HBsAg positive at 6 weeks of age; and the third patient's ...

The presentation, nonradiologic diagnostic evaluation, and course (including complications and outcome) of gastrointestinal disorders in pregnancy are not substantially different than for the nonpregnant patient. The possible exception is the higher mortality for pancreatitis when it occurs during pregnancy. With the exception of nausea/vomiting and hyperemesis gravidarum, there does not ...

Further investigation was carried out on the action patterns of two chondroitinase-AC [EC 4.2.2.5.] preparations obtained from Arthrobacter aurescens and Flavobacterium heparinum. To infer the action patterns of the chondroitinases, we proposed a new method for the calculation of the degree of multiple attack, based on the concept established by ...

An integrative survey is given of three disease processes, in which recent progress of a fundamental nature has been made, primarily affecting the liver, either coincident with or caused by the gravid state. The three conditions considered include (1) recurrent cholestasis of pregnancy (RCP), (2) viral hepatitis coincident with pregnancy, ...

A study of coagulation disorders due to hepatitis A infection occurring during pregnancy was undertaken to determine if the unique coagulation status produced by pregnancy (elevated clotting factors and decreased fibrinolytic activity) was responsible for the increased severity of hepatitis A infections reported for pregnant women from various parts of ...

A family study was prompted by the presence of benign recurrent intrahepatic cholestasis in three members and probably in a fourth. Pruritus and/or jaundice occurred during pregnancy in nine members. Two additional members suffered from pruritus while using oral contraceptives. The literature on benign recurrent intrahepatic cholestasis since 1959 describes ...

Several congenital abnormalities result in dentofacial and craniofacial deformities in the middle third of the face. Each of these deformities presents unique problems with multiple coexisting anomalies of the entire dentofacial and craniofacial region. Those engaged in the habilitation of patients with congenital facial deformities must be cognizant of the ...

The effect of methaqualone on the induction of hepatic enzymes was evaluated in rats and compared with that of phenobarbital by measuring effects on hexobarbital and methaqualone hypnosis, plasma and tissue levels of methaqualone, hepatic aniline hydroxylase and aminopyrine demethylase activity and warfarin-induced hypoprothrombinemia. Maximal reductions in hexobarbital hypnosis occurred ...

Three women dying from hepatic carcinoma during pregnancy are presented. One of these women with a hepatocellular carcinoma and alpha fetoprotein in the serum and antibody to hepatitis B antigen. A fourth patient died 2 months post partum with a cholangiocarcinoma. A false positive pregnancy test suggested that she had ...

Estriol, estriol sulfate, progesterone, and 17 neutral steroid sulfates, including estriol precursors and progesterone metabolites, were determined in 27 cord plasma samples collected after pregnancies complicated by intrahepatic cholestasis of the mother. The levels of these steroids were compared with those in the cord plasma of 42 healthy controls. In ...

Multiple intercalated discs were frequently observed in muscle cells from patients with cardiac hypertrophy of various causes. Evidence is presented that these structures are the intercellular junctions of lateral processes of muscle cells. The sizes and shapes of these processes showed marked variations, depending in part on the plane of ...

The striking mortality in viral hepatitis associated with pregnancy, regularly observed in developing countries, has shown a significant decrease in Saudi Arabia during a period of unprecedented economic growth. However, the risk of fatal hepatitis in the pregnant Saudi woman remains approximately four times that for the nonpregnant woman. The ...

Morphogenetic events are described which characterize early stages of the interaction between mesenchyme and expanding epithelial cell cords derived from the hepatic endodermal diverticulum in the C57BL/6J mouse. This interaction culminates in the differentiation of hepatic epithelial and hematopoietic tissues. No basement membrane separates the presumptive hepatic epithelial cells from ...

Comparative data on fetal and neonatal deaths following maternal mumps, rubella, hepatitis, chicken pox and measles were obtained in a prospective study in New York City from 1957 to 1964, inclusive. The evidence pointed to an increase in early fetal death rate after rubella and mumps and an increase in ...