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Am Surg 2020 Apr;86(4):e198-e199

J Med Invest 2020 ;67(1.2):207-210

Department of Anesthesiology, Tokushima University Graduate School, Tokushima, Japan.

Two types of amniotic fluid embolism (AFE) have been described : cardiopulmonary collapse type and disseminated intravascular coagulation (DIC) type, with the latter proposed as uterine type. This report describes a healthy 28-year-old woman who developed AFE during a cesarean section. Because of a previous cesarean section, the patient underwent an elective cesarean section, under combined spinal-epidural anesthesia, at 38 weeks of pregnancy. Read More

J Reprod Immunol 2020 Jun 10;139:103116. Epub 2020 Mar 10.

Department of Obstetrics & Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Uterine atony is a major cause of postpartum hemorrhage. We recently proposed the new histological concept of postpartum acute myometritis (PAM) for the pathophysiology of refractory uterine atony of unknown etiology, which is characterized by the diffuse activation of mast cells and the complement system as well as the massive infiltration of macrophages and neutrophils into the uterine body. We herein focused on the uterine isthmus just adjacent to the body. Read More

Arch Gynecol Obstet 2020 Apr 9;301(4):923-929. Epub 2020 Mar 9.

Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany.

Introduction: Amniotic fluid embolism (AFE) continues to be a rare, enigmatic condition with high maternal mortality. It is characterized by cardiovascular compromise, loss of consciousness or other neurologic symptoms, and coagulopathy. The latter is usually treated according to existing protocols for consumptive coagulopathy. Read More

J Int Med Res 2020 Feb;48(2):300060520903640

Department of Anesthesiology and Pain Medicine, Eulji University Medical Center, Daejeon, Korea.

JA Clin Rep 2019 Nov 28;5(1):79. Epub 2019 Nov 28.

Department of Anesthesiology and Intensive Care, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Background: Amniotic fluid embolism (AFE) is a life-threatening obstetric emergency. Because the maternal mortality associated with AFE is very high, early recognition and prompt treatment are important for improving the prognosis. We report a case of amniotic fluid embolism successfully treated by multidisciplinary treatment. Read More

JA Clin Rep 2019 Jul 20;5(1):48. Epub 2019 Jul 20.

Department of Emergency and Critical Care Center, Hyogo Prefectural Nishinomiya Hospital, 13-9 Rokutanji-cho, Nishinomiya, Hyogo, 662-0918, Japan.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) can control massive postpartum hemorrhage.

Case Presentation: A 41-year-old woman transferred to hospital following cesarean section presented in refractory hemorrhagic shock. REBOA was blindly performed in the emergency department. Read More

Anesthesiol Clin 2020 Mar;38(1):85-105

Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, PO Box 208051, New Haven, CT 06520-8051, USA.

Over the past 30 years, maternal mortality has increased in the United States to 18 deaths per 100,000 live births. Obstetric emergencies, including hemorrhage, hypertensive disorders in pregnancy, HELLP syndrome, and amniotic fluid embolism, and anesthesia complications, including high neuraxial blockade, local anesthetic systemic toxicity, and the difficult obstetric airway, contribute to maternal cardiac arrest and maternal and fetal morbidity and mortality. Expeditious intervention by the obstetric anesthesiologist is critical in these emergent scenarios, and knowledge of best practices is essential to improve maternal and fetal outcomes. Read More

Medicine (Baltimore) 2020 Jan;99(4):e18951

Department of Cardiology, First Hospital of Jilin University, Changchun, 130031, China.

Rationale: An amniotic fluid embolism (AFE) is a rare, lethal syndrome that is commonly associated with disseminated intravascular coagulation (DIC). Anticoagulation therapy is the most important strategy to inhibit excessive activation of the coagulation cascade in patients with AFE and DIC. At present, treatment of AFE with rivaroxaban has not been reported. Read More

Medicina (Kaunas) 2020 Jan 15;56(1). Epub 2020 Jan 15.

Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-0008, Japan.

Background: To evaluate maternal and neonatal outcomes of assisted reproductive technology (ART).

Materials And Methods: Pregnant women registered from 2015 through 2017 ( = 6994) at five perinatal centers that managed high-risk pregnancies in Mie, Japan, retrospectively. Rates of preterm birth (<37 gestational weeks), early onset preeclampsia (<34 gestational weeks), late onset preeclampsia (≥34 gestational weeks), low-lying placenta, placenta previa, placenta accreta, placental abruption, atonic bleeding, uterine rupture, and amniotic fluid embolism after ART were evaluated. Read More

Case Rep Crit Care 2019 21;2019:4589636. Epub 2019 Dec 21.

Kaweah Delta Medical Center, Visalia, CA, USA.

Amniotic fluid embolism (AFE) is an extremely rare yet fatal obstetric emergency. AFE presents as sudden cardiovascular collapse after a breach of maternal-fetal membranes and is often complicated by severe coagulopathy. We present a case where an AFE was treated with veno-arterial extracorporeal membrane oxygenation (ECMO) to help overcome the acute cardiopulmonary insult. Read More

Anaesthesist 2020 01;69(1):11-19

Klinik und Poliklinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.

In 2019 the annual conference of the scientific working group on obstetric anesthesiology of the German Society of Anesthesiology and Intensive Care Medicine (DGAI) took place in the usual manner. Emergency situations, such as the challenge of a preclinical birth or the recognition and treatment of an amniotic fluid embolism were discussed. In addition, topics on the correct treatment of a female patient with a known addictive disorder were of great interest as well as the discussion on the question when a transfusion should be performed in postpartum anemia and which risks accompany the increasing prevalence of obesity, especially during pregnancy. Read More

BMC Pregnancy Childbirth 2020 Jan 3;20(1). Epub 2020 Jan 3.

Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA.

Background: Amniotic fluid embolism (AFE) is a rare, life threatening obstetric complication, often associated with severe coagulopathy. Induced abortions are extremely safe procedures however complications including AFE can occur.

Case Presentation: A 29-year-old previously healthy woman, gravida 1 para 0, presented for a scheduled second trimester induced abortion via dilation and evacuation at 22-weeks gestation. Read More

Z Geburtshilfe Neonatol 2019 Dec 4;223(6):337-349. Epub 2019 Dec 4.

Institut für Rettungs-und Notfallmedizin, Universitätsklinikum Schleswig-Holstein.

As far as prehospital but in part also clinical obstetrics is concerned, the acute nature of perinatal emergencies is overshadowed by limited diagnostic and therapeutic options. The need for acute and targeted intervention may result from both maternal and fetal indications. As common in emergency services for pregnant women, prehospital primary assessment and logistics management (e. Read More

J Med Primatol 2020 Feb 19;49(1):60-62. Epub 2019 Nov 19.

California National Primate Research Center, Anatomic and Clinical Pathology Service, University of California, Davis, California.

A pregnant female rhesus macaque died spontaneously during stage two labor. Gross and histopathologic findings included severe pulmonary edema, with low numbers of blood vessels containing pale basophilic mucinous material (Alcian Blue positive and PTAH negative), consistent with intravascular amniotic fluid-derived mucin resulting in pulmonary amniotic fluid embolism. Read More

PLoS Med 2019 11 12;16(11):e1002962. Epub 2019 Nov 12.

National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

Background: Amniotic fluid embolism (AFE) remains one of the principal reported causes of direct maternal mortality in high-income countries. However, obtaining robust information about the condition is challenging because of its rarity and its difficulty to diagnose. This study aimed to pool data from multiple countries in order to describe risk factors, management, and outcomes of AFE and to explore the impact on the findings of considering United Kingdom, international, and United States AFE case definitions. Read More

PLoS Med 2019 11 12;16(11):e1002976. Epub 2019 Nov 12.

Department of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.

In a Perspective, Sarka Lisonkova and Michael Kramer discuss the accompanying study by Kathryn Fitzpatrick and co-authors on management of amniotic fluid embolism. Read More

Medicine (Baltimore) 2019 Nov;98(44):e17679

National Office for Maternal and Child Health Surveillance of China West China Second University Hospital, Sichuan University, Chengdu, Sichuan.

To introduce the National Maternal Near Miss Surveillance System (NMNMSS) in detail and to report the composition of maternal near miss (MNM) in China.The NMNMSS was established by the National Health Commission at the end of 2010, covered over 400 health facilities from 30 provinces in China. The NMNMSS was designed to collect individual information for every pregnant woman admitted to obstetric department in the sampled health facilities. Read More

N Engl J Med 2019 10;381(17):1664-1673

From the Departments of Obstetrics and Gynecology (S.N.B., A.G.), Anesthesia (G.A.C.-D., V.E.O.), and Surgery (A.S.J.), Massachusetts General Hospital, and the Departments of Obstetrics and Gynecology (S.N.B., A.G.), Anesthesia (G.A.C.-D., V.E.O.), and Surgery (A.S.J.), Harvard Medical School - both in Boston.

Obstet Gynecol 2019 11;134(5):989-994

Département de Médecine, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Québec, the Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.

Background: Amniotic fluid embolism (AFE) is a catastrophic disease with significant mortality. Because the cardiopulmonary dysfunction associated with AFE is self-limited, the disease could be well suited to the use of extracorporeal therapies.

Case: A woman progressed into cardiac arrest immediately after an elective cesarean delivery. Read More

Bratisl Lek Listy 2019 ;120(9):690-694

Aim: Severe acute maternal morbidity (SAMM) is a state of the woman, when she nearly died, but survived. The aim of study was to find out the exact incidence of SAMM in Slovakia, establishment of functional surveillance system and improve quality of health care.

Materials And Methods: The regular annual analyses of SAMM cases in Slovakia from January 1st 2012 to December 31st 2016. Read More

Am J Obstet Gynecol 2020 01 31;222(1):48-52. Epub 2019 Jul 31.

Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, TX.

Amniotic fluid embolism is an uncommon, but potentially lethal, complication of pregnancy. Because amniotic fluid embolism usually is seen with cardiac arrest, the initial immediate response should be to provide high-quality cardiopulmonary resuscitation. We describe key features of initial treatment of patients with amniotic fluid embolism. Read More

Sci Rep 2019 07 30;9(1):11026. Epub 2019 Jul 30.

Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan.

This descriptive study was based on the maternal death registration system established by the Japan Association of Obstetricians and Gynecologists and the Maternal Death Exploratory Committee (JMDEC). 361 women died during pregnancy or within 42 days after delivery between January 2010 and June 2017 throughout Japan were analysed, in order to investigate the trend in maternal deaths related to obstetric medical practice. Reports of maternal death were consistent, ranging from 45 cases in 2010 to 44 cases in 2017. Read More

Int J Obstet Anesth 2020 02 9;41:59-64. Epub 2019 Jul 9.

Department of Obstetrics and Gynecology, Japanese Red Cross Shizuoka Hospital, Japan.

Background: Intra-operative cell salvage is not routinely used during cesarean delivery because it is not cost-effective for patients at low risk of hemorrhage and there are theoretical concerns about amniotic fluid embolism. Some guidelines recommend using leukocyte depletion filters to decrease the risk of amniotic fluid embolism before re-infusing salvaged blood, but these filters are not available in Japan. We compared the efficacy and safety of leukocyte depletion and micro-aggregate filters in combination with intra-operative cell salvage during cesarean delivery. Read More

J Obstet Gynaecol Can 2020 Jan 16;42(1):88-91. Epub 2019 Jul 16.

Department of Cardiology, St Vincent's Hospital Melbourne, Australia.

Background: The differential diagnosis of peripartum chest pain and cardiogenic shock is broad and includes pulmonary embolism, amniotic fluid embolism, peripartum and Takotsubo cardiomyopathy, myocardial infarction, and anaesthetic complications.

Case: A 31-year-old woman with Addison's disease underwent an elective caesarean section that was complicated by chest pain and cardiogenic shock. After initial resuscitation, she was transferred to a tertiary hospital, and urgent transthoracic echocardiography revealed severe systolic dysfunction. Read More

Ceska Gynekol 2019 ;84(2):129-139

Objective: Analysis of maternal morbidity and mortality in Slovak Republic in the years 2007-2015.

Design: Prospective epidemiological perinatological nation-wide.

Settings: 1st Department of Gynaecology and Obstetrics Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. Read More

J Obstet Gynaecol Res 2019 Aug 10;45(8):1553-1561. Epub 2019 Jun 10.

Department of Obstetrics & Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Aim: Uterine atony is a major cause of postpartum hemorrhage. We recently proposed a new concept for the histopathophysiology of refractory uterine atony, postpartum acute myometritis (PAM), characterized by acute inflammatory changes with massive stromal edema, increased numbers of complement C5a receptors and diffuse mast cell activation in the myometrium. We herein focused on the possible involvement of the kinin-kallikrein system in the rapid development of interstitial edema in PAM, particularly bradykinin receptor type 1 (B1R), which is up-regulated under inflammatory conditions. Read More

Eur J Obstet Gynecol Reprod Biol 2019 Jun 19;237:145-150. Epub 2019 Apr 19.

Department of Obstetrics, Birth Centre Wilhelmina's Children Hospital, Division Woman and Baby, University Medical Centre Utrecht, Utrecht, the Netherlands.

Background: Maternal cardiac arrest is a complex and demanding clinical situation requiring a well-attuned team effort of healthcare workers of multiple disciplines. A recent report on maternal cardiac arrest in the United Kingdom reported a rise in incidence over a span of 10 years, while maternal mortality increased in the United States between 2000 and 2014. However, reported causes of maternal cardiac arrest differed between both countries. Read More

Anaesth Intensive Care 2019 Mar 1;47(2):193-196. Epub 2019 May 1.

Royal North Shore Hospital, Sydney, Australia.

J Cardiovasc Echogr 2019 Jan-Mar;29(1):20-22

Department of Medicine and Surgery, Division of Cardiology, University of Salerno, Largo Città di Ippocrate, Salerno, Italy.

Amniotic fluid embolism (AFE) is a rare but potentially lethal obstetric condition affecting women during labor, delivery, or also in the immediate postpartum period, when amniotic fluid, fetal cells, hair, or other debris could enter the maternal circulation. We present the first case of AFE described in literature in a 33-year-old patient with a complex history of congenital heart disease, where the crucial points for successful course were the prompt recognition and treatment of the disease and the use, for the first time, as diagnostic tool for AFE, of right ventricular free-wall longitudinal speckle-tracking strain. Read More

Int J Obstet Anesth 2019 05 29;38:4-9. Epub 2019 Mar 29.

Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, Essen, Germany; TEM Innovations GmbH, Munich, Germany.

Semin Perinatol 2019 06 9;43(4):218-221. Epub 2019 Mar 9.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main Street, Suite F420, Houston, Texas.

A sustained increase in the maternal death rate in the U.S. remains one of the most challenging issues of the twenty-first century. Read More

Emerg Med Clin North Am 2019 May 8;37(2):351-363. Epub 2019 Mar 8.

Department of Critical Care Medicine, MedStar Washington Hospital Center, Georgetown University School of Medicine, 110 Irving Street Northwest, Suite 4B-42, Washington, DC 20010, USA. Electronic address:

Many health care providers lack familiarity with maternal physiologic changes and the distinctive underlying etiology of cardiac arrest in pregnancy. Knowledge of what changes are expected in pregnancy and an understanding of how to adapt clinical practice is essential for the care of the pregnant woman in the emergency department. Amniotic fluid embolism should be recognized as a rare cause of cardiac arrest in pregnancy, characterized by the triad of cardiovascular collapse, hypoxic respiratory failure, and coagulopathy. Read More

Emerg Med Clin North Am 2019 May;37(2):287-300

UCLA Ronald Reagan-Olive View Emergency Medicine Residency, UCLA Medical Center, 924 Westwood Boulevard, Suite 300, Los Angeles, CA 90095, USA.

This article covers a high-risk time in a woman's life, the period just after delivery of her baby. There are large variations in complication rates across various groups in the United States. Many women seek care in the emergency department for routine and more serious postpartum pathologies. Read More

Emerg Med Clin North Am 2019 May;37(2):277-286

UCLA Ronald Reagan-Olive View Emergency Medicine Residency, Ronald Reagan Medical Center, 924 Westwood Boulevard, Suite 300, Los Angeles, CA 90095, USA.

The period just after delivery is a high-risk period for women with associated morbidity and even mortality. There are large variations in complication rates across various groups in the United States. This article covers complications commonly encountered in the emergency department in late pregnancy and the early postpartum period. Read More

Malays J Med Sci 2018 Sep 30;25(5):151-157. Epub 2018 Oct 30.

Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

Traumatic brain injury is the major contributing factor in non-obstetric mortality in developing countries. Approximately 20% of maternal mortality is directly correlated to injuries. Road traffic accidents and domestic violence are the most common nonlethal injuries that can threaten either the maternal or foetal life, and such events occur in one out of every 12 pregnancies. Read More

Anaesthesia 2019 Aug 25;74(8):976-983. Epub 2019 Mar 25.

Department of Anaesthesia, Royal Cornwall Hospitals NHS Trust, Truro, UK.

The use of cell salvage during caesarean section has been increasing steadily, although there are concerns relating to cost, a perceived risk of amniotic fluid embolism, and fetal red cell sensitisation. We present observational data from almost a decade of use of intra-operative cell salvage in obstetrics. By the end of this period, we set up cell salvage collection for > 98% of all caesarean sections. Read More

Medicine (Baltimore) 2019 Mar;98(11):e14835

The Third Affiliated Hospital of Guangzhou Medical University, The Medical Center for Critical Pregnant Women in Guangzhou, Guangzhou, China.

The aim of this study was to identify risk factors among obstetric patients admitted to the intensive care unit (ICU).The study was conducted in Third Affiliated Hospital of Guangzhou Medical University during January 1, 2009 and December 31, 2016. A total of 44,817 pregnant women ≥20 weeks of gestational age were scanned. Read More

A A Pract 2019 Jul;13(2):74-77

From the Departments of Anesthesiology and Surgical Intensive Care.

Amniotic fluid embolism is a rare but dreaded complication of pregnancy, with an incidence between 2 and 7/100,000 deliveries. We report an amniotic fluid embolism after urgent cesarean delivery diagnosed on a cardiac arrest, complicated by cardiogenic shock and acute respiratory distress syndrome. This report describes the indication, efficacy, and success of venoarterial extracorporeal membrane oxygenation in the early management of cardiac arrest, cardiac failure driven by amniotic fluid embolism, and acute respiratory distress syndrome. Read More

Am J Obstet Gynecol 2019 10 5;221(4):311-317.e1. Epub 2019 Mar 5.

University of Arizona College of Medicine Phoenix at Banner University Medical Center Phoenix, Phoenix, AZ.

The Centers for Disease Control and Prevention have demonstrated continuous increased risk for maternal mortality and severe morbidity with racial disparities among non-Hispanic black women an important contributing factor. More than 50,000 women experienced severe maternal morbidity in 2014, with a mortality rate of 18.0 per 100,000, higher than in many other developed countries. Read More

Int J Obstet Anesth 2019 05 16;38:146-147. Epub 2019 Feb 16.

Département d'anesthésie-réanimation, hôpital Antoine Béclère, Clamart, France. Electronic address:

N Engl J Med 2019 02;380(9):842-849

From the School of Biomedical Sciences and the Institute of Health and Biomedical Innovation, Queensland University of Technology (M.T.G.), the School of Medicine (M.T.G., J.L., R.S.), the Institute for Molecular Bioscience (G.W.M.), and the Centre for Clinical Research (N.M.F.), University of Queensland, Genetic Health Queensland (M.T.G., P.M.), the Centre for Advanced Prenatal Care (J.L., R.S., N.M.F.), and the Department of Cytogenetics (A.N.), Royal Brisbane and Women's Hospital, and QIMR Berghofer Medical Research Institute (Y.S., G.W.M.), Brisbane, the School of Medicine, Griffith University, Gold Coast, QLD (M.T.G.), Victorian Clinical Genetics Services, Murdoch Children's Research Institute, Melbourne, VIC (T.B.), the Department of Pediatrics, University of Melbourne, Royal Children's Hospital, Parkville, VIC (T.B.), and the Faculty of Medicine, University of New South Wales, Sydney (N.M.F.) - all in Australia; and Li Ka Shing Institute of Health Sciences, Department of Chemical Pathology, Chinese University of Hong Kong, Hong Kong (P.J., H.Z., R.C.).

Sesquizygotic multiple pregnancy is an exceptional intermediate between monozygotic and dizygotic twinning. We report a monochorionic twin pregnancy with fetal sex discordance. Genotyping of amniotic fluid from each sac showed that the twins were maternally identical but chimerically shared 78% of their paternal genome, which makes them genetically in between monozygotic and dizygotic; they are sesquizygotic. Read More

MedEdPORTAL 2018 10 26;14:10768. Epub 2018 Oct 26.

Perinatal Patient Safety Coordinator, NewYork-Presbyterian Hospital.

Introduction: Cardiac arrest in pregnancy is rare. Advanced Cardiovascular Life Support courses rarely address interventions specific to obstetric patients, and knowledge gaps are frequent among providers. The Society for Obstetric Anesthesia and Perinatology and American Heart Association have published guidelines regarding management of cardiac arrest in pregnancy, and interdisciplinary simulation training has been advocated to reinforce key management points for this clinical scenario. Read More

J Gynecol Obstet Hum Reprod 2019 May 20;48(5):309-314. Epub 2019 Feb 20.

INSERM U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France; Port-Royal Maternity Unit, Cochin Hospital, Hôpitaux Universitaires Paris Centre, Assistance Publique-Hôpitaux de Paris, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.

The incidence of maternal cardiac arrest ranges from 1/55,000 to 1/12,000 births. It is due most frequently to cardiovascular, hemorrhagic, and anesthesia-related causes, as well as to amniotic fluid embolism. The basic principles of resuscitation remain applicable in this situation, but the physiological modifications of pregnancy must be taken into account, in particular, the aortocaval compression syndrome. Read More

Anesthesiology 2019 06;130(6):1032-1033

From the Department of Anesthesiology, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina.

Nurs Womens Health 2019 Feb;23(1):38-48

Anaphylactoid syndrome of pregnancy (ASP) is a widespread, proinflammatory, anaphylactic-like reaction that can occur when amniotic fluid enters the maternal blood circulation. ASP is characterized by four cardinal findings: respiratory distress, altered mental status, hypotension, and disseminated intravascular coagulation. ASP is commonly associated with maternal and neonatal mortality. Read More

Case Rep Womens Health 2019 Jan 23;21:e00097. Epub 2019 Jan 23.

University of South Alabama, Children's and Women's Hospital, Department of Obstetrics and Gynecology, 251 Cox Street, Mobile, AL 36604, United States.

Cerebrovascular disease is not uncommon during pregnancy as a result of either venous or arterial occlusion, or a hemorrhagic event, resulting in ischemia. Pregnancy may alter the prognosis of these neurologic disorders, with increased risks of morbidity and mortality for the mother and the developing fetus. Etiologies of stroke during pregnancy and the postpartum period include preeclampsia, eclampsia, HELLP syndrome, posterior reversible encephalopathy syndrome (PRES), amniotic fluid embolism, postpartum angiopathy, postpartum cardiomyopathy, thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), cerebral venous thrombosis, CNS infections, and maternal thrombophilia. Read More

Case Rep Oncol 2018 Sep-Dec;11(3):822-834. Epub 2018 Dec 11.

University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, The Netherlands.

Among the differential diagnoses that should be considered in acute respiratory failure (ARF) are infectious processes, autoimmune diseases, interstitial pulmonary fibrosis, and pulmonary neoplasia. Timely diagnosis of lung neoplasia is complicated in the early stages. An opportune diagnosis, as well as the specific treatment, decrease mortality. Read More

J Clin Anesth 2019 09 17;56:4-5. Epub 2019 Jan 17.

Department of Obstetrics, Baoan Maternal and Child Health Hospital, Jinan University, Shenzhen, China. Electronic address:

J Matern Fetal Neonatal Med 2019 Jan 22:1-6. Epub 2019 Jan 22.

a Russian Ministry of Health , Federal State Budget Educational Institution of Higher Education Omsk State Medical University , Omsk , Russia.

Aim: To assess the efficacy of a Zhukovsky obstetric double balloon for improving outcomes in women undergoing hysterectomy for postpartum hemorrhage.

Materials And Methods: This was a randomized controlled study. Participants were divided into two groups to undergo insertion of a Zhukovsky obstetric double balloon prior to hysterectomy (n = 16) or conventional hysterectomy (n = 25). Read More