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    Maternal morbidity and mortality associated with retroperitoneal haematomas in pregnancy.
    JRSM Open 2018 Jan 8;9(1):2054270417746059. Epub 2018 Jan 8.
    Ipswich Hospital NHS Trust, IP4 5PD, UK.
    Retroperitoneal haematomas in obstetrics are uncommon. The causes and pathogenesis of retroperitoneal haematomas lack clarity and the aim of this review is to recognise retroperitoneal haematomas as a separate entity from commonly seen vaginal and pelvic haematomas. It is time to raise awareness among obstetricians to recognise retroperitoneal haematomas as an important cause of maternal morbidity and mortality which requires high clinical suspicion and multidisciplinary input. Read More

    Emotional and cognitive experiences during the time of diagnosis and decision-making following a prenatal diagnosis: a qualitative study of males presented with congenital heart defect in the fetus carried by their pregnant partner.
    BMC Pregnancy Childbirth 2018 Jan 12;18(1):26. Epub 2018 Jan 12.
    Department of Women's and Children's Health, Uppsala University, SE-75237, Uppsala, Sweden.
    Background: Expectant fathers consider the second-trimester obstetric ultrasound examination as an important step towards parenthood, but are ill prepared for a detection of a fetal anomaly. Inductive research is scarce concerning their experiences and needs for support. Consequently, the aim of this study was to explore the emotional and cognitive experiences, during the time of diagnosis and decision-making, among males presented with congenital heart defect in the fetus carried by their pregnant partner. Read More

    Induced hypothermia in patients with septic shock and respiratory failure (CASS): a randomised, controlled, open-label trial.
    Lancet Respir Med 2018 Jan 8. Epub 2018 Jan 8.
    Centre of Excellence in Immunity and Infection/Centre of Excellence for Personalised Medicine of Infectious Complications in Immune Deficiency, Department of Infectious Diseases, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark; Respiratory Medicine Division, Department of Internal Medicine, Herlev and Gentofte Hospital, Hellerup, Denmark. Electronic address:
    Background: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock.

    Methods: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America. Read More

    Acute kidney injury in critically ill obstetric patients: a cross-sectional study in an intensive care unit in Northeast Brazil.
    J Bras Nefrol 2017 Oct-Dec;39(4):357-361
    Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Medicina Clínica, Fortaleza - CE, Brazil.
    Introduction: Acute kidney injury (AKI) is a complication still poorly studied in the setting of obstetric patients, which is associated with increased mortality. Objective: The aim of this study was to investigate the frequency and risk factors of AKI among critically ill obstetric patients.

    Methods: A cross-sectional study was conducted with all patients admitted to an intensive care unit (ICU) due to obstetric complications, in Fortaleza, Brazil, in the period between January 2012 and December 2014. Read More

    A single-center experience with 12 consecutive cases of pregnancy among patients with membranous ventricular septal aneurysm.
    BMC Pregnancy Childbirth 2018 Jan 3;18(1). Epub 2018 Jan 3.
    Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
    Background: Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. Read More

    Hemoperitoneum in peripartum: A case-series.
    J Neonatal Perinatal Med 2017 ;10(4):451-454
    Anesthésistes Réanimateurs, Pôle MPO, Gynécologie Obstétrique et Reproduction Humaine, Hôpital Estaing, CHU Clermont-Ferrand, 1 Place Lucie Aubrac, 63000 Clermont-Ferrand, France.
    Hemorrhages are the first cause of perinatal deaths in French women. Thirteen percent of these deaths are not linked to obstetrical problems but rather to hemoperitoneum. These incidents are under-diagnosed and as a result, treatment is delayed and fetal and maternal mortality increases. Read More

    Proteomic investigation of the effects of preimplantation factor on human embryo implantation.
    Mol Med Rep 2017 Dec 22. Epub 2017 Dec 22.
    Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China.
    Despite the use of adjuvant therapies, the cumulative proportion of live births remains at ~40%. Accumulating data show that low pregnancy rates, even in the presence of high fertility rates, are due to implantation failure. The present study aimed to identify and construct a profile of proteins that react with preimplantation factor (PIF) and to provide an understanding into the molecular mechanisms by which PIF promotes trophoblast invasion. Read More

    Parental experiences after prenatal diagnosis of fetal abnormality.
    Semin Fetal Neonatal Med 2017 Dec 16. Epub 2017 Dec 16.
    Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Genetics Education and Health Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
    For many pregnant women, prenatal testing is a routine component of contemporary pregnancy care. Receiving a prenatal diagnosis is frequently associated with intense feelings of shock and grief; the extent of which may be unrelated to the pregnancy gestation or the condition diagnosed. During this time of crisis, parents are often faced with important choices about their pregnancy. Read More

    Pregnancy History Influences the Level of Autophagy in Peripheral Blood Mononuclear Cells From Pregnant Women.
    Reprod Sci 2017 Jan 1:1933719117746763. Epub 2017 Jan 1.
    2 Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
    Objective: Maternal immune responses are altered during pregnancy and differ between nulliparous and multiparous women. The influence of a prior gestation on autophagy in peripheral blood mononuclear cells (PBMCs) from pregnant women has not been determined and is the subject of this investigation.

    Methods: Peripheral blood mononuclear cells were isolated from 212 pregnant women and immediately lysed in the presence of protease inhibitors, and the extent of autophagy was determined by quantitation of the concentration of p62 (sequestosome-1) in the lysates by enzyme-linked immunosorbent assay (ELISA). Read More

    Postpartum Hemorrhage.
    Tech Vasc Interv Radiol 2017 Dec 10;20(4):266-273. Epub 2017 Oct 10.
    Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.
    Interventional radiologists are often called for emergent control of abnormal uterine bleeding. Bleeding, even heavy bleeding as a result of uterine fibroids is not a common emergent procedure; instead, pregnancy and pregnancy related conditions, trauma and malignancy associated with bleeding can be the source of many interventional radiology on call events or procedures. Postpartum hemorrhage (PPH) is the most common cause, and is defined as blood loss of 500mL after vaginal delivery or 1000mL after cesarean section. Read More

    Low doses of prenatal ethanol exposure and maternal separation alter HPA axis function and ethanol consumption in adult male rats.
    Neuropharmacology 2017 Dec 6;131:271-281. Epub 2017 Dec 6.
    Department of Life and Environmental Sciences, Section of Neuroscience and Anthropology, University of Cagliari, Monserrato, 09042, Cagliari, Italy.
    Adverse maternal behaviors during pregnancy and unfavorable postnatal experiences during development are associated with an increased risk of developing psychiatric disorders, as well as, a vulnerability to alcohol addiction in adulthood. Here, we examined the effects of combined ethanol exposure during late pregnancy and postnatal maternal separation (MS) on HPA responsiveness, anxiety behavior and preference for alcohol consumption in adult male rats. Animals exposed to both conditions revealed a decrease in blood levels of allopregnanolone accompanied by increased anxiety behavior. Read More

    Fever in pregnancy and the risk of congenital malformations: a cohort study.
    BMC Pregnancy Childbirth 2017 Dec 8;17(1):413. Epub 2017 Dec 8.
    Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, Box 2099, 1014, København K, Denmark.
    Background: In a variety of animal species, hyperthermia in pregnancy has been recognized as teratogenic. Hyperthermia interferes with protein synthesis via heat-shock proteins, which can entail membrane disruption, cell death, vascular disruption, and placental infarction. This can induce severe fetal malformations or death. Read More

    The first case report of septic abortion resulting from β-lactamase-negative ampicillin-resistant non-typeable Haemophilus influenzae infection.
    JMM Case Rep 2017 Oct 12;4(10):e005123. Epub 2017 Oct 12.
    Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
    Introduction. This is the first case report of septic abortion due to β-lactamase-negative ampicillin-resistant (BLNAR) non-typeable Haemophilus influenzae infection. In Japan, BLNAR H. Read More

    Bilateral Tubal Pregnancy without Known Risk Factor.
    Case Rep Obstet Gynecol 2017 18;2017:4356036. Epub 2017 Oct 18.
    Department of Obstetrics and Gynecology, Yalgado Ouedraogo Teaching Hospital, 03 P.O. Box 7022, Ouaga 03, Burkina Faso.
    Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. Read More

    [Not everything is Zika: congenital toxoplasmosis, still prevalent in Colombia?]
    Rev Peru Med Exp Salud Publica 2017 Apr-Jun;34(2):332-336
    Organización Latinoamericana para el Fomento de la Investigación en Salud (OLFIS). Bucaramanga, Santander, Colombia.
    Congenital toxoplasmosis continues to be a public health threat. Even existing guidelines, publicly known, its implementation and lack of appropriate interpretation of serological tests in pregnancy is often observed. This leds to failure in opportunities for positive and known interventions to decrease the fetal risk due to Toxoplasma gondii infection. Read More

    Successful peritoneal dialysis using a percutaneous tube for peritoneal drainage in an extremely low birth weight infant: a case report.
    Surg Case Rep 2017 Nov 9;3(1):115. Epub 2017 Nov 9.
    Department of Pediatrics, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, Wakayama, 640-8558, Japan.
    Background: Peritoneal dialysis (PD) for acute kidney injury (AKI) of newborns has been performed safely. AKI occurs in 8 to 24% of extremely low birth weight (ELBW) infants. Although PD has only been used occasionally in ELBW infants, prognosis is poor for ELBW infants with AKI. Read More

    Management of maternal anaphylaxis in pregnancy: a case report.
    Acute Med Surg 2017 Apr 10;4(2):202-204. Epub 2016 Nov 10.
    Department of General MedicineSapporo Tokushukai HospitalSapporoHokkaidoJapan.
    Case: A 26-year-old woman (gravida 2, para 1) at 25 weeks' gestation was brought to the emergency department because of anaphylactic symptoms. She reported eating Japanese soba and developed symptoms of dyspnea, generalized itchy rash, abdominal pain, and severe uterine contractions within 15-30 min of eating. She was immediately treated by normal saline infusion, two injections of epinephrine (intramuscularly), and a nebulized short-acting β2-receptor agonist, followed by H1-antihistamine and methylprednisolone. Read More

    Maternal and fetal outcomes of pregnant women with type 1 diabetes, a national population study.
    Oncotarget 2017 Oct 16;8(46):80679-80687. Epub 2017 Sep 16.
    Office for Big Data Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
    Pregnancy in women with type 1 diabetes is associated with poor maternal and neonatal outcomes. However, the risk of these outcomes has never been evaluated in an Asian national population. In this work, we report the maternal and fetal outcomes of pregnant women with type 1 diabetes in Taiwan. Read More

    Emergency Medicine Myths: Ectopic Pregnancy Evaluation, Risk Factors, and Presentation.
    J Emerg Med 2017 Dec 27;53(6):819-828. Epub 2017 Oct 27.
    University of Texas-Southwestern, Parkland Hospital, Dallas, Texas.
    Background: Ectopic pregnancy (EP) is an important cause of morbidity and mortality in females of reproductive age. Proper diagnosis and treatment are critical, as complications such as rupture, hemorrhagic shock, and even death can occur.

    Objective: EP is a condition emergency physicians are trained to detect, yet there are multiple myths concerning its evaluation and diagnosis. Read More

    [Maternal deaths due to infectious cause, results from the French confidential enquiry into maternal deaths, 2010-2012].
    Gynecol Obstet Fertil Senol 2017 Dec 3;45(12S):S48-S53. Epub 2017 Nov 3.
    Service d'anesthésie-réanimation, hôpital Nord, AP-HM, chemin des Bourrely, 13015 Marseille, France.
    Over the period 2010-2012, maternal mortality from infectious causes accounted for 5% of maternal deaths by direct causes and 16% of maternal deaths by indirect causes. Among the 22 deaths caused by infection occurred during this period, 6 deaths were attributed to direct causes from genital tract origin, confirming thus the decrease in direct maternal deaths by infection during the last ten years. On the contrary, indirect maternal deaths by infection, from extragenital origin, doubled during the same period, with 16 deaths in the last triennium, dominated by winter respiratory infections, particularly influenza: the 2009-2010 influenza A (H1N1) virus pandemic was the leading cause of indirect maternal mortality by infection during the studied period. Read More

    Like the Eye of the Tiger: Inpatient Psychiatric Facility Exclusionary Criteria and Its "Knockout" of the Emergency Psychiatric Patient.
    J Emerg Trauma Shock 2017 Oct-Dec;10(4):189-193
    Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, Texas, USA.
    Context: Over 6% of all emergency department (ED) visits in the United States involve primary mental health or behavioral issues. The patients are stabilized in the ED but frequently require admission to an inpatient psychiatric unit or institution for longer term treatment and management. To facilitate this process, an emergency physician (EP) must first "medically clear" the patient as stable for transfer. Read More

    Group A Streptococcus Septic Shock after Surgical Abortion: A Case Report and Review of the Literature.
    Case Rep Obstet Gynecol 2017 11;2017:6316739. Epub 2017 Sep 11.
    Department of Obstetrics and Gynecology, Hofstra Northwell School of Medicine, Hofstra University, North Shore-LIJ University Hospital, 270-05 76th Avenue, New Hyde Park, NY 11040, USA.
    Group A Streptococcus (GAS) causing puerperal sepsis is a leading cause of maternal mortality worldwide. Although rare, GAS infection is a relatively significant public health concern because of its propensity to evolve rapidly into septic shock, streptococcal toxic shock syndrome, and death. We report the case of a 27-year-old patient who presented with GAS septic shock after undergoing a surgical termination of pregnancy and was treated successfully and recovered without sequelae. Read More

    Preimplantation Factor (PIF) Promotes HLA-G, -E, -F, -C Expression in JEG-3 Choriocarcinoma Cells and Endogenous Progesterone Activity.
    Cell Physiol Biochem 2017 27;43(6):2277-2296. Epub 2017 Oct 27.
    School of Biological Sciences, University of Essex, Colchester, United Kingdom.
    Background/aims: Pregnancy success requires mandatory maternal tolerance of the semi/ allogeneic embryo involving embryo-derived signals. Expression levels of PreImplantation Factor (PIF), a novel peptide secreted by viable embryos, correlate with embryo development, and its early detection in circulation correlates with a favourable pregnancy outcome. PIF enhances endometrial receptivity to promote embryo implantation. Read More

    Pulmonary Hypertension and Pregnancy Outcomes: Insights From the National Inpatient Sample.
    J Am Heart Assoc 2017 Oct 24;6(10). Epub 2017 Oct 24.
    Department of Medicine, Division of Cardiovascular Medicine, State University of New York Stony Brook University Medical Center, Stony Brook, NY
    Background: Pregnant women with pulmonary hypertension (PH) are at risk for adverse cardiac outcomes, particularly at the time of labor and delivery. The purpose of this study is to define the impact of PH on pregnancy outcomes and the risk of major adverse cardiac events (MACE).

    Methods And Results: The National Inpatient Sample was screened for hospital admissions of women delivering during the years 2003 to 2012. Read More

    Barriers to safe abortion access: uterine rupture as complication of unsafe abortion in a Ugandan girl.
    BMJ Case Rep 2017 Oct 20;2017. Epub 2017 Oct 20.
    Uganda-UK Health Alliance (UUKHA), Department of Health Innovation and Investment, Kampala, Uganda.
    A 15-year-old girl at 18 weeks gestation by the last menstrual period presented to a rural Ugandan healthcare facility for termination of her pregnancy as a result of rape by her uncle. Skilled healthcare workers at the facility refused to provide the abortion due to fear of legal repercussions. The patient subsequently obtained an unsafe abortion by vaginal insertion of local herbs and sharp objects. Read More

    Spontaneous hemoperitoneum in pregnancy (SHiP) and endometriosis - A systematic review of the recent literature.
    Eur J Obstet Gynecol Reprod Biol 2017 Dec 12;219:57-65. Epub 2017 Oct 12.
    VU University Medical Center, Endometriosis Center VUmc, Amsterdam, The Netherlands.
    Spontaneous Hemoperitoneum in Pregnancy (SHiP), an unprovoked (nontraumatic) intraperitoneal bleeding in pregnancy (up to 42days postpartum), is associated with serious adverse pregnancy outcomes. To evaluate the clinical consequences of SHiP and its association with endometriosis, a systematic review was conducted according to the PRISMA guidelines. PubMed, Embase. Read More

    Resuscitative endovascular balloon occlusion of the aorta as an adjunct for hemorrhagic shock due to uterine rupture: a case report.
    Clin Case Rep 2017 Oct 15;5(10):1565-1568. Epub 2017 Aug 15.
    Department of Obstetrics and GynecologyOsaka City General Hospital2-13-22 MiyakojimahondoriMiyakojima-kuOsakaJapan.
    Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a life-saving procedure used to control bleeding and maintain blood pressure temporarily in traumatic hemorrhagic shock. Uterine rupture and placenta accreta provoke uncontrollable massive hemorrhaging. REBOA may be useful for hemodynamic stabilization to prevent cardiac arrest in high-risk pregnancy. Read More

    Epidemic hemorrhagic fever complicated with late pregnancy: A case report.
    Medicine (Baltimore) 2017 Oct;96(40):e8137
    aDepartment of Shandong University School of Medicine, Jinan bDepartment of Respiratory Disease (Taishan Scholar Position), Binzhou Medical University Hospital, Binzhou, China.
    Rationale: Hantaviruses cause two forms of diseases in humans, namely hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome. Hantavirus infections can occur in pregnant women, and could influence the maternal and fetal outcomes, although this is a rare finding, even in endemic areas.

    Patient Concerns: In this report, we describe anunusual case involving a pregnant woman with HFRS who was in a state of shock. Read More

    Renal artery aneurysm rupture during post-partum period: A case report.
    Electron Physician 2017 Aug 1;9(8):5138-5141. Epub 2017 Aug 1.
    M.D., Assistant Professor of obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences (MUMS), Mashhad, Iran.
    Renal artery aneurysm has an incidence of lower than one in 1000 of the general population. The risk of aneurysm rupture increases during pregnancy due to hormonal and hemodynamic changes. Therefore, these patients often refer to physicians with abdominal pain that is followed by shock. Read More

    Practice Bulletin No. 183: Postpartum Hemorrhage.
    • Authors:
    Obstet Gynecol 2017 10;130(4):e168-e186
    Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2). Read More

    Practice Bulletin No. 183 Summary: Postpartum Hemorrhage.
    • Authors:
    Obstet Gynecol 2017 Oct;130(4):923-925
    Maternal hemorrhage, defined as a cumulative blood loss of greater than or equal to 1,000 mL or blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process, remains the leading cause of maternal mortality worldwide (1). Additional important secondary sequelae from hemorrhage exist and include adult respiratory distress syndrome, shock, disseminated intravascular coagulation, acute renal failure, loss of fertility, and pituitary necrosis (Sheehan syndrome).Hemorrhage that leads to blood transfusion is the leading cause of severe maternal morbidity in the United States closely followed by disseminated intravascular coagulation (2). Read More

    The composition of the vaginal microbiome in first trimester pregnant women influences the level of autophagy and stress in vaginal epithelial cells.
    J Reprod Immunol 2017 Sep 8;123:35-39. Epub 2017 Sep 8.
    Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States. Electronic address:
    Epithelial cells lining the vagina are major components of genital tract immunity. The influence of the vaginal microbiome on properties of host epithelial cells is largely unexplored. We evaluated whether differences in the most abundant lactobacilli species or bacterial genera in the vagina of first trimester pregnant women were associated with variations in the extent of stress and autophagy in vaginal epithelial cells. Read More

    Holding of bovine blastocysts at suprazero temperatures using small molecules.
    Sci Rep 2017 Aug 25;7(1):9490. Epub 2017 Aug 25.
    Cellular Reprogramming and Embryo Biotechnology Laboratory, Dental Research Institute, BK21, Seoul National University School of Dentistry, Seoul, Republic of Korea.
    Although assisted reproductive technology (ART) currently exists, the only embryo preservation technology that is available is cryopreservation. In the present study, small molecules were used to hold embryos at room temperature. The basic medium for embryo holding for a short period of time at 4 °C, 10 °C and 20 °C consisted of 1% BSA non-cryopreservation medium (BNC) instead of fetal bovine serum. Read More

    Chlamydia trachomatis: the Persistent Pathogen.
    Clin Vaccine Immunol 2017 Oct 5;24(10). Epub 2017 Oct 5.
    Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York, USA.
    Chlamydia trachomatis is an obligate intracellular bacterium whose only natural host is humans. Although presenting as asymptomatic in most women, genital tract chlamydial infections are a leading cause of pelvic inflammatory disease, tubal factor infertility, and ectopic pregnancy. C. Read More

    Placental Malaria: A New Insight into the Pathophysiology.
    Front Med (Lausanne) 2017 25;4:117. Epub 2017 Jul 25.
    Department of Microbiology, Panjab University, Chandigarh, India.
    Malaria in pregnancy poses a great health risk to mother and her fetus and results into complications, such as abortion, still birth, intra uterine growth retardation, and low birth weight. The heavy infiltration of Plasmodium falciparum-infected RBCs in the intervillous spaces of placenta seems to be responsible for all the complications observed. Infected RBCs in the placenta cause an inflammatory environment with increase in inflammatory cells and cytokines which is deleterious to the placenta. Read More

    Bilateral Subcapital Femoral Neck Fracture in a 28 Year Old Postpartum Woman.
    Med Arch 2017 Apr;71(2):151-153
    Department of Orthopedics and Traumatology, General hospital Niksic, Montenegro.
    Introduction: Subcapital femoral neck fractures are associated with high morbidity and mortality. These fractures mostly occur as a result of a high-force impact from traffic accidents and a fall from a great height, though non-traumatic forms are described in transient osteoporosis during the second half of pregnancy, in convulsions during electric shock, eclampsia, hypocalcemia, osteomalacia, renal osteodystrophy and myeloma.

    Case Report: In this report we present a bilateral subcapital femoral neck fracture in a woman sustained two days after delivery. Read More

    Collaborative Strategies for Management of Obstetric Hemorrhage.
    Crit Care Nurs Clin North Am 2017 Sep 16;29(3):315-330. Epub 2017 Jun 16.
    Clinical Concepts in Obstetrics, Inc, Nashville, TN, USA; Labor and Delivery, Vanderbilt University Medical Center, Vanderbilt University School of Nursing, Nashville, TN, USA.
    Obstetric hemorrhage is a significant cause of perinatal morbidity and mortality that requires prompt recognition and collaborative intervention to prevent poor outcomes. Medical and surgical management goals include controlling bleeding, supporting tissue oxygenation and perfusion, and monitoring for coagulopathies and complications. Read More

    Case of spontaneous splenic rupture caused by ectopic pregnancy in the spleen.
    J Obstet Gynaecol Res 2017 Nov 1;43(11):1778-1780. Epub 2017 Aug 1.
    Department of Hepatobiliary Surgery, First People's Hospital of Changzhou, Changzhou, China.
    Splenic ectopic pregnancy refers to the implantation of the oosperm in the spleen. If not diagnosed early, the results of this phenomenon would almost certainly be splenic rupture, which is equivalent to the spontaneous rupture of the spleen. If the patient has no history of trauma, it is difficult to diagnose this condition early and an explicit diagnosis is often obtained by exploratory laparotomy. Read More

    Streptococcal toxic shock syndrome occurring in the third trimester of pregnancy: A case report.
    J Obstet Gynaecol Res 2017 Oct 1;43(10):1639-1643. Epub 2017 Aug 1.
    Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Maimonides Medical Center, Brooklyn, New York, USA.
    Group A streptococcal (GAS) toxic shock syndrome (TSS) is a rare life-threatening illness. Most reported cases have occurred in the post-partum period. Here, we report a rare case of a primigravid who developed GAS TSS in the third trimester. Read More

    Aortocaval Compression Syndrome: Time to Revisit Certain Dogmas.
    Anesth Analg 2017 12;125(6):1975-1985
    From the Department of Anesthesiology, Columbia University, New York, New York.
    More than 70 years ago, the phenomenon of "postural shock" in the supine position was described in healthy women in late pregnancy. Since then, avoidance of the supine position has become a key component of clinical practice. Indeed, performing pelvic tilt in mothers at term to avoid aortocaval compression is a universally adopted measure, particularly during cesarean delivery. Read More

    Subsequent Safe Pregnancy with Cesarean Delivery in a Patient with a History of Peripartum Takotsubo Syndrome Complicated by Cardiogenic Shock.
    J Cardiovasc Echogr 2017 Jul-Sep;27(3):114-117
    Division of Obstetrics and Gynecology, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
    Takotsubo syndrome (TTS) is an acute and reversible heart failure syndrome, usually occurring in females but rarely in the peripartum period. In women with a history of peripartum TTS, it is unclear how to manage subsequent pregnancies. A 39-year-old female with a history of peripartum TTS complicated by cardiogenic shock became pregnant again. Read More

    Complete recovery of fulminant peripartum cardiomyopathy on mechanical circulatory support combined with high-dose bromocriptine therapy.
    ESC Heart Fail 2017 Nov 25;4(4):641-644. Epub 2017 Jul 25.
    Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy presenting with heart failure due to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of heart failure is found. We report a case of a woman with PPCM who developed a critical cardiogenic shock with repeated cardiopulmonary resuscitation. We show for the first time that mechanical circulatory support combined with high-dose bromocriptine therapy to suppress systemic prolactin levels may serve as an effective therapeutic option in patients with fulminant PPCM and cardiogenic shock. Read More

    Management and outcome of hepatocellular adenoma with massive bleeding at presentation.
    World J Gastroenterol 2017 Jul;23(25):4579-4586
    Anne J Klompenhouwer, Jan NM Ijzermans, Department of Surgery, Erasmus MC, 3000 CA Rotterdam, the Netherlands.
    Aim: To evaluate outcome of acute management and risk of rebleeding in patients with massive hemorrhage due to hepatocellular adenoma (HCA).

    Methods: This retrospective cohort study included all consecutive patients who presented to our hospital with massive hemorrhage (grade II or III) due to ruptured HCA and were admitted for observation and/or intervention between 1999-2016. The diagnosis of HCA was based on radiological findings from contrast-enhanced magnetic resonance imaging (MRI) or pathological findings from biopsy or resection of the HCA. Read More

    Post-partum streptococcal toxic shock syndrome associated with necrotizing fasciitis.
    IDCases 2017 27;9:91-94. Epub 2017 Jun 27.
    Department of Obstetrics & Gynaecology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia.
    We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock requiring high inotropic support. Read More

    Analysis Of Two Years Cases Of Ectopic Pregnancy.
    J Ayub Med Coll Abbottabad 2017 Jan-Mar;29(1):65-67
    Department of Gynaecology & Obstetrics, Ayub Teaching Hospital, Abbottabad, Pakistan.
    Background: Ectopic pregnancy is the leading cause of pregnancy related deaths in the first trimester. The aim of this study was to evaluate the frequency of risk factors, clinical presentation, diagnostic methods and site of ectopic pregnancy.

    Methods: This descriptive cross sectional study was conducted in Gynaecology and Obstetrical Unit-A of Ayub Teaching Hospital Abbottabad from 1st October 2013 to 31st October 2015. Read More

    Cervical shock: a complication of incomplete abortion.
    BMJ Case Rep 2017 Jul 14;2017. Epub 2017 Jul 14.
    Emergency Department, John Radcliffe Hospital, Oxford, Oxfordshire, UK.
    A case of a 37-year-old female primagravida who attended the emergency department (ED) via ambulance in hypotensive shock. She was 10 weeks pregnant, but had an inevitable miscarriage confirmed in the local Early Pregnancy Unit 3 weeks previously. She was hypotension (90/60 mm Hg), bradycardic (45 bpm) and was peripherally shut down. Read More

    Rare complication of fibroids in pregnancy: Spontaneous fibroid rupture.
    J Obstet Gynaecol Res 2017 Sep 10;43(9):1485-1488. Epub 2017 Jul 10.
    Department of Obstetrics & Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana.
    Uterine fibroids in pregnancy present with numerous complications. However, spontaneous rupture is a rare and potentially life-threatening event. We report a case of a 43-year-old multiparous woman who presented with hypovolemic shock secondary to a ruptured uterine fibroid 2 days after a spontaneous vaginal delivery. Read More

    Isolation of Salmonella typhi from high vaginal swab in a case of septic abortion.
    Indian J Med Microbiol 2017 Apr-Jun;35(2):311-313
    Department of Microbiology, Dr. Baba Saheb Ambedkar Hospital, Government of NCT of Delhi, New Delhi, India.
    Salmonella Typhi can be a significant cause of morbidity and mortality in pregnant females with adverse outcomes. Risk of infections increases manifold during pregnancy due to hormonal changes and immunological phenomena. S. Read More

    An update on the risk factors for and management of obstetric haemorrhage.
    Womens Health (Lond) 2017 Aug 6;13(2):34-40. Epub 2017 Jul 6.
    St George's University Hospitals NHS Foundation Trust, London, UK.
    Obstetric haemorrhage is associated with increased risk of serious maternal morbidity and mortality. Postpartum haemorrhage is the commonest form of obstetric haemorrhage, and worldwide, a woman dies due to massive postpartum haemorrhage approximately every 4 min. In addition, many experience serious morbidity such as multi-organ failure, complications of multiple blood transfusions, peripartum hysterectomy and unintended damage to pelvic organs, loss of fertility and psychological sequelae, including posttraumatic stress disorders. Read More

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