5,465 results match your criteria Shock and Pregnancy


The outcome of patients with peripartum cardiomyopathy and consecutive implantation of a left ventricular assist device.

J Card Surg 2021 May 7. Epub 2021 May 7.

Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany.

Objectives: Peripartum cardiomyopathy (PPCM) is a form of systolic heart failure occurring toward the end of pregnancy or in the period after delivery. Lack of myocardial recovery or therapy-refractory cardiogenic shock are rare complications and left ventricular assist device (LVAD) systems might be used as a life-saving option. The aim of this study was to investigate outcomes of PPCM patients supported with LVAD, registered in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS). Read More

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Thermal-treatment protocol to induce thermotolerance in bovine embryos.

Reprod Fertil Dev 2021 May;33(7):497-501

Animal Reproduction Laboratory, Embrapa Dairy Cattle, Fazenda Santa Monica Road, Barao de Juparana, Valença, RJ, Brazil.

Artificial reproduction in dairy cattle is challenged by summer temperatures in tropical environments. We describe a treatment based on mild temperature increases to induce thermotolerance and improve the embryo's performance under heat stress conditions. A protocol was established to induce upregulation of heat shock protein A (HSPA, formerly known as HSP70) but not impair embryonic development. Read More

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Management of Implantable Cardioverter-Defibrillators during Pregnancy-A Systematic Review.

J Clin Med 2021 Apr 14;10(8). Epub 2021 Apr 14.

Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria.

Background: With the advent of implantable cardioverter-defibrillator (ICD) technology in recent decades, patients with inherited or congenital cardiomyopathy have a greater chance of survival into adulthood. Women with ICDs in this group are now more likely to reach reproductive age. However, pregnancy represents a challenge for clinicians, as no guidelines for the treatment of pregnant women with an ICD are currently available. Read More

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Case 2-2021: A Pregnant Woman with Ventricular Tachycardia and Shock.

Authors:
Peter Bogaty

N Engl J Med 2021 04;384(17):e64

Laval University, Quebec, QC, Canada

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Current Key Challenges in Managing Maternal Sepsis.

J Perinat Neonatal Nurs 2021 Apr-Jun 01;35(2):132-141

Mount Pleasant, South Carolina (Ms Roberts); and Clinical Concepts in Obstetrics, LLC, Brentwood, Tennessee (Drs Baird and Martin).

Sepsis resulting from maternal infection is the second leading cause of pregnancy-related death. Although screening and initial care of a septic nonpregnant patient is standardized in nonpregnant adults, many challenges exist for early recognition and management of sepsis and septic shock in the obstetric population. Because most sepsis research excludes pregnant patients, there are many challenges that contribute to a lack of standardized approach to maternal sepsis. Read More

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Trends, characteristics, and outcomes of placenta accreta spectrum: A national study in the United States.

Am J Obstet Gynecol 2021 Apr 21. Epub 2021 Apr 21.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA. Electronic address:

Background: Although an infrequent occurrence, the placenta can adhere abnormally to the gravid uterus leading to significantly high maternal morbidity and mortality during cesarean section (CS). Contemporary national statistics related to a morbidly adherent placenta, referred to as placenta accreta spectrum (PAS), are needed.

Objective: To examine national trends, characteristics, and perioperative outcomes of women who underwent CS for PAS in the United States. Read More

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Maternal undernutrition during pregnancy and lactation increases transcription factors, ETV5 and GDNF, and alters regulation of apoptosis and heat shock proteins in the testis of adult offspring in the rat.

Reprod Fertil Dev 2021 May;33(7):484-496

Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, L8S 4L8, Canada; and Department of Pediatrics, McMaster University, Hamilton, L8S 4L8, Canada, and Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, L8S 4L8, Canada.

We tested whether changes in Sertoli cell transcription factors and germ cell heat shock proteins (HSPs) are linked to the effects of maternal undernutrition on male offspring fertility. Rats were fed ad libitum with a standard diet (CONTROL) throughout pregnancy and lactation or with 50% of CONTROL intake throughout pregnancy (UNP) or lactation (UNL) or both periods (UNPL). After postnatal Day 21, 10 male pups per group were fed a standard diet ad libitum until postnatal Day 160 when testes were processed for histological, mRNA and immunohistochemical analyses. Read More

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Effect of the CRADLE vital signs alert device intervention on referrals for obstetric haemorrhage in low-middle income countries: a secondary analysis of a stepped- wedge cluster-randomised control trial.

BMC Pregnancy Childbirth 2021 Apr 21;21(1):317. Epub 2021 Apr 21.

Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, SE1 7EH, UK.

Background: Obstetric haemorrhage is the leading cause of maternal death worldwide, 99% of which occur in low and middle income countries. The majority of deaths and adverse events are associated with delays in identifying compromise and escalating care. Management of severely compromised pregnant women may require transfer to tertiary centres for specialised treatment, therefore early recognition is vital for efficient management. Read More

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Pregnancy in catecholaminergic polymorphic ventricular tachycardia: therapeutic optimization and multidisciplinary care are key to success.

Herzschrittmacherther Elektrophysiol 2021 Apr 21. Epub 2021 Apr 21.

Centre for Cardiovascular Innovation, Division of Cardiology, Department of Medicine, The University of British Columbia, Vancouver, Canada.

Women of child-bearing age comprise a large proportion of the patients followed by inherited arrhythmia clinics. Despite being a rare and dangerous diagnosis, cardiac and obstetric care providers should know that catecholaminergic polymorphic ventricular tachycardia (CPVT) is not a contraindication to pregnancy. In fact, pregnancy was not associated with an increased risk of CPVT-associated arrhythmias in a recent large cohort study, and most guideline-based anti-arrhythmic drug treatments are life-saving and carry a low risk of teratogenesis. Read More

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Acute fatty liver of pregnancy causes severe acute pancreatitis and stillborn fetus: A case report.

Medicine (Baltimore) 2021 Apr;100(16):e25524

Department of Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, China.

Rationale: Acutefatty liver of pregnancy (AFLP) is a potentially fatal obstetric emergency characterized by acute hepatic failure secondary to fatty infiltration. The resultant effects include coagulopathy, electrolyte abnormalities, and multisystem organ dysfunction. Pancreatitis typically develops after the onset of renal and hepatic dysfunction. Read More

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Complicated Monochorionic-Diamniotic Twins in a Pregnant Woman with COVID-19 in the Second Trimester.

Am J Perinatol 2021 Apr 14. Epub 2021 Apr 14.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles, California.

Objective:  A majority of studies evaluating the risk of vertical transmission and adverse outcomes in pregnancies with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are mostly based on third-trimester infections. There is limited data available on pregnancy sequelae of maternal infection in the first or second trimester.

Study Design:  We present a patient with monochorionic-diamniotic twins that develops coronavirus disease 2019 infection at 15 weeks of gestation. Read More

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AN OVERVIEW OF AUTOIMMUNITY IN IMPLANTATION FAILURE: A LITERATURE REVIEW.

Wiad Lek 2021 ;74(3 cz 2):777-783

KYIV STATE MATERNITY HOSPITAL №5, KYIV, UKRAINE.

Objective: The aim: This review was aimed to understand the role of different types of autoantibodies like antiphospholipid, antithyroid, antisperm, antinuclear, anti-ovarian autoantibodiesand heat shock protein HSP 60 in the process of implantation in the normal way of conceiving and IVF and also to estimate that how the presence of these autoantibodies affect the normal pregnancy outcome.

Patients And Methods: Materials and methods: This review process performed in the obstetrics and gynaecology postgraduate department, Bogomolets national medical university, Kyiv, Ukraine. It was a review of already published papers not to need the ethical board committee's approval. Read More

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Uterine pseudoaneurysm on the basis of deep infiltrating endometriosis during pregnancy-a case report.

BMC Pregnancy Childbirth 2021 Apr 9;21(1):282. Epub 2021 Apr 9.

Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland.

Background: Pseudoaneurysm of the uterine artery (UPA) is a rare cause of potentially life-threatening hemorrhage during pregnancy and puerperium. It is an uncommon condition that mainly occurs after traumatic injury to a vessel following pelvic surgical intervention, but also has been reported based on underlying endometriosis. There is an increased risk of developing UPA during pregnancy. Read More

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The interplay between environmental exposures and COVID-19 risks in the health of children.

Environ Health 2021 03 26;20(1):34. Epub 2021 Mar 26.

Superfund Research Program, National Institute of Environmental Health Sciences, 530 Davis Drive, Durham, NC, 27709, USA.

Background: An unusual feature of SARS-Cov-2 infection and the COVID-19 pandemic is that children are less severely affected than adults. This is especially paradoxical given the epidemiological links between poor air quality and increased COVID-19 severity in adults and that children are generally more vulnerable than adults to the adverse consequences of air pollution.

Objectives: To identify gaps in knowledge about the factors that protect children from severe SARS-Cov-2 infection even in the face of air pollution, and to develop a transdisciplinary research strategy to address these gaps. Read More

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Extracorporeal life support for cardiogenic shock during pregnancy and postpartum: a single center experience.

Perfusion 2021 Mar 26:2676591211004369. Epub 2021 Mar 26.

INOVA Cardiac and Thoracic Surgery, INOVA Fairfax Hospital, Falls Church, VA, USA.

Background: The use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) for cardiogenic shock in pregnant and postpartum patients remains limited by concerns of bleeding, hemolysis, and fetal risks. This case series examines the underlying characteristics and management strategies for this high-risk population.

Methods: All pregnant and post-partum patients who underwent VA ECMO in the cardiovascular intensive care unit between January 1, 2016 and November 1, 2019, were included in this retrospective study. Read More

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Maternal near-miss patients and maternal mortality cases in a Turkish tertiary referral hospital.

Ginekol Pol 2021 Mar 10. Epub 2021 Mar 10.

Department of Obstetrics and Gynecology, Dicle Memorial Hospital, Diyarbakır, Turkey, Turkey.

Objectives: This study aimed to estimate the incidence of maternal near-miss (MNM) morbidity in a tertiary hospital setting in Turkey.

Material And Methods: In this retrospective study, we concluded 125 MNM patients who delivered between January 2017 and December 2017 and fulfilled the WHO management-based criteria and severe pre-eclamptic and HELLP patients which is the top three highest mortality rates due to pregnancy. Two maternal death cases were also included. Read More

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Catastrophic antiphospholipid syndrome presented as ruptured papillary muscle during puerperium in a patient with systemic lupus erythematosus.

Lupus 2021 May 18;30(6):1017-1021. Epub 2021 Mar 18.

Department of Internal Medicine, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.

Introduction: Catastrophic antiphospholipid syndrome (CAPS) is a rare and serious phenomenon that requires prompt recognition and treatment.

Case Presentation: The authors present the case of a puerperal woman with systemic lupus erythematosus (SLE) admitted to the emergency room with headache, blurred vision, thoracic pain, and purpuric lesions on both ears. Echocardiogram revealed global decrease in left ventricular function while cardiac and inflammatory markers were elevated. Read More

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Spontaneous coronary artery dissection with cardiogenic shock in the third trimester, and a successful early-term delivery: a case report.

Eur Heart J Case Rep 2021 Mar 10;5(3):ytab080. Epub 2021 Mar 10.

Department of Medicine, Centennial Heart at Parkridge, 2333 McCallie Avenue, Chattanooga, TN 37404, USA.

Background : Acute myocardial infarction in pregnancy is occasionally due to spontaneous coronary artery dissection (SCAD). Although uncommon, the majority of cases of pregnancy-associated SCAD (pSCAD) has critical presentations with more profound defects that portend high maternal and foetal mortality, and frequently necessitate preterm delivery. This is a case of pSCAD with ongoing ischaemia that required temporary mechanical circulatory support (MCS) and emergent revascularization, while the pregnancy was successfully continued to early-term. Read More

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Two Different Antibody-Dependent Enhancement (ADE) Risks for SARS-CoV-2 Antibodies.

Authors:
Darrell O Ricke

Front Immunol 2021 24;12:640093. Epub 2021 Feb 24.

Biological and Chemical Technologies, Massachusetts Institute of Technology Lincoln Laboratory, Biotechnology and Human Systems, Lexington, MA, United States.

COVID-19 (SARS-CoV-2) disease severity and stages varies from asymptomatic, mild flu-like symptoms, moderate, severe, critical, and chronic disease. COVID-19 disease progression include lymphopenia, elevated proinflammatory cytokines and chemokines, accumulation of macrophages and neutrophils in lungs, immune dysregulation, cytokine storms, acute respiratory distress syndrome (ARDS), etc. Development of vaccines to severe acute respiratory syndrome (SARS), Middle East Respiratory Syndrome coronavirus (MERS-CoV), and other coronavirus has been difficult to create due to vaccine induced enhanced disease responses in animal models. Read More

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Role of Heat Shock Protein 70 (HSP-70) after Giving Nanoherbal Haramonting () in Preeclamptic Rats.

Pak J Biol Sci 2021 Jan;24(1):139-145

Background And Objective: Haramonting (Rhodomyrtus tomentosa) is an alternative herb to improve health because it has many biological activities and antioxidant. HSP-70 levels as biomarkers of preeclampsia affected the anti-apoptosis of damaged cells in the placenta. This study aimed to evaluate the role of HSP-70 expressions by investigating whether effect haramonting leaves in PE rats. Read More

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January 2021

Endometriosis-related spontaneous hemoperitoneum in the early second trimester: A case report.

Taiwan J Obstet Gynecol 2021 Mar;60(2):328-330

Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address:

Objective: To present a rare case of endometriosis-related spontaneous hemoperitoneum in pregnancy (SHiP) with atypical subacute symptoms, which is likely to be mistaken as an infectious disease initially.

Case Report: A 35-year-old primigravid woman presented with diffuse lower abdominal pain and signs of peritoneal irritation for five days at 18 weeks' gestation, and the initial diagnosis was acute peritonitis. An abrupt deterioration with maternal shock and stillbirth of fetus was found in spite of close observation in emergent department. Read More

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Effects of cooled floor pads combined with chilled drinking water on behavior and performance of lactating sows under heat stress.

J Anim Sci 2021 Mar;99(3)

West Central Research and Outreach Center, University of Minnesota, Morris, MN 56267.

This study was conducted to evaluate whether cooled floor pads combined with chilled drinking water could alleviate negative impacts of heat stress on lactating sows. Thirty sows (Landrace × Yorkshire, Parity = 1 to 6) were housed in individual farrowing stalls in two rooms with temperatures being controlled at 29.4°C (0700-1900 hours) and 23. Read More

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Hemoperitoneum during removal of the placenta in advanced abdominal pregnancy with live fetus delivered at 37 weeks of gestation. A case report in a low-resource setting and literature review.

Int J Surg Case Rep 2021 Mar 26;80:105694. Epub 2021 Feb 26.

Mutoyi Hospital, Obstetrics and Gynecology Department, Gitega, Burundi.

Introduction And Importance: Advanced abdominal pregnancy (> 20 weeks gestation) is a rare condition life-threatening for mother and fetus.

Case Presentation: A 31-years-old African woman presented from a rural district to Mutoyi Hospital for first gynecological evaluation after 37 weeks of amenorrhea, abdominal pain and vaginal bleeding. An ultrasound revealed an extra-uterine fetus. Read More

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Effect of dexamethasone in patients with ARDS and COVID-19 - prospective, multi-centre, open-label, parallel-group, randomised controlled trial (REMED trial): A structured summary of a study protocol for a randomised controlled trial.

Trials 2021 Mar 1;22(1):172. Epub 2021 Mar 1.

Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, Gower Street, London, WC1E 6BT, UK.

Objectives: The primary objective of this study is to test the hypothesis that administration of dexamethasone 20 mg is superior to a 6 mg dose in adult patients with moderate or severe ARDS due to confirmed COVID-19. The secondary objective is to investigate the efficacy and safety of dexamethasone 20 mg versus dexamethasone 6 mg. The exploratory objective of this study is to assess long-term consequences on mortality and quality of life at 180 and 360 days. Read More

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Comparison of immune modulatory properties of human multipotent mesenchymal stromal cells derived from bone marrow and placenta.

Biotech Histochem 2021 Mar 1:1-11. Epub 2021 Mar 1.

Department of Stem Cell Sciences, Graduate School of Health Sciences, Hacettepe University, Ankara, Turkey.

Multipotent mesenchymal stromal cells (MSC) can be isolated from many tissues, including bone marrow (BM) and placenta (PL). Human placenta can be obtained readily without invasive procedures. There may be differences, however, in differentiation capacity and immunomodulation by MSC isolated from BM or PL. Read More

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Managing Ruptured Splenic Ectopic Pregnancy Without Splenectomy: Case Report and Literature Review.

Reprod Sci 2021 Feb 26. Epub 2021 Feb 26.

Pathology, St Bernard's Hospital, Gibraltar, UK.

Splenic ectopic pregnancy is extremely rare but carries a high risk of uncontrollable life-threatening bleeding. Our aim is to try to diagnose those cases earlier and to include splenic preservation as good alternative for selected cases. Extensive review of the literature has been performed. Read More

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February 2021

[Analyses of triggers for recurrent cardiac events in 38 patients with symptomatic long QT syndrome].

Zhonghua Xin Xue Guan Bing Za Zhi 2021 Feb;49(2):165-169

Cardiology Department, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.

To evaluate the main triggers of recurrent cardiac events in patients with symptomatic congenital long QT syndrome (cLQTS). In this retrospective case analysis study, clinical characteristics were reviewed from 38 patients with recurrent cardiac events after first visit out of 66 symptomatic cLQTS patients. General clinical data such as gender, age, clinical presentation, family history and treatment were collected, auxiliary examination results such as electrocardiogram and gene detection were analyzed. Read More

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February 2021

Clinical Outcomes of Pregnant and Postpartum Extracorporeal Membrane Oxygenation Patients.

Anesth Analg 2021 03;132(3):777-787

Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland.

Background: The use of extracorporeal membrane oxygenation (ECMO) as a rescue therapy for cardiopulmonary failure is expanding in critical care medicine. In this case series, we describe the clinical outcomes of 21 consecutive pregnant or postpartum patients that required venovenous (VV) or venoarterial (VA) ECMO. Our objective was to characterize maternal and fetal survival in peripartum ECMO and better understand ECMO-related complications that occur in this unique patient population. Read More

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