1,721,012 research outputs found
Intrapartum pyrexia, cardiotocography traces and histologic chorioamnionitis: a case-control study
No full textObjectives: To compare characteristics of labor, cardiotocography traces, and maternal and neonatal outcomes, in a cohort of pregnancies at term complicated by maternal intrapartum pyrexia, with or without a histologic diagnosis of chorioamnionitis. Methods: This is a retrospective case-control study including pregnancies at term with detection of maternal intrapartum pyrexia, delivered between January 2020 and June 2021. Cardiotocography traces were entirely evaluated, since admission till delivery, and classified according to the International Federation of Obstetrics and Gynecology (FIGO) guideline. Maternal and neonatal outcomes were also recorded as secondary outcomes. Placentas have been studied according to the Amniotic Fluid Infection Nosology Committee. Results: Forty four patients met the inclusion criteria and were included in the study cohort. There was a significant association between the use of oxytocin augmentation in labor and the histologic diagnosis of chorioamnionitis. A significative recurrence of loss and/or absence of accelerations at the point of pyrexia was also documented in women with histological chorioamnionitis compared to the others. Conclusions: Chorioamnionitis appears to be associated with myometrial disfunction, as suggested by the increased use of oxytocin augmentation during active labor of women at term with intrapartum pyrexia and histologic diagnosis of chorioamnionitis
Echocardiographic evaluation in patients with previous pregnancies complicated by HELLP syndrome
No full textPrimary Hyperparathyroidism in Pregnancy: A Case Report
No full textPrimary hyperparathyroidism (PHP) is the third most common endocrine disorder. We report the case of a 28-year-old woman who experienced general weakness, hyperemesis gravidarum and hypercalcemia at 11 weeks of gestation. Corresponding to hypercalcemia, we found inappropriately elevated parathyroid hormone levels. Through neck computed tomography a solitary adenoma of the parathyroid gland, measuring 6 × 2.9 × 11 mm has been documented. An ultrasound-guided fine needle aspiration from the mass confirmed the suspicious of a benign tumor. Left superior parathyroidectomy resulted in immediate and permanent resolution of hypercalcemia. The postoperative course was uneventful. Histopathological and immunohistochemical analyses were consistent with parathyroid adenoma. The diagnostic approach to hypercalcemia in pregnancy represents a challenge for multidisciplinary teamwork
Elastic properties of ascending aorta in women with previous pregnancy complicated by early- or late-onset pre-eclampsia
No full textEndothelial Dysfunction And Vascular Stiffness In Women With A Previous Pregnancy Complicated By Hellp Syndrome
No full textInsights into cardiac alterations after pre-eclampsia: an echocardiographic study.
No full textOBJECTIVES:
Pre-eclampsia (PE) is associated with persistent abnormalities in cardiac findings, known to be important in cardiovascular (CV) risk stratification. Two-dimensional (2D) speckle tracking echocardiography (STE) allows an objective quantification of myocardial deformation overcoming many of the limitations of tissue Doppler imaging (TDI), and provides insights into aspects of left ventricular (LV) function that were exclusively analyzed by magnetic resonance imaging. Early-onset (EO) and late.onset (LO) PE could be more than one disease leading to a different CV involvement, being myocardial and vascular impairment more frequent after pregnancies complicated by the early form of the disease than the late one. Understanding LV performance status requires examining not only the properties of the left ventricle itself, but also investigating the modulating effects of the arterial system on LV function. This aspect is globally resumed in the concept of ventricular-arterial coupling (VAC). The aim of this study was to investigate CV performance status few years after EOPE or LOPE taking into account myocardial 2D strain, LV torsional mechanics and VAC.
METHODS:
30 non-pregnant women with a previous singleton pregnancy complicated by EOPE, 30 who experienced LOPE and 30 controls underwent echocardiography from 6 months to 4 years after delivery. All the study cohort was free from any CV risk factor. VAC was defined as the ratio between aortic elastance (Ea) and left ventricular end-systolic elastance (Ees).
RESULTS:
The EOPE group showed a subclinical impairment in left ventricular systole and a slight alteration in right ventricular function. Although VAC was normal in the whole study cohort, Ea and Ees were altered significantly more in the EOPE group than both LOPE and controls. All parameters we studied were independently associated with GA at the diagnosis of PE.
CONCLUSIONS:
Women with a history of EOPE showed a persistent subclinical contractile impairment involving the whole heart, if compared with LOPE and healthy controls. In previously pre-eclamptics VAC value was maintained in normal range, although its single components showed subclinical alterations which were more significant in EOPE than LOPE and controls
Endothelial dysfunction and vascular stiffness in women with a previous pregnancy complicated by early or late preeclampsia
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