Journal articles on the topic 'Fetus Case studies'
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1
Mackenzie, Thomas B., Theodore C. Nagel, and Barbara Katz Rothman. "Case Studies: When a Pregnant Woman Endangers Her Fetus." Hastings Center Report 16, no. 1 (February 1986): 24. http://dx.doi.org/10.2307/3562466.
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Nathani, Richa S., and Zeba Nisar. "A Rare Case Report of Molar Pregnancy with Coexisting Fetus." International Journal of Recent Surgical and Medical Sciences 04, no. 01 (January 2018): 037–39. http://dx.doi.org/10.5005/jp-journals-10053-0069.
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Abstract Aim: Here we report a molar pregnancy with a coexisting fetus progressing to a viable, healthy infant which is an extreme rarity, with the incidence of 0.005–0.01% of all the pregnancies. Background: Partial mole is defined as excessive trophoblastic proliferation with normal and hydropic villi and presence of a fetus or a fetal circulation with nucleated cells. Partial molar pregnancy with a singleton live fetes is a rare condition. it is commonly seen with twin gestation and it is rare with singleton pregnancy Case report: A 30 years old primigravida, referred from a private hospital at 38 weeks of gestation delivered a phenotypically normal and healthy infant 2200 gm in weight by caesarean section. The placenta weighed 500 gms and on sectioning revealed widespread, grape-like vesicles. Light microscopy revealed normal villi coexisting with villi showing hydropic change and cistern formation and diffuse circumferential trophoblastic hyperplasia consistent with molar change. A diagnosis of partial molar pregnancy with normal fetus was made. Conclusion: Very few twin pregnancies with a hydatidiform mole and a foetus continue to term as they often have spontaneous or induced terminations for maternal complications Management of molar changes associated with normal appearing fetus still remains challenging as not many studies have been done due to rarity of this disorder. Clinical significance: Though the general trend is to terminate pregnancy in foetus with coexistent mole in anticipation of complications, under close surveillance, optimal outcomes can be achieved. Monitoring of serum β-hCG, serial ultrasound for fetal growth, size of molar component, and theca lutein cysts can help to predict good patient outcomes.
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Potrony, Miriam, Antoni Borrell, Narcís Masoller, Alfons Nadal, Leonardo Rodriguez-Carunchio, Karmele Saez de Gordoa Elizalde, Juan Francisco Quesada-Espinosa, et al. "Lethal Congenital Contracture Syndrome 11: A Case Report and Literature Review." Journal of Clinical Medicine 11, no. 13 (June 21, 2022): 3570. http://dx.doi.org/10.3390/jcm11133570.
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Lethal congenital contracture syndrome 11 (LCCS11) is caused by homozygous or compound heterozygous variants in the GLDN gene on chromosome 15q21. GLDN encodes gliomedin, a protein required for the formation of the nodes of Ranvier and development of the human peripheral nervous system. We report a fetus with ultrasound alterations detected at 28 weeks of gestation. The fetus exhibited hydrops, short long bones, fixed limb joints, absent fetal movements, and polyhydramnios. The pregnancy was terminated and postmortem studies confirmed the prenatal findings: distal arthrogryposis, fetal growth restriction, pulmonary hypoplasia, and retrognathia. The fetus had a normal chromosomal microarray analysis. Exome sequencing revealed two novel compound heterozygous variants in the GLDN associated with LCCS11. This manuscript reports this case and performs a literature review of all published LCCS11 cases.
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Ku, Vanessa, Srikanth Mukkera, Nathan Joshua Manales, Asley Sanchez, and Kushal Gandhi. "Repeated cholestyramine washouts in a pregnant patient on leflunomide: A case report." Journal of Case Reports and Images in Obstetrics and Gynecology 8, no. 2 (March 6, 2022): 10–13. http://dx.doi.org/10.5348/100117z08vk2022cr.
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Introduction: Leflunomide is a disease modifying antirheumatic drug (DMARD) that is commonly used for the treatment of rheumatoid arthritis (RA). It is considered as a category X drug because it is contraindicated during pregnancy (studies in pregnant women have demonstrated a risk to the fetus, and/or human or animal studies have shown fetal abnormalities; risks of the drug outweigh the potential benefits). In women attempting to conceive, it is necessary to ensure that leflunomide levels are undetectable in plasma to prevent the risk of fetal malformations. An 11-day treatment of cholestyramine has been shown to lower leflunomide active metabolite levels to near undetectable levels. Case Report: In this case report, we discuss an RA patient taking leflunomide, who had an unintended pregnancy requiring two treatment courses of cholestyramine for complete washout of leflunomide. A C-section was performed at 39 weeks and 3 days due to concerns about the fetus’ health and was complicated by postpartum hemorrhage. The infant received Apgar scores of 9 and 9 at 1 and 5 minutes. The infant was also found with no birth anomalies and was deemed healthy at a check-up of nine months of age. Conclusion: Although a single 11-day treatment is typically sufficient to safely lower the concentration of leflunomide, it is important to remeasure the leflunomide active metabolite levels after the treatment course of cholestyramine to ensure that levels have reached zero. When leflunomide levels remain significantly elevated, a second treatment course of cholestyramine is required, otherwise the fetus could potentially be exposed to its teratogenic properties.
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Fatima Khidri, Feriha, Faiza Kamran Ali, Beenish Ghafar, and Hafsa Shabir Ahmed. "The Intrapartum eclampsia: A case series presented at Tertiary Care Hospital." Professional Medical Journal 26, no. 08 (August 10, 2019): 1389–92. http://dx.doi.org/10.29309/tpmj/2019.26.08.1130.
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Preeclampsia is the complex disorder characterized by hypertension and proteinuria. Preeclampsia if complicated can progress to eclampsia, endangering life of both mother and fetus. Eclampsia occurring during delivery is referred as intrapartum eclampsia. Few studies have been conducted on intrapartum eclampsia, as it is less frequent in developed countries due to the availability of better health care facilities and awareness. Here we report a case series of patients presented with intrapartum eclampsia presented at a tertiary care hospital.
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van Lijnschoten, Gesina, Johanna E. M. Groener, Saskia M. Maas, Yoav Ben-Yoseph, Koert P. Dingemans, and G. Johan A. Offerhaus. "Intrauterine Fetal Death Due to Farber Disease: Case Report." Pediatric and Developmental Pathology 3, no. 6 (November 2000): 597–602. http://dx.doi.org/10.1007/s100240010107.
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We report a case of Farber disease in a fetus who died in utero at a gestational age of 29 weeks. Macroscopic examination showed moderate postmortem changes in a microcephalic female fetus (46,XX) with mild internal hydrops, two vessels in the umbilical cord, and a moderately enlarged, relatively well-preserved spleen. Microscopic examination showed foamy cells in the spleen. Electron microscopic examination revealed the presence of Farber bodies within these foamy cells. Enzyme studies of the fetus were not possible because all tissues were formalin fixed. Lipids were extracted from formalin-fixed tissues and increased levels of ceramide and the presence of hydroxyceramide in tissue of the spleen, liver, and lung were found. Glucosylceramide was not increased excluding saposin-precursor-deficiency. Because of these findings, both parents were tested for acid ceramidase activity in their leukocytes. They both had markedly reduced enzyme activity consistent with heterozygosity for Farber disease. To the best of our knowledge, this is the first published case of Farber disease in Dutch nonconsanguineous parents.
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Galagan, Vira O., Yuliia V. Dudierina, and Anna O. Pavlova. "Prenatal Diagnosis of Chromosome 22q11.21 Microduplication Syndrome in a Fetus with Congenital Malformation of the Cardiovascular System: Case Report." Ukrainian Journal of Cardiovascular Surgery 30, no. 3 (September 26, 2022): 98–103. http://dx.doi.org/10.30702/ujcvs/22.30(03)/gd037-98103.
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A clinical case of microduplication of chromosome 22q11.21 in a fetus with a malformation of the cardiovascular system (vascular ring) is presented. This anatomical variant of the vascular ring is extremely rare and is formed by the pathological circumflex retroesophageal left-sided cervical aortic arch with the left arterial ductus arteriosus. The anatomical features of the circumflex cervical aortic arch are the left-sided pathological curved aortic arch in combination with the right-sided descending aorta. This vascular pathology can cause compression of the trachea and esophagus. This variant of the vascular ring is extremely unfavorable for surgical correction. Chromosome 22q11.21 microduplication syndrome is associated with the clinical presentation of “cat eye syndrome”. The clinical case description shows unique data from instrumental and genetic studies. All stages of examination of a pregnant woman from primary to tertiary medical care are described. The features and importance of a multidisciplinary approach are also presented.
Every case of congenital heart defect in fetus, confirmed by echocardiographic method in a specialized institution, requires medical and genetic counseling. Using of the highly sensitive specific molecular cytogenetic method, comparative genomic hybridization, in prenatal diagnosis allows for timely diagnosis of microstructural disorders of chromosomes in fetus. Follow-up of a pregnant woman with congenital heart defect in the fetus requires a multidisciplinary approach not only to improve diagnosis and treatment, but also to calculate genetic risk.
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Shetty, Ashmitha Kishan, Swaroop Hegde, Jayaraman Anbu, and Ashish Jagannath Rai. "Review on Human Placental Proteomics." ECS Transactions 107, no. 1 (April 24, 2022): 19529–41. http://dx.doi.org/10.1149/10701.19529ecst.
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The human placenta plays a crucial part during conception of another human life. Through this time the placenta forms and grows along with the fetus and removed after the birth of the child. The human placenta is rich in proteins and other nutrients required for the growth of the fetus is now discarded. The proteins present in the placenta is studied by extracting proteins from the spongy tissue or by growing the cells in culture media. Use of appropriate technique is also essential in case of diagnosis of pathological condition or to use these proteins as potent drug. This paper reviews the basic components of the placenta and proteomic techniques used in various studies for normal and pathological conditions in the human placenta.
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Zaiken, Kathy, and Kalindi D. Raval. "Treatment of Hypercholesterolemia in Pregnancy: Risks versus Benefits." Journal of Pharmacy Technology 21, no. 5 (September 2005): 258–61. http://dx.doi.org/10.1177/875512250502100504.
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Objective: To identify treatment options for hypercholesterolemia in pregnant women. Data Sources: A search was conducted of MEDLINE (1966–March 2004), EMBASE (1980–March 2004), and International Pharmaceutical Abstracts (1970–March 2004). Key terms included fibric acid derivatives, plant stanol/sterols, niacin, ezetimibe, vitamin E, LDL-apheresis, and fish oil. Study Selection and Data Extraction: The articles evaluated described hypercholesterolemia during pregnancy and lipid therapy options. Data Synthesis: Elevated lipid levels in pregnant women may have a negative impact on the fetus. Case reports and clinical trials from 1966 to March 2004 were evaluated for information regarding the impact of various cholesterol-lowering agents on both the mother and fetus. These case reports and trials conclude that additional studies are needed to determine their overall safety in pregnant women. Conclusions: Lipid-lowering therapies have differing levels of safety and efficacy and are not well studied in pregnant women. Therefore, a diet low in cholesterol and fat is the recommended treatment for hypercholesterolemia during pregnancy.
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Connor, Paul D. "Synthesizing Animal and Human Studies of Prenatal Alcohol Exposure." Journal of the International Neuropsychological Society 7, no. 5 (July 2001): 648–49. http://dx.doi.org/10.1017/s1355617701225120.
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The primary focus of this volume is on the impact of alcohol on brain development. It is a perfect example of how research on both animals and humans can interact to produce very important findings. In the case of prenatal alcohol exposure, dialogue between animal and human researchers has proved to be very profitable for both lines of research. Initial observations by human researchers identified a syndrome of facial stigmata, physical malformations, and early behavioral disturbances that was related to maternal alcohol abuse during pregnancy. They gave this syndrome the name Fetal Alcohol Syndrome. However, human researchers were unable to state unequivocally that prenatal alcohol exposure was teratogenic to the fetus. Thus, they turned to animal researchers who were able to model Fetal Alcohol Syndrome in a variety of animals and to confirm the teratogenicity of alcohol on the developing fetus. The quarter century of studies of the damage caused by prenatal alcohol exposure is replete with such interactions between these two groups of researchers. Without the input and pioneering studies of animal researchers on the effects of prenatal alcohol exposure, human researchers would have much less understanding of the damage caused by alcohol exposure in utero or insights into possible treatment or remediation strategies for those damaged by alcohol exposure.
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Collins, D. W., C. S. Downs, S. G. Katz, S. P. Gatt, C. Marsland, N. Abrahams, and R. J. Turner. "Airway Management on Placental Support (AMPS)—The Anaesthetic Perspective." Anaesthesia and Intensive Care 30, no. 5 (October 2002): 647–59. http://dx.doi.org/10.1177/0310057x0203000518.
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Neonatal airway obstruction has been reported to have a high mortality. Antenatal diagnosis of this condition is now possible. Anaesthetic and surgical techniques have been developed that allow neonatal airway obstruction to be managed at delivery, while the fetus remains oxygenated via the placental circulation. Three case studies are presented, and the anaesthetic issues for mother and fetus/neonate are discussed with reference to previously published cases of airway management on placental support. In particular, techniques for uterine relaxation and maintenance of placental circulation are explored. The history of these procedures and issues of planning and logistics are also discussed.
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Huszti, Ana Maria, Nicolae Gica, Radu Botezatu, Gheorghe Peltecu, and Anca Maria Panaitescu. "Hemolytic disease of the newborn, beyond the Rhesus disease." Romanian Medical Journal 69, no. 2 (June 30, 2022): 45–49. http://dx.doi.org/10.37897/rmj.2022.2.1.
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Hemolytic disease of the fetus and newborn is a consequence of maternal immune response to fetal red blood cells antigens inherited from the father, that the mother does not possess, stimulated by antepartum or intrapartum fetomaternal hemorrhage. As a result, fetal erythrocytes are destroyed, leading to various degrees of anemia and hyperbilirubinemia, with high perinatal morbidity and mortality rates. This review’s purpose is to reveal the importance of the alloantibodies beyond RhD and ABO system, the updated algorithms used in the diagnosis and management of the disease and the importance of RhD universal immune prophylaxis practice. For this purpose, the database from PubMed and UpToDate was searched for literature reviews, case studies, society guidelines and retrospective studies in English regarding hemolytic disease of the fetus and newborn from 2013 to March 2022. Anti D prophylaxis protocols, early diagnosis and proper intrauterine and postpartum treatment help significantly reduce the disease’s burden.
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Gallone, Gabriella. "An “inexplicable” problem of habitual abortion." Clinical Management Issues 1, no. 3 (September 15, 2007): 123–28. http://dx.doi.org/10.7175/cmi.v1i3.605.
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Thyroid autoimmunity (TAI) appears to be a determining factor in pregnancy loss. Many studies have confirmed this association, not only in hypo- and hyperthyroid women but also in euthyroid ones. The main risk associated with TAI is the occurrence of maternal hypothyroidism, with its potential deleterious effects for both the mother and fetus. We report a case of a 35-years-old woman with a history of habitual abortion. After diagnosis of TAI with normal thyroid function and treatment with levothyroxine, the patient became pregnant. After a normal pregnancy without problems, she gave birth of normal fetus at 39’ weeks gestation.
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Nitica, Ruxandra-Patricia, Nicolae Gica, Radu Botezatu, Gheorghe Peltecu, and Anca Maria Panaitescu. "Parvovirus infection in fetal life. Case report and recent literature updates." Romanian Journal of Infectious Diseases 25, no. 1 (March 31, 2022): 30–33. http://dx.doi.org/10.37897/rjid.2022.1.6.
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Background. The parvovirus B19 (B19V) belongs to the Parvoviridae family, genus Erythrovirus, and is a virus that causes a common childhood disease called erythema infectiosum, also largely known as the fifth childhood disease. The clinical appearance is marked by the “slapped cheek” facies and an erythematous rash localized mainly on the extremities and on the trunk. Most people gain immunity during childhood, and when it occurs in pregnancy in non-immunized women, there are some serious complications for the fetus that can occur. B19V infection in pregnancy can conduct to fetal loss or severe hydrops fetalis, due to the risk of vertical transmission to the fetus and the virus tropism for the erythropoietic fetal stem cells with subsequent cell destruction and fetal anemia. Invasive treatment, as intrauterine fetal transfusion, is necessary for the cases of severe fetal anemia with good survival rates afterwards. The purpose of this review is to update the current knowledge regarding the best management of severe fetal anemia and other complications related to B19V infection in pregnancy, based on the latest data from literature and guidelines. Methods. Electronic research for relevant articles published in the last years was made, with the usage of PubMed, Medline, Cochrane Data Base, and the current international guidelines promoted by the Obstetrics and Gynecology Societies. Results and conclusions. The importance of prenatal detection of non-immunized women by serologic testing for parvovirus B19 should not be overlooked, and subsequent follow-up should be recommended in order to lower the incidence of fetal complications associated with developing the disease in pregnancy, especially during epidemics. In case of P19V infection in pregnancy, serial ultrasounds and lab tests should be performed in order to determine the impact on the fetus and the apparition of fetal hydrops. The future moms who are not immunized to B19V should be advised about the risk of vertical transmission and the associated fetal sequelae that can occur. Assessment for maternal disease and for fetal impairment has to become a priority when there are signs of primary infection in pregnancy.
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Huddle, Lauren N., Christine Fuller, Tiffany Powell, Judith A. Hiemenga, Jia Yan, Brian Deuell, Eric M. Lyders, et al. "Intraventricular twin fetuses in fetu." Journal of Neurosurgery: Pediatrics 9, no. 1 (January 2012): 17–23. http://dx.doi.org/10.3171/2011.10.peds11196.
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The authors report a rare case of multiple intracranial fetuses in fetu, fulfilling Willis' traditional criteria, which include an axial and appendicular skeleton with surrounding organized tissue. This case was ascertained from studies of a full-term female neonate who presented with ventriculomegaly. A CT scan showed intracranial calcifications that were suggestive of an axial skeleton. Her birth weight was 3.176 kg (50th–75th percentile), length was 52 cm (90th percentile), head circumference was 35 cm (50th–75th percentile), and Apgar scores were 7 and 8 at 1 and 5 minutes, respectively. Prenatal ultrasonography studies performed at 12 weeks and 5 days, and 19 weeks and 6 days revealed normal findings. A 37-week prenatal ultrasonography study showed ventriculomegaly and obstructive hydrocephalus, with a possible intracranial teratoma. Cranial imaging at birth with ultrasonography, CT and MR imaging, and MR angiography demonstrated 2 complex intraventricular masses with cystic, solid, and bony elements. A craniotomy with resection of the masses was performed at 3 months of age. The infant survived and is now 12 months old with some developmental progress. Two axial skeletons, with accompanying rib cage and extremities, including well-formed feet and toes, were noted. Both anencephalic structures had skin with hair, fat, skeletal and smooth muscle, and bony structures with bone marrow and focal areas of calcification. Multiple viscera were present and included thymus, bowel, stomach, salivary gland, kidney, adrenal gland, lung, and presumed adnexal structures. A diagnosis of fetuses in fetu was rendered. Chromosomal studies of the child and tissue from the 2 fetuses in fetu showed normal female karyotypes. A single nucleotide polymorphism array analysis from the proband infant and tissue from the 2 identified fetuses in fetu appeared to be genetically identical. These results are consistent with a monozygotic twin embryonic origin of the fetus in fetu tissue, which is a mechanism that has been suggested in previous reports in which karyotypes, blood types, and limited genetic loci have been studied. This is the first report of a rare example of intracranial intraventricular twin fetuses in fetu for which a genome-wide single nucleotide polymorphism assay has confirmed their genetic identity.
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Shkodkin, S. V., and Yu B. Idashkin. "Pyelonephritis of Pregnant Women: Clinical Case." Urology Herald 8, no. 1 (April 20, 2020): 55–58. http://dx.doi.org/10.21886/2308-6424-2020-8-1-55-58.
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Pyelonephritis during pregnancy is a threat to the fetus and the pregnant woman. There are no studies showing the benefits of drainage management for pregnant women with pyelonephritis. Despite this, the drainage of the upper urinary tract is a tradition of a fairly large number of clinics. Guidelines for the duration of drainage in this category of patients are also not defined. Frequently, drainage is removed after delivery. And this is the «standard» in clinical practice. The negative side of this approach is persistent drainage infection, obstruction, and the need for frequent drainage changes. The article presents the clinical observations of patients with early removal of urinary drainage, which made it possible to stop bacteriuria and inflammatory changes in the urine.
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Rezaee Moradali, Monireh, Moradali Zareipour, and Zhila Mohammad Rezaei. "Assessment of Fetal and Infant health status based on Non-Stress Test." International Journal of Ayurvedic Medicine 10, no. 4 (January 14, 2020): 329–32. http://dx.doi.org/10.47552/ijam.v10i4.1290.
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Introduction: Non stress test (NST) is commonly considered as a screening test to assess the health of the fetus especially in high risk pregnancies in most studies. The purpose of this study was to Assessment of fetal and Infant health status based on Non-Stress Test. Methods: This study was a case-control design carried out on 984 pregnant in Urmia selected by census sampling during 2014-2015; 500 pregnant had experienced NST and considered as case group and 484 pregnant had not experienced NST and considered as control group. Data were collected using records of NST among mothers and checklist including variables related to maternal characteristics such as fetal characteristics. The data were analyzed through SPSS version 22 software. Results: In pregnant women who experienced NST, the mean age, Apgar min 1 and 5 was significantly different and NST group had better situation than other group (p=0.001). Fetal distress was more in the presence of meconium (p=0.0001). In binary logistic regression analysis, meconium and NST were presented as a risk factor in the model, that is, by shifting one level of the meconium or NST status (yes/no) (OR Meconium = 14.262, p = 0.0001; OR NST = 2.874, p = 0.001). Conclusion: Using non stress test to observe the abnormal results of the fetus especially meconium-stained amniotic fluid is crucial and vital because can prevent the fetal distress, infection of pregnant women and fetus and even the mortality of the fetus.
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Norvilaitė, Kristina, Diana Ramašauskaitė, Daiva Bartkevičienė, Bronius Žaliūnas, and Juozas Kurmanavičius. "Doppler Ultrasonography of the Fetal Tibial Artery in High-Risk Pregnancy and Its Value in Predicting and Monitoring Fetal Hypoxia in IUGR Fetuses." Medicina 57, no. 10 (September 29, 2021): 1036. http://dx.doi.org/10.3390/medicina57101036.
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Background and Objectives: Intrauterine growth restriction (IUGR) is the term used to describe a fetus whose estimated weight is less than the 10th percentile of its age growth curve. IUGR is the second most common cause of perinatal death. In many cases there is a deficiency in the standardization of optimal management, prenatal follow-up and timing of delivery. Doppler examination is the most sensitive test that can assess the condition of the fetus and indicate fetal intrauterine hypoxia. Numerous studies of the fetal intrauterine state focus on the umbilical artery and the fetal cerebral blood vessels, while the peripheral arteries have so far received insufficient attention. Materials and Methods: We present a case of an IUGR fetus monitored with a non-stress test (NST) and a Doppler examination of the fetal arteries (tibial, umbilical, middle cerebral and uterine) and the ductus venosus. In this case the first early sign of fetal hypoxia was revealed by blood flow changes in the tibial artery. Results: We hypothesize that peripheral vascular changes (in the tibial artery) may more accurately reflect the onset of deterioration in the condition of the IUGR fetus, such that peripheral blood flow monitoring ought to be employed along with other techniques already in use. Conclusion: This paper describes the clinical presentation of an early detection of late IUGR hypoxia and claims that blood flow changes in the tibial artery signal the worsening of the fetus’s condition.
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Radunovic-Gojkovic, Tatjana, and Gordana Velisavljev-Filipovic. "Neonatal withdrawal syndrome: Case report." Medical review 62, no. 3-4 (2009): 181–84. http://dx.doi.org/10.2298/mpns0904181r.
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Introduction. Maternal drug abuse has increased over the past decade. It has a multiple negative influence on a pregnant woman, as well as her newborn. Practically, every drug taken during pregnancy crosses the placenta, and the developing fetus may also be affected by the effects of a drug. After delivery, an infant of a drug-abusing mother may potentially develop neonatal withdrawal syndrome. Existing studies on the neonatal effects of drug exposure in utero are subject to many factors. Many studies have relied on the history obtained from the mother, which is innacurate. Urine testing for drug abuse does not reflect exposure to a drug through pregnancy and does not provide quantitative information. Social and economic deprivation is common among drug abusers, and this factor has a major effect on long term studies of infant outcome. The purpose of this article is to underline the problems during management of a neonatal withdrawal syndrom, and growing incidence of it in our society. Case report. A case of an infant of a heroin-abusing mother is reported. Conclusion. It is very important to take care of an infant with neonatal withdrawal syndrome, but it is also of a great importance to supervise these children for a long period of time.
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Abdul-Hameed, Azhar, Israa Abid Al-Karim, and Raad Hameed. "Ultrasound in Prediction of Perinatal Outcomes in Fetuses with Restriction of Intrauterine Growth." Al-Kitab Journal for Pure Sciences 04, no. 2 (December 31, 2020): 26–38. http://dx.doi.org/10.32441/kjps.04.02.p3.
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Studies of Doppler flow velocimetry have been proceeding as a principle mechanism for identification the compromised small fetus from a small fetus that is improbable to suffer from dangerous perinatal complications. The aim of this study is the Prediction of Perinatal Outcome in Fetuses Suspected to Have Intrauterine Growth Restriction: Doppler US Study of Fetal Cerebral, and Umbilical Arteries. This is a longitudinal prospective study done at department of Obstetrics and Gynecology in Salah Al-Deen General Hospital in Tikrit city between February-July 2020. The study included a convenient sample 100 pregnant women in 3rd trimester suspected of IUGR (n=100). Studies of various fetal vessels were performed using color Doppler ultrasound curvilinear probe with a high pass filter. The following vessels were studied with the mother in a recumbent position during fetal inactivity and apnea. 1st Umbilical Artery (UA), 2nd Middle Cerebral Artery (MCA). Fetal outcome was studied under major and minor adverse outcomes. The current study found that the umbilical artery systolic/diastolic ratio was concordant with major and minor adverse outcome among 55 cases regarding of abnormal finding, and among 25 case regarding negative findings. The umbilical artery RI was concordant with major and/or minor adverse outcome among 34 cases regarding of abnormal finding, and among 28 case regarding negative findings. The umbilical artery PI was concordant with major and/or minor adverse outcome among 52 cases regarding of abnormal finding, and among 29 case regarding negative findings. Serial Doppler examinations of fetal (S/D ratio, UA RI, & UA PI), and (MCA PI, & MCA/UA PI) provide better information than does a single measurement.
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Ghasemzadeh, Aliyeh, Samira Abdollahi Moghadam, Laya Farzadi, and Mohammad Noori. "Q10 Co-enzyme Effect on Fetus Implantation in ART Cycles." Advances in Bioscience and Clinical Medicine 8, no. 2 (June 28, 2020): 17. http://dx.doi.org/10.7575/aiac.abcmed.v.8n.2p.17.
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Background and Aim: Infertility is a common condition that affects many couples. Although current cutting-edge therapeutic methods have been found promising in this regard, their success still is not sufficiently high. Accordingly, researchers are working to develop new methods to augment the likelihood of successful results of Assisted Reproductive Technology (ART). Recently, coenzyme Q10 has been recognized an important and influential factor in the process of reproduction and some scarce studies have been along favorable results in this regard. This study aims to examine the effect of oral administration of coenzyme Q10 on embryo implantation in ART cycles. Methods and Materials: In this randomized, placebo-controlled clinical trial, a total of 128 infertile females who were candidates for ART were randomized in two groups receiving either a daily capsule of coenzyme Q10 by the commencement of gonadotropin through to pregnancy test result (case group, 64 patients), or placebo (control group, 64 patients). Finally, oocyte count, fertilization rate, embryo count, quality of embryos, transferred embryo count, implantation rate and pregnancy rate were compared between the two groups. Results: The mean age of the patients was 32.77±6.01 years (20-41) in the case group and 32.45±5.93 years (20-42) in the case group, with no significant difference between the two groups (p=0.77). In comparison between the case and control groups, in spite of better results in the case group, no significant difference was found in terms of oocyte count (10.47±7.16 and 9.38±7.52, respectively; p=0.40), fertilization rate (66.88±16.08 % and 66.73±21.50 %, respectively; p=0.96), embryo count (7.03±4.78 and 5.84±4.85, respectively; p=0.17), quality of embryos (71.9% grade I and 28.1% grade II in cases, 68.8% grade I and 31.3% grade II in controls; p=0.70) transferred embryo count (10.9% one, 56.3% two-three and 32.8% more than three in cases, 14% one, 56.3% two-three and 29.7% more than three in controls; p=0.84), implantation rate (8.39±12.73 % and 7.22±12.80 %, respectively; p=0.60), and pregnancy rate (34.4% and 26.6%, respectively; p=0.34). Conclusion: Although using coenzyme Q10, in comparison with placebo, was along with better results in terms of outcome variables of ART, the difference was statistically insignificant possibly because of a small sample size and short duration of the intervention.
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Mills, Catherine. "The Case of the Missing Hand: Gender, Disability, and Bodily Norms in Selective Termination." Hypatia 30, no. 1 (2015): 82–96. http://dx.doi.org/10.1111/hypa.12137.
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The practice of terminating a pregnancy following the diagnosis of a fetal abnormality raises questions about notions of bodily normality and the ways these shape ethical decision‐making. This is particularly the case with terminations done on the basis of ostensibly minor morphological anomalies, such as cleft lip and isolated malformations of the limbs or digits. In this paper, I examine a recent case of selective termination after a morphology ultrasound scan revealed the fetus to be missing a hand (acheiria). Using the work of Georges Canguilhem, I show that a person with acheiria could be considered normal. Further, I show that this case reveals a kind of “undecidability” in the significance of fetal sex/gender and disability in termination. From this, I consider the conceptual interaction of disability with sex/gender, to argue that the ethics of disability termination are not as distinct from those of sex/gender selection as is commonly supposed.
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Fogliatto, Laura, Caroline Brum, Alethea Zago, Thiago Faltoe, Fabio Rodrigues, Gustavo Falhauber, Denise Leugeur, and Lucia Silla. "Pregnancy during Treatment with Imatinib: A Case Report." Blood 106, no. 11 (November 16, 2005): 4851. http://dx.doi.org/10.1182/blood.v106.11.4851.4851.
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Abstract CFSA, an 18-year-old woman with a history of weight loss and abdominal discomfort was diagnosed with chronic myelogenous leukemia (CML) in December 2002. The WBC were 440 x 109 /L with 25% neutrophils, 20% bands, 9% metamyelocytes, 9% myelocytes, 8% promyelocytes, 10% basophils, 9% eosinophils, 1% lymphocytes and 8% blasts. The hemoglobin was 9,8 g/dL and platelet count 416 x 109/ L. A bone marrow examination demonstrated granulocytic hyperplasia and the presence of Philadelphia chromosome in 100% of the metaphasis. A diagnosis of CML was made and she was started on hydroxyurea and imatinib 600mg daily. No matched HLA donor was found. There was a partial hematological response. In February 2005 on imatinib (600 mg) she was pregnant and an ultrasound scan showed a viable fetus of 17 weeks. The WBC were 22 x 109 /L with 50% neutrophils, 23% bands, 8% metamyelocytes, 12% myelocytes, 1% promyelocytes, 5% lymphocytes, hemoglobin 11,4 g/dl and platelet count 290 x 109. Imatinib was stopped and she remained off treatment during pregnancy. Cesarean section was performed at 38th week because of preeclampsia (hypertension, headache and scotomas). A healthy girl weighing 2980 g, 46,5 cm in length with Apgar score of 9 was delivered. The infant’s physical examination, WBC, hemoglobin, platelet count and cranial ultrasonography were normal. The baby is presently healthy with no developmental abnormalities. There are few reports on the use of 600 mg a day of imatinib and pregnancy. It is of notice, although probably unrelated, the event of preeclampsia. The effects of imatinib on fetus are unkown and should be considered teratogenic until more studies or cases are reported.
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Delashoub, Omolbanin, Salman Jafari, Mohammad Saleh Hajializadeh, Hamid Abdollahi, and Reza Afzalipour. "Pregnant Women and Infants Infected with SARS-COV-2: A Brief Overview." International Electronic Journal of Medicine 9, no. 2 (June 30, 2020): 92–95. http://dx.doi.org/10.34172/iejm.2020.16.
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Coronavirus disease 2019 (COVID-19) is now a global health concern and a wide range of people are at risk. Pregnant women are considered high-risk groups due to hormonal changes and weakness in the immune system. In the present study, the transmission of COVID-19 from mother to fetus and infection of children under the age of 10 with this virus were discussed. This study tries to investigate whether the coronavirus can be transmitted from a pregnant mother to her fetus and whether the virus can be transmitted to the baby through breast milk. According to researchers, children under the age of 10 do not get the disease; however, the first case of a baby with coronavirus was reported in Mashhad, Iran, based on the world’s up-to-date studies and the perceptions of medical experts.
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Korotovskikh, L. I., M. V. Koval, A. M. Bogdanova, L. D. Litvina, and V. V. Tsypushkina. "Cesarean scar ectopic pregnancy: clinical case." Perm Medical Journal 38, no. 5 (September 15, 2021): 153–60. http://dx.doi.org/10.17816/pmj385153-160.
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Today, cesarean scar pregnancy is a rare type of ectopic pregnancy (1:18001: 2200). Moreover, the mortality rate in cesarean scar pregnancy is 191.2 per 100 000 cases, that 12 times exceeds the mortality rate in tubal pregnancy. In this article, we present a clinical observation of a rare case of cesarean scar pregnancy, as diagnosed by ultrasonography, in a 23-year-old patient after the cesarean surgery. The diagnosis was based on clinical, biochemical and ultrasound studies. Ultrasound played a crucial role in the determination of the fetus localization. Pathological pregnancy was eliminated by means of excision of the old scar and restoration of the uterine wall integrity. Such cases are becoming more common in connection with the increase in the frequency of caesarean sections, the improvement of technology, continuing medical education and professional development in the field of ultrasound. Knowledge of differential diagnosis can save the patient's life since the outcomes of cesarean scar pregnancy include severe complications with a possible loss of patients fertile function and immediate risk of death.
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Duminica-Turcu, Ana Gabriela, Andrei Marin, Nicolae Gica, Gheorghe Peltecu, Radu Botezatu, and Anca Maria Panaitescu. "Burn injury during pregnancy." Romanian Medical Journal 69, S2 (January 31, 2022): 94–97. http://dx.doi.org/10.37897/rmj.2022.s2.20.
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Burn injuries represent an important health problem, resulting in severe comorbidity and even death. Described as one of the most uncommon conditions during pregnancy, burn injuries represent a challenge for obstetricians and health care providers among the world, primarily because of the need to find proper treatment options that could benefit both the future mother and the foetus. Diagnosis and treatment require the combined effort of a multidisciplinary team in order to find the best therapeutic options. Given the physiological changes that occur during pregnancy, the body's ability to respond as a result of the stress caused by a burn injury may be affected, while maintaining the viability of the fetus is also considered. Although there is a number of dressings which can be used in superficial burn injuries, in the case of a pregnant woman there are emerging concerns regarding absorption and toxicity. Nonetheless, treatment is individualized according to the degree of burn and gestational age.
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Aksenova, O. A., E. V. Chaplygina, O. A. Kaplunova, V. G. Bedarev, G. V. Bedarev, and O. T. Vartanova. "Primary lymphangioma, lymphedema of the lower limb of the fetus in the practice of ultrasound." Medical Herald of the South of Russia 13, no. 3 (September 22, 2022): 188–92. http://dx.doi.org/10.21886/2219-8075-2022-13-3-188-192.
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Scientifically based and experimentally confirmed data on the morphogenesis of the lymphatic system are necessary to clarify critical periods of development characterized by an increased risk of congenital anomalies of the lymphatic system in order to plan and implement effective prevention, diagnosis and correction of related abnormalities. Among the studied anomalies of lymphatic vessels, lymphangioma is most often mentioned — a congenital benign tumor consisting of many cysts of various sizes. Detection of primary fetal lymphangioma in the early stages of intrauterine development is extremely rare. The purpose of the study: to report a case of early diagnosis of congenital cystic lymphangioma and lymphedema of the left lower limb of the fetus. Congenital (primary) peripheral lymphedema, limb lymphangioma is associated with a malformation of the lymphatic system. Taking into account the fact that operative methods of correction of all types of primary lymphedema are considered unreasonable and ineffective, the main attention requires timely detection of this congenital malformation during screening studies of the fetus and the issuance of recommendations for the management of pregnancy, up to termination for medical reasons. It is necessary to raise the issue of genetic counseling of the couple and conducting the necessary genetic studies. The use of modern diagnostic methods allows for the prevention and treatment of abnormalities in the development of the lymphatic system at an earlier stage of the intrauterine period.
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Gozar, Liliana, Dorottya Gabor-Miklosi, Rodica Toganel, Amalia Fagarasan, Horea Gozar, Daniela Toma, and Andreea Cerghit-Paler. "Fetal Tachyarrhythmia Management from Digoxin to Amiodarone—A Review." Journal of Clinical Medicine 11, no. 3 (February 2, 2022): 804. http://dx.doi.org/10.3390/jcm11030804.
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Sustained fetal tachycardias are rare but represent a high risk of mortality and morbidity. Consensus has yet to be found regarding their optimal management. The aim of this narrative review is to summarize the data available in the current literature regarding the efficacy and safety of medications used in the management of intrauterine tachyarrhythmias and to provide possible treatment protocols. In this review, we would like to emphasize the importance of a thorough evaluation of both the fetus and the mother, prior to transplacental antiarrhythmic drug initiation. Factors such as the hemodynamic status of the fetus, possible mechanisms of fetal arrhythmia, and concomitant maternal conditions are of primordial importance. As a possible treatment protocol, we would like to recommend the following: due to the risk of sustained supraventricular tachycardia (SVT), fetuses with frequent premature atrial beats should be evaluated more frequently by echocardiography. A careful hemodynamic evaluation of a fetus with tachycardia is primordial in forestalling the appearance of hydrops. In the case of atrial flutter (AFL), sotalol therapy could represent a first choice, whereas when dealing with SVT patients, flecainide should be considered, especially for hydropic patients. These data require consolidation through larger scale, non-randomized studies and should be handled with caution.
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Cao, Yang, Nicole L. Hoppman, Sarah E. Kerr, Christopher A. Sattler, Kristi S. Borowski, Myra J. Wick, W. Edward Highsmith, and Umut Aypar. "False Negative Cell-Free DNA Screening Result in a Newborn with Trisomy 13." Case Reports in Genetics 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/7397405.
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Background.Noninvasive prenatal screening (NIPS) is revolutionizing prenatal screening as a result of its increased sensitivity, specificity. NIPS analyzes cell-free fetal DNA (cffDNA) circulating in maternal plasma to detect fetal chromosome abnormalities. However, cffDNA originates from apoptotic placental trophoblast; therefore cffDNA is not always representative of the fetus. Although the published data for NIPS testing states that the current technique ensures high sensitivity and specificity for aneuploidy detection, false positives are possible due to isolated placental mosaicism, vanishing twin or cotwin demise, and maternal chromosome abnormalities or malignancy.Results.We report a case of false negative cell-free DNA (cfDNA) screening due to fetoplacental mosaicism. An infant male with negative cfDNA screening result was born with multiple congenital abnormalities. Postnatal chromosome and FISH studies on a blood specimen revealed trisomy 13 in 20/20 metaphases and 100% interphase nuclei, respectively. FISH analysis on tissues collected after delivery revealed extraembryonic mosaicism.Conclusions.Extraembryonic tissue mosaicism is likely responsible for the false negative cfDNA screening result. This case illustrates that a negative result does not rule out the possibility of a fetus affected with a trisomy, as cffDNA is derived from the placenta and therefore may not accurately represent the fetal genetic information.
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Cioroba, Teodora Gabriela, Nicolae Gica, Radu Botezatu, Gheorghe Peltecu, and Anca Maria Panaitescu. "HIV medication to prevent fetal infection during pregnancy." Romanian Journal of Infectious Diseases 25, no. 1 (March 31, 2022): 9–13. http://dx.doi.org/10.37897/rjid.2022.1.2.
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When it has been declared a global epidemic, HIV infection became a challenge for medical world. Even if there is only one healed case cited in literature, treatment for HIV-infection have evolved during time leading to very good results in disease control and limitation of virus transmission. When it comes for viral transmission, an essential research topic became the prevention of mother to fetal transmission. In the long run, many discovered antiretroviral drugs proved to be efficient in controlling HIV infection during pregnancy and thereby in reducing the risk of viral transmission to the fetus. But along with use of the HIV-treatment in pregnancy, many questions have appeared. Are the drugs safe for the fetus, or are there any adverse pregnancy outcomes? Should the treatment be adjusted for the desired results in pregnancy, or should the initial treatment be changed when the pregnancy is diagnosed? Many retrospective or prospective observational studies and comparative studies have been conducted in order to answer those questions and to analyze the efficacy and the safety of mostly used antiretroviral drugs in pregnancy. This article reviews the existing studies, guidelines and recommendations regarding the combined antiretroviral HIV treatment during pregnancy for fetal infection prevention.
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Martin, Pauline L., and Gerhard F. Weinbauer. "Developmental Toxicity Testing of Biopharmaceuticals in Nonhuman Primates." International Journal of Toxicology 29, no. 6 (October 6, 2010): 552–68. http://dx.doi.org/10.1177/1091581810378896.
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Developmental toxicity studies for pharmaceutical safety testing are designed to evaluate potential adverse effects of drug treatment on pregnancy and on the developing embryo/fetus. Biopharmaceuticals present specific challenges for developmental toxicity testing because the pharmacology of these molecules, which are frequently human-specific proteins, is often restricted to humans and nonhuman primates (NHPs). For those species-restricted molecules, the only option for the evaluation of potential effects on development of the human biopharmaceutical is to use NHPs. This article reviews each of the stages of development in cynomolgus macaques (the most frequently used NHP) and the potential exposure of the embryo, fetus, and infant following administration of a biopharmaceutical during pregnancy and lactation. Because the purpose of the NHP developmental studies is to identify potential human risks, a comparison between macaque and human development and potential exposure has been made when possible. Understanding the potential exposure of the conceptus relative to critical periods in development is essential to designing a scientifically based study that adequately addresses human risks. Some options for NHP study designs, including the option of combining end points into a single study, and the pros and cons of each of the study options have been reviewed. Developmental studies for biopharmaceuticals in NHPs need to be optimally designed on a case-by-case basis taking into consideration the pharmacology of the molecule, the type of molecule (antibody or non-antibody), the potential exposure relative to the development of potential target organs, the clinical use, and the ethical considerations associated with the use of NHPs.
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Lesnic, Anca, Bashar Haj Hamoud, Mircea-Octavian Poenaru, Valentin-Tiberiu Moldovan, Radu Chicea, Romina-Marina Sima, Mihai Popescu, and Liana Ples. "Can SARS-CoV-2 Induce Uterine Vascular Anomalies and Poor Contractile Response?—A Case Report." Medicina 57, no. 7 (June 29, 2021): 670. http://dx.doi.org/10.3390/medicina57070670.
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We are reporting a case of a 36 year-old Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) positive hypertensive primigravida with postpartum uterine atony that required emergency subtotal hysterectomy at Saint John Hospital Bucur Maternity Bucharest. The maternity was designated as the Coronavirus Disease 2019 (COVID-19) Maternity for Bucharest and Ilfov County since March 2020. The patient was mildly symptomatic for SARS-CoV-2, infection confirmed with reverse transcription polymerase chain reaction (RT-PCR). The caesarean section was performed and a live male fetus was born, 2630 g and Apgar Score of 9 (the male fetus was negative for SARS-CoV-2). Postpartum hysterectomy with adnexal preservation was performed because of uterine atony. The postoperative evolution was favorable. The patient was discharged with her baby 10 days after birth. Given the limited resources, the placenta, the umbilical cord and the uterus were not tested for SARS-CoV-2. The pathology exam revealed that on the maternal side there were specific uterine atony lesions as well as endometrial and miometrial ischaemia. The placenta had nonspecific findings: chronic ischemic lesions with small villi, fibrin deposits in the materno-fetal interface. The peculiarity of the case is that we report the morphological findings of the placenta and uterus resulted from intrapartum uterine atonia in a patient with gestational arterial hypertension, premature birth and COVID-19. Further studies are required to characterize the pattern of such intricate conditions.
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Puvabanditsin, Surasak, Rosanna Abellar, Adaora Madubuko, Rajeev Mehta, and Lauren Walzer. "Pulmonary Vasculitis and a Horseshoe Kidney in Noonan Syndrome." Case Reports in Pathology 2018 (2018): 1–4. http://dx.doi.org/10.1155/2018/6829586.
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We report a term male neonate with congenital myeloproliferative disorder, thrombocytopenia, a horseshoe kidney, feeding difficulty secondary to dysphagia/foregut dysmotility, and respiratory failure. Prenatal molecular genetic analysis revealed a fetus carrying c.184T>G (p.Tyr62Asp) pathogenic variant in PTPN11. The infant eventually succumbed to respiratory failure. Bacterial and viral cultures/studies were all no growth/negative. Pulmonary capillaritis and vasculitis were noted at autopsy. This report presents a new case of Noonan syndrome with unusual associated disorders and a review of the literature.
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Behura, Jharna, Ayushi Sinha, Aafreen Naaz, and Soni Bharti. "Conservative management of a case of a cardiac anceps twin reversed arterial perfusion sequence misdiagnosed as vanishing twin: a case report." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 1 (December 26, 2020): 385. http://dx.doi.org/10.18203/2320-1770.ijrcog20205805.
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Twin reversed arterial perfusion (TRAP) sequence is a specific, rare and severe complication of monochorionic multiple pregnancy, which is characterized by one normal fetus (pump twin) and another with no cardiac activity and variable degree of deficient development of the head and upper limbs. The management of these pregnancies are a real challenge due to the parasitic hemodynamic dependence of the acardiac twin on the pump twin. The aim of management is to maximize the chances of survival of the pump twin with some intervention. The preferred management suggested is elective ultrasound-guided laser coagulation or radiofrequency ablation of the umbilical cord vessels at 11-13 weeks when the survival is 70-75%. Delay in intervention until 16-18 weeks is associated with spontaneous cessation of blood flow in the acardiac twin in 60% of cases and in about 50% of these there is death or brain damage in the pump twin. However, pregnancies diagnosed late need to follow a tailored approach with expectant management. The authors report a case of TRAP twin sequence which on ultrasound was diagnosed as a case of vanishing twin at 20 weeks. Subsequently on follow up ultrasound, it was diagnosed as a trap sequence with the pump twin developing polyhydramnios at 30 weeks. She was counselled regarding the prognosis of the pump twin and she opted for conservative management. Weekly ultrasound and color doppler were done. The amniotic fluid index (AFI) decreased gradually at 33 and 35 weeks, there were no signs of congestive cardiac failure of the pump twin on Doppler studies and she had a spontaneous delivery of a healthy male child and an acardiac anceps fetus at 36weeks and 5 days. The perinatal mortality of a pump twin managed conservatively ranges from 35 to 55%. It is essential to diagnose the presence of trap sequence at an early gestational age through improved imaging techniques to plan a timely and effective intervention to salvage most of the pump twins.
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Sultana, Aneela, and Gulfam. "Socio-Cultural Implications of Son Preference: A Case of Danyor, Gilgit." Global Anthropological Studies Review III, no. I (December 30, 2020): 39–48. http://dx.doi.org/10.31703/gasr.2020(iii-i).05.
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The study deals with the dilemma of son preference and its causes and consequences. The fieldwork was conducted in village 'Danyor' in Gilgit-Baltistan, for the period of six months. Socio-economic survey was conducted from seventy-five households, detailed in-depth interviews were taken from thirty respondents in addition to 35 case studies. The field findings revealed the prevailing perceptions are sons as powerful and socially strong, owner and successor of family property, old age security for parents, symbol of prestige, custodian of family strength and honor etc. On the contrary, daughters are considered as burden of dowry and financial dependency on parents. The study concludes that son preference results in many discriminatory practices against female child such as abortion of female fetus, high infant mortality, lower status of daughters bearing mother in the family, short birth spacing, high probability of husband's remarriage and increased chances of being divorced.
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Thompson, Geoffrey B., Benzon M. Dy, Eitan Podgaetz, and William F. Young. "Pheochromocytomas, MEN 2A and Pregnancy: A Case Report with Review of the Literature." World Journal of Endocrine Surgery 4, no. 1 (2012): 29–32. http://dx.doi.org/10.5005/jp-journals-10002-1090.
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ABSTRACT Pheochromocytoma in pregnancy is a rare condition with an estimated incidence of one in 54,000 pregnancies. Pheochromocytoma in the setting of multiple endocrine neoplasia (MEN) type 2A develops in approximately 40% of the patients with this germline mutation. MEN 2A patients with pheochromocytoma are often asymptomatic compared to those with nonsyndromic pheochromocytoma. We present a 28-year-old pregnant woman with a known MEN 2A mutation who was incidentally found to have a pheochromocytoma. She underwent an uncomplicated laparoscopic right adrenalectomy after proper α- and α-adrenergic blockade. Her serum fractionated metanephrines normalized prior to discharge from the hospital. The remainder of her pregnancy was uneventful and she delivered a health baby at term. Pheochromocytoma in pregnancy requires careful management to assure the well being of both the mother and the fetus. In pregnancy, laparoscopic surgical removal of the pheochromocytoma is feasible with excellent results when performed in the second trimester. In late pregnancy, medical management with close monitoring of the mother and fetus is recommended until fetal maturity is achieved. In the third trimester, cesarean section followed by open adrenalectomy is the preferred operation. An integrated and multidisciplinary approach with close communication among the endocrinologist, surgeon and perinatal services is paramount to achieve excellent outcomes for both patients. Women with MEN 2 should be advised to refrain from pregnancy until updated biochemical and imaging studies have ruled out pheochromocytoma. How to cite this article Dy BM, Podgaetz E, Young WF, Thompson GB. Pheochromocytomas, MEN 2A and Pregnancy: A Case Report with Review of the Literature. World J Endocr Surg 2012;4(1):29-32.
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Taller, András. "Safety of gastrointestinal endoscopy during pregnancy." Orvosi Hetilap 152, no. 26 (June 2011): 1043–51. http://dx.doi.org/10.1556/oh.2011.29116.
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There are only few data of gastrointestinal endoscopy in pregnant patients. Only 0.4% of all procedures are carried out during pregnancy. Case reports and some small retrospective studies are available. Because of physiological changes in pregnancy there might be special risks of endoscopy. There might be complaints which can be physiologic during pregnancy, but can be signs of gastrointestinal disorders, too. Therefore, indications for endoscopy are not always clear and easy. Safety of the procedures is also not well studied. Besides the risks of endoscopy, medication given to the mother, electrocoagulation and radiation exposure from fluoroscopy during endoscopic retrograde cholangiopancreatography might be harmful to the fetus. Endoscopy should only be done when indication is unquestionable and strong. Only FDA „A” and „B” category medication is allowed. Gastroscopy is necessary for bleeding and for patients with pyrosis going together with alarm signs. Nausea, vomiting, abdominal pain and fecal occult blood test positivity are not indications for endoscopy, only for gastroenterogical consultation. Sigmoidoscopy is recommended for indication of lower gastrointestinal bleeding and sigmoid or rectal mass. Only therapeutic endoscopic retrograde cholangiopancreatography should be performed. Obstructive jaundice and biliary pancreatitis need immediate endoscopic intervention. The fetus must be shielded from radiation exposure. Orv. Hetil., 2011, 152, 1043–1051.
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Cemortan, Maria, and Olga Cernețchi. "The role of vitamin K during pregnancy – a literature review." Romanian Medical Journal 68, no. 4 (December 31, 2021): 454–60. http://dx.doi.org/10.37897/rmj.2021.4.7.
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Micronutrients are indispensable substances for ensuring proper metabolism, which, in the case of pregnant women, has an indirect influence on perinatal outcomes. Hypovitaminosis K is a rare condition in adults. However, vitamin K deficiency can pose a significant risk to the health of both mother and fetus, which can cause bleeding, especially in newborns. Newborns have a low natural level of vitamin K because they do not receive the necessary amounts in the antenatal period, which is caused by the slower transfer of this vitamin through the placenta. The use of drugs that affect the metabolism of vitamin K by pregnant women can increase the rate of various complications in newborns, related to hypovitaminosis K. Micronutrients, especially vitamin K, are essential for the body of pregnant women, being crucial in fetal development.
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Bonte, Diana Camelia, Olivera Iordache, Izabella Petre, Marius Craina, Veronica Daniela Chiriac, Dana Stoian, Lavinia Cristina Moleriu, and Alina Sisu. "Macroscopic Examination of Placental Vascularization with a Corrosive Agent in Pregnant Women Diagnosed with Thrombophilia." Materiale Plastice 54, no. 4 (December 30, 2017): 678–81. http://dx.doi.org/10.37358/mp.17.4.4924.
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The normal development of the placenta is a major factor in the fetus s growth and development, whilst the maternal-fetal placental vasculature is essential in this regard. During placentation, there is an ongoing process, which combines angiogenesis with vasculogenesis, as demonstrated by numerous studies, which reveal important roles of various known angiogenic factors, while other studies show the roles of different classes of factors in vascular morphogenesis nonspecific to the placenta. The method used in the case of our study is a standardized method of the Laboratory of Anatomy and Embryology, Victor Babes University of Medicine and Pharmacy, Timişoara, for over 50 years. The making of corrosion concoction followed the recipe of the laboratory using type AGO II plastic substances, differently colored and then subjected to the corrosive action of hydrochloric acid. During the routine check outs all the pregnant woman�s were diagnosed with thrombophilia. The examination of the placental parameters - shape, weight, thickness - is important as a preliminary stage for the study of the placental architecture. The normal placental development remains a major factor in the growth and development of the fetus, and the maternal-fetal placental vasculature is essential in this regard. Placental angiogenesis has a different local component of angiogenesis, found in other anatomical regions.
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Berwart, Julia, Barbara Buonomo, Fedro A. Peccatori, Anabel Marioni, Juliana Lescano, and Emilia Pressel Coretto. "Management of HER2-positive breast cancer during pregnancy: a case report." Tumori Journal 106, no. 6 (July 30, 2020): NP33—NP35. http://dx.doi.org/10.1177/0300891620944218.
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Introduction: Breast cancer is one of the most common malignancies diagnosed during pregnancy, with an incidence of 1:3000 pregnancies. Its rising incidence is related to the trend to postpone childbearing during the last 30 years. Breast cancer during pregnancy should not be managed differently from the nonpregnant setting. Chemotherapy is reported to be safe after the first trimester, whereas trastuzumab and tamoxifen are contraindicated regardless of the trimester. Case description: A patient diagnosed with breast cancer recurrence during pregnancy was exposed to both tamoxifen and trastuzumab during the first two trimesters of pregnancy. In addition, docetaxel was administered during the second and third trimesters, without subsequent fetal malformations or obstetric complications. Conclusions: When conception occurs inadvertently during assumption of tamoxifen or anti-HER2 agents, their effects on the fetus and on the course of pregnancy are not completely understood. Further studies are needed in this setting, highlighting the importance to share clinical experiences.
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Reis-de-Carvalho, Catarina, João Lopes, Alexandra Henriques, and Nuno Clode. "Management of pregnancy in case of multiple and giant uterine fibroids." BMJ Case Reports 13, no. 11 (November 2020): e235572. http://dx.doi.org/10.1136/bcr-2020-235572.
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Uterine fibroids are common among women of reproductive age. During the pregnancy, the potential complications of fibroids, although rare, are of frequent clinical concern. Available studies describing management and obstetrical outcomes in pregnant women with giant fibroids are limited. We present the case of a 39-year-old pregnant woman with multiple and large uterine fibroids. During the pregnancy, there was adequate fetal development, without major maternal complications. Given the characteristics of the fibroids and breech position of the fetus, an elective caesarean section was decided, and postpartum hysterectomy planned. This challenging obstetrical case required a multidisciplinary approach.We considered crucial discussing five main issues: preconceptional counselling, tailored pregnancy surveillance, decision of time and route of delivery, decision to perform a peripartum hysterectomy and management of decreasing blood loss perioperatively. Given the limitation of the published reports, we believe that sharing our experience, along with a literature review, is beneficial for other clinicians.
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Kaba, Metin. "Treatment of Chorioamnionitis with Piperacillin/Tazobactam and Clindamycin." Medical Science and Discovery 9, no. 6 (June 29, 2022): 368–70. http://dx.doi.org/10.36472/msd.v9i6.740.
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Objective: Chorioamnionitis is a condition that bacteria infects the chorion and amnion and the amniotic fluid which can affect pregnant women. Infections may affect both the mother and fetus. Cervical insufficiency and chorioamnionitis cause preterm birth and perinatal morbidities. Case: A 37-year-old patient was referred to the clinic with the diagnosis of preterm labor and cervical insufficiency at 26 weeks + 4 days of pregnancy. Cervix was 3 cm dilated, effaced 70%, the amnion membrane intact, and there was a cerclage thread on the cervix. There was a single, viable fetus in the uterine cavity with fetal measurements compatible with 27-28 weeks on ultrasonography. Ampicillin and azithromycin treatments were started. On the seventh day of observation, leukocytes and C reactive protein values had increased, and there was an onset of serohemorrhagic vaginal discharge. Thereupon, intravenous treatment of piperacillin/tazobactam and clindamycin started. Signs of chorioamnionitis were resolved. The patient was delivered on day 38 of admission due to vaginal bleeding. The newborn and patient outcomes were good. Further studies are needed to evaluate the new treatment regime's efficacy in chorioamnionitis treatment.
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Oliveira, Lisiane Vital de, Camila Radelley Azevedo Costa da Silva, Lorenna Peixoto Lopes, and Isabela Karine Rodrigues Agra. "Current evidence of SARS-CoV-2 vertical transmission: an integrative review." Revista da Associação Médica Brasileira 66, suppl 2 (2020): 130–35. http://dx.doi.org/10.1590/1806-9282.66.s2.130.
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SUMMARY OBJECTIVE To review the current scientific evidence of vertical transmission related to coronavirus disease 2019 (COVID-19). METHODS An integrative review was performed by two independent researchers, based on the literature available in the MEDLINE (via PubMed) and LILACS databases, using the descriptors “pregnancy” AND “COVID-19” AND “vertical transmission”. This search included case reports or case series published up until 17th June 2020 in English or Portuguese. After reading the articles available in their entirety, those related specifically to the potential risks of vertical transmission of COVID-19 during pregnancy were selected. We initially found a total of 57 articles; 26 were carefully screened and 15 were finally selected. RESULTS Pregnancy can make women more susceptible to infections, especially by viral pathogens, given the various physiological and immunological changes that occur to maintain maternal-fetal balance. It is speculated that the fetus may be a possible target for COVID-19. Few studies (3 out of 15) in our analysis have found positive results for SARS-CoV-2 in fetal membranes, placenta, and in newborns right after birth. Additionally, no difference was noticed when comparing different modes of delivery, and seems reasonable to assume that pregnant women with stable clinical conditions can be encouraged for vaginal delivery. CONCLUSION Further studies with a great number of cases are warranted to elucidate whether the virus may be vertically transmitted to the fetus and if any maternal conditions can influence that. Our findings seem to demonstrate that vertical transmission is possible but quite unusual.
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Joksic, Ivana, Thomas Liehr, Mina Toljic, Natasa Karadzov-Orlic, Zagorka Milovanovic, Zeljko Mikovic, and Amira Egic. "Prenatal ultrasonographic manifestations of partial trisomy 12q(12q24.2→qter) and partial monosomy 2q (2q37.3→qter)." Vojnosanitetski pregled 77, no. 7 (2020): 754–57. http://dx.doi.org/10.2298/vsp170316136j.
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Introduction. Partial trisomy of chromosome 12 long arm is rare condition with significant clinical impact and is usually diagnosed postnatally. Case report. We present prenatal sonographic findings and molecular cytogenetic characterization of partial trisomy 12q and partial monosomy 2q in two consecutive pregnancies of a healthy non-consanguineous couple. A 35-year-old pregnant woman G3P1A1 was referred to genetic counseling due to sonographic anomalies detected in the fetus. First trimester ultrasound examination revealed hyperechogenic focus in the left cardiac ventricle, single umbilical artery, hyperechogenic bowel and unilateral clubfoot with knee joint ankylosis. Previous pregnancy of the couple was terminated at 26th gestation weeks due to multiple fetal anomalies: bilateral ventriculomegaly, corpus callosum hypoplasia, single umbilical artery and clubfoot. In G3P1A1, amniocentesis was performed and cytogenetic analyses revealed a derivative chromosome 2. Subsequent cytogenetic analyses of parental lymphocytes showed that paternal karyotype was normal, while maternal karyotype showed a der(2). Metaphase fluorescence in situ hybridization (FISH) studies demonstrated partial trisomy 12q24.2?12qter and partial monosomy 2q37.3?2qter in the fetus, resulting from an unbalanced segregation of a maternal balanced translocation t(2;12)(q37.3;q24.2). To date, this is the first such prenatally detected case. Literature search revealed three more cases of prenatally detected partial trisomy 12q and anomalies described were consistent with ones detected in present case. Our findings contribute to further clinical delineation of partial trisomy 12q. Conclusion. Prenatal detection of single umbilical artery, clubfoot, arthogryposis and ventriculomegaly should alert suspicion to chromosome 12q aberrations.
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Paton, B. C., B. Schmid, B. Kustermann-Kuhn, A. Poulos, and K. Harzer. "Additional biochemical findings in a patient and fetal sibling with a genetic defect in the sphingolipid activator protein (SAP) precursor, prosaposin. Evidence for a deficiency in SAP-1 and for a normal lysosomal neuraminidase." Biochemical Journal 285, no. 2 (July 15, 1992): 481–88. http://dx.doi.org/10.1042/bj2850481.
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It has been shown that sphingolipid activator proteins (SAPs) 1 and 2 are encoded on the same gene along with two other putative activator proteins [Fürst, Machleidt & Sandhoff (1988) Biol. Chem. Hoppe-Seyler 369, 317-328 and O'Brien, Kretz, Dewji, Wenger, Esch & Fluharty (1988) Science 241, 1098-1101]. We have undertaken further biochemical investigations on a patient and fetal sibling, who were previously shown to have a unique sphingolipid storage disorder associated with an SAP-2 deficiency [Harzer, Paton, Poulos, Kustermann-Kuhn, Roggendorf, Grisar & Popp (1989) Eur. J. Pediatr. 149, 31-39]. The severity of their disorder suggested that other products of the SAP precursor or prosaposin gene may also be deficient. The turnover of cerebroside sulphate and globotriaosylceramide were investigated and were both impaired in fibroblasts from the patient and fetus. However, the activities of cerebroside sulphate sulphatase and globotriaosylceramide alpha-galactosidase in vitro were normal in cells from the fetus and patient respectively. In addition, there was an increase in cerebroside sulphate concentration in the kidney of the affected fetus. These results indicate that, in addition to the SAP-2 deficiency, there was a defect in SAP-1 function in this disorder. Additional increases in the concentration of monohexosyl- and dihexosyl-ceramide in the fetal kidney probably reflect the deficiency of SAP-2 in the case of monohexosylceramides, and the combined activator deficiency in the case of dihexosylceramides. Lactosylceramide-loading studies confirmed that there was a defect in the turnover of this lipid in fibroblasts from the affected patient and fetus but not from a patient with an isolated SAP-1 deficiency, or from patients with Krabbe disease, GM1 gangliosidosis or galactosialidosis. It has been suggested [Potier, Lamontagne, Michaud & Tranchemontagne (1990) Biochem. Biophys. Res. Commun. 173, 449-456] that the prosaposin gene also codes for lysosomal neuroaminidase. However, we found normal neuraminidase activity in fibroblasts from our patient, using assay conditions which are diagnostic for sialidosis patients. The role of prosaposin gene products in sphingolipid metabolism is discussed in view of our biochemical findings in this genetic disorder.
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Toner, Lorraine E., Shari E. Gelber, Juan A. Pena, Nathan S. Fox, and Andrei Rebarber. "A Case Report to Assess Passive Immunity in a COVID Positive Pregnant Patient." American Journal of Perinatology 37, no. 12 (August 13, 2020): 1280–82. http://dx.doi.org/10.1055/s-0040-1715643.
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Introduction Data regarding transplacental passage of maternal coronavirus disease 2019 (COVID-19) antibodies and potential immunity in the newborn is limited. Case Report We present a 25-year-old multigravida with known red blood cell isoimmunization, who was found to be COVID-19 positive at 27 weeks of gestation while undergoing serial periumbilical blood sampling and intrauterine transfusions. Maternal COVID-19 antibody was detected 2 weeks after positive molecular testing. Antibodies were never detected on cord blood samples from two intrauterine fetal cord blood samples as well as neonatal cord blood at the time of delivery. Conclusion This case demonstrates a lack of passive immunity of COVID-19 antibodies from a positive pregnant woman to her fetus, neither in utero nor at the time of birth. Further studies are needed to understand if passage of antibodies can occur and if that can confer passive immunity in the newborn. Key Points
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Hani, Umu, Susilo Rudatin, Swasti Jamalina, and Ikit Netra. "Implementasi Pemberian Aromaterapi Lavender untuk Mengurangi Nyeri Post Sectio Caesarea di Ruang Haji RSI Banjarnegara: Case Study." Journal of Bionursing 4, no. 2 (June 28, 2022): 110–15. http://dx.doi.org/10.20884/1.bion.2022.4.2.142.
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Background : Labor is the process of expulsion of the fetus that occurs during a full-term pregnancy, with the expulsion of the placenta and membranes. Problems during saecarea due to tearing of tissue after a cesarean section may cause pain due to surgery.
Objectives: This study aims to describe nursing care of patients with disturbed pain comfort Mrs. S With a Post Section Caesarea Medical Diagnosis at RSI Banjarnegara.
Methods: This type of study is descriptive in the form of case studies. The sample used in this case study is Mrs. S with a sense of discomfort and pain disorder. The focus of the study discussed by the author is pain comfort disorders in postoperative sectio caesaria patients. Processing and analyzing data using descriptive analysis.
Result: The three nursing diagnoses that have been established show that the acute pain associated with the physical injury agent is partially resolved, the other diagnoses that have been established have been resolved.
Conclusion: Non-pharmacological therapy with Lavender aromatherapy can relieve Post Sectio Caesarea Pain
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Litton, Jennifer K., Richard L. Theriault, and Ana M. Gonzalez-Angulo. "Breast Cancer Diagnosis during Pregnancy." Women's Health 5, no. 3 (May 2009): 243–49. http://dx.doi.org/10.2217/whe.09.2.
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Breast cancer diagnosed during pregnancy is a challenging situation for the patient and her medical team. As women are delaying childbirth, the incidence is expected to increase. Most of the data surrounding the diagnosis and treatment of cancer during pregnancy is in case reports and small cohort studies. However, the data continues to expand regarding the safety of systemic treatments during the second and third trimesters for both the mother and the fetus. In this article, the use of diagnostic imaging, procedures, surgery and chemotherapy are reviewed as well as prognosis and future pregnancies after the treatment for breast cancer.
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Molero-Osorio, Antonio, Joel Santos-Bolívar, Oscar Mencías, and Carlos Briceño-Pérez. "Early Prenatal Diagnosis of Congenital Ranula." American Journal of Sonography 2 (December 13, 2019): 7. http://dx.doi.org/10.25259/ajs_11_2019.
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Congenital ranula (CR) is a rare tumor. Few cases of prenatal diagnosis (PD) of CR have been reported in the literature and diagnosis usually is beyond 20 weeks of gestation. We report a case of a pregnant patient with 16 weeks of gestation, where ultrasound (US) visualized in her fetus, a cystic tumor protruding in his oral cavity. Basis and complementary studies, including fetal echocardiography, were normal. Serial two-dimensional (2D) and three-dimensional (3D) US studies monitored fetal growth, amniotic fluid, progressive changes in the cystic mass, and maxillary movements. At 38.5 weeks of gestation, a cesarean section was performed. At 17th neonate days old, the neonate was done the simple and complete excision. Early PD of CR is possible. In this case was done as early as at 16 weeks of gestation. This is the first CR reported case with the earliest PD (16 week of gestation). We recommend that during the first trimester US, the oral cavity must be well explored, to rule out tumors.
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Oi, Shizuo, Hideyoshi Saya, and Satoshi Matsumoto. "A hypothesis for myeloschisis: overgrowth and reopening." Journal of Neurosurgery 68, no. 6 (June 1988): 947–54. http://dx.doi.org/10.3171/jns.1988.68.6.0947.
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✓ A hypothesis for embryopathogenesis of myeloschisis is described on the basis of experimental studies analyzing the stage specificity and immunohistochemical/histological characteristics of the exposed neural tissue (placode). Myeloschisis developed in six fetuses among 205 chick embryos treated in various stages with teratogens including ethylnitrosourea, and anticonvulsant and antipyretic agents. All but one case (with associated cephalothoracopagus) demonstrated myeloschisis in the thoracic region with a lamina defect of two and three levels. No fetus was exposed to a teratogen prior to or within Hamburger and Hamilton stage 12 (45 to 49 hours postincubation), when the neuropore closes. Immunohistochemical studies of chick myeloschisis clearly indicated that neuron-specific enolase-positive elements were extremely active only in the overgrown placode, corresponding to the histological findings with Kluver-Barrera's special stain. These findings were compared with observations in a case of myeloschisis in a human neonate. The results of this study imply the possibility of another mechanism for the embryopathogenesis of myeloschisis: namely, the overgrowth and reopening hypothesis.