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Littérature scientifique sur le sujet « Post partum desease treatment »

Auteur : Grafiati

Publié le 9 mars 2023

Mis à jour le 10 mars 2023

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Articles de revues sur le sujet "Post partum desease treatment"

Azizi, Fereidoun. « Treatment of post-partum thyrotoxicosis ». Journal of Endocrinological Investigation 29, n^o 3 (mars 2006) : 244–47. http://dx.doi.org/10.1007/bf03345547.

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Leite, F., O. Campos, H. Salgado et P. Carvalho. « Post-partum psychosis ». European Psychiatry 33, S1 (mars 2016) : S625. http://dx.doi.org/10.1016/j.eurpsy.2016.01.2344.

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IntroductionPostpartum psychosis (or puerperal psychosis) is a term that covers a group of mental illnesses with the sudden onset of psychotic symptoms following childbirth. A typical example occurs when after childbirth, a woman becomes irritable, has extreme mood swings and hallucinations with the possibility of needing psychiatric hospitalization. Often, out of fear of stigma or misunderstanding, women hide their condition.Aims and objectivesTo review the evidence regarding prophylactic treatment and acute management of postpartum psychosis and affective disorders in the puerperium.MethodsOnline search/review of the literature has been carried out, using Medline/Pubmed, concerning “postpartum psychosis”, “postpartum”, “mental disorders”, “mania” and “depression”.ResultsPostpartum psychosis is a rare and severe psychiatric condition requiring rapid restoration of health in view of significant risks to both mother and the infant. The known risk factors and negative consequences of postpartum psychosis point to the importance of preventive and acute treatment measures. The majority of patients who develop psychosis immediately following childbirth suffer from bipolar disorder.ConclusionsUnderstanding the relationship between postpartum psychosis and affective disorders has implications for perinatal and long-term treatment. The rapid and accurate diagnosis of postpartum psychosis is essential to expedite appropriate treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Hauser, I., B. Schneider et K. Lechner. « Post-Partum Factor VIII Inhibitors ». Thrombosis and Haemostasis 73, n^o 01 (1995) : 001–5. http://dx.doi.org/10.1055/s-0038-1651666.

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SummaryIn a retrospective study 51 published cases of post-partum factor VIII inhibitors were analyzed with regard to the outcome according to treatment. The overall outcome was favorable with 97% survival at two years. The probability of complete remission (CR, absence of the inhibitor and normalization of factor VIII activity) was almost 100% at 30 months. Steroid treatment appears to be not superior to no treatment, but patients treated with immunosuppressive drugs (cyclophosphamide, azathioprine, 6-mercaptopurine) had a significantly shorter time to CR. In the absence of a randomized trial this analysis may be helpful for decision-making in women with factor VIII post-partum inhibitors. Because of the retrospective study design, conclusions have to be regarded with caution.

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Tufts, Jennifer A. « Brexanolone injection for post-partum depression treatment ». Lancet 394, n^o 10196 (août 2019) : 379. http://dx.doi.org/10.1016/s0140-6736(19)30727-5.

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Tang, George Y., et Jay Parekh. « Brexanolone injection for post-partum depression treatment ». Lancet 394, n^o 10196 (août 2019) : 379. http://dx.doi.org/10.1016/s0140-6736(19)30714-7.

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Owen, P. J. D., et J. H. Lazarus. « The treatment of post-partum thyroid disease ». Journal of Endocrinological Investigation 26, n^o 4 (avril 2003) : 290–91. http://dx.doi.org/10.1007/bf03345173.

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Noviana, Ulva. « PENGARUH ROLLING MASSAGE TERHADAP KELANCARAN PRODUKSI ASI IBU POST PARTUM PRIMIPARA DI DESA CAMPOR KEC. GEGER KAB. BANGKALAN ». JURNAL ILMIAH OBSGIN : Jurnal Ilmiah Ilmu Kebidanan & ; Kandungan P-ISSN : 1979-3340 e-ISSN : 2685-7987 10, n^o 2 (28 novembre 2019) : 35–39. http://dx.doi.org/10.36089/job.v1i2.111.

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Production of breast milk (ASI) wich is little and is not smooth one day after dilivery becomes an obstacle of early breastfeeding forpost partum primipara. Of 6 post partum primipara. 3 underwent breasr milk wich did not come out and 2 underwent breasr milk wich did not flow out smoothly and 1 underwent smooth flow of breast milk. This research was aimed to find aout the effects of rolling massage on smoothness of breast milk production for post partum primipara.This research employed preeksperiment, one group pretest-posttest design. Population consisted of post partum primipara and sample which used a porposive sampling technique consisted of 13 post partum primipara. The result showed that before treatment, 69.2% post partum priipara had unsmooth production of breast milk and only 30.8% post partum primipara had smooth production of breast milk and after treatment, 77% post partum primipara had smooth production of breast milk and only 23% post partum primipara had unsmooth production of breast milk.

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Turab, Syed Mohsin, Muhammad Furqan, Shah Nawaz Jamali et Syeda Amber Zaidi. « POST PARTUM IRON DEFICIENCY ANEMIA ; ». Professional Medical Journal 24, n^o 01 (18 janvier 2017) : 95–101. http://dx.doi.org/10.29309/tpmj/2017.24.01.475.

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Objectives: To Analyze and compare the effect of oral vs parenteral iron therapyon various hematological parameters in women suffering from post-partum iron deficiencyanemia. Study Design: Comparative, randomized and prospective study. Setting: Departmentof Pharmacology, HCMD, HU in collaboration with the Dept of Obs/Gynae, JPMC Karachi.Period: January to December 2015. Subjects and Methods: 40 patients divided in two groupsA and B of 20 each. Group A received oral iron (Tab Iberet 525 mg once daily) for a period of 3months while group B was treated with intravenous iron sucrose complex (Inj Venofer 100mg/Amp) the total no of doses were calculated according to Hemoglobin deficit. Hemoglobin,Hematocrit and MCV were observed at day 0, 45 and 90 of the treatment. Results: Group Ashows a mean increase of 25.85% at day 90th of the treatment in comparison to this group Bshows a much better result with a mean increase of 36.71% in Hemoglobin conc. At the end of12 weeks therapy. Conclusion: Parenteral iron therapy was found to be an effective means oftreatment in patients with postpartum iron deficiency anemia.

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Menascu, Shay, Michal Siegel-Kirshenbaum, Sapir Dreyer-Alster, Yehuda Warszawer, David Magalashvili, Mark Dolev, Mathilda Mandel, Gil Harari et Anat Achiron. « Intravenous immunoglobulin treatment during pregnancy and the post-partum period in women with multiple sclerosis : A prospective analysis ». Multiple Sclerosis Journal - Experimental, Translational and Clinical 9, n^o 1 (janvier 2023) : 205521732211511. http://dx.doi.org/10.1177/20552173221151127.

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Background Relapsing-remitting multiple sclerosis (RRMS) affects predominantly young women within reproductive years. As an increased risk of relapses is known to occur during the post-partum period, it is important to consider treatment options. Aim Evaluate the effects of intravenous immunoglobulins (IVIg) to prevent post-partum relapses. Methods We prospectively followed 198 pregnant female RRMS patients, 67 treated with IVIg during pregnancy and the three months post-partum, and 131 untreated patients that served as controls. Results During the pre-gestation year, 41.4% were treated with immunomodulatory drugs, and 28.3% experienced a relapse. During pregnancy and the post-partum period, the number of relapsing patients significantly decreased in the IVIg group (37.3%, 10.4%, 8.9%, respectively, p = 0.0003), while no significant change was observed in the untreated group (23.7%, 17.6%, and 22.1%). During the three-month post-partum period, there were only mild and moderate relapses in the IVIg group, while in the untreated group, there were also severe relapses. Stepwise logistic regression that assessed the relation between three-month post-partum relapse and explanatory variables demonstrated that untreated patients had increased risk for post-partum relapse (odds ratio = 4.6, 95% CI [1.69, 12.78], p = 0.033). Conclusions IVIg treatment proved efficient to reduce the rate and severity of relapses during pregnancy and the three-month post-partum.

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Ledger, William J. « Post-partum endomyometritis diagnosis and treatment : A review ». Journal of Obstetrics and Gynaecology Research 29, n^o 6 (décembre 2003) : 364–73. http://dx.doi.org/10.1111/j.1341-8076.2003.00145.x.

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Thèses sur le sujet "Post partum desease treatment"

DOLCE, ROSSELLA. « Il disagio della maternità tra diagnosi e trattamento ». Doctoral thesis, Università degli Studi di Milano-Bicocca, 2012. http://hdl.handle.net/10281/39280.

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Studies in maternity disease usually describes characteristics, prevalence, onsets and consequences in the wellness of women and childs. The multidisciplinary model applied to this issues focused new topics like risk factors, protective factors, aggravating factors and maintaining factors of suffering state. From constructivist and cognitive perspective (Guidano, 1999), the project of research investigated clients representations in a clinical surgery for maternity support located in San Gerardo Hospital in Monza that is managed by the Panda Onlus Association for parenting. Objectives was the collection of epidemiological local data on the risk factors, diagnoses, caratteristics of desease. We also wanted to build a model for evaluating the efficacy and relaxation afforded to users. The instruments selected and used are varied and provide qualitative and quantitative data can compare the symptoms with the individual's subjective experience and make a card of welcome. Finally, the effectiveness of 'intervention is carried out through semi-structured interview on perceived change (S. Di Nuovo, 2000) which provides an indication of the vision of the patient and the therapist also reference, the protagonists of the care pathway. The results reported for a total sample of 76 subjects, confirmed the findings of the literature on risk factors and in particular highlighted the importance of a relationship supportive and devoted special attention to primiparas and to immigrant women. The type of user has an average age and educational level higher than those reported in the literature and is aimed at the counter in the form of car transmission in case of second or third child and is sent to the service if the first pregnancy by the services area of that work, therefore, as a filter. The reasons that lead mothers to seek help are pervasive and debilitating emotional feelings of sadness or anxiety and the greatest areas of impairment appear to be those related to the relationship with the partner and the emotional sharing of everyday life with baby. The intervention focuses on the personal history of development and the path that led to motherhood in order to support the maternal sense of competence, the first factor of change according to the dedicated review (Dennis, 2005). The intervention is judged positively by the users surveyed species in having been able to promote a more functional mode of expression, and manage their emotions in meaningful relationships. In conclusion, the methodology and research design proved effective in identifying the links between clinical evaluations and diagnostic symptom with subjective experience of patients, the flexibility of structuring of the instruments used allows an application to different types of intervention: screening, individual therapy, couple and group psychotherapy and pharmacotherapy, psychoeducation.

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Sanford, Ashley E. « Trauma-related Distress and Growth| A study of Pregnant and Post-Partum Women in Residential Mental Health and Substance Use Treatment ». Thesis, University of California, Santa Barbara, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10192178.

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Positive outcomes associated with traumatic stress have been gaining attention over the past 20 years. Posttraumatic growth (PTG) is one such outcome, characterized by changes resulting from struggling with trauma that leave an individual or community with improved wisdom, strengths, or skills in certain areas that they would not have gained without struggling with trauma. The current study looked at PTG among women in residential treatment for substance use and mental health concerns. All women were also pregnant or had a child under one year of age. Pregnant and new mothers are a particularly high-risk group for negative outcomes related to substance use. This was the first study to assess PTG among women who use substances. Participants were 104 women in a six-month residential treatment in central California from 2012-2015. Services included substance use recovery interventions, trauma interventions, parenting education, and individual and group counseling. Ninety-eight percent reported at least minimal PTG; the mean growth score was the equivalent of between a moderate and great degree of growth. Results demonstrated no relationship between trauma symptoms or change in substance use severity and PTG scores. However, consumer satisfaction was related to PTG, with greater satisfaction being related to higher levels of PTG.

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Eriksson, Lars-Gunnar. « Transcatheter Arterial Embolization in the Management of Life Threatening Bleeding Applied in Upper Gastrointestinal and Post Partum Bleedings ». Doctoral thesis, Uppsala : [Department of Oncology, Radiology and Clinical Immunology, Uppsala University], 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8248.

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Livres sur le sujet "Post partum desease treatment"

Therapy and the postpartum woman : Notes on healing postpartum depression for clinicians and the women who seek their help. New York : Brunner-Routledge, 2008.

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Depresión : Tratamientos científicos y naturales. Nuez de Ebro, Zaragoza : Ediciones Vida Sana, 2007.

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Dalfen, Ariel. When Baby Brings the Blues. Wiley & Sons, Incorporated, John, 2009.

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When Baby Brings the Blues. John Wiley & Sons, 2008.

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Dalfen, Ariel. When Baby Brings the Blues : Solutions for Postpartum Depression. HarperCollins Canada, Limited, 2014.

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Dalfen, Ariel. When Baby Brings the Blues : Solutions for Postpartum Depression. Wiley & Sons, Incorporated, John, 2010.

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Hanley, Jane, et Mark Williams. Fathers and Perinatal Mental Health : A Guide for Recognition, Treatment and Management. Taylor & Francis Group, 2019.

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Hanley, Jane, et Mark Williams. Fathers and Perinatal Mental Health : A Guide for Recognition, Treatment and Management. Taylor & Francis Group, 2019.

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Hanley, Jane, et Mark Williams. Fathers and Perinatal Mental Health : A Guide for Recognition, Treatment and Management. Taylor & Francis Group, 2019.

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Fathers and Perinatal Mental Health : A Guide for Recognition, Treatment and Management. Taylor & Francis Group, 2019.

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Chapitres de livres sur le sujet "Post partum desease treatment"

Gurbuz, Hande, Hulya Topcu, K. Tolga Saracoglu et Volker Wenzel. « Locoregional Anaesthesia During Pregnancy and the Post-partum Period ». Dans ENT Diseases : Diagnosis and Treatment during Pregnancy and Lactation, 141–61. Cham : Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-05303-0_13.

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« Puerperal Disorders ». Dans Advances in Medical Diagnosis, Treatment, and Care, 159–76. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-4357-3.ch007.

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Unfortunately, the complexities of human pregnancy and birth make it a risky endeavor. The most vulnerable time for maternal death is the post-partum period during which 60% deaths and 65% deaths are reported. Around 62.3% deaths are estimated to occur in post-partum period. Unfortunately, post-partum period is the most neglected period. In the developing world, while 65% of all women have some form of antenatal care, 53% get intra-natal care; only 30% get post-partum care. Women continue to need care and support after childbirth. Postpartum checkups can make all the difference for an abnormal bleeding or infection. Living away from services or being unable to afford those services prevents a woman from acquiring the knowledge needed after birth to look after herself or to receive the life-saving antibiotics and the attention she may need after delivery.

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Gauntlett, Rupert. « Maternal critical care ». Dans Oxford Textbook of Medicine, sous la direction de Catherine Nelson-Piercy, 2701–5. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0281.

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Critical illness during pregnancy or after giving birth is rare: in the United Kingdom 0.29% of maternities involve admission to a critical care unit, and the maternal death rate is 0.01%. Over 80% of obstetric admissions to critical care occur in the post-partum phase, mainly due to complications relating to massive haemorrhage. Other pregnancy specific conditions that may require critical care support include pre-eclampsia (typically when diagnosis and treatment have been delayed), amniotic fluid embolism, peri-partum cardiomyopathy, and acute fatty liver of pregnancy. Puerperal sepsis remains a major problem in resource-poor parts of the world. Pregnant women who survive critical illness may be particularly prone to long-term psychological morbidity. It is vital that, once physiological stability has been achieved, no time is wasted before a mother is reunited with her baby.

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Chettiar, Teri. « Problem Mothers ». Dans The Intimate State, 80—C3.P105. Oxford University Press, 2023. http://dx.doi.org/10.1093/oso/9780190931209.003.0004.

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Abstract Chapter 3 investigates new rehabilitative programs designed to tackle the increasingly visible problems of child neglect and post-partum mental illness in post-1945 Britain, focusing on the joint admission of mothers and their young children at the Cassel Hospital for Functional Nervous Disorders in London. Although Cassel medical and nursing staff sought to humanize “bad” mothers and establish greater empathy for severe cases of emotional distress, they ultimately reinforced post-WWII expectations that childcare was the “natural” central preoccupation of female adults. Treatment at the hospital focused on helping mostly young married female patients resolve their “emotional immaturity” through an intensive around-the-clock therapeutic regime that centered on patients’ appropriately loving relationships with their children. This chapter argues that new post-WWII visibility surrounding the emotional burdens of motherhood ended up further reifying, rather than undermining, the presumption that women were, by nature, relational “experts” and better suited to childcare than men.

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Carty, David. « Endocrine disease in pregnancy ». Dans Oxford Textbook of Medicine, sous la direction de Catherine Nelson-Piercy, 2638–41. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0273.

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During pregnancy, there are several diseases of the endocrine system that can affect women. This chapter looks at a few of these. Many pregnant women will develop goitre. Gestational thyrotoxicosis needs to be differentiated from Grave’s disease, which requires treatment with propylthiouracil in early pregnancy and carbimazole in later pregnancy. Overt hypothyroidism is associated with adverse maternal and fetal outcomes and should be treated to maintain thyroid-stimulating hormone within the trimester-specific reference range. The diagnosis of both Addison’s disease and Cushing’s syndrome can be challenging in pregnancy. Patients with adrenal insufficiency require higher replacement steroid doses in the first and third trimesters. Prolactinomas are commonly encountered in pregnancy, with dopamine agonists the treatment of choice. Women with macroprolactinomas should have visual field monitoring throughout pregnancy. Lymphocytic hypophysitis is increasingly recognized as a cause of hypopituitarism arising in late pregnancy and in the post-partum period.

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Humphreys, Jacqueline. « Perinatal Psychiatry : Motherhood in Mental Health Services ». Dans Women's Voices in Psychiatry, 91–103. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198785484.003.0010.

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Mental illness in the post-partum period was first documented in the 1800s. Early analysis of the impact of separating women and their babies has made the United Kingdom a world leader in psychiatric mother and baby units. However, perinatal psychiatry has lagged behind other specialties for recognition and funding; many areas still do not have specialist perinatal psychiatry teams. This chapter discusses whether cultural narratives of pregnancy and motherhood as a joyful experience have combined with the stigmatizing of mental health to create this environment. The treatment of pregnant and postnatal women requires consideration of factors not commonly found in other psychiatric specialties. Undertreatment of maternal mental illness has profound consequences, sometimes including the tragic death of the mother and child. However, the lobbying of perinatal psychiatrists (many of whom are women) and women with lived experience has led to increased recognition, funding, and training in the National Health Service.

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Wiles, Kate. « Renal disease in pregnancy ». Dans Oxford Textbook of Medicine, sous la direction de Catherine Nelson-Piercy, 2589–96. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0267.

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Pregnancy leads to extensive and complex physiological changes in the kidney and renal system. This chapter explores the various complications that can occur in the renal system of the pregnant woman, including acute kidney injury, chronic kidney disease, and urinary tract infection. The causes of acute kidney injury in pregnancy are as those in the non-pregnant patient, but additional pregnancy-related pathologies must be considered, including pre-eclampsia and HELLP syndrome. Microangiopathic haemolytic anaemias (haemolytic uraemic syndrome and thombotic thrombocytopenic purpura) are rare but can be triggered by pregnancy or the post-partum state. Failure of the renal system to adapt to pregnancy is hypothesized to lead to the increase in adverse maternal and fetal outcomes seen in women with chronic kidney disease. Asymptomatic bacteriuria affects 2–10% of pregnant women and is associated with increased risks of symptomatic infection, preterm birth, low birth weight, and perinatal mortality. Antibiotic treatment mitigates these risks.

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Graham, Maryemma. « The Walls of My Prison House ». Dans The House Where My Soul Lives, 301—C18.F1. Oxford University PressNew York, 2022. http://dx.doi.org/10.1093/oso/9780195341232.003.0018.

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Abstract This chapter describes how, even though she made her public and private declarations of renewal each January, Margaret Walker’s growing dependency on her husband Alex, the creative lull, and endless domestic responsibilities combined into emotions that not only overburdened her but also aggravated whatever ailment she had, even if it was a simple cold. Post-partum depression accounted for some of her mood swings, for which she received ineffective treatment, but she refused to ask her parents for help, not wanting to admit failure. The physical compatibility and love that she and Alex felt drew them closer, but too often she concluded that “this dulls my creative and religious impulses otherwise but my love will not let me leave.” The result was that they fought often and in different ways. On one occasion, Alex’s abuse was so severe that she considered taking out a warrant for his arrest, but she could not face the options: leave right away or lose face. Walker’s routine of self-therapy steeled her during these years. Even if she exaggerated in those moments of acute distress, equating her marriage with slavery, for example, she took marriage and motherhood as a given rather than an option.

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Kaushal, Sushruti, et Harpreet Kaur. « Pregnancy and COVID-19 ». Dans Fighting the COVID-19 Pandemic. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.98710.

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Pregnancy is a physiological state that alters the body’s response to infections. COVID-19 has been found to cause severe disease in pregnancy with morbidity and mortality that is higher than in non-pregnant adults. There is risk of transmission of SARS-CoV2 infection to fetus during ante-natal period, intra-partum and post-delivery from an infected mother. It is necessary to provide an un-interrupted ante-natal care and delivery services to pregnant women during the pandemic. Tele-consultation is important modality to reduce the physical exposure of pregnant women to the hospital environment and should be utilised. Screening, isolation, testing and treatment for SARS-CoV2 infection in pregnant women should follow the local guidelines and remain essentially the same as in non-pregnant adults. Admission, if required, should be in a facility that can provide obstetric maternal and fetal monitoring in addition to care for COVID-19 illness. Use of nitrous oxide and inhalational oxygen for fetal indication should be avoided during labor. Second stage of labor is considered an aerosol generating procedure and should be managed with adequate precautions. Mode of delivery should be as per obstetric indications. Regional anaesthesia should be preferred during caesarean. COVID-19 is not a contra-indication to breast feeding. For antenatal women, COVID-19 vaccination can be considered after shared decision making.

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Actes de conférences sur le sujet "Post partum desease treatment"

Istighosah, Nining, et Aprilia Nurtika Sari. « Oxytocyn Massage Using Innovative Massage Tool and Conventional Effleurage Techniques to Increase Breastmilk Production in Post Partum Mothers ». Dans The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.03.48.

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ABSTRACT Background: Exclusive breastfeeding for the first six months of life is recommended by the World Health Organization and United Nations Children’s Fund. The World Health Organization (WHO) recommends exclusive breastfeeding for up to 6 months and continuous breastfeeding for up to 2 months. Exclusive breastfeeding is the most effective intervention to reduce infant mortality. It is estimated that it can prevent 13% of under-five mortality in low-income countries. This study aimed to analyze the difference in breastmilk volume before and after the mother received the oxytocin massage using innovative massage tool and conventional effleurage techniques. Subjects and Methods: This was a quasi-experiment study with a non-randomized control trial pretest-posttest design was conducted in Kediri from August to September 2020. The sample used was post-partum women on days 4 to 10 using purposive sampling technique. The dependent variable was amount of breast milk production. The independent variables were oxytocin massage treatment with effleurage technique, and the combination of oxytocin massage, effleurage technique and innovation massage tool. The data was analyzed by T-Test. Results: In the oxytocin massage treatment group used the conventional Effleurage method (Mean = 42; SD = 29) while in the massage treatment group using an innovative massage tool (Mean = 60; SD = 51) this was very different in the control group (Mean = 3.4; SD = 8.8) and it was statistically significant (p= 0.005). Conclusion: Giving oxytocin massage using an innovative massage device were higher than oxytocin massage using the conventional Effleurage method and massage using this innovative massage device had a statistical impact on increasing breast milk production Keywords: oxytocin massage, breast milk production, innovative massage tool Correspondence: Nining Istighosah. School of Midwifery Dharma Husada Kediri. Jl. Penanggungan No. 41-A Kediri. E-mail: dealovanining@gmail.com. Mobile: +6281231352032. DOI: https://doi.org/10.26911/the7thicph.03.48

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Conard, J., M. H. Horellou, P. Van Dreden et M. Samama. « PREGNANCY AND CONGENITAL DEFICIENCY IN ANTITHROMBIN III OR PROTEIN C ». Dans XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642942.

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Pregnancy as well as congenital deficiency in coagulation inhibitors are recognized as predisposing conditions to thrombosis. Thus, in women with a congenital deficiency, the risk of thrombosis associated to pregnancy is expected to be higher than in normal women (incidence of approximately 1°/..). We have investigated this risk in 16 women with congenital Antithrombin III (AT III) deficiency and in 31 with Protein C (PC) deficiency.In the 16 women with AT III deficiency, 30 pregnancies occured 3 of them were interrupted by provoked abortions and a deep vein thrombosis (DVT) or pulmonary embolism were observed in 2 patients after abortion. Of the 27 other pregnancies, in the absence of any anticoagulant treatment, 17 were complicated by thrombosis (62 %), either during pregnancy (n = 8) or in the post-partun period (n = 9).In the group of 31 women with PC deficiency, 82 pregnancies occured : 16 ended with a provoked abortion, followed by a DVT in one case. Out of the 66 other pregnancies, 17 (25 %) were associated with thrombosis, during pregnancy (n = 5) or in the post-partum (n = 12).Thus, pregnancy is a situation at high risk of thrombosis in PC deficient women, and even higher in AT III deficient ones. No standardized anticoagulant prophylaxis being available, various anticoagulant treatments (mainly SC heparin) were given at various doses, started at different moments of pregnancy to 6 AT III and 3 PC deficient women : 3 and O thrombosis occured respectively.In the post-partum, a thrombosis was observed in 1 of 4 AT III and 2 of 4 PC deficient women who received a treatment. Consequently, an efficient treatment remains to be determined.If a pregnancy is unwanted, estroprogestogens are contra-indicated but progestogen only treatments with chlormadinone acetate, levonorgestrel or low dose of norethisterone were given to 4 AT III and 6 PC deficient women who were simultaneously receiving AVK : no recurrence of thrombosis was observed afer 1 to 3 years of treatment.

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Purwar, Roli, Saritha Shamsunder, Swati Gupta, Geetika Khanna, Usha Rani et Sunita Malik. « Metastatic gestational trophoblastic neoplasia presenting after a normal pregnancy ». Dans 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685343.

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Gestational Trophoblastic Neoplasia presenting after a normal delivery is very rare & seen in 1 in 1,60,000 pregnancies and is associated with a poor outcome due to delay in diagnosis. Only three cases have been reported in the literature till date. A 27 year old lady, P2L1 delivered a stillborn baby in some peripheral hospital. Intrapartumand post-partum period were uneventful. After a period of 2 months, in view of persistent bleeding pervaginumshe underwent dilatation & evacuation in the same hospital. Ultrasonography showed circumscribed lesion 4.1 x 3.6 cm in lower uterine segment indenting the endometrium. MRI showed a heterogeneous space (4.2 x 3.2 x 3.3 cm) occupying lesion extending to involve the anterior myometrium. She was discharged on single dose of methotrexate 50 mg intramuscular injection. After one month, she again had an episode of heavy bleeding pervaginum leading to shock, for which she was referred to Safdarjung Hospital for further management. At Safdarjung Hospital an emergency hysterectomy was performed as a lifesaving measure. Preoperative serum Bhcg was >1 lac mIU/ml. later it was reported as gestational choriocarcinoma by histopathology. Metastatic workup showed cannonball lesions in lungs. On the 10th post-op day, she had severe episode of headache followed by right sided hemiplegia. NCCT head showed multiple haemorrhagiclesion in bilateral parietal and right frontal region suggestive of brain metastasis. She was started on the EMA/CO regimen. Conclusion: The main modality of treatment of choriocarcinoma is multiagent chemotherapy. Hysterectomy is generally reserved for those gestational trophoblasticneoplasia where it is chemotherapy resistant. Although in exceptional circumstances of heavy uncontrolled bleeding per vaginum hysterectomy is a lifesaving procedure, it is not curative to the other metastatic manifestations.

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