Cutaneous Leishmaniasis: Case Series on Pregnancy Outcome

Yossi Bitton; Orna Diav-Citrin

doi:10.1093/ofid/ofaa479

PREGNANCY OUTCOME IN FEMALES WITH HIGH BODY MASS INDEX (BMI)

Pakistan Postgraduate Medical Journal ◽

10.51642/ppmj.v31i03.357 ◽

2021 ◽

Vol 31 (03) ◽

pp. 159-162

Author(s):

Sadia Zahoor ◽

Tahira Malik ◽

Sadia Younas ◽

Zilla Huma ◽

Aalia Tayyba ◽

...

Keyword(s):

Body Mass Index ◽

Key Words ◽

Pregnancy Outcome ◽

Body Mass ◽

Study Design ◽

Pregnancy Outcomes ◽

Case Series ◽

High Body Mass Index ◽

Pregnant Females ◽

Age Range

Objective: To determine the various pregnancy outcomes in females with high pre pregnancy BMI. Study Design: Descriptive case series. Setting: Sheikh Zayed Hospital, Rahim Yar Khan. Duration: 30-06-2016 to 31-12-2017. Methodology; In the present study, pregnant females with age of gestation less than 12 weeks presenting with their first ante natal visit falling in the age range of 20-40 years having pre pregnancy BMI > 25 kg/m2 were included. Then these cases were followed for their whole pregnancy to look for various outcomes. Results; In the present study there were 150 subjects enrolled with high pre pregnancy BMI. Mean age of the participants was 28.41±4.67 year and mean BMI was 28.31±3.57 kg/m2. Regarding various outcome the most common one was C section which was seen in 42 (28%) of the cases, followed by PIH seen in 35 (23.34%) of the cases, while pregnancy remained uneventful in only 21 (14%) of the cases. Conclusion: High pre pregnancy BMI leads to various complication, which are seen in almost 8 out of 10 cases and the most common one is C section. Key words: BMI, C section, PIH

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Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS)

Virology Journal ◽

10.1186/s12985-021-01494-3 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Kerina Duri ◽

◽

Simbarashe Chimhuya ◽

Exnevia Gomo ◽

Privilege Tendai Munjoma ◽

...

Keyword(s):

Pregnant Women ◽

Vertical Transmission ◽

Pregnancy Outcomes ◽

Preterm Births ◽

Multivariate Logistic Regression Model ◽

Birth Cohort Study ◽

Childhood Disability ◽

Hiv 1 ◽

Cmv Dnaemia ◽

Rna Levels

Introduction Despite being a leading infectious cause of childhood disability globally, testing for cytomegalovirus (CMV) infections in pregnancy is generally not done in Sub-Sahara Africa (SSA), where breastfeeding practice is almost universal. Whilst CMV and human immunodeficiency virus (HIV) are both endemic in SSA, the relationship between antenatal plasma CMV-DNA, HIV-1-RNA levels and HIV-1-mother to child transmission (MTCT) including pregnancy outcomes remains poorly described. Methods Pregnant women at least 20 weeks’ gestational age at enrolment were recruited from relatively poor high-density suburbs in Harare, Zimbabwe. Mother-infant dyads were followed up until 6 months postpartum. In a case–control study design, we tested antenatal plasma CMV-DNA levels in all 11 HIV-1 transmitting mothers, as well as randomly selected HIV-infected but non-transmitting mothers and HIV-uninfected controls. CMV-DNA was detected and quantified using polymerase chain reaction (PCR) technique. Antenatal plasma HIV-1-RNA load was quantified by reverse transcriptase PCR. Infants’ HIV-1 infection was detected using qualitative proviral DNA-PCR. Predictive value of antenatal plasma CMV-DNAemia (CMV-DNA of > 50 copies/mL) for HIV-1-MTCT was analyzed in univariate and multivariate regression analyses. Associations of CMV-DNAemia with HIV-1-RNA levels and pregnancy outcomes were also explored. Results CMV-DNAemia data were available for 11 HIV-1 transmitting mothers, 120 HIV-infected but non-transmitting controls and 46 HIV-uninfected mothers. In a multivariate logistic regression model, we found a significant association between CMV-DNAemia of > 50 copies/mL and HIV-1 vertical transmission (p = 0.035). There was no difference in frequencies of detectable CMV-DNAemia between HIV-infected and -uninfected pregnant women (p = 0.841). However, CMV-DNA levels were higher in immunosuppressed HIV-infected pregnant women, CD4 < 200 cells/µL (p = 0.018). Non-significant associations of more preterm births (< 37 weeks, p = 0.063), and generally lower birth weights (< 2500 g, p = 0.450) were observed in infants born of HIV-infected mothers with CMV-DNAemia. Furthermore, in a multivariate analysis of HIV-infected but non-transmitting mothers, CMV-DNAemia of > 50 copies/mL correlated significantly with antenatal plasma HIV-1-RNA load (p = 0.002). Conclusion Antenatal plasma CMV-DNA of > 50 copies/mL may be an independent risk factor for HIV-1-MTCT and higher plasma HIV-1-RNA load, raising the possibility that controlling antenatal CMV-DNAemia might improve infant health outcomes. Further studies with larger sample sizes are warranted to confirm our findings.

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766. Everything Old is New Again-A Case Series of New World Leishmaniasis in African Children in Portland, Maine

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.956 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S428-S428

Author(s):

Jennifer Jubulis ◽

Amanda Goddard ◽

Elizabeth Seiverling ◽

Marc Kimball ◽

Carol A McCarthy

Keyword(s):

Latin America ◽

Cutaneous Leishmaniasis ◽

New World ◽

Pediatric Patients ◽

Data Extraction ◽

Clinical Manifestations ◽

Case Series ◽

Surgical Excision ◽

Skin Lesions ◽

Travel History

Abstract Background Leishmaniasis has many clinical manifestations and treatment regimens, dependent on species and host. Old world leishmaniasis is found primarily in Africa and Asia, and is associated with visceral disease, while new world disease, seen primarily in Latin America, is more commonly mucocutaneous. We present a case series of pediatric African patients with New World cutaneous leishmaniasis (NWCL). Methods Data extraction was performed via chart review, analyzing travel history, clinical presentation, diagnosis, and management in children with cutaneous leishmaniasis presenting to the pediatric infectious diseases clinic in Portland, ME. Biopsy specimens were sent to the federal CDC for identification by PCR and culture. Results Five cases of NWCL were diagnosed in pediatric patients in Maine from November 2018 through February 2020. Median age of patients was 10 years (range 1.5-15 years). Four cases (80%) occurred in children from Angola or Democratic Republic of Congo, arriving in Maine via Central/South America, with one case in a child from Rwanda who arrived in Maine via Texas. Three patients had multiple skin lesions and two had isolated facial lesions. Leishmaniasis was not initially suspected resulting in median time to diagnosis of 5 months (range 1-7 months). Four patients were initially treated with antibacterials for cellulitis and one was treated with griseofulvin. After no improvement, patients underwent biopsy with 2 patients diagnosed with L panamensis, 1 with L braziliensis, 1 with mixed infection (L panamensis and L mexicana), and 1 with Leishmania species only. One patient was managed with surgical excision, 3 with ketoconazole, and 1 was observed off therapy. Four patients were referred to otolaryngology. All continue to be followed in infectious disease clinic. Conclusion We present five cases of new world cutaneous leishmaniasis in African pediatric patients arriving to Maine through Latin America or Texas. Patients were diagnosed with cellulitis, tinea corporis or atopic dermatitis initially, underscoring importance of high index of suspicion in migrant patients. Detailed travel history and epidemiologic knowledge is essential to diagnosis, as patients may present with illness not congruent with country of origin. Optimal therapy remains unclear. Disclosures All Authors: No reported disclosures

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Neonatal outcome in pregnant patients with antiphospholipid syndrome

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0118 ◽

2015 ◽

Vol 43 (6) ◽

Cited By ~ 13

Author(s):

Katarina Jeremic ◽

Aleksandar Stefanovic ◽

Jelena Dotlic ◽

Jelena Stojnic ◽

Sasa Kadija ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Distress Syndrome ◽

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Distress Syndrome ◽

Adverse Pregnancy Outcome ◽

Perinatal Asphyxia ◽

Premature Delivery ◽

Control Group ◽

Adverse Pregnancy

AbstractThe study aim was to evaluate pregnancy outcomes in patients with antiphospholipid syndrome (APS) and to determine which clinical parameters present risk factors for adverse pregnancy outcomes in these patients.The study included 55 patients with APS treated at the Clinic for Ob/Gyn, Clinical Center of Serbia, from 2006 to 2012. The control group consisted of 55 healthy pregnant women. Data regarding previous pregnancies and conception method were registered. Immunological and laboratory tests were performed. Pregnancy outcomes, including miscarriage, intrauterine fetal death, hypertensive disorders, diabetes mellitus, phlebothrombosis, fetal growth restriction, premature delivery, delivery method, perinatal asphyxia, respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis were followed.The premature delivery rate in APS patients was 31.8%, and pregnancy loss was 18.2%. Significantly more patients with APS had thrombocytopenia, pregnancy losses, intrauterine growth restriction, and perinatal asphyxia compared with the control group. More miscarriages, preterm delivery, lower birth weight, preeclampsia, and IgM anticardiolipin antibody levels significantly correlated with adverse pregnancy outcomes. Although rare, respiratory distress syndrome can also worsen neonatal health status. According to ROC analysis, previous miscarriages correctly explained 66.3% of adverse pregnancy outcome cases. We generated four equations of adverse pregnancy outcome risk factors.The most important prognostic factor for pregnancy outcome in APS patients is the number of previous miscarriages. Using appropriate current therapeutic protocol can enable live birth of a healthy newborn in most cases.

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Pregnancy outcome following use of levodopa, pramipexole, ropinirole, and rotigotine for restless legs syndrome during pregnancy: a case series

European Journal of Neurology ◽

10.1111/ene.12001 ◽

2012 ◽

Vol 20 (9) ◽

pp. 1241-1246 ◽

Cited By ~ 33

Author(s):

M. Dostal ◽

C. Weber-Schoendorfer ◽

J. Sobesky ◽

C. Schaefer

Keyword(s):

Pregnancy Outcome ◽

Restless Legs Syndrome ◽

Case Series ◽

Restless Legs

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Efficacy of erbium glass laser in the treatment of Old World cutaneous leishmaniasis: A case series

Australasian Journal of Dermatology ◽

10.1111/ajd.12896 ◽

2018 ◽

Vol 60 (1) ◽

pp. e29-e32 ◽

Cited By ~ 2

Author(s):

Vahid Mashayekhi Goyonlo ◽

Mahboubeh Karrabi ◽

Bita Kiafar

Keyword(s):

Cutaneous Leishmaniasis ◽

Case Series ◽

Glass Laser ◽

Old World ◽

Erbium Glass

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Pregnancy Outcome in Uterine Anomalies

The Journal of Medical Sciences ◽

10.5005/jp-journals-10045-0052 ◽

2017 ◽

Vol 3 (1) ◽

pp. 31-33

Author(s):

Nagendra Prasad ◽

James Thingujam

Keyword(s):

Retrospective Study ◽

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

Intrauterine Growth Restriction ◽

Preterm Labor ◽

Premature Rupture ◽

Intrauterine Growth ◽

Preterm Premature Rupture ◽

Uterine Anomalies ◽

Uterine Anomaly

ABSTRACT Maternal with congenitial anomalies are known to have higher incidence of infertility, intrauterine growth restriction, fetal malposition, preterm labor, preterm premature rupture of membrane and increased cesaerean section rate. Study Design This is retrospective study, the pregnancies with uterine anomaly confirmed by ultrasound between Jan 2016 to jan 2017 at our hospital was taken and its outcome is observed. Reults The majority of preterm delivery in our study are mainly associated with septate and bicornuate uterus. Cesaerean section comprised of 80% and its major indication is due to fetal malpresentation (breech). Thus Pregnancy outcomes of individual depending on the type of uterine anomalies. How to cite this article Nagarathnamma R, James T, Prasad N. Pregnancy Outcome in Uterine Anomalies. J Med Sci 2017;3(1):31-33.

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Prediction of Healthy Pregnancy Outcomes in Women with Overweight and Obesity: The Role of Maternal Early-Pregnancy Metabolites

Metabolites ◽

10.3390/metabo12010013 ◽

2021 ◽

Vol 12 (1) ◽

pp. 13

Author(s):

Rama J. Wahab ◽

Vincent W. V. Jaddoe ◽

Romy Gaillard

Keyword(s):

Pregnancy Outcome ◽

Early Pregnancy ◽

Pregnancy Outcomes ◽

Gestational Hypertension ◽

Characteristic Curve ◽

Overweight And Obesity ◽

Large For Gestational Age ◽

Maternal Characteristics ◽

Healthy Pregnancy ◽

Increased Risk

Women with obesity receive intensified antenatal care due to their increased risk of pregnancy complications, even though not all of these women develop complications. We developed a model based on maternal characteristics for prediction of healthy pregnancy outcomes in women with obesity or who are overweight. We assessed whether early-pregnancy metabolites improved prediction. In a population-based cohort study among a subsample of 1180 Dutch pregnant women with obesity or who are overweight, we developed a prediction model using 32 maternal socio-demographic, lifestyle, physical and pregnancy-related characteristics. We determined early-pregnancy amino acids, nonesterifed fatty acids, phospholipids and carnitines in blood serum using liquid chromatography-tandem mass spectrometry. A healthy pregnancy outcome was the absence of fetal death, gestational hypertension, preeclampsia, gestational diabetes, caesarian section, preterm birth, large-for-gestational-age at birth, macrosomia, postpartum weight retention and offspring overweight/obesity at 5 years. Maternal age, relationship status, parity, early-pregnancy body mass index, mid-pregnancy gestational weight gain, systolic blood pressure and estimated fetal weight were selected into the model using backward selection (area under the receiver operating characteristic curve: 0.65 (95% confidence interval 0.61 to 0.68)). Early-pregnancy metabolites did not improve model performance. Thus, in women with obesity or who are overweight, maternal characteristics can moderately predict a healthy pregnancy outcome. Maternal early-pregnancy metabolites have no incremental value in the prediction of a healthy pregnancy outcome.

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FIRST TRIMESTER MATERNAL BMI AND PREGNANCY OUTCOME AT DMCH, LAHERIASARAI, BIHAR

10.36106/ijsr/6930378 ◽

2020 ◽

pp. 79-81

Author(s):

Supriya Kumari ◽

Surya Narayan ◽

Kumudini Jha ◽

Debarshi Jana

Keyword(s):

Pregnancy Outcome ◽

Pregnancy Outcomes ◽

First Trimester ◽

Normal Weight ◽

Obese Women ◽

Family History Of Diabetes ◽

Medical College ◽

Asian Indian Women ◽

Adverse Pregnancy ◽

Maternal Bmi

Aim: The aim of the study was to find out relationship of maternal BMI to pregnancy outcome. Methodology: The study carried out in Department of Obstetrics and Gynaecology, Darbhanga Medical College and Hospital, Laheriasarai, Bihar from February 2019 to January 2020 and pregnancy outcomes were analyzed in relation BMI recorded in first trimester of primigravida. Results: Mean age of pregnant women was 26.2 years. At first booking obese women were significantlyolder (28.0 years) than others. Family history of diabetes was significantly higher among obese women (8.25%) compared to others. Rates of cesarean sections were higher in obese compared to others. The macrosomia rates were higher in obese compared to other group. The preeclampsia (1.89%), were significantly higher in obese women than others. Conclusions: Obese women were at a high risk of developing adverse pregnancy outcomes in terms ofgestational diabetes, macrosomia, preeclampsia more of ceasarean section. Normal weight women have low risk for cesarean section and macrosomia. These results highlight the need for preconception counseling, especially for obese and overweight and have beneficial outcomes in Asian Indian women.

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