scholarly journals Dyspnoea at Term in an Obese Mother

2011 ◽  
Vol 2011 ◽  
pp. 1-3
Author(s):  
Vicky O'Dwyer ◽  
Yvonne O'Brien ◽  
Nadine Farah ◽  
Michael J. Turner
Keyword(s):  
Differential Diagnosis ◽  
Heart Disease ◽  
Obese Woman ◽  
Peripartum Cardiomyopathy ◽  
Morbidly Obese ◽  
Shortness Of Breath ◽  
Healthy Women ◽  
Obese Mother ◽  
Life Threatening ◽  
In Pregnancy

Peripartum cardiomyopathy is a serious, potentially life-threatening heart disease of uncertain aetiology in previously healthy women. We report a morbidly obese woman who presented with peripartum shortness of breath. We discuss the differential diagnosis of dyspnoea in pregnancy and highlight the complexity of care of the morbidly obese woman.

Subglottic tracheal stenosis complicating pregnancy: A case report

2021 ◽  
pp. 1753495X2199022
Author(s):  
Edward J Miller ◽  
Emily YS Huning
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Tracheal Stenosis ◽  
Multidisciplinary Management ◽  
Shortness Of Breath ◽  
Uncommon Case ◽  
In Pregnancy

The case presented details an uncommon case of subglottic tracheal stenosis exacerbated by pregnancy. We outine the multidisciplinary management involved and the outcomes for the pregnancy. The case serves as a reminder that shortness of breath in pregnancy has a broad differential diagnosis, and stridor is always abnormal.

Obesity in pregnancy

2020 ◽  
pp. 439-454
Author(s):  
Huda Al-Foudri ◽  
Stuart Davies ◽  
Abrie Theron
Keyword(s):  
Obese Woman ◽  
Epidemiological Studies ◽  
Morbidly Obese ◽  
Antenatal Screening ◽  
Screening Criteria ◽  
Obesity In Pregnancy ◽  
Labour Ward ◽  
Manual Handling ◽  
Body Mass Index Classification ◽  
In Pregnancy

Epidemiological studies show the incidence of obesity in pregnancy to be increasing, and the management of the morbidly obese woman on labour ward can be a challenge for anaesthetists. The chapter defines obesity, body mass index, classification, and prevalence, and reviews the physiological effects of obesity on the respiratory, cardiovascular, gastrointestinal, renal, endocrine, and haematological systems, as well as pharmacokinetic changes. Both fetal and maternal morbidities are listed followed by management proposals in the antenatal, peripartum, and postpartum periods. This includes antenatal screening, criteria for anaesthetic referral for assessment and what this should include to plan for delivery. Suggestions for management during labour and during an operative delivery are made. Attention is given to the ramped position and enhanced pre-oxygenation prior to induction of general anaesthesia with CPAP and THRIVE. Practical considerations and technical challenges are discussed and include manual handling, IV access, monitoring, regional techniques, and previous bariatric surgery.

scholarly journals How I treat thrombotic thrombocytopenic purpura in pregnancy

Blood ◽  
2020 ◽  
Vol 136 (19) ◽  
pp. 2125-2132
Author(s):  
Barbara Ferrari ◽  
Flora Peyvandi
Keyword(s):  
Differential Diagnosis ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Current Knowledge ◽  
Fetal Outcome ◽  
Subsequent Pregnancy ◽  
Thrombocytopenic Purpura ◽  
Severe Deficiency ◽  
Life Threatening ◽  
High Index Of Suspicion ◽  
In Pregnancy

Abstract Thrombotic thrombocytopenic purpura (TTP) is an acute, life-threatening thrombotic microangiopathy (TMA) caused by acquired or congenital severe deficiency of ADAMTS13. Pregnancy is a recognized risk factor for precipitating acute (first or recurrent) episodes of TTP. Differential diagnosis with other TMAs is particularly difficult when the first TTP event occurs during pregnancy; a high index of suspicion and prompt recognition of TTP are essential for achieving a good maternal and fetal outcome. An accurate distinction between congenital and acquired cases of pregnancy-related TTP is mandatory for safe subsequent pregnancy planning. In this article, we summarize the current knowledge on pregnancy-associated TTP and describe how we manage TTP during pregnancy in our clinical practice.

scholarly journals Peripartum Cardiomyopathy (PPCM): How to Diagnose and Deal with?

2021 ◽  
Vol 2 (1) ◽  
pp. 46-49
Author(s):  
Monika Sitio ◽  
Cholid Tri Tjahjono ◽  
Heny Martini ◽  
Novi Kurnianingsih
Keyword(s):  
Heart Failure ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Morbidity And Mortality ◽  
Shortness Of Breath ◽  
History Taking ◽  
Aldosterone Antagonist ◽  
Threatening Condition ◽  
Life Threatening

Peripartum cardiomyopathy (PPCM) is a diagnosis of exclusion, where patients present with heart failure (HF) secondary to left ventricular (LV) systolic dysfunction without any other cause of HF identified in the last month of pregnancy or within first five months after delivery, abortion, or miscarriage. PPCM is a life-threatening condition which frequently under diagnosed and inadequately treated, whereas the morbidity and mortality rate ranges between 7% and 50%. Early diagnosis is important to decrease morbidity and mortality. Therefore, it is necessary to report the case related to this condition. A 34-year-old woman was referred to RSSA with worsening shortness of breath (SOB). She has given birth about 2.5 months prior to admission. History taking and supporting findings form this case were supported to diagnosis of PPCM. She was treated with diuretic, aldosterone antagonist, ACE-I, beta blocker, anticoagulant, and bromocriptine. The symptoms were improved in the following days. She was discharged with better condition and educated to comply with medication.

scholarly journals Peripartum Cardiomyopathy: a Life Threatening Obstetric Emergency

2019 ◽  
Vol 13 (2) ◽  
pp. 93-96
Author(s):  
Dilruba Zeba ◽  
Mrinmoy Biswas ◽  
Rajib Biswas
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Angiotensin Receptor Blockers ◽  
Multiple Pregnancy ◽  
Systolic Heart Failure ◽  
Severe Heart Failure ◽  
Clinical Manifestations ◽  
Peripartum Cardiomyopathy ◽  
Presenting Symptoms ◽  
Life Threatening

Peripartum cardiomyopathy (PPCM) is a rare, life-threatening heart disease of unclear origin and is characterized by heart failure of sudden onset between the final weeks of pregnancy and 5 months after delivery. Incidence varies over geography and ethnicity. Risk factors include advanced maternal age, multiparity, preeclampsia, multiple pregnancy, anaemia, and so many other causes. PPCM is often not diagnosed until late in its course, because of its clinical manifestations are highly variable and a heart disease may not be suspected at first. Frequent presenting symptoms of PPCM, such as lassitude, shortness of breath on mild exertion and coughing are often initially misinterpreted as evidence of pneumonia or as physiological accompaniments of pregnancy and delivery. The clinical picture of PPCM corresponds to a dilated cardiomyopathy (DCM) with signs of severe heart failure. Medical management is similar to other causes of systolic heart failure, except for the ACE inhibitors and angiotensin receptor blockers are avoided in pregnancy. As there are lots of physiological changes during pregnancy and immediately after delivery, it is usually difficult to measure PPCM effectively. Complications include cardiac arrhythmia, thromboembolism, and refractory heart failure. Maternal deaths are not uncommon. Recently the role of abnormal prolactin metabolism and resulting myocardial toxicity have been explored and bromocriptine has shown promise as a potential treatment option. Faridpur Med. Coll. J. Jul 2018;13(2): 93-96

scholarly journals Peripartum Cardiomyopathy: The Hidden Enemy

2021 ◽  
Author(s):  
Fatima Zahra Merzouk ◽  
Sara Oualim ◽  
Mohammed Sabry
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Lv Function ◽  
Close Monitoring ◽  
Mortality And Morbidity ◽  
Life Threatening ◽  
History Of ◽  
The Brain ◽  
In Pregnancy

Peripartum cardiomyopathy (PPCM) is the most common cardiomyopathy in pregnancy. It is potentially life-threatening. It is, diagnosed in women without a history of heart disease 1 month before delivery or within 5 months. It is marked by heart failure and left ventricular dyshfunction. The evolution is favorable. LV function improves within 6 months in the majority of patients, but long-lasting mortality and morbidity are not infrequent. Recent work suggests the critical toxic role for late-gestational hormones on the maternal vasculature and the genetic underpinnings of PPCM. Complications include different types of supraventricular and ventricular arrhythmias, heart failure and ischemic stroke. The brain natriuretic peptide (BNP) can be used to risk stratify women for adverse events. Management of peripartum cardiomyopathy is based on treatment of heart failure. The addition of bromocriptine seemed to improve LVEF. Close monitoring of pregnant women with cardiomyopathy by multidisciplinary team is recommended.

scholarly journals Case series of COVID-19 infection in pregnancy complicated by ketoacidosis and symptomatic breathlessness

2021 ◽  
pp. 1753495X2110245
Author(s):  
Iona Thorne ◽  
Samantha Steele ◽  
Marcus Martineau ◽  
Joanna Girling
Keyword(s):  
Differential Diagnosis ◽  
Metabolic Acidosis ◽  
Pregnant Woman ◽  
Pregnant Women ◽  
Specific Treatment ◽  
Case Series ◽  
Metabolic Abnormalities ◽  
Shortness Of Breath ◽  
Blood Gas ◽  
In Pregnancy

Background The differential diagnosis of acute shortness of breath in a pregnant woman with COVID-19 is broad. Pregnancy is a ketosis-prone state, which can result in metabolic acidosis and tachypnoea. Methods We describe four pregnant women with COVID-19 and breathlessness where ketoacidosis was found to contribute to symptomatic tachypnoea. Results One patient did not have associated COVID-19 pneumonitis, but presented with severe tachypnoea and metabolic acidosis; three women had pneumonitis and metabolic acidosis. Corrective treatment for the metabolic abnormalities resulted in resolution of the ketoacidosis in all cases. No women had coexistent diabetes. Conclusion This is the first series of COVID-19 in pregnancy complicated by ketoacidosis and symptomatic tachypnoea. Ketoacidosis associated with COVID-19 is an important cause of tachypnoea requiring specific treatment, which should not be overlooked. Potential mechanisms for this are discussed with a framework for interpretation of blood gas results during pregnancy.

A case of peripartum cardiomyopathy associated with an atypical presentation of preeclampsia

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Amit Verma ◽  
Shanthi Pinto
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ventricular Dysfunction ◽  
Early Recognition ◽  
Good Prognosis ◽  
Peripartum Cardiomyopathy ◽  
Medical Professionals ◽  
Atypical Presentation ◽  
Life Threatening ◽  
High Index Of Suspicion

AbstractPeripartum cardiomyopathy is idiopathic heart failure occurring in the last month of pregnancy or during the first 5 months postpartum in the absence of determinable heart disease prior to the last month of pregnancy. We aim to raise awareness for this rare and potentially life-threatening disorder amongst all medical professionals involved in the care for pregnant women. A high index of suspicion is required for its diagnosis. Early recognition and treatment in a multidisciplinary team is vital for good prognosis, which depends on reversal of ventricular dysfunction.

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