scholarly journals Genitourinary Tuberculosis: A Rare Cause of Obstructive Uropathy in Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Emily H. Adhikari ◽  
Elaine L. Duryea ◽  
Martha W.F. Rac ◽  
Jeanne S. Sheffield
Keyword(s):  
Pregnancy Outcomes ◽  
Early Recognition ◽  
Obstructive Uropathy ◽  
Extrapulmonary Tuberculosis ◽  
Percutaneous Nephrostomy ◽  
Foreign Born ◽  
Imaging Studies ◽  
Genitourinary Tuberculosis ◽  
Prompt Treatment ◽  
In Pregnancy

Background. A rare but morbid form of extrapulmonary tuberculosis (TB), genitourinary TB is an important cause of obstructive uropathy and is likely underdiagnosed in pregnancy.Case. A 30-year-old primigravida undergoing treatment for active pulmonary TB presented with anuria at 13-14-weeks gestation. Bilateral ureteral strictures above the level of the ureterovesicular junctions were seen on imaging studies. Given her pulmonary disease, her obstructive uropathy was attributed to genitourinary TB. Bilateral percutaneous nephrostomy tubes were placed during pregnancy with successful ureteral reimplantation postpartum.Conclusion. Genitourinary TB should be considered as an etiology of urinary tract pathology during pregnancy, especially in foreign-born and immunocompromised persons. Early recognition resulting in prompt treatment can prevent further deterioration of maternal renal function and optimize pregnancy outcomes.

scholarly journals Genitourinary Tuberculosis: An Atypical Clinical Presentation

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Pei Shan Lim ◽  
Ixora Kamisan Atan ◽  
Aruku Naidu
Keyword(s):  
Clinical Presentation ◽  
Surgical Intervention ◽  
Early Recognition ◽  
Extrapulmonary Tuberculosis ◽  
Uterovaginal Prolapse ◽  
Genitourinary Tuberculosis ◽  
Immunocompromised Individual ◽  
Atypical Clinical Presentation ◽  
The Common ◽  
Complicated Situation

Genitourinary tuberculosis is one of the common forms of extrapulmonary tuberculosis. We report a case of atypical genitourinary tuberculosis: massive uterovaginal prolapse with cervical lesion mimicking cervical carcinoma. This particular case highlights the problem of healthcare in most of the developing countries. Lack of patient education, awareness, and access to a healthcare system resulted in a complicated situation. In an endemic area or in an immunocompromised individual, a higher index of suspicion would allow early recognition and treatment institution to minimise its late consequences as well as spreading of the disease. Though anti-TB is the mainstay of treatment, surgical intervention might be needed in selected cases.

scholarly journals Tuberculose Urinária: Graves Complicações Podem Ocorrer com um Diagnóstico Tardio

2015 ◽  
Vol 28 (3) ◽  
pp. 382 ◽  
Author(s):  
Inês Sanches ◽  
Cláudia Pinto ◽  
Mário Sousa ◽  
Aurora Carvalho ◽  
Raquel Duarte ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis Complex ◽  
Extrapulmonary Tuberculosis ◽  
Infectious Agent ◽  
Percutaneous Nephrostomy ◽  
Tuberculosis Complex ◽  
Ureteral Stenosis ◽  
Genitourinary Tuberculosis ◽  
Therapeutic Measures ◽  
Sterile Pyuria ◽  
Tract Infections

Genitourinary tuberculosis is the third most common form of extrapulmonary tuberculosis, comprising 4 - 17% of extrapulmonary forms. The authors describe the case of a patient with recurrent urinary tract infections, without isolation of an infectious agent and without symptomatic resolution, despite antibiotic treatment. Imaging exams showed left ureteral stenosis with moderate hydronephrosis. The attempt of retrograde catheterization was impossible so we opted for percutaneous nephrostomy to renal relief. Microbiological urine<br />analysis colleted by that way was positive for Mycobacterium tuberculosis complex. The patient started therapy with classical quadruple therapy and underwent nephrostomy for catheter placement. Despite therapeutic measures the patient required nephrectomy due to nonfunctioning kidney. Genitourinary tuberculosis is a diagnosis that should be considered in the presence of a persistent sterile pyuria.

scholarly journals Marijuana use and pregnancy outcomes among women with hypertension in pregnancy

2020 ◽  
pp. 1-8
Author(s):  
Karen S. Greiner ◽  
Jamie O. Lo ◽  
Rosa J. Speranza ◽  
Mónica Rincón ◽  
Richard M. Burwick
Keyword(s):  
Pregnancy Outcomes ◽  
Marijuana Use ◽  
Hypertension In Pregnancy ◽  
In Pregnancy

scholarly journals Percutaneous nephrostomy versus retrograde ureteral stenting for acute upper obstructive uropathy: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ismail Zul Khairul Azwadi ◽  
Mohd Noor Norhayati ◽  
Mohd Shafie Abdullah
Keyword(s):  
Quality Of Life ◽  
Clinical Trials ◽  
Obstructive Uropathy ◽  
Meta Analysis ◽  
Percutaneous Nephrostomy ◽  
Procedural Pain ◽  
Controlled Trials ◽  
Failure Rates ◽  
Ureteral Stenting

AbstractAcute obstructive uropathy is associated with significant morbidity among patients with any condition that leads to urinary tract obstruction. Immediate urinary diversion is necessary to prevent further damage to the kidneys. In many centres, the two main treatment options include percutaneous nephrostomy (PCN) and retrograde ureteral stenting (RUS). The purpose of this study if to compare the efficacy and safety of PCN and RUS for the treatment of acute obstructive uropathy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL, EMBASE, the World Health Organisation International Clinical Trials Registry Platform and ClinicalTrials.gov. We also searched the reference lists of included studies to identify any additional trials. We included randomised controlled trials and controlled clinical trials comparing the outcomes of clinical improvement (septic parameters), hospitalisation duration, quality of life, urinary-related symptoms, failure rates, post-procedural pain [measured using a visual analogue scale (VAS)] and analgesics use. We conducted statistical analyses using random effects models and expressed the results as risk ratio (RR) and risk difference (RD) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with 95% confidence intervals (CIs). Seven trials were identified that included 667 patients. Meta-analysis of the data revealed no difference in the two methods in improvement of septic parameters, quality of life, failure rates, post-procedural pain (VAS), or analgesics use. Patients receiving PCN had lower rates of haematuria and dysuria post-operatively and longer hospitalisation duration than those receiving RUS. PCN and RUS are effective for the decompression of an obstructed urinary system, with no significant difference in most outcomes. However, PCN is preferable to RUS because of its reduced impact on the patient’s post-operative quality of life due to haematuria and dysuria, although it is associated with slightly longer hospitalisation duration.

Comparison of pregnancy outcomes after second trimester amniocentesis between procedures performed by experts and non-experts

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tanapak Wisetmongkolchai ◽  
Fuanglada Tongprasert ◽  
Kasemsri Srisupundit ◽  
Suchaya Luewan ◽  
Kuntharee Traisrisilp ◽  
...  
Keyword(s):  
Pregnancy Outcomes ◽  
Loss Rate ◽  
Fetal Loss ◽  
Adverse Pregnancy Outcomes ◽  
Expert Group ◽  
Second Trimester ◽  
Single Institution ◽  
Adverse Pregnancy ◽  
In Pregnancy ◽  
Singleton Pregnancies

AbstractObjectivesTo compare the rate of fetal loss in pregnancy after second trimester amniocentesis between procedures performed by experts and non-experts and to assess other pregnancy complications as secondary outcomes.MethodsA retrospective cohort study was performed on singleton pregnancies that underwent mid-trimester amniocenteses in a single institution. The fetal loss rates of procedures performed by experts and non-experts were collected and analyzed. Other adverse pregnancy outcomes were also examined.ResultsIn total, 14,450 amniocenteses were performed during the study period. These included 11,357 (78.6%) procedures in the group expert operators and 3,093 (21.4%) procedures in the group non-expert operators. In the non-expert group, the fetal loss rate was slightly increased but not significantly (p=0.24).In addition, the higher number of spontaneous abortions was associated with blood-stained amniotic fluid sample (p<0.001; RR=9.28). Multiple needle insertions also increased in the non-expert group significantly. However, no difference in pregnancy outcomes was found between in single and multiple needle insertions.ConclusionsThe amniocentesis procedures performed by the non-experts was not increase the fetal loss rate. However, the other adverse pregnancy outcomes, including preterm birth, low birth weight and fetal growth restriction were significantly increased in the non-expert group.

Recognition and management of neonatal sepsis

2021 ◽  
Vol 30 (7) ◽  
pp. 410-415
Author(s):  
Luke William Crocker ◽  
Ayesha White ◽  
Paul Anthony Heaton ◽  
Débora Pascoal Horta ◽  
Siba Prosad Paul
Keyword(s):  
Neonatal Sepsis ◽  
Early Recognition ◽  
Signs And Symptoms ◽  
Evidence Based ◽  
Suspected Sepsis ◽  
Serious Illness ◽  
Prompt Treatment ◽  
Serious Infection ◽  
Common Causes ◽  
Red Flag

Neonatal sepsis results from acute bacterial or viral infection occurring in the first 28 days of life. It causes significant morbidity and mortality, although the outcome can be improved by early recognition and prompt treatment by health professionals. This article describes the most common causes of sepsis, and explains why neonates are particularly vulnerable to infection. It highlights the non-specific way in which an infant with a serious infection may present, indicating the crucial features to elicit during history taking and examination, and emphasising the ‘red-flag’ signs and symptoms that should increase suspicion of a serious illness. The authors have adapted National Institute for Health and Care Excellence guidelines to produce an evidence-based approach to the management of an infant with suspected sepsis, and describe the roles of nurses in ensuring effective treatment and best outcomes for these babies.

Acute Appendicitis in Pregnancy: Predictive Clinical Factors and Pregnancy Outcomes

2016 ◽  
Vol 34 (06) ◽  
pp. 523-528 ◽  
Author(s):  
Vincent Mellnick ◽  
Anthony Shanks ◽  
Methodius Tuuli ◽  
Anthony Odibo ◽  
George Macones ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Pregnancy Outcomes ◽  
Clinical Factors ◽  
In Pregnancy
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