scholarly journals Maternal Complication of Pregnancy

2020 ◽  
Author(s):  
Author(s):  
Smritee Virmani ◽  
Pushpa Kaul

Caesarean scar ectopic involves an abnormal implantation of the embryo within the myometrium of previous caesarean scar. It is a rare and serious entity involving maternal complication like abnormal placentation, hemorrhage or death due to uterine rupture. Authors present a case report of 32 years old female diagnosed as a case of caesarean scar ectopic pregnancy on TVS and MRI and managed conservatively by USG guided D and C.


2020 ◽  
Vol 11 (2) ◽  
pp. 52-57
Author(s):  
Siska Nawang Ayunda Maqfiro ◽  
Irmasanti Fajrin

Premature birth is one of the most important factors in neonatal morbidity and mortality. Based on the survey shows an increase in the incidence of premature birth at dr. H. Chasan Boesoirie hospital in 2015-2017. The purpose of this study was to determine the relationship between the history of maternal complication and the incidence of premature birth at dr. H. Chasan Boesoirie hospital used an analytic correlation research design with a cross-sectional approach. The population is all multiparity and grand multiparity at dr. H. Chasan Boesoirie hospital on January-December 2018, the sampling technique used simple random sampling, with the total sample are 196 respondents. The results show that 66,3% do not have the history of maternal complication and 85,7% do not have an incidence of premature birth. Then, that were analyzed using Spearman-rank. The results show that p-value is 0,001 (p-value<α). The conclusion that there is a relationship between the history of maternal complication and the incidence of premature birth at dr. H. Chasan Boesoirie hospital. So, it is necessary to provide information and education to pregnant women in order to plan their pregnancy well and build a referral system with primary care facilities.


1994 ◽  
Vol 5 (5) ◽  
pp. 1178-1185
Author(s):  
A B Chapman ◽  
A M Johnson ◽  
P A Gabow

The effect of pregnancy on renal disease has not been defined in autosomal dominant polycystic kidney disease (ADPKD). Therefore, fetal and maternal complication rates in ADPKD women as compared with those in unaffected family members (NADPKD) were assessed. Two hundred thirty-five ADPKD and 108 NADPKD women with 605 and 244 pregnancies, respectively, were studied. Overall, fetal complication rates were similar between ADPKD and NADPKD women (32.6 versus 26.2%). Fetal complications were more common in ADPKD women when they were older than 30 yr. Increased fetal prematurity rates were found in preeclamptic ADPKD women as compared with normotensive ADPKD women (28 versus 10%; P < 0.01). More maternal complications occurred in ADPKD as compared with NADPKD women (35 versus 19%; P < 0.001), with preexisting hypertension being the most important risk factor for a maternal complication to occur. Normotensive ADPKD women who developed preeclampsia were more likely to develop chronic hypertension as compared with those without preeclampsia (89 versus 58%; P < 0.01). Hypertensive ADPKD women with four or more pregnancies had lower creatinine clearances than age-adjusted hypertensive ADPKD women with fewer than four pregnancies (49 +/- 5 versus 66 +/- 3 mL/min per 1.73 m2; P < 0.01). Therefore, normotensive ADPKD women usually have successful, uncomplicated pregnancies. However, hypertensive ADPKD women are at high risk for fetal and maternal complications and measures should be taken to prevent the development of preeclampsia in these women.


Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4222-4222
Author(s):  
Valeria Coluccio ◽  
Roberto Marasca ◽  
Rita Santachiara ◽  
Giovanna Leonardi ◽  
Alessandro Ghiddi ◽  
...  

Abstract Abstract 4222 Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon acquired disorder, consequence of a clonal expansion of haematopoietic stem cells that have acquired a somatic mutation of PIGA gene and is characterized by intravascular haemolysis, susceptibility to infections and arterial and venous thromobophilia. PNH frequently arises in association with disorders of bone marrow failure, particularly aplastic anaemia. Venous thrombo-embolism (VTE) is a major cause of morbidity and mortality in accounting for about 1/3 of all death. Pathogenesis of VTE is multifactorial but may be related to the ongoing haemolysis and the increased platelets activation by release of ADP and consumption of nitric oxide. Thromboembolic risk is known to be related to the clone size being higher in patients with PNH granulocytes > 50%, and probably to the ongoing haemolysis. PNH often affects the middle aged adults, of reproductive age, but women with PNH have to be generally discouraged from becoming pregnant because of the increased risk of complication both for the mother and the foetus. Twenty-six published clinical reports describe pregnancy outcome in 43 women with PNH: in the majority of cases no prophylactic anticoagulant therapy was administrated. Major maternal complication (mainly thromboembolic events) are reported in 16,3% of cases during pregnancy and in 30.2% of cases during puerperium. Five patients died as a consequence of thromboembolic events (n=3) and infections (n=2). The pregnancy terms with a pre-term delivery in 38% of cases, usually as a consequence of maternal complication: no foetal abnormalities were reported. Anticoagulation with low molecular weight heparin (LMWH) is generally recommended during pregnancy and puerperium, however, it provide only partial protection from thrombotic complications. Eculizumab is a humanized monoclonal antibody directed against the C5 complement protein, with inhibition of complement-mediated cell lysis. This drug is effective in controlling intravascular haemolysis, stabilizes haemoglobin levels, reduces transfusion requirements and thrombotic events and improves quality of life of PNH patients. It is composed by a hybrid IgG2-IgG4 constant fraction portion without antibody effector mechanism, moreover IgG2 isotypes do not cross placenta but few and partial experiences have been reported about its effects during pregnancy. We report the case of a 35-year old woman with a diagnosis of PNH establish in 2003 evolved from aplastic anaemia (1995). She needed about one unit of packed red blood cells monthly. She started eculizumab treatment at standard dosage (900 mg every other week) in April 2005 obtaining a rapid normalization of haemoglobin and LDH levels. She hadn't further haemolytic events and she never presented vascular complications. The patient became pregnant in October 2008: flow-cytometry analysis demonstrated that 35% of neutrophils and monocytes had loss of CD55 and CD59. Although the patient had a relatively small PNH clone and she hadn't previous thrombotic event, we decided to continue eculizumab during pregnancy in order to avoid haemolysis and the consequent VTE risk. Moreover, we started a prophylactic anticoagulant therapy with LMWH and anti-platelet therapy with acetylsalicylic acid at 16 weeks of gestation. During the entire pregnancy the patient never required transfusional support and the minimal haemoglobin dosage was 9 g/dl. Anti-platelet therapy was stopped at 36 weeks of gestation. At 38th weeks of gestation the patient delivered vaginally a child male, 3430 g, with Apgar score of 9 and 10. Both the mother and the newborn didn't experience any complication in particular the mother didn't need transfusional support and haemoglobin level maintained stable in spite of a mild LDH increase. Eculizumab treatment was continued also in the puerperium. In absence of data about the possible presence of eculizumab in breast milk and its possible effect on the newborn, we decided to avoid breast-feeding. At this time, after 2 months from the childbirth, both the mother and the newborn haven't medical complication. This is the first report of a pregnancy carried out during eculizumab treatment without significant toxicity for both the mother and the baby. The role of eculizumab in pregnancy and puerperium has to be further investigate in order to reduce the disease related maternal and foetal risk. Disclosures: No relevant conflicts of interest to declare.


2010 ◽  
Vol 22 (2) ◽  
pp. 459 ◽  
Author(s):  
Natalee W. Bessette ◽  
Dan W. Rurak

The objective was to compare gestation length in chronically instrumented (laboratory) pregnant sheep (n = 131) and in the breeding flock (n = 476) that provided the experimental sheep. In the breeding flock, gestation length was normally distributed and varied between 141 and 151 days (mean = 147 ± 0.1 days). In the laboratory sheep, gestation length varied between 128 and 151 days (mean = 142 ± 1 day), and was bimodal, with 35.9% delivering preterm (<141 days). To examine potential factors that contributed to the preterm birth, a severity score was used, which comprised surgery characteristics, number of experiments and maternal or fetal complications. There was a significant inverse linear relationship (P < 0.001) between the total severity score and gestation length. The median values for the surgical (15 v. 12), overall complication (6 v. 2), maternal complication (2 v. 0) and fetal complication (2 v. 2) components were significantly greater in the preterm compared with the term groups. There was no relationship between fetal number and gestation length in either group. It is concluded that in chronic pregnant sheep preparations, there is a significant incidence of preterm birth and that this is associated with the severity of the surgical intervention and with several maternal and fetal complications.


2020 ◽  
Vol 17 (4) ◽  
pp. 495-500
Author(s):  
Amarnath Thakur ◽  
Ganesh Dangal

Background: A hypertensive disorder in pregnancy comprises one of the deadly triad along with hemorrhage and infection-that contributes greatly to maternal morbidity and mortality. The aim of this study was to compare the feto-maternal outcome in pregnancy induced hypertension with normotensive pregnant women.Methods: A cross sectional prospective study was conducted in Paropakar Maternity and Women’s Hospital from 1st February 2018 to 1st May 2018. All pregnant women seeking help for hypertension during this period was included in the study and were followed up to six weeks of postpartum period.Results: Total 40 patients were enrolled in each arm. The highest number of pregnancy induced hypertension cases was seen in age group 20-24years (32.5%) and were mostly primigravidas (60%). The commonest symptom in Pregnancy induced hypertension was headache 47.5 %. The mean hemoglobin value was 11.91 gm/dl, mean SGPT (Gestational hypertension 25.44 IU/L, preeclampsia 55.25 IU/L and eclampsia 32.17 IU/L) and mean platelet count was 1, 95,140 lakh/cumm in pregnancy induced hypertension. Mean prothrombin time in gestational hypertension was 13.78±0.7 seconds. Most common maternal complication was preterm labor and fetal complication was prematurity. The most common mode of delivery was vaginal.Conclusions: Pregnancy induced hypertension was more common in primigravida with young age group of 20-24 years and presented commonly with complain of headache. Preterm labor was the most common maternal complication similarly prematurity was the commonest fetal complication seen in pregnancy induced hypertension. Vaginal delivery was the commonest mode of delivery. Blood investigation showed significant thrombocytopenia in eclampsia and decreased prothrombin time in gestational hypertension.Keywords: Fetal outcome; maternal complications; pregnancy induced hypertension.


2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Razia Ashraf ◽  
Asma Gul ◽  
, Aliya Bashir ◽  
Arif Tajammal

Objective: To compare the maternal complication in elective vs emergency caesarean section. Design: Prospective study. Place and duration of study: Department of Obstetrics & Gynaecology, Lahore General Hospital, Lahore Patients and methods: The study was conducted from August 2004 to August 2005. During this period all women underwent elective or emergency caesarean section included. Results: A total of 920 caesarean sections were performed, 770 were emergency and 150 were elective. Intraoperative and postoperative complications were 76, 70 in emergency and 6 in elective group. Postoperative complications were 120, 110 in emergency and 10 in elective cases. Conclusion: In emergency caesarean section maternal mortality and morbidity is high.


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