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and microangiopathic diseases. Because of the high associated mortality rate, prompt recognition and treatment are paramount.A twenty-five-year-old G3P0111 with a history of multiple thromboembolisms presented at 21 weeks and 3 days of gestation with complaints of right upper quadrant pain, visual disturbances, headache, and syncopal episodes. Laboratory evaluation demonstrated microangiopathic disease with hemolysis (confirmed on peripheral smear), elevated liver enzymes, and abnormal 24-hour urine protein (...) Clinical Report of Probable Catastrophic Antiphospholipid Syndrome in Pregnancy Catastrophic APS (CAPS) is a rare but life-threatening form of APS defined as multiorgan thrombosis affecting a minimum of three organs with confirmation by histopathology of small vessel occlusions in at least one organ or tissue. The development of CAPS in pregnancy poses many diagnostic challenges as a result of its broad range of clinical presentations and its overlap with other obstetric complications
Description Go to Brief Summary: Tranexamic acid has been proposed and used for prevention and management of antepartum and postpartum hemorrhage. Condition or disease Intervention/treatment Phase Vaginal Bleeding During Pregnancy Drug: Tranexamic Acid Not Applicable Detailed Description: Bleeding during pregnancy is associated with a three- to fourfold increase in perinatal mortality. Hemorrhage in pregnancy is characterized by activation of the fibrinolytic system. Tranexamic acid is a potent (...) pharmaceutical agent that suppresses fibrinolysis, and thus can be used for managing hemorrhage in pregnancy. The FDA's pregnancy category for tranexamic acid is Category B. It crosses the placenta however; its lack of effect on plasminogen activator activity in the vascular cell wall protects the fetus and newborn from potential thromboembolic complications. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 79 participants Intervention
airway pressure (CPAP) in pregnancy will result in a reduction in the rate of hypertensive disorders of pregnancy. Condition or disease Intervention/treatment Phase Obstructive Sleep Apnea of Adult Preeclampsia Obstetrical Complications Device: Continuous Positive Airway Pressure Other: Sleep Hygiene Control Not Applicable Detailed Description: Emerging data support a link between sleep disordered breathing (SDB) and adverse pregnancy outcomes. In particular, women with obstructive sleep apnea (OSA (...) such as: Active liver disease (acute hepatitis, chronic active hepatitis, persistently abnormal liver enzymes) Thrombocytopenia with platelet count <100,000 because of the difficulty in assessing the primary outcome. Active vaginal bleeding (more than spotting) at the time of randomization. Known chromosomal, genetic, major malformations or fetal demise, or planned termination of pregnancy because inclusion would compromise evaluation of secondary neonatal outcomes. Known major uterine malformations
reactions of rhTPO in the treatment of pregnancy-induced thrombocytopenia. Condition or disease Intervention/treatment Phase Immune Thrombocytopenia Drug: recombinant human thrombopoietin Drug: Platelet Concentrate Phase 3 Detailed Description: The project is undertaken by Qilu Hospital of Shandong University and other 6 well-known hospitals in China. The investigators anticipate to undertaking a concurrent control, multicentre trial including 60 pregnancy associated ITP adult patients which (...) of the serum urea nitrogen, creatinine, serum transaminase and bilirubin ); No severe cardiac and pulmonary dysfunction; No history of mental illness; Voluntarily signed written informed consent. Exclusion Criteria: A history of serious allergies to biologics; The history of thrombosis; Thromboembolic or hemorrhagic disease; Patients who are deemed unsuitable for the study by the investigator. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you
and/or other autoimmune diseases are well known history-based predictive factors for obstetrical complications, such as miscarriage, maternal venous thromboembolism, intrauterine foetal demise, preeclampsia, and neonatal death. Moreover, laboratory findings associated with poor pregnancy outcome are:triple antiphospholipid antibodies aPL positivity, double aPL positivity, single aPL positivity, false-positive IgM for CMV, and hypocomplementemia. Triple positivity is confirmed as the most significant risk (...) Antiphospholipid syndrome: An update on risk factors for pregnancy outcome. The optimal treatment of women with primary antiphospholipid syndrome (APS) is still debated. About 20-30% of women with APS remain unable to give birth to healthy neonates despite conventional treatment, consisting of prophylactic-dose heparin and low-dose aspirin. These cases are defined "refractory obstetric APS". The early identification of risk factors associated with poor pregnancy outcome could be the optimal
· deep vein thrombosis and pulmonary thromboembolism · dural venous sinus thrombosis and brain haemorrhage · aplastic marrow crisis from parvovirus B19 infection (in children and less commonly in adults). Common pathologies that are less often the direct cause of death: · left ventricular hypertrophy 16 · bone marrow necrosis from painful bony sickle crisis. CEff 050417 7 V4 Final Less common pathologies and scenarios: · posterior reversible encephalopathy syndrome (PRES) 17 · ischaemic heart disease (...) 16 · pregnancy-related with multi-organ failure and ACS, and sepsis · hyperhaemolysis (post-transfusion) syndrome in adults 18 · multi-organ haemosiderosis related to therapeutic/prophylactic blood transfusions; this mainly affects heart, liver, kidney and pancreas · biliary stone diseases: obstructive jaundice, cholecystitis and pancreatitis · overdose of opiate pain-killers: morphine/heroin, pethidine (which also causes seizures), fentanyl patches 19 · gut ulceration and perforation from NSAID
concerning pulmonary embolism (PE). The aim is to estimate and compare the risk of both PE and VTE during the the different phases of pregnancy after IVF to that in age and period matched control women. The investigators will use the Swedish National Health Registers to estimate the risk. Condition or disease Pulmonary Embolism Venous Thromboembolism Detailed Description: Background: Occurrence of venous thromboembolism (VTE) during IVF pregnancies has been reported in numerous case reports and in two (...) Posted: February 2, 2012 Last Verified: January 2012 Keywords provided by Professor Peter Henriksson, Danderyd Hospital: Assisted Reproductive Techniques Pregnancy Pulmonary Embolism Venous Thromboembolism Additional relevant MeSH terms: Layout table for MeSH terms Thromboembolism Embolism Venous Thromboembolism Pulmonary Embolism Embolism and Thrombosis Vascular Diseases Cardiovascular Diseases Lung Diseases Respiratory Tract Diseases
with progesterone, or placebo and then followed them for an average of 5.6 years. The estrogen plus progestin arm was prematurely terminated (after 5.2 years of follow-up), and at the time of study discontinuation, there was an increased risk of CHD with HRT (HR, 1.29; nominal 95% CI, 1.02–1.63). These data confirm that postmenopausal HRT is associated with both breast cancer and CVD (stroke, thromboembolic events, CHD), and this is a potentially modifiable risk factor for both diseases. , , Genetics Clinical (...) , reduced risk) or negative (red upward arrow, increased risk) on developing CVD or breast cancer. , CVD indicates cardiovascular disease. Cardiovascular Effects of Cancer Therapy Cancer treatment can result in early or delayed cardiotoxicity that can vary from LV dysfunction to overt HF, hypertension, arrhythmias, myocardial ischemia, valvular disease, thromboembolicdisease, pulmonary hypertension, and pericarditis. The most commonly reported and monitored side effect of chemotherapy is LV systolic
are unsure about the safety of a medication during pregnancy, contact the on 0344 892 0909 for a patient-specific risk assessment. Assess and document the risk factors for venous thromboembolism including: History of thromboembolism. Thrombophilia (such as Factor V Leiden deficiency, Antiphospholipid syndrome, Prothrombin 20210, Protein C, protein S or antithrombin deficiencies). Other medical conditions (such as heart disease, sickle cell disease, systemic lupus erythematosus, obesity, anaemia, diabetes (...) ). Seven appointments are sufficient for a parous woman (having borne at least one viable offspring — usually after 24 weeks). Two ultrasound scans are usually offered during the course of an uncomplicated pregnancy: A dating scan (10–13 weeks). A fetal anomaly scan (18–20 weeks). Women with an uncomplicated pregnancy are usually offered screening for: Gestational diabetes. Hypertension in pregnancy and pre-eclampsia. Anaemia. Down's syndrome. Haemoglobinopathies (sickle cell disease and thalassaemia
, there is an association between an increased risk of ischemic stroke in pregnancy (OR range 7.9 to 30.7), particularly with active migraine. There is also an association between migraine and increased risk of acute myocardial infarction and heart disease (OR 4.9; 95% CI 1.7, 14.2), and thromboembolic events during pregnancy (deep venous thrombosis OR 2.4; 95% CI 1.3, 4.2 and pulmonary embolus OR 3.1; 95% CI 1.7, 5.6).In this review, we summarized the association between migraine and risk of vascular disease during (...) Migraine, cardiovascular disease, and stroke during pregnancy: systematic review of the literature. The objective of this article is to review the literature relating migraine, cardiovascular disease, and stroke during pregnancy in order to better define the relationship between migraines and vascular disease.We conducted a systematic review of the literature using Medline and Cochrane Review with the following search terms: migraine AND pregnancy and vascular disease OR myocardial infarction
Pregnancy and reproductive aspects of systemic lupus erythematosus. To discuss pregnancy and reproductive aspects in women with systemic lupus erythematosus (SLE) with particular focus on preconception counselling, maternal and foetal outcomes, safety and beneficial effects of drugs during pregnancy as well as contraception methods, assisted reproduction techniques and strategies for thromboembolism prophylaxis in patients with positive antiphospholipid antibodies.Evidence-based recommendations (...) and risk stratification (based on disease activity and serological profile) are key points for having successful pregnancies thanks to individualized treatments and close monitoring for maternal and foetal complications. Contraception and assisted reproduction techniques are feasible in women with SLE, provided that potential risks are minimized by individualized management and appropriate prophylaxis.
Obstetrical history of women with cerebral vein thrombosis: outcome of the pregnancies before and after the thrombotic event. Cerebral vein thrombosis (CVT) is a rare disease usually affecting young people, especially women, with a high prevalence of thrombophilic defects. It is known that thrombophilia is associated with pregnancy complications; therefore, a high rate of complications could be expected in women with the previous CVT who become pregnant. This study examined the whole obstetric (...) at prophylactic dosage during pregnancy. No recurrent CVT, venous thromboembolic events, or death was recorded during the observed pregnancies. Ten miscarriages were recorded (rate 8.1%), with a rate similar to that expected in the general population. We confirm the favorable outcome of pregnancies in women who suffered from CVT during their entire lifespan, whether they have occurred before and after or in relation to CVT.
their obstetric history. Reference data on pregnancy outcomes and complications of non-diseased women were collected from population-based cohorts from the literature.Prevalence of complications, specifically venous thromboembolism and postpartum haemorrhage.Sixty women completed the survey. Seventeen patients did not conceive, of whom three refrained from pregnancy because of KTS. A total of 97 pregnancies and 86 deliveries were reported in 43 patients. KTS-related symptoms were aggravated during pregnancy (...) Complications of pregnancy and labor in women with Klippel-Trenaunay syndrome: a nationwide cross-sectional study. To evaluate complications of pregnancy, including thromboembolism, in women with extensive vascular malformations associated with Klippel-Trénaunay syndrome (KTS).Nationwide cross-sectional study.Two tertiary expert centres and the Dutch Klippel-Trénaunay patient organisation.Adult women with KTS.Patients with KTS were invited to participate in a comprehensive online survey about
of hypertensive disorders in pregnancy). Condition or diseasePregnancy, Physical Activity Detailed Description: Pregnancy is a natural state of low grade inflammation in the mother and the feto-placental unit. The severity of this inflammation increases with higher pregravid Body Mass Index (BMI). This is reflected by an increase in pro-inflammatory cytokines in the maternal circulation and in the placenta. It has been proposed that the pro-inflammatory maternal and fetal environment plays a role (...) of women who are not physically active, and Group3 consists of women with a risk of hypertensive disorders or metabolic diseases (not diabetes). PA before and in early pregnancy will be assessed with a screening questionnaire. Women reporting a minimum of 150 mins of moderate to vigorous PA per week will be classified as active, women with less PA will be classified as inactive. 20 women each group will be recruited not later than 14 weeks of gestation. Women will be recruited at the outpatient clinic
reproductive period) . In 2012, the American Society for Reproductive Medicine Practice Committee issued a statement that defined recurrent pregnancy loss as a disease distinct from infertility defined by two or more failed consecutive pregnancies. Thrombophilia is the tendency to develop thromboses due to inherited defects in the coagulation system. Thrombophilia was identified as a major cause of recurrent pregnancy loss , Because pregnancy is a hypercoagulable state, thromboembolism is the leading cause (...) Committee issued a statement that defined recurrent pregnancy loss as a disease distinct from infertility defined by two or more failed consecutive pregnancies. Condition or disease Intervention/treatment Recurrent Pregnancy Loss Diagnostic Test: polymerase chain reaction Detailed Description: Recurrent miscarriage is a pregnancy loss before 20 weeks of gestation. The recurrent pregnancy loss usually occurring in the first trimester of gestation and its rate is quite high (15-20% even in full