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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
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
associated with thrombophilia could be more useful in the prediction for RPL than FVL and PT alone. Condition or disease Miscarriage, Recurrent Detailed Description: Recurrent pregnancy loss can affect up to 5% of women in child-bearing age and is considered one of the most common causes of female sterility. In recent years, the association between thrombophilia and pregnancy failure has been observed in a number of studies, varying according to the nature of the thrombophilia (for example (...) a higher risk of developing thromboembolism and complications in pregnancy. Another recent meta-analysis of prospective cohort studies concluded that women who were carriers of FVL had a higher risk of late pregnancy loss, at 52%, as opposed to non-carriers (OR=1.52), though the differences in absolute risk were discreet (4.2% and 3.2%, respectively). However, the analysis of these 2 single nucleotide polymorphisms (SNPs) showed low discriminative capacity and diagnostic sensitivity. This study
Hypercapnic respiratory failure during pregnancy due to polymyositis-related respiratory muscle weakness: a case report Polymyositis is a rare medical disorder complicating pregnancy. Ventilatory muscle weakness leading to respiratory failure is an uncommon manifestation of this autoimmune disease. We report a case of life-threatening hypercapnic respiratory failure due to polymyositis-related respiratory muscle weakness in a pregnant woman.A 31-year-old, African woman in her second trimester (...) of pregnancy presented to the emergency department with fever, shortness of breath and muscle weakness. Initial investigations excluded pulmonary infection, thromboembolism, and cardiac dysfunction as the underlying cause of her symptoms. She developed deterioration in her level of consciousness due to carbon dioxide narcosis requiring invasive mechanical ventilation. Further workup revealed markedly elevated serum creatine kinase, abnormal electromyography and edema of her thigh muscles on magnetic
Autoimmune hepatitis and pregnancy: report of two cases with different maternal outcomes Women of childbearing age with autoimmune hepatitis (AIH) are now able to get pregnant. The progress of the disease during pregnancy is not well clarified yet. The first pregnant woman had cirrhosis secondary to AIH, and she delivered by cesarean section. The patient had severe thrombocytopenia at the time of hospitalization. Unfortunately, she died due to massive thromboembolism at the 24th hour after (...) delivery. The other patient had three recurrent abortions with a diagnosis of AIH. Low-dose low molecular weight heparin and low-dose acetylsalicylic acid along with low-dose prednisolone were administered during the course of the following pregnancies. The following pregnancies ended up with a living child. There is a high morbidity and mortality risk for both fetus and mother. Hepatic performance of the patients, thrombotic events, inflammatory disorders and autoimmune system activation must
, MSK shoulder disease, peripheral neuropathies, MS, ETOH abuse, diabetes, and many others! Management depends on the severity and type: Nerve compression only = physio, shoulder rehab, then maybe surgery Arterial compression is a BIG deal: Risk for thrombosis, thromboembolism, acute ischemia, rupture, etc. Acute thrombosis = see the first few questions above. 17) List four anatomic abnormalities associated with thoracic outlet syndrome. See Rosen’s Fig 87-3. Think muscle, ligament, and bone (...) CRACKCast E087 – Peripheral Arteriovascular Disease CRACKCast E087 - Peripheral Arteriovascular Disease - CanadiEM CRACKCast E087 – Peripheral Arteriovascular Disease In , , by Chris Lipp June 26, 2017 This episode of CRACKCast covers Rosen’s Chapter 87, Peripheral Arteriovascular Disease. This episode covers the diagnosis and management of acute and chronic arterial insufficiency, differentiating between thrombotic and embolic insufficiency, as well as aneurysms, AV fistulae, and thoracic
, Yao X, Shah ND, Gersh BJ? Comparative effective- ness and safety of non-vitamin K antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and valvular heart disease? Int J Cardiol? 2016;209:181–3? 36? Avezum A, Lopes RD, Schulte PJ, et al? Apixaban in comparison with warfarin in patients with atrial fibrillation and valvular heart disease: findings from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial (...) 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines CLINICAL STATEMENTS AND GUIDELINES Circulation. 2017;135:e1159–e1195. DOI: 10.1161/CIR.0000000000000503 June 20/27, 2017 e1159 WRITING GROUP MEMBERS* Rick A. Nishimura, MD, MACC, FAHA, Co-Chair Catherine M. Otto, MD, FACC, FAHA, Co-Chair Robert O. Bonow, MD, MACC
‘valvular AF’ and refer simply to ‘AF related to hemodynamically significant mitral stenosis or prosthetic mechanical heart valves’. AF clearly leads to an incremental risk for thromboembolism in patients with mitral valve stenosis, but there are limited data for other valvular diseases. Another proposal is to use the acronym MARM-AF as a simple acronym to designate ‘Mechanical and Rheumatic Mitral AF’ as an alternative to term ‘valvular AF’ to designate the clinical scenarios for which at the non (...) valves 3.5 High Lillehei-Kaster, Omniscience, Starr-Edwards, Bjork-Shiley and other tilting-disc valves 4.0 * Risk factors: previous thromboembolism; AF; mitral stenosis of any degree; left ventricular ejection fraction < 35%. Reproduced from reference. The duration of antithrombotic therapy also varies according to a number of factors. Lifelong anticoagulant treatment is indicated for all patients with mechanical valves and those with bioprosthetic valves or native valve disease with ≥1 additional
Pulmonary hypertensive vascular changes in lungs of patients with sudden unexpected death. Emphasis on congenital heart disease, Eisenmenger syndrome, postoperative deaths and death during pregnancy and postpartum. Pulmonary hypertension (PH) in asymptomatic patients is a rare cause of sudden death. This study aims to determine the incidence of this entity and raise awareness among pathologists.We retrospectively investigated 44 cases of sudden unexpected death in relation to PH in patients (...) heart disease. The cause of PH was recognised as congenital heart disease in 27 patients (61.36%), 14 of whom had simple congenital heart disease, such as atrial or ventricular septal defect,and 13 had complex congenital heart disease with associated atrial septal defect or ventricular septal defect. The remaining 17 patients (29.55%) suffered from primary PH due to plexiform arteriopathy, veno-occlusive disease and thromboembolicdisease. Extensive sampling of the lungs is required to detect