Osteogenesis imperfecta(OI)is a primary bone fragility disorder with an estimated prevalence of 1/15,000 births and is a hereditary syndrome characterized by one or more of the following:fractures,blue sclerae,impaire...Osteogenesis imperfecta(OI)is a primary bone fragility disorder with an estimated prevalence of 1/15,000 births and is a hereditary syndrome characterized by one or more of the following:fractures,blue sclerae,impaired hearing,defective dentition,and hyperlaxibility throughout life.[1,2]We report a pregnant woman with type II OI and review her prenatal counseling,diagnosis,and pregnancy management to assist obstetricians in understanding the disease and managing it in emergency situations.展开更多
BACKGROUND Post-stroke epilepsy is a common and easily overlooked complication of acute cerebrovascular disease.Long-term seizures can seriously affect the prognosis and quality of life of patients.Electroencephalogra...BACKGROUND Post-stroke epilepsy is a common and easily overlooked complication of acute cerebrovascular disease.Long-term seizures can seriously affect the prognosis and quality of life of patients.Electroencephalogram(EEG)is the simplest way to diagnose epilepsy,and plays an important role in predicting seizures and guiding medication.AIM To explore the EEG characteristics of patients with post-stroke epilepsy and improve the detection rate of inter-seizure epileptiform discharges.METHODS From January 2017 to June 2020,10 patients with post-stroke epilepsy in our hospital were included.The clinical,imaging,and EEG characteristics were collected.The stroke location,seizure type,and ictal and interictal EEG manifestations of the patients with post-stroke epilepsy were then retrospectively analyzed.RESULTS In all 10 patients,epileptiform waves occurred in the side opposite to the stroke lesion during the interictal stage;these manifested as sharp wave,sharp-wave complex,or spike discharges in the anterior head lead of the side opposite to the lesion.CONCLUSION In EEG,epileptiform waves can occur in the side opposite to the stroke lesion in patients with post-stroke epilepsy.展开更多
Thrombotic thrombocytopenic purpura (TTP) is a rare but acute, life-threatening condition which may be precipitated by pregnancy. This disorder that presents with thrombocytopenia, haemolytic anemia, and clinical cons...Thrombotic thrombocytopenic purpura (TTP) is a rare but acute, life-threatening condition which may be precipitated by pregnancy. This disorder that presents with thrombocytopenia, haemolytic anemia, and clinical consequences of microvascular thrombosis such as stroke. The exact cause is not known but it is associated with a deficiency of ADAMTS13 enzymes. Immune mediated TTP is more common and can present in pregnancy. The aim of this case is to bring awareness as many clinicians are unaware of this condition in pregnancy, its diagnosis may be missed or delayed, leading to fetal loss or serious maternal implications. In this case the patient presented at 29 weeks with stroke in Emergency department, referred to delivery suit for Obstetric review, with suspicion of Pre-eclampsia/HELLP. The diagnosis of TTP was achieved by a multidisciplinary team who worked tirelessly together. The patient was transferred to a Specialist Tertiary Care Centre for further management. The pregnancy continued until 33 weeks and 5 days. She underwent an emergency caesarean section for fetal distress. Steroids and Rituximab were continued postnatally. The outcome was favourable due to fast and efficient multidisciplinary care. Awareness of this rare but important condition can lead to recognition of clinical presentation, prompt diagnosis and appropriate management.展开更多
BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a pregnancy-specific liver condition that typically arises in the middle and late stages of pregnancy.Short-chain fatty acids(SCFAs),prominent metabolites of the...BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a pregnancy-specific liver condition that typically arises in the middle and late stages of pregnancy.Short-chain fatty acids(SCFAs),prominent metabolites of the gut microbiota,have significant connections with various pregnancy complications,and some SCFAs hold potential for treating such complications.However,the metabolic profile of SCFAs in patients with ICP remains unclear.AIM To investigate the metabolic profiles and differences in SCFAs present in the maternal and cord blood of patients with ICP and determine the clinical significance of these findings.METHODS Maternal serum and cord blood samples were collected from both patients with ICP(ICP group)and normal pregnant women(NP group).Targeted metabolomics was used to assess the SCFA levels in these samples.RESULTS Significant differences in maternal SCFAs were observed between the ICP and NP groups.Most SCFAs exhibited a consistent declining trend in cord blood samples from the ICP group,mirroring the pattern seen in maternal serum.Correlation analysis revealed a positive correlation between maternal serum SCFAs and cord blood SCFAs[r(Pearson)=0.88,P=7.93e-95].In both maternal serum and cord blood,acetic and caproic acids were identified as key metabolites contributing to the differences in SCFAs between the two groups(variable importance for the projection>1).Receiver operating characteristic analysis demonstrated that multiple SCFAs in maternal blood have excellent diagnostic capabilities for ICP,with caproic acid exhibiting the highest diagnostic efficacy(area under the curve=0.97).CONCLUSION Compared with the NP group,significant alterations were observed in the SCFAs of maternal serum and cord blood in the ICP group,although they displayed distinct patterns of change.Furthermore,the SCFA levels in maternal serum and cord blood were significantly positively correlated.Notably,certain maternal serum SCFAs,specifically caproic and acetic acids,demonstrated excellent diagnostic efficiency for ICP.展开更多
Background: Fahr’s disease, also recognized as Idiopathic Basal Ganglia Calcification (IBGC) or Primary Familial Brain Calcification (PFBC), was first identified by the German neurologist Karl Theodor Fahr in 1930. T...Background: Fahr’s disease, also recognized as Idiopathic Basal Ganglia Calcification (IBGC) or Primary Familial Brain Calcification (PFBC), was first identified by the German neurologist Karl Theodor Fahr in 1930. This rare condition, which involves the calcification of the basal ganglia and presents significant treatment challenges, is most commonly diagnosed in middle-aged adults and is notably uncommon in children. Purpose: We report a case of a younger patient and review this disease as an aid to early detection and diagnosis of the disease. Case Introduction: In this report, we present a unique case of Fahr’s disease in a child, where epilepsy manifested as the initial symptom during infancy. In this report, we present a case of Fahr’s disease in a child who presented with epilepsy as the first symptom in infancy. The child had no imaging abnormalities at the onset of the seizure, and subsequent antiepileptic drugs were reduced and discontinued, and when the seizure recurred 3 years later, a perfect cranial CT revealed symmetrical calcifications in the brain, which gradually worsened, and subsequently the child was unable to take care of himself and had regression of his psychomotor development, and the family requested discharge from the hospital, and then the child died during the follow-up visit. Conclusion: The disease is currently associated with a number of disorders for which there is no specific treatment, and half of all patients currently have a well-defined gene, emphasizing more importantly the importance of genetic counseling for parents known to be at risk prior to conception.展开更多
Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level mon...Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests,the advent of continuous glucose monitoring(CGM)systems has revolutionized the approach.These devices offer a safe and reliable means of tracking glucose levels in real-time,benefiting both women with diabetes during pregnancy and the healthcare providers.Moreover,CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes,especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device.Such a combined approach has been demonstrated to improve overall blood sugar control,lessen the occurrence of preeclampsia and neonatal hypoglycaemia,and minimize the duration of neonatal intensive care unit stays.This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.展开更多
Background: Heterotopic pregnancy is a very rare event in a natural cycle. Its incidence is rising mostly due to induction of ovulation or Assisted Reproductive Technique. Most ectopic in heterotopic pregnancies are l...Background: Heterotopic pregnancy is a very rare event in a natural cycle. Its incidence is rising mostly due to induction of ovulation or Assisted Reproductive Technique. Most ectopic in heterotopic pregnancies are localized in the fallopian tubes. The occurrence of molar tubal ectopic pregnancy coexisting with intrauterine pregnancy is uncommon and consequently not often considered a diagnostic possibility. Case Report: We report the case of a 25-year-old woman, gravida 4 para 1, who complained of vaginal spotting and lower abdominal pain after 6 weeks of amenorrhea following clomiphene citrate ovarian stimulation. Transvaginal Ultrasonography revealed an intrauterine pregnancy and an unruptured left tubal ectopic pregnancy. She underwent successful laparoscopic salpingectomy while the intra-uterine pregnancy was allowed to continue. The ectopic pregnancy tissue histology reported an ectopic partial molar pregnancy. She subsequently had a normal vaginal delivery at 39 weeks and 3 days and her follow-up was uneventful. Conclusion: Heterotopic pregnancy is a rare but life-threatening condition. It should be suspected in a pregnant woman with a risk factor of multiple gestations who presents vaginal bleeding and lower abdominal pain in the context of early pregnancy. Laparoscopic surgery is effective for confirming the diagnosis and treating the ectopic component. Routine histological examination of tubal specimens must be taken very seriously because some findings like molar pregnancies may require specific management.展开更多
INTRODUCTION.Depression,a common mental disorder,is a leading cause of disability worldwide,with a global prevalence ranging from 20% to 25% in women and 7% to 12% in men,and it has exhibited an increasing trend in re...INTRODUCTION.Depression,a common mental disorder,is a leading cause of disability worldwide,with a global prevalence ranging from 20% to 25% in women and 7% to 12% in men,and it has exhibited an increasing trend in recent decades.Despite being known for decades,a consensus on the definition and diagnosis of treatment-resistant depression(TRD)is still lacking.展开更多
This exploratory study examined the short-term reliability of cortical auditory evoked responses recorded from patients undergoing whole-head scalp elec-troencephalography (EEG) monitoring to assess their candidacy fo...This exploratory study examined the short-term reliability of cortical auditory evoked responses recorded from patients undergoing whole-head scalp elec-troencephalography (EEG) monitoring to assess their candidacy for surgical treatment of intractable focal seizures. Participants were 26 patients with either left-sided (N = 13) or right-sided focal epilepsy admitted to the hospital for continuous scalp EEG monitoring for possible epilepsy surgery planning. Cortical auditory evoked responses were recorded over multiple days from scalp EEG electrodes using tones presented binaurally in a passive oddball paradigm. Test-retest intervals were 1 - 6 days (mean 2 days). Test-retest reproducibility of the auditory N1 response was assessed by paired t-test (latency) and cross-correlation analysis (amplitude and latency). Within-patient comparisons of test-retest auditory N1 peak latencies revealed no significant differences. The cross-correlation coefficient indicated high test-retest reproducibility of the N1 waveform (rcc = 0.88). Seizure lateralization was not associated with asymmetries in N1 latencies or amplitudes. An N1 amplitude asymmetry (right > left) in patients with focal seizures originating from the left hemisphere was initially observed, but disappeared when patients with prior resections were excluded, suggesting that reduced left hemisphere tissue volume may account for the smaller N1 amplitudes. Test-retest reliability of cortical auditory evoked responses was unexpectedly high in patients with focal epilepsy regardless of seizure lateralization or localization. These findings challenge the view that neural responses are intrinsically unstable (unreliable) in patients with seizures.展开更多
Experimental records in the cerebral cortex indicate that ammonia injection can lead to seizures. Considering that astrocytes play a vital role in mediating the uptake and absorption of ammonium ions in the extracellu...Experimental records in the cerebral cortex indicate that ammonia injection can lead to seizures. Considering that astrocytes play a vital role in mediating the uptake and absorption of ammonium ions in the extracellular space of the cortical circuit, we constructed a new astrocyte neuron coupling model, which is composed of a neuron and its astrocytes connected through the extracellular space, taking into account of the influence of extracellular ammonium ions. The numerical results verified the previous experimental observation that obtained epileptic firing modes of neurons and postsynaptic GABA reversal potential depolarization triggered by ammonia injection. In addition, we also determined the concentration–response relationship between the ammonium ion concentration and the time of entering epilepsy and predicted the threshold of the ammonium ion concentration for the onset of epilepsy.展开更多
Introduction: Obesity is one of the most common problems of reproductive age women and has been associated with diverse adverse pregnancy outcomes. Its prevalence in pregnancy is estimated at 14% in Cameroon. Objectiv...Introduction: Obesity is one of the most common problems of reproductive age women and has been associated with diverse adverse pregnancy outcomes. Its prevalence in pregnancy is estimated at 14% in Cameroon. Objective: The main objective of this study was to determine the adverse pregnancy outcomes associated with obesity in the Regional Hospital Bamenda. Methodology: This was a hospital-based cross-sectional study. We recruited 283 participants and their BMIs were used to classify them as underweight ( - 24.9), overweight (25 - 29.9) and obese (≥30). Ethical clearance, administrative authorisation and consent of participants were obtained. Data was collected using a pretested questionnaire. We collected data on sociodemographic characteristics, anthropometric characteristics, and adverse pregnancy outcomes. Data was analysed using Microsoft Excel version 2010. Fisher’s test was used to determine relative risk on bivariate logistic regression. P-values < 0.05 were considered statistically significant. Results: Most participants were in the age group 20 - 34 years, and were multigravida and multipara. The prevalence of maternal obesity was 31.4%. Obesity was associated with an increased risk of hypertensive disorders [RR: 7.7, 95% CI (2.13 - 42.39), p = 0.0003], caesarean section [RR: 2.9, 95% CI (1.11 - 4.01), p = 0.017] and macrosomia [RR: 7.3, 95% CI (3.03 - 19.61), p Conclusion: Maternal obesity is associated with hypertensive disorders, caesarean section and macrosomia.展开更多
Introduction: Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The presence of COVID-19 in a pregnant patient can raise concerns, ...Introduction: Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The presence of COVID-19 in a pregnant patient can raise concerns, as other types of coronaviruses were associated with many adverse outcomes. This study aims to study the effect of COVID-19 on pregnancy outcomes. Methods: A prospective cross-sectional cohort study within Central First Health Care Cluster (multicentric), Riyadh, included all pregnant women with a singleton pregnancy diagnosed as COVID-19-positive. The primary outcome is the severity of COVID during pregnancy in terms of ICU admission and mortality. The participants were divided into three groups (preterm less than 37 weeks, the term from 37 - 40 weeks, and late-term after 40 weeks. In addition, parameters included: Gestational age at diagnosis, symptoms at presentation (cough, fever), presence of congenital anomalies, IUFD, mode of delivery, presence of PPH, newborn Apgar score, cord PH, need for NICU admission, and the newborn becoming infected with COVID-19 were also measured as secondary outcomes. Results: One hundred pregnant, COVID-19-positive women met the inclusion criteria;the average age of participants was 31.2 years (SD ± 6.4). Asymptomatic patients represented 54% of participants. Most of the deliveries occurred at 36 weeks or less as preterm delivery. Cesarean sections represented 55% of our population. Four-term mothers (12.5%), more than 37 weeks, need ICU admission compared to 13 (25%) preterm cases diagnosed with preeclampsia. No maternal death. Conclusion: COVID-19 during pregnancy can increase ICU admission. A high rate of preterm labor, miscarriage, cesarean section, and newborn testing positive for COVID-19 were observed among our population. No congenital anomalies related to COVID-19 were observed.展开更多
Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the presen...Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the present study is to highlight the prevalence of physical coercion leading to pregnancy and the associated maternal-fetal complications. Methodology: This was a comparative descriptive and analytical cross-sectional study of complications associated with post-rape pregnancy by physical restraint among minors who were treated at the General Reference Hospital of Panzi over a two-year period from June 2020 to June 2022. A total of 140 minor survivors of violence with pregnancy were included in the study. Data were collected using a questionnaire, coded and analyzed in Excel and XLSTAT version 2014. Results: The prevalence of physical constraints was 65%. After mulltivariate analyses, denial of pregnancy (ORa: 9.64 95% CI: 1.1 - 81.2;p-value: 0.0370), attempted abortion (ORa: 56.1 95% CI: 1.5 - 2027.6;p-value: 0.0278) and agitation during delivery (ORa: 88.7 95% CI: 4.5 - 1715;p-value: 0.0030) were the complications associated with pregnancy in minors who experienced physical restraint rape. In addition, BMI was a factor in reducing the risk of physical restraint rape at the ORa of 0.5054 [0.3;0.8];p 0.006). Conclusion: Pregnancy among minors is a reality and occurs in a situation of physical coercion in the eastern Democratic Republic of Congo. These pregnancies are often associated with complications that require an intensive management system since they can jeopardize the maternal-fetal prognosis of minors.展开更多
To investigate the role of nutrients intake during pregnancy with longitudinal development of rhinitis,asthma,eczema,wheeze,and food allergy in offspring.The PubMed,Embase,and Cochrane library were searched for articl...To investigate the role of nutrients intake during pregnancy with longitudinal development of rhinitis,asthma,eczema,wheeze,and food allergy in offspring.The PubMed,Embase,and Cochrane library were searched for articles published throughout May 2022.The pooled effect estimate were presented using relative risk and calculated by the random-effects model.Twenty-three prospective cohort studies enrolling 210817 individuals were included.The risk of wheeze in offspring were lowered when high vitamin D,vitamin E,zinc,and milk intakes during pregnancy,whereas high meat intake during pregnancy could induce additional risk of wheeze in offspring.Moreover,highβ-carotene and magnesium intakes during pregnancy were related to lower eczema risk in offspring,whereas eczema risk in offspring was increased for pregnant women with high intake of butter and margarine.Finally,the asthma risk in offspring could protect against for pregnant women with high intake of vitamin D and apple,whereas high folic acid during pregnancy could produce excess asthma risk in offspring.This study provides the summary evidences regarding the role of nutrients intake during pregnancy and subsequent risk of rhinitis,asthma,eczema,wheeze,and food allergy,and further effective intervention strategies should be employed to improve childhood allergic diseases.展开更多
Background: The two most common types of cephalalgia in women are migraine and tension-type cephalalgia. Cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficul...Background: The two most common types of cephalalgia in women are migraine and tension-type cephalalgia. Cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Objectives: To investigate the prevalence and the characteristics of maternal cephalalgia during pregnancy and early postpartum and identify associated risk factors. Study Design: This study was conducted between May 2012 and August 2012. The study population comprised 170 mothers. The interviews were conducted in a postnatal ward during the first postpartum week and information on the characteristics of maternal cephalalgia before and during pregnancy was collected. Data regarding previous history of cephalalgia, pregnancy and postpartum health history, as well as the mode of delivery were also recorded. Mothers were given a cephalalgia diary in order to record medication use, as well as cephalalgia attack frequency, severity (5-level scale) and duration. The following surveys were administered: Edinburgh Postnatal Depression Scale (EPDS), Mediterranean Diet Score (Medi Score), International Physical Activity Questionnaire (IPAQ) and Women Abuse Screening Tool (WAST) within the first week postpartum. Statistical analyses were performed using SPSS 19. The level of statistical significance was set at p Results: Maternal self-reported cephalalgia in pregnancy and early postpartum was significantly associated with scores in EPDS (depressive symptoms) (p = 0.005), hypertension (p Conclusion: Pregnancy and early postpartum is a graceful period in women with cephalalgia. However, cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Further studies should elucidate the safety and recommended use of cephalalgia medication during pregnancy and breastfeeding.展开更多
BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a rare but severe complication for both the mother and the unborn child.The diagnosis is primarily based on elevated serum levels of bile acids.In a large ICP co...BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a rare but severe complication for both the mother and the unborn child.The diagnosis is primarily based on elevated serum levels of bile acids.In a large ICP cohort,we here study in detail liver stiffness(LS)using transient elastography(TE),now widely used to noninvasively screen for liver cirrhosis within minutes.AIM To specifically explore LS in a large cohort of women with ICP compared to a control group with uncomplicated pregnancy.METHODS LS and hepatic steatosis marker controlled attenuation parameter(CAP)were measured in 100 pregnant women with ICP using TE(Fibroscan,Echosens,Paris,France)between 2010 and 2020.In 17 cases,LS could be measured postpartum.450 women before and 38 women after delivery with uncomplicated pregnancy served as control group.Routine laboratory,levels of bile acids and apoptosis marker caspase-cleaved cytokeratin 18 fragment(M30)were also measured.RESULTS Women with ICP had significantly elevated transaminases but normal gammaglutamyl transferase(GGT).Mean LS was significantly increased at 7.3±3.0 kPa compared to the control group at 6.2±2.3 kPa(P<0.0001).Postpartum LS decreased significantly in both groups but was still higher in ICP(5.8±1.7 kPa vs 4.2±0.9 kPa,P<0.0001),respectively.In ICP,LS was highly significantly correlated with levels of bile acids and M30 but not transaminases.No correlation was seen with GGT that even increased significantly after delivery in the ICP group.Bile acids were mostly correlated with the liver apoptosis marker M30,LS and levels of alanine aminotransferase,aspartate aminotransferase,and bilirubin.In multivariate analysis,LS remained the sole parameter that was independently associated with elevated bile acids.CONCLUSION In conclusion,LS is significantly elevated in ICP which is most likely due to toxic bile acid accumulation and hepatocyte apoptosis.In association with conventional laboratory markers,LS provides additional non-invasive information to rapidly identify women at risk for ICP.展开更多
Introduction: The growing phenomenon of early pregnancies in Benin has adverse consequences on the lives of adolescent girls, impacting various social, health, economic, and educational aspects. This study aims to ide...Introduction: The growing phenomenon of early pregnancies in Benin has adverse consequences on the lives of adolescent girls, impacting various social, health, economic, and educational aspects. This study aims to identify the factors associated with early pregnancies in the municipality of Bohicon in 2022. Materials and Methods: This is a case-control study conducted in Bohicon, involving 47 cases and 94 controls from 16 secondary and technical schools. Cases were selected exhaustively, while controls were randomly drawn from girls aged 10 to 19 in the same class who had never been pregnant. Matching was based on the type of institution and class. Data were collected through a questionnaire and analyzed using Epi info 7.2.1.0 and STATA 15 software, employing multiple conditional logistic regression (5% significance threshold) to identify factors related to early pregnancies. Results: The average age of adolescents was 17.63 years ± 0.09 for cases and 17.12 years ± 0.13 for controls. Associated factors included age over 16 years (p = 0.049), the marital status of the adolescent (single) (p = 0.001), and the monthly pocket money of the adolescent less than 10,000 FCFA (p = 0.031). Conclusion: Three factors related to early pregnancies were identified. To counteract this phenomenon and promote responsible sexuality among adolescents, it is essential to strengthen communication efforts aimed at modifying behaviors.展开更多
Background: In developing countries maternal mortality and morbidity are most often due to the late to consult, poverty and ignorance. Added to this is, the under-medicalization of the health system. The objective of ...Background: In developing countries maternal mortality and morbidity are most often due to the late to consult, poverty and ignorance. Added to this is, the under-medicalization of the health system. The objective of study is to report a case of late consultation and its consequences and make recommendations to improve: case of abdominal pregnancy with hemorrhagic placenta at the Health and Mother Center (CSME) in Zinder/Niger. Clinical Observation: We describe a case of abdominal pregnancy with hemorrhagic placenta in a 24-year-old woman, without profession, resident in the city of Zinder with a low economic level, consulted for abdomino-pelvic pain. She had a notion of amenorrhea for 5 months without any consultation made. She was pale, feverish and had abdominal pain. Ultrasound revealed a 23-week-old fetus and an empty uterus. The diagnosis was abdominal pregnancy. A laparotomy was performed and a The morbidity was hysterectomy and anemia. The postoperative period course was complicated with anemia. The patient was cured on the 9th day with a good vital prognosis. Conclusion: Abdominal pregnancy occurred in a patient who presented a risk factor. Ultrasound was the key diagnostic test. Surgery was the treatment of choice and the prognosis depends on the earliness of the consultation. Community awareness and early consultation with health services can improve the prognosis of abdominal pregnancy.展开更多
Background: The gram-positive, beta-hemolytic, and chain-forming Group B Streptococcus (GBS), commonly known as Streptococcus agalactiae, may asymptomatically invade the human gastrointestinal and vaginal tracts. Howe...Background: The gram-positive, beta-hemolytic, and chain-forming Group B Streptococcus (GBS), commonly known as Streptococcus agalactiae, may asymptomatically invade the human gastrointestinal and vaginal tracts. However, GBS may become very invasive and pathogenic to the mother and baby during pregnancy, having negative effects. Study Aim: This study aims to investigate the pregnancy outcomes of women who tested positive for genitourinary GBS infection during pregnancy in Najran, Saudi Arabia. Methods: Data was collected retrospectively from patient files in Armed Forces Hospital, Najran, Saudi Arabia. Data collected were entered to a Microsoft Excel sheet, then imported and analysed using the Statistical Package for Social Sciences. Results: The study included 272 women of whom 66.5% were 31 to 45 years old. Gestational diabetes was diagnosed in 8.5% of the sample, 71.7% had a normal spontaneous vaginal delivery (NSVD), 1.8% had previous abortions, and 27.2% of new-borns were admitted to the NICU after delivery. There was a significant association between NICU admissions and women employment status (p = 0.001), gravidity (p = 0.001), parity (p = 0.001), history of abortions (p = 0.001), medical conditions (p = 0.049), and mode of delivery (p = 0.049). Conclusion: According to the findings of our study, GBS infection during pregnancy is associated to more NICU admissions. NICU admissions were significantly correlated with gestational diabetes, hypertension, and hypothyroidism in mothers but not with intrapartum antibiotic use.展开更多
Objective This study aims to identify the effect of third interstitial fluid on adverse outcomes in twin pregnancies with severe pre-eclampsia,and explore the differences in bad ending between twins and singletons.Met...Objective This study aims to identify the effect of third interstitial fluid on adverse outcomes in twin pregnancies with severe pre-eclampsia,and explore the differences in bad ending between twins and singletons.Methods The present retrospective cohort study was conducted on patients with severe pre-eclampsia,who delivered in Tongji Hospital,Wuhan,China,between 2017 and 2022.The adverse outcomes in singleton and twin pregnancies with severe pre-eclampsia were initially investigated.Then,the diverse maternal and fetal consequences between singleton and twin pregnancies in patients with severe pre-eclampsia were compared after merging with the third interstitial fluid.Results A total of 709 patients were included for the present study.Among these patients,68 patients had twin pregnancies,and 641 patients had singleton pregnancies.The rate of postpartum hemorrhage(2.81%vs.13.24%,P<0.001),and admission rate to the Neonatal Intensive Care Unit(NICU)after birth(30.73%vs.63.24%,P=0.011)were significantly higher in twin pregnancies.The neonatal weight of twins was statistically lower than singletons(1964.73±510.61 g vs.2142.92±731.25 g,P=0.008).For the groups with the third interstitial fluid,the delivery week(P=0.001)and rate of admission to the NICU after birth were significantly advanced in twin pregnancy group,when compared to singleton pregnancy group(P=0.032),and the length of hospital stay was shorter(P=0.044).Furthermore,there was no statistically significant difference between the twin pregnancy group and the singletony pregnancy group without the third interstitial fluid.Conclusion The maternal and fetal adverse outcomes of patients with severe pre-eclampsia increased in twin pregnancies,when compared to singleton pregnancies.Thus,when patients develop the third interstitial fluid,twin pregnancies would more likely lead to adverse fetal outcomes,when compared to singleton pregnancies,and there would be no significant difference in maternal adverse outcomes.More attention should be given to patients who merge with the third interstitial fluid.展开更多
文摘Osteogenesis imperfecta(OI)is a primary bone fragility disorder with an estimated prevalence of 1/15,000 births and is a hereditary syndrome characterized by one or more of the following:fractures,blue sclerae,impaired hearing,defective dentition,and hyperlaxibility throughout life.[1,2]We report a pregnant woman with type II OI and review her prenatal counseling,diagnosis,and pregnancy management to assist obstetricians in understanding the disease and managing it in emergency situations.
基金Research Fund for Lin He’s Academician Workstation of New Medicine and Clinical Translation in Jining Medical University,No.JYHL2019FMS25and The Key Research and Development Program of Jining,No.2022YXNS028.
文摘BACKGROUND Post-stroke epilepsy is a common and easily overlooked complication of acute cerebrovascular disease.Long-term seizures can seriously affect the prognosis and quality of life of patients.Electroencephalogram(EEG)is the simplest way to diagnose epilepsy,and plays an important role in predicting seizures and guiding medication.AIM To explore the EEG characteristics of patients with post-stroke epilepsy and improve the detection rate of inter-seizure epileptiform discharges.METHODS From January 2017 to June 2020,10 patients with post-stroke epilepsy in our hospital were included.The clinical,imaging,and EEG characteristics were collected.The stroke location,seizure type,and ictal and interictal EEG manifestations of the patients with post-stroke epilepsy were then retrospectively analyzed.RESULTS In all 10 patients,epileptiform waves occurred in the side opposite to the stroke lesion during the interictal stage;these manifested as sharp wave,sharp-wave complex,or spike discharges in the anterior head lead of the side opposite to the lesion.CONCLUSION In EEG,epileptiform waves can occur in the side opposite to the stroke lesion in patients with post-stroke epilepsy.
文摘Thrombotic thrombocytopenic purpura (TTP) is a rare but acute, life-threatening condition which may be precipitated by pregnancy. This disorder that presents with thrombocytopenia, haemolytic anemia, and clinical consequences of microvascular thrombosis such as stroke. The exact cause is not known but it is associated with a deficiency of ADAMTS13 enzymes. Immune mediated TTP is more common and can present in pregnancy. The aim of this case is to bring awareness as many clinicians are unaware of this condition in pregnancy, its diagnosis may be missed or delayed, leading to fetal loss or serious maternal implications. In this case the patient presented at 29 weeks with stroke in Emergency department, referred to delivery suit for Obstetric review, with suspicion of Pre-eclampsia/HELLP. The diagnosis of TTP was achieved by a multidisciplinary team who worked tirelessly together. The patient was transferred to a Specialist Tertiary Care Centre for further management. The pregnancy continued until 33 weeks and 5 days. She underwent an emergency caesarean section for fetal distress. Steroids and Rituximab were continued postnatally. The outcome was favourable due to fast and efficient multidisciplinary care. Awareness of this rare but important condition can lead to recognition of clinical presentation, prompt diagnosis and appropriate management.
基金Supported by The Medical and Health Research Project of Zhejiang Province,No.2023KY1105the Traditional Chinese Medical and Health Research Project of Zhejiang Province,No.2022ZB328.
文摘BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a pregnancy-specific liver condition that typically arises in the middle and late stages of pregnancy.Short-chain fatty acids(SCFAs),prominent metabolites of the gut microbiota,have significant connections with various pregnancy complications,and some SCFAs hold potential for treating such complications.However,the metabolic profile of SCFAs in patients with ICP remains unclear.AIM To investigate the metabolic profiles and differences in SCFAs present in the maternal and cord blood of patients with ICP and determine the clinical significance of these findings.METHODS Maternal serum and cord blood samples were collected from both patients with ICP(ICP group)and normal pregnant women(NP group).Targeted metabolomics was used to assess the SCFA levels in these samples.RESULTS Significant differences in maternal SCFAs were observed between the ICP and NP groups.Most SCFAs exhibited a consistent declining trend in cord blood samples from the ICP group,mirroring the pattern seen in maternal serum.Correlation analysis revealed a positive correlation between maternal serum SCFAs and cord blood SCFAs[r(Pearson)=0.88,P=7.93e-95].In both maternal serum and cord blood,acetic and caproic acids were identified as key metabolites contributing to the differences in SCFAs between the two groups(variable importance for the projection>1).Receiver operating characteristic analysis demonstrated that multiple SCFAs in maternal blood have excellent diagnostic capabilities for ICP,with caproic acid exhibiting the highest diagnostic efficacy(area under the curve=0.97).CONCLUSION Compared with the NP group,significant alterations were observed in the SCFAs of maternal serum and cord blood in the ICP group,although they displayed distinct patterns of change.Furthermore,the SCFA levels in maternal serum and cord blood were significantly positively correlated.Notably,certain maternal serum SCFAs,specifically caproic and acetic acids,demonstrated excellent diagnostic efficiency for ICP.
文摘Background: Fahr’s disease, also recognized as Idiopathic Basal Ganglia Calcification (IBGC) or Primary Familial Brain Calcification (PFBC), was first identified by the German neurologist Karl Theodor Fahr in 1930. This rare condition, which involves the calcification of the basal ganglia and presents significant treatment challenges, is most commonly diagnosed in middle-aged adults and is notably uncommon in children. Purpose: We report a case of a younger patient and review this disease as an aid to early detection and diagnosis of the disease. Case Introduction: In this report, we present a unique case of Fahr’s disease in a child, where epilepsy manifested as the initial symptom during infancy. In this report, we present a case of Fahr’s disease in a child who presented with epilepsy as the first symptom in infancy. The child had no imaging abnormalities at the onset of the seizure, and subsequent antiepileptic drugs were reduced and discontinued, and when the seizure recurred 3 years later, a perfect cranial CT revealed symmetrical calcifications in the brain, which gradually worsened, and subsequently the child was unable to take care of himself and had regression of his psychomotor development, and the family requested discharge from the hospital, and then the child died during the follow-up visit. Conclusion: The disease is currently associated with a number of disorders for which there is no specific treatment, and half of all patients currently have a well-defined gene, emphasizing more importantly the importance of genetic counseling for parents known to be at risk prior to conception.
文摘Managing diabetes during pregnancy is challenging,given the significant risk it poses for both maternal and foetal health outcomes.While traditional methods involve capillary self-monitoring of blood glucose level monitoring and periodic HbA1c tests,the advent of continuous glucose monitoring(CGM)systems has revolutionized the approach.These devices offer a safe and reliable means of tracking glucose levels in real-time,benefiting both women with diabetes during pregnancy and the healthcare providers.Moreover,CGM systems have shown a low rate of side effects and high feasibility when used in pregnancies complicated by diabetes,especially when paired with continuous subcutaneous insulin infusion pump as hybrid closed loop device.Such a combined approach has been demonstrated to improve overall blood sugar control,lessen the occurrence of preeclampsia and neonatal hypoglycaemia,and minimize the duration of neonatal intensive care unit stays.This paper aims to offer a comprehensive evaluation of CGM metrics specifically tailored for pregnancies impacted by type 1 diabetes mellitus.
文摘Background: Heterotopic pregnancy is a very rare event in a natural cycle. Its incidence is rising mostly due to induction of ovulation or Assisted Reproductive Technique. Most ectopic in heterotopic pregnancies are localized in the fallopian tubes. The occurrence of molar tubal ectopic pregnancy coexisting with intrauterine pregnancy is uncommon and consequently not often considered a diagnostic possibility. Case Report: We report the case of a 25-year-old woman, gravida 4 para 1, who complained of vaginal spotting and lower abdominal pain after 6 weeks of amenorrhea following clomiphene citrate ovarian stimulation. Transvaginal Ultrasonography revealed an intrauterine pregnancy and an unruptured left tubal ectopic pregnancy. She underwent successful laparoscopic salpingectomy while the intra-uterine pregnancy was allowed to continue. The ectopic pregnancy tissue histology reported an ectopic partial molar pregnancy. She subsequently had a normal vaginal delivery at 39 weeks and 3 days and her follow-up was uneventful. Conclusion: Heterotopic pregnancy is a rare but life-threatening condition. It should be suspected in a pregnant woman with a risk factor of multiple gestations who presents vaginal bleeding and lower abdominal pain in the context of early pregnancy. Laparoscopic surgery is effective for confirming the diagnosis and treating the ectopic component. Routine histological examination of tubal specimens must be taken very seriously because some findings like molar pregnancies may require specific management.
文摘INTRODUCTION.Depression,a common mental disorder,is a leading cause of disability worldwide,with a global prevalence ranging from 20% to 25% in women and 7% to 12% in men,and it has exhibited an increasing trend in recent decades.Despite being known for decades,a consensus on the definition and diagnosis of treatment-resistant depression(TRD)is still lacking.
文摘This exploratory study examined the short-term reliability of cortical auditory evoked responses recorded from patients undergoing whole-head scalp elec-troencephalography (EEG) monitoring to assess their candidacy for surgical treatment of intractable focal seizures. Participants were 26 patients with either left-sided (N = 13) or right-sided focal epilepsy admitted to the hospital for continuous scalp EEG monitoring for possible epilepsy surgery planning. Cortical auditory evoked responses were recorded over multiple days from scalp EEG electrodes using tones presented binaurally in a passive oddball paradigm. Test-retest intervals were 1 - 6 days (mean 2 days). Test-retest reproducibility of the auditory N1 response was assessed by paired t-test (latency) and cross-correlation analysis (amplitude and latency). Within-patient comparisons of test-retest auditory N1 peak latencies revealed no significant differences. The cross-correlation coefficient indicated high test-retest reproducibility of the N1 waveform (rcc = 0.88). Seizure lateralization was not associated with asymmetries in N1 latencies or amplitudes. An N1 amplitude asymmetry (right > left) in patients with focal seizures originating from the left hemisphere was initially observed, but disappeared when patients with prior resections were excluded, suggesting that reduced left hemisphere tissue volume may account for the smaller N1 amplitudes. Test-retest reliability of cortical auditory evoked responses was unexpectedly high in patients with focal epilepsy regardless of seizure lateralization or localization. These findings challenge the view that neural responses are intrinsically unstable (unreliable) in patients with seizures.
基金supported by the National Natural Science Foundation of China (Grant Nos. 12132012 and 11972275)the National Science Foundation for Young Scientists of China (Grant No. 12102240)。
文摘Experimental records in the cerebral cortex indicate that ammonia injection can lead to seizures. Considering that astrocytes play a vital role in mediating the uptake and absorption of ammonium ions in the extracellular space of the cortical circuit, we constructed a new astrocyte neuron coupling model, which is composed of a neuron and its astrocytes connected through the extracellular space, taking into account of the influence of extracellular ammonium ions. The numerical results verified the previous experimental observation that obtained epileptic firing modes of neurons and postsynaptic GABA reversal potential depolarization triggered by ammonia injection. In addition, we also determined the concentration–response relationship between the ammonium ion concentration and the time of entering epilepsy and predicted the threshold of the ammonium ion concentration for the onset of epilepsy.
文摘Introduction: Obesity is one of the most common problems of reproductive age women and has been associated with diverse adverse pregnancy outcomes. Its prevalence in pregnancy is estimated at 14% in Cameroon. Objective: The main objective of this study was to determine the adverse pregnancy outcomes associated with obesity in the Regional Hospital Bamenda. Methodology: This was a hospital-based cross-sectional study. We recruited 283 participants and their BMIs were used to classify them as underweight ( - 24.9), overweight (25 - 29.9) and obese (≥30). Ethical clearance, administrative authorisation and consent of participants were obtained. Data was collected using a pretested questionnaire. We collected data on sociodemographic characteristics, anthropometric characteristics, and adverse pregnancy outcomes. Data was analysed using Microsoft Excel version 2010. Fisher’s test was used to determine relative risk on bivariate logistic regression. P-values < 0.05 were considered statistically significant. Results: Most participants were in the age group 20 - 34 years, and were multigravida and multipara. The prevalence of maternal obesity was 31.4%. Obesity was associated with an increased risk of hypertensive disorders [RR: 7.7, 95% CI (2.13 - 42.39), p = 0.0003], caesarean section [RR: 2.9, 95% CI (1.11 - 4.01), p = 0.017] and macrosomia [RR: 7.3, 95% CI (3.03 - 19.61), p Conclusion: Maternal obesity is associated with hypertensive disorders, caesarean section and macrosomia.
文摘Introduction: Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The presence of COVID-19 in a pregnant patient can raise concerns, as other types of coronaviruses were associated with many adverse outcomes. This study aims to study the effect of COVID-19 on pregnancy outcomes. Methods: A prospective cross-sectional cohort study within Central First Health Care Cluster (multicentric), Riyadh, included all pregnant women with a singleton pregnancy diagnosed as COVID-19-positive. The primary outcome is the severity of COVID during pregnancy in terms of ICU admission and mortality. The participants were divided into three groups (preterm less than 37 weeks, the term from 37 - 40 weeks, and late-term after 40 weeks. In addition, parameters included: Gestational age at diagnosis, symptoms at presentation (cough, fever), presence of congenital anomalies, IUFD, mode of delivery, presence of PPH, newborn Apgar score, cord PH, need for NICU admission, and the newborn becoming infected with COVID-19 were also measured as secondary outcomes. Results: One hundred pregnant, COVID-19-positive women met the inclusion criteria;the average age of participants was 31.2 years (SD ± 6.4). Asymptomatic patients represented 54% of participants. Most of the deliveries occurred at 36 weeks or less as preterm delivery. Cesarean sections represented 55% of our population. Four-term mothers (12.5%), more than 37 weeks, need ICU admission compared to 13 (25%) preterm cases diagnosed with preeclampsia. No maternal death. Conclusion: COVID-19 during pregnancy can increase ICU admission. A high rate of preterm labor, miscarriage, cesarean section, and newborn testing positive for COVID-19 were observed among our population. No congenital anomalies related to COVID-19 were observed.
文摘Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the present study is to highlight the prevalence of physical coercion leading to pregnancy and the associated maternal-fetal complications. Methodology: This was a comparative descriptive and analytical cross-sectional study of complications associated with post-rape pregnancy by physical restraint among minors who were treated at the General Reference Hospital of Panzi over a two-year period from June 2020 to June 2022. A total of 140 minor survivors of violence with pregnancy were included in the study. Data were collected using a questionnaire, coded and analyzed in Excel and XLSTAT version 2014. Results: The prevalence of physical constraints was 65%. After mulltivariate analyses, denial of pregnancy (ORa: 9.64 95% CI: 1.1 - 81.2;p-value: 0.0370), attempted abortion (ORa: 56.1 95% CI: 1.5 - 2027.6;p-value: 0.0278) and agitation during delivery (ORa: 88.7 95% CI: 4.5 - 1715;p-value: 0.0030) were the complications associated with pregnancy in minors who experienced physical restraint rape. In addition, BMI was a factor in reducing the risk of physical restraint rape at the ORa of 0.5054 [0.3;0.8];p 0.006). Conclusion: Pregnancy among minors is a reality and occurs in a situation of physical coercion in the eastern Democratic Republic of Congo. These pregnancies are often associated with complications that require an intensive management system since they can jeopardize the maternal-fetal prognosis of minors.
基金supported by CAMS Innovation Fund for Medical Science(CIFMS 2019-I2M-5-024)。
文摘To investigate the role of nutrients intake during pregnancy with longitudinal development of rhinitis,asthma,eczema,wheeze,and food allergy in offspring.The PubMed,Embase,and Cochrane library were searched for articles published throughout May 2022.The pooled effect estimate were presented using relative risk and calculated by the random-effects model.Twenty-three prospective cohort studies enrolling 210817 individuals were included.The risk of wheeze in offspring were lowered when high vitamin D,vitamin E,zinc,and milk intakes during pregnancy,whereas high meat intake during pregnancy could induce additional risk of wheeze in offspring.Moreover,highβ-carotene and magnesium intakes during pregnancy were related to lower eczema risk in offspring,whereas eczema risk in offspring was increased for pregnant women with high intake of butter and margarine.Finally,the asthma risk in offspring could protect against for pregnant women with high intake of vitamin D and apple,whereas high folic acid during pregnancy could produce excess asthma risk in offspring.This study provides the summary evidences regarding the role of nutrients intake during pregnancy and subsequent risk of rhinitis,asthma,eczema,wheeze,and food allergy,and further effective intervention strategies should be employed to improve childhood allergic diseases.
文摘Background: The two most common types of cephalalgia in women are migraine and tension-type cephalalgia. Cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Objectives: To investigate the prevalence and the characteristics of maternal cephalalgia during pregnancy and early postpartum and identify associated risk factors. Study Design: This study was conducted between May 2012 and August 2012. The study population comprised 170 mothers. The interviews were conducted in a postnatal ward during the first postpartum week and information on the characteristics of maternal cephalalgia before and during pregnancy was collected. Data regarding previous history of cephalalgia, pregnancy and postpartum health history, as well as the mode of delivery were also recorded. Mothers were given a cephalalgia diary in order to record medication use, as well as cephalalgia attack frequency, severity (5-level scale) and duration. The following surveys were administered: Edinburgh Postnatal Depression Scale (EPDS), Mediterranean Diet Score (Medi Score), International Physical Activity Questionnaire (IPAQ) and Women Abuse Screening Tool (WAST) within the first week postpartum. Statistical analyses were performed using SPSS 19. The level of statistical significance was set at p Results: Maternal self-reported cephalalgia in pregnancy and early postpartum was significantly associated with scores in EPDS (depressive symptoms) (p = 0.005), hypertension (p Conclusion: Pregnancy and early postpartum is a graceful period in women with cephalalgia. However, cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Further studies should elucidate the safety and recommended use of cephalalgia medication during pregnancy and breastfeeding.
文摘BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a rare but severe complication for both the mother and the unborn child.The diagnosis is primarily based on elevated serum levels of bile acids.In a large ICP cohort,we here study in detail liver stiffness(LS)using transient elastography(TE),now widely used to noninvasively screen for liver cirrhosis within minutes.AIM To specifically explore LS in a large cohort of women with ICP compared to a control group with uncomplicated pregnancy.METHODS LS and hepatic steatosis marker controlled attenuation parameter(CAP)were measured in 100 pregnant women with ICP using TE(Fibroscan,Echosens,Paris,France)between 2010 and 2020.In 17 cases,LS could be measured postpartum.450 women before and 38 women after delivery with uncomplicated pregnancy served as control group.Routine laboratory,levels of bile acids and apoptosis marker caspase-cleaved cytokeratin 18 fragment(M30)were also measured.RESULTS Women with ICP had significantly elevated transaminases but normal gammaglutamyl transferase(GGT).Mean LS was significantly increased at 7.3±3.0 kPa compared to the control group at 6.2±2.3 kPa(P<0.0001).Postpartum LS decreased significantly in both groups but was still higher in ICP(5.8±1.7 kPa vs 4.2±0.9 kPa,P<0.0001),respectively.In ICP,LS was highly significantly correlated with levels of bile acids and M30 but not transaminases.No correlation was seen with GGT that even increased significantly after delivery in the ICP group.Bile acids were mostly correlated with the liver apoptosis marker M30,LS and levels of alanine aminotransferase,aspartate aminotransferase,and bilirubin.In multivariate analysis,LS remained the sole parameter that was independently associated with elevated bile acids.CONCLUSION In conclusion,LS is significantly elevated in ICP which is most likely due to toxic bile acid accumulation and hepatocyte apoptosis.In association with conventional laboratory markers,LS provides additional non-invasive information to rapidly identify women at risk for ICP.
文摘Introduction: The growing phenomenon of early pregnancies in Benin has adverse consequences on the lives of adolescent girls, impacting various social, health, economic, and educational aspects. This study aims to identify the factors associated with early pregnancies in the municipality of Bohicon in 2022. Materials and Methods: This is a case-control study conducted in Bohicon, involving 47 cases and 94 controls from 16 secondary and technical schools. Cases were selected exhaustively, while controls were randomly drawn from girls aged 10 to 19 in the same class who had never been pregnant. Matching was based on the type of institution and class. Data were collected through a questionnaire and analyzed using Epi info 7.2.1.0 and STATA 15 software, employing multiple conditional logistic regression (5% significance threshold) to identify factors related to early pregnancies. Results: The average age of adolescents was 17.63 years ± 0.09 for cases and 17.12 years ± 0.13 for controls. Associated factors included age over 16 years (p = 0.049), the marital status of the adolescent (single) (p = 0.001), and the monthly pocket money of the adolescent less than 10,000 FCFA (p = 0.031). Conclusion: Three factors related to early pregnancies were identified. To counteract this phenomenon and promote responsible sexuality among adolescents, it is essential to strengthen communication efforts aimed at modifying behaviors.
文摘Background: In developing countries maternal mortality and morbidity are most often due to the late to consult, poverty and ignorance. Added to this is, the under-medicalization of the health system. The objective of study is to report a case of late consultation and its consequences and make recommendations to improve: case of abdominal pregnancy with hemorrhagic placenta at the Health and Mother Center (CSME) in Zinder/Niger. Clinical Observation: We describe a case of abdominal pregnancy with hemorrhagic placenta in a 24-year-old woman, without profession, resident in the city of Zinder with a low economic level, consulted for abdomino-pelvic pain. She had a notion of amenorrhea for 5 months without any consultation made. She was pale, feverish and had abdominal pain. Ultrasound revealed a 23-week-old fetus and an empty uterus. The diagnosis was abdominal pregnancy. A laparotomy was performed and a The morbidity was hysterectomy and anemia. The postoperative period course was complicated with anemia. The patient was cured on the 9th day with a good vital prognosis. Conclusion: Abdominal pregnancy occurred in a patient who presented a risk factor. Ultrasound was the key diagnostic test. Surgery was the treatment of choice and the prognosis depends on the earliness of the consultation. Community awareness and early consultation with health services can improve the prognosis of abdominal pregnancy.
文摘Background: The gram-positive, beta-hemolytic, and chain-forming Group B Streptococcus (GBS), commonly known as Streptococcus agalactiae, may asymptomatically invade the human gastrointestinal and vaginal tracts. However, GBS may become very invasive and pathogenic to the mother and baby during pregnancy, having negative effects. Study Aim: This study aims to investigate the pregnancy outcomes of women who tested positive for genitourinary GBS infection during pregnancy in Najran, Saudi Arabia. Methods: Data was collected retrospectively from patient files in Armed Forces Hospital, Najran, Saudi Arabia. Data collected were entered to a Microsoft Excel sheet, then imported and analysed using the Statistical Package for Social Sciences. Results: The study included 272 women of whom 66.5% were 31 to 45 years old. Gestational diabetes was diagnosed in 8.5% of the sample, 71.7% had a normal spontaneous vaginal delivery (NSVD), 1.8% had previous abortions, and 27.2% of new-borns were admitted to the NICU after delivery. There was a significant association between NICU admissions and women employment status (p = 0.001), gravidity (p = 0.001), parity (p = 0.001), history of abortions (p = 0.001), medical conditions (p = 0.049), and mode of delivery (p = 0.049). Conclusion: According to the findings of our study, GBS infection during pregnancy is associated to more NICU admissions. NICU admissions were significantly correlated with gestational diabetes, hypertension, and hypothyroidism in mothers but not with intrapartum antibiotic use.
基金the Hubei Provincial Natural Science Foundation of China(No.2021cfb375).
文摘Objective This study aims to identify the effect of third interstitial fluid on adverse outcomes in twin pregnancies with severe pre-eclampsia,and explore the differences in bad ending between twins and singletons.Methods The present retrospective cohort study was conducted on patients with severe pre-eclampsia,who delivered in Tongji Hospital,Wuhan,China,between 2017 and 2022.The adverse outcomes in singleton and twin pregnancies with severe pre-eclampsia were initially investigated.Then,the diverse maternal and fetal consequences between singleton and twin pregnancies in patients with severe pre-eclampsia were compared after merging with the third interstitial fluid.Results A total of 709 patients were included for the present study.Among these patients,68 patients had twin pregnancies,and 641 patients had singleton pregnancies.The rate of postpartum hemorrhage(2.81%vs.13.24%,P<0.001),and admission rate to the Neonatal Intensive Care Unit(NICU)after birth(30.73%vs.63.24%,P=0.011)were significantly higher in twin pregnancies.The neonatal weight of twins was statistically lower than singletons(1964.73±510.61 g vs.2142.92±731.25 g,P=0.008).For the groups with the third interstitial fluid,the delivery week(P=0.001)and rate of admission to the NICU after birth were significantly advanced in twin pregnancy group,when compared to singleton pregnancy group(P=0.032),and the length of hospital stay was shorter(P=0.044).Furthermore,there was no statistically significant difference between the twin pregnancy group and the singletony pregnancy group without the third interstitial fluid.Conclusion The maternal and fetal adverse outcomes of patients with severe pre-eclampsia increased in twin pregnancies,when compared to singleton pregnancies.Thus,when patients develop the third interstitial fluid,twin pregnancies would more likely lead to adverse fetal outcomes,when compared to singleton pregnancies,and there would be no significant difference in maternal adverse outcomes.More attention should be given to patients who merge with the third interstitial fluid.
