American Journal of Perinatology Reports最新文献

FETAL HYPERTHYROIDISM SECONDARY TO MATERNAL BASEDOW-GRAVES DISEASE 继发于母体巴索-格雷夫斯病的胎儿甲状腺功能亢进症

American Journal of Perinatology Reports Pub Date : 2024-05-02 DOI: 10.1055/a-2317-9431

Julio SOTO BARROS, Bunio Weissglas, Gustav von Plesssing-Pierry, María Paz Del Solar, Carolina Peña-Villa, Ximena Flores, Mónica Arancibia, Laura Campos

引用次数: 0

Pregnancy-Associated Onset of Adult-Onset Still's Disease 与妊娠相关的成年型斯蒂尔病发病

American Journal of Perinatology Reports Pub Date : 2024-05-02 DOI: 10.1055/a-2318-0305

Nawras Zayat, Avish Arora, Joselle O'Brien, Japjot K. Bal, Rebekah Sugarman, Leeshun Rivera, Amir A. Shamshirsaz, Kavita Vani, Dimitrios Mastrogiannis

{"title":"Pregnancy-Associated Onset of Adult-Onset Still's Disease","authors":"Nawras Zayat, Avish Arora, Joselle O'Brien, Japjot K. Bal, Rebekah Sugarman, Leeshun Rivera, Amir A. Shamshirsaz, Kavita Vani, Dimitrios Mastrogiannis","doi":"10.1055/a-2318-0305","DOIUrl":"https://doi.org/10.1055/a-2318-0305","url":null,"abstract":"Objective: This study aims to elucidate the clinical manifestations, diagnostic challenges, and management strategies of Adult-Onset Still’s Disease (AOSD) during pregnancy, leveraging a case series overview and a detailed case report from our center.\u0000Study Design: A comprehensive review of 21 published case reports on AOSD diagnosed during pregnancy was conducted, alongside a detailed case report of a patient diagnosed and managed at our center. This study emphasizes the importance of recognizing AOSD in pregnant patients, outlines the therapeutic challenges encountered, and discusses the potential complications arising from the disease and its treatment.\u0000Results: The onset of AOSD during pregnancy predominantly occurs in the first or second trimester, with a polycyclic disease course observed in the majority of cases. Management primarily involves corticosteroids and immunosuppressive medications. The case report highlights the complex interplay between AOSD, Hemophagocytic Lymphohistiocytosis (HLH), and pregnancy, illustrating a multidisciplinary approach to management that ensured favorable maternal and fetal outcomes despite the significant challenges.\u0000Conclusion: AOSD presents unique diagnostic and therapeutic challenges during pregnancy, requiring careful consideration of maternal and fetal health. Early diagnosis, a multidisciplinary approach to care, and judicious use of immunosuppressive therapy are critical for managing AOSD flares and associate","PeriodicalId":368060,"journal":{"name":"American Journal of Perinatology Reports","volume":"3 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141020984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Superoxide anions inhibit intracellular calcium response in porcine airway smooth muscle cells. 超氧阴离子抑制猪气道平滑肌细胞的细胞内钙反应

American Journal of Perinatology Reports Pub Date : 2024-05-02 DOI: 10.1055/a-2318-0625

Ramesh Krishnan, Mathur S. Kannan, Deepak Deshpande

{"title":"Superoxide anions inhibit intracellular calcium response in porcine airway smooth muscle cells.","authors":"Ramesh Krishnan, Mathur S. Kannan, Deepak Deshpande","doi":"10.1055/a-2318-0625","DOIUrl":"https://doi.org/10.1055/a-2318-0625","url":null,"abstract":"BACKGROUND: Superoxide anions (O2-) have multiple effects on pulmonary parenchyma altering cell proliferation, cellular metabolism, and airway smooth muscle (ASM) contraction. Intracellular Ca2+ concentration ([Ca2+]i) plays a significant role in the regulation of ASM contraction, relaxation, proliferation, and gene expression. \u0000OBJECTIVE: We investigated the effects of O2- on agonist-stimulated changes in [Ca2+]i in ASM cells. \u0000DESIGN/METHODS: Fura-2 AM-loaded, freshly isolated porcine ASM (PASM) cells were used to examine [Ca2+]i release in response to acetylcholine (ACh), histamine, endothelin, caffeine, and thapsigargin in the presence or absence of extracellular calcium. \u0000RESULTS: Exposure of PASM cells to xanthine and xanthine oxidase (X+XO) resulted in a time-dependent generation of O2-, inhibited by superoxide dismutase (SOD). Pre-incubating PASM cells with X+XO for 15- or 45-min inhibited net [Ca2+]i responses to ACh, Histamine, Caffeine, and Thapsigargin compared to control cells. Pretreating PASM cells with SOD for 30 min mitigated the inhibitory effect of X+XO treatment on ACh-induced Ca2+ elevation suggesting role of O2-. X+XO treatment also inhibited caffeine-and thapsigargin-induced Ca2+ elevation suggesting effect of O2- on intracellular calcium release and reuptake mechanisms.\u0000CONCLUSIONS: Superoxide attenuates [Ca2+]i release, reuptake and may interfere with physiological functions of ASM cells. \u0000","PeriodicalId":368060,"journal":{"name":"American Journal of Perinatology Reports","volume":"38 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful treatment of massive pulmonary embolism in pregnancy with catheter-directed embolectomy 导管引导栓子切除术成功治疗妊娠期大面积肺栓塞

American Journal of Perinatology Reports Pub Date : 2024-04-04 DOI: 10.1055/a-2299-4026

Rachel Truong, Sarah R Cheyney, Mai Vo, Joel Garcia Fernandez, Neeraj Desai, J. Kropf, Hatem Hassanein

{"title":"Successful treatment of massive pulmonary embolism in pregnancy with catheter-directed embolectomy","authors":"Rachel Truong, Sarah R Cheyney, Mai Vo, Joel Garcia Fernandez, Neeraj Desai, J. Kropf, Hatem Hassanein","doi":"10.1055/a-2299-4026","DOIUrl":"https://doi.org/10.1055/a-2299-4026","url":null,"abstract":"Pulmonary embolism (PE) is associated with approximately 10.5% of maternal deaths in the United States. Despite heightened awareness of its mortality potential, there is little data available to guide its management in pregnancy. We present the case of a massive PE during gestation successfully treated with catheter-directed embolectomy.\u0000\u0000A 37-year-old G2P1001 presented with a syncopal episode preceded by dyspnea and chest pain. Upon presentation, she was hypotensive, tachycardiac, and hypoxic. Imaging showed an occlusive bilateral PE, right heart strain, and a possible intrauterine pregnancy. Beta-hCG was positive. She was taken emergently for catheter-directed embolectomy. Her condition immediately improved afterwards. Post-procedure pelvic ultrasound confirmed a viable intrauterine pregnancy at 10 weeks gestation. She was discharged with therapeutic enoxaparin and gave birth to a healthy infant at 38 weeks gestation.\u0000\u0000Despite being the gold standard for PE treatment in non-pregnant adults, systemic thrombolysis is relatively contraindicated in pregnancy due to concern for maternal or fetal hemorrhage. Surgical or catheter-based thrombectomies are rarely recommended. Limited alternative options forces their consideration, particularly in a hemodynamically unstable patient. Catheter-directed embolectomy can possibly bypass such complications. Our case exemplifies the consideration of catheter-directed embolectomy as the initial treatment modality of a hemodynamically unstable gestational PE.","PeriodicalId":368060,"journal":{"name":"American Journal of Perinatology Reports","volume":"17 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140742195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Expectant management of a triploid partial molar pregnancy at 26 weeks’ gestation: a case report 妊娠 26 周时三倍体部分臼齿妊娠的孕期管理：病例报告

American Journal of Perinatology Reports Pub Date : 2024-04-04 DOI: 10.1055/a-2299-4409

Karen Wong, Mohannad Ali, Marc Stalder, Brigitte Bonin, D. El-Chaâr

{"title":"Expectant management of a triploid partial molar pregnancy at 26 weeks’ gestation: a case report","authors":"Karen Wong, Mohannad Ali, Marc Stalder, Brigitte Bonin, D. El-Chaâr","doi":"10.1055/a-2299-4409","DOIUrl":"https://doi.org/10.1055/a-2299-4409","url":null,"abstract":"Introduction\u0000Triploid partial molar pregnancies are not viable, and confer maternal risks including preeclampsia, hemorrhage, gestational trophoblastic neoplasia, and trophoblastic embolization. We report a case managed expectantly until 26 weeks’ gestation in a patient requesting continuation of pregnancy. \u0000\u0000Case \u0000This G2P1 presented with fetal anomalies indicative of triploid partial molar pregnancy. The pregnancy was complicated by anemia, hyperthyroidism, supraventricular tachycardia, and threatened preterm labour. \u0000Her care involved Maternal Fetal Medicine collaborating with Internal Medicine, Palliative Care, Anesthesia and Critical Care. Labor was augmented at 26 weeks’ gestation, resulting in vaginal delivery. Postpartum course was notably complicated by acute respiratory distress in the immediate post-partum period, which self-resolved. Postpartum hemorrhage and retained products of conception were additional complications.\u0000\u0000Conclusion\u0000This unique case highlights the role of multidisciplinary collaboration and shared decision making in challenging circumstances.","PeriodicalId":368060,"journal":{"name":"American Journal of Perinatology Reports","volume":"8 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140744351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe early-onset vitamin K deficiency bleeding in a boy born to a mother with Crohn’s disease in clinical remission: a case report 临床缓解期克罗恩病母亲所生男孩早发严重维生素 K 缺乏性出血：病例报告

American Journal of Perinatology Reports Pub Date : 2023-11-29 DOI: 10.1055/a-2219-5024

Chiho Ikenaga, Ryosuke Uchi, Fumihiko Ishida, Michisato Hirata, Kazuhiro Iwama, Shinichiro Ina, Yuko Tatsuno, Takahiro Kemmotsu, Jun Shibasaki, Shuichi Ito

{"title":"Severe early-onset vitamin K deficiency bleeding in a boy born to a mother with Crohn’s disease in clinical remission: a case report","authors":"Chiho Ikenaga, Ryosuke Uchi, Fumihiko Ishida, Michisato Hirata, Kazuhiro Iwama, Shinichiro Ina, Yuko Tatsuno, Takahiro Kemmotsu, Jun Shibasaki, Shuichi Ito","doi":"10.1055/a-2219-5024","DOIUrl":"https://doi.org/10.1055/a-2219-5024","url":null,"abstract":"Vitamin K deficiency bleeding (VKDB) in neonates is a significant disorder that causes skin, gastrointestinal, and intracranial hemorrhaging. Early-onset VKDB occurs within 24 h of birth, and its prognosis is poor due to severe hemorrhage. The causes of early-onset VKDB include maternal intake of warfarin and anticoagulants, and maternal vitamin K deficiency. We report the case of a boy with early-onset VKDB born to a mother with Crohn’s disease. He developed severe cerebellar hemorrhage on the day of birth and subsequent non-communicating hydrocephalus requiring a ventriculoperitoneal shunt. The mother had a 14-year history of Crohn’s disease and short bowel owing to intestinal resection. She was in complete remission during pregnancy according to the Crohn’s Disease Activity Index. Endoscopic examination performed shortly before pregnancy revealed inflammatory findings in the residual small intestine. Her blood tests at delivery showed an elevated prothrombin induced by vitamin K deficiency or antagonist II (PIVKA-II) level of 26900 mAU/mL. A definitive protocol to prevent early-onset VKDB in mothers with Crohn’s disease complicated by a short bowel is lacking. Administering vitamin K to mothers with elevated PIVKA-II levels before delivery may help prevent early-onset VKDB.","PeriodicalId":368060,"journal":{"name":"American Journal of Perinatology Reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139212769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mesenchymal stem cells suppress inflammatory cytokines in lipopolysaccharide exposed preterm and term human pregnant myometrial cells. 间充质干细胞可抑制暴露于脂多糖的早产和过期妊娠人类子宫肌细胞中的炎症细胞因子。

American Journal of Perinatology Reports Pub Date : 2023-11-23 DOI: 10.1055/a-2216-9194

Arunmani Mani, John W. Hotra, Sean C Blackwell, Laura Goetzl, J. Refuerzo

{"title":"Mesenchymal stem cells suppress inflammatory cytokines in lipopolysaccharide exposed preterm and term human pregnant myometrial cells.","authors":"Arunmani Mani, John W. Hotra, Sean C Blackwell, Laura Goetzl, J. Refuerzo","doi":"10.1055/a-2216-9194","DOIUrl":"https://doi.org/10.1055/a-2216-9194","url":null,"abstract":"Objective The objective of this study was to determine the cytokine response in human pregnant preterm and term myometrial cells exposed to lipopolysaccharide (LPS) and co-cultured with mesenchymal stem cells (MSCs). Study design Myometrium was obtained at cesarean delivery in term and preterm patients. Human myometrial cells were exposed to 5 μg/ml LPS for 4 hours (h) followed by 1 μg/ml LPS for 24 h and were co-cultured with MSCs for 24 h. Culture supernatants were collected at 24h and expression of cytokines, including IL-1β, IL-6, IL-8, TNF-α, TGF-β and IL-10, was quantified by ELISA. Results There was significantly increased expression of the pro-inflammatory cytokines IL-1β, IL-6, IL-8 and TNF-α in preterm myometrial cells treated with LPS compared to untreated preterm myometrial cells. Co-culture with MSCs significantly suppressed the pro-inflammatory cytokine levels in LPS treated preterm vs. treated term myometrial cells. Moreover, MSC co-cultured preterm myometrial cells expressed increased levels of the anti-inflammatory cytokines TGF-β and IL-10 compared to treated term myometrial cells. Conclusion MSCs ameliorate LPS-mediated inflammation in preterm human myometrial cells compared to term myometrial cells. Immunomodulatory effects of MSCs mediated through anti-inflammatory cytokine regulation suggest a potential cell-based therapy for preterm birth.","PeriodicalId":368060,"journal":{"name":"American Journal of Perinatology Reports","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139245820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pregnancy-Associated Atypical Hemolytic Uremic Syndrome: A Case Report with a rare MCP Gene Mutation and Successful Eculizumab Treatment 妊娠相关的非典型溶血性尿毒症综合征:罕见的MCP基因突变和成功的依曲单抗治疗的病例报告

American Journal of Perinatology Reports Pub Date : 2023-09-01 DOI: 10.1055/a-2164-8438

Alex Domínguez-Vargas, Fanny Ariño, Diana Silva, Henry J González-Torres, Gustavo Aroca-Martínez, Eduardo Egea, Carlos G. Musso

{"title":"Pregnancy-Associated Atypical Hemolytic Uremic Syndrome: A Case Report with a rare MCP Gene Mutation and Successful Eculizumab Treatment","authors":"Alex Domínguez-Vargas, Fanny Ariño, Diana Silva, Henry J González-Torres, Gustavo Aroca-Martínez, Eduardo Egea, Carlos G. Musso","doi":"10.1055/a-2164-8438","DOIUrl":"https://doi.org/10.1055/a-2164-8438","url":null,"abstract":"Pregnancy-associated atypical hemolytic uremic syndrome (P-aHUS) is a rare condition characterised by microangiopathic haemolytic anaemia and kidney injury from thrombotic microangiopathy. P-aHUS occurs in approximately 1 in 25,000 pregnancies and is strongly related to complement dysregulation and pregnancy-related disorders, such as preeclampsia, eclampsia, and hemolysis, elevated liver enzymes, low platelet (HELLP) syndrome, resulting in adverse perinatal and fetal outcomes. Complement dysregulation in P-aHUS is commonly attributed to genetic mutations or autoantibodies affecting complement factors, including CFH, CFI, and MCP. We present a case of a 25-year-old primigravida who experienced severe preeclampsia and HELLP syndrome followed by the development of complicated P-aHUS during the early postpartum period. The patient exhibited severe clinical manifestations, including hypertensive emergency, central nervous system involvement, renal impairment, and microangiopathic hemolytic anemia. Timely initiation of eculizumab therapy resulted in successful disease remission. Further genetic analysis revealed a likely rare pathogenic MCP gene variant.","PeriodicalId":368060,"journal":{"name":"American Journal of Perinatology Reports","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123520872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Uterine Leiomyomata as a Cause of Abdominal Compartment Syndrome in the Postpartum Period 子宫平滑肌瘤是产后腹部隔室综合征的病因之一

American Journal of Perinatology Reports Pub Date : 2023-09-01 DOI: 10.1055/a-2164-8100

Mason Hui, B. Sibai, Alvaro Montealegre, Mateo G. Leon

{"title":"Uterine Leiomyomata as a Cause of Abdominal Compartment Syndrome in the Postpartum Period","authors":"Mason Hui, B. Sibai, Alvaro Montealegre, Mateo G. Leon","doi":"10.1055/a-2164-8100","DOIUrl":"https://doi.org/10.1055/a-2164-8100","url":null,"abstract":"Objective: To describe a case of uterine leiomyomata as a cause of abdominal compartment syndrome in the postpartum period. \u0000Study Design: Case report, short communication\u0000Results: n/a\u0000Conclusion: Uterine leiomyomas are common benign smooth muscle tumors that often occur during the reproductive years. Although many cases may not result in significant complications, negative pregnancy outcomes have been associated with the size and location of the fibroids. Degeneration of fibroids can occur as early as the late first trimester when they undergo significant volumetric growth, contributing to pain during pregnancy. While myomectomy is typically avoided during pregnancy, conservative management with anti-inflammatory medications may be effective. Surgical removal or preterm delivery may be necessary if symptoms persist. Abdominal compartment syndrome (ACS) is a rare condition characterized by sustained elevated intraabdominal pressure leading to organ failure. Although ACS resulting from large-volume leiomyomas in the postpartum period has not been previously described, we present a case of a 25-year-old patient with massive uterine fibroids who required indicated preterm delivery via primary Cesarean section at 25-weeks gestation. Her postpartum course was complicated by ACS, requiring emergent surgical decompression. When large fibroid burden is present during pregnancy or in the postpartum period, ACS should be considered.","PeriodicalId":368060,"journal":{"name":"American Journal of Perinatology Reports","volume":"258 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122258618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0