Maternal health, neonatology and perinatology最新文献

{"title":"Maternal healthcare use by women with disabilities in Rajasthan, India: a secondary analysis of the Annual Health Survey.","authors":"M Tara Casebolt, Kavita Singh, Ilene S Speizer, Carolyn T Halpern","doi":"10.1186/s40748-023-00165-1","DOIUrl":"10.1186/s40748-023-00165-1","url":null,"abstract":"<p><strong>Background: </strong>Women with disabilities face a number of barriers when accessing reproductive health services, including maternal healthcare. These include physical inaccessibility, high costs, transportation that is not accessible, negative attitudes from family and healthcare providers, and a societal belief people with disabilities shouldn't be parents. While qualitative studies have uncovered these barriers, there is limited quantitative research to determine their effect on use of maternal health services. This study aims to analyze associations between disability and maternal healthcare use among married women in Rajasthan.</p><p><strong>Methods: </strong>This study is a secondary analysis of the Indian Annual Heath Survey first wave data from 2011. The sample includes 141,983 women aged 15-49 who had given birth between 2007 and 2009. Logistic regression was used to assess the association between disability and use of antenatal, delivery, and postnatal care. Stratified models were created to analyze difference based on birth order of the pregnancy and whether the woman's place of residence is rural or urban.</p><p><strong>Results: </strong>The prevalence of disability was 1.23%. Attending at least three antenatal care visits was reported by 50.66% of the sample, skilled delivery use by 83.81%, and receiving postnatal care within 48 h of birth by 76.02%. In the regression model, women with disabilities were less likely to report attending the minimum antenatal care visits (OR = 0.84; CI: 0.76, 0.92). No association was found between disability and skilled delivery or postnatal care. Once the sample was stratified by birth order, women with disabilities reporting their first birth were more likely to report receiving postnatal care than women without disabilities (OR = 1.47; CI: 1.13, 1.91).</p><p><strong>Conclusion: </strong>Additional research is needed to determine use of maternal healthcare among women with disabilities in India. Maternal services need to be assessed to determine their accessibility, especially regarding recent laws requiring accessibility.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10522415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous immunoglobulin treatment of congenital parvovirus B19 induced anemia - a case report.","authors":"Stephanie T Aronson, Mahmut Y Celiker, Ludovico Guarini, Rabia Agha","doi":"10.1186/s40748-023-00164-2","DOIUrl":"10.1186/s40748-023-00164-2","url":null,"abstract":"<p><strong>Background: </strong>Parvovirus is a common childhood infection that could be very dangerous to the fetus, if pregnant women become infected. The spectrum of effects range from pure red blood cell aplasia with hydrops fetalis to meningoencephalitis, with many symptoms in between. Severe anemia in the setting of pure red blood cell aplasia is one of the more common effects that neonatal experience (if infected intrapartum), with the current gold standard treatment being intrauterine or postnatal packed red blood cell (PRBC) transfusions, yet intravenous immunoglobulin (IVIG) may be a superior treatment option.</p><p><strong>Case presentation: </strong>A preterm infant was born at 26th week of gestational age via emergency Cesarean section due to hydrops fetalis, with parvovirus B19 exposure one month prior. The infant tested positive for IgM antibodies against parvovirus B19. Among many other serious complications of both hydrops fetalis and premature delivery, the infant had severe unremitting anemia, and received many PRBC transfusion over the course of his 71-day-long neonatal intensive care unit stay. During a follow up appointments as outpatient, his blood tests showed persistent high copies of parvovirus B19. He was then supported with PRBC transfusions and treated with IVIG. After three doses of IVIG, the infant's parvovirus B19 viral copy numbers have dramatically reduced and the infant did not require any more PRBC transfusions.</p><p><strong>Conclusions: </strong>IVIG infusion effectively treated the parvovirus B19 infection and restored erythropoiesis making the child transfusion independent. Furthermore, since IVIG is safe and readily crosses the placenta, further studies are needed to determine if IVIG should be considered as an alternative prenatal treatment for congenital parvovirus B19 infection.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benzylpenicillin concentrations in umbilical cord blood and plasma of premature neonates following intrapartum doses for group B streptococcal prophylaxis.","authors":"Amadou Samb,&nbsp;Thomas H Dierikx,&nbsp;Yuma A Bijleveld,&nbsp;Timo R de Haan,&nbsp;Caspar J Hodiamont,&nbsp;Elisabeth van Leeuwen,&nbsp;Anton H L C van Kaam,&nbsp;Ron A A Mathôt,&nbsp;Douwe H Visser","doi":"10.1186/s40748-023-00163-3","DOIUrl":"https://doi.org/10.1186/s40748-023-00163-3","url":null,"abstract":"<p><strong>Background and method: </strong>Dutch obstetrics guideline suggest an initial maternal benzylpenicillin dose of 2,000,000 IU followed by 1,000,000 IU every 4 h for group-B-streptococci (GBS) prophylaxis. The objective of this study was to evaluate whether concentrations of benzylpenicillin reached concentrations above the minimal inhibitory concentrations (MIC) in umbilical cord blood (UCB) and neonatal plasma following the Dutch guideline.</p><p><strong>Results: </strong>Forty-six neonates were included. A total of 46 UCB samples and 18 neonatal plasma samples were available for analysis. Nineteen neonates had mothers that received intrapartum benzylpenicillin. Benzylpenicillin in UCB corresponded to concentrations in plasma drawn directly postpartum (R2 = 0.88, p < 0.01). A log-linear regression suggested that benzylpenicillin concentrations in neonates remained above the MIC threshold 0.125 mg/L up to 13.0 h after the last intrapartum dose.</p><p><strong>Conclusions: </strong>Dutch intrapartum benzylpenicillin doses result in neonatal concentrations above the MIC of GBS.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10120722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What are the barriers preventing the screening and management of neonatal hypoglycaemia in low-resource settings, and how can they be overcome?","authors":"Lauren M Irvine, Deborah L Harris","doi":"10.1186/s40748-023-00162-4","DOIUrl":"10.1186/s40748-023-00162-4","url":null,"abstract":"<p><p>Over 25 years ago, the World Health Organization (WHO) acknowledged the importance of effective prevention, detection and treatment of neonatal hypoglycaemia, and declared it to be a global priority. Neonatal hypoglycaemia is common, linked to poor neurosensory outcomes and, if untreated, can cause seizures and death. Neonatal mortality in low and lower-middle income countries constitutes an estimated 89% of overall neonatal deaths. Factors contributing to high mortality rates include malnutrition, infectious diseases, poor maternal wellbeing and resource constraints on both equipment and staff, leading to delayed diagnosis and treatment. The incidence of neonatal hypoglycaemia in low and lower-middle income countries remains unclear, as data are not collected.Data from high-resource settings shows that half of all at-risk babies will develop hypoglycaemia, using accepted clinical thresholds for treatment. Most at-risk babies are screened and treated, with treatment aiming to increase blood glucose concentration and, therefore, available cerebral fuel. The introduction of buccal dextrose gel as a first-line treatment for neonatal hypoglycaemia has changed the care of millions of babies and families in high-resource settings. Dextrose gel has now also been shown to prevent neonatal hypoglycaemia.In low and lower-middle income countries, there are considerable barriers to resources which prevent access to reliable blood glucose screening, diagnosis, and treatment, leading to inequitable health outcomes when compared with developed countries. Babies born in low-resource settings do not have access to basic health care and are more likely to suffer from unrecognised neonatal hypoglycaemia, which contributes to the burden of neurosensory delay and death.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9556655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Congenital pleuropulmonary blastoma in a newborn with a variant of uncertain significance in DICER1 evaluated by RNA-sequencing.","authors":"Allison N J Lyle,&nbsp;Timothy J D Ohlsen,&nbsp;Danny E Miller,&nbsp;Gabrielle Brown,&nbsp;Natalie Waligorski,&nbsp;Rebecca Stark,&nbsp;Mallory R Taylor,&nbsp;Mihai Puia-Dumitrescu","doi":"10.1186/s40748-023-00161-5","DOIUrl":"https://doi.org/10.1186/s40748-023-00161-5","url":null,"abstract":"","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9526071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of maternally-administered infant massage for mothers of hospitalized preterm infants: a scoping review.","authors":"Dana B McCarty, Sandra Willett, Mary Kimmel, Stacey C Dusing","doi":"10.1186/s40748-023-00151-7","DOIUrl":"10.1186/s40748-023-00151-7","url":null,"abstract":"<p><strong>Objectives: </strong>Infant massage (IM) is a well-studied, safe intervention known to benefit infants born preterm. Less is known about the benefits of maternally-administrated infant massage for mothers of preterm infants who often experience increased rates of anxiety and depression in their infants' first year of life. This scoping review summarizes the extent, nature, and type of evidence linking IM and parent-centered outcomes.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for scoping reviews (PRISMA-ScR) protocol was followed using three databases: PubMed, Embase, and CINAHL. Thirteen manuscripts evaluating 11 separate study cohorts met pre-specified inclusion criteria.</p><p><strong>Results: </strong>Six primary topics related to the influence of infant massage on parent outcomes emerged: 1) anxiety, 2) perceived stress, 3) depressive symptoms, 4) maternal-infant interaction, 5) maternal satisfaction, and 6) maternal competence. Emerging evidence supports that infant massage, when administered by mothers, benefits mothers of preterm infants by reducing anxiety, stress, and depressive symptoms and improving maternal-infant interactions in the short-term, but there is limited evidence to support its effectiveness on these outcomes in longer periods of follow-up. Based on effect size calculations in small study cohorts, maternally-administered IM may have a moderate to large effect size on maternal perceived stress and depressive symptoms.</p><p><strong>Conclusions: </strong>Maternally-administered IM may benefit mothers of preterm infants by reducing anxiety, stress, depressive symptoms, and by improving maternal-infant interactions in the short-term. Additional research with larger cohorts and robust design is needed to understand the potential relationship between IM and parental outcomes.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9465725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of intestinal parasitic infections and associated factors among pregnant women in East Africa: a systematic review and meta-analysis.","authors":"Getu Mosisa,&nbsp;Dereje Chala Diriba,&nbsp;Reta Tsegaye,&nbsp;Gemechu Kejela,&nbsp;Diriba Bayisa,&nbsp;Adugna Oluma,&nbsp;Bizuneh Wakuma,&nbsp;Muktar Abadiga,&nbsp;Ebisa Turi,&nbsp;Tesfaye Abera,&nbsp;Lami Bayisa,&nbsp;Girma Tufa","doi":"10.1186/s40748-023-00150-8","DOIUrl":"https://doi.org/10.1186/s40748-023-00150-8","url":null,"abstract":"<p><strong>Background: </strong>The ultimate goal of preventing intestinal parasites among pregnant women is to reduce maternal and newborn morbidity and mortality. Numerous primary studies were conducted in East Africa presented intestinal parasite infection and associated factors among pregnant women. However, the pooled finding is not known. Therefore, this review aimed to identify the pooled prevalence of intestinal parasite infection and its determinants among pregnant women in East Africa.</p><p><strong>Methods: </strong>Articles published from 2009 to 2021 were searched in PubMed, Web of Science, EMBASE, and HINARI databases. The search for unpublished studies such as thesis and dissertations was checked in Addis Ababa University and Africa Digital Library. PRISMA checklist was used to report the review. Articles published in the English Language were considered. The data were extracted by two authors using data extraction checklists on Microsoft excel. Heterogeneity among the included studies was checked using I² statistics on forest plots. Sensitivity and sub-group analyses were conducted to assess the presence of primary studies, and study characteristics responsible for the observed heterogeneity.</p><p><strong>Results: </strong>Of the 43 identified articles, about 23 articles were removed due to duplications. Then, by assessing the abstracts and full texts, four articles were removed because they failed to meet the eligibility criteria. Finally, 16 articles were included in the systematic and meta-analysis.The pooled prevalence of intestinal parasites among pregnant women in East Africa was 38.54 (28.77, 48.32). In this study, variables like residing in rural areas (OR: 3.75; CI: 1.15,12.16), availability of latrine(OR: 2.94; 95% CI: 2.22, 3.91), eating raw fruits/vegetables (OR: 2.44; 95% CI: 1.16, 5.11). and sources of water as unprotected sources (OR: 2.20; 95% CI: 1.11,4.35) show statistically significant association with the increased burden of intestinal parasites among pregnant women.</p><p><strong>Conclusion: </strong>The burden of intestinal parasite infection among pregnant women in East Africa was high. Therefore, efforts should be made in deworming pregnant women at the community and institutional level by stakeholders to reduce the burden of intestinal parasite infections and related complications.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9264078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital pleuropulmonary blastoma in a newborn with a variant of uncertain significance in DICER1 evaluated by RNA-sequencing.","authors":"Allison N J Lyle, Timothy J D Ohlsen, Danny E Miller, Gabrielle Brown, Natalie Waligorski, Rebecca Stark, Mallory R Taylor, Mihai Puia-Dumitrescu","doi":"10.1186/s40748-023-00148-2","DOIUrl":"10.1186/s40748-023-00148-2","url":null,"abstract":"<p><strong>Background: </strong>Pleuropulmonary blastoma (PPB) is a rare mesenchymal malignancy of the lung and is the most common pulmonary malignancy in infants and children. Cystic PPB, the earliest form of PPB occurring from birth to approximately two years of age, is often mistaken for a congenital pulmonary airway malformation, as the two entities can be difficult to distinguish on imaging and pathology. Diagnosis of PPB should prompt workup for DICER1 syndrome, an autosomal dominant tumor predisposition syndrome. We report a newborn with a congenital PPB presenting with tachypnea and hypoxia, who was found to have variant of uncertain clinical significance (VUS) in DICER1.</p><p><strong>Case presentation: </strong>A term female infant developed respiratory distress shortly after birth. Initial imaging was concerning for a congenital pulmonary airway malformation versus congenital diaphragmatic hernia, and she was transferred to a quaternary neonatal intensive care unit for management and workup. Chest CT angiography demonstrated a macrocytic multicystic lesion within the right lower lobe without systemic arterial supply. The pediatric surgery team was consulted, and the neonate underwent right lower lobectomy. Pathology revealed a type I PPB. Oncology and genetics consultants recommended observation without chemotherapy and single gene sequencing of DICER1, which identified a germline VUS in DICER1 predicted to alter splicing. RNA-sequencing from blood demonstrated that the variant resulted in an in-frame deletion of 29 amino acids in a majority of transcripts from the affected allele. Due to the patient's young age at presentation and high clinical suspicion for DICER1 syndrome, tumor surveillance was initiated. Renal and pelvic ultrasonography were unremarkable.</p><p><strong>Conclusion: </strong>We present the case of a term neonate with respiratory distress and cystic lung mass, found to have a type I PPB with a germline VUS in DICER1 that likely increased her risk of DICER1-related tumors. Nearly 70% of patients with PPB demonstrate germline mutations in DICER1. Review of RNA sequencing data demonstrates the difficulty in classifying splice variants such as this. Penetrance is low, and many patients with pathogenic DICER1 variants do not develop a malignancy. Best practice surgical and oncologic recommendations include an individualized approach and tumor board discussion. This case highlights the importance of a multidisciplinary team approach and the utility of international registries for patients with rare diagnoses.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10018833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9543271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of maternal nationality with preterm birth and low birth weight rates: analysis of nationwide data in Japan from 2016 to 2020.","authors":"Tasuku Okui,&nbsp;Yoko Sato,&nbsp;Seiichi Morokuma,&nbsp;Naoki Nakashima","doi":"10.1186/s40748-023-00149-1","DOIUrl":"https://doi.org/10.1186/s40748-023-00149-1","url":null,"abstract":"<p><strong>Background: </strong>The rate of low birth weight or preterm birth is known to vary according to the birth place of mothers. However, in Japan, studies that investigated the association between maternal nationalities and adverse birth outcomes are few. In this study, we investigated the association between maternal nationalities and adverse birth outcomes.</p><p><strong>Methods: </strong>We obtained live birth data from the Vital Statistics 2016-2020 of the Ministry of Health, Labour, and Welfare. We used data on maternal age, sex, parity, gestational age, birth weight, number of fetuses, household occupation, paternal nationality, and maternal nationality for each infant. We compared the rates of preterm birth and low birth weight at term among mothers whose nationalities were Japan, Korea, China, Philippines, Brazil, and other countries. Log binomial regression model was used to investigate the association between maternal nationality and the two birth outcomes using the other infants' characteristics as covariates.</p><p><strong>Results: </strong>In the analysis, data on 4,290,917 singleton births were used. Mothers from Japan, Korea, China, the Philippines, Brazil, and other nations had preterm birth rates of 4.61%, 4.16%, 3.97%, 7.43%, 7.69%, and 5.61%, respectively. The low birth weight rate among Japanese mothers was 5.36% and was the highest among the maternal nationalities. Regression analysis showed that the relative risk for preterm birth among Filipino, Brazilian, and mothers from other countries (1.520, 1.329, and 1.222, respectively) was statistically significantly higher compared with Japanese mothers. In contrast, the relative risk for Korean and Chinese mothers (0.870 and 0.899, respectively) was statistically significantly lower compared with Japanese mothers. Mothers from Korea, China, the Philippines, Brazil, and other nations had a relative risk for low birth weight that was statistically significantly lower than that of Japanese mothers (0.664, 0.447, 0.867, 0.692, and 0.887, respectively).</p><p><strong>Conclusions: </strong>Support for mothers from the Philippines, Brazil, and other countries are necessary to prevent preterm birth. A future study is necessary to investigate the differences in characteristics among mothers of different nationalities in order to uncover the reason for the high risk for low birth weight among Japanese mothers.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9993667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic vasculitis diagnosed during the post-partum period: case report and review of the literature.","authors":"Sophie Demotier,&nbsp;Pauline Orquevaux,&nbsp;Yohan N'Guyen","doi":"10.1186/s40748-023-00147-3","DOIUrl":"https://doi.org/10.1186/s40748-023-00147-3","url":null,"abstract":"<p><strong>Introduction: </strong>The vasculitis diagnosed specifically in the post-partum period are less well known. We report here such a case followed by a descriptive review of the literature.</p><p><strong>Case report: </strong>A 25 year-old French nurse reported abrupt-onset musculoskeletal pain 15 days after delivery of her first infant. Her first pregnancy was uneventful. The physical examination yielded only bilateral conjunctivitis and purpuric eruption of lower limbs, and complementary investigations evidenced pulmonary renal syndrome in connection with the diagnosis of Granulomatosis with Polyangiitis.</p><p><strong>Methods: </strong>We screened previous articles in Medline database using keywords (i) \"post-partum\" or \"puerperium\" (ii)\"peripartum\" (iii) \"pregnancy\" associated with \"vasculitis\". Full texts were obtained from case reports or cases series whose title or abstract included keywords of interest (or synonyms). These references were secondarily excluded if the diagnosis of vasculitis was not confirmed or made before or more than 6 months after delivery and if vasculitis occurred only in the new born or affected only the cerebral vasculature or the retina.</p><p><strong>Results: </strong>Fifty-six cases of vasculitis diagnosed in the post-partum period were included, 50 (89.3%) were secondary to an immunological process and 44 corresponded to primary vasculitis, 4 were secondary to Systemic Lupus Erythematosus, 1 to cryoglobulinaemia and 1 to cryoglobulinaemia associated with inflammatory bowel disease. The main primary vasculitis diagnosed were Takayasu Arteritis (n = 10), Eosinophilic granulomatosis with polyangiitis (n = 9), Granulomatosis with Polyangiitis (n = 7), Periarteritis Nodosa (n = 5) and Behcet's disease (n = 4). The first symptom occurred before delivery in 26 (59.1%) and maternal death occurred in 4 (9.1%) out of the 44 primary vasculitis cases.</p><p><strong>Conclusion: </strong>The vasculitis diagnosed in the post-partum period were mainly primary vasculitis among patients in whom the diagnosis had not been made during pregnancy. In less than half of cases and as described in ours, there were no reported symptoms before delivery. Therefore, the physicians should pay attention to symptoms and keep a high degree of suspicion for vasculitis before as well as after delivery.</p>","PeriodicalId":74120,"journal":{"name":"Maternal health, neonatology and perinatology","volume":"9 1","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9906945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10684461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}