AJP Reports最新文献

{"title":"Refractory Pulmonary Interstitial Emphysema in Extreme Premature Newborn.","authors":"Mahmoud Ali,&nbsp;Lea Mallett,&nbsp;Greg Miller","doi":"10.1055/s-0041-1727261","DOIUrl":"https://doi.org/10.1055/s-0041-1727261","url":null,"abstract":"<p><p>Pulmonary interstitial emphysema (PIE) occurs when air leaks into the pulmonary interstitium due to overdistension of distal airways, it occurs mainly in neonates with respiratory distress syndrome who need positive pressure ventilation but has also been reported in spontaneously breathing infants. Herein, we report on an extremely low birth weight infant with severe persistent PIE, while on invasive mechanical ventilation (high-frequency oscillatory ventilation, high-frequency jet ventilation, and neurally adjust ventilator assist) managed successfully with 2 weeks of selective right lung ventilation after failure of more conservative measures, including shorter periods of right mainstem intubation, before the prolonged trial that was successful.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 2","pages":"e61-e64"},"PeriodicalIF":0.9,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1727261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38953806","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":"Pneumothorax in Neonates Born to COVID-19-Positive Mothers: Fact or Fortuity?","authors":"Ranjith Kamity,&nbsp;Amrita Nayak,&nbsp;Vikramaditya Dumpa","doi":"10.1055/s-0041-1726020","DOIUrl":"https://doi.org/10.1055/s-0041-1726020","url":null,"abstract":"<p><p>Neonates born to mothers with coronavirus disease 2019 (COVID-19) have been largely asymptomatic based on initial reports. All neonates born to mothers with COVID-19 have tested negative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in our institution (published data as of April 12, 2020). As novel presentations of COVID-19, such as multisystem inflammatory syndrome in children are being increasingly reported, we raise the possibility of increased incidence of pneumothorax in neonates born to SARS-CoV-2-positive mothers. Two recently described neonates with COVID-19 infection were noted to have pneumothoraces. We describe two SARS-CoV-2-negative neonates born to COVID-19-positive mothers at 38 and 33 weeks, respectively, admitted to our neonatal intensive care unit for respiratory distress and subsequently developed pneumothoraces. As diverse clinical presentations in various age groups are being described, it becomes difficult to differentiate the increased incidence of complications related to an underlying illness, from COVID-19-related illness. It remains to be seen if neonates with in utero exposure to SARS-CoV-2 have an elevated inflammatory response with pneumonitis and exaggerated lung disease, similar to adult COVID-19 patients, due to in utero exposure.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 1","pages":"e49-e53"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1726020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25517602","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":"Risk of Early Birth among Women with a Urinary Tract Infection: A Retrospective Cohort Study.","authors":"Rebecca J Baer, Nichole Nidey, Gretchen Bandoli, Brittany D Chambers, Christina D Chambers, Sky Feuer, Deborah Karasek, Scott P Oltman, Larry Rand, Kelli K Ryckman, Laura L Jelliffe-Pawlowski","doi":"10.1055/s-0040-1721668","DOIUrl":"10.1055/s-0040-1721668","url":null,"abstract":"<p><p><b>Objective</b>  The aim of the study is to evaluate the risk of preterm birth (PTB, <37 weeks) and early term (37 and 38 weeks) birth among women with an emergency department (ED) visit or hospitalization with a urinary tract infection (UTI) by trimester of pregnancy. <b>Methods</b>  The primary sample was selected from births in California between 2011 and 2017. UTIs were identified from the ED or hospital discharge records. Risk of PTB, by subtype, and early term birth were evaluated by trimester of pregnancy and by type of visit using log-linear regression. Risk ratios were adjusted for maternal factors. Antibiotic usage was examined in a population of privately insured women from Iowa. <b>Results</b>  Women with a UTI during pregnancy were at elevated risk of a birth <32 weeks, 32 to 36 weeks, and 37 to 38 weeks (adjusted risk ratios [aRRs] 1.1-1.4). Of the women with a diagnostic code for multiple bacterial species, 28.8% had a PTB. A UTI diagnosis elevated risk of PTB regardless of antibiotic treatment (aRR 1.4 for treated, aRR 1.5 for untreated). <b>Conclusion</b>  UTIs are associated with early birth. This association is present regardless of the trimester of pregnancy, type of PTB, and antibiotic treatment.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 1","pages":"e5-e14"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1721668","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38855121","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 between Receipt of Intrapartum Magnesium Sulfate and Postpartum Hemorrhage.","authors":"Emily M S Miller, Allie Sakowicz, Elise Leger, Elizabeth Lange, Lynn M Yee","doi":"10.1055/s-0040-1721671","DOIUrl":"10.1055/s-0040-1721671","url":null,"abstract":"<p><p><b>Objective</b>  The aim of the study is to investigate the association between intrapartum administration of magnesium sulfate in women with hypertensive disorders of pregnancy and postpartum hemorrhage. <b>Study Design</b>  This was a retrospective cohort study of women diagnosed with a hypertensive disorder of pregnancy who delivered singleton gestations >32 weeks at a single, large volume tertiary care center between January 2006 and February 2015. Women who received intrapartum magnesium sulfate for seizure prophylaxis were compared with women who did not receive intrapartum magnesium sulfate. The primary outcome was frequency of postpartum hemorrhage. Secondary outcomes included estimated blood loss, uterine atony, and transfusion of packed red blood cells. Bivariable analyses were used to compare the frequencies of each outcome. Multivariable logistic regression models examined the independent associations of magnesium sulfate with outcomes. <b>Results</b>  Of 2,970 women who met inclusion criteria, 1,072 (36%) received intrapartum magnesium sulfate. Women who received magnesium sulfate were more likely to be nulliparous, publicly insured, of minority race or ethnicity, earlier gestational age at delivery, and undergo labor induction. The frequency of postpartum hemorrhage was significantly higher among women who received magnesium sulfate compared with those who did not (12.4 vs. 9.3%, <i>p</i>  = 0.008), which persisted after controlling for potential confounders. Of secondary outcomes, there was no difference in estimated blood loss between women who did and did not receive magnesium sulfate (250 mL [interquartile range 250-750] vs. 250 mL [interquartile range 250-750], <i>p</i>  = 0.446). However, compared with women who did not receive magnesium sulfate, women who received magnesium sulfate had a greater frequency of uterine atony (8.9 vs 4.9%, <i>p</i>  < 0.001) and transfusion of packed red blood cells (2.0 vs. 0.8%, <i>p</i>  = 0.008). These differences persisted after controlling for potential confounders. <b>Conclusion</b>  Intrapartum magnesium sulfate administration to women with hypertensive disorders of pregnancy is associated with increased odds of postpartum hemorrhage, uterine atony, and red blood cell transfusion.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 1","pages":"e21-e25"},"PeriodicalIF":0.8,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/66/10-1055-s-0040-1721671.PMC7850913.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25335287","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":"Biallelic Variants in <i>LAMB1</i> Causing Hydranencephaly: A Severe Phenotype of a Rare Malformative Encephalopathy.","authors":"Kuntal Sen,&nbsp;Shagun Kaur,&nbsp;David W Stockton,&nbsp;Mary Nyhuis,&nbsp;Jacquelyn Roberson","doi":"10.1055/s-0040-1722728","DOIUrl":"https://doi.org/10.1055/s-0040-1722728","url":null,"abstract":"<p><p><b>Case Report</b>  A 32-year-old female with a history of three prior pregnancy losses presented for genetic testing following an ultrasonography diagnosis of fetal hydranencephaly. Baby was born via C-section and was noted to have a head circumference of 48 cm, in addition to ocular and cardiac anomalies and dysmorphic features. Whole genome sequencing revealed a homozygous variant in <i>LAMB1</i> gene. <b>Discussion</b>  The pathobiogenesis of hydranencephaly is incompletely understood and is attributed to vascular, infectious, or genetic etiology. Herein we present <i>LAMB1</i> as a monogenic cause of fetal hydranencephaly which was incompatible with life. Previously, <i>LAMB1</i> -associated phenotype consisted of cobblestone lissencephaly and hydrocephalus, developmental delay, and seizures. Our proband expands the phenotypic spectrum of this malformative encephalopathy.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 1","pages":"e26-e28"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1722728","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25335289","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":"Expectant Management of Severe COVID-19 Pneumonia in Late Preterm Pregnancy and Subsequent Cholecystitis: Lessons Learned.","authors":"Neggin B Mokhtari, Daphnie Drassinower, Lindsey A Orr, Nathan K Cobb, Oscar L Mims, Helain J Landy","doi":"10.1055/s-0040-1721672","DOIUrl":"10.1055/s-0040-1721672","url":null,"abstract":"<p><p><b>Introduction</b>  Since the emergence of coronavirus disease 2019 (COVID-19) as a pandemic in March 2020, research and guidance have been published with regard to the management of infection and considerations in pregnancy, but much is still unknown. Pregnant women with COVID-19 infection are more likely to be hospitalized and are at increased risk for intensive care unit admissions and intubation than nonpregnant women with COVID-19 infection. The optimal timing of delivery among pregnant women with COVID-19 infection has not been established at this time, especially when the infection arises in late preterm and early term gestation. It is suggested that COVID-19 infection should not be considered a sole indication for delivery. The risks and benefits of prolonging pregnancy versus delivery should be taken into consideration at any given gestational age in a patient with COVID-19 infection. <b>Case Report</b>  We report a case of a patient in the late third trimester of pregnancy that presented with severe COVID-19 infection and was managed expectantly through her disease course with improvement of respiratory status without necessitating delivery. We also discuss the unique development of cholecystitis in her hospitalization that may represent another clinical association to COVID-19 infection. <b>Conclusion</b>  This case illustrates that delaying delivery is an option even in later gestational ages for maternal stabilization. A multidisciplinary approach and teamwork is needed to manage pregnant women with COVID-19 infection for optimal outcomes for both mother and fetus. <b>Key Points</b> Delaying delivery in severe coronavirus disease 2019 (COVID-19) infection is a reasonable option even in late gestation.A multidisciplinary team is of utmost importance when managing a pregnant woman with COVID-19.Other clinical sequalae such as cholecystitis may arise in the setting of COVID-19 infection.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 1","pages":"e29-e33"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/29/10-1055-s-0040-1721672.PMC7880816.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25377105","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":"Spontaneous Broad Ligament Hematoma after Vaginal Delivery Requiring Hysterectomy.","authors":"Megan Varvoutis,&nbsp;Nguyen Thao Thi Nguyen,&nbsp;Chad Grotegut","doi":"10.1055/s-0040-1722727","DOIUrl":"https://doi.org/10.1055/s-0040-1722727","url":null,"abstract":"<p><p><b>Background</b>  Broad ligament hematomas are rare in the setting of vaginal delivery. When they do occur, patients typically present with acute hemodynamic instability. No cases of infected broad ligament hematomas have been reported. <b>Case</b>  A 22-year-old G2 P1011 status post vaginal delivery complicated by chorioamnionitis and pre-eclampsia presented 5 days postpartum with subjective complaints of fever, vomiting, and increased vaginal bleeding. She was treated with antibiotics and uterine evacuation was planned for presumed retained products. After dilation and curettage, the patient was transferred to our facility, as her clinical status did not improve, and was later found to have an infected broad ligament hematoma requiring hysterectomy. <b>Conclusion</b>  Though uncommon, broad ligament hematomas should be considered in postpartum women presenting with anemia and vaginal bleeding, even without hemodynamic instability. Recent intrauterine infections may predispose to hematoma infection.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 1","pages":"e34-e37"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1722727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25391795","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 between Levels of Total Cell-Free DNA and Development of Preeclampsia-A Literature Review.","authors":"Yi Wu, Ana Werlang, Weiwei Cheng, Andrea Lanes, Shi Wu Wen, Mark Walker","doi":"10.1055/s-0040-1721674","DOIUrl":"10.1055/s-0040-1721674","url":null,"abstract":"<p><p><b>Objectives</b>  The aim of the study is to synthesize the evidence and evaluate the total cell-free deoxyribonucleic (cfDNA) associated with the prediction of preeclampsia (PE). Total cfDNA is constituted by both cell-free fetal DNA (cffDNA) originated mainly from the placenta, and maternal cfDNA derived from maternal leukocytes. <b>Methods</b>  A systematic review was conducted by searching PubMed and Medline. Literature reporting levels of total cfDNA in the development of PE was included. Studies that only reported cffDNA, but no cfDNA concentrations were not included in this review. <b>Results</b>  Eight studies were included. Seven reported values of cfDNA in PE patients, regardless of early or late onset PE, six of which demonstrated a significant increase of cfDNA in patients who subsequently developed PE. Seven studies evaluated cfDNA levels in the first trimester, six of which showed significant increase of cfDNA concentrations in women who later developed PE. Five studies investigated cfDNA levels in the second trimester, all presenting increased total cfDNA levels in the PE group compared with normal controls. <b>Conclusion</b>  Total cfDNA may play a role as a biochemical marker of PE, compared with fetal cfDNA. Large prospective studies with homogeneous populations and standardized methodology are needed to further confirm its predictive value.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 1","pages":"e38-e48"},"PeriodicalIF":0.8,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3d/c8/10-1055-s-0040-1721674.PMC7964254.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25501368","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 Perineal Groove Defect in Monozygotic Twin Infants: A Literature Review.","authors":"Mimily Harsono,&nbsp;David Yanishevski,&nbsp;Massroor Pourcyrous","doi":"10.1055/s-0041-1727145","DOIUrl":"https://doi.org/10.1055/s-0041-1727145","url":null,"abstract":"<p><p>Perineal groove is a rare benign congenital anomaly with lesion that resembles perforation of mid-perineum or perineal raphe area. Most reported cases of congenital perineal groove presented as an isolated defect in term or early-term singleton female infants. Thus far, there is no reported case of this anomaly in monozygotic twins. Embryo pathogenesis of this female predominance congenital defect remains controversial. Many clinicians are unfamiliar with this congenital anomaly. This congenital defect tends to get self-resolved at around 2 year of age. Nevertheless, the exposed nonepithelized mucous membrane can carry risk of local infection or irritation with the possibility of requiring early surgical correction. The defect can be infrequently associated with other ano-urogenital malformations that required immediate surgical intervention. Most isolated cases tend to be asymptomatic and self-healed with expectant management. Surgical correction may be considered if not healed after 2 years of age. Early diagnosis at birth is important to avoid misdiagnoses at later age for trauma, dermatitis, sexual abuse, and risk of unnecessary aggressive intervention. Early parental counseling for providing good hygiene and close follow-up is important to prevent infection or inflammation. Presentation of this anomaly in both monozygotic twins may support the hypothesis of potential disruption during embryo morphogenesis stages.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 1","pages":"e54-e57"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1727145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25558810","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":"Clinical Characteristics of Mother-Infant Dyad and Placental Pathology in COVID-19 Cases in Predominantly African American Population.","authors":"Sanket Jani,&nbsp;Suzanne M Jacques,&nbsp;Faisal Qureshi,&nbsp;Girija Natarajan,&nbsp;Sujit Bajaj,&nbsp;Pradeep Velumula,&nbsp;Cindy Agu,&nbsp;Monika Bajaj","doi":"10.1055/s-0040-1721673","DOIUrl":"https://doi.org/10.1055/s-0040-1721673","url":null,"abstract":"<p><p><b>Objective</b>  In this currently evolving coronavirus disease 2019 (COVID-19) pandemic, the evidence is scarce about the impact of COVID-19 infection on women in labor and neonates in an inner city African-Americans (AA) population. The objective of this study was to evaluate the clinical outcomes and placental pathology in mother-infant dyads in COVID-19 cases. <b>Study Design</b>  Retrospective chart review was conducted on 34 COVID-19 positive mother-infant dyads to study their baseline characteristics and outcomes. Placental pathology was reviewed by two perinatal pathologists. <b>Results</b>  COVID-19 was noted in 3% of pregnant women who delivered in our institution. The majority (82%) of them were asymptomatic. Out of the four mothers who were symptomatic, only three (9%) required supplemental oxygen. None of them required invasive ventilation. All the neonates tested negative for COVID-19 at 24 hours of age. There were no gross or microscopic pathological abnormalities detected that could be definitely associated with any COVID-19 related complications during pregnancy in any of the 34 placentas. <b>Conclusion</b>  COVID-19 does not appear to increase morbidity and mortality among pregnant women and their neonates in a predominantly AA population. Our study did not find any evidence of vertical transmission of COVID-19 infection nor any specific findings on placental pathology. <b>Key Points</b> Majority of women infected by coronavirus disease 2019 (COVID-19) during labor were asymptomatic.None of the newborns tested positive for COVID-19 at 24 hours of age.Placental pathology findings were nonspecific in COVID-19 mothers.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"11 1","pages":"e15-e20"},"PeriodicalIF":0.9,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0040-1721673","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25333906","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}