AJP Reports最新文献_第7页

The Combined Influence of Maternal Medical Conditions on the Risk of Primary Cesarean Delivery. 产妇医疗状况对初次剖宫产风险的综合影响。

IF 0.8

AJP Reports Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1777996

Robert Fresch, Kendal Stephens, Emily DeFranco

{"title":"The Combined Influence of Maternal Medical Conditions on the Risk of Primary Cesarean Delivery.","authors":"Robert Fresch, Kendal Stephens, Emily DeFranco","doi":"10.1055/s-0043-1777996","DOIUrl":"10.1055/s-0043-1777996","url":null,"abstract":"Background Common maternal medical comorbidities such as hypertensive disorders, diabetes, tobacco use, and extremes of maternal age, body mass index, and gestational weight gain are known individually to influence the rate of cesarean delivery. Numerous studies have estimated the risk of individual conditions on cesarean delivery. Objective To examine the risk for primary cesarean delivery in women with multiple maternal medical comorbidities to determine the cumulative risk they pose on mode of delivery. Study Design In this population-based retrospective cohort study, we analyzed data from Ohio live birth records from 2006 to 2015 to estimate the influence of individual and combinations of maternal comorbidities on rates of singleton primary cesarean delivery. The exposures were individual and combinations of maternal medical conditions (chronic hypertension [CHTN], gestational hypertension, pregestational diabetes, gestational diabetes, tobacco use, advanced maternal age, and maternal obesity) and outcomes were rates and adjusted relative risk (aRR) of primary cesarean delivery. Results There were 1,463,506 live births in Ohio during the study period, of which 882,423 (60.3%) had one or more maternal medical condition, and of those 243,112 (27.6%) had primary cesarean delivery. The range of rates and aRR range of primary cesarean delivery were 13.9 to 29.3% (aRR 0.78-1.68) in singleton pregnancies with a single medical condition, and this increased to 21.9 to 48.6% (aRR 1.34-3.87) in pregnancies complicated by multiple medical comorbidities. The highest risk for primary cesarean occurred in advanced maternal age, obese women with pregestational diabetes, and CHTN. Conclusion A greater number of maternal medical comorbidities during pregnancy is associated with increasing cumulative risk of primary cesarean delivery. These data may be useful in counseling patients on risk of cesarean during pregnancy.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 1","pages":"e51-e56"},"PeriodicalIF":0.8,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545012","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}

引用次数: 0

Atypical Presentation of Rocky Mountain Spotted Fever in Pregnancy. 妊娠期落基山斑疹热的非典型表现。

IF 0.8

AJP Reports Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1778118

Jenny Wu, Sarah K Dotters-Katz, Megan Varvoutis

引用次数: 0

Intrahepatic Cholestasis of Pregnancy and Transaminitis in Women with COVID-19: A Case Series. 患有 COVID-19 的女性妊娠期肝内胆汁淤积症和转氨酶炎：病例系列。

IF 0.8

AJP Reports Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1777999

Anne R Waldrop, Andrea Henkel, Kelley B Lee, Maurice L Druzin, Natali Aziz, Yasser El-Sayed, Deirdre J Lyell

{"title":"Intrahepatic Cholestasis of Pregnancy and Transaminitis in Women with COVID-19: A Case Series.","authors":"Anne R Waldrop, Andrea Henkel, Kelley B Lee, Maurice L Druzin, Natali Aziz, Yasser El-Sayed, Deirdre J Lyell","doi":"10.1055/s-0043-1777999","DOIUrl":"10.1055/s-0043-1777999","url":null,"abstract":"Objective The four initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant women presenting at term gestation to our institution presented with transaminitis. Three of the four were diagnosed with intrahepatic cholestasis of pregnancy (IHCP). Growing evidence exists of an associated transaminitis in nonpregnant SARS-CoV-2 patients. However, there are limited data of hepatic involvement of SARS-CoV-2 in pregnancy, and no previous studies have assessed the association with IHCP in patients with coronavirus disease 2019 (COVID-19). Study Design This was a retrospective, single-center case series of four consecutive pregnant women with a positive result for SARS-CoV-2 presenting with transaminitis in third trimester. Results The clinical courses of four pregnant women with COVID-19 and transaminitis, three of four of whom were diagnosed with IHCP, are described. Testing for SARS-CoV-2 was done through a reverse transcription polymerase chain reaction test of a nasopharyngeal swab. Conclusion As we await larger studies ascertaining the incidence of IHCP in SARS-CoV-2, this prevalence highlights the importance of diagnosing IHCP among women with COVID-19 as a potential etiology of transaminitis, as IHCP risks may be ameliorated with earlier delivery. Moreover, delineating a hepatobiliary association in pregnancy may provide further information about the mechanism of liver impairment in SARS-CoV-2 in all patients.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 1","pages":"e16-e18"},"PeriodicalIF":0.8,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139548262","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}

引用次数: 0

Bicoastal Spontaneous Coronary Artery Dissection: A Therapeutic Dilemma. 双腔自发性冠状动脉夹层：治疗难题。

IF 0.8

AJP Reports Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1778112

Ann B Nguyen Pham, Madushka Y De Zoysa, Brian B Ghoshhajra, Nandita S Scott, Afshan B Hameed

{"title":"Bicoastal Spontaneous Coronary Artery Dissection: A Therapeutic Dilemma.","authors":"Ann B Nguyen Pham, Madushka Y De Zoysa, Brian B Ghoshhajra, Nandita S Scott, Afshan B Hameed","doi":"10.1055/s-0043-1778112","DOIUrl":"10.1055/s-0043-1778112","url":null,"abstract":"Due to the potential for severe maternal morbidity and even mortality, pregnancy-associated spontaneous coronary artery dissection (P-SCAD) often presents as a clinical conundrum. While current recommendations encourage coronary interventions when medically indicated even during pregnancy, the hesitation still understandably exists. Meanwhile, given the rarity of the condition, the guidelines for management are still based on expert consensus. We present a case of P-SCAD in a 38-year-old woman with initial presentation at 28 weeks' gestation and recurrence at 9 days postpartum. A unique complication of this case is its transcontinental nature: the initial event occurred while the patient was on vacation across the country from her home. Questions arose not only with regard to her immediate management and care but also when she would be able to travel and how her complex care would be continued cross-country. This case raised important questions regarding the antepartum management of acute coronary syndrome (ACS). It also highlights the importance of multidisciplinary care, especially with a cardio-obstetrics team, in the management of P-SCAD and emphasizes the role for universal screening for cardiac diseases in pregnancy.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 1","pages":"e34-e39"},"PeriodicalIF":0.8,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139544775","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}

引用次数: 0

Small Cell Cervical Carcinoma in Pregnancy: Therapeutic Options for an Aggressive Cancer Diagnosis. 妊娠期小细胞宫颈癌：侵袭性癌症诊断的治疗方案。

IF 0.8

AJP Reports Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1777998

Alyssa Savelli Binsted, Zeinab Kassem, David Le, Margarita de Veciana

引用次数: 0

Peripartum Abdominal Compartment Syndrome Following Extracorporeal Hemodynamic Support. 体外血流动力学支持后的围产期腹腔隔室综合征。

IF 0.8

AJP Reports Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1777997

Violetta Lozovyy, Fawzi Saoud, Luis D Pacheco

引用次数: 0

Early Prenatal Diagnosis of Cornelia de Lange's Syndrome with Whole-Exome Sequencing: A Case Report. 利用全基因组测序对科尼莉亚-德-朗格综合征进行早期产前诊断：病例报告。

IF 0.8

AJP Reports Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1776149

Amna Iftikhar, Kathleen Barnes, Melissa Figueroa, Antonia P Francis

引用次数: 0

Fetal Metabolic Alkalosis Resulting from Maternal Vomiting. 产妇呕吐导致的胎儿代谢性碱中毒

IF 0.8

AJP Reports Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI: 10.1055/s-0043-1778113

William M Curtin, Emily A O'Brien, Rachel M Mauro, Elizabeth A Lucarelli-Baldwin, Serdar H Ural, Christina T DeAngelis

{"title":"Fetal Metabolic Alkalosis Resulting from Maternal Vomiting.","authors":"William M Curtin, Emily A O'Brien, Rachel M Mauro, Elizabeth A Lucarelli-Baldwin, Serdar H Ural, Christina T DeAngelis","doi":"10.1055/s-0043-1778113","DOIUrl":"10.1055/s-0043-1778113","url":null,"abstract":"We describe a pregnant patient with severe compulsive water ingestion and vomiting that lead to metabolic alkalosis and preterm delivery. A 21-year-old patient was hospitalized multiple times throughout pregnancy for symptoms initially thought to be related to hyperemesis gravidarum. Overtime, it became apparent that the patient induced vomiting by rapidly drinking large volumes of water. At 32 weeks' gestation, rapid ingestion of water caused 3 days of vomiting with findings of hyponatremia, hypokalemia, hypochloremia, metabolic alkalosis, and compensatory respiratory acidosis. Fetal monitoring showed minimal variability and recurrent decelerations; subsequent biophysical profile score of 2/10 prompted urgent cesarean section. A male newborn was delivered and cord blood gases reflected neonatal metabolic alkalosis and electrolyte imbalances identical to those of the mother. Compensatory hypoventilation in both mother and fetus were treated with assisted ventilation. With saline administration and repletion of electrolytes, metabolic alkalosis resolved for both patients within days. Metabolic alkalosis was transplacentally acquired by the fetus. This case demonstrates the development of metabolic alkalosis in a pregnant woman caused by vomiting severe enough to prompt preterm delivery for nonreassuring fetal status. It also demonstrates fetal dependence on both placenta and mother to maintain physiologic acid-base and electrolyte balance.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"14 1","pages":"e48-e50"},"PeriodicalIF":0.8,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139544914","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}

引用次数: 0

A Case of Significant Transaminitis with Liver Biopsy in a Pregnant Patient with COVID-19. 妊娠COVID-19患者肝活检显示明显转氨炎1例

IF 0.9

AJP Reports Pub Date : 2023-11-28 eCollection Date: 2023-07-01 DOI: 10.1055/s-0043-1777099

Dana Senderoff Berger, Anna Galyean, Kelvin Nguyen, Najeeb Alshak, Elizabeth Blumenthal

引用次数: 0

Evaluation of Early Screening for Diabetes Mellitus in Pregnancy with Hemoglobin A1c. 糖化血红蛋白早期筛查妊娠期糖尿病的评价。

IF 0.9

AJP Reports Pub Date : 2023-11-07 eCollection Date: 2023-07-01 DOI: 10.1055/s-0043-1776150

Andrew S Haddad, Melissa H Fries, Helain Landy, Priyanka S Tripuraneni, Sara N Iqbal

{"title":"Evaluation of Early Screening for Diabetes Mellitus in Pregnancy with Hemoglobin A1c.","authors":"Andrew S Haddad, Melissa H Fries, Helain Landy, Priyanka S Tripuraneni, Sara N Iqbal","doi":"10.1055/s-0043-1776150","DOIUrl":"10.1055/s-0043-1776150","url":null,"abstract":"Early diabetes screening is recommended for high-risk pregnant women risk via a 1-hour glucose challenge test (1-hour GCT). Hemoglobin A1c (HbA1c) can be obtained with initial obstetric laboratories. We sought to examine the relationship between HbA1c and 1-hour GCT for early diabetes screening in pregnancy. This is a retrospective cohort study of 204 high-risk pregnant women who underwent early HbA1c and 1-hour GCT. Simple logistic regression analysis was performed to predict abnormal 1-hour GCT and diagnosis of diabetes using HbA1c. A total of 158 (77.5%), 44 (21.5%), and 2 (1%) women had HbA1c of less than 5.7, 5.7 to 6.4, and 6.5% or higher, respectively. Seven of 158 (4.4%) women with HbA1c less than 5.7% and 8 of 44 (18.2%) with HbA1c of 5.7 to 6.4% had a diagnosis of diabetes. A positive correlation between early HbA1c and 1-hour GCT was detected. Logistic regression showed HbA1c significantly predicted the risk of diabetes but was not a good predictor of abnormal 1-hour GCT. HbA1c of 5.5% or less had a 97% or higher negative predictive value for early diabetes in pregnancy. There is a positive correlation between HbA1c and 1-hour GCT for the early screening of diabetes in pregnancy. Women with early HbA1c ≤ 5.5% could forego further testing in early pregnancy.","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"13 4","pages":"e71-e77"},"PeriodicalIF":0.9,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71520239","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}

引用次数: 0