Pre-eclampsia and the anaesthetist

Publication date: Available online 15 June 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Yogini Kalamkar, Kailash BhatiaAbstractPre-eclampsia is a multisystem disorder of pregnancy that forms an integral part of the spectrum known as hypertensive diseases of pregnancy, occurring after 20 weeks of gestation. Intracerebral haemorrhage, pulmonary, liver and renal dysfunction are recognized complications of pre-eclampsia that contribute to maternal morbidity and mortality. Measurement of specific maternal angiogenic factors such as placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1) may aid in the diagnosis of and management of this condition. Strict blood pressure control using anti-hypertensive medications, aspirin in the dose of 75–150 mg for prophylaxis antenatally, fluid restriction, magnesium sulphate for seizure prophylaxis and timely delivery remain the key strategies to decrease maternal morbidity. Neuraxial anaesthesia, provided the coagulation status is normal is the preferred technique for delivery. If general anaesthesia is used, emphasis should be on preparing for a difficult airway and ablation of the pressor response of laryngoscopy and intubation.
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research

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ConclusionMigraines have a high incidence in gynaecology and obstetrics. Health care providers must include screening questions when history taking to identify women with migraines and effectively manage them. Proper follow-up and treatment is required for all women with migraines in order to minimize the risk of cerebrovascular events, and negative pregnancy outcomes. Women with migraines are advised to avoid combined hormonal contraception and use progesterone only pills.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Publication date: Available online 16 July 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Kai-Lun Hu, Hongcui Zhao, Yang Yu, Rong LiAbstractKisspeptins are a family of neuropeptides that are critical for the puberty initiation and female fertility. Plasma or serum kisspeptin is mainly derived from the placenta during pregnancy and plasma kisspeptin levels significantly increase across pregnancy. Plasma kisspeptin levels could be used as a potential biomarker for the detection of miscarriage, pre-eclampsia, gestational trophoblastic neoplasia (GTN), and fetal development. Kissp...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
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ConclusionAspirin use in pregnancy reduces the risks of maternal hypertensive disorders. Early initiation of aspirin in high-risk women was associated with lower incidence of preeclampsia/eclampsia. Meanwhile, the protective effect of aspirin on term preeclampsia/eclampsia and gestational hypertension may continue till late pregnancy.
Source: Pregnancy Hypertension: An International Journal of Womens Cardiovascular Health - Category: OBGYN Source Type: research
Kisspeptins are a family of neuropeptides that are critical for the puberty initiation and female fertility. Plasma or serum kisspeptin is mainly derived from the placenta during pregnancy and plasma kisspeptin levels significantly increase across pregnancy. Plasma kisspeptin levels could be used as a potential biomarker for the detection of miscarriage, pre-eclampsia, gestational trophoblastic neoplasia (GTN), and fetal development. Kisspeptin may also be involved in the process of parturition by stimulating oxytocin secretion during term pregnancy.
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Review article Source Type: research
Vitamin D deficiency has been associated with an increased risk of abnormal pregnancy implantation leading to obstetric complications such as pre-eclampsia and fetal growth restriction. However, the effect of ...
Source: Reproductive Health - Category: OBGYN Authors: Tags: Research Source Type: research
Authors: Eslick R, McLintock C Abstract Around 1 in 10 pregnant women will develop thrombocytopenia during an otherwise unremarkable pregnancy. While the most frequent cause is gestational thrombocytopenia, a benign clinical entity which typically induces a mild platelet fall in late pregnancy, a number of important pregnancy-specific causes must be excluded, particularly pre-eclampsia and its severe form hemolysis with elevated liver enzymes and low platelets (HELLP). For women who do not have an identifiable pregnancy-related cause of thrombocytopenia, an underlying medical condition should be considered. The mos...
Source: Platelets - Category: Hematology Tags: Platelets Source Type: research
ConclusionManagement of SE in pregnancy is influenced by etiology of SE and duration of pregnancy. It carries a good prognosis if detected early and treated appropriately. Large-scale multicentric studies are warranted for formulating definite guidelines for management of SE in pregnancy.This article is part of the Special Issue “Proceedings of the 7th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures”.
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
ConclusionssLR11 increases during pregnancy, with levels further exaggerated in pre-eclampsia, and may be related to the pathology of pre-eclampsia.
Source: Clinica Chimica Acta - Category: Laboratory Medicine Source Type: research
CONCLUSION: Management of SE in pregnancy is influenced by etiology of SE and duration of pregnancy. It carries a good prognosis if detected early and treated appropriately. Large-scale multicentric studies are warranted for formulating definite guidelines for management of SE in pregnancy. This article is part of the Special Issue "Proceedings of the 7th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures". PMID: 31303443 [PubMed - as supplied by publisher]
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
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