scholarly journals Cerebral Vascular Accident in Young Women: A Problem for Pregnancy and Contraception? Report of Two Cases

2020 ◽  
Vol 3 (3) ◽  
pp. 178-185
Author(s):  
Fernandes ALM ◽  
Araujo AHSL ◽  
Fonseca CC ◽  
Pinto CDC ◽  
Mata DS ◽  
...  
Keyword(s):  
Young Women ◽  
Pregnancy Outcomes ◽  
Protein C ◽  
Causes Of Death ◽  
Medical Emergency ◽  
Cerebral Vascular Accident ◽  
Recurrent Miscarriages ◽  
Hereditary Thrombophilia ◽  
Clinical Events ◽  
Adverse Pregnancy

Cerebrovascular disease (CVD) is a neurological medical emergency and one of the main causes of death worldwide; it is classified as ischemic or hemorrhagic. The disease is one of the most severe clinical events related to pregnancy due to thrombogenesis and thrombophilia; there is an incidence of 25 to 34 CVD per 100 thousand births. The current research reports two cases of stroke episode, one previous and another during pregnancy, as well as their associated complications. The first patient had hereditary thrombophilia caused by PAI 4G/5G polymorphism and previous stroke; however, she had regular pregnancy. The second patient had hereditary thrombophilia caused by protein C deficit, had a stroke during pregnancy, and preeclampsia in the first gestational semester; therefore, she was subjected to the cesarean section on the 35th week of pregnancy. Stroke episodes during pregnancy can be very aggressive because it can lead to death or disabilities, not only in the mother but also in the fetus. Based on the association between thrombotic processes and complications, prophylactic anticoagulant therapy is recommended for women with thrombophilia who had a stroke and/or certain adverse pregnancy outcomes, such as recurrent miscarriages.

Do adverse pregnancy outcomes contribute to accelerated cardiovascular events seen in young women with systemic lupus erythematosus?

Lupus ◽  
2017 ◽  
Vol 26 (13) ◽  
pp. 1351-1367 ◽  
Author(s):  
M C Soh ◽  
C Nelson-Piercy ◽  
M Westgren ◽  
L McCowan ◽  
D Pasupathy
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Cardiovascular Disease ◽  
Young Women ◽  
Lupus Erythematosus ◽  
Pregnancy Outcomes ◽  
Cardiovascular Events ◽  
Adverse Pregnancy Outcomes ◽  
Systemic Lupus ◽  
Adverse Pregnancy

Cardiovascular events (CVEs) are prevalent in patients with systemic lupus erythematosus (SLE), and it is the young women who are disproportionately at risk. The risk factors for accelerated cardiovascular disease remain unclear, with multiple studies producing conflicting results. In this paper, we aim to address both traditional and SLE-specific risk factors postulated to drive the accelerated vascular disease in this cohort. We also discuss the more recent hypothesis that adverse pregnancy outcomes in the form of maternal–placental syndrome and resultant preterm delivery could potentially contribute to the CVEs seen in young women with SLE who have fewer traditional cardiovascular risk factors. The pathophysiology of how placental-mediated vascular insufficiency and hypoxia (with the secretion of placenta-like growth factor (PlGF) and soluble fms-tyrosine-like kinase-1 (sFlt-1), soluble endoglin (sEng) and other placental factors) work synergistically to damage the vascular endothelium is discussed. Adverse pregnancy outcomes ultimately are a small contributing factor to the complex pathophysiological process of cardiovascular disease in patients with SLE. Future collaborative studies between cardiologists, obstetricians, obstetric physicians and rheumatologists may pave the way for a better understanding of a likely multifactorial aetiological process.

Adverse pregnancy outcomes and inherited thrombophilia

2018 ◽  
Vol 46 (4) ◽  
pp. 411-417 ◽  
Author(s):  
Dominik Dłuski ◽  
Radzisław Mierzyński ◽  
Elżbieta Poniedziałek-Czajkowska ◽  
Bożena Leszczyńska-Gorzelak
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Protein C ◽  
Antithrombin Iii ◽  
Activated Protein C ◽  
Protein S ◽  
Adverse Pregnancy Outcomes ◽  
Control Group ◽  
Inherited Thrombophilia ◽  
Adverse Pregnancy

Abstract Aim: (1) To evaluate the prevalence of inherited thrombophilia in pregnant women with adverse pregnancy outcomes: intrauterine growth retardation (IUGR), preeclampsia (PE) and placental abruption. (2) To assess the impact of inherited thrombophilia on the nature of obstetric complications. (3) To assess levels of protein S, protein C, antithrombin III and homocysteine in pregnant women with adverse pregnancy outcomes. Subjects and methods: The study comprised 162 pregnant women. The patients were divided into three test groups and one control group. In all 162 patients the following tests were completed: activated protein C resistance (APC-R), the level of free protein S, activity of protein C, antithrombin III and the level of homocysteine. The data were statistically analyzed via χ2 of independence or homogeneity test. Results: In 32 of 162 patients participating in clinical research thrombophilia was diagnosed (10 patients with APC-R, 21 patients with protein S deficiency, one patient with hyperhomocysteinemia): seven patients belonged to the control group and 25 patients had diagnosed adverse pregnancy outcomes (P=0.04). In 32 patients with diagnosed thrombophilia, level of protein S was decreased (P=0.04). Protein S deficiency was diagnosed, when level of protein S was lower than 30% in the second trimester and lower than 24% in the third trimester. The incidence of activated protein C resistance caused by the mutation of factor V Leiden was in six patients (5.9%) with adverse pregnancy outcomes, and in four patients (6.6%) from the control group. Results were not statistically significant. No protein C deficiency was diagnosed (diagnosis: level<60%), but in 50% of patients with thrombophilia level of protein C was over the norm (P=0.02). The level of antithrombin III was often decreased in patients with preeclampsia – (32.4%), then in the other patients – (17.2%) (P=0.04), but no patient was diagnosed with antithrombin III deficiency (diagnosis: level<60%). Conclusions: Tests for thrombophilia should be carried out in women with adverse pregnancy outcomes in their history, who are planning pregnancy, to start anticoagulant prophylaxis. Our study supports the thesis that tests for thrombophilia should be carried out in women with a history of adverse pregnancy outcomes and who are planning a pregnancy to start anticoagulant prophylaxis.

Abstract MP71: Ten Year Predicted Cardiovascular Disease Risk in Young Women With Adverse Pregnancy Outcomes

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Janet M Catov ◽  
Becky McNeil ◽  
Philip Greenland ◽  
Noel Bairey Merz ◽  
Deborah Ehrenthal ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Women ◽  
Pregnancy Outcomes ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Adverse Pregnancy Outcomes ◽  
Reproductive Age ◽  
Risk Scores ◽  
Cvd Risk ◽  
Adverse Pregnancy

Introduction: Cardiovascular disease (CVD) is the leading cause of death among women. In stark contrast to mortality declines in other groups, CVD deaths to young women are increasing. CVD prediction in this group is imprecise, and how adverse pregnancy outcomes (APO) may unmask risk during the reproductive years is unknown. Hypothesis: Women with APO will have higher 10-year predicted CVD risk within 7 years following a first pregnancy compared to women with no APO. Study design: We enrolled 10,038 women at 8 sites in their first pregnancy and followed 4,500 through a CVD visit 2-7 years later. Presented here are results for the first 2,705 with lab results and no hypertension or diabetes before pregnancy. The Atherosclerotic CVD (ASCVD), American Health Association Healthy Heart, Pathobiological Determinants of Atherosclerosis in Youth (PDAY), and Reynolds risk scores were compared in women with preterm birth (PTB), preeclampsia/gestational hypertension (PE/GH), gestational diabetes (GDM), small for gestational age (SGA), and no adverse outcomes (no APO, referent). Results: As expected, 10-year predicted CVD risk was very low in women at a median age of 30, although differences at the tail of the distribution were detected based on APO history. Women with no APO had the lowest CVD risk. Women with PTB, PE/GH, GDM, or SGA had higher 10-year CVD risk as predicted by the ASCVD score compared to women with no APO (p<0.05 for PTB and PE/GH). Six to 10% of women with these APOs had ASCVD scores greater than 5%. The PDAY score that predicts risk of coronary artery calcification in young adults was also higher in women with PE/GH or GDM than in those with no APO. Risk factors perturbed after delivery in women with APOs were blood pressure, BMI, waist circumference, HDL-cholesterol, triglycerides, glucose, and HbA1c. Conclusion: While risk scores customized for women of reproductive age are needed, those with a first pregnancy complicated by PTB, PE/GH or GDM have modest but detectable predicted 10-year CVD risk as soon as 2-7 years after delivery.

Reproductive health issues in patients with psoriasis (literature review)

2019 ◽  
Vol 1 (7) ◽  
pp. 5-8
Author(s):  
L. S. Kruglova ◽  
A. A. Osina ◽  
A. A. Khotko
Keyword(s):  
Drug Therapy ◽  
Reproductive Health ◽  
Literature Review ◽  
Pregnancy Outcomes ◽  
Adverse Pregnancy Outcome ◽  
Certolizumab Pegol ◽  
Genetically Engineered ◽  
Health Issues ◽  
Degree Of Confidence ◽  
Adverse Pregnancy

Among patients with psoriasis, approximately 50% are women and almost 75 % of them are under the age of 40 years. Thus, most women with psoriasis have childbearing potential. When pregnancy occurs in 22 % of patients, the activity of psoriasis persists, characteristic of the course before pregnancy, in 23 % of women, the course of the disease worsens. The article provides up-to-date data on the management of pregnant patients with psoriasis. To improve pregnancy outcomes in patients with psoriasis, it is important to prevent exacerbation of the disease. The choice of drug therapy in this case is based on an assessment of the ratio of the risk of undesirable effects of the drugs on the developing fetus and the risk of the development of exacerbation of psoriasis, which can cause an adverse pregnancy outcome. Despite the fact that the available clinical experience of using genetically engineered drugs is still limited, with a certain degree of confidence we can say that there is no increase in the risk of adverse pregnancy outcomes associated with therapy with certolizumab pegol.

The prevalence of Trichomonas vaginalis and Candida albicans infection in the lower genital tracts of antenatal patients in Abakaliki, Southeastern Nigeria

1970 ◽  
Vol 4 (1) ◽  
pp. 11-14 ◽  
Author(s):  
IM Sunday-Adeoye ◽  
JOK Adeoye ◽  
OUJ Umeora ◽  
PI Okonta
Keyword(s):  
Candida Albicans ◽  
Pregnancy Outcomes ◽  
Trichomonas Vaginalis ◽  
Dropout Rate ◽  
Antenatal Clinic ◽  
Southeastern Nigeria ◽  
High Dropout Rate ◽  
Adverse Pregnancy ◽  
June July ◽  
A Prospective Study

Aims: To determine the prevalence of Trichomonas vaginalis and Candida albican infection among anasymptomatic pregnant population and to document their pregnancy outcomes.Methods: This was a prospective study involving antenatal clinic attendees at the Ebonyi State UniversityTeaching Hospital, Abakaliki, Nigeria. They were randomly recruited and informed consent obtained. Vaginalspecimens were collected from them and analyzed in the laboratory. They were followed up till delivery andpregnancy outcomes documented.Results: Two hundred expectant mothers were recruited. The prevalence rate of Trichomonas vaginalis andCandida albicans were 0.5% and 27.5% respectively. Due to the high dropout rate in the study, it wasimpossible to make any reasonable inference about the pregnancy outcomes associated with these conditions.Conclusion: There is probably the need for the use of more sophisticated methods for the detection ofTrichomonas vaginalis. The existing methods in most laboratories in the country may not be adequate. Thereis also probably the need for a larger sample size and a stricter follow up of the patients in order to documentany adverse pregnancy outcomes associated with these conditions.Keywords: Prevalence; Trichomonas vaginalis; Candida albicans; antenatal careDOI: 10.3126/njog.v4i1.3325Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 11-14

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