scholarly journals Leptospirosis in COVID-19 Positive Pregnancy: A Rare Case Report Mimicking Hellp Syndrome

2021 ◽  
pp. 379-383
Author(s):  
Aarshika Singh ◽  
Surekha Tayade ◽  
Ooha Thadiboina ◽  
Cherukuri Srinidhi
Keyword(s):  
Hellp Syndrome ◽  
Neonatal Intensive Care ◽  
First Trimester ◽  
Lower Segment Caesarean Section ◽  
Normal Limits ◽  
Elevated Bilirubin ◽  
Rare Case Report ◽  
Acute Fatty Liver ◽  
Elevated Transaminases ◽  
High Degree

Leptospirosis in pregnancy is often underdiagnosed and not commonly reported due to its unusual appearance and rarity. It looks like HELLP syndrome, obstetric cholestasis, viral hepatitis & pregnancy-related acute fatty liver. Miscarriages in the first trimester, stillbirths, and neonatal leptospirosis are serious complications that necessitate a high degree of concern, heightened sensitivity, and prompt diagnosis and treatment. We have one such incidence of leptospirosis in a COVID-19 positive pregnant female. A 21-year-old Primigravida with a predisposition of serious anaemia & thrombocytopenia, presented with fever, haematemesis, malena and sore throat at 38 weeks and 2 days gestation, during the COVID-19 pandemic. She had pallor, oedema, and haematuria on catheterization, rest all investigations were within normal limits. Proteinuria, haemolysis, low platelets, and elevated bilirubin were discovered during the investigation. Due to the lack of hypertension and elevated transaminases, the working diagnosis was atypical haemolysis, low platelets (HELLP) syndrome. The patient was tested for COVID-19 RT-PCR, came out to be positive and the fever spikes continued, leading to further investigations for Dengue, Malaria, Scrub Typhus, and Leptospirosis due to the ongoing Covid-19 pandemic. After the EIA (Enzyme Immunoassay) IgM antibody (confirmatory for Leptospirosis) tested positive for Leptospirosis, the decision to start Doxycycline was made. Meanwhile, the patient's CTG (Cardio tocograph) revealed signs of foetal distress, and a decision for an emergency LSCS was taken (Lower Segment Caesarean Section). The histology of the placenta after the section revealed normal findings. Doxycycline was initiated with a neonatal feeding regimen that was acceptable. On day two of life, the newborn had no indications of inherited leptospirosis and was removed from Neonatal Intensive Care. Within one week, the patient's symptoms had disappeared, and her biochemistry had went back to normal within 2 weeks.

scholarly journals ACUTE FATTY LIVER OF PREGNANCY MASQUERADING AS HELLP SYNDROME

2018 ◽  
Vol 5 (20) ◽  
pp. 1592-1595
Author(s):  
Santhosh Narayanan ◽  
Divya Prakash ◽  
Gomathy Subramaniam ◽  
Lakshminarayanan Lakshminarayanan
Keyword(s):  
Fatty Liver ◽  
Hellp Syndrome ◽  
Acute Fatty Liver

scholarly journals Comparison of Maternal and Neonatal Outcomes between Acute Fatty Liver of Pregnancy and Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Sau Xiong Ang ◽  
Chie-Pein Chen ◽  
Fang-Ju Sun ◽  
Chen-Yu Chen
Keyword(s):  
Cohort Study ◽  
Fatty Liver ◽  
Retrospective Cohort Study ◽  
Hellp Syndrome ◽  
Retrospective Cohort ◽  
Liver Enzymes ◽  
Neonatal Outcomes ◽  
Elevated Liver Enzymes ◽  
Acute Fatty Liver ◽  
Maternal And Neonatal Outcomes

Abstract Background: Acute fatty liver of pregnancy (AFLP) and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome are two uncommon disorders that mimic each other clinically, but are distinct pathophysiologically. This study aimed to compare maternal and neonatal outcomes between AFLP and HELLP syndrome.Methods: This retrospective cohort study was performed at a tertiary referral center in Taiwan between June 2004 and April 2020. We used the Swansea Criteria to diagnose AFLP, and the Tennessee Classification System to diagnose HELLP syndrome. Maternal characteristics, laboratory data, complications, and neonatal outcomes were analyzed.Results: During the study period, 21 women had AFLP and 80 women had HELLP syndrome. There was a higher rate of preeclampsia (95.0% versus 23.8%) in the HELLP syndrome group compared to the AFLP group. However, the AFLP group had more other maternal complications including jaundice (85.7% versus 13.8%), acute kidney injury (61.9% versus 15.0%), disseminated intravascular coagulopathy (66.7% versus 8.8%), and sepsis (47.6% versus 10.0%) compared to the HELLP syndrome group. Nevertheless, higher rates of small for gestational age neonates (57.1% versus 33.3%), neonatal respiratory distress syndrome (39.2% versus 8.3%) and neonatal sepsis (34.2% versus 12.5%) were noted in the HELLP syndrome group.Conclusions: AFLP is associated with a higher rate of multiple organ dysfunction in mothers, whereas HELLP syndrome is associated with a higher rate of neonatal morbidity.

Markedly higher sFlt-1/PlGF ratio in a woman with acute fatty liver of pregnancy compared with HELLP syndrome

2018 ◽  
Vol 45 (1) ◽  
pp. 96-103 ◽  
Author(s):  
Hirotada Suzuki ◽  
Shiho Nagayama ◽  
Chikako Hirashima ◽  
Kayo Takahashi ◽  
Hironori Takahashi ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Hellp Syndrome ◽  
Acute Fatty Liver ◽  
Plgf Ratio

scholarly journals 863: Pragmatic laboratory studies to differentiate acute fatty liver of pregnancy and HELLP syndrome on admission

2019 ◽  
Vol 220 (1) ◽  
pp. S561 ◽  
Author(s):  
John J. Byrne ◽  
Angela Seasely ◽  
Donald McIntire ◽  
David B. Nelson ◽  
F. Gary Cunningham
Keyword(s):  
Fatty Liver ◽  
Hellp Syndrome ◽  
Laboratory Studies ◽  
Acute Fatty Liver

scholarly journals Pregnancy outcome of a patient following myomectomy performed during first trimester for red degeneration of fibroid

2016 ◽  
Vol 6 (1) ◽  
pp. 69
Author(s):  
Asma Habib ◽  
Shahla Khatun ◽  
Nafisa Khanum
Keyword(s):  
Surgical Intervention ◽  
First Trimester ◽  
Female Child ◽  
Clinical Findings ◽  
Lower Segment ◽  
Early Gestation ◽  
Lower Segment Caesarean Section ◽  
Healthy Female ◽  
The Common ◽  
Red Degeneration

Pain due to red degeneration of fibroid during pregnancy is usually associated with large myomas. Necrobiosis / red degeneration typically manifests itself about midpregnancy when Lhe leiomyoma suddenly becomes acutely painful, enlarged and tender. The common differential diagnosis of this condition are torsion of the pedicle of an ovarian cyst/a leiomyoma, abruplion placentae, acute pyelitis or any abdominal catastrophe. Ultrasound can easily delineate the presence of myomas of mixed echogenicity along with pregnancy and clinical findings usually suggest the diagnosis of pregnancy complicated by red degeneration of fibroid. The acute pain usually subsides within 3-10 days of conservative treatment. Only refractory cases (2% of patients) may demand surgical intervention in early gestation with the known risk of miscarriage. Here we report a pregnancy managed at 13 weeks by myomectomy for red degeneration. The patient ultimately delivered a healthy female child at 38 weeks by lower segment caesarean section.

First trimester prediction of HELLP syndrome

2015 ◽  
Vol 36 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Natacha Oliveira ◽  
Liona C. Poon ◽  
Kypros H. Nicolaides ◽  
Ahmet A. Baschat
Keyword(s):  
Hellp Syndrome ◽  
First Trimester

scholarly journals Persistence of G10P[11] neonatal rotavirus infections in southern India

2021 ◽  
Author(s):  
Sudhir Babji ◽  
Kulandaipalayam Natarajan Sindhu ◽  
Sribal Selvarajan ◽  
Sasirekha Ramani ◽  
Srinivasan Venugopal ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Southern India ◽  
Neonatal Intensive Care Units ◽  
Age Group ◽  
Rt Pcr ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Stool Samples ◽  
Strain Stability ◽  
Rotavirus Infections

ABSTRACTNeonatal rotavirus infections are predominantly caused by distinct genotypes restricted to this age-group and are mostly asymptomatic. Stool samples from neonates admitted for >48 hours in neonatal intensive care units (NICUs) in Vellore (2014-2015) and Chennai (2015-2016) in southern India, and from neonates born at hospitals in Vellore but not admitted to NICUs (2015-2016) were tested for rotavirus by ELISA and genotyped by hemi-nested RT-PCR. Of the 791 neonates, 150 and 336 were recruited from Vellore and Chennai NICUs, and 305 were born in five hospitals in Vellore. The positivity rates in the three settings were 49.3% (74/150), 29.5% (99/336) and 54% (164/305), respectively. G10P[11] was the commonly identified genotype in 87.8% (65/74), 94.9% (94/99) and 98.2% (161/164) of the neonates in Vellore and Chennai NICUs, and those born at Vellore hospitals, respectively. Neonates delivered by lower segment caesarean section (LSCS) at Vellore hospitals, not admitted to NICUs, had a significantly higher odds of acquiring rotavirus infection compared to those delivered vaginally [p=0.002, OR=2.4 (1.4-4.3)]. This report demonstrates the persistence of G10P[11] strain in Vellore and Chennai, indicating widespread neonatal G10P[11] strain in southern India and their persistence over two decades, leading to interesting questions about strain stability.

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