Biomedical subjects
Publications and source records attributed to K Rezig.
We report a case of spontaneous rupture of uterine varicose vein revealed by a massive peritoneal hemorrhage in a 34-year-old patient at 27th weeks of gestation. Laparotomy enabled diagnosis and treatment of this complication. The pregnancy was continued without any problem with a normal delivery at term of a healthy child.
Pregnancy is a rare occurrence in patient suffering from spinal cord lesion. The authors report the case of labour and delivery in a paraplegic patient who was suffering from lesion located T6 level. In early labour epidural analgesia was maintained and the vaginal delivery was successful without associated fluctuation of blood pressure or other signs of autonomic hyperreflexia. The epidural catheter was maintained for 48 h post-partum. The main risks and anaesthesic management of pregnancy in paraplegic patients are discussed.
Factor X deficiency is one of the rarest inherited coagulation disorders. It is an autosomal recessive inherited disease. In its homozygous form factor X deficiency has an estimated prevalence of 1: 500,000. However in its heterozygous form it has an estimated frequency of 1: 500 to 1: 2000. Pregnancy in women with congenital factor X deficiency has been associated with adverse foetal outcomes. We report a case of pregnancy in a woman with factor X deficiency. She was treated early during labour with prophylactic replacement of prothrombin complex concentrates (Kaskadil). An initial infusion of 40 UI.kg-1 of factor X was followed by 20 UI.kg-1 every 24 hours during three days. During labour and peripartum maternal coagulation was screened. She delivered a healthy baby at 33 weeks of gestation. No episode of abnormal bleeding was observed. Therefore in this case, prophylactic therapy using prothrombin complex concentrates during labour and delivery did prevent severe haemorrhages.
During pregnancy the thyroid undergoes several changes including altered function and gland enlargement. We describe the management of a 36-week pregnant woman presenting with upper-way obstruction secondary to tracheal compression by a large multinodular goitre. The patient was successfully managed with an awake fibreoptic intubation performed orally followed by a caesarean section and thyroidectomy as a combines procedure.
Myocardial infarction is rare during pregnancy. We report the case of a 35-year-old woman at 38 weeks gestation who developed a non-Q wave myocardial infarction. She was successfully treated with percutaneous transluminal coronary angioplasty and stenting. Maternal and fetal outcome were good. We discuss cardiologic and anaesthetic management of labour and delivery.
Although aberrant locations were classical complications of central venous catheterization, the left superior diaphragmatic vein was an exceptional one. A case of this particular complication occurring after left internal jugular venous catheterization is described. The venous dilatation due to portal hypertension was probably partly responsible for this.
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