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PubMedDate not supplied

Pregnancy in patients with mechanical prosthetic heart valves. Our experience regarding 98 pregnancies in 57 patients.

Ninety-eight pregnancies in 57 patients with mechanical (ball or tilting disc) prosthetic heart valves are described. Sixty-one pregnancies developed in 36 patients with a mitral prosthesis, 12 pregnancies in 9 patients with an aortic prosthesis, 17 pregnancies in 10 patients with both mitral and aortic prostheses and 8 pregnancies in 2 patients with mitral and tricuspid prostheses. All patients were in I or in II NYHA class at conception and no significative change was noted during pregnancy. All the patients were treated with oral anticoagulant therapy at conception. Different kinds of antithrombotic and antiembolic prophylaxis were employed. There were 13 voluntary interruptions of pregnancy and 37 spontaneous abortions. In the 47 newborn 2 malformation complications (1 warfarin syndrome, 1 cleft palate) and 4 haemorrhagic complications (without sequelae) were noted. Two fatal thromboses of a mitral prosthesis occurred; systemic embolic complications were noted in 7 cases. These observations suggested different incidences of complications regarding the antithrombotic and anti-embolic prophylaxis. The authors point out the high risk of thrombotic and embolic complications and the low rate of successful outcome of pregnancy in these patients.

Abortion, Spontaneous↗
PubMed1976

Perirenal hemorrhage in newborn.

An unusual cause of a palpable abdominal mass in the newborn is adrenal hemorrhage with a secondary perirenal hematoma. All the urologic diagnostic modalities including sonography can be used to diagnose this benign condition. Surgical exploration should be considered when the possibility of a malignancy cannot be excluded.

Adrenal Gland Diseases↗
PubMed1977

Perinatal addiction: outcome and management.

The care of the pregnant drug-dependent woman and her newborn infant has become a major and controversial health problem requiring specific approaches to this high-risk mother and neonate. A comprehensive approach to the care of 278 pregnant drug-dependent women and their infants at the Philadelphia General Hospital has significantly reduced maternal and infant morbidity heretofore associated with pregnancies complicated by opiate addiction. Most significantly, the incidence of low birth weight has been reduced to below 20 per cent, and a decrease in severe withdrawal in infants born to mothers in the comprehensive care program has occurred. We propose that application of this approach to women whose pregnancies are complicated by drug dependency is a significant factor in successful management.

Abruptio Placentae↗
PubMed1976

Echography: a new approach to the diagnosis of adrenal hemorrhage of the newborn.

A case of adrenal hemorrhage of the newborn, diagnosed by ultrasound, is presented. All other diagnostic modalities were found to be non-specific. Ultrasonic evaluation is recommended in the evaluation of pediatric abdominal masses. This is a safe, non-invasive, rapid and easily performed study. It is felt that the use of diagnostic ultrasound in evaluating neonates for adrenal hemorrhage wil obviate the necessity of more invasive procedures, such as exploratory laparotomy.

Adrenal Gland Diseases↗
PubMed1976

[Acute adrenal hemorrhage in newborn infants: the importance of early diagnosis (author's transl)].

Two case reports demonstrate the importance of an early diagnosis for the therapy of adrenal hemorrhage. In the first case with unilateral hemorrhage, the hemorrhage as such was of importance. In the second case with bilateral hemorrhage, the course was dominated by acute adrenal insufficiency with circulatory collapse and major salt loss. The diagnosis was supported by the typical changes in electrolyte levels as well as by radiography, and endocrinological results. With early therapy (in the first instance by surgery, and in the latter by substitution of corticosteroids), both children safely passed the critical period. In the second child ACTH administration did not, in the first phase of the disease, result in a significant rise of plasma cortisol. However, two months later there was a normal rise of the cortisol level following ACTH administration. From this observation we conclude that a favourable regeneration of the adrenal glands has resulted.

Addison Disease↗
PubMed1991

Comparison of infant mortality among twins and singletons: United States 1960 and 1983.

Infant mortality among US black and white twins and singletons was compared for 1960 and 1983 using the Linked Birth/Infant Death Data Sets from the National Center for Health Statistics. Both twin and singleton infant mortality rates showed impressive declines since 1960 but almost all of the improvement in survival for both twins and singletons was related to increased birth weight-specific survival rather than improved birth weight distribution. One-half of white twins and two-thirds of black twins weighed less than 2,500 g at birth, and 9% of white twin births and 16% of black twin births were in the very low (less than 1,500g) birth weight category. In 1983, twin infant mortality rates were still four to five times that of singletons. However, twins had a survival advantage in the 1,250-3,000 g range, which persisted after adjustment for gestational age. Cause-specific mortality among twins was considerably higher for every major cause of death: twin mortality risks due to newborn respiratory disease, maternal causes, neonatal hemorrhage, and short gestation/low birth weight were six to 15 times that of singletons. The lowest twin-to-singleton mortality ratios observed were for congenital anomalies and sudden infant death syndrome with relative risks twice that of singletons. The data underscore the need to develop effective strategies to decrease infant mortality among twins.

Birth Weight↗
PubMed1981

Perinatal hemorrhage associated with the Kassabach-Merritt syndrome.

The case of a newborn infant with the Kassabach-merritt syndrome who presented with a significant intrauterine ocular and skin hemorrhage, followed shortly after birth by a massive hematemesis, is reported. The presence of cavernous hemangioma at birth should be a reminder of the risk of major hemorrhagic complications due to thrombocytopenia secondary to platelet trapping.

Eye Diseases↗
PubMed1979

Adrenal hemorrhage in the newborn: scintigraphic diagnosis.

Four neonates with abdominal masses following adrenal hemorrhages were investigated by renal scintigraphy. Characteristic photon-deficient lesions were noted in the suprarenal areas during the phase of whole-body radionuclide distribution.

Adrenal Gland Diseases↗
PubMed1979

Clinical and laboratory diagnosis of hemostatic disorders in newborn infants.

We describe a microtechnology for the study of the coagulation system in newborn infants. Interpretation of results demands an understanding of the techniques used and the nature of the control population from which normal values are drawn. We have examined two syndromes which represent the majority of hemostatic disorders of sick newborn infants. The first is thrombocytopenia resulting from bacterial infections in which there are minimal changes in the levels of blood coagulation factors and little tendency to bleed. The second is a syndrome of disseminated intravascular coagulation in which there is a profound disturbance in the coagulation mechanism, relatively little change in platelet counts, a severe hemorrhagic diathesis, and widespread ischemic necrosis.

Bacterial Infections↗
PubMed1980

Ultrasonography in the diagnosis of neonatal adrenal haemorrhage.

Two cases of neonates with adrenal haemorrhage are presented. The clinical, radiological and ultrasonographical signs are described. The future role of echography as compared to other radiological procedures, including computerized tomography, is discussed. Ultrasonography is recommended as a screening method, and is well suited for assessing the size and internal structure of pathological processes.

Adrenal Gland Diseases↗