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At least 19 recordsLinked to original sources
PubMed1965

MATERNAL MORTALITY IN BRITISH COLUMBIA: A STUDY OF 145 DEATHS FROM 1955 TO 1962.

Between 1955 and 1962, 145 maternal deaths were reported in the Province of British Columbia. One hundred of them were due to obstetrical causes. Of these deaths, hemorrhage was by far the commonest cause (40 cases), followed in frequency by vascular accidents (23 cases), infections (17 cases), toxemia (10 cases), anesthetic deaths (five cases), and other causes (five cases). Significant avoidable factors were noted in 80%. Indirect obstetrical deaths accounted for 29 cases, or 20% of all maternal mortalities. The most frequently encountered causes of indirect obstetrical deaths were cardiac (nine cases) and vascular accidents (six cases). Avoidable factors were considered to be present in 19 of the 29, an incidence of 65%.When all deaths were considered together, 72% were felt to have significant avoidable factors when judged against an academic standard. It was also apparent that some 40% to 50% of deaths were intimately involved with social factors.

Abortion, Illegal↗
PubMed2002

Midwifery basics. Antenatal care--blood tests in pregnancy.

Joanna is now 16 weeks pregnant. She has been feeling particularly tired and her mum suggested that she might be anaemic. Louis is rather insulted as he prides himself on buying the best fresh ingredients from the local market, they love cooking and eat plenty of fruit and vegetables. Joanna had a full blood count taken by the community midwife who came to the flat to do her booking history. The midwife said that the surgery would contact her if she needed treatment for anaemia, but she hasn't heard anything yet.

Female↗
PubMedDate not supplied

Stroke in pregnancy and the puerperium.

Recent studies suggest that the risk of cerebral infarction is increased during the puerperium but not during pregnancy itself. Most of the known causes of ischaemic stroke in the young have been reported during pregnancy. In most of these conditions, it is uncertain whether pregnancy is coincidental or plays a role in the occurrence of stroke. Eclampsia is the main pregnancy-specific cause, which may be associated with focal neurological deficits of sudden onset, consistent with a clinical diagnosis of stroke. However, the precise pathogenesis of these stroke-like focal deficits remains poorly understood. The two other pregnancy-specific conditions (choriocarcinoma and amniotic fluid embolism) are rarely responsible for focal cerebral ischaemia. In a significant number of patients, the cause of the stroke remains undetermined, despite an extensive aetiological investigation. Whether a hypercoagulable state and vessel wall changes associated with pregnancy may play a role in the occurrence of these otherwise unexplained ischaemic strokes remains unknown. The occurrence of cerebral venous thrombosis is clearly linked to the puerperal state, suggesting a direct role of the latter. However, cerebral venous thrombosis during pregnancy or the puerperium has been related to various aetiologies, stressing the need for an aetiological study, particularly when the thrombosis occurs during pregnancy. Pregnancy may increase the risk of subarachnoid haemorrhage, The most common cause is rupture of an arterial aneurysm. Although this is a controversial issue, the increased tendency of an aneurysm to bleed with advancing gestational age suggests that haemodynamic, hormonal or other physiological changes of pregnancy may play a role in aneurysmal rupture. The classic notion that rupture of an arterial aneurysm occurs more frequently during labour has not been confirmed. Most authors agree that surgical management after subarachnoid haemorrhage in pregnancy should be the same as that in the non-pregnant state. Data specifically devoted to intraparenchymal haemorrhage in pregnancy are scarce. Pregnancy and in particular the puerperium seem to be associated with an increased risk of intracerebral haemorrhage. The most common causes are eclampsia and ruptured vascular malformations. Whether pregnancy increases the risk of rupture of an arteriovenous malformation is controversial.

Adult↗
PubMed2002

Management of haematologic malignancies in pregnancy.

INTRODUCTION: Malignancy complicates about 1 in 1000 pregnancies and is the second leading cause of death in women of reproductive age. Commonly diagnosed malignancies during pregnancy include breast cancer, cervical carcinoma, melanoma and lymphoma. Chemotherapy is usually necessary for optimal treatment, especially in patients with leukaemia and lymphoma. Concerns arise regarding the effects of imaging modalities in the pregnant cancer patients and the effects of chemotherapeutic agents on the developing fetus. METHODS: A Medline search of articles describing haematologic malignancies in pregnant patients was performed. Particular attention was paid to the kind of malignancy, stage of pregnancy, the types and side effects of chemotherapeutic agents used and the outcome of the pregnancy. RESULTS: There is no entirely safe cytotoxic drug or timing of exposure for the developing fetus. The administration of chemotherapy during pregnancy will not always produce a poor outcome. A pregnant cancer patient can also be safely and reasonably staged with imaging. Magnetic resonance imaging will most often be the procedure of choice as it does not use ionising radiation. CONCLUSIONS: The management of each pregnant patient diagnosed with a malignancy has to be highly individualized and involves a multidisciplinary team of medical personnel. The patient and her family need counselling regarding the diagnosis, long-term prognosis, options of termination of pregnancy, choice of chemotherapeutic agents and their effects on the fetus and pregnancy.

Antineoplastic Agents↗
PubMed1991

Pregnancy outcome in hematologic malignancies.

By means of a mail questionnaire, information on a series of 56 pregnancies i in 48 women diagnosed with leukemia or lymphoma was collected from ten hospitals. Seven patients conceived while receiving treatment for their neoplasms; in 22 patients, the hematologic disease was diagnosed during pregnancy, and the remaining 27 patients became pregnant after completion of the antineoplastic treatment. When a comparison was made of the evolution of these pregnancies to that of pregnancies in a healthy population, no increase in the incidence of complications was observed: 64% of the pregnancies went to term, 9% resulted in spontaneous abortion, and 5% resulted in premature births. The observed incidence of one major malformation in 56 pregnancies did not differ from the frequency of malformations in the offspring of healthy individuals. There were no fetal losses in six pregnancies in which conception occurred during the first year after chemotherapy. In spite of the inherent limitations derived from the design of this type of study and the type of subject analyzed, the data here support the hypothesis that the cytostatic treatment of hematologic malignancies, if deemed necessary, should not be postponed because of pregnancy. Moreover, the authors agree with advice recommending that no antifolic or alkylating agents be used for prolonged periods and that radiotherapy be avoided, especially to those fields involving the pelvic area.

Abortion, Induced↗
PubMed1992

[Erythroleukemia in pregnancy with successful outcome of delivery].

A 37-year-old woman was admitted to our hospital because of anemia in the 33rd week of pregnancy. On admission, the hemoglobin was 7.6 g/dl, platelets 508,000/microliters and WBC 8,300/microliters with 4% blast cells. Bone marrow aspirate demonstrated 50% erythroblasts of nucleated cells, which had prominent megaloid and polynucleic changes, and 20% myeloblast cells. We diagnosed her as having erythroleukemia. Receiving packed-red-cell transfusions, she had a cesarean section, and gave birth to a female infant (BW 2,175 g) in the 34th week of pregnancy. At the same time, she had a total hysterectomy with left adnexectomy. The postoperative course was favorable. She had a combination chemotherapy of BHAC-DMP, resulting in a partial remission. After the second induction chemotherapy with subcutaneous use of G-CSF and BHAC-DMP, complete remission was obtained, which lasted for almost 17 months. The child is growing well without any hematological disorder.

Adult↗
PubMedDate not supplied

Splenectomy for hairy cell leukemia in pregnancy.

OBJECTIVE: Hairy cell leukemia is a rare hematologic malignant disease characterized by pancytopenia and splenomegaly. Its occurrence during pregnancy limits treatment with standard chemotherapeutic agents. A woman was found to have hairy cell leukemia and massive splenomegaly late in the second trimester. A review of the literature did not provide a carefully formulated treatment plan. It was believed that splenectomy (the historic therapy for hairy cell leukemia) would likely result in improved hematologic values and allow the pregnancy to progress. STUDY DESIGN: Case report with literature review. RESULTS: Preoperative laboratory studies revealed platelet count 65,000/mm3, hematocrit 28.6%, white blood cell count 4000/mm3, and hairy cell index 0.06 to 0.07. At 24 weeks' gestation, the patient underwent splenectomy with resolution of thrombocytopenia and normal progression of pregnancy without complication. Repeat cesarean section at 38 weeks produced a 2875 gm healthy male infant with Apgar scores of 9 and 9. CONCLUSION: If antepartum management of hairy cell leukemia is warranted, splenectomy is a safe and effective treatment option during the second trimester.

Adult↗
PubMedDate not supplied

[Pancytopenia as a complication of the treatment of toxoplasmosis].

Therapeutical doses of pyrimethamine are very close to toxic ones. Pyrimethamine is widely used in toxoplasmosis therapy. Hematological complications following pyrimethamine administration were seen in 4 patients treated for toxoplasmosis at our hospital in the last year. Pancytopenic syndrome was diagnosed in all four cases. Three patients recovered completely whereas ITP is persisting in one patient.

Adult↗
PubMed1992

[Two cases of acute promyelocytic leukemia in pregnancy and the effect of anthracyclines on fetal development].

Two patients with acute promyelocytic leukemia (APL) in 2nd and 3rd trimester of pregnancy are reported on. Case 1: 38-year-old female consulted our hospital because of bleeding tendency and pancytopenia in April, 1988. She was diagnosed as having APL with disseminated intravascular coagulopathy (DIC) and was found to be in the 14th week of gestation. Combined chemotherapy (BHAC-DMP) including the total dose (440 mg) of daunorubicin (DNR) resulted in intrauterine fetal death at 19 weeks of gestation. The fetus was severely anemic and the bone marrow was hypoplastic. Case 2: A 27-year-old female was diagnosed as having APL with DIC at 29 weeks of gestation. BHAC-DMP including 440 mg DNR achieved complete remission. At 35 weeks of gestation, she delivered a normal infant by Caesarean section. The child had normal hematological findings and showed normal growth. Both cases developed APL accompanied by DIC during pregnancy and were treated with a similar regimen including high dose of anthracyclines. Case 2 treated in the late period of gestation delivered a normal infant, while fetal death resulted in case 1, treated in the early period of gestation. We reviewed the literature regarding chemotherapy using anthracyclines during pregnancy.

Adult↗
PubMed1995

Hematologic malignancies during pregnancy.

Most hematologic malignancies are rare during the childbearing years with the exception of Hodgkin's lymphoma. However, the continued spread of retroviruses, such as human immunodeficiency virus, in the heterosexual population may result in a substantial rise in viral-induced non-Hodgkin's lymphomas. Although pregnancy does not affect the natural course of these illnesses, adequate staging and therapy can be a difficult task. The obstetrician and the consultant hematologist/oncologist must weigh the benefit of immediate treatment while minimizing toxicity to the fetus.

Decision Trees↗
PubMed1993

A primary cytomegalovirus infection in pregnancy presenting with unusual hematologic manifestations: a case report.

A previously healthy multigravida woman presenting with pyrexia was found to be pancytopenic at 32 weeks' gestation. The leukopenia and the thrombocytopenia responded to supportive therapy. The anemia, which was Coombs' negative, continued and was associated with a drop in fibrinogen, but both eventually returned to normal with time. The isolation of the cytomegalovirus and the detection of an IgM immune response to cytomegalovirus implicated the virus as the agent responsible for the clinical manifestations. The fetus, who was well throughout the maternal illness, had no evidence of anemia or thrombocytopenia at birth; however, intrauterine infection was confirmed by isolation of the virus from the newborn's urine.

Adult↗