morphine and Hypertension--Pregnancy-Induced

There are five reported cases of fetal meconium peritonitis developing after episodes of maternal hepatitis. These cases demonstrate a potential association between severe maternal liver injury and subsequent fetal meconium peritonitis.. A 26-year-old primigravid woman developed acute liver failure 4 days after unilateral oophorectomy for ovarian torsion at 24 weeks of gestation. Her liver function gradually normalized with conservative management. She was readmitted for acute abdominal pain with elevated blood pressure at 29 weeks of gestation. An emergency cesarean delivery was performed for severe preeclampsia. Her neonate was noted to have a distended abdomen. Laparotomy and bowel resection were performed for meconium peritonitis and bowel perforation.. Fetal meconium peritonitis may develop after severe maternal liver disease. Thus, the latter may warrant heightened fetal surveillance.

Topics: Adult; Cesarean Section; Female; Humans; Hypertension, Pregnancy-Induced; Infant, Newborn; Intestinal Perforation; Liver Failure, Acute; Male; Meconium; Obstetric Surgical Procedures; Ovariectomy; Peritonitis; Pre-Eclampsia; Pregnancy

Obesity is critically important to maternal and fetal health during the perinatal period. We have detected an increasing prevalence of maternal obesity in recent years and investigated its complications during pregnancy.. A total of 931 pregnant females were investigated between March 2012 and March 2013. The patients were divided into four groups: body mass index (BMI) < 18.5 kg/m(2) was underweight, 18.5-24.9 kg/m(2) was normal weight, 25-29.9 kg/m(2) was overweight and ≥30 kg/m(2) was obese. The effects of obesity on fetal and maternal outcomes were investigated.. Significant increases in pregnancy-induced hypertension, gestational diabetes mellitus, cesarean delivery, premature rupture of membranes, shoulder dystocia, meconium-stained amniotic fluid, abnormal heart rate pattern and postpartum infection rates were found in the obese group during the perinatal period. Adverse maternal effects in obese cases were significantly more frequent than those in normal-weight cases. Preterm birth, perinatal mortality, low APGAR scores, newborn intensive care unit requirement, hypoglycemia and macrosomia rates were significantly higher in obese cases than those in non-obese cases. However, low birth weight infant rate was higher in the low BMI cases than that in the other BMI categories (p < 0.01).. We conclude that obesity is an important factor associated with pregnancy complications and the increase in maternal-fetal morbidity and mortality.

Topics: Adult; Apgar Score; Body Mass Index; Cesarean Section; Diabetes, Gestational; Dystocia; Female; Fetal Macrosomia; Fetal Membranes, Premature Rupture; Heart Rate; Humans; Hypertension, Pregnancy-Induced; Hypoglycemia; Infant, Newborn; Intensive Care, Neonatal; Meconium; Obesity; Overweight; Perinatal Mortality; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Puerperal Infection; Shoulder

AIM. To revisit the role of first trimester homocysteine levels with the maternal and fetal outcome. METHODS. This was a cohort study comprising 100 antenatal women between 8 and 12 weeks of gestation. Serum homocysteine levels were checked after overnight fasting. RESULTS. There were significantly elevated homocysteine levels among women with prior history of hypertensive disorders of pregnancy and prior second or third trimester pregnancy losses. There was no significant difference in homocysteine levels among women with previous gestational diabetes mellitus, preterm deliveries, or fetal malformations. Homocysteine levels were significantly elevated in those who developed hypertensive disorder of pregnancy, oligohydramnios, and meconium stained amniotic fluid, had a pregnancy loss, or delivered a low birth weight baby. There was no significant difference in homocysteine levels for those who developed gestational diabetes mellitus. CONCLUSIONS. Increased first trimester serum homocysteine is associated with history of pregnancy losses, hypertensive disorders of pregnancy, and preterm birth. This is also associated with hypertensive disorders of pregnancy, pregnancy loss, oligohydramnios, meconium stained amniotic fluid, and low birth weight in the current pregnancy. This trial is registered with ClinicalTrials.gov CTRI/2013/02/003441.

Topics: Abortion, Spontaneous; Adult; Amniotic Fluid; Cohort Studies; Diabetes, Gestational; Female; Homocysteine; Humans; Hypertension, Pregnancy-Induced; Infant, Low Birth Weight; Meconium; Oligohydramnios; Pregnancy; Pregnancy Trimester, First; Prospective Studies; Young Adult