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Menstrual abnormalities and predisposition to pregnancy-related hypertensive disorders: a retrospective study

Londero Ambrogio DGYE-2009-0139.r1 [ID 463718] 6 PAG

Objective: Pregnancy-related hypertensive disorders (PRHDs) are a leading cause of maternal and perinatal morbidity and mortality in developed countries. This study investigated a possible association of PRHDs with menstrual abnormalities.
Materials and methods: We contacted all women with PRHDs who delivered in our clinic between 2004 and 2007 as well as a random control cohort without pregnancy complications and asked them about their menstrual cycle characteristics. Statistical analyses were performed using R, with significance set at p<0.05. Results: We collected data for 237 women with normal pregnancies and 255 women with PRHDs, among whom 143 had gestational hypertension and 70 had mild and 41 severe preeclampsia. By monovariate analysis, PRHDs correlated with dysmenorrhea, hypermenorrhea and menstrual irregularity (p<0.05). By multivariate analysis, the occurrence of PRHDs was influenced by dysmenorrhea and menstrual irregularity (p<0.05).
Conclusions: PRHDs usually affect women with painful or irregular menstrual cycles, perhaps due to metabolic syndrome or molecular pathways involving vasoactive substances, with clear vascular implications.

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Abstract: OBJECTIVE We evaluated the value of computerized CTG in pregnancies complicated by gestational diabetes mellitus (GDM). PURPOSE OF STUDY We studied FHR recordings from 100 pregnant women affected by GDM on diet therapy, 60 pregnant women affected by GDM on insulin therapy and 100 normal pregnant controls. The results were compared among the groups and related to neonatal umbilical artery cord blood analysis at birth. RESEARCH DESIGN AND METHODS Baseline FHR and the duration of episodes of low variation were significantly higher in diabetic than in controls and were negatively related to umbilical artery glycemia at birth, whereas the short-term variation in diabetics was significantly lower than in controls and was positively related to. CONCLUSIONS Our study demonstrates that GDM does impact FHR. The alteration is slight but evident; it reflects fetal well being and correlate with neonatal reactivity. Only computerized cardiotocography may allow to detect those slight but significant differences.

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Pure gonadal dysgenesis and spontaneous pregnancy: A case report

Kokcu, Arif, Tosun, Migraci; Cetinkaya, Mehmet; Bildircin, Devran; Celik, Handan

Abstract: We report a case of pure gonadal dysgenesis with streak gonads in which spontaneous conception occurred ten years after the diagnosis. Her pregnancy proceeded as normal, and she gave birth to a live baby at term by cesarean section. A lactation period lasting one year and afterwards proceeded as amenorrheic. Gonadotropins measurements in post-lactational period were at the menopausal levels again. To the best of our knowledge, this is the first case of pure gonadal dysgenesis with streak gonads in which spontaneous conception occurred.

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Hyponatremia associated coma due to pituitary apoplexy in early pregnancy: A case report

Krull, Ina, Christ, Emanuel; Kamm, Christian; Ganter, Christoph; Sahli, Rahel

Abstract: Pituitary apoplexy in pregnancy is rare. Its clinical features may range from unspecific complaints to panhypopituitarism resulting even in coma and death. Therefore, alertness to signs and symptoms of acute loss of pituitary function in pregnancy is mandatory. We report a woman in her 7th week of her first gestation presenting with sudden coma due to severe hyponatremia. Secondary adrenal insufficiency could be identified as the underlying cause. Panhypopituitarism including central diabetes insipidus and spontaneous abortion developed during the follow-up. Magnetic resonance imaging showed pituitary apoplexy without a pre-existing pituitary mass. The clinical course was notable for severe complications, including neurological deficits through cerebral ischemia, but eventual recovery could be achieved. We discuss the diagnostic difficulties in the evaluation of pituitary disease in pregnancy.

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Drug addiction during pregnancy. Correlations between the placental health and the newborn’s outcome. Elaboration of a predictive score.

Domenici Chiara; Cuttano Armando; Nardini Vincenzo; Varese Luca; Ghirri Paolo; Boldrini Antonio

During pregnancy drug addiction represents one of the most dangerous situation. Each drug can badly affect the foetal development and, when the pregnancy is over, the negative influence continues on the newborn which is exposed to many risks, in particular the withdrawal syndrome. more

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