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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We analyzed the gestational, parturitional, neonatal (GPN) histories of 281 severely mentally retarded patients with cerebral palsy to define the etiology or pathogenesis of cerebral palsy in each patient. No association between type of cerebral palsy and GPN histories was found except for an increase in spastic-athetoid patients in the breech delivery subgroup. Significant findings include: increased incidence of prematurity and postmaturity, small and large for-gestational age (GA) fetal size, a normal birthweight for GA distribution of patients with diabetic mothers, an excess of mothers greater than or equal to 35 and less than or equal to 20 years old, an increased immediately-previous sib interval of 2.59 years suggestive of an "infertility factor", an unremarkable GPN history in one third of the cases, in another one third GPN problems not usually associated with a high risk of CNS damage, and in one third gross complications which were probably responsible for the CP, including: an increased incidence of breech deliveries, twinning, prolonged and precipitous labor and placental complications; no increased association of athetosis and Rh incompatibility or incidence of toxemia was found. Disseminated intravascular coagulation due to prenatal death of a twin may have been the cause of brain damage in several patients.
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PMID:Analysis of etiologic factors in cerebral palsy with severe mental retardation. I. Analysis of gestational, parturitional and neonatal data. 97 79

At the Kiel University Department of Gynaecology, 21 patients between the 21th and 39th week of gestation were treated in 1987 and 1988 following diagnosis of HELLP syndrome. At the time of diagnosis all patients presented an advanced gestosis/eclampsia. 9 patients developed the classical signs and symptoms, while hospitalised. The typical signs of gestosis, hypertension, proteinurea, oedema and hypoproteinaemia preceded the changes in laboratory values caused by the HELLP syndrome. Upper abdominal pain and increase in transaminase values occurred on the average 3.4 or 2.7 days prior to the decrease of, thrombocyte count. In 19 of the 21 cases, pregnancy was terminated by caesarean section. Severe peripartal complications occurred in 7 cases e.g. foetal death in utero (n = 3), eclampsia (n = 5), renal failure (n = 2), cerebral oedema (n = 1), intracerebral haemorrhage (n = 1), disseminated intravascular coagulation (n = 1), abdominal wall haematoma (n = 1). 6 of these patients were admitted after complications had occurred prior to admittance. All 18 infants born alive survived the neonatal period. The average birth weight was 1,571 g. 11 infants were discharged clinically normal. The remaining infants included 5 cases pointing to retinopathy and 3 cases of cerebral palsy. One infant developed post-haemorrhagic hydrocephalus.
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PMID:[Development of symptoms and perinatal complications in HELLP syndrome]. 177 22

Neurologic morbidity is observed more frequently in twins than in singletons. Low birthweight and premature birth are observed more frequently in twins but cannot always explain the cause of cerebral palsy, although circumstances related to twinning may cause brain damage. We attempted to select the patients whose brain damages might be caused by circumstances related to twinning and discussed the developmental mechanisms of their brain damages. We divided the cases into 3 groups. One comprised the monozygotic (MZ) twins whose co-twins had died. The second comprised the MZ twins with the complication of the twin-twin transfusion syndrome or discordant twins. The third comprised the MZ twins with concordant co-twins. We postulated that group I and II had complication of the disturbance of fetal circulation, but group III did not. Hydranencephaly (group I) and polymicrogyria (group II) might develop when the disruption occurs at an intermediate stage of morphogenesis (before the 6th month of gestation). In the cases with cerebral infarction (group I), the distribution of the lesions were related to the main vascular territories of the mature form, might be caused by occlusion of blood vessels associated with intrauterine disseminated intravascular coagulation. In the cases of MCE (group I), multiple cavities are present mainly in the white matter, the gray matter having a tendency to be spared. As the distribution of the cavities is not related to the main vascular territories, it was less likely that the lesions was produced by occluded vessels. The death of one fetus might cause severe blood deprivation, leading to hypoxic-ischemic brain insults in the surviving fetus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pattern of the brain damages and its developmental mechanisms in monozygotic twins]. 766 9

In multiple gestations, intrauterine death of one fetus occurs frequently. Sonographic studies indicate that many twin pregnancies are converted in early pregnancy to singletons. The "vanished" twin is sometimes recognized as a fetus papyraceous (compressus) incorporated into the placenta of the survivor. Death of one twin later in pregnancy may have serious implications for the survivor, especially in cases of monochorionic twins. One postulated mechanism has been that thromboplastic proteins from the dead twin are transfused into the survivor's circulation, resulting in disseminated intravascular coagulation. More recently it has been proposed that massive blood loss may occur from the survivor into the more relaxed circulation of a dead monochorionic twin through vascular anastomoses. These mechanisms may explain the higher frequency of cerebral palsy in monochorionic twins. These concepts emphasize the importance of careful examination and thoughtful interpretation of twin placentas.
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PMID:Intrauterine death of a twin: mechanisms, implications for surviving twin, and placental pathology. 821 Jul 73

The purpose of this study was to evaluate the fetal/neonatal outcome and to determine the important factors in that outcome, including the use of ultrasonography and fetal heart rate monitoring, in abruptio placentae during preterm gestation. A case-control study was performed using a logistic regression model. Adverse outcome was defined as neonatal death before hospital discharge or a diagnosis of cerebral palsy in surviving neonates. Stillbirth (group 1) occurred in eight of 50 cases of abruptio placentae (16%). Adverse outcome was seen in 11 survivors (11 of 42; 26.2%). The obstetrical disseminated intravascular coagulation (DIC) score in group 1 (11.8 +/- 7.1) was higher than that in the adverse (5.7 +/- 1.3) and satisfactory (5.3 +/- 2.4) outcome groups. A low Apgar score (< 7) at 5 minutes (odds ratio, 19.8; 95% confidence interval, 2.0 to 197.8) was associated with increased risk of adverse outcome in the logistic regression model. Although the obstetrical DIC score was high and may reflect the severity of maternal complications in the stillbirth group, there were no typical ultrasonographic findings and fetal heart rate patterns in abruptio placentae during preterm gestation predicting adverse outcome among survivors.
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PMID:Fetal/neonatal outcome in abruptio placentae during preterm gestation. 1605 5

This study investigated the clinical manifestations and outcomes of central nervous system (CNS) infection by enteroviruses. Cases with CNS involvement among all enterovirus-culture-positive cases from January 1995 to June 2003 were retrospectively reviewed. Among 1028 enterovirus-culture-positive cases, there were 333 cases involving the CNS. Of these, the ratio of male to female subjects was 1.78, and the mean (+/- standard deviation) age was 6.83 +/- 5.9 years; 21 were premature neonates, and 10 failed to thrive. Disease entities included 282 cases of aseptic meningitis (84.7%), 44 cases of encephalitis (13.2%), and 7 cases of encephalomyelitis/polio-like syndrome (2.1%). Of these cases, 97.9% (326/333) had fever with peak body temperature at 38.9 degrees C, 85% had headache and vomiting, 70% had meningeal signs, 64% had neck stiffness, 16.6% (55/333) had change of consciousness, 5.4% (18/333) had seizures and 5.2% (17/333) had myoclonic jerks. Mannitol was administered in 77.2% of patients (257/333), along with intravenous immunoglobulin in 6.6% (22/333). Twelve cases received ventilator support. One patient died of hand-foot-and-mouth disease, encephalitis plus cardiopulmonary failure, and 2 premature neonates died of hepatic failure, disseminated intravascular coagulation, sepsis-like syndrome and myocarditis. Eighteen had neurologic sequelae, including 7 with limb weakness, 5 with epilepsy, 2 with sixth cranial nerve palsy, 3 with cerebral palsy, 4 with psychomotor retardation, 2 with spasticity, and 1 with hearing loss. Factors associated with unfavorable outcomes (death or sequelae) included younger age (p=0.0003), higher peak white blood cell count (WBC) [p=0.0009] and skin rash (p=0.005). Younger age and higher peak WBC were poor prognostic factors of severe enterovirus CNS infection. Death was related to neonatal enterovirus infection and enterovirus 71 infection in young children.
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PMID:Clinical features and factors of unfavorable outcomes for non-polio enterovirus infection of the central nervous system in northern Taiwan, 1994-2003. 1634 42

A 12-year-old boy with mental retardation and cerebral palsy developed hyperthermia during dental treatment performed while he was conscious. During the treatment, he was highly excited, and shortly after completion of the procedure, general muscular spasms occurred. His axillary temperature was 41.6 degrees C then. He was transferred to another general hospital and there he was judged to have become afebrile and was discharged. His condition deteriorated during the night, and he was readmitted to the same hospital the following morning. The patient did not respond to the therapy and died from multiple organ failure on the 13th day. It was thought that hyperthermia had led to rhabdomyolysis and DIC. The cause of death is discussed. Hyperthermia in a handicapped patient is not always transient or benign, and can be life threatening.
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PMID:Fatal hyperthermia due to dental treatment. 1650 53

A 34-year-old pregnant woman experienced cardiac arrest at home. Out-of-hospital perimortem cesarean delivery was performed 27 minutes after the collapse. Both mother and child were resuscitated and had return of spontaneous circulation before they were transported to a university hospital. The mother underwent hysterectomy and developed disseminated intravascular coagulation. Despite intensive treatment, she died 8.5 hours after arrival. The infant was extubated the next day, and her subsequent hospital course was uneventful. She was later diagnosed with cerebral palsy and severe gastroesophageal reflux. At 2 years of age, she communicated by sounds, eye contact, and smiling.
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PMID:Out-of-Hospital Perimortem Cesarean Delivery Performed in a Woman at 32 Weeks of Gestation: A Case Report. 2804 24

Placental abruption is a condition that should be carefully considered in perinatal management because it is associated with serious events in both the mother and neonate, such as intrauterine fetal death, cerebral palsy, obstetric critical bleeding, and uncontrollable bleeding. The concomitant presence of disseminated intravascular coagulation (DIC) more easily causes critical bleeding that may necessitate hysterectomy or multi-organ failure resulting in maternal death. Therefore, early management should be provided to prevent progression to serious conditions by performing both hemostatic procedures and DIC treatment. To take measures to improve the outcomes in both the mother and neonate, health guidance for pregnant women, early diagnosis, early treatment, development of the emergency care system, and provision of a system for transport to higher-level medical institutions should be implemented.
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PMID:Management of disseminated intravascular coagulation associated with placental abruption and measures to improve outcomes. 3153 72