Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With improving standards of antenatal care, severe pre-eclampsia dn eclampsia are becoming less common and experience in the management of these conditions is lessening. Co-ordinated plans for the care of patients should be established by obstetricians and anaesthetists working as a team. A suitable regime for drug therapy in severe pre-eclampsia or eclampsia is the following: Initial management Diazepam 10 mg slowly i.v. Pethidine 100-150 mg i.m. or i.v. in incremental dosage, or extradural blocks, if analgesia is also required. Hydrallazine 20 mg i.v. initially, followed by 5 mg at intervals of 20 min until the diastolic pressure is less than 110 mm Hg. Then, preferably by syringe pump in a concentration of 2 mg/ml, at a rate of 2-20 mg/h. If vomiting occurs this can be controlled by administration of atropine. Subsequent management Sedation and anticonvulsant therapy. Continue diazepam and, in severe cases, institute chlormethiazole infusion. Continue analgesia with pethidine or extradural block. Control of hypertension by adjusting the dose of hydrallazine. If tachycardia exceeds 120 beat/min give propanolol 2-4 mg i.v. Plasma protein depletion with groww oedema is treated by administration of salt-free albumin or plasma protein fraction. Diuretic therapy is indicated if there is gross oedema or signs suggestive of acute renal failure. Oliguria associated with increased blood urea may be a result of renal failure or dehydration. The latter should be evident from the patient's condition and central venous pressure, but i.v. fluids and frusemide 20-40 mg can be used as a therapeutic test. Mannitol reduces cerebral oedema and may be given if diuresis has been first produced with frusemide. Potassium chloride is given if the plasma potassium decreases to less than 3 mmol/litre. Heparin therapy is considered if there is clinical evidence of disseminated intravascular coagulation.
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PMID:The management of severe pre-eclampsia and eclampsia. 83 44

Selective reduction in multiple gestation refers to abortion of specific fetuses, either because of congenital defect of grand multiple gestation. Fetal indications for which selective termination has been reported are Down syndrome, microcephaly, hemophilia A, spina bifida, thalassemia major and Tay-Sachs disease. Grand multiple gestations, defined as 4 or more fetuses in a pregnancy, have been selectively terminated in cases of 4-9 fetuses. Most couples choose to reduce multiple gestations to twin pregnancies. Very short women with multiple gestation are particularly at risk. Methods used have included needle aspiration of amniotic fluid, cardiac puncture and aspiration, and intrathoracic injection of KC1 or calcium gluconate. Potassium chloride is preferred because it is rapid, so results can be determined immediately without having to repeat the procedure. It is preferable to time the termination at 11 weeks' gestation to lower the risk of disseminated intravascular coagulation, which can result from absorption of fetal tissue. Most gynecologists prefer to select for fundal implantations. The ethical alternatives of this type of termination are either to abort the entire pregnancy, or risk the life of the mother as well as the life and well-being of all the fetuses. Most women with multiple gestations are those with history of infertility, who have gone to greater expense and emotional investment to become pregnant. Legally, selective reduction is a type of 1st trimester abortion, subject to institutional experimental protocols and patient's informed consent.
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PMID:Selective reduction in multiple gestation. 273 40