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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Polyarteritis nodosa developing during gestation has an extremely grave prognosis. To an uncertain extent, this results from a delay in recognition and therapy. The diagnosis of PAN is complicated by the expanded differential of common conditions associated with pregnancy such as pre-eclampsia and toxemia which can present with similar symptoms and signs. On the other hand, the pregnant woman with known, quiescent disease has a much better prognosis with only one of four women experiencing exacerbation. In women with Behcet's disease, convincing reports of both pregnancy-related flares and remissions involving primarily mucocutaneous manifestations are found in the literature. Gestational exacerbation of the more serious manifestations including chorioretinitis, vasculitis and CNS disease does not appear to be a problem. Also, a significant effect on fetal development or survival is not evident. The pregnant woman with the Marfan syndrome and pre-existing cardiovascular disease, particularly dilatation of the aortic root, has a substantially increased risk of developing a major complication during gestation most commonly aortic aneurysm, dissection, rupture or insufficiency. Echocardiographic determination of the aortic root diameter is prognostic with a decreased risk at a diameter of 40 mm or less. A diameter of greater than 40 to 45 mm constitutes a significant contraindication to pregnancy. All pregnancies in patients with the Marfan syndrome are considered high risk and frequent evaluations and echocardiograms are required. The EDS patient is subject to a wide range of gestational complications resulting from the basic connective tissue defect manifested clinically by hyperextensible skin, joint hypermobility, connective tissue and vascular fragility, and poor wound healing. The most serious complications occur in type I EDS (gravis) and type IV (ecchymotic) and include extensive perineal tears and hematoma after vaginal delivery, uterine prolapse and rupture, difficulty in suturing wounds and controlling hemorrhage after cesarean section, spontaneous rupture of major arteries, and bowel perforation. Management of the pregnant patient with the EDS must be individualized after identification of the particular type.
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PMID:Rare inflammatory and hereditary connective tissue diseases. 256 43

Myometrial norepinephrine was measured consecutively with high-performance liquid chromatography in women who delivered by cesarean section. The previously recorded marked reduction in tissue norepinephrine at the end of normal pregnancy was confirmed. When cesarean section was performed because of abruptio placentae/hemorrhage, impending asphyxia, dystocia or preeclampsia, the norepinephrine concentrations were six to ten times higher than in normal pregnancy. When an emergency cesarean section was carried out for premature breech presentation, transverse position of the fetus or prolapse of the umbilical cord (following an otherwise-normal pregnancy), the reduced norepinephrine values were not significantly different from those measured in a control group of women who underwent elective cesarean section. It is possible that the abnormally elevated levels of myometrial norepinephrine are part of the primary pathophysiologic condition associated with sympathetic overactivity, resulting in disturbed myometrial circulation and/or motor activity.
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PMID:Myometrial norepinephrine in human pregnancy. Elevated levels in various disorders leading to cesarean section. 258 92

A mail survey of Canadian sheep flocks registered on the Record of Performance program was conducted, and the association of management practices and diseases with productivity was studied using multiple regression techniques. The relationships between management practices and diseases of lambs which were associated with production were also investigated using discriminant analysis. Flocks in the maritimes had a lower average flock productivity than those in Ontario-Quebec and the western provinces. In purebred flocks, the average adjusted weight at 100 days of age was higher than in other types of flocks, and the prevalence of scours was lower. At the herd level, the rates of pregnancy toxemia and vaginal prolapse were associated with heavier lambs, while the average daily weight gain between 50 and 100 days of age was lower in herds affected by scours and starvation. Using pasture and bush as winter housing was also detrimental to lamb productivity. No management practices discriminated between case and control flocks for scours and starvation in lambs. It was concluded that the reasons for the geographic differences should be investigated as should the management differences between purebred and other producers. Prevention of scours and starvation in lambs should be given priority in order to increase productivity.
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PMID:Factors associated with productivity in Canadian sheep flocks. 356 50

Stressed and non-stressed antenatal fetal monitoring was carried out 9 520 times in 5 932 high-risk patients. Intra-uterine death occurred in 48 patients. In 19 patients the fetus died within 1 week of monitoring but before the onset of labour; the results of monitoring had been normal in 14 of these. Abruptio placentae was the cause of 6 of these deaths. Many of the other causes of intra-uterine death were also acute complications such as haemorrhage due to placenta praevia, amniotic fluid infection, and cord prolapse. True false-negative test results were rare, and were seen most often in patients with preeclampsia, diabetes and haemolytic disease. Twin pregnancies also caused a problem, as double recording of the heart rate of the normal fetus could create a false sense of security.
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PMID:Intra-uterine deaths after suspicious, uncertain and normal antenatal fetal heart rate monitoring. 740 46

Two cases of neurological dysfunction are presented. Neurological deficits after recovery from anaesthesia are unusual in young women perioperatively. In the first case, a 39-yr-old woman presented at 36-wk gestation with antepartum haemorrhage and in labour. Pregnancy had been complicated by pre-eclampsia and she underwent emergency Caesarean section under general anaesthesia without complication. The trachea was extubated when she was awake but almost immediately she became hypertensive, obtunded and reintubation was required. Her pupils became fixed and dilated but the Computerised Axial Tomogram (CT) was normal. A coagulopathy was evident. She made a full neurological recovery within 24 hr. On the same day, a previously healthy 41-yr-old woman who had undergone uneventful surgery for uterine prolapse 24 hr previously developed headache, nausea and over the next four hours signs of progressive brainstem ischaemia. The CT scan showed oedema of the mid- and hindbrain. Brainstem death was confirmed 12 hr later and the post-mortem revealed acute dissection of the vertebral artery secondary to cystic medial necrosis. Such dramatic neurological sequelae are rare but the importance of identifying "at risk" groups is underlined as is early recognition of neurological injury postoperatively.
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PMID:Unexpected neurological deficits following recovery from anaesthesia. 800 39

During 1981-1990, there were 12,925 deliveries and 68,668 mothers received prenatal care at Wesley Guild Hospital in Ilesa, Nigeria. Physicians retrospectively analyzed data on these deliveries to determine trends in the perinatal mortality rate under harsh economic conditions. Rising economic hardship in Nigeria forced the hospital to introduce fees in late 1984, after which, the number of mothers receiving prenatal care and the resultant number of deliveries at the hospital declined significantly (p 0.001). In fact, the percentage of deliveries where the mothers did not receive prenatal care increased as the total number of deliveries decreased (p 0.001). The fees and the concurrent economic hardship decreased the purchasing power of the people, thus more and more mothers could not afford to pay for prenatal care and delivery in the hospital. During the study period, there were 747 perinatal deaths for a perinatal mortality rate of 57.8/1000 total births. The rate increased from 38.7 after introduction of fees and peaked at 110.5 in 1987. Leading obstetric complications were antepartum hemorrhage, prolonged obstetric labor, preeclampsia, cord prolapse, retained second twin, severe anemia, and maternal and fetal distress. The distribution of stillbirths, early neonatal deaths, and major obstetric complications was unequal during the study period. Stillbirths accounted for more than 75% of perinatal deaths. Factors related to stillbirth included prolonged obstructed labor, antepartum hemorrhage, multiple pregnancy, and eclampsia. The two leading causes of early neonatal death were preterm delivery (low birth weight 2500 g) (62.2%) and birth asphyxia (27.7%). More than 75% of these deaths occurred within the first 48 hours of life. More than 50% of the preterm infants weighed less than 1500 g at birth. These findings reflect the adverse effect of economic hardship and of the introduction of fees on perinatal health at Wesley Guild Hospital.
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PMID:Trends in utilization of obstetric care at Wesley Guild Hospital, Ilesa, Nigeria. Effects of a depressed economy. 859 70

A distinctive segmental glomerular abnormality is confined to the region of the tubular opening. The hypothesis was that this followed prolapse of the tuft into the tubule. Analysis was made of 39 renal biopsy specimens with acute postinfective glomerulonephritis, later material from ten cases, four specimens from three women with pre-eclampsia, and 21 control specimens, with morphometry of glomeruli and immunohistological examination for immunoproteins and monocytes/macrophages. Prolapse was found in 14 specimens with acute postinfective glomerulonephritis, associated in eight with adhesion to Bowman's capsule and local alterations in the tuft, which together constitute early tip changes. Another three had early tip changes only and eight others had thin adhesions between the tuft and capsule next to the tubular opening. Later material confirmed this order of development and showed another late change, with sclerosed and hyaline material in the tuft and adhesion at the tubular origin. Findings in pre-eclampsia were comparable. Glomeruli were significantly larger in acute postinfective glomerulonephritis than in controls and were shown by others to be larger in pre-eclampsia than in normal pregnancy. Immunohistology showed IgM and a few foamy monocytes/macrophages in early tip changes but not in prolapsed loops. Glomerular prolapse appears to be a temporary consequence of acute enlargement of the tuft, probably causes mechanical damage to epithelial cells, and is a precursor of permanent structural changes near the tubular origin. This gives a unifying hypothesis to explain how these changes can be seen in acute postinfective glomerulonephritis, pre-eclampsia, and many other human and experimental renal disorders.
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PMID:Glomerular prolapse as precursor of one type of segmental sclerosing lesions. 1069 98

The aim of the study was to identify maternal risk factors for perinatal asphyxia in Malawi. Records of 100 mothers who delivered neonates with Apgar scores less than 6 at 5 minutes of birth during March to September 1998 were analyzed. The majority of the mothers were primigravidas (79%) and were within the normal childbearing ages of 20 to 34 years (61.2%). Sixty-one percent of the mothers started antenatal care at 20 to 28 weeks' gestation. Sixty-five percent of the mothers developed obstetric and medical problems that contributed to perinatal asphyxia, and of these, 12 mothers (18.5%) had more than one problem. The problems were premature labor and delivery (21%), preeclampsia (10%), cephalopelvic disproportion (8%), breech presentation (12%), prolonged second stage (11%), fetal distress (7%), cord prolapse (4%), antepartum hemorrhage (2%), prolonged rupture of membranes (1%), and malaria (1%). Forty-six percent had assisted deliveries, and these were cesarean section (18%), vacuum extraction (14%), breech delivery (12%), and forceps delivery (2%). Eighty-one percent of the neonates were admitted to the neonatal nursery, and of these, 56 neonates (67.1%) developed complications; the most common was hypoxic ischemic encephalopathy (38 neonates; 67.9%). Thirty-three percent of the neonates died within 6 days postdelivery. Morbidity and mortality related to perinatal asphyxia can be reduced if staff are knowledgeable and skilled in basic neonatal resuscitation and necessary equipment is available. Mothers should be encouraged to report early for antepartum and intrapartum care for adequate surveillance. The quality of neonatal care, with a focus on thermoregulation and infection prevention, needs to be improved.
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PMID:Risk factors for perinatal asphyxia at Queen Elizabeth Central Hospital, Malawi. 1127 Nov 18

This study focused on the interaction between specific obstetrical complications and early family adversity in predicting violent behavior during childhood and adolescence, in a sample of 849 boys from low socioeconomic areas of Montreal, Canada. Obstetrical complication data from medical records were used to create three scales using a nonlinear principal component analysis followed by rotation. Family adversity and teacher-rated physical aggression were assessed when the boys were in kindergarten and self-reports of delinquency were collected when they were 17. Elevated scores on the Deadly Risk Situation scale of obstetrical complications (preeclampsia, umbilical cord prolapse, and induced labor) increased the risk of being violent at both 6 and 17 years of age, only among boys who grew up in high adverse familial environments. Moreover, this interaction partly accounted for the continuity between violence in childhood and adolescence. Interventions for young pregnant women from deprived environments and their babies are discussed in light of these results.
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PMID:Obstetrical complications and violent delinquency: testing two developmental pathways. 1194 5

Pregnancy is often associated with ocular changes which may be more commonly transient but occasionally, permanent. It may be associated with the development of new ocular conditions, or can exacerbate pre-existing conditions. The ocular effects of pregnancy may be physiological or pathological or may be modifications of pre-existing conditions. Adnexial changes include chloasma, spider angiomas and ptosis. Anterior segment changes include a decrease in conjunctival capillaries and an increase in the granularity of conjunctival venules and in corneal curvature, changes in corneal thickness, refractive index, accommodation and refractive errors, and a decrease in intraocular pressure. Posterior segment changes include worsening of diabetic retinopathy, central serous chorioretinopathy, increased risk of peripheral vitreochorioretinal dystrophies and retinal detachment, and a beneficial effect on non-infectious uveitis. Systemic disorders of importance include preeclampsia, Graves disease and multiple sclerosis. Intracranial disorders with ocular effects in pregnancy include Pseudotumor cerebri, prolactinomas and Sheehan's syndrome.
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PMID:A review of the changes in the ophthalmic and visual system in pregnancy. 1943 22


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