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Gestational hypertension and pre-eclampsia
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
More than 35,000 women have participated in a variety of randomized control trial describing the effects of low-dose aspirin (60–81 mg/day) on pre-eclampsia (42). Some of these studies were conducted in healthy nulliparous women (43,44), whereas others included patients with various obstetric and medical complications (45–49).
Sleep–Wake Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Margaret Kay-Stacey, Eunice Torres-Rivera, Phyllis C. Zee
RLS affects 5–10% of the general population and is thought to be higher in North America and Europe with most estimates ranging from 5.5% to 11.6% and lower in Asia with most estimates ranging from 1.0% to 7.5%.47 Prevalence in women is 1.5–2 times higher than men. This is in part associated with parity, as nulliparous women have disease prevalence similar to men. Age of onset of the disease ranges from childhood to late adulthood, and prevalence increases with age.48 Late-onset disease (> 45 years old) tends to progress more rapidly than early-onset RLS. Strongly associated conditions include chronic kidney disease, pregnancy, and iron deficiency anemia.
Gestational Trophoblastic Neoplasia
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
It follows from this that hysterectomy still remains a central part of management of patients with ETT/PSTT. Nevertheless, in younger nulliparous women, there is often a strong desire to preserve fertility, particularly when there appears to be a focal abnormality in the uterus. While uterine-sparing surgery is possible,3 multifocal microscopic uterine disease can occur,180 which could compromise survival, and careful counseling is required. Another alternative might be to give chemotherapy and/or immunotherapy up front to try to effectively treat these cancers. Such approaches should be regarded as experimental, as there are insufficient data to be certain of efficacy and in the case of immunotherapy, the risk of interfering with subsequent fertility due to immunological rejection of new pregnancies.
Restrictions and distress in daily, social, and sexual functioning, and intimate relationships in women with pelvic floor complaints: A mixed-method study
Published in Health Care for Women International, 2023
A. M. Brand, W. Waterink, S. Stoyanov, J. J. D. M. van Lankveld
In pregnant women, relationship quality is known to affect distress levels (Rosand et al., 2011; Witting et al., 2008). In this study, the distress that pregnant participants experienced appeared consistent with the changes in their bodies and their relationships. Parous and nulliparous participants emphasized the importance of a satisfactory sex life for different reasons. Similar to parous women in previous studies, our participants reported that pelvic floor damage from childbirth often challenged their sexual functioning and intimate relationships (Andreucci et al., 2015; Bazi et al., 2016; Brand & Waterink, 2018; Lopes et al., 2018; Yount, 2013). Some participants disclosed to even (temporarily) having hated their child for causing (undeliberately) their complaints; a conspicuous and understudied finding (O’Reilly et al., 2009). In line with previous findings (Witting et al., 2008), nulliparous women’s sexual functioning tends to define their relationship quality, and sexual dysfunction might jeopardize their intentions to become pregnant. In comparison, parous participants’ distress seems more overwhelming than pregnant and nulliparous participants’ distress (Skinner et al., 2018). Furthermore, many parous and nulliparous participants reported experiencing an increase in pain, incontinence, or aggravated sense of pelvic organ prolapse before or during menstruation. This phenomenon appears to be common, but research on this topic has thus far been limited (Righarts et al., 2018).
A One-Year Cross Sectional Analysis of Emergency Medical Services Utilization and Its Association with Hypertension in Pregnancy
Published in Prehospital Emergency Care, 2022
Megan L. Hutchcraft, Oluwabusola Ola, Eric M. McLaughlin, Erinn M. Hade, Andrew J. Murphy, Heather A. Frey, Ashley Larrimore, Ashish R. Panchal
Consistent with known risk factors and the pathophysiology of pre-eclampsia, hypertensive patients in our sample frequently presented in the third trimester, were nulliparous, were more likely to have a personal history of chronic hypertension and diabetes (25, 26). These patients were also older and more likely to live in higher income areas, representing the positive association between advancing maternal age and increased socioeconomic status (27). The significant proportion of patients with severe hypertension supports the concept that obstetric patients utilizing EMS are at a high risk to carry hypertensive disorders of pregnancy. Furthermore, many of these patients had findings suggestive of pre-eclampsia with severe features; 38.1% (8/21) of patients complaining of headache also had elevated blood pressures (12, 25).
Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in pregnant women with systemic lupus erythematosus
Published in Journal of Obstetrics and Gynaecology, 2022
Huseyin Ekici, Metehan Imamoglu, Firat Okmen, Gizem Gencosman, Gunes Ak, Mete Ergenoglu
Retrospective evaluation of medical records revealed 57 pregnant women with SLE diagnosis. Among these, 11 patients were excluded due to lack of adequate records regarding delivery. Forty-six patients with full records available were included in the study. Clinical characteristics of the patients enrolled in this study are depicted in Table 1. Mean age of patients was 30.58 ± 4.57 years. Fourteen patients were nulliparous (30.4%). Thirteen patients (%28.2) had an history of abortion and four (8%) of these patients had two or more previous abortions. Renal involvement was diagnosed in six patients (13%). In addition, ACA and LCA were positive in 12% and 6% of patients, respectively. Of 46 patients, 14 patients did not receive any treatment during their pregnancies. Fifteen patients were on steroids alone, whereas 10 patients were on hydroxychloroquine as the preferred treatment. Seven patients were diagnosed with flares during pregnancy and were managed with hydroxychloroquine and prednisolone treatment. Two patients with antiphospholipid syndrome were also started on enoxaparin in addition to their treatment regimen.