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Gastrointestinal diseases and pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Murtaza Arif, Anjana Sathyamurthy, Jessica Winn, Jamal A. Ibdah
Endoscopy during pregnancy appears to be safe provided the indication for endoscopy is appropriate and adequate precautions are taken. A multidisciplinary team involving an endoscopist, obstetrician, and an anesthesiologist may be required for the management of gastrointestinal diseases in pregnancy requiring endoscopic diagnosis and intervention. Potential risks associated with endoscopy during pregnancy include the following: Fetal hypoxia: Caused by maternal hypotension and hypoxia due to oversedation and may lead to fatal consequences.Exposure of the fetus to potentially teratogenic drugs and radiation.Maternal positioning during endoscopy can cause inferior vena caval obstruction by the pregnant uterus, which can lead to decreased uterine blood flow and fetal hypoxia.
DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Forceps delivery is indicated in:Cord prolapse with the cervix fully dilated.Failure to progress in the second stage with the head in the OP position.A mother with cardiac disease to avoid strenuous pushing.Cases of fetal hypoxia with the membranes intact.Delivery of the head in breech presentation.
Cocaine Pharmacology and Drug Interaction in the Fetal-Maternal Unit
Published in Richard J. Konkol, George D. Olsen, Prenatal Cocaine Exposure, 2020
George D. Olsen, Peter C. Schalock
Vasoconstriction of the uterine vessels and the cerebral circulation remain prominent mechanisms in the theories of cocaine-induced fetal neurotoxicity. Decreased blood flow would lead to fetal hypoxia and tissue damage. Glantz and Woods (Chapter 3), and Madden and Schreiber (Chapter 5) discuss the vascular effects of cocaine in more detail in this volume.
Emerging pharmacologic interventions for pre-eclampsia treatment
Published in Expert Opinion on Therapeutic Targets, 2022
Xiao Zhang, Yue Chen, Dongli Sun, Xiaojun Zhu, Xia Ying, Yao Yao, Weidong Fei, Caihong Zheng
The possible applications of hemoglobin vesicles (HbVs) as artificial oxygen nanocarriers have recently been explored in animal models for the treatment of hypoxia-induced diseases such as brain ischemia [176]. The unique advantage of HbVs is their particle size (230–280 nm), which allows them to cross narrow pathogenic spiral arteries [176]. Effective delivery of oxygen to the placenta during pre-eclampsia may improve fetal hypoxia. Ohta et al., in 2017 [177] prepared HbVs with a size of ~ 250 nm and adjusted the oxygen affinity. Subsequent injection of the HbVs in pre-eclamptic rat models lowered the levels of placental HIF-1α and circulating sFlt-1. As a result, fetal weight was successfully improved and apoptotic injury in the fetal brain was attenuated [177]. A safety study in pre-eclamptic rat models confirmed that HbVs accumulate in the placenta without fetal exposure [177].
Evaluation of Fetal Serum Thiol/Disulfide Homeostasis and Ischemia-Modified Albumin Levels in Fetal Distress
Published in Fetal and Pediatric Pathology, 2022
Seyit Ahmet Erol, Atakan Tanacan, Orhan Altinboga, Filiz Halici Ozturk, Burcin Salman Ozgu, Yasemin Tasci, Salim Neselioglu, Ozcan Erel, Dilek Sahin
Fetal hypoxia is a complex process with many unknown points. Finding the exact etiology of fetal hypoxia is not possible most of the time and diagnosis of fetal/neonatal hypoxia is usually subjective. Assessment of hypoxia-related metabolites may be valuable in many aspects. First of all, studies on this subject may enlighten the complicated pathophysiological events behind FD. Secondly, they may serve as objective indicators of fetal hypoxic status, and accumulation of data in this area may lead to the establishment of more standardized reference levels for specific mediators. Lastly, identification of fetal/neonatal hypoxia just after the delivery may allow physicians to effectively co-ordinate with the neonatology staff. This approach allows organizing required interventions promptly. Moreover, possible estimation of hypoxic events may be useful in protecting the obstetricians from medico-legal pressure. In conclusion, the thiol-disulfide homeostasis shifts toward the oxidant direction during the FD pathogenesis and the increased IMA levels may be the best indicator of an underlying non-acute ischemic condition.
Maternal serum thiol/disulfide homeostasis in pregnancies complicated by fetal hypoxia
Published in Journal of Obstetrics and Gynaecology, 2021
Serhat Ege, Hasan Akduman, Muhammet Hanifi Bademkıran, Nurullah Peker, Selami Erdem, İhsan Bağlı, Erdal Özmen, Ruşen Köçeroğlu, Recep Yıldızhan
Fetal distress (FD) is a pathophysiological condition in which the foetus does not have enough oxygen, and it is associated with acidosis and perinatal asphyxia (Thurlow and Kinsella 2002). The aim of fetal monitoring is to recognise fetal hypoxia and perform appropriate interventions before serious asphyxia develops. In the first studies that investigated the accuracy of FD as a caesarean indication, the pH and acid-base values of postpartum cord blood were analysed to confirm fetal hypoxia, and, in time, the non-stress test (NST) was accepted as the prepartum control method (Liu et al. 1975; Tejani et al. 1976). The Apgar score, which was developed for determining the need for resuscitation of new-borns, was also accepted as a control criterion for the NST. However, it has been recommended that neonatal asphyxia should not be evaluated by Apgar scoring alone, and blood gas analysis should be considered for a more objective evaluation (Martin et al. 2005).