The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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J. Matern. Fetal. Neonatal. Med. · Nov 2009
Ventricular access device versus ventriculosubgaleal shunt in post hemorrhagic hydrocephalus associated with prematurity.
Post-hemorrhagic hydrocephalus (PHH) secondary to germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) continues to be a common problem affecting preterm neonates. Two different devices are used to treat hydrocephalus in preterm neonates under 2.5 kg: (1) ventricular access device (VAD) and (2) ventricular to subgaleal shunt (VSGS). We aim to determine the differences between VAD and VSGS in daily patient management and shunt requirement outcome in premature infants with PHH. ⋯ VSGS is an effective means of providing temporary continuous drainage of CSF in PHH with an acceptable complication rate. VSGS has many advantages that make it superior to VAD as a temporizing shunt.
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J. Matern. Fetal. Neonatal. Med. · Oct 2009
Review Case ReportsSuccessful pregnancy outcome in Ehlers-Danlos syndrome, vascular type.
Ehlers-Danlos syndrome (EDS) is a rare connective tissue disorder characterized by tissue fragility, translucent skin and joint hypermobility. Patients with the vascular type of EDS are prone to spontaneous arterial and visceral rupture. Pregnancy for women with vascular EDS can be life-threatening. Mortality rates are high due to the increased risk for uterine and arterial rupture in the peripartum period. ⋯ There is no consensus in the literature on the timing and mode of delivery for pregnant women with vascular EDS. The management undertaken in our patient may assist others in optimizing the perinatal outcome in other women who elect to continue their pregnancy despite the risks of this severe medical condition.
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Obstetric anesthesia is science and art combined, and obstetric anesthesiologists must be concerned simultaneously with the lives of (at least two) intricately interwoven patients - the mother and her baby (ies). Obstetric anesthesia, by definition, is a subspecialty of anesthesia devoted to peripartum, perioperatvie, pain and anesthetic management of women during pregnancy and the puerperium. Perhaps no other subspecialty of anesthesiology provides more personal gratification than the practice of obstetric anesthesia. ⋯ Exchange on information and communication skills in ever changing environment of labor and delivery is essential for perfect outcome, which is always expected when providing safe passage for both the mother and her fetus from antepartum to postpartum period. Changes in maternal-fetal and neonatal medicine and obstetric anesthesia have continued to develop rapidly during the recent years. The purpose of this article is to explore a number of important issues in modern practice of obstetric anesthesia.
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J. Matern. Fetal. Neonatal. Med. · Oct 2009
Case ReportsPregnancy after a previous gestation complicated by an acute aortic dissection.
Acute aortic dissection is a rare life-threatening event. No further pregnancies in women who had a previous acute aortic dissection have been reported. We present the case of a chronic hypertensive woman, who in her previous gestation was submitted to an acute aortic dissection repair at 28 weeks of gestation with cesarean delivery at the same operative procedure. ⋯ An elective cesarean was performed at 33 weeks' gestation. Aneurysm expansion, rupture or redissections are potential complications of operated aortic dissection. Normal blood pressure values and close cardiologic and obstetrical follow-up are essential to obtain a favourable outcome.
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J. Matern. Fetal. Neonatal. Med. · Sep 2009
Characteristics of obstetric intensive care unit admissions in New Jersey.
To assess the demographic characteristics, risk factors and perinatal outcomes among maternal intensive care unit (ICU) admissions in New Jersey from 1997 to 2005. ⋯ Pregnancy complications are predictive of ICU admission amongst pregnant patients after adjusting for demographic factors.