Abstract:
:Elevated serum transaminase levels can have many different etiologies, especially in the pregnant patient. Hypoxic hepatitis is a distinct syndrome caused by decreased hepatic blood flow that presents with a marked, but transient, increase in liver enzymes. A 28-year-old woman, gravida 3, para 2 with history of gastric bypass, presented in the second trimester with bright red blood per rectum, syncope, and epigastric pain. Laboratory studies were significant for anemia, elevated liver enzymes, and low platelets, raising concern for hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) and the need for emergent delivery. Complete evaluation included an upper endoscopy, which revealed a bleeding jejunal ulcer that was subsequently cauterized. Shortly after cauterization, the patient's laboratory values normalized and her pain resolved. Diagnosis of hypoxic hepatitis was made after exclusion of other liver-toxic entities, thus preventing delivery of a preterm infant. Hypoxic hepatitis may masquerade as other clinical syndromes, especially in the pregnant patient. Meticulous physical examination and assessment of laboratory values is essential for making a proper diagnosis and guiding management.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Kummer N,Cackovic M,Paidas M,Funai Edoi
10.1055/s-0028-1085065subject
Has Abstractpub_date
2008-09-01 00:00:00pages
469-71issue
8eissn
0735-1631issn
1098-8785journal_volume
25pub_type
杂志文章abstract::The objective of this paper was to determine if routine postpartum hemoglobin (Hb) determination changes patient management. One thousand patients with a vaginal delivery at Hermann Hospital, Houston, TX, had antepartum Hb testing, and a postpartum Hb for: (1) an antepartum Hb <9.0 mg/dL, (2) an estimated blood loss (...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993881
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:Our objective was to evaluate the efficacy of perioperative multimodal pain management in reducing opioid use after elective cesarean delivery (CD). STUDY DESIGN:A single-center, double-blinded, placebo-controlled randomized trial of women undergoing elective CD. Participants were allocated 1:1 to receive th...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0039-1681096
更新日期:2019-09-01 00:00:00
abstract::Aim To determine the challenges, if any, in translating the benefits of surfactant replacement therapy (SRT) to a resource-limited setting. Method This was a retrospective descriptive study comparing the outcome of 75 cases who received surfactant and 69 controls who did not at the University Hospital of the West Indi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1598023
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To determine epidemiology and clinical characteristics of infants with methicillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) in a level III neonatal intensive care unit (NICU). STUDY DESIGN:All NICU admissions (2001 to 2008) with any positive S. aureus culture were included as cases. Cas...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1304819
更新日期:2012-06-01 00:00:00
abstract::Introduction Bronchopulmonary dysplasia (BPD) is a frequent, long-term complication in very low-birth-weight (VLBW) newborns. Its etiology is multifactorial and the oxidative stress is one of its main causes. Breast milk (BM) reduces oxidative stress and provides antioxidant protection, therefore, BM may have a protec...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1586503
更新日期:2017-02-01 00:00:00
abstract::Pulmonary hypoplasia is lethal in its most severe form; in less severe cases the clinical course is protracted, usually resulting in chronic lung disease. A case of unexpected survival of an infant with clinical and radiologic evidence of pulmonary hypoplasia, in whom dexamethasone was administered, is presented. Poss...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999375
更新日期:1991-05-01 00:00:00
abstract::Magnesium sulfate is used for seizure prophylaxis in patients with preeclampsia. It also has significant effects on calcium metabolism and could, therefore, alter the pressor response to calcium-dependent vasoconstrictors. The present in vivo rat study examined the effect of magnesium sulfate to alter the pressor resp...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999292
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:To determine whether 17-α-hydroxyprogesterone caproate (17P) reduces the incidence of preterm birth in women with a history-indicated cerclage. STUDY DESIGN:Retrospective cohort study of women who received a cerclage for a prior preterm birth, analyzed based on exposure to 17P. The primary outcome variable w...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1332799
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between midpregnancy cervical length and postterm delivery and cesarean delivery during labor. STUDY DESIGN:In a multicenter cohort study, cervical length was measured in low-risk singleton pregnancies between 16 and 22 weeks of gestation. From this cohort, we identified nulliparo...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0035-1556067
更新日期:2016-01-01 00:00:00
abstract::First-trimester prenatal diagnosis was offered to 104 twin pregnancies mainly for advanced maternal age and cytogenetic evaluation of a new fertilization technique. Chorionic villus sampling (CVS) was performed transcervically (35%), transabdominally (23%), or by combination of these two techniques (42%). Although no ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994380
更新日期:1996-10-01 00:00:00
abstract::A 27-year-old primigravida women was referred for ultrasound studies at 32 weeks' gestation because of the suspicion of fetal ventriculomegaly. Sonographic examination of the fetal brain found a marked shift of the midline, with enlarged left hemisphere and ipsilateral occipital horn, and abnormal convolutions. A 3500...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999330
更新日期:1991-01-01 00:00:00
abstract::Discordancy in twins is generally described as a weight difference between the fetuses of 15 to 25% and its prevalence in normal twin gestations is estimated at 15 to 29%. The present study was performed in order to determine the frequency of discordant newborns in uncomplicated triplet gestations. One hundred and fou...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994724
更新日期:1993-05-01 00:00:00
abstract::Rh disease has largely disappeared as a result of prophylaxis with anti-D. However, the cases that remain are more complicated with a combination of novel challenges with regard to in utero management with transfusion and its effects on the course of the neonate, both early and late. Thrombocytopenia in the neonate ca...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2003-45392
更新日期:2003-11-01 00:00:00
abstract::Anti-Cw is an uncommon cause of clinically significant hemolytic disease of the newborn (HDN). We report an unusually severe case of HDN due to anti-Cw that required phototherapy and exchange transfusion. We also describe a novel PCR-RFLP method for Cw typing of fetal genomic DNA that was used for prenatal diagnosis i...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993872
更新日期:1999-01-01 00:00:00
abstract::Classically, genetically decreased bilirubin conjugation and/or hemolysis account for the mechanisms contributing to neonatal hyperbilirubinemia associated with glucose-6-phosphate dehydrogenase (G6PD) deficiency. However, these mechanisms are not involved in most cases of this hyperbilirubinemia. Additional plausible...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1585465
更新日期:2017-02-01 00:00:00
abstract::The significance and management of prepartum bradycardia is not well established in prepartum fetal assessment. The incidence of prolonged bradycardia was 3.5% (45 per 1284), defined as a decrease of greater than or equal to 40 beats per minute of the fetal heart rate (FHR) below the baseline for at least 2 minutes. T...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999972
更新日期:1985-10-01 00:00:00
abstract:OBJECTIVE:To determine the risk of gestational diabetes mellitus (GDM) and insulin resistance (IR) in obesity defined by body mass index (BMI), waist-to-hip ratio (WHR), or both combined. METHODS:Secondary analysis of a randomized multicenter trial of antioxidant supplementation versus placebo in nulliparous low-risk ...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1055/s-0035-1562928
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE: Semiquantitative lung ultrasound improves the timeliness of surfactant replacement, but its financial consequences are unknown. We aim to investigate if the ultrasound-guided surfactant administration influences the general costs of surfactant therapy for preterm neonates affected by respiratory distress syn...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1715821
更新日期:2020-08-20 00:00:00
abstract::We examined the prevalence of cesarean delivery (CD) among women with morbid obesity and extreme morbid obesity. Using Kentucky birth certificate data, a cross-sectional analysis of nulliparous singleton gestations at term was performed. We examined the prevalence of CD by body mass index (BMI; in kg/m2) using the Nat...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0031-1280852
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE: This study aimed to examine the effects of interpregnancy weight change on pregnancy outcomes, including recurrent preeclampsia, preterm birth, small-for-gestational age (SGA), large-for-gestational age (LGA), and cesarean delivery, among women with a history of preeclampsia. We also evaluated whether these ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1713000
更新日期:2020-06-10 00:00:00
abstract::The manifestations of fetal varicella syndrome usually involve several organ systems, including skin, ocular, neurologic, gastrointestinal, and genitourinary. Although ocular anomalies have been reported to be as high as 68%, manifestations limited to the eyes is extremely rare. Herein we report the case of fetal vari...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994493
更新日期:1995-09-01 00:00:00
abstract::We sought to identify prenatal predictive factors for perinatal outcome and to estimate fetal hemoglobin (Hb) levels in large fetomaternal hemorrhages (transfused blood volume [TBV] > 20 mL) by performing a case-series study ( N = 32). Perinatal outcome was favorable (F group, N = 22) and poor (P group, N = 10: four f...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0028-1103150
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:Our aim was to estimate the incidence of unintentional hysterotomy extension at the time of cesarean delivery and to identify associated risk factors and maternal morbidity. STUDY DESIGN:We conducted a secondary analysis of a randomized controlled trial evaluating chlorhexidine-alcohol versus iodine-alcohol ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1676112
更新日期:2019-08-01 00:00:00
abstract::Preeclampsia is uncommon prior to 24 weeks gestation and has been associated with partial and complete hydatidiform moles. We present an unusual case in which a patient was diagnosed with preeclampsia at 17 weeks gestation. Ultrasound findings were consistent with a partial hydatidiform mole. Within 24 hours of the on...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2006-934093
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To determine the associations of measured protein, energy, and protein-to-energy (PER) intakes with body composition in human milk (HM)-fed preterm infants. STUDY DESIGN:Neonates born at < 33 gestational weeks were eligible. Standard fortification method with modular supplements was used and the HM compositi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1626717
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:The definition of postpartum hemorrhage (PPH) was developed more than 50 years ago. Since then, the obstetric population has changed dramatically. We sought to determine how well we estimated blood loss (EBL) and find thresholds predicting need for transfusion. STUDY DESIGN:We performed a prospective cohort ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1552940
更新日期:2015-11-01 00:00:00
abstract::We report the case of a term male infant with severe persistent pulmonary hypertension of the newborn, who developed massive neutrophilia of unknown etiology. An extensive evaluation failed to disclose an obvious cause for his neutrophilia. A bone marrow aspirate was performed and was consistent with a leukemoid react...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2003-45288
更新日期:2003-10-01 00:00:00
abstract::A prospective study of 377 premature infants (less than or equal to 1500 gm) was undertaken to delineate the natural history of subependymal/intraventricular hemorrhage (S/IVH) and its complications using ultrasound (US) and computed tomography (CT). Low grade (I, II) S/IVH had a low mortality while higher grades (III...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-999929
更新日期:1985-04-01 00:00:00
abstract::While treatment of respiratory distress syndrome (RDS) with surfactant in premature neonates is well established, evidence for its use in non-RDS conditions, especially in the term neonate, has been less abundant. The last published review on a PubMed search was in 2001. In this review, we comprehensively and critical...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1556883
更新日期:2016-01-01 00:00:00
abstract::The purpose of this study was to evaluate the feasibility of the use oral ibuprofen suspension (OIS) in the treatment of patent ductus arteriosus (PDA) in premature infants. Premature infants (= 35 weeks) age 2 to 7 days who suffered from respiratory distress and had been diagnosed with PDA were included in this stu...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-2007-976550
更新日期:2007-05-01 00:00:00