Book of Medical Disorders in Pregnancy - Tintash

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dysmenorrhea, dysuria, and even obstruction of urine. The hydatid disease of the pelvic organs can be a cause of infertility. Differential diagnosis: In gynecological patient the cystic mass must be differentiated from primary ovarian cyst, uterine fibromyoma and chronic inflammatory disease of the adnexa. The pelvic cysts can rupture during labor and result in expulsion of cyst fluid. This produces daughter cysts into the peritoneal cavity or into the vagina. They may even obstruct the course of labour. Diagnosis: An echinococcus cyst should be suspected in the differential diagnosis of hepatic, abdominal, and pelvic masses associated with eosinophilia. When ring like calcified shadows are seen in the liver or in the lung fields on x-rays, this disease should be suspected. The specific diagnosis may be made by the demonstration of positive skin test sensitivity to echinococcus antigen. This test is called the Casein reaction or test. Similarly complement fixation test can be done. Microscopic examination of aspiration of a liver cyst shows hydatid scolices and hook lets. Treatment: Surgery: An entire cyst can be excised if it can be mobilized. However, if the cyst is inoperable, it should be drained with extreme care to prevent spillage, and the cavity should be filled with dilute formalin to kill the germinal layer. 163 If a cyst interferes with pregnancy, no attempt should be made to push it up out of the pelvis since it is usually fixed and such manipulation might lead to rupture. The treatment of choice is Cesarean Section. Puncture of the cyst and its evacuation and formularization through the vagina is not recommended. REFERENCES: 1. Cardiac longitudinal study of children perinatally exposed to human immunodeficiency virus type 1] Arq Bras Cardiol 2005 Oct;85(4):233-40. Portuguese. 2. Determinants and trends in perinatal human immunodeficiency virus type 1 (HIV-1) transmission in the metropolitan area of Belo Horizonte, Brazil: 1998 - 2005 Mem Inst Oswaldo Cruz 2008. 3. Management of HIV positive pregnancies in Ontario: current status. Can J Clin Pharmacol. 2009 Winter;16(1):e68-77. 4. Adverse Effects of Antiretrovirals in HIV-Infected Pregnant Women 2009 Medscape 5. Guidelines for the Prevention and Treatment of Opportunistic Infections among HIV-exposed and HIV-infected children MMWR Recomm Rep 2009. 6. Pregnancy outcomes in young women with perinatally acquired human immunodeficiency virus-1. Am J Obstet Gynecol 2009 Feb;200(2):149.e1-5. 7. No relation between in-utero exposure to HAART and intrauterine growth retardation. AIDS 2009 Jun 19;23(10):1235-43. 8. Amniocentesis and mother-to-child human immunodeficiency virus transmission in the Agence Nationale de Recherches sur le SIDA et les Hépatites
Virales French Perinatal Cohor Am J Obstet Gynecol 2009 Feb;200(2):160.e1-9 9. Morphologic and metabolic abnormalities in vertically HIV-infected children and youth. AIDS 2009 Mar 10. Guidelines for prevention and treatment of opportunistic infections in HIVinfected adults and dolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Recomm Rep 2009 Apr 10;58(RR-4):1-207 11. [A prospective study of neurodevelopment of uninfected children born to human immunodeficiency virus type 1 positive mothers] Rev Neurol. 2009 Mar 16- 31;48(6):287-91. Spanish. 12. Progress in prevention of mother-tochild transmission of HIV infection in Ukraine: results from a birth cohort study. BMC Infect Dis. 2009 13. Predictors of early and late mother-tochild transmission of HIV in a breastfeeding population: HIV Network for Prevention Trials 012 experience, Kampala, Uganda. J Acquir Immune Defic Syndr. 2009 Sep 1;52(1):32-9. 164
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MEDICAL DISORDERS IN PREGNANCY M. S
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PREFACE Almost all medical disorder
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Dedication This manuscript is dedic
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Uri. Elkayam MD Professor of Cardio
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Chapter No: 1 Anaemia in pregnancy:
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performance. Tiredness, listlessnes
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pregnancy and labour. The monthly b
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Fig 1.3: Shows developmental stages
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Prophylactic this includes routine
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granulocytes and thrombocyte is als
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or because the hemoglobin A is repl
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iron. Decrease in the number of gra
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Labor/delivery: Expedite for normal
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Risk factors: The risk of GDM incre
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to a large extent on the measure of
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vomiting, or through intercurrent i
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largely related to the problems of
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femoral epiphyses can help in asses
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in a randomized design the efficacy
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of the previous day’s dose of ins
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women with vascular disease are awa
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Chapter No 3 THYROID DISEASE IN PRE
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such as phenobarbitone 30 mg given
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REFERENCES: 1. Hawe, P. and Francis
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Incidence - Its incidence varies ac
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cerning the disturbance in the Reni
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Renal function: In normal pregnant
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severe pre eclampsia and eclampsia
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Epipastic pain: It is also a late s
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arely occurs. However, if pregnancy
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differentiating between chronic hyp
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fetuses. Recent studies indicate th
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to procrastinate all available meth
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cases are said to occur up to 1 wee
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has been carried out. There can be
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intensive care room for the next 48
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Severe pre eclampsia at or remote f
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Chapter No: 5 HEART DISEASE IN PREG
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pregnancy. The increase in volume i
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Fourth Heart sound - This is rarely
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Class III - With cardiac disease pr
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differentiate from hemodynamically
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dominant). Jervell + Lange Nielson
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striking of which is stippling seen
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increase venous pressure and burden
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determine whether she will be safe
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supplemental 02. Fetal surveillance
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11. Percutaneous transluminal angio
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ureter at the pelvic brim may play
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Fig6.3: Shows location of kidney in
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A clear cut history of streptococca
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(a) Polycystic renal disease - Fort
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with patients in this category. In
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2. Beard, R.W.and Roberts, A.P. (19
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increases slightly. Arterial blood
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scan, 0.004 Gy; pulmonary angiograp
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CD4 + cell count (200/ml) should re
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embark upon a pregnancy. Severe air
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Chapter No: 8 LIVER DISEASE IN PREG
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owel, but conjugated bilirubin is n
Page 122 and 123: Hepatic causes - Viral hepatitis bo
Page 124 and 125: Immunoprophylaxis at birth followed
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Page 128 and 129: curs in 60 to 70 percent of subsequ
Page 130 and 131: Chronic liver disease: An increased
Page 132 and 133: 22. Riely CA. Hepatic disease in pr
Page 134 and 135: ilirubin is transported across the
Page 136 and 137: when the titre is greater than 1: 3
Page 138 and 139: Induction of labour: When screening
Page 140 and 141: Blood brain barrier and bilirubin e
Page 142 and 143: place if the infant develops jaundi
Page 144 and 145: REFERENCES 1. UpToDate a. “Pathog
Page 146 and 147: of embolus formation is far less in
Page 148 and 149: Unfortunately this faculty is not a
Page 150 and 151: hours. The maximal effect takes 36
Page 152 and 153: may complain of constricting type o
Page 154 and 155: When the embolus is small and non f
Page 156 and 157: 3. Sukal S, Geronemus R. "Deep Veno
Page 158 and 159: damage specific cells in the tissue
Page 160 and 161: is capable of breaking off and deve
Page 162 and 163: Chapter No: 12 PARASITIC INFECTIONS
Page 164 and 165: sporozoite stage. The main characte
Page 166 and 167: insect repellents and insecticide s
Page 168 and 169: is 2 tablets i.e. (400 mgs) thrice
Page 170 and 171: Cardiac failure resulting from seve
Page 174 and 175: Chapter No: 13 VIRAL DISEASES IN PR
Page 176 and 177: after exposure favors but does not
Page 178 and 179: Fig13.4: shows CMV infection rash o
Page 180 and 181: three quarters of HYH strains isola
Page 182 and 183: where 'T' stands for toxoplasmosis
Page 184 and 185: Chapter No: 14 Introduction: The dr
Page 186 and 187: hexacyanoferrate (II) 2H2O (Prussia
Page 188 and 189: Restricted indications: Anti lepros
Page 190 and 191: potential Teratogen and inhibits ma
Page 192 and 193: placental abruption, and intrauteri
Page 194 and 195: Inhalation of volatile organic comp
Page 196 and 197: Chapter No: 15 Pregnancy is a norma
Page 198 and 199: time periods during the pregnancy f
Page 200 and 201: y the maternal kidney in urine or b
Page 202 and 203: continues after the end of the uter
Page 204 and 205: Amniography - In this technique rad
Page 206 and 207: at the cranial end of the neural tu
Page 208 and 209: least maceration: placenta, lung, a
Page 210 and 211: fetal hydrops with monosomy X, or T
Page 212 and 213: cause progressive renal failure as
Page 214 and 215: 9. Papageorgiou, E.A.; Karagrigorio
Page 216 and 217: position of the head. The student s
Page 218 and 219: centimeter ruler is placed alongsid
Page 220 and 221: echoes in B mode. The operator appl
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also affects depth resolution and t
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From twelve week onwards the bipari
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tract. Normal kidneys can easily be
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3.19, 1.29 and 1.30, respectively [
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iodinated contrast during pregnancy
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Only tiny amounts of iodinated or g
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intraperitoneal hemorrhage, or inju
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REFERENCE: 1. Stewart A, Webb J, Gi
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cardiac defects 181, 200 cardiac di
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gestational age 26, 31, 40, 165, 19
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monitoring, invasive 83-6 monosomy
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sensitization 124-5 sepsis 22, 95-6
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