MyMedR

The occurrence of congenital diaphragmatic hernia in a pregnant adult is rare. In contrast to neonatal diaphragmatic hernias, most of the adult patients present with vague gastrointestinal symptoms mimicking other diseases hence the importance of high index of suspicion. We report a case of a young pregnant lady with congenital diaphragmatic hernia presenting with symptoms and clinical signs suggestive of acute pancreatitis. The patient had a laparotomy performed to reduce the hernial content and the diaphragmatic defect was successfully repaired.

Matched MeSH terms: Pregnancy Complications/diagnosis*; Pregnancy Complications/pathology

Fulltext Arteriovenous malformation of the pregnant uterus

Kathiravan C, Emilia SH, Mutum SS

Med J Malaysia, 2007 Jun;62(2):179-80.

PMID: 18705462

Arteriovenous malformation of the pregnant uterus is very rare, and may present with unexplained torrential bleeding. We report a patient with absence of the conventional risk factors, and was saved by quick recourse to hysterectomy to control the bleeding.

Matched MeSH terms: Pregnancy Complications/diagnosis*; Pregnancy Complications/therapy

Dengue infections and pregnancy: caution in interpreting high rates of premature deliveries and maternal mortality

Seneviratne SL, Perera J, Wijeyaratne C

Southeast Asian J. Trop. Med. Public Health, 2007 Jan;38(1):195-6.

PMID: 17539267

Matched MeSH terms: Pregnancy Complications, Infectious/mortality; Pregnancy Complications, Infectious/epidemiology*

Successful pregnancy following aplastic anaemia

Leong KW, Teh A, Bosco JJ, Lim J

Postgrad Med J, 1995 Oct;71(840):625-7.

PMID: 8545293

Pregnancy following idiopathic aplastic anaemia is rare and is difficult to manage because of life-threatening episodes of bleeding and infections. Only a handful of cases has been reported in the literature. The pregnancies were unsuccessful in the majority. The present report describes a patient with moderately severe idiopathic aplastic anaemia who was managed with intensive haematological support leading to delivery of a healthy infant by caesarean section. Despite platelet transfusion refractoriness as a result of transfusions prior to pregnancy, adequate platelet transfusions prevented excessive bleeding. The literature is reviewed and management with platelet transfusions is discussed.

Matched MeSH terms: Pregnancy Complications, Hematologic/etiology*; Pregnancy Complications, Hematologic/therapy

Fulltext Gene expression in obstetric antiphospholipid syndrome: a systematic review

Muhammad Aliff M, Muhammad Shazwan S, Nur Fariha MM, Hayati AR, Nur Syahrina AR, Maizatul Azma M, et al.

Malays J Pathol, 2016 Dec;38(3):285-294.

PMID: 28028299 MyJurnal

BACKGROUND: Antiphospholipid syndrome (APS) is a multisystem disease that may present as venous or arterial thrombosis and/or pregnancy complications with the presence of antiphospholipid antibodies. Until today, heterogeneity of pathogenic mechanism fits well with various clinical manifestations. Moreover, previous studies have indicated that genes are differentially expressed between normal and in the disease state. Hence, this study systematically searched the literature on human gene expression that was differentially expressed in Obstetric APS.

METHODOLOGY: Electronic search was performed until 31st March 2015 through PubMed and Embase databases; where the following Medical Subject Heading (MeSH) terms were used and they had been specified as the primary focus of the articles; gene, antiphospholipid, obstetric, and pregnancy in the title or abstract. From 502 studies retrieved from the search, only original publications that had performed gene expression analyses of human placental tissue that reported on differentially expressed gene in pregnancies with Obstetric APS were included. Two reviewers independently scrutinized the titles and the abstracts before examining the eligibility of studies that met the inclusion criteria. For each study; diagnostic criteria for APS, method for analysis, and the gene signature were extracted independently by two reviewers. The genes listed were further analysed with the DAVID and the KEGG pathways.

RESULTS: Three eligible gene expression studies involving obstetric APS, comprising the datasets on gene expression, were identified. All three studies showed a reduction in transcript expression on PRL, STAT5, TF, DAF, ABCA1, and HBEGF in Obstetric APS. The high enrichment score for functionality in DAVID had been positive regulation of cell proliferation. Meanwhile, pertaining to the KEGG pathway, two pathways were associated with some of the listed genes, which were ErBb signalling pathway and JAK-STAT signalling pathway.

CONCLUSION: Ultimately, studies on a genetic level have the potential to provide new insights into the regulation and to widen the basis for identification of changes in the mechanism of Obstetric APS.

Matched MeSH terms: Pregnancy Complications/genetics*; Pregnancy Complications/immunology*

Leptospirosis in pregnancy: A lesson in subtlety

Rahimi R, Omar E, Tuan Soh TS, Mohd Nawi SFA, Md Noor S

Malays J Pathol, 2018 Aug;40(2):169-173.

PMID: 30173235 MyJurnal

INTRODUCTION: Leptospirosis is a zoonotic disease caused by spirochaete of the genus Leptospira. Human infection occurs after exposure to water or soil contaminated by urine from an infected animal. Most patients manifest as self-limited systemic illness. However 10% of patients manifest as severe disease associated with high fatality. The disease affects mostly men, cases involving pregnant women are uncommon. We presented a case of leptospirosis in a pregnant woman leading to mortality of both mother and foetus.

CASE REPORT: A 28-year-old woman at 18 weeks of gestation, had shortness of breath and collapsed. She was brought unconscious to the emergency department and died shortly after arrival. A week prior to this, she had presented to the same hospital with pain on both thighs. Examination of the patient and ultrasound of the foetus revealed normal findings. Post mortem examination revealed hepatosplenomegaly and congested lungs; no jaundice, meningeal inflammation or cardiac abnormalities was evident. Histopathology examination of the lungs revealed pulmonary haemorrhages and oedema. Multiple infarcts were seen in the spleen and the kidneys showed foci of acute tubular necrosis. Laboratory investigations revealed Leptospira IgM antibody and PCR for leptospira were positive. This case illustrates the subtleness of clinical presentation of leptospirosis. The diagnosis was obscure even at post-mortem and was only suspected following histopathological examination, leading to further investigations.

CONCLUSION: Leptospirosis may have a subtle presentation and a high index of suspicion for this infection is required for early identification of the disease.

Matched MeSH terms: Pregnancy Complications, Infectious/diagnosis*; Pregnancy Complications, Infectious/pathology*

Trends in selected obstetric complications from University Hospital, Kuala Lumpur, Malaysia

Zulkifli SN, Paine LL, Greener DL, Subramaniam R

Int J Gynaecol Obstet, 1991 May;35(1):29-36.

PMID: 1680072

Trends in selected pregnancy complications from 1969 to 1987 in a tertiary hospital in Malaysia are presented. Complications reviewed were abortion, ectopic pregnancy, anemia, hypertension, hyperemesis, antepartum and postpartum hemorrhage. Possible explanations for the observed trends were discussed, including the role of improved obstetric care and changes in the characteristics of the childbearing population. The data presented give some indication of maternal morbidity in the childbearing population served by this tertiary center and should lead to improvements in provision of services as well as in health data collection in the future.

Matched MeSH terms: Pregnancy Complications/epidemiology*; Pregnancy Complications, Cardiovascular/epidemiology; Pregnancy Complications, Hematologic/epidemiology

Obstetrical data in Malaysian aborigine women

Ong HC

Trop Geogr Med, 1974 Dec;26(4):384-8.

PMID: 4456697

Matched MeSH terms: Pregnancy Complications/epidemiology; Pregnancy Complications, Hematologic/epidemiology; Pregnancy Complications, Infectious/epidemiology

Feasibility of successful pregnancies in women with spinal injury

Nor Azlin MI, Abd Rahman R, Abdul Karim AK, Sulaiman AS, Mahdy ZA

J Obstet Gynaecol, 2013 Aug;33(6):631-2.

PMID: 23919870 DOI: 10.3109/01443615.2013.807781

Matched MeSH terms: Pregnancy Complications*

Fulltext Abstracts of the RCOG (Royal College of Obstetricians and Gynaecologists) 10th International Scientific Congress. June 5-8, 2012. Kuching, Sarawak, Malaysia

BJOG, 2012 Jun;119 Suppl 1:2-250.

PMID: 22672235 DOI: 10.1111/j.1471-0528.2012.03375.x

Matched MeSH terms: Pregnancy Complications*

Fulltext Pregnancy complicated by Hodgkin's disease

Fadilah SA, Leong CF, Jamil MY, Cheong SK, Rozilaila R

Med J Malaysia, 2006 Aug;61(3):358-60.

PMID: 17240590 MyJurnal

Hodgkin's disease (HD) in association with pregnancy is rarely reported. Thus, the data in the management of pregnancy complicated by HD is limited. We report here the management of advanced HD in pregnancy that was treated successfully with chemotherapy.

Matched MeSH terms: Pregnancy Complications, Neoplastic/surgery*

Fulltext Traumatic hip dislocation in late pregnancy: a case report

Kamarul T, Loh WYC

Med J Malaysia, 2005 Jul;60 Suppl C:114-6.

PMID: 16381296

Hip dislocation in pregnancy is an uncommon injury. We report a case of traumatic hip dislocation in the third trimester of pregnancy to highlight potential problems associated with its treatment. The rationale for choosing the preferred treatment options is discussed.

Matched MeSH terms: Pregnancy Complications/surgery*

Sideroblastic anemia recurring during two pregnancies

Jackson N, Hamizah I

Int J Hematol, 1996 Dec;65(1):85-8.

PMID: 8990629

A 25-year-old lady presented with a severe normocytic anemia (Hb 5.3 g/dl) and a sideroblastic marrow at the end of her first pregnancy. Six months into the puerperium, after the transfusion of a total of 8 units of red cells, there was apparent spontaneous improvement and then she was lost to follow-up. After a second pregnancy without clinical problems, she presented during a third pregnancy, at the age of 30 years, with similar hematological findings. Twenty-two months later she was well with a normal blood count. One possible reason for relapse in pregnancy is the increased demand for pyridoxine that occurs, but only one other case of sideroblastic anemia relapsing during pregnancies has been reported.

Matched MeSH terms: Pregnancy Complications*

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