estimation of pulmonary artery systolic pressure in normal pregnancy

Objective: To assess the effects of various stages of pregnancy as well as pregnant women age on the level of pulmonary artery systolic pressure

Methods: One hundred and thirty five healthy pregnant women, aged 18 to 42 years, were included in this study. They underwent voluntary transthoracic echocardiogram measurements of pulmonary artery systolic pressure at rest. Three groups of pregnant women were designed according to gestational age; Group 1 included pregnancies less than 13 weeks of gestation and considered as control group. Group II included pregnancies equal to 13 weeks gestation and less than 28 weeks. Group III included those pregnancies with 28 weeks of gestation up to term. Each group included 45 women. The mean pulmonary artery systolic pressure was calculated for each group. Results for groups two and three were compared separately to the control group. The study population was then regrouped according to women's age; Group A included women aged less than 35 years [n=95], Group B included women aged 35 years and above [n=40]. Difference in mean pulmonary artery systolic pressure between groups A and B were studied

Results: Lower and upper limits of pulmonary artery systolic pressure during pregnancy were found to be 14 and 45 mmHg. Pulmonary artery systolic pressure during pregnancy showed an increase with maternal age after 35. Marginal change was also noted with gestational age; however that was of no statistical significance

Conclusion: During the different stages of pregnancy, mean pulmonary artery systolic pressure does not alter; however, it may reach high values in healthy asymptomatic women. When interpreting pulmonary artery systolic pressure in pregnancy, age correction may be required since pulmonary artery systolic pressure is found to physiologically increase with increasing pregnant women's age

Wernicke's encephalopathy associated with fetal loss in a patient with severe hyperemesis gravidarum

Wernicke's encephalopathy is an acute neurological condition caused by thiamine deficiency. It is a rare disorder which classically occurs in alcoholic patients due to recurrent vomiting and poor oral intake. When it occurs in non-alcoholics, it is often missed and consequent mortality and morbidity is high. Pregnancy complicated by hyperemesis gravidarum represents one important clinical setting in which Wernicke's encephalopathy may occur. We present the case of a 32-year old lady who presented in the 18[th] week of her third pregnancy with recent history of difficulty walking, visual symptoms, poor concentration and lethargy. She had suffered with hyperemesis gravidarum for the preceding 10 weeks. Obstetric ultrasound revealed a dead fetus of 16 weeks size. The patient's neurological features improved significantly after starting parenteral thiamine

Use of antibiotics in low-risk caesarean sections; Is it wise?

A prospective double-blind, placebo controlled study, was performed to determine the effectiveness of single-dose antibiotic prophylaxis versus no antibiotics in low-risk patients undergoing caesarean section. One hundred women, at low-risk for postoperative infectious morbidity, who were to undergo caesarean section at Prince Zeid Military Hospital, were randomly assigned to receive either one gram of ceftizoxime after clamping of the cord, or no antibiotic. The incidence of febrile morbidity, endometritis and wound infection was similar in both groups. In low-risk patients, no benefit was encountered after using single-dose prophylactic antibiotic compared to no prophylaxis