ABSTRACT
INTRODUCTION: Rare cases of pregnancy in women with homozygous familial hypercholesterolemia (HFH) have been reported. HFH might pose significant risks for the mother and her fetus. Statins, the most potent agents for low-density lipoprotein (LDL) cholesterol reduction, are contraindicated; thus lipoprotein apheresis remains the only effective treatment. CASE REPORT: We report on a 34-year-old pregnant woman with HFH who was treated throughout the entire pregnancy by lipoprotein apheresis (immunoadsorption method). Increasing levels of LDL-cholesterol were stabilized at 9-10 mmol/L by lipoprotein apheresis (performed every 10 days). No complications were observed during the treatment procedures. Monitoring of the fetus revealed no impairment of the umbilical cord and blood flow in the uterine arteries, as well as no intrauterine growth retardation. The delivery was spontaneous and the child was breastfed for two months. CONCLUSION: Intensive treatment by lipoprotein apheresis is an effective and safe therapeutic strategy during pregnancy, even in severe cases of HFH, as it can stabilize progressively increasing lipoprotein levels and prevent severe complications.
Subject(s)
Blood Component Removal/methods , Cholesterol, LDL/blood , Homozygote , Hyperlipoproteinemia Type II/therapy , Immunosorbent Techniques , Mutation , Pregnancy Complications/therapy , Receptors, LDL/genetics , Biomarkers/blood , DNA Mutational Analysis , Female , Genetic Predisposition to Disease , Humans , Hyperlipoproteinemia Type II/blood , Hyperlipoproteinemia Type II/diagnosis , Hyperlipoproteinemia Type II/genetics , Live Birth , Phenotype , Pregnancy , Pregnancy Complications/blood , Pregnancy Complications/diagnosis , Pregnancy Complications/genetics , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVE: The purpose of this study was to summarize the published data on the anatomical structure of the ductus venosus, the mechanism of regulation of the ductus venosus shunting and its role in the fetal survival and the possible use of the measurement of the ductus venosus shunting in the clinical practice. DESIGN: Review. SETTING: Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Králové. METHODS: We summarized published data on the ductus venosus shunting in the fetal venosus circulation with the regulatory mechanisms, doppler ultrasound diagnostic methods and the medical importance. CONCLUSION: The present review summarizes the results of clinical and experimental research on the ductus venosus in the fetal circulation.
Subject(s)
Fetus/blood supply , Veins/embryology , Blood Flow Velocity , Down Syndrome/pathology , Female , Fetal Hypoxia/pathology , Humans , Pregnancy , Ultrasonography, Doppler , Ultrasonography, Prenatal , Veins/abnormalitiesABSTRACT
OBJECTIVE: The purpose of this study was to evaluate the prevalence of the maternal lower genital tract colonization by Ureaplasma urealiticum and Mycoplasma hominis in patiens with preterm premature rupture of the membranes. DESIGN: Retrospective study. SETTING: Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Králové. METHODS: We studied 150 women between 24 and 34 weeks of gestation with preterm premature rupture of the membranes. These patients were divided into 2 groups. In group 1 swabs were obtained for genital mycoplasmas. In both groups 1 and 2 were obtained standard swabs for aerobic and anaerobic cultivation. Control group 3 were women with normal pregnancy. RESULTS: Ureaplasma urealyticum was detected in 96% (72/75) of the patients with PPROM between 24 and 34 weeks of gestation and in 32% (24/75) of the patiens of the control group (normal pregnancy). CONCLUSION: The maternal lower genital tract colonization by Ureaplasma urealyticum might be associated with preterm premature rupture of the membranes and chorioamniitis.
