ABSTRACT
Pneumomediastinum can easily be mistaken for a pulmonary embolus or myocardial infarction. We describe herein a case of pneumomediastinum postpartum. A primigravida complained five-hours postpartum of acute chest pain and mild dyspnea. The initial (working) diagnosis was pulmonary embolus and the patient was treated with antithrombotic therapy. A CT scan revealed the real cause of the chest pain: pneumomediastinum. The patient was given adequate analgesia and two days later was able to leave the hospital in good clinical condition. We suggest that in the case of acute chest pain during or shortly following labor, pneumomediastinum should be considered.
Subject(s)
Chest Pain/etiology , Mediastinal Emphysema/diagnosis , Obstetric Labor Complications/diagnosis , Adult , Female , Humans , Postpartum Period , PregnancyABSTRACT
Cytomegalovirus (CMV) is one of the most common causes of congenital infection without an effective treatment or an effective vaccine available to date. The emphasis has to be on preventive strategies, which rely on the epidemiological situation. The incidence of congenital CMV infections, however, is not known for The Netherlands. Therefore, a prospective virological study was carried out in a population of 7,524 pregnant women and 7,793 newborns. CMV-specific IgG antibodies were determined in cord blood by ELISA. When CMV antibodies were present, a CMV specific PCR was performed on the throat swab. A positive PCR was confirmed by urine culture. In addition, the seroepidemiology for CMV was investigated in the metropolitan region (Amsterdam and Rotterdam) which has a different ethnic composition. Congenital CMV infection was found in 7 infants (0.9 per 1,000). None had symptoms at birth or during 24 month follow-up. Carriage or CMV was 41%, with a variation between 35% and 100% depending on ethnicity. The ethnic composition in the south-eastern region was different from that in large cities, but similar to that in the rest of the country. The incidence of congenital CMV infections in The Netherlands is the lowest described to date, which does not justify special preventive policies.
Subject(s)
Cytomegalovirus Infections/epidemiology , Cytomegalovirus/isolation & purification , Pregnancy Complications, Infectious/epidemiology , Antibodies, Viral/blood , Cohort Studies , Cytomegalovirus/immunology , Cytomegalovirus Infections/blood , Cytomegalovirus Infections/congenital , Cytomegalovirus Infections/urine , Female , Fetal Blood/virology , Humans , Immunoglobulin G/blood , Infant, Newborn , Netherlands/epidemiology , Pharynx/virology , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/urine , Seroepidemiologic Studies , Urban PopulationABSTRACT
Postpartum haemorrhage may be a life threatening complication. Seven cases are described in which the B-Lynch surgical technique (a brace like suture over the uterus) was successful in obtaining haemostasis. In four cases, the B-Lynch technique was the first line of treatment. In three cases, the B-Lynch was used after, or in combination with artery or other vessel ligation.
