ABSTRACT
BACKGROUND: Whereas carrying group B streptococcus during pregnancy is common, second trimester group B streptococcus chorioamnionitis with intact membranes is rare, and recurrence of the latter problem even more so. CASE: A 38-year-old multipara with a history of recurrent second trimester group B streptococcus chorioamnionitis resulting in pregnancy loss was treated, beginning at 14 weeks' gestation, with monthly prophylactic ampicillin therapy throughout pregnancy and delivered a healthy male infant at term. CONCLUSION: In women with recurrent pregnancy loss due to second trimester group B streptococcus chorioamnionitis, an intermittent prophylactic antibiotic regimen throughout pregnancy might increase the probability of successful pregnancy.
Subject(s)
Ampicillin/therapeutic use , Antibiotic Prophylaxis , Chorioamnionitis/prevention & control , Penicillins/therapeutic use , Pregnancy Complications, Infectious/prevention & control , Streptococcal Infections/prevention & control , Streptococcus agalactiae , Adult , Ampicillin/administration & dosage , Chorioamnionitis/microbiology , Female , Humans , Infant, Newborn , Male , Penicillins/administration & dosage , Pregnancy , Pregnancy Complications, Infectious/microbiology , Pregnancy Trimester, Second , RecurrenceABSTRACT
Disseminated intravascular coagulopathy is a serious complication of pregnancy. Therapy includes treating the underlying cause, maintenance of blood volume, replacement of depleted clotting factors, and often delivery of the fetus and placenta. We present a case of disseminated intravascular coagulopathy occurring at 19 weeks' gestation that resolved spontaneously with conservative management.
Subject(s)
Disseminated Intravascular Coagulation/diagnosis , Pregnancy Complications, Hematologic/diagnosis , Adult , Disseminated Intravascular Coagulation/physiopathology , Female , Fibrinogen/analysis , Humans , Kidney/physiopathology , Platelet Count , Pregnancy , Pregnancy Complications, Hematologic/physiopathology , Pregnancy Outcome , Pregnancy Trimester, Second , Remission, Spontaneous , Ultrasonography, Prenatal , Uterine HemorrhageABSTRACT
BACKGROUND: Delayed-interval delivery is infrequent in twin gestation and more rare in triplet and quadruplet gestation. Coexistence of a triploid pregnancy with a normal fetus has not previously been reported to have resulted in survival of the normal fetus. CASE: A 26-year-old woman, gravida 2, para 0-0-1-0, was diagnosed with a quadruplet pregnancy. At 16 1/2 weeks' gestation she developed preeclampsia and severe hyperemesis. Ultrasound was consistent with partial molar pregnancy in quadruplet D. Quadruplet D died in utero, and the preeclampsia and hyperemesis resolved. At 19 5/7 weeks, spontaneous rupture of the membranes and preterm labor occurred, and quadruplet A, stillborn female weighing 260 g, was delivered. With the use of antibiotic therapy, tocolysis and bed rest, the remaining two fetuses were maintained in utero until 32 6/7 weeks' gestation, when quadruplet B, a 1,470-g female, and quadruplet C, a 1,700-g female, were delivered. CONCLUSION: This was the first reported case of surviving fetuses coexisting with a partial molar pregnancy. This case was also complicated by preterm delivery and successful delayed-interval birth in a quadruplet pregnancy.
Subject(s)
Fetal Death , Hydatidiform Mole , Obstetric Labor, Premature , Pregnancy Outcome , Pregnancy, Multiple , Uterine Neoplasms , Adult , Female , Humans , Pregnancy , QuadrupletsABSTRACT
Total plasma fibronectin is elevated in preeclampsia due to vascular injury release, increased production, or enzymatic degradation resulting in multimers. To examine the etiology of the fibronectin increase in preeclampsia, we quantified plasma fibronectin in nonpregnant women, pregnant women from 28 to 42 weeks' gestation, latent labor, and preeclampsia by both nephelometry and turbidimetry. Western blotting and gel electrophoresis were used to examine the structural integrity of the fibronectin molecule. In addition, functional assays explored the potential for dysfunctional fibronectin. Fibronectin was elevated in pregnant patients compared with nonpregnant patients and exhibited a further significant increase with preeclampsia. The increase was not a result of degradation to multimers but possibly to increased variants. Notably, fibronectin function, as defined by collagen binding, may be impaired during pregnancy and preeclampsia. It appears that the clinical pathophysiology of preeclampsia may be related to dysfunctional fibronectin measured by collagen binding.
Subject(s)
Fibronectins/physiology , Pre-Eclampsia/blood , Blotting, Western , Collagen/metabolism , Electrophoresis, Agar Gel , Female , Fibronectins/blood , Fibronectins/chemistry , Humans , Molecular Structure , Polymers , Pre-Eclampsia/metabolism , Pregnancy/blood , Protein BindingABSTRACT
We present a case of theca-lutein cysts associated with homozygous alpha-thalassemia. Theca-lutein cysts have been associated with various types of nonimmune hydrops fetalis but have not been reported previously in association with homozygous alpha-thalassemia.
