RESUMO
Congenital anomalies causing airway obstruction in the newborn are potentially fatal. However if an effective airway can be maintained the long-term prognosis is often excellent. We present four cases of airway obstruction, three of which were diagnosed antenatally. We discuss the role of antenatal imaging and review delivery options including the need for a multidisciplinary team approach. In conclusion, we recommend antenatal imaging with both ultrasound scan and magnetic resonance to inform perinatal management. Polyhydramnios, in association with suspected neonatal airway obstruction, should alert clinicians to a high-risk situation. We recognize that even in skilled hands, securing an airway can be very difficult and alternatives such as maintenance of the fetomaternal circulation or extra-corporeal life support should be considered.
Assuntos
Obstrução das Vias Respiratórias/diagnóstico , Anormalidades Congênitas , Assistência Perinatal , Adulto , Obstrução das Vias Respiratórias/terapia , Evolução Fatal , Feminino , Humanos , Recém-Nascido , Linfangioma Cístico , Imageamento por Ressonância Magnética , Masculino , Equipe de Assistência ao Paciente , Poli-Hidrâmnios , Gravidez , PrognósticoRESUMO
OBJECTIVE: To reinforce the risk of heterotopic pregnancy in a natural cycle when intrauterine pregnancy and abdominal pain co-exist. METHOD: A single case report with a literature review. RESULTS: Our case was associated with significant haemorrhage, laparotomy and salpingectomy. The obstetric outcome was favourable in this case. The literature review demonstrates the diagnostic difficulties as well as treatment options. CONCLUSIONS: Sonographic diagnosis of a heterotopic pregnancy is not always possible. Patients with abdominal pain and intrauterine pregnancy should heighten the clinician's suspicion of a heterotopic pregnancy.
Assuntos
Dor Abdominal/etiologia , Anexos Uterinos/diagnóstico por imagem , Gravidez Tubária/diagnóstico , Ultrassonografia Pré-Natal , Dor Abdominal/diagnóstico por imagem , Adulto , Cesárea , Diagnóstico Diferencial , Feminino , Humanos , Nascido Vivo , Gravidez , Redução de Gravidez Multifetal , Gravidez Tubária/diagnóstico por imagem , Gravidez Tubária/etiologia , Gravidez Tubária/cirurgia , Fatores de Risco , Ruptura Espontânea/complicações , Ruptura Espontânea/diagnóstico por imagem , Ruptura Espontânea/etiologiaRESUMO
We report a twin pregnancy complicated by fetal goitrous hypothyroidism secondary to dyshormonogenesis caused by thyroglobulin deficiency. Antenatal treatment with intra-amniotic thyroxine was considered but not performed, given the late gestational age at diagnosis and the multiple nature of the pregnancy. Both twins developed airway obstruction at delivery, requiring intubation and ventilation. We review the literature and describe the practical issues relating to the antenatal assessment and perinatal management of fetal goitre.
Assuntos
Hipotireoidismo Congênito , Doenças em Gêmeos , Bócio , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/terapia , Hipotireoidismo Congênito/complicações , Hipotireoidismo Congênito/diagnóstico , Hipotireoidismo Congênito/terapia , Parto Obstétrico , Feminino , Bócio/complicações , Bócio/diagnóstico , Bócio/terapia , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Gravidez , Diagnóstico Pré-Natal , Tireoglobulina/deficiênciaAssuntos
Glândulas Suprarrenais/irrigação sanguínea , Aneurisma Roto/etiologia , Complicações Cardiovasculares na Gravidez/etiologia , Descolamento Prematuro da Placenta/diagnóstico , Adulto , Aneurisma Roto/terapia , Artérias , Diagnóstico Diferencial , Embolização Terapêutica/métodos , Feminino , Humanos , Hemorragia Pós-Parto/etiologia , Hemorragia Pós-Parto/terapia , GravidezRESUMO
We evaluated inter-assay variation in anticardiolipin antibody status, comparing three centres, and using different assays among 36 women with recurrent miscarriage and 26 controls. There was no more agreement between the laboratories than would be predicted on the basis of chance for IgM and only fair agreement among the laboratories for IgG. None of the tests were significantly more likely to be positive in the cases compared with the controls.
