RESUMO
Epilepsy is the presence of two or more seizures in the absence of an identifiable cause for the seizures; that is, no intracranial or metabolic abnormality. Epilepsy affects approximately 1% of the US population, which represents an estimated 1.1 million women of reproductive age. The management of women with epilepsy during pregnancy is the focus of this article.
Assuntos
Anticonvulsivantes/farmacologia , Epilepsia/tratamento farmacológico , Epilepsia/fisiopatologia , Complicações na Gravidez/tratamento farmacológico , Complicações na Gravidez/fisiopatologia , Anormalidades Induzidas por Medicamentos/etiologia , Anormalidades Induzidas por Medicamentos/prevenção & controle , Aleitamento Materno , Feminino , Feto/efeitos dos fármacos , Humanos , Cuidado Pré-Concepcional , GravidezRESUMO
The incidence of cerebral palsy is 1 per 1,000, whereas the proportion caused by perinatal asphyxia is only 8% to 10%. The purpose of this article is to review the relationship between asphyxia and cerebral palsy. Only a minority of cases, those involving severe pathological fetal academia, are consistently associated with neonatal encephalopathy and an increased risk of cerebral palsy.
Assuntos
Asfixia Neonatal/complicações , Paralisia Cerebral/etiologia , Desequilíbrio Ácido-Base/complicações , Biomarcadores , Encefalopatias/etiologia , Feminino , Doenças Fetais , Humanos , Recém-Nascido , Trabalho de Parto , Gravidez , Fatores de RiscoRESUMO
The purpose of this study is to identify pregnancy and labor factors that place women at increased risk for symptomatic uterine rupture during trial of labor following cesarean section. The study population consisted of 16 women with uterine rupture after a trial of labor who were compared with 32 women without uterine rupture after a trial of labor. Using a case-control study design with a 1:2 match, we examined risk factors that might be associated with an increased risk of uterine rupture. Cases were more likely to have an induction of labor with the use of oxytocin and/or amniotomy (56 vs. 34%) and more likely to undergo augmentation with oxytocin (25 vs. 19%) in comparison with controls. In addition, cases were more likely to be given oxytocin (for either induction or augmentation) (75 vs. 50%) and cervical ripening agents (31 vs. 9%) versus controls. Neonates born after uterine rupture had a higher rate of significant acidosis (pH < 7.0, 57 vs. 0%, p = 0.0002) and lower Apgar scores. There was a significantly higher risk of maternal infection (36 vs. 3%, p = 0.003), transfusion (13 vs. 0%, p = 0.03), and longer length of stay in patients with uterine rupture. There is a trend for increased use of augmentation and induction agents to be associated with uterine rupture. Serious maternal and fetal morbidities are increased following uterine rupture.
