Cases Of Toxemia Research Articles

Pregnancy toxaemia in a French bulldog due to extremely large fetal number: A case report

The aim of this report was to describe a clinical case of pregnancy toxaemia in a bitch in the late gestational phase. The patient was presented 61 days after the last mating with an extreme abdominal distension, depression, prostration, apathy, vomiting, anorexia, dehydration, dyspnea and without any labour signs. Ultrasonography revealed fetal distress and laboratory analysis showed anaemia, hypoglycaemia and ketonuria, so diagnosis of pregnancy toxaemia was made. Caesarean section was performed and 13 live puppies were born. In conclusion, this is a very rare case of toxaemia during gestation period in a bitch caused by the large number of fetuses.

Study of Platelets Derangement in Toxemia of Pregnancy

Background: Toxemia of pregnancy has been identified as multisystem disorder associated with high maternal and neonatal complications. Platelets, Liver enzymes and Lactic Acid Dehydronagenase (LDH) derangements have been shown to be associated with the severity of the disorder. The present study aims to find the association of toxemia of pregnancy with the derangement of platelets count at our centre.
 Methods: The study was a prospective study conducted with sixty cases of toxemia of pregnancy during the study period of one and half years (December 2014 to July 2016). The statistical evaluation was calculated using SPSS software version 20.1 with student t-test and Anova.
 Results: The incidence of toxemia of pregnancy was found to be 10.45%. The majority of cases (66.70%) were between 20 to 29 years of age. Most of the cases 68.34% were primigravida. Mild pre-eclampsia was seen in 45% of cases and severe pre-eclampsia in 38.30% of cases. Eclampsia was seen in 10% of cases and 6.7% of the cases of chronic hypertension developed superimposed preeclampsia. Mean platelets count observed in severe pre-eclampsia toxemia (PET) was 1. 21 lac/mm3 in eclampsia was 1.03 lac/mm3 (P-Value 0.001). The mean platelets count was statistically significant and correlated with the severity of the diseases.
 Conclusions: The study concluded with the observation that derangements of platelets counts significantly correlate with the severity of the diseases and its early detection during pregnancy can reduce eventual maternal and fetal complications.
 Keywords: eclampsia; hypertensive disorder of pregnancy; platelets count; pre-eclampsia; toxemia of pregnancy.

SUN-327 SUCCESSFUL PREGNANCY AFTER KIDNEY TRANSPLANTATION: EXPERIENCE OF SAHLOUL HOSPITAL DE SOUSSE

A successful transplant allows the restoration of pituitary ovarian function and fertility. The objective of our study was to report successful pregnancies in our renal transplant patients, and analyze them through a review of the literature Our study is retrospective, descriptive, including all successful pregnancies occurring in patients who had a kidney transplant between 2007 and 2018. Four pregnancies were identified in 3 patients. The average age of patients at the time of renal transplantation was 26 years. The average age of patients at the time of pregnancy was 30 years. When pregnancies were planned, MycophenolateMofetiland blockers of the renin angiotensin aldosterone systemwerestopped before pregnancy. The average time between transplant and first conception after transplant was 39 months. All pregnancies were completed, and the mean term of delivery was 38 weeks of amenorrhea. The delivery route was caesarean section in all cases. No maternal complications occurred during pregnancy except one case of toxemia of pregnancy without eclampsia. No cases of acute graft rejection during pregnancy were observed Mean serum creatinine levels during pregnancy were stable at 87.5μmol /L. Mean birth weight was 3160 g with 1 child with hypotrophy (<2500 g). Six months postpartum, mean serum creatinine was 92.33 μmol /L and blood pressure was normal. The good evolution of pregnancies in renal transplant patients requires multidisciplinary management for the well-being of the mother and the baby. These are at-risk pregnancies that need to be planned. A minimum delay of 12 months between transplantation and conception with a creatinemia lower than 150 μmol /L should be respected.

Factores placentarios, nutricionales y hepáticos en la etiopatogenia de la toxemia gravídica

Los autores han estudiado 92 casos de toxemia desde un punto de vista nutricional. En 162 más potients que han estudiado la morfología de la placenta. Un tercer grupo de pacientes estaba formado por 54 casos de toxemia complicada con diabetes; 94 pacientes con toxemia y mola; 234 de embarazo múltiple y la toxemia y 15 casos de hidropesía fetal en pacientes toxémicas; estudios histológicos de tejido de la placenta se realizaron en la mayoría de los casos; como el control que tienen 55 placentas de partos normales. Después de una discusión de los datos pertinentes, los autores suponen que el daño del hígado en pacientes con toxemia del embarazo es secundario a la enfermedad, y que el alguna relación se produce entre los infartos de placenta y la enfermedad. lt se postula que los pacientes con diabetes mellitus y mola hidatiforme como aquellos con hidropesía fetal sufren una especie de toxemia diferente del "tipo puro".

Uterine torsion in late gestation alpacas and llamas: 60 cases (2000–2009)

Sixty occurrences of uterine torsion during late gestation in alpacas (n=56) and llamas (n=4) were evaluated to identify the relationship of direction and degree of severity of torsion, method of correction, and dam and cria survival. Other recorded data included the time to presentation, stage of gestation, parity, and clinicopathologic assessment. Three treatment groups were identified: animals which had uterine torsion corrected by rolling only (60%; n=36); animals which underwent Cesarean section only (23.3%; n=14); and animals which first were rolled but then underwent Cesarean section (16.7%; n=10). Significant relationships were recorded between the degree of uterine torsion and the method of correction – 360° torsions were more likely to have to undergo Cesarean section, either as a solitary treatment method or after rolling (p<0.05). No significant relationship was recorded between the gestation age of the fetus and the treatment method implemented. Counter-clockwise torsions accounted for 18.3% of the cases. Survival of females was high (96.7%; n=60), regardless of the treatment method. Survival of the cria was lower for torsions corrected by Cesarean section alone (71.4%; n=14) or after rolling (70%; n=10), when compared to rolling only (100%; n=36). The most common clinicopathological findings were toxemia alone or with concurrent hypocalcemia or hepatic lipidosis, and elevated creatine kinase. All cases of toxemia had hyperglycemia and tended to have a prolonged interval to presentation.

Computed tomographic changes of the brain in toxaemia of pregnancy

Four cases of toxaemia of pregnancy examined with computed tomography scans of the brain are reported. A review of the literature reveals 19 other cases with previously reported CT brain scans. The review shows intracerebral oedema as the main finding. Haemorrhage, massive or punctate was noted in four cases. The pathogenesis of the CT changes and the clinico-radiological correlation of the visual disturbances are discussed.

Preconceptional treatment with insulin infusion pumps in insulin-dependent diabetic women with particular reference to prevention of congenital malformations.

Severe congenital malformations occur more often in infants of diabetic mothers than in infants of non-diabetic mothers. Fetuses exhibiting early fetal growth delay are in increased risk to be malformed and the early fetal growth rate seems to be related to the degree of metabolic control around the time of conception and in the early pregnancy. Nine insulin-dependent diabetic women (White classes B-F) were treated by means of continuous subcutaneous insulin infusion (CSII) initiated at least two months prior to conception and continued throughout pregnancy in order to evaluate the influence of optimized metabolic control on the course and outcome of diabetic pregnancy. Eleven conventionally treated pregnant diabetics (White classes B-D) served as controls. In the pump group the mean blood glucose values in the 4 weeks immediately before and after the conception were 7.7 +/- 0.2 mmol/l and 8.0 +/- 0.3 mmol/l, respectively, the HbA1c was 7.3 +/- 0.5% at the time of conception and 6.9 +/- 0.2% 6-10 weeks later. In the control group the HbA1c 6-10 weeks after conception was 7.2 +/- 0.5%. In the pump group two fetuses exhibited early growth delay while all of the 11 fetuses in the control group were of normal early growth. There were no malformations in either group. All pregnancies were uncomplicated except for one case of toxaemia in the control group. Thus, during CSII treatment the metabolic control was improved in all patients. A possible beneficial effect of this improved control on the early fetal growth delay was not demonstrated. Both groups are, however, still small and definite conclusions must await further results.

A scoring system for toxemia of pregnancy.

AbstractA total of 1026 cases of toxemia of pregnancy were chosen from some 1500 cases collected in cooperation with many hospitals and medical facilities in Japan, and examined for the purpose of devising an appropriate scoring system for toxemia of pregnancy. We prepared various scoring methods relating to toxemia of pregnancy and compared them to determine their value in predicting intrauterine growth retardation, fetal death, and maternal persistent hypertension at 30 days after delivery. A scoring method taking edema, proteinuria, and hypertension (EPH) was found to be better and easier to use than other methods.

Retinopathy in Toxemia of Pregnancy

Two cases of toxemia of pregnancy are presented, with color photographic documentation of the accompanying retinopathy. Although both pregnancies resulted in delivery of a viable infant and resolution of other systemic manifestations of toxemia, both patients were left with severe visual impairment. The retinopathy of toxemia is emphasized as a potential source of permanent morbidity in this complication of pregnancy.

The antihypertensive effect of rhomotoxin in the treatment of 10 cases of toxemia during pregnancy (a preliminary report)

The antihypertensive effect of rhomotoxin in the treatment of 10 cases of toxemia during pregnancy (a preliminary report)

Storage of some organochlorine compounds in toxemia of pregnancy

Nine out of 18 cases of toxemia of pregnancy had high PCB serum levels in comparison with a control group of 12 women with normal pregnancies. Seven out of the nine high PCB levels cases were multiparae. These findings suggest a role of PCBs in the promotion of toxemia of pregnancy, possibly by depressing the maternal immunological response to fetal antigens. The pattern of the gas chromatogram of PCBs differed in the control and in the low PCB levels toxemia groups, due possibly to differences in some hormonal and/or enzymatic activities. In the high PCB levels toxemia cases, the chromatograms showed high peaks at 8. This fact adds to the quantitative dimension a qualitative one. The DDT DDE ratios were lowest in the high PCB levels toxemia group suggesting an increased degradation of DDT to DDE and/or a decreased excretion of DDE.

Placenta as an Indicator of Fetal Postnatal Prognosis

468 placentas were studied microscopically and by gross examination. Velamentous insertion of the umbilical cord, placenta circumvallate, retroplacental hematoma in connection with ablation of the placenta, and cord prolapse were found to be causative factors in asphyxia of the newborn. The increased placental weight was characteristic in maternal diabetes, hepatosis and, sometimes, in cases of infant malformations and specific inflammations. So-called embryonal persistence was often found histologically in these changes. Small fibrous placentas and those with ramification defects were commonly encountered among cases of toxemia and prolonged gestation. Microscopical placental maturation defects were not indicative of the fetal condition. Thus, only the changes found at gross examination appeared to be a significant indicator of the fetal prognosis.

Cellular hyperreactivity to placenta in toxemia of pregnancy

It is generally assumed that maternal immune response may be involved in some pathological conditions of pregnancy, such as toxemia. The activity of cell-mediated immunity to placenta was studied in women with gestosis. The leucocyte inhibition technique was employed to test reactivity of peripheral blood leucocytes from postpartum women. The results indicated that leucocyte migration was significantly inhibited in the presence of placental microsomal fraction when blood from toxemic women was used. Thus, about 87% out of 30 studied cases of toxemia showed positive results. At the same time, in only 22% of women with uncomplicated pregnancy was such a positive leucocyte migration inhibition test found. There was no correlation between the severity of the toxemic symptoms and the extent of inhibition. In further experiments the leucocyte migration inhibition test with the microsomal fraction antigens from cadaver kidneys was performed; only 1 out of 6 patients showed positive leucocyte migration inhibition. These findings may suggest that the normal status of the mother is altered towards cellular hyperreactivity to placental antigens in toxemic pregnancy.

Maternal plasma total oestriol and dehydroepiandrosterone sulfate loading test as indicators of feto-placental function or placental sulfatase deficiency

Serum total oestriol (E 3P) concentrations were measured by radioimmunoassay with I 125 oestriol after enzymatic hydrolysis, and the range of values were first established in 88 normal singleton pregnancies. E 3P and urinary oestrogen excretion were estimated in 141 high-risk subjects throughout the last trimester of pregnancy and free oestriol determinations were also made in some cases of diabetes on intra-uterine growth retardation (IUGR). The intra-uterine fetal deaths were easily predictable from E 3P, even in seven cases of toxemia and one of diabetes. The lack of increase of E 3P during the 4 weeks preceding delivery indicates severe fetal hypotrophy and/or malformation. Total- and free-E 3P and urinary oestrogen excretion were studied in 222 pregnancies with IUGR and their predictive efficacity were compared. The half-life of dehydroepiandrosterone sulfate (DHA-S) and the increase of unconjugated oestradiol (E 2) after IV of the former have been determined in both pregnancies, normal and with retarded fetal development. The E 2 increases and chiefly the lengthening of DHA-S half-life provide accurate assessment of the utero-placental function and fetal well-being, and obviously allow the diagnosis of placental sulfatase deficiency. The conclusion of this study is that the assessment of high-risk pregnancies, until now accomplished principally by urinary oestriol assays, may be performed by more convenient and rapid radioimmunoassays of plasma oestriol, and completed in some cases (IUGR, placental sulfatase deficiency) by dynamic tests, chiefly by DHA-S half-life determinations.

Placenta as an Indicator of Fetal Postnatal Prognosis

468 placentas were studied microscopically and by gross examination. Velamentous insertion of the umbilical cord, placenta circumvallate, retroplacental hematoma in connection with ablation of the placenta, and cord prolapse were found to be causative factors in asphyxia of the newborn. The increased placental weight was characteristic in maternal diabetes, hepatosis and, sometimes, in cases of infant malformations and specific inflammations. So-called embryonal persistence was often found histologically in these changes. Small fibrous placentas and those with ramification defects were commonly encountered among cases of toxemia and prolonged gestation. Microscopical placental maturation defects were not indicative of the fetal condition. Thus, only the changes found at gross examination appeared to be a significant indicator of the fetal prognosis.

Active and Inactive Renin in Pregnancy and in Women on Estrogen-Containing Oral Contraceptives

Total and active renin concentrations (TRC and ARC) were determined in pregnant women and in women on estrogen-containing oral contraceptives to study the variation of plasma renin forms in pregnancy. TRC was already elevated in the first trimester. After that TRC increased consistently reaching the maximum in the third trimester. The ratio of inactive renin concentrations (IRC) to TRC was between 20 and 30% throughout gestation. Therefore, it was supposed that the development of the placenta or the enlargement of the uterus do not affect the ratio of IRC to TRC too much. In women on oral contraceptives in whom plasma renin activity was increased due to elevation of renin substrate, the ratio of IRC to TRC was almost the same as that in normal controls. From these results, it was suggested that the development of the placenta and the enlargement of the uterus do not play an important role in the variation of plasma renin forms, although remarkable changes are observed in the renin substrate and total amounts of renin in pregnancy.

Studies on lipoperoxide of normal pregnant women and of patients with toxemia of pregnancy

1. 1. Serum lipoperoxide was determined by the method of Yagi et al. (Yagi, K., Nishigaki I. and Ohama H. (1968) Jap. J. Vitamin 37, 105) for 22 cases of non-pregnant women, 24 cases of 1st trimester of pregnancy (1–12 weeks), 39 cases of 2nd trimester of pregnancy (13–26 weeks), 58 cases of 3rd trimester of pregnancy (27–40 weeks), and 30 cases of toxemia of pregnancy (27–40 weeks). Remarkable increases of lipoperoxide were observed at 2nd and 3rd trimester of pregnancy compared with non-pregnant women, and the increase in toxemia of pregnancy was more remarkable than that at 3rd trimester of pregnancy. In umbilical cord blood a higher level of lipoperoxide was observed in patients with toxemia of pregnancy than in normal pregnant women. 2. 2. The total TEA value determined by extracting the serum-lipids with chloroform and methanol solution showed a similar tendency to the above. 3. 3. Those showing TBA-reaction by the analysis of lipids with thin-layer chromatography were the fractions of cholesterol ester, triglyceride and phospholipid. While triglyceride fraction showed a marked increase of TEA value during pregnancy and in toxemia of pregnancy.

Acid- and alkaline phosphatase in amniotic fluid in normal and complicated pregnancy.

171 samples of amniotic fluid were obtained by abdominal amniocentesis from 67 women with complicated pregnancies (isoimmunization, diabetes mellitus or toxaemia). The levels of heat-labile alkaline phosphatase (HLAP), heat-stable alkaline phosphatase (HSAP) and acid phosphatase (AcP) were determined and compared to the enzyme levels in 179 samples from women with normal pregnancies of corresponding gestational ages. HLAP showed two "peaks" of activity, one in the 5th-22nd week and the other at term. HSAP and AcP showed increased activity at term. HSAP was decreased (p less than 0.01) in isoimmunization between the 36th and 40th week. 11 cases of toxaemia with placental insufficiency showed no differences in the levels of HLAP and HSAP compared with normal pregnancy. AcP showed no differences between normal and complicated pregnancy. Samples contaminated by blood showed no significant increase in the acid- and alkaline phosphatase levels. Samples contaminated by meconium showed a complex pattern. Some samples had normal enzyme levels, some had high levels of HLAP only and some had high levels of HSAP and AcP. The origin of the enzymes is not known with certainty. HSAP in amniotic fluid is most likely not of placental but intestinal origin. Determinations of acid- and alkaline phosphatase in amniotic fluid seem to be of little values in the clinical management of complicated pregnancy.

Hemodynamic and metabolic studies of a case of toxemia of pregnancy

Hemodynamic and metabolic studies of a case of toxemia of pregnancy

Maternal mortality rates in eclampsia

This study evaluates the dominant factors that influence the course of eclampsia toward a lethal outcome by means of statistical analysis of various clinical, laboratory, and morphologic data of 365 cases of toxemia with convulsions, that included 49 deaths and 33 autopsies, registered during a 9 year period. This communication suggests that the death of eclamptic patients resulted from a combination of several factors that showed a very wide individual variation. Since advancing age of the mother was associated with a high incidence of coincidental renal and vascular diseases, this was the most clearly influential factor. The presence of twins, delay in hospitalization, under haste in deciding upon cesarean delivery, and underestimation of the initial clinical condition were all influential factors, although without statistical significance. Cesarean section, performed in 141 instances of ante- and intrapartum eclasmpsia (40.4 per cent), was not associated with a higher maternal mortality rate.