Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease associated with major obstetrical complications such as gestational loss, preterm delivery, fetal growth restriction (FGR) and preeclampsia. Published literature is not consensual regarding the main risk factors for each of these outcomes. Our goal with this study was to determine the most important predictors for each of the main adverse pregnancy outcomes in this population.

Lipschütz Genital Ulceration as Initial Manifestation of Primary Sjögren's Syndrome.

Genital ulcers are challenging to any clinician and causes transcend many specialties. Skin ulceration in patients with primary Sjögren's syndrome is infrequent but an established feature of cutaneous involvement. Although gynecological symptoms, such as vulvovaginal dryness, dyspareunia, and pruritus, are common in women with primary Sjögren's syndrome, patients affected by vulvar ulcers are unknown.

Ten Years' Experience of Pregnancy Outcomes in Women with Cardiac Valvulopathies: Are Valve Prostheses Worst?

Background And Aim Of The Study: The population of pregnant women with valvular heart disease (VHD), and in particular with valvular heart prostheses (VHPs), represents a unique patient group where data are scarce, and where there is an increased risk for adverse maternal and obstetric events. The study aim was to assess the experience of a tertiary center with regards to cardiac and pregnancy outcomes in women with VHD, comparing VHPs with other VHD pathologies.

Methods: A retrospective analysis of 84 pregnancies in women with VHD (mean age 27.

Inferior Vena Cava Filter Placement during Pregnancy: An Adjuvant Option When Medical Therapy Fails.

The authors present a case of a 27-year-old multiparous woman, with multiple thrombophilia, whose pregnancy was complicated with deep venous thrombosis requiring placement of a vena cava filter. At 15th week of gestation, following an acute deep venous thrombosis of the right inferior limb, anticoagulant therapy with low-molecular-weight heparin (LMWH) was instituted without improvement in her clinical status. Subsequently, at 18 weeks of pregnancy, LMWH was switched to warfarin.

Acute Sheehan's syndrome presenting as central diabetes insipidus.

Sheehan's syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage. Improvements in obstetrical care have significantly reduced its incidence in developed countries, but postpartum pituitary infarction remains a common cause of hypopituitarism in developing countries. We report a case of severe postpartum haemorrhage followed by headache, central diabetes insipidus and failure to lactate, which prompted us to investigate and identify both anterior and posterior pituitary deficiency compatible with Sheehan's syndrome.

[Renal oncocytoma in pregnancy--an unusual presentation of secondary hypertension].

Introduction: Renal oncocytoma accounts for 5-7% of primary renal neoplasms. It is usually, diagnosed in asymptomatic patients and is characterized by a benign behavior without invasion of adjacent tissues or metastasis. Diagnosis during pregnancy is uncommon and to date there have been only a few cases reported in the literature.

[Warfarin hipersensitivity: how to deal with it?].

The authors report a clinical case of warfarin hypersensitivity noticed when a patient, with thromboembolic risk, was submitted to warfarin. She was found to be heterozigotic to -1639G>A (gene VKORC1) and homozygotic to 1075A>C (genotype CYP2C9*3/*3). In this article the warfarin pharmacodinamics and its role over Vitamin K is revisited.

Primary antiphospholipid syndrome: pregnancy outcome in a portuguese population.

Introduction: Women with antiphospholipid syndrome (APS) may suffer from recurrent miscarriage, fetal death, fetal growth restriction (FGR), pre-eclampsia, placental abruption, premature delivery and thrombosis. Treatment with aspirin and low molecular weight heparin (LMWH) combined with close maternal-fetal surveillance can change these outcomes.

Objective: To assess maternal and perinatal outcome in a cohort of Portuguese women with primary APS.

Lupus and pregnancy--15 years of experience in a tertiary center.

This retrospective study was designed to evaluate the outcome of pregnancies in women diagnosed with systemic lupus erythematosus (SLE) followed in a tertiary fetal-maternal center. Data were collected from clinical charts between January 1993 and December 2007, with a total of 136 pregnancies (107 patients). Mean maternal age was 29 years, with the vast majority of patients being Caucasian.

Acute myocardial infarction in the puerperium.

The authors describe the case of a forty-two-year-old patient with acute myocardial infarction (MI) on the third day of puerperium, who underwent direct angioplasty. The authors review the main physiological cardiovascular and hemostatic changes in pregnancy, which are usually well tolerated but which increase the probability of cardiovascular events when risk factors or previous cardiac disease are associated. Blood volume and cardiac output increase by around 50% during pregnancy, hemoglobin concentration falls, and reduced peripheral vascular resistance leads to a fall in arterial blood pressure during the first half of pregnancy.

[Kidney abscess during pregnancy. A case report].

The development of a kidney abscess is extremely rare despite the fact that urinary tract infections are quite common during pregnancy. The pathogenesis of renal abscess has changed over the years. Nowadays, more than 75% of the renal abscess arises from a previous urinary tract infection.