Maternal Fetal Medicine Unit, Department of Obstetrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Published: September 2021
AI Article Synopsis
Article Abstract
Objective: To evaluate the maternal and perinatal outcomes in a cohort of pregnant women at high risk of venous thromboembolism (VTE).
Methods: Women at high risk of VTE were evaluated in a multidisciplinary program using a complete diagnostic workup, and specific prophylactic or therapeutic treatment.
Results: Women were considered at high risk of VTE in 57% (85/148) because of prior (75) or current (10) thromboembolism, and in 27% (40/148) of the cases due to adverse obstetric history. Thrombophilia was diagnosed in 57% of the cases (85/148), either in patients with previous thromboembolism (48%, 41/85) or without a history of thrombosis (70%, 44/63). The most common thrombophilia was antiphospholipid syndrome in 34% (29/85) of the cases. Under respective prophylactic or therapeutic treatment, there were no VTE during pregnancy (0%, 0/148), whereas four events occurred during the puerperium (3%, 4/148). An adverse obstetric outcome was present in 5% (7/148) of all pregnancies, with four early spontaneous abortions (3%, 4/148) and three late miscarriages (2%, 3/148).
Conclusion: Pregnant women at high risk of VTE can be effectively managed using a risk-adapted treatment. Our results support prospective enrollment and a multidisciplinary assessment of VTE in high-risk pregnant women.
Department of Obstetrics and Gynaecology, School of Clinical Medicine, University of Cambridge, United Kingdom. (J.A.M., U.S., F.G., E.C., D.S.C.-J., G.C.S.S.).
Background: Elevated maternal serum sFLT1 (soluble fms-like tyrosine kinase 1) has a key role in the pathophysiology of preeclampsia. We sought to determine the relationship between the maternal and fetal genome and maternal levels of sFLT1 at 12, 20, 28, and 36 weeks of gestational age (wkGA).
Methods: We studied a prospective cohort of nulliparous women (3968 mother-child pairs).
Aim: In early-stage breast cancer, the axillary lymph nodes play a crucial role in determining the prognosis of the disease. The rate of lymph node involvement might be a more valuable prognostic factor than the number of positive lymph nodes. Therefore, we aimed to evaluate whether the lymph node ratio (LNR) is a superior prognostic indicator compared to the pathologic lymph node count in early-stage disease.
Endovascular repair has significantly improved the treatment of aortic aneurysms, particularly in older and high-risk patients. However, many studies have not found significant differences in long-term outcomes when comparing open and endovascular repair methods. Additionally, endovascular repair is associated with a higher rate of aortic-related reinterventions compared to open repair (OR), sometimes necessitating late open surgical conversion (LOSC).
White matter hyperintensities (WMH) of presumed vascular origin are a magnetic resonance imaging (MRI)-based biomarker of cerebral small vessel disease (CSVD). WMH are associated with cognitive decline and increased risk of stroke and dementia, and are commonly observed in aging, vascular cognitive impairment, and neurodegenerative diseases. The reliable and rapid measurement of WMH in large-scale multisite clinical studies with heterogeneous patient populations remains challenging, where the diversity of imaging characteristics across studies adds additional complexity to this task.
Aim: We aimed to identify the characteristics of patients with diabetes who can derive cognitive benefits from intensive blood pressure (BP) treatment using machine learning methods.
Materials And Methods: Using data from the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) study, 1349 patients with type 2 diabetes who underwent BP treatment (intensive treatment targeting a systolic BP <120 mmHg vs. standard treatment targeting <140 mmHg) were included in the machine learning analysis.
