Pregnancy outcome and fetomaternal hemorrhage after noncatastrophic trauma

Article Abstract:

The medical management of pregnant women who have experienced noncatastrophic trauma, an injury in which the life of the mother was not in danger, is difficult. Quantifying the amount of bleeding experienced by the fetus and mother can help ascertain the extent of the damage. The cause of the trauma and the outcome of the pregnancy relative to degree of fetal or maternal hemorrhage, were studied in 205 noncatastrophic trauma cases. The primary types of noncatastrophic trauma included physical assault, motor vehicle accidents and falls. A complication of pregnancy occurred in a total of 18 patients (8.8 percent). There were 10 patients with premature labor, five patients with early separation of the placenta, one injured fetus and two infants deaths. Uterine contractions, a tender uterus and bleeding were associated with complications, appearing in 17 out of 88 patients (19.3 percent). These symptoms occurred in only one out of 117 (0.9 percent) patients without a complication of pregnancy. Fetomaternal hemorrhage was ascertained by the number of fetal blood cells found in the mother's circulation. Hemorrhage was detected in 18 out of 205 trauma patients and 2 out of 110 normal patients. Large hemorrhages are rare in the absence of obstetrical symptoms. Therefore, fetomaternal hemorrhage need not be assessed when obstetrical symptoms are not present. Since early separation of the placenta (abruptio placenta) is rare, cases lacking contractions, bleeding or uterine tenderness should be observed for two to three hours in the hospital. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Injuries, Pregnant women, Traumatology, Uterus, Pregnant, Pregnant uterus

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Systemic cystic angiomatosis in pregnancy: a case presentation and review of the literature

Article Abstract:

Lymphangiomatosis is a rare but benign congenital malformation affecting the lymphatic system, the network of vessels, ducts, nodes and organs involved in the circulation of lymph fluid. When more than one organ system is affected, the term cystic angiomatosis is used. A 35-year-old white women in her 16th week of pregnancy developed a low-grade fever and pain in the upper left side of her abdomen. An enlarged spleen felt during physical and confirmed by ultrasound examination revealed extensive cystic changes within that lymphatic organ. Exploratory surgery performed in the 18th week of pregnancy allowed a sample of the spleen to be analyzed in the laboratory, resulting in a diagnosis of lymphangioma. The pregnancy continued without complications and a normal male infant was born by vaginal delivery. The cysts that develop on the organs and tissues cause pain as the organs enlarge. This patient had cysts on the kidneys, liver and spleen. Although there is a chance that the spleen could rupture, to remove the spleen during pregnancy could be even riskier. Furthermore, patients who have their spleens removed are at risk for future infections and abscesses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Lymphangioma, Angiomatosis

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