Relationship between antepartum cocaine abuse, abnormal umbilical artery Doppler velocimetry, and placental abruption

Article Abstract:

Cocaine abuse causes adverse effects on the cardiovascular system, which consists of the heart and blood vessels. The use of cocaine is associated with the development of rapid heart rate and high blood pressure, leading to insufficient supply of oxygen to various tissues. Cocaine can constrict blood vessels, and thereby reduce blood flow within the umbilical artery. This may result in decreased blood flow to the uterus and reduced oxygen supply to the fetus. The circulation of blood within the placenta, the tissue that provides nourishment to the fetus, was assessed in 314 pregnant women. Circulation within the placenta was monitored using Doppler flow velocimetry, a method in which sound waves are used to evaluate blood flow. The women were placed into groups characterized by cocaine abuse before labor; cocaine abuse before labor and premature delivery; premature delivery without cocaine abuse; and no cocaine abuse or premature delivery. Premature delivery (birth before 36 weeks gestation) occurred in 28 percent of pregnancies. Infants were considered small for gestational age (SGA) in 13 cases, and had a low birth weight (LBW) in 33 cases. Abnormal blood pressure, indicated by the systolic-diastolic ratio, was associated with placental abruption, the early detachment of fetal membranes from the wall of the uterus; and premature labor was associated with a history of cocaine abuse. All patients without a history of cocaine abuse had normal blood pressure. These findings suggest that cocaine abuse is associated with placental abruption and abnormal blood pressure. In addition, abnormal blood pressure may contribute to premature delivery, and SGA and LBW infants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Cocaine, Drug abuse in pregnancy, Abruptio placentae, Placental abruption, Umbilical arteries

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Successful pregnancy with isolated herpes simplex virus encephalitis: case report and review of the literature

Article Abstract:

Encephalitis, swelling of the brain, is characterized by headache, bizarre behavior, seizures and neurological irritability. Although herpes simplex virus is the most common form of viral encephalitis, only five cases have been reported during pregnancy. Encephalitis caused by the herpes simplex virus is life-threatening during pregnancy. In those earlier cases, four of the mothers died, as did three of the infants. A sixth case involves a 37-year-old woman in her 26th week of pregnancy who complained of headache, confusion, difficultly speaking and numbness on her right side. Upon hospital admission, fever, oral thrush, rash and neck stiffness were noted. Electroencephalography, a recording of brain activity, was consistent with a brain abscess and encephalitis. Intravenous acyclovir (antiviral medication), penicillin (antibacterial medication) and methylprednisone (steroid anti-inflammatory) were begun immediately. Cultures of the spinal fluid and blood were negative. However, there was high concentration of antibodies for herpes simplex virus. Acyclovir therapy was continued throughout the remainder of the pregnancy and gradually her symptoms resolved. A normal healthy infant was born at term. Since herpes simplex encephalitis is potentially fatal during pregnancy, all pregnant women with symptoms should begin antiviral treatment immediately after samples of spinal fluid are removed for analysis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Pregnancy, Complications of, Pregnancy complications, Herpesvirus diseases, Herpesvirus infections, Encephalitis, Herpes simplex

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