Introduction: Hyperemesis gravidarum (HG) is vomiting and/or nausea in pregnancy causes dehydration, electrolytes imbalance, weight loss and further serious organs dysfunction. Methods: This was a descriptive, prospec...Introduction: Hyperemesis gravidarum (HG) is vomiting and/or nausea in pregnancy causes dehydration, electrolytes imbalance, weight loss and further serious organs dysfunction. Methods: This was a descriptive, prospective, cross-sectional hospital based total coverage analytic study, which was conducted from November 2013 to May 2014 at Omdurman New Hospital (ONH) for Obstetrics & Gynecology, Khartoum-Sudan. Results: HG prevalence is 13% of complicated pregnancy of ONH admission. Acetonurea is reported in all cases with significant association between acetonurea and smoking (P value = 0.005). A significant association between Hemoglobulin level and the readmission the (P value = 0.01) was reported. One maternal death is reported from severe hypoglycemia and liver impairment. Conclusion: Hyperemesis gravidarum has serious maternal morbidity with social negative impacts and significant financial burden on the health services.展开更多
To editor:Wernicke encephalopathy(WE)is an acute neurological disorder caused by a deficiency of vitamin B1(thiamine),with a prevalence of 1.3%in autopsy studies.1 Eighty-four percent of patients with WE will develop ...To editor:Wernicke encephalopathy(WE)is an acute neurological disorder caused by a deficiency of vitamin B1(thiamine),with a prevalence of 1.3%in autopsy studies.1 Eighty-four percent of patients with WE will develop Korsakoff syndrome,which is characterized by amnesia and confusion.2 Although WE is more common in alcoholics,it can also be caused by vomiting,malnourishment,and other situations.展开更多
Early pregnancy is commonly characterized by the disturbance of digestive function, characteristically manifested by nausea and vomiting. These symptoms during early pregnancy usually disappear spontaneously after abo...Early pregnancy is commonly characterized by the disturbance of digestive function, characteristically manifested by nausea and vomiting. These symptoms during early pregnancy usually disappear spontaneously after about 12 weeks. In a minority of pregnant women, these symptoms are very severe, and are associated with weight loss, dehydration, acidosis from starvation,展开更多
Helicobacter pylori(H.Pylori)is a gram-negative,flagellated and spiral-shaped bacterial pathogen that impacts approximately 46%among pregnant women globally and has been associated with various maternal-fetal complica...Helicobacter pylori(H.Pylori)is a gram-negative,flagellated and spiral-shaped bacterial pathogen that impacts approximately 46%among pregnant women globally and has been associated with various maternal-fetal complications.Iron deficiency anemia,fetal growth restriction,cardiovascular diseases,and insufficient nutrient absorption can be observed in pregnant women,as well as miscarriages and pregnancy-specific hypertensive disease,such as pre-eclampsia.Thus,the evidence supports the influence of H.pylori infection on fetal implantation/placentation failure,and positive strains of the cytotoxin-associated gene A of H.Pylori were reported as the most prevalent in these conditions.However,current knowledge indicates a relationship between this infection and the occurrence of hyperemesis gravidarum,characterized by frequent nausea and vomiting.Regarding the diagnosis of this bacterial infection,non-invasive approaches such as stool antigen test,urea breath test,and serological tests are more accepted during pregnancy,as they are easy to carry out and cost-effective.Finally,the bacteria eradication therapy should consider the risks and benefits for the pregnant woman and her child,with pharmacological intervention depending on the clinical presentation.展开更多
Helicobacter pylori (H. pylori) infection is investigated in gastric diseases even during pregnancy. In particular, this Gram-negative bacterium seems to be associated with hyperemesis gravidarum, a severe form of nau...Helicobacter pylori (H. pylori) infection is investigated in gastric diseases even during pregnancy. In particular, this Gram-negative bacterium seems to be associated with hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy. During the last decade, the relationship among H. pylori and several extra-gastric diseases strongly emerged in literature. The correlation among H. pylori infection and pregnancy-related disorders was mainly focused on iron deficiency anemia, thrombocytopenia, fetal malformations, miscarriage, pre-eclampsia and fetal growth restriction. H. pylori infection may have a role in the pathogenesis of various pregnancy-related disorders through different mechanisms: depletion of micronutrients (iron and vitamin B<sub>12</sub>) in maternal anemia and fetal neural tube defects; local or systemic induction of pro-inflammatory cytokines release and oxidative stress in gastrointestinal disorders and pre-eclampsia; cross-reaction between specific anti-H. pylori antibodies and antigens localized in placental tissue and endothelial cells (pre-eclampsia, fetal growth restriction, miscarriage). Since H. pylori infection is most likely acquired before pregnancy, it is widely believed that hormonal and immunological changes occurring during pregnancy could activate latent H. pylori with a negative impact not only on maternal health (nutritional deficiency, organ injury, death), but also on the fetus (insufficient growth, malformation, death) and sometime consequences can be observed later in life. Another important issue addressed by investigators was to determine whether it is possible to transmit H. pylori infection from mother to child and whether maternal anti-H. pylori antibodies could prevent infant’s infection. Studies on novel diagnostic and therapeutic methods for H. pylori are no less important, since these are particularly sensitive topics in pregnancy conditions. It could be interesting to study the possible correlation between H. pylori infection and other pregnancy-related diseases of unknown etiology, such as gestational diabetes mellitus, obstetric cholestasis and spontaneous preterm delivery. Since H. pylori infection is treatable, the demonstration of its causative role in pregnancy-related disorders will have important social-economic implications.展开更多
A 24-year-old female patient with parathyroid carcinoma,the rarest endocrine malignancy,had two pregnancies.In the first pregnancy,she had severe nausea and fatigue.Hypercalcemia and hyperparathyroidism were diagnosed...A 24-year-old female patient with parathyroid carcinoma,the rarest endocrine malignancy,had two pregnancies.In the first pregnancy,she had severe nausea and fatigue.Hypercalcemia and hyperparathyroidism were diagnosed in the postpartum period.Hyperemesis gravidarum masked a diagnosis of hypercalcemia.Neck ultrasound and Tc-99 m sestamibi found an enlarged lower right parathyroid gland.The gland was surgically removed,and an initial pathology report described atypical adenoma.Shortly afterward,she became pregnant again.During the second pregnancy,her calcium level was frequently controlled but was always in the normal range.Normocalcemia is explained by the specific physiology of pregnancy accompanied by hemodilution,hypoalbuminemia and maternal hypercalciuria(mediated by increased glomerular filtration).During lactation,calcium levels rose,and a newneck ultrasound showed a solitary mass in the area of prior surgery and an enlarged pretracheal lymph node.Fine needle aspiration of the solitary mass and node showed parathyroid carcinoma cells.The tumor mass was resected en bloc with the contiguous tissues and surrounding lymph nodes(pathology report; parathyroid carcinoma with metastases).Over the next five years,four consecutive surgeries were performed to remove malignant parathyroid tissue,lymph nodes and local metastases.Following the surgical procedures,no hypocalcemia was observed.More serious hypercalcemia recurred; the calcium level was difficult to control with a combination of pamidronate,cinacalcet and loop diuretic.No elements of multiple endocrine neoplasia were present.展开更多
文摘Introduction: Hyperemesis gravidarum (HG) is vomiting and/or nausea in pregnancy causes dehydration, electrolytes imbalance, weight loss and further serious organs dysfunction. Methods: This was a descriptive, prospective, cross-sectional hospital based total coverage analytic study, which was conducted from November 2013 to May 2014 at Omdurman New Hospital (ONH) for Obstetrics & Gynecology, Khartoum-Sudan. Results: HG prevalence is 13% of complicated pregnancy of ONH admission. Acetonurea is reported in all cases with significant association between acetonurea and smoking (P value = 0.005). A significant association between Hemoglobulin level and the readmission the (P value = 0.01) was reported. One maternal death is reported from severe hypoglycemia and liver impairment. Conclusion: Hyperemesis gravidarum has serious maternal morbidity with social negative impacts and significant financial burden on the health services.
文摘To editor:Wernicke encephalopathy(WE)is an acute neurological disorder caused by a deficiency of vitamin B1(thiamine),with a prevalence of 1.3%in autopsy studies.1 Eighty-four percent of patients with WE will develop Korsakoff syndrome,which is characterized by amnesia and confusion.2 Although WE is more common in alcoholics,it can also be caused by vomiting,malnourishment,and other situations.
文摘Early pregnancy is commonly characterized by the disturbance of digestive function, characteristically manifested by nausea and vomiting. These symptoms during early pregnancy usually disappear spontaneously after about 12 weeks. In a minority of pregnant women, these symptoms are very severe, and are associated with weight loss, dehydration, acidosis from starvation,
文摘Helicobacter pylori(H.Pylori)is a gram-negative,flagellated and spiral-shaped bacterial pathogen that impacts approximately 46%among pregnant women globally and has been associated with various maternal-fetal complications.Iron deficiency anemia,fetal growth restriction,cardiovascular diseases,and insufficient nutrient absorption can be observed in pregnant women,as well as miscarriages and pregnancy-specific hypertensive disease,such as pre-eclampsia.Thus,the evidence supports the influence of H.pylori infection on fetal implantation/placentation failure,and positive strains of the cytotoxin-associated gene A of H.Pylori were reported as the most prevalent in these conditions.However,current knowledge indicates a relationship between this infection and the occurrence of hyperemesis gravidarum,characterized by frequent nausea and vomiting.Regarding the diagnosis of this bacterial infection,non-invasive approaches such as stool antigen test,urea breath test,and serological tests are more accepted during pregnancy,as they are easy to carry out and cost-effective.Finally,the bacteria eradication therapy should consider the risks and benefits for the pregnant woman and her child,with pharmacological intervention depending on the clinical presentation.
文摘Helicobacter pylori (H. pylori) infection is investigated in gastric diseases even during pregnancy. In particular, this Gram-negative bacterium seems to be associated with hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy. During the last decade, the relationship among H. pylori and several extra-gastric diseases strongly emerged in literature. The correlation among H. pylori infection and pregnancy-related disorders was mainly focused on iron deficiency anemia, thrombocytopenia, fetal malformations, miscarriage, pre-eclampsia and fetal growth restriction. H. pylori infection may have a role in the pathogenesis of various pregnancy-related disorders through different mechanisms: depletion of micronutrients (iron and vitamin B<sub>12</sub>) in maternal anemia and fetal neural tube defects; local or systemic induction of pro-inflammatory cytokines release and oxidative stress in gastrointestinal disorders and pre-eclampsia; cross-reaction between specific anti-H. pylori antibodies and antigens localized in placental tissue and endothelial cells (pre-eclampsia, fetal growth restriction, miscarriage). Since H. pylori infection is most likely acquired before pregnancy, it is widely believed that hormonal and immunological changes occurring during pregnancy could activate latent H. pylori with a negative impact not only on maternal health (nutritional deficiency, organ injury, death), but also on the fetus (insufficient growth, malformation, death) and sometime consequences can be observed later in life. Another important issue addressed by investigators was to determine whether it is possible to transmit H. pylori infection from mother to child and whether maternal anti-H. pylori antibodies could prevent infant’s infection. Studies on novel diagnostic and therapeutic methods for H. pylori are no less important, since these are particularly sensitive topics in pregnancy conditions. It could be interesting to study the possible correlation between H. pylori infection and other pregnancy-related diseases of unknown etiology, such as gestational diabetes mellitus, obstetric cholestasis and spontaneous preterm delivery. Since H. pylori infection is treatable, the demonstration of its causative role in pregnancy-related disorders will have important social-economic implications.
文摘A 24-year-old female patient with parathyroid carcinoma,the rarest endocrine malignancy,had two pregnancies.In the first pregnancy,she had severe nausea and fatigue.Hypercalcemia and hyperparathyroidism were diagnosed in the postpartum period.Hyperemesis gravidarum masked a diagnosis of hypercalcemia.Neck ultrasound and Tc-99 m sestamibi found an enlarged lower right parathyroid gland.The gland was surgically removed,and an initial pathology report described atypical adenoma.Shortly afterward,she became pregnant again.During the second pregnancy,her calcium level was frequently controlled but was always in the normal range.Normocalcemia is explained by the specific physiology of pregnancy accompanied by hemodilution,hypoalbuminemia and maternal hypercalciuria(mediated by increased glomerular filtration).During lactation,calcium levels rose,and a newneck ultrasound showed a solitary mass in the area of prior surgery and an enlarged pretracheal lymph node.Fine needle aspiration of the solitary mass and node showed parathyroid carcinoma cells.The tumor mass was resected en bloc with the contiguous tissues and surrounding lymph nodes(pathology report; parathyroid carcinoma with metastases).Over the next five years,four consecutive surgeries were performed to remove malignant parathyroid tissue,lymph nodes and local metastases.Following the surgical procedures,no hypocalcemia was observed.More serious hypercalcemia recurred; the calcium level was difficult to control with a combination of pamidronate,cinacalcet and loop diuretic.No elements of multiple endocrine neoplasia were present.