Clinics in perinatology
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Vaso-occlusive sickle cell crisis (VSCC) is the most common maternal complication in pregnancies associated with sickle hemoglobinopathies. Maternal and fetal morbidity and mortality secondary to this serious obstetric problem can be reduced significantly with a well-devised therapeutic plan, expert perinatal teams, and careful attention to obstetric and medical detail in a setting of comprehensive tertiary health care. A variety of better medical, obstetric, and neonatal care practices have helped considerably to improve the combined life span for affected mothers and fetuses. In the absence of any effective and safe pharmacologic agent to prevent sickle crisis, our experience suggests that adherence to the described management principles offers the greatest hope to the sickling parturient that her vaso-occlusive crises can be effectively managed for a healthy outcome, both for herself and for her baby.
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Septic shock in the obstetric population remains an uncommon yet potentially lethal complication of infection. Effective therapy mandates early recognition and aggressive intervention. ⋯ In addition, the antepartum subject carries with her another potentially viable human being who deserves consideration. Optimal therapy should be directed at reestablishing an effective intravascular volume, maintaining adequate oxygen delivery to peripheral and central tissues, and the initiation of appropriate broad-spectrum antimicrobial agents to eradicate the causative pathogens.
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Clinics in perinatology · Dec 1986
ReviewEtiology and management of acute fatty liver of pregnancy.
Acute fatty liver of pregnancy (AFLP) remains a problem for which there is no discernible cause. Therefore, a precise definition awaits the discovery or elucidation of its exact etiology. ⋯ It is characterized histopathologically by changes in the liver consistent with microvesicular fatty infiltration but occurring in a pregnant women with no clearly identifiable etiology. Management tenets include prompt delivery and supportive care of the mother.
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Clinics in perinatology · Dec 1986
ReviewThe obstetric patient and disseminated intravascular coagulation.
Disseminated intravascular coagulation remains a major problem for the practicing obstetrician. The various etiologies, the pathophysiology, and suggested therapeutic regimens are reviewed.