To compare short-term outcomes at index and subsequent pregnancies, as well as the long-term medical complications encountered later than 5 years after index pregnancy incomplete and partial HELLP syndromes. Pregnancies complicated by partial HELLP or complete HELLP during a period of 19 years were identified. Searches were limited to cases before 2012 to ensure an adequate follow-up period. Data on index or subsequent pregnancies occurring at our center were extracted from the hospital database, while data pertaining to subsequent obstetric outcomes when deliveries occurred elsewhere together with current medical conditions were acquired by patient self-reporting. Complete HELLP was defined as the presence of the 3 components of the syndrome whereas partial HELLP was defined by the presence of 1 or 2 components. 100 pregnancies were included. At index pregnancy, there was a higher rate of composite adverse maternal outcome in complete HELLP when compared to partial HELLP (45.8% vs 21.1%, p = 0.017). Outcomes at subsequent pregnancies showed no difference between the two variants of HELLP syndrome. When examined years later, a higher frequency of ''composite medical morbidity'' in the complete HELLP group was observed, though this difference did not reach statistical significance (77.7% vs 61.9%, p = 1.00). Although partial HELLP is relatively less harmful, it can nonetheless cause serious maternal complications including ruptured liver hematoma, intracranial hemorrhage and even mortality. These two clinical entities represent a continuum of the same pathology, which implies that the approach at management should be uniform. Furthermore, the prognosis and longterm outcomes were not different between these 2 variants.
Lymphangiomas are rare congenital malformations of the lymphatic system. Authors present a case with giant, septated, axillary thoraco-abdominal lymphangioma. Diagnosis was made at 19 weeks’ gestation by antenatal ultrasonography. The case underwent prenatal expectation treatment.
Electronic Fetal Heartrate Monitoring (EFHM) is the standard method for fetal well-being surveillance used during labor and delivery. There are, however, situations when tracings displayed by the EFHM are ambiguous and misleading. We present two cases where the Maternal Heart Rate (MHR) artefacts were mistaken for Fetal Heart Rate (FHR). In the first case, MHR masked the severity of fetal distress and caused a delayed and inappropriate management with subsequent poor neonatal outcome. In the second case, MHR was misinterpreted as FHR causing embarrassment of the birth attendants upon delivery of a dead macerated newborn. FHR should initially and continuously be verified as the actual origin of the signal displayed on the EFHM before any intervention is undertaken. Understanding the EFHM patterns produced by FHR or MHR and the utilization of modern EFHMs that apply concomitant recording and displaying of MHR and FHR can avert problems associated with signal ambiguity.
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