Fatal Brain Damage Associated with Cardiomyopathy of Pregnancy, with Notes on Caesarean Section in a Hyperbaric Chamber

In the United States, peripartum cardiomyopathy (PC) is an uncommon form of dilated cardiomyopathy, which, when associated with stroke, results in a high mortality rate. The estimated incidence of PC at the University of Iowa Hospitals and Clinics from 1/1/1976 to 7/1/1993 averaged only 1 out of every 8,135 deliveries. Of the total 5 cases diagnosed, only 1 presented with neurologic manifestations. Through the use of echocardiography, cine-computerized tomography and magnetic resonance imaging, a large left ventricular mural thrombus in a diffusely hypokinetic heart was found. Newer cardiac imaging techniques are improving our ability to diagnose the cause of stroke in the younger population, including women in the peripartum period, allowing early institution of appropriate medical treatment and hopefully improving prognosis.

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“…Lcdingham et al [37] studied a patient whose autop sy demonstrated 'watershed' infarctions. Similar cases of stroke dur-…”

Section: Discussionmentioning

confidence: 99%

Peripartum Cardiomyopathy and Stroke

Dyken

Biller

1994

Cerebrovasc Dis

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“…Several animal and in vitro studies showed that HBO treatment results in terato genicity [6][7][8][9], mutagenicity [10,11], retinop athy of prematurity [12], cardiovascular ef fects, and alterations in placental blood flow [13,14], Other animal experimental studies indicate that HBO can be used safely during pregnancy [15][16][17], Also, several clinical trials support HBO treatment during pregnancy [2,[18][19][20][21],…”

Section: Introductionmentioning

confidence: 99%

Effects of Hyperbaric Oxygen on Rat Embryos

Sapunar¹,

Saraga-Babić²,

Peruzović

et al. 1993

Neonatology

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The aim of the study was to investigate the toxic effects of hyperbaric oxygen (HBO) on rat embryos. Two groups of Fischer pregnant rats were exposed to oxygen at pressures of 324 and 426 kPa for 90 min per day for 5 consecutive days (8–12 days of gestation). The third group was exposed to normobaric oxygen for 12 h on the eighth day of gestation. Two control groups were used; the first was comprised of intact and the second of sham-treated animals. The HBO treatment did not significantly affect maternal weight gain or reduce litter size, nor did it induce any embryonic abnormalities. However, the fetal body weight was reduced and the placental weight increased in the groups exposed to HBO at pressures of 324 and 426 kPa. When female fetuses which had been exposed to oxygen at 324 or 426 kPa were compared to the intact control group, a reduction in wet weights of 9.2 (p < 0.05) and 12.1 % (p < 0.01), respectively, was noted. Male fetuses exposed to oxygen at 324 and 426 kPa displayed a reduced body weight of 11.7 (p < 0.01) and 16.6% (p < 0.01), respectively. Placental weight was increased by 18.9 (p < 0.01) and 23.6% (p < 0.01) in the groups exposed to oxygen at 324 and 426 kPa, respectively. These data suggest that HBO, either at 324 or 426 kPa, is not potent at inducing malformations and that the largest embryotoxic effects are upon fetal body weight and placental weight. However, the histological examination of placentas revealed alterations in labyrinthine blood vessels and a statistically significant thickening of the placental barrier. In conclusion, this study suggests that transient interference with normal placentation is probably sufficient to cause permanent maldevelopment of the placenta and embryo.

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Should hyperbaric oxygen be used to treat the pregnant patient for acute carbon monoxide poisoning? A case report and literature review

Hoesen

Camporesi²,

Moon³

et al. 1989

JAMA: The Journal of the American Medical Association

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Carbon monoxide (CO) is the leading cause of death due to poisoning. Although uncommon, CO poisoning does occur during pregnancy and can result in fetal mortality and neurological malformations in fetuses who survive to term. Uncertainty arises regarding the use of hyperbaric oxygen (HBO) as a treatment for the pregnant patient because of possible adverse effects on the fetus that could be induced by oxygen at high partial pressures. While the dangers of hyperoxia to the fetus have been demonstrated in animal models, careful review of animal studies and human clinical experience indicates that the short duration of hyperoxic exposure attained during HBO therapy for CO poisoning can be tolerated by the fetus in all stages of pregnancy and reduces the risk of death or deformity to the mother and fetus. A case is presented of acute CO poisoning during pregnancy that was successfully treated with HBO. Recommendations are suggested for the use of HBO during pregnancy.

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Fatal Brain Damage Associated with Cardiomyopathy of Pregnancy, with Notes on Caesarean Section in a Hyperbaric Chamber

Cited by 17 publications

References 7 publications

Peripartum Cardiomyopathy and Stroke

Peripartum Cardiomyopathy and Stroke

Effects of Hyperbaric Oxygen on Rat Embryos

Should hyperbaric oxygen be used to treat the pregnant patient for acute carbon monoxide poisoning? A case report and literature review

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