Serum Histaminase During Pregnancy

Barnes, Lloyd

doi:10.1097/00006250-195706000-00018

Cited by 14 publications

(4 citation statements)

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“…The rarity of peptic ulcer and of its complications in pregnancy correlate with the hypochlorhydria found in pregnant women and with increased secretions of the anterior pituitary-like hormones in the urine [ 5 ]. An increase in plasma histamine in pregnancy (caused by placental histaminase synthesis) increases metabolism of maternal histamine, thereby reducing gastric acid secretion during pregnancy [ 6 ]. It has also been suggested that female gestational hormones (particularly progesterone) decrease the rate of ulcer formation by increasing gastric mucus synthesis.…”

Section: Discussionmentioning

confidence: 99%

Perforated duodenal ulcer in the third trimester of pregnancy, with survival of both the mother and neonate, in Ethiopia: a case report

et al. 2022

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Background Perforated peptic ulcer disease is a serious complication of peptic ulcer disease (PUD) that presents as acute abdomen. It is very uncommon during pregnancy, but its diagnosis in pregnancy is very challenging in general, and more so in the third trimester. Timely diagnosis and prompt surgical intervention can prevent maternal and fetal mortality, but delayed diagnosis is linked with poor maternal and fetal outcomes. The aim of this case report is to emphasize the need for healthcare professionals to consider the differential diagnosis of perforated PUD when presented with cases of acute abdomen in pregnancy and to involve a multidisciplinary team in management for better feto-maternal outcome. Case presentation A 35-year-old pregnant Ethiopian woman, Gravida 7 and Para 6, presented with a sudden onset of right upper quadrant pain, nausea, and vomiting of 7 hours duration at 36 weeks of gestation. She also had contractions and leakage of liquor of two hours duration. Her abdomen was grossly distended, rigid, and diffusely tender, and showed limited movement with respiration. An upright abdominal X-ray demonstrated air under the diaphragm. She was diagnosed with perforated peptic ulcer disease. Labor was augmented, and a 2.9-kg live male neonate was delivered vaginally. Two hours after delivery, laparoscopic omental patch repair was performed. The patient was discharged 7 days after the omental patch repair surgery in stable condition. Conclusions Perforated PUD in pregnancy is a rare occurrence, which may account for the delay in diagnosis and management. Obstetricians should keep a high index of suspicion when a pregnant woman presents with acute abdomen. Care provided by obstetricians should be coupled with care provided by other disciplinary teams, in order to reduce maternal and fetal morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Perforated duodenal ulcer in the third trimester of pregnancy, with survival of both the mother and neonate, in Ethiopia: a case report

et al. 2022

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“…Complications of peptic ulcer disease are rare in pregnancy due to hormonal influences including progesterone and increased plasma histamine levels [17,18]. Its occurrence after cesarean section warrants further evaluation.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Gastroduodenal Perforation Following Cesarean Section

et al. 2019

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Peptic ulcer disease with its complications in recent centuries has become a disease of global burden associated with high morbidity and mortality. There are several risk factors that have been implicated. These include Helicobacter pylori infection, regular use of non-steroidal anti-inflammatory drugs (NSAIDS), smoking, alcohol use, steroid use, male gender and low socioeconomic status. The ulcer can be either acute or chronic. Acute ulcers are mostly stress ulcerations with documented risk factors. Bleeding, and rarely perforation are the main complications which remain a surgical challenge. Some underlying causes of gastroduodenal perforation have been reported but remain largely rare. These include gastric carcinoma, ingestion of sharp foreign material, opportunistic infections, metastatic cancer, eating disorders and pregnancy. It is in line with these rare causes that we report two cases of gastroduodenal perforation post cesarean section in two young women, both succumbing to complications of the perforation.

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“…Also due to the effect of estrogen, increased levels of diamine oxidase (histaminase) is seen during pregnancy. This enzyme breaks down the histamine that is responsible for the release of hydrochloric acid from the parietal cells in the stomach [4]. Other plausible factors are nutritious diet, rest, avoidance of smoking, alcohol and use of antacids [5].…”

Section: Discussionmentioning

confidence: 99%

Duodenal Perforation in a Lady with Twin Gestation and Severe Preeclampsia

Ranganna¹,

Nalini²,

Hn³

2013

JCR

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We present a case where the clinical manifestation of a duodenal perforation was masked by preeclampsia during the initial workup. A 22 year G2A1, 32 weeks pregnant female presented with symptoms of impending eclampsia and blood pressure of 190/120 mm Hg. Emergency cesarean section was done for failed induction. Subsequently, she developed subacute bacterial peritonitis leading to acute renal failure and disseminated intravascular coagulation. On post-operative day 4, the abdominal wound dressing was stained with greenish yellow discharge when the possibility of a perforated viscus was made. Laparotomy was done on day 6 and a perforation was seen on the anterior part of duodenum. Being vigilant to make an early diagnosis and intervention can reduce the maternal morbidity and mortality associated with duodenal perforation which is a rare occurrence during pregnancy.

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Serum Histaminase During Pregnancy

Cited by 14 publications

References 0 publications

Perforated duodenal ulcer in the third trimester of pregnancy, with survival of both the mother and neonate, in Ethiopia: a case report

Perforated duodenal ulcer in the third trimester of pregnancy, with survival of both the mother and neonate, in Ethiopia: a case report

Two Cases of Gastroduodenal Perforation Following Cesarean Section

Duodenal Perforation in a Lady with Twin Gestation and Severe Preeclampsia

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