Thrombophilia is a group of genetical disorders that cause blood to clot abnormally. Thrombophilia is linked to recurrent pregnancy loss, foetal growth restriction, late miscarriages, stillbirth and preeclampsia. Clinicians usually apply the term thrombophilia only to patients with atypical thrombosis. A successful outcome of pregnancy requires an efficient uteroplacental circulation. Since this system may be compromised by disorders associated with a prothrombotic state, it was postulated that maternal thrombophilia might be a risk factor for preeclampsia and intrauterine growth retardation. The study included 459 pregnant women with gestational ages ranging from 14 weeks to 28 weeks and the patients in the study were tested for hereditary thrombophilia. The type of thrombophilic mutation most common found was the MTHFR mutation (25.7%), followed by the prothrombin gene mutation (20.9%) and the Leiden factor V mutation (15.7%). Also 15.03% patients had been diagnosed with preeclampsia and 6.75% of the pregnant women had IUGR fetuses.
Methods to prevent the development of pathologies due to placental dysfunctions, such as gestational hypertension and preeclampsia, are the main approaches for obtaining the best maternal and fetal antepartum and postpartum prognosis. During 5 years of study (January, 2015 to December, 2019, the cases of pregnancy and puerperium complicated with pathology due to placental dysfunction were analyzed. The main objective was to determine the magnitude of the impact of thrombophilia on the development of an entity of gestational hypertension disorder. We compared the impact of thrombophilia and its associated complications in patients with gestational hypertension with moderate and severe preeclampsia. Thus, we found obesity, thrombophilia, and underlying cardiac pathology to be significant risk factors for severe preeclampsia. Regarding the comparative analysis of the risk factors and complications associated with patients with mild preeclampsia compared with those with severe preeclampsia, the presence in severe preeclampsia of thrombophilia, endocrine, liver, and cardiac pathology was higher and, a higher rate of complications was observed; complications included fetal death, intrauterine growth restriction (IUGR), prematurity, fetal arrhythmia with acute fetal distress, HELLP syndrome, and placental abruption. Thrombophilia has a significant effect on the development of severe preeclampsia, and oligohydramnios as specific complication of mild preeclampsia. Factors indicating an increased risk of progression from mild preeclampsia to severe preeclampsia are in addition to inherited thrombophilia the underlying pathologies, namely cardiac, hepatic, and endocrine factors.
Bone is a typical location of metastasis that usually reflects a negative outcome in oncologic patients. Once cancer has spread to the bones, it can rarely be cured, but sometimes it can be treated to minimize its rate of proliferation. Most skeletal metastases are produced by tumors originating in the breast and prostate. Osseous metastases are actually much more frequent than primary bone tumors, especially in adults. The diagnosis relies on signs, symptoms, and imaging techniques. This paper is a review of all cases of bone metastasis from our unit and a comprehensive review regarding the clinical approach and treatment of patients with such lesions.
Ovarian carcinoma is a deadly disease, with one of the highest case-to-fatality ratio amongst all gynecological malignancies. The high mortality of these tumors can be explained by the fact that most patients present at an advanced stage, with widely spread metastatic disease, especially within the peritoneal cavity. Extraperitoneal, occult metastases are usually rare in cancer surviving patients. Bone metastases are not a common finding, but their incidence seems to be higher than expected, as proven by autopsy studies. Because most clinicians are not very familiar with bone metastases of ovarian carcinoma, in this article we intended to discuss the most controversial aspects concerning the diagnosis of this type of disease.
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