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invasive procedures for Prenatal Diagnosis in Salmaniya Medical Complex in Bahrain: A Retrospective Cross-Sectional Descriptive Study

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 1046-1059页

作者： Basma Alsayegh Bayan Ahmed Fatema Ahmed Amal Hassani Department of Obstetrics and Gynecology Salmaniya Medical Complex Manama Kingdom of Bahrain

Background: Prenatal diagnosis is the process of evaluating the presence of disease or potential disease in the fetus, this enables families to be better prepared before the birth of the baby. There are non-invasive prenatal diagnosis procedures and invasive prenatal diagnosis procedures. The invasive prenatal diagnosis procedures are CVS (chorionic villus sampling) and amniocentesis. The American College of Obstetricians and Gynecologists states that invasive diagnostic testing should be available to all women, regardless of age or risk. Objective: To determine the indications, outcome and results of diagnostic invasive prenatal procedures. Study setting: The obstetrics and Gynecology Department in Salmaniya Medical Complex in Kingdom of Bahrain. Study design: Retrospective descriptive study. Study subjects and Methods: This retrospective descriptive study was conducted on 175 pregnant women who underwent invasive prenatal procedures (CVS and amniocentesis) between January 2013 and December 2018 at SMC in Kingdom of Bahrain. All medical records of the participants were reviewed and entered the study. According to the implemented procedures, medical records were categorized into two chorionic villus sampling (CVS) and amniocentesis groups. The study subject will include indications of the procedures which are advanced maternal age, hematological disorders, genetic disorders, metabolic disorders, abnormal structural findings in fetal ultrasound and previous child with aneuploidy. In addition, the study will address the complications, outcome and results of procedures. Results: About half of our indications of the procedures were due to hematological disorders (47.6%) followed by abnormal structural findings in fetal ultrasound (30.1%) then genetic disorders (15.7%), metabolic disorders (4.8%) and advanced maternal age (1.8%). Regarding complications of the procedure;threatened miscarriage or loss of pregnancy within 3 weeks was (2.3%), amniotic fluid leakage (0.7%),

关键词： invasive procedures Prenatal Diagnosis Chorionic Villus Sampling Amniocentesis

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Recombinant human thrombopoietin treatment in patients with chronic liver disease-related thrombocytopenia undergoing invasive procedures:A retrospective study

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World Journal of Gastrointestinal Surgery 2022年第11期14卷 1260-1271页

作者： Jing-Nuo Ding Ting-Ting Feng Wei Sun Xin-Yi Cai Yun Zhang Wei-Feng Zhao Department of Infectious Diseases The First Affiliated Hospital of Soochow UniversitySuzhou 215000Jiangsu ProvinceChina

BACKGROUND Chronic liver disease(CLD)related thrombocytopenia increases the risk of bleeding and poor *** liver disease patients require invasive procedures or surgeries,such as liver biopsy or endoscopic variceal ligation,and most of them have lower platelet counts,which could aggravate the risk of bleeding due to liver dysfunction and coagulation ***,there is no defined treatment modality for CLD-induced *** human thrombopoietin(rhTPO)is commonly used to treat primary immune thrombocytopenic purpura and thrombocytopenia caused by solid tumor chemotherapy;however,there are few reports on the use of rhTPO in the treatment of CLD-related *** To evaluate the efficacy of rhTPO in the treatment of patients with CLDassociated thrombocytopenia undergoing invasive *** All analyses were based on the retrospective collection of clinical data of patients with CLD who were treated in the Department of Infectious Diseases at The First Affiliated Hospital of Soochow University between June 2020 and December ***-nine male and 41 female patients with liver disease were enrolled in this study to assess the changes in platelet counts and parameters before and after the use of rhTPO for *** events related to treatment,such as bleeding,thrombosis,and disseminated intravascular coagulation,were also *** Among the enrolled patients,78(78%)showed a platelet count increase after rhTPO use,while 22(22%)showed no significant change in platelet *** mean platelet count after rhTPO treatment in all patients was 101.53±81.81×10^(9)/L,which was significantly improved compared to that at baseline(42.88±16.72×10^(9)/L),and this difference was statistically significant(P50×10^(9)/L).Subgroup analyses showed that the medi

关键词： Recombinant human thrombopoietin invasive procedures Chronic liver disease Liver cirrhosis Thrombocytopenia Platelet transfusion

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Viscoelastic tests in liver disease: where do we stand now?

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World Journal of Gastroenterology 2021年第23期27卷 3290-3302页

作者： Alina Buliarca Adelina Horhat Tudor Mocan Rares Craciun Bogdan Procopet Zeno Sparchez The Third Medical Department “Iuliu Hatieganu”University of Medicine and PharmacyInstitute for Gastroenterology and Hepatology“Prof.Dr.O.Fodor”Cluj-Napoca 400162Romania

Hemostasis is a complex physiological process based on the balance between procoagulant and anticoagulant systems to avoid pathological bleeding or *** changes in standard coagulation tests in liver disease were assumed to reflect an acquired bleeding disorder,and cirrhotic patients were considered naturally *** the light of the new evidence,the theory of rebalanced hemostasis replaced the old *** to this model,the hemostatic alteration leads to a unique balance between pro-coagulant,anticoagulant,and fibrinolytic *** the balance is fragile and may prone to bleeding or thrombosis depending on various risk *** standard coagulation tests[INR(international normalized ratio),platelet count and fibrinogen]only explore parts of the hemostasis,not offering an entire image of the *** thromboelastometry(ROTEM)and thromboelastography(TEG)are both point of care viscoelastic tests(VET)that provide real-time and dynamic information about the entire hemostasis process,including clot initiation(thrombin generation),clot kinetics,clot strength,and clot stability(lysis).Despite prolonged PT/INR(international normalized ratio of prothrombin time)and low platelet counts,VET is within the normal range in many patients with both acute and chronic liver ***,bleeding remains the dominant clinical issue in patients with liver diseases,especially when invasive interventions are *** has been shown to asses more appropriately the risk of bleeding than conventional laboratory tests,leading to decrial use of blood products *** clotting is common but often subtle and may be challenging to predict even with the help of *** VET has shown its benefit,more studies are needed to establish cut-off values for TEG and ROTEM in these populations and standardization of transfusion guidelines before invasive interventions in cirrhotic patients/orthotopic liver transplantation.

关键词： Liver diseases Viscoelastic tests Portal vein thrombosis Acute-on-chronic liver failure Bleeding risk invasive procedures

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