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Demartini B, Nisticò V, Limonta S, Tarantino V, Stefanelli G, Calistro F, Giambanco L, Faggioli R, Gambini O, Turriziani P. Long-term Memory of Sensory Experiences from the First Pregnancy, its Peri-partum and Post-partum in Women with Autism Spectrum Disorders without Intellectual Disabilities: A Retrospective Study. J Autism Dev Disord 2023:10.1007/s10803-023-06189-y. [PMID: 37966534 DOI: 10.1007/s10803-023-06189-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE To explore the recalled experience of pregnancy and motherhood in women diagnosed with Autism Spectrum Disorders (ASD) without intellectual disabilities, focusing on sensory perceptions and mood. METHODS We retrospectively evaluated, through an ad-hoc structured interview, the sensory sensitivity during the pre-partum, the peri-partum, and the post-partum of thirty-three mothers with ASD and thirty-two neurotypical mothers. Participants also underwent a psychometric assessment about autistic traits, general sensory sensitivity, and post-partum depressive symptomatology. RESULTS Mothers with ASD recalled a higher sensitivity than the comparison group across the three time-points; however, during the peri-partum their recalled hypersensitivity decreases, and in the post-partum it returned as high as before childbirth. The difference in the length of recall between groups did not statistically influence our results. Higher levels of autistic traits correlated with higher depressive post-partum symptomatology. CONCLUSIONS Mothers with ASD seem to recall their experience of pregnancy, childbirth, and post-partum period differently from neurotypical mothers, particularly in terms of hypersensitivity. The correlation with depressive symptoms and the potential role of oxytocin and of long-term memory (encoding and recollection) are discussed. Further exploring these aspects might give fundamental hints to provide tailored support to mothers with ASD during pregnancy and motherhood.
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Affiliation(s)
- Benedetta Demartini
- Unità di Psichiatria 51 e 52, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
- "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milano, Italy
| | - Veronica Nisticò
- "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milano, Italy.
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Presidio San Paolo, via A. Di Rudinì, 8, Milano, 20142, Italy.
- Dipartimento di Psicologia, Università degli Studi di Milano-Bicocca, Milano, Italy.
| | - Serena Limonta
- Scuola di Specializzazione in Psichiatria, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Vincenza Tarantino
- Dipartimento di Scienze Psicologiche, Pedagogiche, dell'Esercizio Fisico e della Formazione, Università degli Studi di Palermo, Palermo, Italy
| | - Giulia Stefanelli
- Unità di Psichiatria 51 e 52, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | | | - Laura Giambanco
- U.O.C. Ostetricia e Ginecologia, Presidio Ospedaliero S.Antonio Abate, Trapani, Italy
| | - Raffaella Faggioli
- Unità di Psichiatria 51 e 52, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
| | - Orsola Gambini
- Unità di Psichiatria 51 e 52, Presidio San Paolo, ASST Santi Paolo e Carlo, Milano, Italy
- "Aldo Ravelli" Research Center for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milano, Italy
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Presidio San Paolo, via A. Di Rudinì, 8, Milano, 20142, Italy
| | - Patrizia Turriziani
- Dipartimento di Scienze Psicologiche, Pedagogiche, dell'Esercizio Fisico e della Formazione, Università degli Studi di Palermo, Palermo, Italy
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Schamroth Pravda N, Houri O, Kornowski R, Porter A. Clinical considerations during spontaneous coronary artery dissection in the post-partum period: a case report. Eur Heart J Case Rep 2023; 7:ytad406. [PMID: 37637097 PMCID: PMC10448854 DOI: 10.1093/ehjcr/ytad406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 08/29/2023]
Abstract
Background Spontaneous coronary artery dissection (SCAD) is a common and under-recognized cause of myocardial infarction during the post-partum period. Case summary We report a case of a young women presenting with chest pain in the post-partum period. Her clinical appearance was that of a myocardial infarction, and angiography was indicative of a Type 2 SCAD. The patients had persistent chest pain, reduced left ventricular function, and critical left anterior descending artery stenosis. Percutaneous coronary intervention was done with caution. Shared decision-making with the patient helped guide the medical treatment plan and follow-up. Discussion We discuss the clinical considerations surrounding the management of this patient.
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Affiliation(s)
- Nili Schamroth Pravda
- Department of Cardiology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Street, Petach Tikva 49100, Israel
- The Faculty of Medicine, Tel Aviv University, 35 Klatchkin Street, Tel Aviv 6997801, Israel
| | - Ohad Houri
- The Faculty of Medicine, Tel Aviv University, 35 Klatchkin Street, Tel Aviv 6997801, Israel
- Department of Obstetrics and Gynecology, Rabin Medical Center, 39 Jabotinsky Street, Petach Tikva 49100, Israel
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Street, Petach Tikva 49100, Israel
- The Faculty of Medicine, Tel Aviv University, 35 Klatchkin Street, Tel Aviv 6997801, Israel
| | - Avital Porter
- Department of Cardiology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Street, Petach Tikva 49100, Israel
- The Faculty of Medicine, Tel Aviv University, 35 Klatchkin Street, Tel Aviv 6997801, Israel
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Tan HS, Habib AS. Peri-operative anaesthetic management of women with obesity. Best Pract Res Clin Obstet Gynaecol 2023; 89:102335. [PMID: 37290264 DOI: 10.1016/j.bpobgyn.2023.102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/27/2023] [Accepted: 03/31/2023] [Indexed: 06/10/2023]
Abstract
Obesity in women is prevalent and growing at an alarming pace worldwide, resulting in significant healthcare and socioeconomic consequences. Obesity is a multisystemic disease that is associated with numerous comorbidities, particularly sleep-disordered breathing, hypertension, coronary artery disease, pulmonary hypertension, thromboembolism, and diabetes mellitus. Additionally, obesity poses several peri-operative challenges including difficulty with airway management and mechanical ventilation, challenges with intravenous access or regional blocks, the need for modified anaesthetic drug dosing, the requirement for correctly sized and rated equipment, and appropriate post-operative monitoring. Therefore, early multidisciplinary planning is crucial to identify and address important peri-operative and clinical issues. Parturients with obesity are especially at high risk due to the additional physiological changes and obstetric comorbidities associated with obesity. Antenatal anaesthetic consultation along with close communication and collaboration within the multidisciplinary team are important to improve maternal and neonatal safety.
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Affiliation(s)
- Hon Sen Tan
- Department of Women's Anaesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Ashraf S Habib
- Department of Anesthesiology, Duke University Medical Center, Box 3094, Durham, NC, 27710, USA. https://twitter.com/ashrafhabib5
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Sidibe S, Perazzini C, Cassagnes L, Boyer L, Magnin B. The role of computed tomography in adrenal gland infarction diagnosis during pregnancy: Two case reports. J Med Vasc 2020; 46:28-31. [PMID: 33546818 DOI: 10.1016/j.jdmv.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Seydou Sidibe
- Radiology Department, University Hospital Gabriel Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - Chiara Perazzini
- Radiology Department, University Hospital Gabriel Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
| | - Lucie Cassagnes
- Radiology Department, University Hospital Gabriel Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - Louis Boyer
- Radiology Department, University Hospital Gabriel Montpied, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - Benoit Magnin
- Radiology Department, University Hospital Estaing, Clermont-Ferrand, France
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Moossdorff-Steinhauser HFA, Bols EMJ, Spaanderman MEA, Dirksen CD, Weemhoff M, Nieman FHM, Berghmans B. Long-term effects of motherfit group therapy in pre-(MOTHERFIT1) and post-partum women (MOTHERFIT2) with stress urinary incontinence compared to care-as-usual: study protocol of two multi-centred, randomised controlled trials. Trials 2019; 20:237. [PMID: 31023381 PMCID: PMC6485130 DOI: 10.1186/s13063-019-3331-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/25/2019] [Indexed: 11/13/2022] Open
Abstract
Background Stress urinary incontinence (SUI) is highly prevalent during pregnancy and after delivery. It is often associated with a failing pelvic floor, sphincteric and/or supportive system. Pelvic-floor-muscle training (PFMT) peri-partum has been proven effective for up to 1 year post-partum; however, its long-term effects are unknown. Group PFMT, given by a physiotherapist, has been proven to be as equally effective as individual therapy. Motherfit is a group-PFMT therapy with an emphasis on pelvic floor exercises, adherence and general fitness. Care-as-usual (CAU), if guideline driven, should, as first treatment option, consist of PFMT. Cost-effective strategies are of relevance, given the rise of health care costs. Motherfit group therapy has the potential to be cost-effective in women with urinary incontinence. Therefore, the objectives of the two current studies are: (1) to investigate whether intensive, supervised, pre-partum (MOTHERFIT1) or post-partum (MOTHERFIT2) pelvic-floor-muscle group therapy reduces 18-month post-partum severity of SUI compared to CAU and (2) whether MOTHERFIT1 OR MOTHERFIT 2 is more (cost-)effective compared to CAU. Methods Two multi-centred, randomised controlled trials (MOTHERFIT1, n = 150, MOTHERFIT2, n = 90) will be performed. Participants will be recruited by their midwife or gynaecologist during their routine check. Participants with SUI will receive either motherfit group therapy or CAU. Motherfit group therapy consists of eight group sessions of 60 min each, instructed and supervised by a registered pelvic physiotherapist. Motherfit group therapy includes instructions on pelvic floor anatomy and how to contract, relax and train the pelvic-floor muscles correctly and is combined with general physical exercises. Adherence during and after motherfit will be stimulated by reinforcement techniques and a mobile app. The primary outcome measure is the absence of self-reported SUI based on the severity sum score of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF) at 18 months post-partum. Secondary outcomes evaluate quality of life, subjective improvement and health care costs. Discussion The motherfit studies are, to our knowledge, the first studies that evaluate both long-term results and health care costs compared to CAU in pregnant and post-partum women with SUI. If motherfit is shown to be (cost-)effective, implementation in peri-partum care should be considered. Trial registration Netherlands Trial Register, ID: NL5816. Registered on 18 July 2016. Electronic supplementary material The online version of this article (10.1186/s13063-019-3331-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Heidi F A Moossdorff-Steinhauser
- Faculty of Health, Medicine and Life Sciences, Department Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
| | - Esther M J Bols
- Faculty of Health, Medicine and Life Sciences, Department Epidemiology, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands
| | - Marc E A Spaanderman
- Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.,Department of Obstetrics and Gynecology, Maastricht, The Netherlands
| | - Carmen D Dirksen
- Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.,Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht, The Netherlands
| | - Mirjam Weemhoff
- Department of Obstetrics and Gynecology, Zuyderland Medisch Centrum, P.O. Box 5500, 6130, MB, Sittard-Geleen, The Netherlands
| | - Fred H M Nieman
- Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
| | - Bary Berghmans
- Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.,Pelvic Care Center Maastricht, Maastricht, The Netherlands
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Chniter M, Salhi I, Harrabi H, Khorchani T, Lainé AL, Nowak R, Hammadi M. Physiological changes in the peri-partum period and colostral IgG transfer in prolific D'man sheep: effects of parity and litter size. Trop Anim Health Prod 2015; 48:387-94. [PMID: 26644226 DOI: 10.1007/s11250-015-0963-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 11/23/2015] [Indexed: 11/24/2022]
Abstract
The aim of this work was to assess maternal and neonatal changes in plasma proteins, glucose and cortisol and to quantify the colostral immunoglobulin G (IgG) transfer in the peri-partum period in D'man sheep, a prolific breed, taking into account the parity of the ewe. The concentrations of proteins and glucose were high in the ewes on day 7 and at lambing before decreasing. Likewise, cortisol plasma concentration was maximal during the 6 h following lambing and dropped at 12 h. Protein and glucose concentrations were low in lambs at 1 h of birth after which they increased. By contrast, cortisol level was the highest during the first 12 h of birth and then decreased. The colostral IgG level was high at lambing and dropped by over 87 % from 1 to 48 h post-partum. In the newborn, the plasma IgG concentration was lowest at birth and increased rapidly during the first 24 h of birth. Parity influenced maternal physiology with multiparous ewes having the lowest concentrations of proteins, glucose, IgG and cortisol, but the highest colostrum IgG level. Accordingly, lambs born from primiparous ewes had lower protein, glucose and plasma IgG concentrations than lambs born from multiparous ewes. The main outcome of this study was that lambs born from primiparous ewes are characterized by the lowest physiological indices and this may influence their survival chance.
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Affiliation(s)
- Mohamed Chniter
- Laboratoire d'Elevage & Faune Sauvage, Institut des Régions Arides, 4119, Médenine, Tunisia.
| | - Imed Salhi
- Laboratoire d'Elevage & Faune Sauvage, Institut des Régions Arides, 4119, Médenine, Tunisia
| | - Hager Harrabi
- Laboratoire d'Elevage & Faune Sauvage, Institut des Régions Arides, 4119, Médenine, Tunisia
| | - Touhami Khorchani
- Laboratoire d'Elevage & Faune Sauvage, Institut des Régions Arides, 4119, Médenine, Tunisia
| | - Anne-Lyse Lainé
- INRA, UMR85 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France.,CNRS, UMR7247 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France.,Université François Rabelais de Tours, F-37041, Tours, France.,Institut Français du Cheval et de l'Equitation, F-37380, Nouzilly, France
| | - Raymond Nowak
- INRA, UMR85 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France.,CNRS, UMR7247 Physiologie de la Reproduction et des Comportements, F-37380, Nouzilly, France.,Université François Rabelais de Tours, F-37041, Tours, France.,Institut Français du Cheval et de l'Equitation, F-37380, Nouzilly, France
| | - Mohamed Hammadi
- Laboratoire d'Elevage & Faune Sauvage, Institut des Régions Arides, 4119, Médenine, Tunisia
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El ghadbane Abdedaim H, el abidine Benali Z, Omari D, Mohammed D, Hicham B, Charki H. Peri-partum cardiomyopathy in a pregnant woman at term revealed by acute pulmonary edema: what to do in front this catastrophic situation? Pan Afr Med J 2014; 18:29. [PMID: 25368718 PMCID: PMC4214563 DOI: 10.11604/pamj.2014.18.29.3782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 05/01/2014] [Indexed: 11/11/2022] Open
Abstract
Peripartum cardiomyopathy is insufficient congestive heart occurring in the last month of pregnancy and 5 months after delivery, in the absence of preexisting heart disease and identified etiology. This heart disease is associated with echocardiography systolic dysfunction and left ventricular dilatation. Its incidence ranges from 1/3000 to 1/15000, depending on the region, including much higher in some African countries, it particularly concern women over 30 years, multiparous and multiple pregnancies. The pathogenesis remains unclear, the prognosis is closely related to the complete recovery of cardiac function. We report through the clinical case of a woman aged 33 years admitted to the ICU for acute pulmonary edema of sudden onset of a term pregnancy and what to do before this critical situation.
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Affiliation(s)
- Hatim El ghadbane Abdedaim
- Department of Anesthesiology & Intensive Care, Military Hospital Mohammed V, University Mohammed V Souissi, Rabat, Morocco
| | | | - Driss Omari
- Department of Internal Medicine and Cardiovascular Diseases, CHP Eddarak, Berkane, Morocco
| | - Drissi Mohammed
- Department of Anesthesiology & Intensive Care, Military Hospital Mohammed V, University Mohammed V Souissi, Rabat, Morocco
| | - Balkhi Hicham
- Department of Anesthesiology & Intensive Care, Military Hospital Mohammed V, University Mohammed V Souissi, Rabat, Morocco
| | - Haimeur Charki
- Department of Anesthesiology & Intensive Care, Military Hospital Mohammed V, University Mohammed V Souissi, Rabat, Morocco
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