Thromboembolism

Ovarian Hyperstimulation Syndrome on the Acute Medical Unit: A problem-based review

Research Audit and Clinical Practice, Volume 14, Issue 1, Pages 1 - 40 (2015)

Abstract

Ovarian Hyperstimulation Syndrome (OHSS) is a spectrum of clinical features typically resulting from assisted conception techniques. With 2.35% of all live births in the UK resulting from in-vitro fertilisation (IVF), OHSS is on the rise. Moreover, there has been an increase in the presentation of its complications to GP surgeries and unscheduled acute care services nationwide. This review will discuss signs and symptoms of the increasingly common and potentially fatal complications of OHSS, namely pleural effusion, ascites and thromboembolic events. With such propensity toward critical, life-threatening events it is not only prudent to recognise the population at risk, but also to be aware of the signs, symptoms and complications to expedite treatment and ensure optimum outcome.

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Stroke due to Thromboembolism from Congenital Aneurysm of Ventricular Septum

Case Reports, Volume 7, Issue 1, Pages 1 - 60 (2008)

We describe the case of a 46-year-old female who presented with recurrent episodes of cerebrovascular events. She had an unremarkable family history and no risk factors for stroke, apart from smoking. A transthoracic echocardiogram with ‘bubble’ contrast was normal. However transoesophageal echocardiography demonstrated an aneurysm of the membranous part of the ventricular septum, representing the likely source of thrombo-embolisation. This case highlights the need for a systematic and rigorous approach to the investigation of young patients with stroke.

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Management of Medical Emergencies in Pregnancy

Clinical Reviews, Volume 1, Issue 3, Pages 77 - 117 (2002)

Abstract

Medical emergencies in pregnant women pose many challenges if both the baby and mother are to have an optimal outcome. Multidisciplinary team working is essential to ensure that the correct treatment is offered, and that potentially lifesaving options are not discarded because of unwarranted concerns about safety in pregnancy. Expertise should be sought from doctors with a special interest in obstetric medicine.

Clinical problems include those unique to pregnancy such as eclampsia or acute fatty liver of pregnancy, exacerbations of chronic medical diseases some of which can be predicted such as pulmonary hypertension, or conditions which have an increased frequency in pregnancy including thromboembolism, urinary tract infection and Bell’s palsy. Cardiopulmonary resuscitation in pregnancy should be managed in the left lateral position, with early recourse to delivery of the fetus.

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