Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
A puerperal disorder is a disorder which presents primarily during the puerperium.
An example is postpartum thyroiditis.
Puerperal disorders may be associated with psychiatric illness in offspring.
Alcohol withdrawal states (delirium tremens) are recognized in addicts whose intake has been interrupted by trauma or surgery. This can occur after childbirth.
Arterial occlusion may be due to thrombi, amniotic fragments or air embolism. Postpartum cerebral angiopathy is a transitory arterial spasm of medium caliber cerebral arteries; it was first described in cocaine and amphetamine addicts, but can also complicate ergot and bromocriptine prescribed to inhibit lactation. Subarachnoid haemorrhage can occur after miscarriage or childbirth. Epidural anaesthesia can, if the dura is punctured, lead to leakage of Cerebrospinal fluid and subdural haematoma. All these can occasionally present with psychiatric symptoms.
Patients with pancreatic abscesses may experience abdominal pain, chills and fever or the inability to eat. Whereas some patients present an abdominal mass, others do not. Nausea and vomiting may also occur.
An unremoved infected abscess may lead to sepsis. Also, multiple abscesses may occur. Other complications may include fistula formation and recurrent pancreatitis.
Uterine hyperstimulation or hypertonic uterine dysfunction is a potential complication of labor induction. It is defined as either a series of single contractions lasting 2 minutes or more OR a contraction frequency of five or more in 10 minutes. Uterine hyperstimulation may result in fetal heart rate abnormalities, uterine rupture, or placental abruption. It is usually treated by administering terbutaline.
Vasitis nodosa is a complication experienced in approximately 66% of men who undergo vasectomy. It is a benign nodular thickening of the vas deferens, in which small offshoots proliferate, infiltrating surrounding tissue. It can be mistaken for low-grade adenocarcinoma by pathologists, and is implicated in late vasectomy failure.
Uterine inversion is a potentially fatal childbirth complication with a maternal survival rate of about 85%. It occurs when the placenta fails to detach from the uterus as it exits, pulls on the inside surface, and turns the organ inside out. It is very rare.
Bloody show is the passage of a small amount of blood or blood-tinged mucus through the vagina near the end of pregnancy. It can occur just before labor or in early labor as the cervix changes shape, freeing mucus and blood that occupied the cervical glands or cervical os. Bloody show is a relatively common feature of pregnancy, and it does not signify increased risk to the mother or baby . A larger amount of bleeding, however, may signify a more dangerous, abnormal complication of pregnancy, such as placental abruption or placenta previa. Large amounts of bleeding during or after childbirth itself may come from uterine atony or laceration of the cervix, vagina, or perineum.
Three common signs of the onset of labor are:
1. A bloody show
2. Rupture of membranes ("Water breaking")
3. Onset of tightenings or contractions
However, these may occur at any time and in any order. Some women neither experience a bloody show nor have their "water break" until well into advanced labor. Therefore, neither bloody show nor rupture of membranes are required to establish labor.
Uterine inversion is often associated with significant Post-partum hemorrhage. Traditionally it was thought that it presented with haemodynamic shock "out of proportion" with blood loss, however blood loss has often been underestimated. The parasympathetic effect of traction on the uterine ligaments may cause bradycardia.
Uterine perforation is a potential complication of any intrauterine procedure. It may be associated with injury to surrounding blood vessels or viscera such as the bladder or intestine. If not diagnosed at the time of the procedure it can occasionally result in massive hemorrhage or sepsis; however, the majority of uterine perforations are sub-clinical and safely resolve by themselves without treatment and do not cause any significant long-term damage. Risk factors include cervical stenosis during trans-cervical procedures or decreased strength of the myometrial wall as in pregnancy or menopause.
Subinvolution is a medical condition in which after childbirth, the uterus does not return to its normal size.
An obstetric labor complication is a difficulty or abnormality that arises during the process of labor or delivery.
An example is dystocia.
The condition may be asymptomatic. The predominant symptoms are:
- Abnormal lochial discharge either excessive or prolonged
- Irregular or at times excessive uterine bleeding
- Irregular cramp like pain is cases of retained products or rise of temperature in sepsis
Hematocolpos is a medical condition in which the vagina fills with menstrual blood. It is often caused by the combination of menstruation with an imperforate hymen. It is sometimes seen in Robinow syndrome, uterus didelphys, or other congenital conditions.
A related disorder is hematometra, where the uterus fills with menstrual blood. It presents after puberty as primary amenorrhoea, recurrent pelvic pain with a pelvic mass. This can be caused by a congenital stenosis of the cervix, or by a complication of a surgical treatment.
A Suprapubc bulge is caused by hematocolpos. Vaginal introitus shows a blue bulging membrane.
Severe pain in perimastoid region, difficulty of swallowing, sore throat, difficulty in breathing, nuchal rigidity, and fever.
Bezold's Abscess is an abscess deep to sternocleidomastoid muscle where pus from mastoiditis erodes through the cortex of Mastoid part of the temporal bone, medial to the attachment of sternocleidomastoid, extends into the infratemporal fossa, and deep to the investing layer of the deep cervical fascia . It is a rare complication of acute otitis media.
Other symptoms of the syndrome include:
- retroorbital pain due to pain in the area supplied by the ophthalmic branch of the trigeminal nerve (fifth cranial nerve),
- abducens nerve palsy (sixth cranial nerve), and
- otitis media.
Other symptoms can include photophobia, excessive lacrimation, fever, and reduced corneal sensitivity.
The syndrome is usually caused by the spread of an infection into the petrous apex of the temporal bone.
A popping or cracking sound, significant pain, swelling, immediate loss of erection leading to flaccidity, and skin hematoma of various sizes are commonly associated with the sexual event.
Diversion colitis is an inflammation of the colon which can occur as a complication of ileostomy or colostomy, often occurring within the year following the surgery. It also occurs frequently in a neovagina created by colovaginoplasty, with varying delay after the original procedure. Despite the presence of a variable degree of inflammation the most suggestive histological feature remains the prominent lymphoid aggregates. A foul smelling, mucous rectal discharge may develop from the inflamed mucosa of the distal, unused colon.
The diagnosis cannot be safely reached without knowing the clinical story. In many milder cases after ileostomy or colostomy, diversion colitis is left untreated and disappears naturally. If treatment is required, possible treatments include short-chain fatty acid irrigation, steroid enemas and mesalazine.
Obliterating endarteritis also called "obliterating arteritis" is severe proliferating endarteritis (inflammation of the intima or inner lining of an artery) that results in an occlusion of the lumen of the artery. Obliterating endarteritis can occur due to a variety of medical conditions such as a complication of radiation poisoning, tuberculosis meningitis or a syphilis infection.
Acute fatty liver of pregnancy (or hepatic lipidosis of pregnancy) usually manifests in the third trimester of pregnancy, but may occur any time in the second half of pregnancy, or in the puerperium, the period immediately after delivery. On average, the disease presents during the 35th or 36th week of pregnancy. The usual symptoms in the mother are non-specific including nausea, vomiting, anorexia (or lack of desire to eat) and abdominal pain; excessive thirst may be the earliest symptom without overlap with otherwise considered normal pregnancy symptoms; however, jaundice and fever may occur in as many as 70% of patients.
In patients with more severe disease, pre-eclampsia may occur, which involves elevation of blood pressure and accumulation of fluid (termed oedema). This may progress to involvement of additional systems, including acute renal failure, hepatic encephalopathy, and pancreatitis. There have also been reports of diabetes insipidus complicating this condition.
Many laboratory abnormalities are seen in acute fatty liver of pregnancy. Liver enzymes are elevated, with the AST and ALT enzymes ranging from minimal elevation to 1000 IU/L, but usually staying in the 300-500 range. Bilirubin is almost universally elevated. Alkaline phosphatase is often elevated in pregnancy due to production from the placenta, but may be additionally elevated. Other abnormalities may include an elevated white blood cell count, hypoglycemia, elevated coagulation parameters, including the international normalized ratio, and decreased fibrinogen. Frank disseminated intravascular coagulation, or DIC, may occur in as many as 70% of people.
Abdominal ultrasound may show fat deposition in the liver, but, as the hallmark of this condition is microvesicular steatosis (see pathology below), this is not seen on ultrasound. Rarely, the condition can be complicated by rupture or necrosis of the liver, which may be identified by ultrasound.
Penile fracture is rupture of one or both of the "tunica albuginea", the fibrous coverings that envelop the penis's "corpora cavernosa". It is caused by rapid blunt force to an erect penis, usually during vaginal intercourse, or aggressive masturbation. It sometimes also involves partial or complete rupture of the urethra or injury to the dorsal nerves, veins and arteries.
Spondylodiscitis is the most common complication of sepsis or local infection, usually in the form of an abscess. The main causative organisms are staphylococci and Mycobacterium tuberculosis, but potential organisms include a large number of bacteria, fungi, zoonoses. Spondylodiscitis frequently develops in immunocompromised individuals, such as by a cancer, infection, or by immunosuppressive drugs used for organ transplantations.