Search

Background: Collaborative multidisciplinary approaches in obstetrics, particularly in conjunction with Intensive Care Units (ICUs), offer innovative treatment strategies for critically ill pregnant women. This study aimed to assess pregnancy outcomes and mortality in critically ill pregnant women in the Intensive Care Unit (ICU) and to provide valuable clinical insights for improving the management of obstetric emergency care, reducing maternal and neonatal adverse outcomes, and improving the level of obstetric care. Methods: This study retrospectively included 152 critically ill pregnant women admitted to the ICU. They were grouped according to the main reason for ICU admission as well as the variety of diseases present at the time of admission. Then their clinical data were evaluated. Results: The results showed that the main obstetric factors leading to ICU admission were pregnancy-related hypertensive disease, postpartum hemorrhage, and acute fatty liver of pregnancy; the non-obstetric factors included either pregnancy complicated by heart disease, sepsis, or malignant tumors. The maternal mortality rate was higher in the non-obstetric direct factor group than in the obstetric direct factor group (22.12% vs. 6.25%, p = 0.016). As for the pregnancy outcome, the cesarean section rate in the group affected by obstetric factors was significantly higher than that in the group affected by non-obstetric factors (p = 0.008). Furthermore, the incidence of pregnancy termination and induced abortion before 28 weeks in the group affected by non-obstetric factors was significantly higher than that in the group affected by obstetric factors (all p < 0.05). There was a statistically significant difference in mortality among the three groups of patients with different SOFA scores (p = 0.000), suggesting that the mortality of critically ill pregnant women with higher SOFA scores increased, making it a valuable tool for evaluating prognosis. Conclusion: Non-obstetric factors were the primary contributors for ICU admission of expecting mothers. Therefore, utilizing modalities that successfully analyze these factors can aid in understanding the characteristics of critically ill pregnant women, and advancing perinatal healthcare technologies to reduce maternal mortality rates. [ABSTRACT FROM AUTHOR]

Background: Hemophagocytic lymphohistiocytosis (HLH) is a severe hyperinflammatory syndrome characterized by excessive activation of NK cells and cytotoxic T lymphocytes, subsequently leading to macrophage activation and increased cytokine production. Misdiagnosis due to nonspecific clinical presentations and inadequate understanding of the disease can significantly jeopardize the safety of both the mother and the infant. We report a case of pregnancy combined with HLH and conduct a literature review to provide insights into the diagnosis and treatment of pregnancy-related HLH. Case Presentation: We discussed a case of a pregnant woman with persistent postpartum fever, serum ferritin, and elevated liver function, who failed to respond to repeated anti-infective therapy and was diagnosed with HLH after multidisciplinary diagnostic treatment. We gave dexamethasone treatment, and the patient's temperature and blood cells quickly returned to normal. Finally, exome sequencing revealed heterozygous variation in UNC13D gene, so we considered this case as pregnancy combined with primary HLH (pHLH). Conclusion: We report the case of HLH diagnosed during pregnancy and show that early diagnosis and timely intervention can prevent rapid disease progression, reduce maternal mortality rates, and improve survival rates. Additionally, molecular genetic testing can confirm pathogenic gene mutations, providing essential genetic counseling for patients with pHLH who plan to conceive a healthy child. [ABSTRACT FROM AUTHOR]

Background: COX20-related mitochondrial complex IV deficiency is a rare autosomal recessive metabolic disorder that arises from biallelic loss-of-function mutations. Given the lack of specific treatments, affected children are at a heightened risk of disability. Consequently, prenatal counseling and prenatal diagnosis should be conducted to reduce the birth rate of children with such mitochondrial diseases. We report a case of COX20 gene associated mitochondrial complex IV deficiency in a child, and describe the prenatal counseling and prenatal diagnosis of the mother in subsequent pregnancies to provide reference for prenatal counseling and prenatal diagnosis of this disease., Case Presentation: In this study, we presented a case of a pediatric patient who displayed symptoms such as gait instability, ataxia, cognitive impairment, dysarthria, muscle weakness, and absent reflexes. Through the application of whole-exome sequencing (WES), compound heterozygous COX20 mutations (c.41A>G and c.259C>T) were detected, leading to the confirmation of a diagnosis of mitochondrial complex IV deficiency. A thorough review of the existing literature revealed seven additional cases carrying the same mutations. Moreover, this report delineated the process of prenatal counseling and diagnostic testing that was undertaken for the subsequent pregnancy of the patient's mother., Conclusion: The presence of ataxia, cognitive impairment, and peripheral neuropathy in children should prompt consideration of COX20-related mitochondrial disease. Utilizing WES is beneficial for identifying COX20 mutations, and offering prenatal counseling and diagnostic testing to mothers of affected children can reduce the birth rate of children with such mitochondrial diseases., Competing Interests: The authors report no conflicts of interest in this work., (© 2025 Su et al.)