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Cardiovascular disease, and particularly ischemic heart disease, is a leading cause of maternal morbidity and mortality in high-income countries. The incidence of acute myocardial infarction has been rising over the past 2 decades due to increasing maternal age and a higher prevalence of cardiovascular risk factors in the pregnant population. Causes of acute myocardial infarction in pregnancy are diverse and may require specific considerations for their diagnosis and management. In this narrative review, we provide an overview of physiologic changes, risk factors, and etiologies leading to acute myocardial infarction in pregnancy, as well as diagnostic tools, reperfusion strategies, and pharmacological treatments for this complex condition. In addition, we outline considerations for labor and delivery planning and long-term follow-up of patients with acute myocardial infarction in pregnancy.

Objective To evaluate the change in the proportion of deaths/bronchopulmonary dysplasia (BPD) among premature infants (born Study design We examined 1249 infants (341 born Results Baseline characteristics were similar across sites and epochs. Medical treatment/ligation use remained stable at site 1 but declined progressively to 0% at site 2, indicating adherence to policy. We saw no difference in death/BPD among infants born at 26-29 weeks of gestational age (12%, 95% CI -1% to 24%). However, incidence of death/BPD increased by 31% among infants born Conclusions Adherence to a strict conservative policy did not impact death or BPD among 26 weeks but was associated with a significant rise in infants born

Background Intrathoracic kidney is a rare congenital anomaly, with only 13 cases reported in the pediatric age group over the past 25 years. The relevant literature is limited to individual case reports or small case series with no follow-up data. Both operative and nonoperative management has been advocated. We report our experience in the management of children with an intrathoracic kidney as well as the efficacy of nonoperative management in select patients. Methods Five cases of intrathoracic kidney were collected prospectively since 1992 and carefully followed up long term. Results Two children presented with acute respiratory distress and underwent right diaphragmatic hernia repair and nephropexy. Incidental diagnosis of a left intrathoracic kidney was made in 3 children. Long-term follow-up has demonstrated normal function and development of these kidneys in all 5 children with no late bowel herniation in the nonoperative group. Conclusion Intrathoracic kidney associated with bowel in the chest should undergo standard repair and nephropexy. An isolated intrathoracic kidney without evidence of bowel herniation can safely be observed. This is the largest pediatric series of intrathoracic kidney as well as the first to document the efficacy of nonoperative management with long-term follow-up.