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9. Association Between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights From the BRO-HF Quebec Cohort Study

Author

Pacheco, Christine, Tremblay-Gravel, Maxime, Marquis-Gravel, Guillaume, Couture, Etienne, Avram, Robert, Desplantie, Olivier, Bibas, Lior, Simard, François, Malhamé, Isabelle, Poulin, Anthony, Tran, Dan, Senechal, Mario, Afilalo, Jonathan, Farand, Paul, Bérubé, Lyne, Jolicoeur, E. Marc, Ducharme, Anique, and Tournoux, François

Published
2022
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16. Remdesivir and three other drugs for hospitalised patients with COVID-19: final results of the WHO Solidarity randomised trial and updated meta-analyses

Author

Pan, Hongchao, Peto, Richard, Henao Restrepo, Ana Maria, Preziosi, Marie-Pierre, Sathiyamoorthy, Vasee, Karim, Quarraisha Abdool, Alejandria, Marissa, Hernàndez García, César, Kieny, Marie-Paule, Malekzadeh, Reza, Murthy, Srinivas, Reddy, K. Srinath, Periago, Mirta Roses, Hanna, Pierre Abi, Abutidze, Akaki, Ader, Florence, Al-Bader, Abdullah, Alhasawi, Almonther, Allum, Emma, Al Mawali, Adhra, Alotaibi, Athari, Alvarez- Moreno, Carlos, Appadoo, Sheila, Arts, Derk, Asiri, Abdullah, Aukrust, Pål, Barratt-Due, Andreas, Genetu Bayih, Abebe, Beaumont, Helena, Bellani, Samir, Benassi, Virginia, Bhargava, Balram, Branca, Mattia, Cappel-Porter, Heike, Cerrato, Nery, Cheick Haidara, Fadima, Chow, Ting Soo, Como, Nadia, Eustace, Joe, Gabunia, Tamar, García, Patricia, Godbole, Sheela, Gotuzzo, Eduardo, Griskevicius, Laimonas, Hamra, Rasha, Hassan, Mariam, Hassany, Mohamed, Hutton, David, Irmansyah, Irmansyah, Jancoriene, Ligita, Khamis, Faryal, Kirwan, Jana, Kumar, Suresh, Lennon, Peter, Lopardo, Gustavo, Lydon, Patrick, Magrini, Nicola, Manevska, Suzana, Manuel, Oriol, McGinty, Sybil, Medina, Marco, Mesa Rubio, Maria Lucia, Miranda Montoya, Maria Consuelo, Nel, Jeremy, Nunes, Estevao, Perola, Markus, Portoles, Antonio, Rasmin, Menaldi, Raza, Aun, Rees, Helen, Reges, Paula, Rogers, Chris, Salami, Kolawole, Salvadori, Marina, Sauermann, Mamatha, Sinani, Narvina, Sow, Samba, Sterne, Jonathan AC, Stevanovikj, Milena, Tacconelli, Evelina, Tavares Maltez, Fernando Manuel, Teferi, Mekonnen, Tikkinen, Kari, Trelle, Sven, Tsertsvadze, Tengiz, Zaid, Hala, Røttingen, John-Arne, Swaminathan, Soumya, Ryan, Michael, Gjermeni, Nevila, Meta, Esmeralda, Aguila, Damian, Alonso, Ignacio, Altamirano, Marcos, Alvarez, María, Alzola, Rodrigo, Arce, Veronica, Arribillaga, Patricia, Avila, Rafael, Balbuena, Juan, Barcelona, Laura, Barletta, José, Benedetti, María, Berdiñas, Verónica, Burgui, Julieta, Caimi, Sabrina, Carrillo, Juan, Carrizo, Juan, Castelli, Juan, Cazaux, Alexis, Cervellino, Flavia, Chalco, Angelo, Chediack, Viviana, Cunto, Eleonora, D'Amico, Nicolàs, de Vedia, Lautaro, Delgado, Carolina, Di Pilla, Debora, Díaz, Miguel, Díaz Aguiar, Pablo, Domínguez, Cecilia, Ellero, Leonor, Farina, Javier, Fernàndez, José, Ferreyra, Roxana, Filippi, María, Fogar, Carolina, Frare, Pablo, Giudiche, Celeste, Golikow, Mariana, Gomez, Maria Georgina, Hermida, Laura, Hurtado, Mariano, Jacobo, Mariela, Jaume, Martin, Laplume, Diego, Lescano, María, Lista, Nicolàs, Loiacono, Flavia, López, Ana Belen, Losso, Marcelo, Luna, Cecilia, Lupo, Sergio, Marianelli, Leonardo, Martin, Anabella, Masciottra, Florencia, Mykietiuk, Analía, Orellano, Lorena, Pachioli, Valeria, Padilla, María José, Pallavicini, Cecilia, Patroso, Jazmin, Perez Blanco, Luz, Presas, Jose Louis, Provenzano, Matias, Lavera, Lorena, Reichert, Viviana, Riveros, Florencia, Rodríguez, Alejandra, Rolon, María José, Salvay, Carolina, Simonetta, María, Sisto, Alicia, Themines, Sandra, Tito, Fernando, Toibaro, Javier, Torales, Graciela, Verón, Luciano, Vizzotti, Carla, Egle, Alexander, Greil, Richard, Joannidis, Michael, Altdorfer, Antoine, Belkhir, Leila, Fraipont, Vincent, Hites, Maya, Arruda, Erico, Breda, Giovanni, Colussi, Arthur, Corradi, Miran, Croda, Julio, Duani, Helena, João, Esaú, Machado, Elizabeth, Mello, Fernanda, Miranda Filho, Demócrito, Monteiro, Poliana, Nunes, Ceuci, Pereira Junior, Luiz Carlos, Pinto, Gustavo, Raboni, Sonia, Ramos, Marcelo, Ruffing, Leonardo, Santos, Valdilea, Souza, Tamara, Medeiros, Melissa, Schwarzbold, Alexandre, Ali, Karim, Azher, Tanweer, Bellemare, David, Binnie, Alexandra, Borgia, Sergio, Cavayas, Yiorgos Alexandros, Chagnon, Nicholas, Cheng, Matthew, Cloutier, Eve, Conly, John, Costiniuk, Cecilia, Daneman, Nick, Douglas, James, Downey, Catarina, Duan, Erick, Durand, Medeline, English, Shane, Farjou, George, Fera, Evadiki, Fontela, Patricia, Fowler, Rob, Fralick, Mike, Gamble, David Gregory, Geagea, Anna, Grant, Jennifer, Harrison, Luke, Havey, Thomas, Hoang, Holly, Kelly, Lauren, Keynan, Yoav, Khwaja, Kosar, Klein, Marina, Kolan, Christophe, Kronfli, Nadine, Lamontagne, Francois, Lee, Nelson, Lee, Todd, Lim, Rachel, Lostun, Alexandra, MacIntyre, Erika, Malhamé, Isabelle, Martin-Carrier, Francois, McGuinty, Marlee, Munan, Matthew, O'Neil, Conar, Ovakim, Daniel, Papenburg, Jesse, Parhar, Ken, Parvathy, SeemaNair, Perez-Patrigeon, Santiago, Rishu, Asgar, Rushton, Moira, Scherr, Kim, Schwartz, Kevin, Semret, Makeda, Silverman, Micahel, Singh, Ameeta, Sligl, Wendy, Smith, Stephanie, Somayaji, Ranjani, Tan, Darrell, Tran, Tuong-Vi, Tremblay, Alain, Tsang, Jennifer, Turgeon, Alexis, Vakil, Erik, Weatherald, Jason, Yansouni, Cedric, Zarychanski, Ryan, Aristizabal, Claudia, Bravo, Juan, Caicedo, Monica, Chacón, Julio, Garzón, Diego, Guevara, Fredy, Lozano-Gonzàlez, Silvia, Macareno, Hugo, Montañez-Ayala, Anita, Oñate, Jose, Rojas-Gambasica, Jose, Rosso, Fernando, Saavedra, Carlos, Valderrama, Sandra, Vàquiro-Herrera, Eliana, Varón-Vega, Fabio, Zuluaga, Ivan, Abdel Baki, Amin, Abdelbary, Akram, Abdel-Razek, Wael, Amin, Wagdi, Asem, Noha, Elassal, Gehan, Elshesheny, Marwa, Fathy, Mohamed, Fathy, Naglaa, Fayed, Notaila, Hammam, Ahmed, Hassany, Sahar, Ibrahim, Hamdy, Kamal, Ehab, Masoud, Hossam, Mohamed, Maryam, Mohamed Gouda, Abdullah, Moustafa, Ehab, Okasha, Shaimaa, Rafik, Ahmed, Said, Ahmed, Sedky, Asmaa, Solyman Kabil, Mohamed, Tarek, Sara, Tharwat, Ahmed, Zaky, Samy, Abegaz, Emawayish Tesema, Bekele, Zelalem Mekonnen, Asfaw, Filmona Mekuria, Tegegne, Netsanet Aragaw, Teklemariam, Miheret Fikre, Nigusse, Frehiwot Tamiru, Achalu, Daniel Legesse, Weldegergs, Shewit Tesfagabr, Huluka, Dawit Kebede, Tereda, Addisu Birhanu, Ala-Kokko, Tero, Delany, Jutta, Ekroos, Heikki, Hankkio, Riina, Haukipää, Mia, Hetemäki, Iivo, Holma, Pia, Holmberg, Ville, Horstia, Saana, Jalkanen, Ville, Jämsänen, Toni, Järventie, Juuso, Järvinen, Petrus, Kalliala, Ilkka, Kauma, Heikki, Kilpeläinen, Tuomas, Kreivi, Hanna-Riikka, Kuitunen, Ilari, Lamminmäki, Satu, Mäkinen, Laura, Mäntylä, Jarkko, Mattila, Tiina, Myllärniemi, Marjukka, Niskanen, Joni, Nykänen, Taina, Nyqvist, Miro, Paajanen, Juuso, Partanen, Terhi, Patovirta, Riitta-Liisa, Paukkeri, Erja-Leena, Puusti, Emmi, Renner, Andreas, Reponen, Emma, Risku, Sari, Rosberg, Tuomas, Rutanen, Jarno, Säilä, Petrus, Salonen, Päivi, Sinisalo, Marjatta, Sivenius, Katariina, Tuominen, Susanna, Aboab, Jerone, Alfaiate, Toni, Andrejak, Claire, Andreu, Pascal, Belhadi, Drifa, Benezit, Francois, Botelho-Nevers, Elisabeth, Bouadma, Lila, Bougon, David, Bouiller, Kevin, Bounes, Fanny, Boyer, Alexandre, Bruel, Cédric, Buffet, Alexandre, Burdet, Charles, Cazanave, Charles, Chabertier, Cyrille, Clere-Jehl, Rapahel, Costagliola, Dominique, Courjon, Johan-Victor, Crockett, Flora, Danion, Francois, Dechanet, Aline, Dellamonica, Jean, Delmas, Christelle, Diallo, Alpha, Djossou, Felix, Dubost, Clement, Dupont, Axelle, Epaulard, Olivier, Faure, Emmmanuel, Faure, Karine, Fayol, Antoine, Figueiredo, Samy, Fougerou, Claire, Gaborit, Benjamin, Gaci, Rostane, Gagneux-Brunon, Amandine, Gallien, Sebastien, Garot, D, Goehringer, Francois, Gruson, Didier, Hinschberger, Olivier, Hulot, Jean-Sebastien, Jaureguiberry, Stephane, Jean-Michel, Vanessa, Kerneis, Solen, Kimmoun, Antoine, Klouche, Kada, Lachatre, Marie, Lacombe, Karine, Laine, Fabrice, Lanoix, Jean Philippe, Laribi, Samira, Launay, Odile, Laviolle, Bruno, Le Moing, Vincent, Le Pavec, Jerome, Lebeaux, David, Leroy, Sylvie, Lescure, Xavier, Livrozet, Marine, Makinson, Alain, Malvy, Denis, Marquette, Charles-Hugo, Martin-Blondel, Guillaume, Mayaux, Julien, Mekontso Dessap, Armand, Mentre, France, Mercier, Noemie, Meziani, Ferhat, Molina, Jean Michel, Mootien, Yoganaden, Mourvillier, Bruno, Navellou, Jean Christoph, Noret, M, Peiffer- Smadja, Nathan, Peytavin, Gilles, Pialoux, Gilles, Pilmis, Benoît, Piroth, Lionel, Poindron, Vincent, Poissy, Julien, Pourcher, Valerie, Quenot, Jean Pierre, Raffi, Francois, Reignier, Jean, Richard, Jean Christoph, Robert, Céline, Saillard, Juliette, Sayre, Naomi, Senneville, Eric, Stefan, Francois, Tellier, Marie Capucine, Terzi, Nicolas, Textoris, Julien, Thiery, Guillame, Timsit, Jean Francois, Tolsma, Violaine, Tubiana, Sarah, Wallet, Florent, Yazdanpanah, Yazdan, Zerbib, Yoann, Aguilar, Carlos, Erazo, Laura, Fiallos, Angel, Figueroa, Rosbinda, Flores, Juan Jose, Melendez, Lesddyy, Moncada, Wendy, Abraham, Ooriapadickal Cherian, Acharya, Chetankumar, Aedula, Vinaya Sekhar, Aggarwal, Richa, Agrawal, Nishant, Agrawal, Umang, Agrawal, Abhishekh, Ahmad, Mohammad, Atal, Shubham, Babu, Avinash, Baidya, Dalim Kumar, Balachandran, Amith, Bangar, Rakhee, Bhadade, Rakesh, Bhandari, Sudhir, Bhapal, Meghavi, Bhardwaj, Pankaj, Bhati, Gaurav, Bhatia, Pradeep, Bhatt, Krishnakant, Bingi, Thrilok Chander, Borse, Rohidas, Buch, Vyom, Chand, Dipti, Chandwani, Ashish, Charan, Jaykaran, Chaudhari, Mayur, Chaudhari, Kirti, Chaudhary, Vipul, Chauhan, Nishant, Chikara, Gaurav, Daswani, Bharti, de Souza, Rosemarie, Desai, Chetna, Divakar, Balusamy, Divhare, Sujeet, Dorairajan, Suresh Kumar, Dutt, Naveen, Ethirajan, Therani Rajan, Gamit, Amit, Gamit, Sweta, Garg, Mahendra, Goenka, Ajay, Goenka, Aniket, Guleria, Randeep, Gupta, Paras, Gupta, Nivedita, Gupta, Madhur, Harde, Minal, Ingle, Vaibhav, Iyer, Shivkumar, Jamalapuram, Vaishnavi, Jayanthi, Rangarajan, Joshi, Rajnish, Kadam, Abhijeet, Kalakuntla, Hemanth, Kalikar, Mrunalini, Kalme, Sayali, Kamble, Suchit, Kant, Ravi, Kantharia, Bansari, Kashikar, Arundhati, Kavishvar, Abhay, Kayina, Choro Athipro, Kerkar, Pranali, Khadanga, Sagar, Khandare, Sagar, Kokate, Pranjali, Komathi, Jayavelu, Krishnan, Vijay, Krishnan, Jayasree, Krishnan, Sumitra, Kulur Mukhyaprana, Sudha, Kumarasamy, N, Mahavar, Sunil, Maitra, Souvik, Majumdar, Falguni, Malhotra, Supriya, Mamulwar, Megha, Malini, Padma, Marwah, Vikas, Maurya, Akhilesh, Mehta, Kedar, Mesipogu, Rajarao, Misra, Shobha, Mitra, Sajal, Mittal, Ankit, Mohan, Bharathi, Momin, Mohmmedirfan, Nag, Vijaya, Nagarajan, Ramakrishnan, Nagmani, Kammili, Narlawar, Uday, Natarajan, Gopalakrishnan, Nischal, Neeraj, Ogale, Dhananjay, Palat, Paltial, Panda, Prasan, Panda, Samiran, Pandya, Amee, Parate, Rohit, Paritekar, Arunita, Patel, Parvati, Patel, Chetna, Patel, Sunaina, Patel, Vitan, Patel, Deep, Patel, Harshad, Patil, Girish, Peter, Deepu, Prasad, Durga, Purohit, Vimlesh, Rabindrarajan, Ebenezer, Ranganathan, Lakshmiarasimhan, Rao, Tushara, Rao, Chakradhara, Rathod, Chirag, Raval, Devang, Ray, Avik, Reddy, Kamini, Rege, Sujata, Revathi, Ayyasamy, Roy, Dhara, Saigal, Saurabh, Sane, Suvarna, Sangale, Shashi, Seetharaman, Krishnamoorthy, Selvamuthu, Poongulali, Seshaiah, Kurada Venkata, Shadrach, Benhur, Shah, Jignesh, Shah, Sonal, Sharma, Swati, Sharma, Raman, Sharma, Shrikant, Singh, Krishna, Singh, Anil, Singh, Arjeet, Singhai, Abhishek, Soneja, Manish, Soni, Kapil Dev, Subhan, Thasneem banu, Subramaniam, Sudharshini, Sudarsanam, Thambu David, Sudarsi, Ravindra Kumar, Suleman, Dawood, Suthar, Nilay, Talati, Shriraj, Tambe, Murlidhar, Tejomurtula, Tilak, Tirupakuzhi Vijayaraghavan, Bharatkumar, Trikha, Anjan, Trivedi, Aarti, Udwadia, Zarir, Upadhyay, Kamlesh, Vasava, Ashwin, Vasudevan, Damodaran, Velayudham, Rajendran, Venkatasubramanian, Ramasubramanian, Verma, Mamta, Waghmare, Rakesh, Waikar, Anushka, Wig, Naveet, Afrilia, Annisa Rizky, Amin, Muhammad, Arlinda, Dona, Avrina, Rossa, Bang, Lois, Djaharuddin, Irawaty, Djojo, Aryan, Driyah, Sri Laning, Erastuti, Mila, Fajarwati, Tetra, Harsini, Harsini, Hartantri, Yovita, Herman, Deddy, Isbaniah, Fathiyah, Karyana, Muhammad, Kusuma, Indra, Mahmudji, Harli Amir, Medison, Irvan, Nugroho, Agung, Nurhayati, Nurhayati, Opitasari, Cicih, Pitoyo, Ceva Wicaksono, Pradana, Antonius Arditya, Raharjo, Sofyan Budi, Rahmaini, Ade, Risniati, Yenni, Riyanto, Bambang Sigit, Sajinadiyasa, I Gede Ketut, Sari, Flora Eka, Sitompul, Pompini Agustina, Soedarsono, Soedarsono, Somia, I Ketut Agus, Sugiri, Yani Jane, Sugiyono, Retna Indah, Susanto, Nugroho Harry, Syarif, Armaji Kamaludi, Yulianto, Aris, Afsharian, Mandana, Akhavi Mirab, Atefehsadat, Amini, Fatemeh, Amini, Mahnaz, Ansarin, Khalil, Baba Mahmoodi, Farhang, Baghaei, Parvaneh, Barazandeh, Fateme, Bayani, Masomeh, Dastan, Farzaneh, Ebrahimpour, Soheil, Eghtesad, Sareh, Fallahi, Mohammad Javad, Fallahpoor Golmaee, Fatemeh, Foroghi Ghomi, Seyed Yaser, Ghadir, Mohammad Reza, Gheitani, Mina, Ghiasvand, Fereshteh, Hafizi Lotfabadi, Saied, Hakamifard, Atousa, Hashemi Madani, Shima Sadat, Hormati, Ahmad, Hosseini, Hamed, Janbakhsh, Alireza, Javanian, Mostafa, Joukar, Farahnaz, Kamali, Alireza, Karampour, Amin, Khajavirad, Nasim, Khodabakhshi, Behnaz, Khodadadi, Javad, Khodashahi, Rozita, Kiani Majd, Somaieh, Mahfoozi, Lida, Mahmoodiyeh, Behnam, Mansour-Ghanaei, Fariborz, Mansouri, Feizollah, Mesgarpour, Bita, Mesri, Mehdi, Mikaeili, Haleh, Miladi, Ronak, Moghadami, Mohsen, Mohamadi, Payam, Mohraz, Minoo, Mohseni Afshar, Zeinab, Moogahi, Sasan, Mousavi Anari, Seyed Alireza, Mozaffar, Seyyed Hassan, Mozdourian, Mahnaz, Najafipour, Reza, Najari, Hamidreza, Nazemiyeh, Masoud, Norouzi, Alireza, Pourkazemi, Aydin, Poustchi, Hossein, Saberhosseini, Seyedeh Naeimeh, Saberi, Marzieh, Saber-Moghaddam, Niloufar, Sadeghi, Anahita, Sadeghi Haddad Zavareh, Mahmoud, Sahraian, Mohammad Ali, Salahi, Mehrdad, Salehi, Mohammad Reza, Sarmadian, Hossein, Sayad, Babak, Shirani, Kiana, Shirvani, Maria, Shojaei, Daryanaz, Shokri, Mehran, Siami, Zeinab, Sima, Ali Reza, Soleimani, Alireza, Soltanmohammad, Saedeh, Tabarsi, Payam, Taghizadieh, Ali, Tavassoli, Samaneh, Varnasseri, Mehran, Vaziri, Siavash, Yadyad, Mohammad Jaafar, Yaghoubi, Shoeleh, Yazdanpanah, Yalda, Yousefi, Farid, Zamanian, Mohammad Hossein, Zand, Farid, Zare Hoseinzade, Elham, Bergin, Colm, Cotter, Aoife, de Barra, Eoghan, Jackson, Arthur, Laffey, John, McCarthy, Cormac, Muldoon, Eavan, Sadlier, Corinna, Maguire, Teresa, Angheben, Andrea, Bai, Francesca, Bandera, Alessandra, Barchiesi, Francesco, Bassetti, Matteo, Bisi, Luca, Bonfanti, Paolo, Calò, Federica, Campoli, Caterina, Canovari, Benedetta, Capetti, Amedeo, Castelli, Francesco, Cauda, Roberto, Cingolani, Antonella, Cocco, Nicolò, Coppola, Nicola, Corcione, Silvia, Cremonini, Eleonora, d'Arminio Monforte, Antonella, de Gaetano Donati, Katleen, De Nardo, Pasquale, De Rosa, Francesco Giuseppe, Degioanni, Maria, Della Siega, Paola, Di Bella, Stefano, Drera, Bruno, Focà, Emanuele, Fornabaio, Chiara, Galli, Massimo, Giacomazzi, Donatella, Gori, Andrea, Gustinetti, Giulia, Iannuzzi, Francesca, Kertusha, Blerta, Lamonica, Silvia, Lichtner, Miriam, Lupia, Tommaso, Luzzati, Roberto, Macera, Margherita, Menatti, Elisabetta, Merelli, Maria, Merlini, Esther, Monari, Caterina, Pan, Angelo, Pecori, Davide, Pezzani, Diletta, Riccardi, Niccolò, Rodari, Paola, Roldan, Eugenia, Rovere, Pierangelo, Rusconi, Stefano, Scabini, Silvia, Tascini, Carlo, Viale, Pierluigi, Vincenzi, Marcello, Zuccalà, Paola, Zucchi, Patrizia, Al-Roomi, Moudhi, Al-Sabah, Salman, Schrapp, Kelly, Hassoun, Mahmoud, Matar, Madonna, Dbouni, Oussaima, Yared, Nadine, Saliba, Michele, Farra, Anna, Riachi, Moussa, Zablockiene, Birute, Reuter, Jean, Staub, Therese, Ab Wahab, Suhaila, Chew, Chun Keat, Chua, Hock Hin, Goh, Pik Pin, Lee, Heng Gee, Leong, Chee Loon, Low, Lee Lee, Mak, Wen Yao, Mohamed Gani, Yasmin, Muhamad, Dzawani, Zaidan, Nor Zaila, Ducker, Camilla, Demiri, Ilir, Aballi, Saad, Berg, Åse, Blomberg, Bjørn, Dalgard, Olav, Dyrhol-Riise, Anne Ma, Eiken, Ragnhild, Ernst, Gernot, Hannula, Ranula, Haugli, Metter, Heggelund, Lars, Hoel, Hedda, Hoff, Dag Arne Lihaug, Holten, Aleksander Rygh, Johannessen, Asgeir, Kåsine, Trine, Kildal, Anders Benjamin, Kittang, Bård Reikvam, Nezvalova-Henriksen, Katerina, Olsen, Inge Christoffer, Olsen, Roy Bjørkolt, Skei, Nina Vibeche, Skudal, Hilde, Tholin, Birgitte, Thoresen, Lars, Trøseid, Marius, Tveita, Anders, Vinge, Leif, Ystrøm, Carl Magnus, Al Jahdhami, Issa, AlNaamani, Khalid, Al Balushi, Zakariya, Pandak, Nenad, Abbas, Salma, Akhtar, Nasim, Azam, Sumeyya, Begum, Dilshad, Hassan, Sadia, Herekar, Fivzia, Khan, Shahzaib, Khan, Ejaz Ahmed, Mahmood, Syed Faisal, Nasir, Nosheen, Rahim, Anum, Sarfaraz, Samreen, Shaikh, Qurat-ul-Ain, Sultan, Faisal, Walayat, Usman, Agurto-Lescano, Erika Cecilia, Alcantara-Díaz, Andrés Martín, Alva-Correa, Ana María, Alvarado-Moreno, José Gustavo, Ángeles-Padilla, Bethsabé, Arbañil-Huamàn, Hugo César, Ávila-Reyes, Pool Christopher, Azañero-Haro, Johan Alexander, Barreto-Rocchetti, Luis Guillermo, Benitez-Peche, Jorge Marko A., Bernal-Màlaga, Karla Hortencia, Cabrera-Portillo, Liliana Norma, Carazas-Chavarry, Reynaldo Javier, Càrcamo, Paloma Mariana, Casimiro-Porras, Indira Catalina, Castillo-Espinoza, Jhuliana, Chacaltana-Huarcaya, Jesús Norberto, Cornejo-Valdivia, Carla Raquel, Cruz-Chereque, Augusto, Del-Aguila-Torres, Keith Cayetano Marcelino, Díaz-Chipana, Erika, Flores-Valdez, Neil, Franco-Vàsquez, Rosanna Andrea, Gallegos-López, Roxana Consuelo, Gastiaburú-Rodriguez, Dauma Yesenia, Gianella-Malca, Gonzalo Ernesto, Gomero-Lopez, Andrés Alonso, Hercilla-Vàsquez, Luis Enrique, Hueda-Zavaleta, Miguel Ángel, Ibarcena-Llerena, Claudia Vanessa, Iberico-Barrera, Carlos Alberto, Inquilla-Castillo, Miguel Angel, Juàrez-Eyzaguirre, Jesus Alberto, Laca-Barrera, Manuel, León-Jiménez, Franco, Luna-Wilson, Carla Vanessa, Màlaga, German, Marin, Ricardo, Mejía-Cordero, Fernando, Mendoza-Laredo, Juan Arturo, Meregildo-Rodríguez, Edinson Dante, Miranda-Manrique, Gonzalo Francisco, Olivera-Chaupis, Marco, Ortega-Monasterios, Fatima Josefina, Otazú-Ybàñez, Jimmy Pedro, Paredes-Moreno, María Angélica, Peña-Mayorga, Claudia Ximena, Peña-Vàsquez, Olivia del Carmen, Peña-Villalobos, Alejandro, Ponce, Oscar J, Ponte-Fernandez, Katherin Estefania, Pro, Jose, Quispe-Nolazco, César Miguel, Ramos-Samanez, Manuel Efrain, Rojas-Murrugarra, Kory Mirtha, Samanez-Pérez, Jorge Mauro, Sànchez-Carrillo, Halbert Chrostian, Sànchez-Garavito, Epifanio, Sànchez-Sevillano, Ricardo Manuel, Sandoval-Manrique, Hernan, Santos-Revilla, Gabriela, Silva-Ramos, Julio Antonio, Solano-Ico, Manuel Alberto, Soto, Alonso, Sotomayor-Woolcott, Giannilu Michelle, Tapia-Orihuela, Ruben Kevin Arnold, Terrazas-Obregón, Carmen Sara, Terrones-Levano, Victor Francisco, Ticona-Huaroto, Cesar Eduardo, Torres-Ninapayta, Walter, Torres-Ruiz, Oscar Martin, Ugarte-Mercado, Dario, Vargas-Anahua, Orlando José, Vàsquez-Becerra, Ruben Dario, Vàsquez-Cerro, José Gabriel, Villegas-Chiroque, Miguel, Williams, Anna Larson, Yauri-Lazo, Randi Mauricio, Abad, Cybele Lara, Andales-Bacolcol, Silverose Ann, Arcegono, Marlon, Arches, Jamie, Astudillo, Mary Grace, Aventura, Emily, Awing, Arlyn, Bala, Mishelle Vonnabie, Bello, Jia An, Blanco, Peter, Benedicto, Jubert, Buno, Susana, Cabrera, Justine, Cajulao, Thea Pamela, Caoili, Janice, Casiple-Amsua, Lina, Catambing, Victor, Chin, Inofel, Chua, Ma. Bernadette, Chua, Mitzi Marie, Climacosa, Fresthel Monica, David-Wang, Aileen, De los Reyes, Virginia, Europa, Gilly May, Fernandez, Lenora, Francisco, Jorge, Garcia, Gerard, Garcia, Jemelyn, Gler, Maria Tarcela, Isidro, Marie Grace Dawn, Javier, Rozelle Jade, Kwek, Marion, Lansang, Mary Ann, Lee, Aileen, Li, Kingbherly, Llanes, Mark Ramon Victor, Llorin, Ryan, Macadato, Omar Khayyam, Malundo, Anna Flor, Mercado, Maria Elizabeth, Mujeres, Mercedes, Nepomuceno, Marisse, Ngo-Sanchez, Katha, Orden, Mary Claire, Pablo-Villamor, Maria Philina, Paez, Ruel Dionisio, Palmes, Patricio, Panaligan, Marion, Quinivista-Yoon, Jenny Mae, Ramos, Mary Shiela Ariola, Ramos -Penalosa, Christine, Reyes, Sheila Marie, Roa, Kathryn, Roman, Arthur Dessi, Rosario, Minette Claire, Roxas, Evalyn, Santos, Lourdes Ella Gonzales, Soldevilla, Helmar, Solante, Rontgene, Suaco, Jane, Tagarda, Daisy, Tang, Issa Rufina, Te, Bob, Teo, Dennis, Tibayan, Christopher John, Villalobos, Ralph Elvi, Ymbong, Duane Richard, Zabat, Gelza Mae, Batkova, Stepanka, Cardoso, Orlando, Garrote, Ana-Raquel, Lino, Sara, Manata, Maria-José, Pinheiro, Helder, Póvoas, Diana, Ramirez, Freddy, Seixas, Diana, Naji, Assem, Al Gethamy, M Al, AL-Mulaify, Mohammed Sami, Al Maghraby, Reem, Alrajhi, A, Al Sharidi, Aynaa, Alotaibi, Naif, AlShaharani, F, Barry, Mazin, Ghonem, Leen, Khalel, Anas, Kharaba, Ayman Mohammed, Alabdan, Lulwah, AlAbdullah, Mohammed Sharaf, Al Shabib, Abdullah, Bengu, Simangele, Bennet, Jacklyn, Dubula, Thozama, Howell, Pauline, Janse van Vuuren, Cloete, Kalla, Ismail, Lifson, Aimee, Maasdorp, Shaun, Magua, Nombulelo, Maluleke, Vongani, Mbhele, Nokuphiwa, Mdladla, Nathi, Mendelson, Mark, Menezes, Colin, Mwelase, Thando, Nchabeleng, Maphoshane, Palanee-Phillips, Thesla, Parker, Victoria, Rassool, Mohammed, Reeder, Paul, Sossen, Bianca, Steyn, Dewald, Tsitsi, Merika, van Blydenstein, Sarah Alex, Venter, Michelle, Van Vuuren, Janse, Venturas, Jacquie, Abad Pérez, Daniel, Abenza, Maria José, Alarcón-Payer, Carolina, Armero Garrigos, Eva, Arribas, Jose Ramon, Ascaso, Ana, Berenguer, Juan, Cabello-Clotet, Noemí, Chamorro Tojeiro, Sandra, Cuenca-Acevedo, Rafael, de la Calle, Fernando, Del Toro, Maria Dolores, Díaz Pollàn, Beatriz, Diez, Cristina, Esquillor-Rodrigo, María José, Estrada, Vicente, Fanciulli, Chiara, Fanjul, Francisco, Fernàndez de Orueta, Lucía, Ferre, Adrian, Ferreira Pasos, Eva Maria, Gainzarain-Arana, Juan-Carlos, Garcia, Felipe, García Deltoro, Miguel, Goikoetxea Agirre, Ane Josune, Gómez Barquero, Julia, Gomez-Huelgas, Ricardo, Gonzàlez Moraleja, Julio, Guijarro, Carlos, Gutierrez, Felix, Guzmàn, Jesús, Ibarguren, Maialen, Iribarren, Jose Antonio, Jerusalem, Koen, Juan Arribas, Arturo, Lalueza, A, Leone, Antonio, Lopez Azkarreta, Iñigo, Lozano-Martin, Daniel, Lucendo, Alfredo J, Luengo López, Mariella, Martín Oterino, JA, Masa, JF, Merino, Esperanza, Monge-Maillo, Begoña, Moran-Rodríguez, Miguel-Angel, Muñez Rubio, Elena, Muñoz Sanchez, Josefa, Nuñez Orantos, Maria Jose, Nuño, Enrique, Ortiz-De-Zarate-Ibarra, Zuriñe, Pagàn-Muñoz, Bàrbara, Paño-Pardo, José Ramón, Peñaranda, Maria, Pérez Chica, Gerardo, Pérez Fernàndez, AM, Pérez-López, Carmen, Polo San Ricardo, Victor, Portu-Zapirain, Joseba, Puchades, Francesco, Rivas Paterna, Ana Belen, Rodríguez Vidigal, Francisco F, Rodríguez-Baño, Jesus, Ruiz-Seco, Pilar, Ryan, Pablo, Saez-De-Adana, Ester, Salas, Rosario, Salavert Lletí, Miguel, Sandoval, Raquel, Toyas-Miazza, Carla, Valencia, Jorge, Vargas, Emilio, Velasco, Maria, Von Wichmann, Miguel Angel, Bosshard, Andreas, Calmy, Alexandra, Castro, Tiago, Cavassini, Matthias, Clerc, Olivier, Conen, Anna, Desbaillets, Nicolas, Desgranges, Florian, Duss, Francois, Emonet, Stephane, Erard, Veronique, Eyer, Myriam, Fayet-Mello, Aurélie, Flammer, Yvonne, Friedl, Andrée, Fulchini, Rosamaria, Furrer, Hansjakob, Garin, Nicolas, Gastberger, Salome, Greiner, Michael, Haefliger, David, Haubitz, Sebastian, Hoffmann, Matthias, Isenring, Egon, Jakopp, Barbara, Lampert, Markus, Marinosci, Annalisa, Martin, Yvonne, Petignat, Pierre-Auguste, Piso, Rein Jan, Prendki, Virginie, Rutishauser, Jonas, Schaefer, Elisabeth, Schmiedel, Yvonne, Schwery, Stefan, Stavropoulou, Elisavet, Stoeckle, Marcel, Suttels, Veronique, Thurnher, Maria Christine, van den Bogaart, Lorena, West, Emily, Wiegand, Jan, and Wiggli, Benedikt

Published
2022
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17. Preventability of stroke during pregnancy and postpartum.

Author

Ding, Jia Jennifer, Mitta, Srilakshmi, Kole-White, Martha, Roth, Julie, and Malhamé, Isabelle

Subjects
STROKE prevention, TRANSIENT ischemic attack prevention, RISK assessment, PATIENT education, ACADEMIC medical centers, PUERPERIUM, HEADACHE, HYPERTENSION, TERTIARY care, HEMORRHAGIC stroke, DESCRIPTIVE statistics, LONGITUDINAL method, HYPERTENSION in pregnancy, ISCHEMIC stroke, STROKE, STROKE patients, CARDIOVASCULAR diseases in pregnancy, TRANSIENT ischemic attack, DISEASE risk factors, SYMPTOMS, PREGNANCY
Abstract

Background: The preventability of strokes during pregnancy and postpartum is understudied. Methods: We identified patients with ischemic and hemorrhagic strokes in pregnancy or within 12 weeks postpartum between 2009 and 2020 at an obstetric teaching hospital. We described the clinical course of the included cases. A multi-disciplinary panel adjudicated each occurrence of stroke according to a modified classification system for preventability. Results: Fifteen patients experienced a stroke during pregnancy or postpartum. Precisely, 60% presented with a headache, and 47% of events were complicated by severe obstetrical hypertension. Two cases were thought to be "possibly preventable" due to delays in presentation to care and miscommunication regarding hypertension management goals. Conclusion: In a cohort of pregnant and postpartum patients with stroke at a tertiary-care center, strokes may be prevented by future initiatives focusing on patient and provider education regarding early warning signs of pregnancy-associated stroke and hypertension thresholds and management specific to pregnancy. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Accuracy of aspirin prophylaxis for preeclampsia prevention documentation within a large administrative dataset.

Author

Tailor, Lauren S., Fajardo, Renee G., Ray, Joel G., Malhamé, Isabelle, and Grandi, Sonia M.

Subjects
ELECTRONIC health records, DATABASES, PREECLAMPSIA, CONFIDENCE intervals, SENSITIVITY & specificity (Statistics), MATERNAL health
Abstract

Background: Low‐dose aspirin prophylaxis is recommended for women at risk of preeclampsia. Capturing aspirin prophylaxis within administrative databases can be challenging since it is an over‐the‐counter medication. The Better Outcome Registry and Network (BORN) database, a perinatal health registry in Ontario, Canada, includes a formal variable that captures aspirin prophylaxis for preeclampsia. This variable has not been formally validated. Objectives: To assess the accuracy of the aspirin prophylaxis variable in the BORN database against an electronic medical record (EMR). Methods: This validation study comprised 200 randomly selected women who had a livebirth at St. Michael's Hospital (SMH) in Toronto, Ontario, from January 2018 to July 2022. Recorded aspirin prophylaxis in pregnancy and maternal sociodemographic characteristics were independently extracted by two abstractors. Accuracy of aspirin prophylaxis use in the BORN database was compared to that in the SMH EMR, expressed as sensitivity, specificity, positive (PPV) and negative predictive values (NPV), Cohen's kappa (κ), and overall percent agreement, with 95% confidence intervals (CI). Sensitivity analyses were performed to account for missing or unclear aspirin prophylaxis use. Results: Among 200 women, 24 (12.0%) received aspirin prophylaxis – 12.5% within the SMH EMR and 8.0% in the BORN database. Women using aspirin were older (37.0 vs 33.0 years) and had higher median gravidity (3 vs. 2). Sensitivity and specificity of the BORN aspirin prophylaxis variable were 62.5% (95% CI 40.6, 81.2) and 100.0% (95% CI 97.3, 100.0), respectively. The corresponding positive and negative predictive values were 100.0% (95% CI 78.2, 100.0), and 93.8% (95% CI 88.6, 97.1), respectively. Cohen's κ was 0.74 (95% CI 0.58, 0.90), and overall percent agreement was 94.4% (95% CI 87.1, 100.0). Conclusions: Aspirin use within the BORN database, based on a standard variable field, appears accurate enough for the potential use in epidemiological studies of aspirin prophylaxis for preeclampsia or as a covariate in related studies. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Trends in maternal ICU admissions at a quaternary centre in Montreal, Canada, and impact of maternal age on critical care outcomes.

Author

Lopez Laporte, Maria Agustina, Shahin, Jason, Blotsky, Andrea, Malhamé, Isabelle, and Dayan, Natalie

Subjects
RISK assessment, PATIENTS, DELIVERY (Obstetrics), MATERNAL age, MATERNAL health services, ACADEMIC medical centers, HOSPITAL admission & discharge, LOGISTIC regression analysis, PUERPERIUM, MATERNAL mortality, AGE distribution, EVALUATION of medical care, DESCRIPTIVE statistics, PREGNANT women, RETROSPECTIVE studies, OPERATIVE surgery, ODDS ratio, INTENSIVE care units, MEDICAL records, ACQUISITION of data, PSYCHOLOGY of mothers, CONFIDENCE intervals, CRITICAL care medicine, PREGNANCY
Abstract

Background: Advancing maternal age is increasingly prevalent and is associated with severe maternal morbidity often requiring intensive care unit (ICU) admission. Objectives: To describe maternal ICU admissions at a quaternary care hospital in Montreal, Canada, and evaluate the association between maternal age and composite of: need for invasive interventions, ICU stay > 48 h, or maternal death. Methods: Chart review of ICU admissions during pregnancy/postpartum (2006–2016); logistic regressions to evaluate the impact of age on outcomes. Results: With 5.1 ICU admissions per 1000 deliveries, we included 187 women (mean age 32 ± 6.3 years; 20 (10.7%) ≥ 40 years). The composite outcome occurred in 105 (56.2%) patients; there were two maternal deaths. Age ≥ 40 years increased the odds of invasive interventions (OR 4.03; 95% confidence interval [CI] 1.15–14.1) but not of the composite outcome (OR 2.30; 95% CI 0.66–8.02). Conclusion: Peripartum women aged ≥ 40 years had worse outcomes in ICU, with an increased need for invasive interventions. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Understanding the patient perspective on research access to national health records databases for conduct of randomized registry trials

Author

Avram, Robert, Marquis-Gravel, Guillaume, Simard, François, Pacheco, Christine, Couture, Étienne, Tremblay-Gravel, Maxime, Desplantie, Olivier, Malhamé, Isabelle, Bibas, Lior, Mansour, Samer, Parent, Marie-Claude, Farand, Paul, Harvey, Luc, Lessard, Marie-Gabrielle, Ly, Hung, Liu, Geoffrey, Hay, Annette E., and Marc Jolicoeur, E.

Published
2018
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29. Cardiovascular mortality in the context of hypertensive disorders of pregnancy: Towards an optimisation of case identification strategies.

Author

Malhamé, Isabelle and Grandi, Sonia M.

Subjects
*PREECLAMPSIA, *PREGNANCY, *HYPERTENSION, *PREGNANT women, *MORTALITY, *PREGNANCY complications
Abstract

A study published in the journal Paediatric & Perinatal Epidemiology explores the association between hypertensive disorders of pregnancy (HDP) and cardiovascular mortality. The study found that specific subtypes of HDP, such as chronic hypertension, preeclampsia with severe features, and eclampsia, were associated with an increased risk of cardiovascular-related deaths. However, the study may have underestimated the true association due to limitations in data collection and classification of cardiovascular events. The findings highlight the need for extended postpartum care and health insurance coverage for individuals with HDP to prevent maternal cardiovascular deaths. Further research is needed to validate the underlying causes of maternal mortality and improve the quality of epidemiological data for surveillance purposes. [Extracted from the article]

Published
2024
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35. multidisciplinary management of a mechanical mitral valve thrombosis in pregnancy: a case report and review of the literature.

Author

Wright, Jennifer M, Bottega, Natalie, Therrien, Judith, Hatzakorzian, Roupen, Buithieu, Jean, Shum-Tim, Dominique, Wou, Karen, Ghandour, Amale, Pelletier, Patricia, Shan, William Li Pi, Kaufman, Ian, Brown, Richard, and Malhamé, Isabelle

Subjects
MITRAL valve, PROSTHETIC heart valves, THROMBOSIS, BIOPROSTHETIC heart valves, LOW-molecular-weight heparin
Abstract

Background The management of anticoagulation for mechanical heart valves during pregnancy poses a unique challenge. Mechanical valve thrombosis is a devastating complication for which surgery is often the treatment of choice. However, cardiac surgery for prosthetic valve dysfunction in pregnant patients confers a high risk of maternofetal morbidity and mortality. Case summary A 39-year-old woman in her first pregnancy at 30 weeks gestation presented to hospital with a mechanical mitral valve thrombosis despite therapeutic anticoagulation with low-molecular-weight heparin. She underwent an emergent caesarean section followed immediately by a bioprosthetic mitral valve replacement. This occurred after careful planning and organization on the part of a large multidisciplinary team. Discussion A proactive, rather than reactive, approach to the surgical management of a mechanical valve thrombosis in pregnancy will maximize the chances of successful maternal and fetal outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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36. Hypertensive disorders of pregnant women with heart disease: the ESC EORP ROPAC Registry.

Author

Ramlakhan, Karishma P, Malhamé, Isabelle, Marelli, Ariane, Rutz, Tobias, Goland, Sorel, Franx, Arie, Sliwa, Karen, Elkayam, Uri, Johnson, Mark R, Hall, Roger, Cornette, Jérôme, and Roos-Hesselink, Jolien W

Subjects
PREGNANCY complications, HEART diseases in women, HYPERTENSION, PULMONARY arterial hypertension, HEART diseases
Abstract

Aims Hypertensive disorders of pregnancy (HDP) occur in 10% of pregnancies in the general population, pre-eclampsia specifically in 3–5%. Hypertensive disorders of pregnancy may have a high prevalence in, and be poorly tolerated by, women with heart disease. Methods and results The prevalence and outcomes of HDP (chronic hypertension, gestational hypertension or pre-eclampsia) were assessed in the ESC EORP ROPAC (n  = 5739), a worldwide prospective registry of pregnancies in women with heart disease. The overall prevalence of HDP was 10.3%, made up of chronic hypertension (5.9%), gestational hypertension (1.3%), and pre-eclampsia (3%), with significant differences between the types of underlying heart disease (P  < 0.05). Pre-eclampsia rates were highest in women with pulmonary arterial hypertension (PAH) (11.1%), cardiomyopathy (CMP) (7.1%), and ischaemic heart disease (IHD) (6.3%). Maternal mortality was 1.4 and 0.6% in women with vs. without HDP (P  = 0.04), and even 3.5% in those with pre-eclampsia. All pre-eclampsia-related deaths were post-partum and 50% were due to heart failure. Heart failure occurred in 18.5 vs. 10.6% of women with vs. without HDP (P  < 0.001) and in 29.1% of those with pre-eclampsia. Perinatal mortality was 3.1 vs. 1.7% in women with vs. without HDP (P  = 0.019) and 4.7% in those with pre-eclampsia. Conclusion Hypertensive disorders of pregnancy and pre-eclampsia rates were higher in women with CMP, IHD, and PAH than in the general population. Adverse outcomes were increased in women with HDP, and maternal mortality was strikingly high in women with pre-eclampsia. The combination of HDP and heart disease should prompt close surveillance in a multidisciplinary context and the diagnosis of pre-eclampsia requires hospital admission and continued monitoring during the post-partum period. [ABSTRACT FROM AUTHOR]

Published
2022
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38. Physician Perspectives on Including Pregnant Women in Covid‐19 Clinical Trials: Time for a Paradigm Change.

Author

Trahan, Marie‐Julie, Cumyn, Annabelle, Cheng, Matthew P., McDonald, Emily G., Lapinsky, Stephen E., Daneman, Nick, Abenhaim, Haim A., and Malhamé, Isabelle

Subjects
PREGNANT women, COVID-19 testing, HUMAN experimentation, MEDICAL societies, CLINICAL trials
Abstract

Excluding pregnant people from Covid‐19 clinical trials may lead to unintended harmful consequences. For this study, an online questionnaire was sent to physicians belonging to Canadian professional medical associations in order to evaluate their perspectives on the participation of pregnant women in Covid‐19 clinical trials. The majority of respondents expressed support for including pregnant women in Covid‐19 trials (119/165; 72%), especially those investigating therapies with a prior safety record in pregnancy (139/164; 85%). The main perceived barriers to inclusion identified were unwillingness of pregnant patients to participate and of treating teams to offer participation, the burden of regulatory approval, and a general "culture of exclusion" of pregnant women from trials. We describe why some physicians may be reluctant to include pregnant individuals in trials, and we identify barriers to the appropriate participation of pregnant people in clinical research. [ABSTRACT FROM AUTHOR]

Published
2021
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39. Maternal and neonatal outcomes in women with disorders of lipid metabolism.

Author

Cai, Emmy, Czuzoj-Shulman, Nicholas, Malhamé, Isabelle, and Abenhaim, Haim A.

Subjects
LIPID metabolism, NOSOLOGY, MEDICAL care costs, RETROSPECTIVE studies, HYPERCHOLESTEREMIA, METABOLIC disorders, PREGNANCY outcomes, DESCRIPTIVE statistics, LOGISTIC regression analysis, INFANT mortality, WOMEN'S health, LONGITUDINAL method
Abstract

The effects of lipid metabolism disorders (LMD) on pregnancy outcomes is not well known. The purpose of this study is to evaluate the impact of LMD on maternal and fetal outcomes. Using the Healthcare Cost and Utilization Project – National Inpatient Sample from the United States, we carried out a retrospective cohort study of all births between 1999 and 2015 to determine the risks of complications in pregnant women known to have LMDs. All pregnant patients diagnosed with LMDs between 1999 and 2015 were identified using the International Classification of Disease-9 coding, which included all patients with pure hypercholesterolemia, pure hyperglyceridemia, mixed hyperlipidemia, hyperchylomicronemia, and other lipid metabolism disorders. Adjusted effects of LMDs on maternal and newborn outcomes were estimated using unconditional logistic regression analysis. A total of 13,792,544 births were included, 9,666 of which had an underlying diagnosis of LMDs for an overall prevalence of 7.0 per 10,000 births. Women with LMDs were more likely to have pregnancies complicated by diabetes, hypertension, and premature births, and to experience myocardial infarctions, venous thromboembolisms, postpartum hemorrhage, and maternal death. Their infants were at increased risk of congenital anomalies, fetal growth restriction, and fetal demise. Women with LMDs are at significantly higher risk of adverse maternal and newborn outcomes. Prenatal counselling should take into consideration these risks and antenatal care in specialized centres should be considered. [ABSTRACT FROM AUTHOR]

Published
2021
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40. Severe and critical COVID-19 in pregnancy: A case series from Montreal.

Author

Trahan, Marie-Julie, Malhamé, Isabelle, Mitric, Cristina, Simard, Camille, Lipes, Jed, and Abenhaim, Haim A

Subjects
*COVID-19, *HOSPITAL patients, *ACQUISITION of data methodology, *PULMONARY embolism, *RETROSPECTIVE studies, *PREGNANT women, *TERTIARY care, *SEVERITY of illness index, *ARTIFICIAL respiration, *MEDICAL records, *OXYGEN therapy, *CRITICAL care medicine, *WOMEN'S health, *PREGNANCY
Abstract

Background: Optimal obstetric management for women with coronavirus disease (COVID-19) is not known. We describe the management of six pregnant women requiring in-hospital care for severe COVID-19. Methods: A retrospective chart review was conducted to identify pregnant women who tested positive for Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) between 15 March and 30 June 2020. A subset of women meeting criteria for severe COVID-19 was included. Results: Four women required non-invasive supplemental oxygen therapy and two required mechanical ventilation. Four women were discharged from hospital undelivered and two required preterm delivery. One woman had a pulmonary embolism, and two required re-admission for worsening symptoms. Conclusion: Management of pregnant women with severe COVID-19 is complex and should involve multidisciplinary expertise. Avoiding early delivery may be a safe option. We recommend an individualized approach to care, including careful consideration of the expected risks and benefits of expectant obstetric management versus delivery. [ABSTRACT FROM AUTHOR]

Published
2021
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42. Prevalence and perinatal outcomes of non- communicable diseases in pregnancy in a regional hospital in Haiti: A prospective cohort study.

Author

Malhamé, Isabelle, Destiné, Rodney, Jacquecilien, Widmise, Coriolan, Bidjinie H., St-Loth, Wacquinn, Excellent, Marie Claudy, Scaide, Benjaminel, Wong, Remy, Meltzer, Sarah, Jean-Baptiste, Eddy, Pilote, Louise, von Oettingen, Julia E., and Israel, Kerling

Subjects
NON-communicable diseases, PREGNANCY complications
Abstract

Background The prevalence of non-communicable diseases (NCDs) is rising in low and middle-income countries (LMIC). We aimed to report on the prevalence of NCDs in pregnancy and their associated perinatal outcomes in a regional hospital in Haiti. Methods We conducted the "Diabète et hYpertension Artéerielle et leurs issues MAternelles et Néonatales" (DYAMAN) prospective cohort study in a regional hospital in Haiti. Pregnant women presenting to care at 24-28 weeks were screened and treated for diabetes (DM) and hypertensive disorders of pregnancy (HDP) using setting-adapted protocols. Prevalence of NCDs and associated maternal-neonatal outcomes were described. Results 715 women were included, of which 51 (7.1%) had DM, 90 (12.6%) had HDP, and 30 (4.2%) had both DM and HDP (DM/HDP). Of 422 (59%) women delivered in hospital, 58 (13.7%) had preeclampsia, including 5 (8.6%) with eclampsia. Preterm birth <32 weeks was more common in the HDP than the control, DM, and DM/HDP groups. More low birth weight babies (n = 20, 25.6%) were born to the HDP group than to the control (n = 20, 7.1%), DM (n = 1, 2.7%), and DM/ HDP (n = 3, 12%) groups (P < 0.001). Macrosomia and hypoglycemia affected 5 (8%) neonates of women with DM. Perinatal mortality, affecting 36/1000 births, was mainly driven by maternal NCDs. Conclusions NCDs in pregnancy led to adverse maternal and perinatal outcomes. This study will help to prepare future refinements aimed at optimizing the management of NCDs in pregnancy in LMIC. Research is required to understand barriers to patient attendance at antenatal follow-up, treatment escalation for hyperglycemia, and in-hospital delivery. [ABSTRACT FROM AUTHOR]

Published
2021
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44. A critical review of the pathophysiology of thrombotic complications and clinical practice recommendations for thromboprophylaxis in pregnant patients with COVID-19.

Author

D'Souza, Rohan, Malhamé, Isabelle, Teshler, Lizabeth, Acharya, Ganesh, Hunt, Beverley J., and McLintock, Claire

Subjects
*COVID-19, *PREGNANT women, *PATHOLOGICAL physiology, *ANTIVIRAL agents, *ANTIBIOTIC prophylaxis, *HOSPITAL admission & discharge, *PREVENTION of communicable diseases, *THROMBOSIS prevention, *PREVENTION of epidemics, *VIRAL pneumonia, *THROMBOSIS, *CARDIOVASCULAR diseases in pregnancy, *PREGNANCY complications, *DISEASE complications, THERAPEUTIC use of fibrinolytic agents
Abstract

Those who are infected with Severe Acute Respiratory Syndrome-related CoronaVirus-2 are theoretically at increased risk of venous thromboembolism during self-isolation if they have reduced mobility or are dehydrated. Should patients develop coronavirus disease (COVID-19) pneumonia requiring hospital admission for treatment of hypoxia, the risk for thromboembolic complications increases greatly. These thromboembolic events are the result of at least two distinct mechanisms - microvascular thrombosis in the pulmonary system (immunothrombosis) and hospital-associated venous thromboembolism. Since pregnancy is a prothrombotic state, there is concern regarding the potentially increased risk of thrombotic complications among pregnant women with COVID-19. To date, however, pregnant women do not appear to have a substantially increased risk of thrombotic complications related to COVID-19. Nevertheless, several organizations have vigilantly issued pregnancy-specific guidelines for thromboprophylaxis in COVID-19. Discrepancies between these guidelines reflect the altruistic wish to protect patients and lack of high-quality evidence available to inform clinical practice. Low molecular weight heparin (LMWH) is the drug of choice for thromboprophylaxis in pregnant women with COVID-19. However, its utility in non-pregnant patients is only established against venous thromboembolism, as LMWH may have little or no effect on immunothrombosis. Decisions about initiation and duration of prophylactic anticoagulation in the context of pregnancy and COVID-19 must take into consideration disease severity, outpatient vs inpatient status, temporal relation between disease occurrence and timing of childbirth, and the underlying prothrombotic risk conferred by additional comorbidities. There is currently no evidence to recommend the use of intermediate or therapeutic doses of LMWH in thromboprophylaxis, which may increase bleeding risk without reducing thrombotic risk in pregnant patients with COVID-19. Likewise, there is no evidence to comment on the role of low-dose aspirin in thromboprophylaxis or of anti-cytokine and antiviral agents in preventing immunothrombosis. These unanswered questions are being studied within the context of clinical trials. [ABSTRACT FROM AUTHOR]

Published
2020
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45. Identifying cardiovascular severe maternal morbidity in epidemiologic studies.

Author

Malhamé, Isabelle, Mehta, Niharika, Raker, Christina A., Hardy, Erica J., Spalding, Hannah, Bouvier, Benjamin A., Savitz, David A., and Danilack, Valery A.

Subjects
*CARDIOVASCULAR diseases, *MATERNAL mortality, *PREECLAMPSIA, *HOSPITAL care, *CARDIAC arrest
Abstract

Background: Cardiovascular severe maternal morbidity (CSMM) is rising and has become the leading cause of maternal mortality. Research using administrative data sets may allow for better understanding of this critical group of diseases.Objective: To validate a composite variable of CSMM for use in epidemiologic studies.Methods: We analysed delivery hospitalisations at an obstetric teaching hospital from 2007 to 2017. We utilised a subset of indicators developed by the Centers for Disease Control and Prevention based on ICD codes to form the composite variable for CSMM. Two expert clinicians manually reviewed all qualifying events using a standardised tool to determine whether these represented true CSMM events. Additionally, we estimated the number of CSMM cases among delivery hospitalisations without qualifying ICD codes by manually reviewing all hospitalisations with severe preeclampsia, a population at high risk of CSMM, and a random sample of 1000 hospitalisations without severe preeclampsia. We estimated validity of the composite variable.Results: Among 91 355 admissions for delivery, we captured 113 potential CSMM cases using qualifying ICD codes. Of these, 65 (57.5%) were true CSMM cases. Indicators for acute myocardial infarction, cardiac arrest, and cardioversion had the highest true-positive rates (100% for all). We found an additional 70 CSMM cases in the 2102 admissions with severe preeclampsia and a single CSMM case in the random sample. Assuming a rate of 1 CSMM case per 1000 deliveries in the remaining cohort, the composite variable had a positive predictive value of 57.5% (95% CI 47,9, 66.8), a negative predictive value of 99.8% (95% CI 99.8, 99.9), a sensitivity of 29.0% (95% CI 23.2, 35.4), and a specificity of 100% (95% CI 99.9, 100.0).Conclusion: A novel composite variable for CSMM had reasonable PPV but limited sensitivity. This composite variable may enable epidemiologic studies geared towards reducing maternal morbidity and mortality. [ABSTRACT FROM AUTHOR]

Published
2020
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47. Maternal monitoring and safety considerations during antiarrhythmic treatment for fetal supraventricular tachycardia.

Author

Malhamé, Isabelle, Gandhi, Christy, Tarabulsi, Gofran, Esposito, Matthew, Lombardi, Kristin, Chu, Antony, and Chen, Kenneth K

Subjects
*ADRENERGIC beta blockers, *AMIODARONE, *DIGOXIN, *FETAL monitoring, *FLECAINIDE, *MYOCARDIAL depressants, *PATIENT safety, *PREGNANCY complications, *SUPRAVENTRICULAR tachycardia
Abstract

Fetal tachycardia is a rare complication during pregnancy. After exclusion of maternal and fetal conditions that can result in a secondary fetal tachycardia, supraventricular tachycardia is the most common cause of a primary sustained fetal tachyarrhythmia. In cases of sustained fetal supraventricular tachycardia, maternal administration of digoxin, flecainide, sotalol, and more rarely amiodarone, is considered. As these medications have the potential to cause significant adverse effects, we sought to examine maternal safety during transplacental treatment of fetal supraventricular tachycardia. In this narrative review we summarize the literature addressing pharmacologic properties, monitoring, and adverse reactions associated with medications most commonly prescribed for transplacental therapy of fetal supraventricular tachycardia. We also describe maternal monitoring practices and adverse events currently reported in the literature. In light of our findings, we provide clinicians with a suggested maternal monitoring protocol aimed at optimizing safety. [ABSTRACT FROM AUTHOR]

Published
2019
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48. The effect of bromocriptine on left ventricular functional recovery in peripartum cardiomyopathy: insights from the BRO‐HF retrospective cohort study.

Author

Tremblay‐Gravel, Maxime, Marquis‐Gravel, Guillaume, Avram, Robert, Desplantie, Olivier, Ducharme, Anique, Bibas, Lior, Pacheco, Christine, Couture, Etienne, Simard, François, Poulin, Anthony, Malhamé, Isabelle, Tran, Dan, Rey, Evelyne, Tournoux, François, Harvey, Luc, Sénéchal, Mario, Bélisle, Pierre, Descarries, Laurence, Farand, Paul, and Pranno, Nicolas

Subjects
BROMOCRIPTINE, PERIPARTUM cardiomyopathy, MYOCARDIAL infarction
Abstract

Aims: Bromocriptine is thought to facilitate left ventricular (LV) recovery in peripartum cardiomyopathy (PPCM) through inhibition of prolactin secretion. However, this potential therapeutic effect remains controversial and was incompletely studied in diverse populations. Methods and results: Consecutive women with new‐onset PPCM (n = 76) between 1994 and 2015 in Quebec, Canada, were classified according to treatment (n = 8, 11%) vs. no treatment (n = 68, 89%) with bromocriptine. We assessed LV functional recovery at mid‐term (6 months) and long‐term (last follow‐up) and compared outcomes among groups. Women treated with bromocriptine experienced better mid‐term left ventricular ejection fraction (LVEF) recovery from 23 ± 10% at baseline to 55 ± 12% at 6 months, compared with a change from 30 ± 12% at baseline to 45 ± 13% at 6 months in women treated with standard medical therapy (P interaction < 0.01). At long‐term, a similar positive association was found with bromocriptine (9% greater LVEF variation, P interaction < 0.01). In linear regressions adjusted for obstetrical, clinical, echocardiographic, and pharmacological variables, treatment with bromocriptine was associated with a greater improvement in LVEF [β coefficient (standard error), 14.1 (4.4); P = 0.03]. However, there was no significant association between bromocriptine use and the combined occurrence of all‐cause death and heart failure events (hazard ratio, 1.18; 95% confidence interval, 0.15 to 9.31), using univariable Cox regressions based over a cumulative follow‐up period of 285 patient‐years. Conclusions: In women newly diagnosed with PPCM, treatment with bromocriptine was independently associated with greater LV functional recovery. [ABSTRACT FROM AUTHOR]

Published
2019
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49. Wernicke's encephalopathy: An uncommon complication from hyperemesis gravidarum.

Author

Shah, Roshan, Malhamé, Isabelle, Fayek, Mariam, Merolli, Alisa, and Mehta, Niharika

Subjects
*ATAXIA, *GAIT disorders, *MORNING sickness, *NEUROLOGICAL disorders, *NYSTAGMUS, *WERNICKE'S encephalopathy, *DISEASE complications
Abstract

Hyperemesis gravidarum is a complication of pregnancy associated with severe nausea and vomiting that can lead to fluid-electrolyte imbalances and nutritional deficiencies. Wernicke's encephalopathy is a neurologic manifestation of acute thiamine (vitamin B1) deficiency. We describe a case of hyperemesis gravidarum presenting with gait ataxia and nystagmus which led to a diagnosis of Wernicke's encephalopathy. [ABSTRACT FROM AUTHOR]

Published
2020
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