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11. Bacterial profiles of the human placenta from term and preterm deliveries

Author

Theis, Kevin R., primary, Winters, Andrew D., additional, Romero, Roberto, additional, Alhousseini, Ali, additional, Greenberg, Jonathan M., additional, Panzer, Jonathan, additional, Galaz, Jose, additional, Pacora, Percy, additional, Shaffer, Zachary, additional, Jung, Eunjung, additional, and Gomez-Lopez, Nardhy, additional

Published
2022
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19. Clinical chorioamnionitis at term X: microbiology, clinical signs, placental pathology, and neonatal bacteremia – implications for clinical care

Author

Romero, Roberto, primary, Pacora, Percy, additional, Kusanovic, Juan Pedro, additional, Jung, Eunjung, additional, Panaitescu, Bogdan, additional, Maymon, Eli, additional, Erez, Offer, additional, Berman, Susan, additional, Bryant, David R., additional, Gomez-Lopez, Nardhy, additional, Theis, Kevin R., additional, Bhatti, Gaurav, additional, Kim, Chong Jai, additional, Yoon, Bo Hyun, additional, Hassan, Sonia S., additional, Hsu, Chaur-Dong, additional, Yeo, Lami, additional, Diaz-Primera, Ramiro, additional, Marin-Concha, Julio, additional, Lannaman, Kia, additional, Alhousseini, Ali, additional, Gomez-Roberts, Hunter, additional, Varrey, Aneesha, additional, Garcia-Sanchez, Angel, additional, and Gervasi, Maria Teresa, additional

Published
2021
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20. Nonovert disseminated intravascular coagulation (DIC) in pregnancy: a new scoring system for the identification of patients at risk for obstetrical hemorrhage requiring blood product transfusion

Author

Alhousseini, Ali, primary, Romero, Roberto, additional, Benshalom-Tirosh, Neta, additional, Gudicha, Dereje, additional, Pacora, Percy, additional, Tirosh, Dan, additional, Kabiri, Doron, additional, Yeo, Lami, additional, Thachil, Jecko, additional, Hsu, Chaur-Dong, additional, Hassan, Sonia S., additional, and Erez, Offer, additional

Published
2020
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22. Nonovert disseminated intravascular coagulation (DIC) in pregnancy: a new scoring system for the identification of patients at risk for obstetrical hemorrhage requiring blood product transfusion.

Author

Alhousseini, Ali, Romero, Roberto, Benshalom-Tirosh, Neta, Gudicha, Dereje, Pacora, Percy, Tirosh, Dan, Kabiri, Doron, Yeo, Lami, Thachil, Jecko, Hsu, Chaur-Dong, Hassan, Sonia S., and Erez, Offer

Abstract

Nonovert disseminated intravascular coagulation (DIC) is a subclinical hemostatic dysfunction that has not yet reached the decompensation stage. The detection of pregnant patients at this stage may assist in the identification of those who will develop severe obstetrical hemorrhage, as it is one of the leading causes for preventable maternal mortality. Currently, nonovert DIC is diagnosed by a scoring system based on nonpregnant patients, originally generated by the International Society on Thrombosis and Hemostasis (ISTH), which does not address the physiologic changes of the hemostatic system during pregnancy. (1) To develop a pregnancy-specific nonovert DIC score, (2) to determine the diagnostic performance of this score in detecting women at risk for obstetrical hemorrhage requiring blood product transfusion, and (3) to compare it to the existing ISTH nonovert DIC score. This retrospective study has longitudinal and cross-sectional components and includes three steps: (1) characterization of the longitudinal changes in the components of modified ISTH nonovert DIC scores, including these parameters – fibrinogen, antithrombin III, protein C, prothrombin time (PT), platelets, thrombin-antithrombin (TAT) complex, and D-dimer – during gestation in a group of normal pregnancies (n = 50); (2) development of a pregnancy-specific nonovert DIC score in a cross-sectional design of high-risk (n = 152) and control (n = 50) pregnancies, based on the predictive performance of each analyte for the detection of women at risk for obstetrical hemorrhage requiring blood product transfusion and a logistic regression model; and (3) comparison between the diagnostic performance of the pregnancy-specific nonovert DIC score and the modified ISTH nonovert DIC score to detect, upon admission, women who are at increased risk for subsequent development of obstetrical hemorrhage requiring blood product transfusion. (1) The study cohort included 202 patients, of which 21 (10%) had obstetrical hemorrhage that required blood product transfusion and were considered to have nonovert DIC; (2) using the nonpregnant ISTH nonovert DIC score, 92% of the patients had a D-dimer concentration above the 0.5 mg/L threshold, and only 2% were identified to have a low fibrinogen concentration (<100 mg/dL); thus, this scoring system was unable to identify any of the patients with nonovert DIC based on the suggested cutoff of a score of ≥5; (3) the parameters included in the pregnancy-specific nonovert DIC score were selected based on their contribution to the performance of the model for the prediction of women at risk for obstetrical hemorrhage requiring blood product transfusion; as a result, we excluded the PT difference parameter from the score and the TAT complex concentration was added; and (4) a pregnancy-specific nonovert DIC score of ≥3 had a sensitivity of 71.4% and a specificity of 77.9% to identify patients at risk for obstetrical hemorrhage requiring blood product transfusion. We propose (1) a pregnancy-specific nonovert DIC score adjusted for the physiologic changes in the hemostatic system during gestation; and (2) that the pregnancy-specific nonovert DIC score can be a useful tool for the identification of patients at risk for obstetrical hemorrhage requiring blood product transfusion. [ABSTRACT FROM AUTHOR]

Published
2022
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23. Umbilical Artery Thrombosis with Associated Acute and Severe Fetal Growth Restriction and Transient Severe Protein S Deficiency: Report of a Case with Prenatal Ultrasound Diagnosis Allowing for Timely Intervention and Good Outcome

Author

Alhousseini, Ali, Jaiman, Sunil, Hernandez-Andrade, Edgar, Zeineddine, Salam, Qureshi, Faisal, and Jacques, Suzanne M.

Subjects
Article Subject
Abstract

Background. Thrombosis of one of the umbilical arteries can be associated with adverse pregnancy outcomes such as stillbirth and severe intrauterine growth restriction (IUGR). Case. A 21-year-old gravida 1 patient, with a history of 3-vessel cord at 20 weeks, presented at 29 weeks with a single umbilical artery. The estimated fetal weight measurements at 26 weeks, 29 weeks, and 31 weeks were at the 27th percentile, the 26th percentile, and less than the 5th percentile, respectively. At 33 weeks, amniotic fluid index became abnormal at 2.3 cm and fetal heart tracing revealed spontaneous prolonged decelerations, and a cesarean delivery was performed. Placental pathology showed thrombosis of one of the umbilical arteries. At birth, a transient protein S deficiency was detected (activity 13%) and resolved at two months of age (activity 66%). The baby had an uneventful clinical course since birth. Conclusion. The recognition of reduction of umbilical arteries from two to one allowed for timely intervention with good outcome in this case. Thrombosis of umbilical vessels may be associated with a deficiency in coagulation proteins such as protein S.

Published
2018
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24. Does the human placenta delivered at term have a microbiota? Results of cultivation, quantitative real-time PCR, 16S rRNA gene sequencing, and metagenomics

Author

Theis, Kevin R., primary, Romero, Roberto, additional, Winters, Andrew D., additional, Greenberg, Jonathan M., additional, Gomez-Lopez, Nardhy, additional, Alhousseini, Ali, additional, Bieda, Janine, additional, Maymon, Eli, additional, Pacora, Percy, additional, Fettweis, Jennifer M., additional, Buck, Gregory A., additional, Jefferson, Kimberly K., additional, Strauss, Jerome F., additional, Erez, Offer, additional, and Hassan, Sonia S., additional

Published
2019
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25. Familial Hydrocephalus and Dysgenesis of the Corpus Callosum Associated with Xp22.33 Duplication and Stenosis of the Aqueduct of Sylvius with X-Linked Recessive Inheritance Pattern

Author

Alhousseini, Ali, primary, Zeineddine, Salam, additional, Husseini, Abraham, additional, Baddah, Heba, additional, Saker, Homam, additional, Mody, Swati, additional, Ibrahim, Salah A., additional, Thakur, Mili, additional, Hernandez-Andrade, Edgar, additional, and Bahado-Singh, Ray, additional

Published
2019
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26. 472: Metabolomic prediction of prematurity in asymptomatic short cervix

Author

Friedman, Perry, primary, Yilmaz, Ali, additional, Zeb, Amna, additional, Buket, Aydas, additional, Whitten, Amy, additional, Alhousseini, Ali, additional, Ogunyemi, Dotun, additional, Han, BeomSoo, additional, Mandal, Rupasri, additional, Wishart, David, additional, Graham, Stewart, additional, and Bahado-Singh, Ray, additional

Published
2019
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27. A Non-Lethal Osteogenesis Imperfecta Type II Mutation

Author

Alhousseini, Ali, primary, Mahaseth, Maheshwar, additional, Zeineddine, Salam, additional, Jaiman, Sunil, additional, Berman, Susan, additional, Bryant, David, additional, Tan, Sidhartha, additional, and Hernandez-Andrade, Edgar, additional

Published
2018
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28. Intrahepatic Cholestasis of Pregnancy Leading to Severe Vitamin K Deficiency and Coagulopathy

Author

Maldonado, Maria, Alhousseini, Ali, Awadalla, Michael, Idler, Jay, Welch, Robert, Puder, Karoline, Patwardhan, Manasi, and Gonik, Bernard

Subjects
Article Subject
Abstract

Intrahepatic cholestasis of pregnancy is seldom associated with significant vitamin K deficiency. We report a case of a 16-year-old primigravid patient at 24 weeks and 3 days of gestation who presented with pruritus, hematuria, and preterm labor. Laboratory work-up showed severe coagulopathy with Prothrombin Time (PT) of 117.8 seconds, International Normalized Ratio (INR) of 10.34, and elevated transaminases suggestive of intrahepatic cholestasis of pregnancy. Her serum vitamin K level was undetectable (

Published
2017
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30. Cover

Author

Gomez-Lopez, Nardhy, primary, Romero, Roberto, additional, Xu, Yi, additional, Miller, Derek, additional, Leng, Yaozhu, additional, Panaitescu, Bogdan, additional, Silva, Pablo, additional, Faro, Jonathan, additional, Alhousseini, Ali, additional, Gill, Navleen, additional, Hassan, Sonia S, additional, and Hsu, Chaur-Dong, additional

Published
2018
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32. Management of Psoriasis Herpeticum in Pregnancy: A Clinical Conundrum

Author

Almario, Leanne, Antonyan, Albert S., Porto, Dennis A., Gomez-Roberts, Hunter, Alhousseini, Ali, and Gonik, Bernard

Subjects
Article Subject
Abstract

Introduction. Kaposi varicelliform eruption (KVE) is a widespread cutaneous viral infection, most commonly herpes simplex virus, which affects patients with underlying dermatosis. When KVE occurs in a patient with a history of psoriasis, it is referred to as psoriasis herpeticum, a rare subtype of KVE with only a handful of cases reported in the literature. To the authors’ knowledge, we report for the first time a case of psoriasis herpeticum in pregnancy. Case Presentation. A 23-year-old woman in her third pregnancy presented at 26-week gestation with a 10-year history of psoriasis. Cutaneous examination revealed diffuse psoriatic plaques with scattered ~1 cm erosions. Punch biopsy of the skin revealed herpes simplex virus (HSV) infection within a psoriatic plaque, necessitating dermatological treatment. The patient experienced premature rupture of membranes at 37-week gestation. Pelvic exam showed no evidence of herpetic lesions. After labor augmentation, the patient delivered a healthy female infant with no evidence of HSV infection. Discussion. Psoriasis herpeticum is a rare and potentially devastating complication of an underlying dermatosis. With a paucity of data available to guide pregnancy-specific issues, the general management of this condition is controversial and requires a multidisciplinary care approach. Concerns for systemic infection in the mother and vertical transmission to the neonate are of critical importance.

Published
2016
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34. A Non-Lethal Osteogenesis Imperfecta Type II Mutation.

Author

Alhousseini, Ali, Mahaseth, Maheshwar, Zeineddine, Salam, Jaiman, Sunil, Berman, Susan, Bryant, David, Tan, Sidhartha, and Hernandez-Andrade, Edgar

Subjects
*OSTEOGENESIS imperfecta, *CONDUCTIVE hearing loss, *AMNIOTIC liquid, *CESAREAN section, *ETHICAL decision making, *SKELETAL dysplasia, *COLLAGEN, *FETAL ultrasonic imaging, *EVALUATION of medical care, *GENETIC mutation, *PREGNANCY
Abstract

Background: We discuss the ethical decision points in a case report that describes a novel COL1A1 mutation associated to Osteogenesis Imperfecta type II, but with a non-lethal outcome.Case: A 33-year-old female underwent a 21-week ultrasound that revealed short bowed femurs and humeri with old fractures and bowed tibias and fibulas. Amniotic fluid testing revealed a novel COL1A1 mutation (c.1840G>A; p.Gly614Arg). OI Type II diagnosis was made. A previously reported mutation of the same gene but different locus (c.1840G>C; p.Gly614Arg) led to a lethal form of OI type II. The newborn was delivered via a cesarean delivery and intravenous bisphosphonates (Zaledronic acid) was administered every 3 months. Currently the infant is 22 months old, is growing, with mild bilateral conductive hearing loss.Conclusion: The unexpected clinical outcome should serve as a reminder that phenotypic variability can occur with genetic mutations. Our case shows that the diagnosis of the type of OI should be based not only on clinical findings and genetic investigations but also on the clinical course over time. [ABSTRACT FROM AUTHOR]

Published
2019
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