Reported is a case of a 29-year old Gravida 5 Para 4(4004), 23 6/7 weeks pregnant, known diabetic with hepatic hemangioma, who previously underwent ligation of ruptured esophageal varices, was admitted for the first time on February 21, 2015 due to left-sided hemiparesis. Identifying the cause of the pontine bleed and its possible association with coexisting medical problems was an arduous process since there are no existing management guidelines. Emergency Caesarean Section with bilateral tubal ligation under general anesthesia was done at 35 weeks AOG and a live baby girl was delivered with an Apgar score of 9,9. Magnetic Resonance Angiography (MRA) of intracranial vessels postpartum revealed a Cavernoma. This case is of particular importance due to the following reasons: 1.) Cerebral Cavernous Malformation (CCM) is a rare disease, 2.) There is scant data associating CCM with pregnancy, 3.) Current literature has not reported CCM with Hepatic Hemangioma in a single patient, 4.) No data has linked it with diabetes mellitus, 5.) There are still no management guidelines of CCM in pregnancy, 6.) A multidisciplinary approach is necessary for optimal maternal and fetal outcomes.

Human ; Female ; Adult ; Hemangioma, Cavernous

Background: Although decreased potassium levels may have a role in the etiopathogenesis of preeclampsia, small number of studies has been done to determine their relationship. Objectives: This study was done to know whether serum potassium is significantly decreased in hypertensive disorders of pregnancy, to determine if the level of potassium correlates with the severity of hypertension, to know whether we can recommend serum potassium as part of preeclamptic work up, and ultimately, to determine if potassium supplementation can be advised to preeclamptic women during prenatal check-up. In this prospective, cross sectional study, subjects were 338, 169 of whom had uncomplicated pregnancies, while 169 had preeclampsia (72 of whom had systolic BP(SBP) 140-150mmHg, while 97 had SBP ?160mmHg). Baseline serum potassium were taken upon admission. The mean serum potassium was significantly lower at 3.37±0.41mmol/L (p-value<0.0003) in hypertensive women (versus 3.62±0.31mmol/L in uncomplicated pregnancies). Furthermore, the serum potassium was significantly decreased in patients with SBP>160mmHg (3.31±0.46) when compared with those with SBP140-150mmHg (3.45±0.32), with p0.013. Wilcoxon Signed-Rank Test showed Z-value -5.68 (significant at p?0.05), showing a significant difference between the level of serum potassium in normotensive compared to hypertensive patients. Chi-Square test showed X2?45.46 (in the critical region 5.9), therefore the level of serum potassium is dependent on the level of BP. Pearson Correlation coefficient showed r -0.1135 stating a negative correlation, hence, as the BP increases, serum potassium decreases. Conclusion This study suggests that hypokalemia observed in preeclamptic patients may bring about altered homeostatis in serum and therefore may act as predisposing factors in pathogenesis of preeclampsia. The authors recommend the addition of serum potassium as part of the criteria of severity of preeclampsia. Hypertensive pregnant women are advised to consume diet containing adequate amount of potassium or have a potassium supplementation during prenatal check up.
Hypokalemia ; Pre-Eclampsia