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هذا حتى العصر يصيح...

ديحاول يتواصل وياك:

Yeah, something like this

Hypothyroidism increases the risk of cardiovascular disease by both genetic and non-genetic mediated ways.

Non-genetic ways include endothelial dysfunction, and disrupting lipid metabolism (increasing serum cholesterol).

Genetic ways involve the myocytes reverting into a fetal genotype and phenotype: usually the cardiac muscle depends on lipids as the main source of energy. Hypothyroidism causes myocytes to change into a fetal phenotype which depends on glucose rather than lipids. This reduces the energy yield and puts the heart in a state of energy insufficiency.

Therefore, low thyroid hormone levels should be interpreted as a cardiovascular risk factor.

Hyperthyroidism (HT) is also a risk factor of cardiovascular disease by means of causing high-output heart failure:
HT increases the metabolism in the whole body, and even though HT increases contractility and heart rate (and therefore cardiac output), this is not enough for the heart to meet the body's demands. And since the heart can't keep up, it's a heart failure... But with high-output.

High-output heart failure is basically when the heart is doing its best, and it's still not enough... Just like med students in exams

The bottom line: whether it's hyper or hypo, your heart is fucked
حرفيًا هنا ينطبق المثل: تعدّدت الأسباب والموت واحد

Also called Ballantyne syndrome, is a rare condition in pregnancy, defined by the presence of the ‘clinical triad’ of fetal hydrops, placentomegaly and maternal oedema. It is called Mirror Syndrome because the maternal pathology mirrors that of the fetus.

Any aetiology of fetal hydrops, including:
Rh iso-immunization, congenital infection, twin-to-twin transfusion, structural anomalies and fetal malignancies, can lead to the syndrome.

The pathogenesis, although not well established, mimics trophoblastic damage and maternal vascular endothelial dysfunction, as is also seen in pre-eclampsia, and, hence, the two conditions may have a similar clinical presentation. They may even co-exist, where a patient with maternal mirror syndrome develops features of pre-eclampsia.

Sonographic findings in fetal hydrops: (A) the arrow indicates the elevation of the fetal skin away from the fetal scalp (bony rim is bright white); (B) arrow indicates bilateral pleural effusions; (C) arrow shows a rim of ascites around the fetal liver; (D) arrow demonstrates a pericardial effusion.

Case:

A 23‐year‐old G3P1011 presented for initial evaluation at 26 weeks 4 days gestation. A large mass consisting of solid and cystic components arising from the sacrum was identified on fetal ultrasound and MRI. The estimated overall volume of the tumor was 642 ml. Placentomegaly was present. The plan for obstetric management included twice weekly fetal ultrasound surveillance and maternal evaluation. The planned mode of delivery would be cesarean with immediate neonatal SCT resection at 32 weeks gestation. Ultrasound at 31 weeks 1 day indicated an overall SCT volume of 1604 ml with continued placentomegaly but no additional evidence of fetal hydros. Maternal assessment indicated elevated blood pressure, trace proteinurea hyperreflexia, and slightly elevated liver enzymes.

Cesarean section was performed at 31 weeks 4 days gestation for impending mirror syndrome. The neonate was stabilized and transferred to an adjoining operating room where she underwent immediate resection of the tumor. The woman's symptoms resolved, and she was discharged within 72 hours.

Interesting..

Preeclampsia is one of the causes of Polyhydramnios, also it’s one of the complications.

P1011?

Parity: 1 term infant delivered, 0 preterm infants delivered, 1 abortion/miscarriage, 1 living child.

Amniotic band syndrome can occur when the inner layer of the placenta, called the amnion, is damaged during pregnancy. If this happens, thin strands of tissue (amniotic bands) form inside the amnion. These fiber-like bands tangle around the developing fetus, restricting blood flow, thus affecting the growth of certain body parts. This can cause congenital deformities of limbs. In some cases, strands can tangle so tightly around the limbs of a fetus that they amputate them. Amniotic band syndrome is usually diagnosed at birth, but can sometimes be detected in the womb by ultrasound.