XXXX in pregnancy: evidence-based management.

@entity1 @entity459 @entity788 @entity3152 @entity7494 @entity425 @entity2742 @entity1592 @entity79 @entity261 @entity1790 @entity3243 @entity116 @entity5617
@entity459 during pregnancy poses significant risks to the mother and the fetus. Fortunately, prompt diagnosis and effective management can improve outcomes for both. There is controversy regarding appropriate management of these @entity1 , especially late in gestation. The objective of this article, therefore, is to review the literature and to propose an evidence-based approach to managing these @entity1 . The prevalence of @entity459 in the general population is 0.15%. This condition is more common in @entity1 and 25% of cases appear in @entity1 during the childbearing years. The true incidence during pregnancy, however, is not known. Because up to 80% of gravid @entity1 with @entity459 are asymptomatic, diagnosing this condition is more difficult. Complications associated with @entity459 in pregnancy have been reported to occur in up to 67% of mothers and 80% of fetuses. In addition to many constitutional symptoms, maternal complications include @entity1790 , @entity79 , @entity788 , @entity7494 , @entity425 , mental status changes, and hypercalcemic crisis. Reported fetal complications include @entity1592 , low birth weight, @entity3152 , @entity5617 , postpartum neonatal @entity116 , and permanent @entity261 . A four-fold decrease in perinatal complications may be achieved with appropriate therapy. Conservative intervention may be appropriate under certain circumstances, but excision of a @entity3243 remains the only definitive treatment. Debate continues regarding the safety of surgery in the third trimester. However, several cases of successful surgery have been reported. TARGET AUDIENCE: Obstetricians _ Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader will be able to describe the typical presentation of a @entity1 with @entity2742 , summarize the work up and management of a @entity1 with @entity2742 , and list the treatment options for a pregnant @entity1 with @entity2742 .
