ABSTRACT
The period just after delivery is a high-risk period for women with associated morbidity and even mortality. There are large variations in complication rates across various groups in the United States. This article covers complications commonly encountered in the emergency department in late pregnancy and the early postpartum period. It specifically addresses postpartum depression, peripartum cardiomyopathy, and the late pregnant or postpartum patient presenting with headache or neurologic complaints. Emergency physicians should be well versed in common and life-threatening postpartum pathologies.
Subject(s)
Pregnancy Complications/diagnosis , Pregnancy Trimester, Third , Puerperal Disorders/diagnosis , Depression, Postpartum/diagnosis , Depression, Postpartum/therapy , Emergency Service, Hospital , Female , Headache/complications , Headache/diagnosis , Headache/therapy , Humans , Postpartum Period , Pregnancy , Pregnancy Complications/therapy , Puerperal Disorders/therapyABSTRACT
This article covers a high-risk time in a woman's life, the period just after delivery of her baby. There are large variations in complication rates across various groups in the United States. Many women seek care in the emergency department for routine and more serious postpartum pathologies. Emergency physicians should be well versed in common and life-threatening complications of delivery. The specific pathologies discussed in this article include lactation in the emergency department, postpartum hemorrhage, amniotic fluid embolism, endometritis, and mastitis.
Subject(s)
Puerperal Disorders/diagnosis , Embolism, Amniotic Fluid/diagnosis , Embolism, Amniotic Fluid/therapy , Emergency Service, Hospital , Endometritis/diagnosis , Endometritis/therapy , Female , Humans , Lactation Disorders/diagnosis , Lactation Disorders/therapy , Mastitis/diagnosis , Mastitis/therapy , Postpartum Hemorrhage/diagnosis , Postpartum Hemorrhage/therapy , Pregnancy , Puerperal Disorders/therapyABSTRACT
Mutations in the RNA binding protein FUS cause amyotrophic lateral sclerosis (ALS), a fatal adult motor neuron disease. Decreased expression of SMN causes the fatal childhood motor neuron disorder spinal muscular atrophy (SMA). The SMN complex localizes in both the cytoplasm and nuclear Gems, and loss of Gems is a cellular hallmark of fibroblasts in patients with SMA. Here, we report that FUS associates with the SMN complex, mediated by U1 snRNP and by direct interactions between FUS and SMN. Functionally, we show that FUS is required for Gem formation in HeLa cells, and expression of FUS containing a severe ALS-causing mutation (R495X) also results in Gem loss. Strikingly, a reduction in Gems is observed in ALS patient fibroblasts expressing either mutant FUS or TDP-43, another ALS-causing protein that interacts with FUS. The physical and functional interactions among SMN, FUS, TDP-43, and Gems indicate that ALS and SMA share a biochemical pathway, providing strong support for the view that these motor neuron diseases are related.
