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Hypertension in Pregnancy

Indira Kosovic, Ivana Kuzmic Prusac, Anna Berkovic, Jelena Marusic, Marko Mimica, Sandra Zekic Tomas
OBJECTIVE: To investigate proliferation, EGF and EGFR expression of villous trophoblast (VTB), decidual cells (DC), and extravillous trophoblast (EVTB) in the placentas from pregnancies complicated with preeclampsia (PE) and to compare them with placentas from normal pregnancies. METHODS: Twenty-nine PE placentas and 19 control placentas were studied for EGF and EGFR immunohistochemical expression (noted as week, moderate or strong). Proliferation was expressed as the proliferation index...
September 22, 2016: Hypertension in Pregnancy
Cassandra N Spracklen, Caitlin J Smith, Audrey F Saftlas, Elizabeth W Triche, Andrew Bjonnes, Brendan J Keating, Richa Saxena, Patrick J Breheny, Andrew T Dewan, Jennifer G Robinson, Josephine Hoh, Kelli K Ryckman
OBJECTIVE: To examine the association between genetic predisposition to elevated C-reactive protein (CRP)and risk for preeclampsia using validated genetic loci for C-reactive protein. METHODS: Preeclampsia cases (n = 177) and normotensive controls (n = 116) were selected from live birth certificates to nulliparous Iowa women during the period August 2002-May 2005. Disease status was verified by the medical chart review. Genetic predisposition to CRP was estimated by a genetic risk score on the basis of established loci for CRP levels...
September 22, 2016: Hypertension in Pregnancy
Mohsen Vigeh, Emiko Nishioka, Kazuhito Yokoyama, Katsumi Ohtani, Takehisa Matsukawa
OBJECTIVE: Pregnancy hypertension is the most common gestational complication and poses a critical risk for mother and fetus. Whether environmental factors may play an important role in disease occurrence is not fully determined. METHODS: To investigate the effects of prenatal manganese (Mn) exposure on gestational blood pressure, 386 women were examined. RESULTS: Early pregnancy blood Mn was significantly (p < 0.05) correlated with blood pressure through gestation...
September 20, 2016: Hypertension in Pregnancy
Xiaohua Zhao, Jingjing Liu, Cuisheng Zhao, Ping Ye, Jing Ji, Jingli Wang, Weiqing Song, Jine Xu, Shiguo Liu
OBJECTIVE: Previous studies have been indicated that catechol-O-methyltransferase gene (COMT) might play a significant role in the development of preeclampsia (PE). Our study aims to investigate the association between polymorphism in COMT with the susceptibility to PE in Chinese Han women. METHOD: A total of 1028 PE patients and 1399 normal pregnant women were enrolled. We detected the genotyping of COMT Val158Met loci by the TaqMan allelic discrimination real-time PCR ...
September 19, 2016: Hypertension in Pregnancy
Jelena Milosevic-Stevanovic, Miljan Krstic, Dragana Radovic-Janosevic, Milan Stefanovic, Vladimir Antic, Ivana Djordjevic
OBJECTIVE: The objective of this study is to determine the differences in histopathological features of basal decidua and placenta in cases of preeclampsia with or without fetal intrauterine growth restriction (IUGR). METHODS: A prospective case-control study included a study group consisting of 30 pregnant women with preeclampsia completed by cesarean section (CS), in 19 of whom preeclampsia was associated with IUGR, and in 11 it was not. The control group consisted of 20 healthy pregnant women delivered by elective CS...
September 13, 2016: Hypertension in Pregnancy
Ender Gedik, Neslihan Yücel, Taylan Sahin, Erdinc Koca, Yusuf Ziya Colak, Turkan Togal
PURPOSE: The aim was to assess outcomes for pregnancies in which hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome develops and the patient requires transfer for critical care. MATERIALS AND METHODS: The cases of women with HELLP syndrome who delivered at our tertiary center or surrounding hospitals and were admitted to the intensive care between January 2007 and July 2012 were retrospectively analyzed. Results were compared for the surviving and non-surviving patients...
September 6, 2016: Hypertension in Pregnancy
Carolien N H Abheiden, Birgit S Blomjous, Sylvia J Kroese, Irene E M Bultink, Ruth D E Fritsch-Stork, A Titia Lely, Marjon A de Boer, Johanna I P de Vries
OBJECTIVE: To relate anticoagulant use to pregnancy complications in women with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (APS). METHODS: All ongoing pregnancies, 184, in two Dutch tertiary centers between 2000 and 2015. RESULTS: LMWH and aspirin was prescribed in 15/109 SLE women without antiphospholipid antibodies (aPL), 5/14 with aPL, 11/13 with APS, 45/48 with primary APS. Main complications in the four treatment groups (no anticoagulant treatment, aspirin, LMWH, aspirin and LMWH) included hypertensive disorders of pregnancy (9...
September 6, 2016: Hypertension in Pregnancy
Jyotsna Verma, Divya C Thomas, Geetu Jhingan, Ratna D Puri, I C Verma
OBJECTIVE: To determine the diagnostic accuracy of preeclampsia (PE) screening test offered in early pregnancy for the prediction of the risks for early-onset (requiring delivery <32 weeks gestation) and late-onset (requiring delivery ≥32 weeks gestation) disease. METHODS: In a retrospective study of 615 women with singleton pregnancy, the risk for PE was calculated by the combined effect of multiple variables: serum placental growth factor (PLGF) and pregnancy-associated plasma protein-A (PAPP-A), maternal age, parity, ethnicity, mean arterial pressure (MAP), body mass index (BMI), uterine artery-pulsatility index, and previous history of PE or hypertension (HT)...
September 6, 2016: Hypertension in Pregnancy
Husham O Elzein, Abdel Rahim M Muddathir, Mohammed Rida, Duria A Rayis, Elhassan M Elhassan, Ishag Adam
BACKGROUND: Although preeclampsia remains a major cause of maternal and fetal morbidity and mortality, its pathogenesis is not fully understood. Coagulation and fibrinolysis changes were suggested to have a role in the pathogenesis of preeclampsia. OBJECTIVES: A case-control study was conducted in Medani Hospital, Sudan, to investigate thrombin-activatable fibrinolysis inhibitor (TAFI) and plasminogen-activated inhibitor (PAI) in women with severe preeclampsia. Obstetrics and medical history was gathered using questionnaire...
September 6, 2016: Hypertension in Pregnancy
A T Dennis, S M Mulligan
OBJECTIVE: We determined pain experience and analgesic usage in women with preeclampsia (PE) after caesarean section (CS). METHOD: We conducted a one-year retrospective case (PE), control (healthy pregnancy HP) study in women undergoing CS. RESULTS: Sixty-two women were included. Cases received more intrathecal bupivacaine (mean difference 0.4 mg) and in the first six hours postoperatively received (mean ± SD, % or median (interquartile range, IQR)), less oxycodone (11...
July 28, 2016: Hypertension in Pregnancy
Tamarra James-Todd, Allison Cohen, Julia Wenger, Florence Brown
OBJECTIVE: Determine the independent association between time-specific placental growth factor (PIGF)-a marker of placental vasculature-and infant birth weight in offspring of mothers with preexisting type 1 and 2 diabetes. METHODS: A total of 150 women were recruited from Joslin Diabetes Center's/Beth Israel Deaconess Medical Center's Diabetes in Pregnancy Program. PlGF was measured up to four times during pregnancy. Infant birth weight and covariate data were collected from medical records...
August 2016: Hypertension in Pregnancy
P J Correa, Y Palmeiro, M J Soto, C Ugarte, S E Illanes
Hypertensive disorders are a major cause of maternal death. Preeclampsia (PE) affects about 5% of pregnancies and is associated to high cardiovascular death risk. Understanding of its origin and cause is difficult and many etiologies have been proposed. So far, little can be done for real prevention and the only treatment is pregnancy interruption, increasing the child's risk for prematurity complications. Early markers of disease are a promising path for understanding the pathogenesis and developing new strategies for prediction and eventually disease prevention...
August 2016: Hypertension in Pregnancy
Jie Gan, Huan He, Hongbo Qi
BACKGROUND: Low-dose aspirin can reduce the incidence of preeclampsia and intrauterine growth restriction (IUGR). However, the effects of ethnicity upon low-dose aspirin's efficacy has not been analyzed. Here, we comparatively evaluated the efficacy of low-dose aspirin in preventing preeclampsia and related fetal complications in East Asian and non-East Asian pregnant women at risk for preeclampsia. METHODS: Several databases were searched for randomized controlled trials (RCTs) comparing low-dose aspirin with either placebo or no treatment in pregnant women at risk for preeclampsia...
August 2016: Hypertension in Pregnancy
Tao Wang, Rong Zhou, Linbo Gao, Yanyun Wang, Xinghui Liu, Lin Zhang
OBJECTIVE: To evaluate the specificity of the adipsin rapid test in clinical practice for the diagnosis of preeclampsia (PE). METHODS: A total of 1144 pregnant women were recruited in this study: 44 pregnant women with PE and 1100 healthy pregnancies as controls. Urine samples were collected and used, respectively, for the adipsin rapid test and the urinary dipstick test for protein detection. Sensitivity and specificity were calculated on the basis of the detection results...
August 2016: Hypertension in Pregnancy
Louise Bjørkholt Andersen, Ralf Dechend, Jan Stener Jørgensen, Birgitte Møller Luef, Jan Nielsen, Torben Barington, Henrik Thybo Christesen
OBJECTIVE: We aimed to investigate how maternal serum soluble Fms-like kinase 1 (sFlt-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio prospectively associate to preeclampsia (PE) and clinical subtypes. METHODS: In an unselected cohort of 1909 pregnant women, sFlt-1 and PlGF were measured with KRYPTOR assays in gestational weeks (GW) 8-14 and 20-34. Associations to PE were assessed by receiver operating characteristics and logistic regression. RESULTS: Concentrations of sFlt-1, PlGF, and sFlt-1/PlGF in GW20-34 were predictive of PE development, but not in GW8-14...
August 2016: Hypertension in Pregnancy
Karina Tamy Kasawara, Fernanda Garanhani Surita, João Luiz Pinto E Silva
OBJECTIVE: Reviewed literature regarding exercise effects on pregnancy-related hypertensive disorders, analyzing basic science perspectives and clinical studies. METHODS: Scientific databases were accessed by research strategy combining Medical Subject Headings terms. Studies published between 2000 and 2015, in English, Portuguese, and Spanish language, were considered. RESULTS: Studies were classified into: recommendations for exercise on high-risk pregnancy; animal models for hypertension in pregnancy; exercise on hypertensive disorders in animal models and pregnant women...
August 2016: Hypertension in Pregnancy
Manisha Kumar, Karuna Sharma, Ritu Singh, Shalini Singh, V Ravi, Kamlesh Singh, Usha Gupta, J Bhattacharya
OBJECTIVE: To determine the predictive value of biochemical markers, uterine artery Doppler, and maternal factors in predicting early-onset (EO) and late-onset (LO) pregnancy hypertension. METHODOLOGY: All singleton pregnancies between 11 and 13 weeks and 6 days gestation underwent estimation of body mass index (BMI), mean arterial pressure (MAP), uterine artery Doppler pulsatality index (PI, and resistance index), biomarker PAPP-A, and free β-hCG. Women who developed hypertension were treated as cases and normotensives were taken as controls...
August 2016: Hypertension in Pregnancy
Wendy M White, Zhifu Sun, Kristi S Borowski, Brian C Brost, Norman P Davies, Carl H Rose, Vesna D Garovic
OBJECTIVE: To analyze methylation profiles of known preeclampsia/eclampsia (PE) candidate genes in normal (NL) and preeclamptic (PE) women at delivery. METHODS: A matched case-control study comparing methylation in 79 CpG sites/33 genes from an independent gene set in maternal leukocyte DNA in PE and NL (n = 14 each) on an Illumina BeadChip platform. Replication performed on second cohort (PE = 12; NL = 32). RESULTS: PE demonstrates differential methylation in POMC, AGT, CALCA, and DDAH1 compared with NL...
August 2016: Hypertension in Pregnancy
Geraldine Skurnik, Andrea Teresa Roche, Jennifer J Stuart, Janet Rich-Edwards, Eleni Tsigas, Sue E Levkoff, Ellen W Seely
OBJECTIVE: Women with prior preeclampsia are at increased risk of cardiovascular disease (CVD). This study investigated barriers and facilitators toward learning about this link and engaging in lifestyle modifications to reduce this risk. METHODS: Four focus groups were held with 14 women within 6 months of a preeclamptic pregnancy. RESULTS: Participants were unaware of the link between preeclampsia and CVD, suggested improvements to provider-patient communication, and discussed the benefits of social support and online tracking (weight, blood pressure) in making lifestyle modifications...
August 2016: Hypertension in Pregnancy
Saira Salahuddin, Julia B Wenger, Dongsheng Zhang, Ravi Thadhani, S Ananth Karumanchi, Sarosh Rana
OBJECTIVE: To evaluate KRYPTOR assays for circulating soluble fms-like tyrosine kinase-1 (sFlt1) and placental growth factor (PlGF) in risk assessment of adverse outcomes in women with suspected preeclampsia. METHODS: We studied 412 women carrying a singleton pregnancy from a previous study cohort who were evaluated for suspected preeclampsia. Another 434 nonpreeclamptic patients with plasma samples drawn throughout pregnancy were used to derive normative data. Plasma sFlt1 and PlGF levels were measured on the automated KRYPTOR platform and evaluated for prediction of adverse maternal and perinatal outcomes within 2 weeks...
August 2016: Hypertension in Pregnancy
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