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Preeclampsia eclampsia

Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Sherihan Adel, Amal Mansour, Manal Louka, M Matboli, F Elmekkawi S, Nahed Swelam
BACKGROUND: The precise origin of Pre-eclampsia (PE) remains elusive. Multiple pieces of evidence support the existence of hypoxia in PE. MiRNA-210 (miR-210), which is induced by Hypoxia-Inducible Factor-1α (HIF-1α) during hypoxia, is one of the most hypoxia sensitive miRNAs. MiR-210 mediates these functions by regulating a lot of target mRNAs. Protein tyrosine phosphatase, non-receptor type 2 (PTPN2) was one of miR-210 targets and was found to be down regulated by hypoxia. OBJECTIVE: to assess the levels of relative expression of miR-210 and its target PTPN2 in Egyptian women with PE...
October 13, 2016: Gene
Andrea G Edlow, Brian L Edlow, Jonathan A Edlow
Acute neurologic symptoms in pregnant and postpartum women may be caused by exacerbation of a preexisting neurologic condition, the initial presentation of a non-pregnancy-related problem, or a new neurologic problem. Pregnant and postpartum patients with headache and neurologic symptoms are often diagnosed with preeclampsia or eclampsia; however, other etiologies must also be considered. A team approach with close communication between emergency physicians, neurologists, maternal-fetal medicine specialists, and radiologists is the key to obtaining best outcomes...
November 2016: Emergency Medicine Clinics of North America
Ran Svirsky, Ron Maymon, Yaakov Melcer, Esther Klog, Howard Cuckle
OBJECTIVE: To investigate maternal serum inhibin as a marker of pre-eclampsia in twins. METHODS: 143 twins and 109 unaffected singleton pregnancies were recruited in the first trimester from the same institution. Blood samples were stored at recruitment and in the second trimester, retrospectively tested for inhibin and values expressed in multiples of the gestation-specific median (MoMs) in singletons, adjusted for maternal weight, as appropriate. RESULTS: The median inhibin level in unaffected twins was 2...
October 12, 2016: Prenatal Diagnosis
Laxman G Jessani, Aumir Moin, Shivaprasad Karnati, Keshavamurthy
Here we report two patients with late post-partum eclampsia without pre-existing preeclampsia presenting with atypical features of posterior reversible encephalopathy syndrome (PRES) which was diagnosed by serial MRI with good outcome emphasizing the fact that early diagnosis and treatment can prevent complications.
February 2016: Journal of the Association of Physicians of India
Mary V Kinney, Jeffrey Michael Smith, Tanya Doherty, Jorge Hermida, Karen Daniels, José M Belizán
Hypertensive disorders of pregnancy (HDP), particularly pre-eclampsia and eclampsia, remain one of the leading causes of maternal mortality and are contributory in many foetal/newborn deaths. This editorial discusses a supplement of seven papers which provide the results of the first round of the CLIP (Community Level Interventions for Pre-eclampsia) Feasibility Studies. These studies report a number of enablers and barriers in each setting, which have informed the implementation of a cluster-randomized trial (cRCT) aimed at reducing pre-eclampsia-related, and all-cause, maternal and perinatal mortality and major morbidity using community-based identification and treatment of pre-eclampsia in selected geographies of Nigeria, Mozambique, Pakistan and India...
September 30, 2016: Reproductive Health
Preenan Pillay, Niren Maharaj, Jagidesa Moodley, Irene Mackraj
INTRODUCTION AND AIM: Exosomes are a subtype of extracellular vesicle (20-130 nm) released by biological cells under normal and pathological conditions. Although there have been reports of circulating exosomes in normal pregnancy, the relevance of placental-derived exosomes in normal and abnormal pregnancies still needs to be elucidated. The aim of this study was to quantify total and placental-derived exosomes in maternal plasma from normal (N), early onset- and late onset-preeclampsia (PE)...
October 2016: Placenta
Pooneh Nikuei, Nahid Davoodian, Iman Tahamtan, Abbas Ali Keshtkar
INTRODUCTION: Pre-eclampsia (PE) is a serious condition affecting 3-5% of all pregnancies worldwide. However, underlying molecular pathogenesis of this disease has largely remained unknown. Recently, several studies have indicated the possibility role of microRNAs, especially miR-210, in the aetiology of PE. The aim of this systematic review is to assess the possible role of miR-210 as a novel biomarker for the prediction of PE. METHODS AND ANALYSIS: Using a combination of mesh terms 'preeclampsia', 'microRNA' and their equivalents, an electronic search will be performed for all observational studies (cross sectional, case-control and cohort) in PubMed, Web of Science, Scopus, Embase, Cochrane, LILACS and OvidSP MEDLINE from January 2005 to December 2015...
September 28, 2016: BMJ Open
L M Webster, J Fetherston, C Chmiel, C Nelson-Piercy, A Khalil, J Myers, L C Chappell
INTRODUCTION: Increased aortic systolic BP (SBPao), pulse wave velocity (PWVao) and augmentation index of the aorta (AIXao) are associated with increased cardiovascular morbidity. These measures may also be increased prior to the development of adverse maternal and perinatal outcomes. The aim of this study was to evaluate the association between haemodynamic parameters and adverse outcomes in women with chronic hypertension (CHT). METHODS: Women recruited to the PANDA study (Pregnancy And chronic hypertension: NifeDipine versus lAbetalol as antihypertensive treatment) had Arteriograph (Tensio Med) readings taken while sitting...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Lo Presti, G Gagliardi, G M Tiralongo, I Pisani, B Vasapollo, G P Novelli, H Valensise
OBJECTIVE: The purpose of our study was to assess cardiac function in non-pregnant women with previous early preeclampsia before a second pregnancy to highlight the cardiovascular pattern, which may take a risk for recurrent preeclampsia. METHODS: Seventy-five normotensive patients with previous preeclampsia and 147 controls with a previous uneventful pregnancy were enrolled in a case control study and submitted to echocardiographic examination in the non-pregnant state 12-18 months after the first delivery...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
J Tay, L Foo, C McEniery, I Wilkinson, C Lees
INTRODUCTION: Studies in pre-eclampsia have demonstrated that central haemodynamic changes give more insight than peripheral measures into maternal cardiac and vascular physiology. This study aims to investigate augmentation index (AIX) and pulse wave velocity (PWV) in pregnancies affected by fetal growth restriction (FGR) and compare them to healthy women in the third trimester of pregnancy. Augmentation index (AIx) is a measure of systemic arterial stiffness derived from the ascending aortic pressure waveform...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Ogochukwu Chantelle Umadia, Dimuthu Vinayagam, Juan Gutierrez Henares, Asma Khalil
AIM: To identify the independent risk factors for PE development in twin pregnancies and explore the associated perinatal outcomes. METHODS: A retrospective cohort study of twin pregnancies was performed at St George's University Hospital, London. Maternal and neonatal data were obtained from the hospital's computerised database. The Chi-square test, Mann-Whitney U test and univariate and multiple-logistic regression analyses were performed. RESULTS: We identified a total of 1250 twin pregnancies who were under the care of SGH from 1999 to 2015...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
M Massimiani, S Salvi, D Piccirilli, L Vecchione, S Moresi, S Ferrazzani, H Stuhlmann, L Campagnolo
INTRODUCTION: Placental development requires invasion and differentiation of trophoblast cells, together with coordinated fetal vasculogenesis and maternal vascular remodeling. During placental development, extravillous cytotrophoblasts invade the uterine spiral arteries of the decidua and myometrium. These invasive cytotrophoblasts replace the endothelial layer of the maternal spiral arteries, transforming them from high-resistance vessels into large-caliber capacitance vessels capable of adequately nourishing the fetus...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Mannaerts, E Faes, J Gielis, J Briedé, P Cos, E Van Craenenbroeck, W Gyselaers, J Cornette, M Spaanderman, Y Jacquemyn
AIMS: Oxidative stress is crucial in the pathophysiology of preeclampsia. Reactive oxygen species (ROS) like the superoxide radical O2-, are produced by the ischemic placenta, causing systemic inflammation and endothelial dysfunction. EPR uses microwave radiation and a high magnetic field and is the most direct and reliable method to detect free radicals. We explored the feasibility of determining O2- concentration in maternal serum and compared pre-eclamptic and uncomplicated pregnancies...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Betül Başaran, Bilge Çelebioğlu, Ahmet Başaran, Seher Altınel, Leyla Kutlucan, James N Martin
OBJECTIVE: Substantial controversy exists regarding anesthetic management for patients with preeclampsia or hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome. Experts, researchers, clinicians, and residents in Turkey were surveyed about their practices. MATERIAL AND METHODS: Questionnaires were distributed to attendees at a national conference, and they were filled out immediately. Anonymous 10-item paper surveys were administered to both residents and non-residents...
2016: Journal of the Turkish German Gynecological Association
Laxmi Maru, Monica Verma, Neha Jinsiwale
OBJECTIVE: To find the correlation between serum homocysteine levels, relevant laboratory investigations and complications associated with PIH. METHODS: This was a prospective study conducted over 2 years. Two hundred and fourteen cases were studied. They were divided into mild preeclampsia (64), severe preeclampsia (50), eclampsia (32) and control groups (68). Parameters evaluated for statistical analysis were blood pressure, platelet counts, SGOT, SGPT and serum homocysteine levels...
October 2016: Journal of Obstetrics and Gynaecology of India
Marie Pedersen, Thorhallur I Halldorsson, Sjurdur F Olsen, Dorrit Hjortebjerg, Matthias Ketzel, Charlotta Grandström, Ole Raaschou-Nielsen, Mette Sørensen
BACKGROUND: Road traffic is a majorsource of air pollution and noise. Both exposures have been associated with hypertension in adults, but pregnant womenhave been less studied. METHODS: We examined single and joint effects of ambient air pollution and road traffic noise on preeclampsia and pregnancy-induced hypertensive disorders among 72,745 singleton pregnancies (1997-2002) from the Danish National Birth Cohort with complete covariate data and residential address history from conception until liveborn birth...
September 15, 2016: Epidemiology
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Leonoor Van Eerden, Miriam F Van Oostwaard, Gerda G Zeeman, Godelieve C M Page-Christiaens, Eva Pajkrt, Johannes J Duvekot, Frank P Vandenbussche, Swan G Oei, Hubertina C J Scheepers, Jim Van Eyck, Johanna M Middeldorp, Steven V Koenen, Christianne J M De Groot, Antoinette C Bolte
OBJECTIVE: To investigate frequency and practise of termination of pregnancy for early-onset hypertensive disorders where the fetus is considered to be non-viable. STUDY DESIGN: Retrospective cohort study in all Dutch tertiary perinatal care centres (n=10), between January 2000 and January 2014. All women who underwent termination of pregnancy, without fetal surveillance or intention to intervene for fetal reasons, for early-onset hypertensive disorders in pregnancy, were analyzed...
September 1, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Dionne Tannetta, Ieva Masliukaite, Manu Vatish, Christopher Redman, Ian Sargent
The release of extracellular vesicles (EV) by the syncytiotrophoblast (STB) may be an important mechanism by which the placenta signals to the mother. STB derived EV (STBEV) are comprised predominantly of exosomes (50-150nm) and microvesicles (100-1000nm) that contain bioactive mediators such as proteins, nucleic acids and lipids. They, along with larger syncytial nuclear aggregates are released by the STB into the maternal circulation throughout gestation in normal pregnancy where they appear to have an immunoregulatory role, inhibiting T cell and NK cell responses...
August 24, 2016: Journal of Reproductive Immunology
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