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https://www.readbyqxmd.com/read/28079872/is-use-of-multiple-antihypertensive-agents-to-achieve-blood-pressure-control-associated-with-adverse-pregnancy-outcomes
#1
S E Allen, A Tita, S Anderson, J R Biggio, Dr L M Harper
OBJECTIVE: We assessed whether requiring >1 medication for blood pressure control is associated with adverse pregnancy outcomes. STUDY DESIGN: Retrospective cohort of 974 singletons with chronic hypertension at a tertiary care center. Subjects on >1 antihypertensive agent were compared with those on one agent <20 weeks gestational age with results stratified by average blood pressure (<140/90 and ⩾140/90 mm Hg) from prenatal visits. The primary maternal outcome was preeclampsia; the primary neonatal outcome was small for gestational age (<10th percentile)...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28079785/antiplatelet-agents-and-the-prevention-of-spontaneous-preterm-birth-a-systematic-review-and-meta-analysis
#2
Elvira O G van Vliet, Lisa A Askie, Ben W J Mol, Martijn A Oudijk
OBJECTIVE: Spontaneous preterm birth is an important cause of neonatal mortality and morbidity. An increasing body of evidence suggests that uteroplacental ischemia plays an important role in the etiology of spontaneous preterm birth. We aimed to study whether antiplatelet agents reduce the risk of spontaneous preterm birth. DATA SOURCES: We included data from an individual participant data meta-analysis of studies that had evaluated the effect of antiplatelet agents to reduce preeclampsia (Perinatal Antiplatelet Review of International Studies Individual Participant Data)...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28078815/repeat-measurements-of-uterine-artery-pulsatility-index-mean-arterial-pressure-and-serum-placental-growth-factor-at-12-22-and-32-weeks-in-the-prediction-of-preeclampsia
#3
Silvia Andrietti, Stefania Carlucci, Alan Wright, David Wright, Kypros H Nicolaides
OBJECTIVE: To investigate the potential value of repeat measurements of uterine artery pulsatility index (UTPI), mean arterial pressure (MAP) and serum placental growth factor (PLGF) at 12, 22 and 32 weeks' gestation in the prediction of preeclampsia (PE) after 32 weeks. METHODS: The data were derived from prospective screening for adverse obstetric outcomes in women attending for their routine hospital visit at 11-13, 19-24 and / or 30-34 weeks' gestation in two maternity hospitals in England...
January 12, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28076991/type-2-diabetes-mellitus-does-prenatal-care-affect-outcomes-suggested-running-head-treatment-of-t2dm-and-perinatal-outcomes
#4
Allison J Allen, Jonathan M Snowden, Bernard Lau, Yvonne Cheng, Aaron B Caughey
OBJECTIVE: To determine if prenatal care affects adverse perinatal outcomes in pregnant women with Type-2 Diabetes Mellitus. STUDY DESIGN: This was a retrospective cohort study of pregnant women with pregestational diabetes mellitus pregnancies in the state of California between 1997 and 2006, using vital statistics data linked to birth certificates. Women were stratified by time of presentation to care and we compared those who presented in the first trimester, third trimester, and those who had no prenatal care prior to delivery...
January 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28067011/accuracy-of-competing-risks-model-in-screening-for-pre-eclampsia-by-maternal-factors-and-biomarkers-at-11-13-weeks-gestation
#5
Neil O'Gorman, David Wright, Liona C Poon, Daniel L Rolnik, Argyro Syngelaki, Alan Wright, Ranjit Akolekar, Simona Cicero, Deepa Janga, Jacques Jani, Francisca S Molina, Catalina de Paco Matallana, Nikos Papantoniou, Nicola Persico, Walter Plasencia, Mandeep Singh, Kypros H Nicolaides
OBJECTIVE: To examine the diagnostic accuracy of a previously developed model for prediction of preeclampsia (PE) by a combination of maternal factors and biomarkers at 11-13 weeks' gestation. METHODS: This was a prospective first-trimester multicenter study of screening for PE in 8,775 singleton pregnancies. A previously published algorithm was used for the calculation of patient-specific risk of PE in each patient. The detection rates (DR) and false positive rates (FPR) for delivery with PE at <32, <37 and ≥37 weeks were estimated and compared to those in the dataset used for development of the algorithm...
January 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28065221/meta-analysis-of-aspirin-heparin-therapy-for-un-explained-recurrent-miscarriage
#6
Tong Ling, Wei Xian-Jiang
Objective This study was designed to evaluate the efficacy and safety of aspirin-heparin treatment for un-explained recurrent spontaneous abortion (URSA). Methods Literatures reporting the studies on the aspirin-heparin treatment of un-explained recurrent miscarriage with randomized controlled trials (RCTs) were collected from the major publication databases. The live birth rate was used as primary indicator, preterm delivery, preeclampsia, intrauterine growth restriction, and adverse reactions (thrombocytopenia ) were used as the secondary indicators...
November 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28049556/magnesium-sulfate-another-cause-of-a-solute-diuresis
#7
Robert S Brown
In pregnant women, magnesium sulfate infusions are a treatment commonly used for preeclampsia and as a tocolytic agent. In this case report, a 33-year-old woman at 26 weeks of gestation received intravenous magnesium sulfate in Ringer's lactate solution and corticosteroids for preterm uterine contractions without preeclampsia. She developed polyuria of more than 18L in 48 hours, with urine chemistries documenting that magnesium sulfate contributed 30% of the solute in this massive isosthenuric diuresis. Therefore, magnesium sulfate should be added to the common solutes, glucose, sodium chloride, urea, and mannitol, as a cause of solute diureses...
December 31, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28043842/repeated-measures-of-inflammation-and-oxidative-stress-biomarkers-in-preeclamptic-and-normotensive-pregnancies
#8
Kelly K Ferguson, John D Meeker, Thomas F McElrath, Bhramar Mukherjee, David E Cantonwine
BACKGROUND: Preeclampsia is a prevalent and enigmatic disease, in part characterized by poor remodeling of the spiral arteries. However, preeclampsia does not always clinically present, even when remodeling has failed to occur. Hypotheses surrounding the 'second hit' that is necessary for the clinical presentation of the disease focus on maternal inflammation and oxidative stress. Yet, the studies to date that have investigated these factors have utilized cross-sectional study designs or small study populations...
December 30, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28040612/association-of-obstructive-sleep-apnea-with-adverse-pregnancy-related-outcomes-in-military-hospitals
#9
Dennis L Spence, Rhonda C Allen, Monica A Lutgendorf, Virginia R Gary, John D Richard, Sara C Gonzalez
BACKGROUND: Obstructive sleep apnea (OSA) is associated with significant morbidity and mortality in non-obstetrical and obstetrical patients. OBJECTIVES: To estimate the prevalence of OSA and its relationship with pregnancy-related complications in a general obstetric population of Department of Defense beneficiaries receiving direct-care at military treatment facilities. STUDY DESIGN: A retrospective cohort study of all women (N=305,001) who gave birth at a military treatment facility from 2008 to 2014...
December 14, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28034657/failure-of-physiologic-transformation-of-spiral-arteries-endothelial-and-trophoblast-cell-activation-and-acute-atherosis-in-the-basal-plate-of-the-placenta
#10
Carlos A Labarrere, Hector L Dicarlo, Elaine Bammerlin, James W Hardin, Yeon M Kim, Piya Chaemsaithong, David M Haas, Ghassan S Kassab, Roberto Romero
BACKGROUND: Failure of physiologic transformation of spiral arteries has been reported in preeclampsia, fetal growth restriction, fetal death, and spontaneous preterm labor with intact or ruptured membranes. Spiral arteries with failure of physiologic transformation are prone to develop atherosclerotic-like lesions of atherosis. There are striking parallels between preeclampsia and atherosclerotic disease, and between lesions of atherosis and atherosclerosis. Endothelial activation, identified by intercellular adhesion molecule-1 (ICAM-1) expression, is present in atherosclerotic-like lesions of heart transplantation, and is considered a manifestation of rejection...
December 26, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28034467/maternal-health-and-the-placental-microbiome
#11
REVIEW
Elise Pelzer, Luisa F Gomez-Arango, Helen L Barrett, Marloes Dekker Nitert
Over the past decade, the role of the microbiome in regulating metabolism, immune function and behavior in humans has become apparent. It has become clear that the placenta is not a sterile organ, but rather has its own endogenous microbiome. The composition of the placental microbiome is distinct from that of the vagina and has been reported to resemble the oral microbiome. Compared to the gut microbiome, the placental microbiome exhibits limited microbial diversity. This review will focus on the current understanding of the placental microbiota in normal healthy pregnancy and also in disease states including preterm birth, chorioamnionitis and maternal conditions such as obesity, gestational diabetes mellitus and preeclampsia...
December 2, 2016: Placenta
https://www.readbyqxmd.com/read/28031147/review-effects-of-maternal-micronutrient-supplementation-on-placental-function
#12
REVIEW
Kerry Richard, Olivia Holland, Kelly Landers, Jessica J Vanderlelie, Pierre Hofstee, James S M Cuffe, Anthony V Perkins
Pregnancy is a physiological challenge that may require additional nutritional support. Suboptimal micronutrient intakes and micronutrient deficiencies during pregnancy are a global problem, often leading to poor maternal and child outcomes. Micronutrient supplementation is commonly recommended during pregnancy to support and enhance maternal metabolism. Recent studies suggest that the use of multiple micronutrient supplements may be of benefit during a normal pregnancy and may significantly reduce the risk of preeclampsia, preterm delivery, gestational diabetes, and improve pregnancy outcomes...
December 20, 2016: Placenta
https://www.readbyqxmd.com/read/28028526/investigation-of-the-relationship-between-idiopathic-microscopic-hematuria-in-the-first-and-second-trimesters-and-major-adverse-outcomes-of-pregnancy
#13
Azar Danesh Shahraki, Mahboobeh Esteki Bardeh, Mohammad Reza Najarzadegan
BACKGROUND: The aim of this study was to investigate the relationship between idiopathic microscopic hematuria (in the first and second trimesters) and major adverse outcomes of pregnancy. MATERIALS AND METHODS: Urinalysis was done for 700 pregnant women before 24 weeks of pregnancy. Those who had 3-5 red blood cells per milliliter in urinalysis were considered positive urinalysis. Then, all individuals were examined for blood pressure and other alarm signs of pregnancy complications in each visit...
2016: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28013100/the-impact-of-highly-active-antiretroviral-therapy-on-obstetric-conditions-a-review
#14
REVIEW
Hannah M Sebitloane, Dhayendre Moodley
HIV is the leading cause of maternal and neonatal morbidity and mortality in resource constrained countries. Highly active antiretroviral treatment (HAART) initiated in pregnancy has now almost eliminated mother to child transmission of the virus, and is beginning to show the desired effect of reducing HIV related maternal mortality. By modulating host immunological responses HAART has the potential to alter infections during pregnancy, in addition to modifying clinical conditions such as preeclampsia. There is increasing evidence of the benefits of HAART given to pregnant women, however there is paucity of data that distinguishes HIV or HAART as the cause or exacerbation of pre-existing medical conditions or conditions specific to pregnancy...
December 9, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28012458/impact-of-early-and-late-onset-preeclampsia-on-features-of-placental-and-newborn-vascular-health
#15
Emilie M Herzog, Alex J Eggink, Anniek Reijnierse, Martina A M Kerkhof, Ronald R de Krijger, Anton J M Roks, Irwin K M Reiss, Alex L Nigg, Paul H C Eilers, Eric A P Steegers, Régine P M Steegers-Theunissen
INTRODUCTION: Offspring exposed to preeclampsia (PE) show an increased risk of cardiovascular disease in adulthood. We hypothesize that this is mediated by a disturbed vascular development of the placenta, umbilical cord and fetus. Therefore, we investigated associations between early-onset PE (EOPE), late-onset PE (LOPE) and features of placental and newborn vascular health. METHODS: We performed a nested case-control study in The Rotterdam Periconceptional Cohort, including 30 PE pregnancies (15 EOPE, 15 LOPE) and 218 control pregnancies (164 uncomplicated controls, 54 complicated controls including 28 fetal growth restriction, 26 preterm birth) and assessed macroscopic and histomorphometric outcomes of the placenta and umbilical cord...
January 2017: Placenta
https://www.readbyqxmd.com/read/28002314/association-between-polycystic-ovary-syndrome-and-the-risk-of-pregnancy-complications-a-prisma-compliant-systematic-review-and-meta-analysis
#16
Hai-Feng Yu, Hong-Su Chen, Da-Pang Rao, Jian Gong
BACKGROUND: Polycystic ovary syndrome (PCOS) is inconsistently associated with increased risk of adverse pregnancy outcomes. The purpose of this meta-analysis was to summarize the evidence regarding the strength of the association between pregnancy in women with PCOS and pregnancy complications. METHODS: We systematically searched PubMed, EmBase, and the Cochrane Library to identify observational studies up to January 2016. The primary focus was pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, pregnancy-induced hypertension (PIH), preterm delivery, cesarean delivery, oligohydramnios, and polyhydramnios...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27998690/preeclampsia-and-preterm-birth-associated-with-visceral-adiposity-in-early-pregnancy
#17
Joel G Ray, Leanne R De Souza, Alison L Park, Philip W Connelly, Emmanuel Bujold, Howard Berger
OBJECTIVE: To determine if an increasing amount of visceral adipose tissue, measured by ultrasound in early pregnancy, is associated with a higher risk of preeclampsia and preterm birth (PTB). METHODS: We completed a prospective cohort study of 463 pregnant women. Maternal visceral adiposity tissue (VAT) depth was measured by ultrasound at 11 to 14 weeks' gestation. Relative risks (RR) were adjusted for age, parity, chronic hypertension, pre-pregnancy BMI, and use of acetylsalicylic acid...
December 17, 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27981252/thyroid-hormone-dysfunction-during-pregnancy-a-review
#18
REVIEW
Aynadis Alemu, Betelihem Terefe, Molla Abebe, Belete Biadgo
Thyroid dysfunctions such as hypothyroidism, thyrotoxicosis and thyroid nodules may develop during pregnancy leading to abortion, placental abruptions, preeclampsia, preterm delivery and reduced intellectual function in the offspring. Epidemiological data have shown the significant role of maternal thyroid hormone in fetal neurologic development and maternal health. It has been suggested that the deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neuro-intellectual development in the early life of the child...
November 2016: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/27968898/single-fasting-plasma-glucose-measurement-compared-with-75-g-oral-glucose-tolerance-test-in-prediction-of-adverse-perinatal-outcomes-a-prospective-cohort-study-from-china
#19
Songying Shen, Jinhua Lu, Lifang Zhang, Jianrong He, Weidong Li, Niannian Chen, Xingxuan Wen, Wanqing Xiao, Mingyang Yuan, Lan Qiu, Kar Keung Cheng, Huimin Xia, Ben Willem J Mol, Xiu Qiu
BACKGROUND: The prevalence of gestational diabetes mellitus has increased markedly in recent years in China, mainly because of the introduction of new diagnostic criteria. We aimed to evaluate whether in the diagnosis of gestational diabetes mellitus, 1h and 2h glucose measurements have additional value compared with a single fasting plasma glucose measurement. METHODS: We included data from 6993 pregnant women who underwent a 2h 75g oral glucose-tolerance test at 22-28 weeks' gestation in the Born in Guangzhou Cohort Study in China...
October 2016: Lancet
https://www.readbyqxmd.com/read/27941633/a-prospective-study-on-serum-methylmalonic-acid-and-homocysteine-in-pregnant-women
#20
Rihwa Choi, Sunkyu Choi, Yaeji Lim, Yoon Young Cho, Hye Jeong Kim, Sun Wook Kim, Jae Hoon Chung, Soo-Young Oh, Soo-Youn Lee
This study aimed to investigate serum methylmalonic acid (MMA) and homocysteine levels and to assess their effects on pregnancy and neonatal outcomes. Serum MMA and homocysteine levels in 278 pregnant Korean women, determined by liquid chromatography-tandem mass spectrometry in each trimester, were compared with those of previous studies in other ethnic groups. We investigated the association between MMA and homocysteine status with pregnancy and neonatal events: gestational diabetes, preeclampsia, gestational age at delivery, preterm birth, small for gestational age, neonatal birth weight, and congenital abnormalities...
December 8, 2016: Nutrients
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