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hypertensive disorder of pregnancy

Vasileios Charalampakis, Abd A Tahrani, Ahmed Helmy, Janesh K Gupta, Rishi Singhal
One of the most effective methods to tackle obesity and its related comorbidities is bariatric surgery. Polycystic ovary syndrome (PCOS) and endometrial hyperplasia (EH), which are associated with increased risk of endometrial carcinoma, have been identified as potentially new indications for bariatric surgery. PCOS is the most common endocrine disorder in women in the reproductive age and is associated with several components of the metabolic syndrome such as obesity, insulin resistance and hypertension. EH is a pre-cancerous condition which arises in the presence of chronic exposure to estrogen unopposed by progesterone such as both in PCOS and obesity...
October 17, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Evangelia Elenis, Gunilla Sydsjö, Alkistis Skalkidou, Claudia Lampic, Agneta Skoog Svanberg
BACKGROUND: Pregnancies resulting through oocyte donation have been associated with increased risk for adverse outcomes for the mother, such as gestational hypertensive disorders. However, little is known about possible neonatal complications of such pregnancies. The purpose of this study was to evaluate the neonatal health outcomes among singleton pregnancies in a population of relatively young and healthy oocyte recipients in Sweden, taking into account the medical indication leading to treatment...
October 21, 2016: BMC Pediatrics
Yu-Min Shen
Atypical hemolytic uremic syndrome (aHUS) is a rare genetic disorder caused by defective complement regulation resulting in thrombotic microangiopathy (TMA). Patients can present as children or adults. The syndrome consists of hemolytic anemia with schistocytosis, thrombocytopenia, significant renal damage, and/or other organ system dysfunction(s). Patients with aHUS may succumb to the complications of the disease with the very first manifestation; surviving patients often suffer from progressive organ dysfunction with significant morbidity and mortality despite plasma infusion or plasma exchange...
2016: Thrombosis Journal
Marina Parca Cavelagna Teixeira, Tatiana Peloso Reis Queiroga, Maria Dos Anjos Mesquita
Objective: To determine the frequency and risk factors of small-for-gestational-age newborns in a high-risk maternity. Methods: This is an observational, cross-sectional, and case-control study, conducted in a public tertiary care maternity hospital. Data from 998 newborns and their mothers were collected through interviews and review of medical records and prenatal care cards. Some placentas underwent histopathological analysis. The variables of small-for-gestational-age and non-small-for-gestational-age newborns and of their mothers were statistically compared by means of Student's t test, Fisher's exact test, and odds ratio...
July 2016: Einstein
Gizem Dilan Yesil, Olta Gishti, Janine F Felix, Irwin Reiss, Mohammad Kamran Ikram, Eric A P Steegers, Albert Hofman, Vincent W V Jaddoe, Romy Gaillard
Gestational hypertensive disorders may lead to vascular changes in the offspring. We examined the associations of maternal blood pressure development and hypertensive disorders during pregnancy with microvasculature adaptations in the offspring in childhood. This study was performed as part of the Generation R Study in Rotterdam, the Netherlands (2002-2012), among 3,748 pregnant mothers and their children for whom information was available on maternal blood pressure in different periods of pregnancy and gestational hypertensive disorders...
October 17, 2016: American Journal of Epidemiology
Sophie Grand'Maison, Louise Pilote, Marisa Okano, Tara Landry, Natalie Dayan
Women with prior hypertensive disorders of pregnancy (HDP) are at twice the risk of cardiovascular disease compared with women with prior normotensive pregnancy, possibly because of sustained vascular dysfunction after delivery. The aim of this systematic review and meta-analysis is to summarize evidence of vascular dysfunction at least 3 months after HDP. Articles in all languages were retrieved from principal databases. Studies included were observational, with HDP as the main exposure and measurements of vascular dysfunction via imaging modalities or serum biomarkers as the main outcome, assessed at least 3 months postpartum...
October 17, 2016: Hypertension
Rebecca L Wilson, Jessica A Grieger, Tina Bianco-Miotto, Claire T Roberts
Adequate zinc stores in the body are extremely important during periods of accelerated growth. However, zinc deficiency is common in developing countries and low maternal circulating zinc concentrations have previously been associated with pregnancy complications. We reviewed current literature assessing circulating zinc and dietary zinc intake during pregnancy and the associations with preeclampsia (PE); spontaneous preterm birth (sPTB); low birthweight (LBW); and gestational diabetes (GDM). Searches of MEDLINE; CINAHL and Scopus databases identified 639 articles and 64 studies were reviewed...
October 15, 2016: Nutrients
Abdullah Mamun
OBJECTIVE: The objectives of this study are to investigate the developmental stages of hypertension between males and females and identify why young males have higher blood pressure than young females. DESIGN AND METHOD: The study used a sub-sample of 2000 offspring from the original cohort of the Mater University of Queensland Study of Pregnancy (MUSP) and its outcomes. The MUSP is a prospective birth cohort study which commenced in early 1980 s in Brisbane, Australia and followed their offspring till young adulthood...
September 2016: Journal of Hypertension
Satoshi Umemura
Primary aldosteronism (PA) is a heterogeneous group of disorders including both sporadic and familial forms (familial hyperaldosteronism type I, II and III). PA is the most frequent endocrine cause of secondary hypertension and associated with a higher rate of cardiovascular complications, compared with essential hypertension.Here I review the recent progress in understanding of the genetic and molecular mechanisms leading to autonomous aldosterone production in PA.Systematic screening detects primary aldosteronism in 5 to 10% of all patients with hypertension and in approximately 20% of patients with resistant hypertension...
September 2016: Journal of Hypertension
Chia Lin Chang, Chia Yu Chang, Da Xian Lee, Po Jen Cheng
Pre-eclampsia is a pregnancy-specific hypertensive disorder that affects 2-8 % of pregnancies. This disorder can lead to seizure, multi-organ failure and maternal death. The best approach to prevent pre-eclampsia-associated adverse outcomes is to be able to prevent pre-eclampsia as early as possible. Unfortunately, current diagnostic methods are ineffective at predicting the risk of pre-eclampsia during early pregnancy. In humans, low levels of a group of placenta-derived Pregnancy Specific Glycoproteins (PSGs) have been associated with intrauterine growth retardation and pre-eclampsia and there is a significant enrichment of cases with deletions in the PSG gene locus in pre-eclampsia patients...
2016: Advances in Experimental Medicine and Biology
Shanika Panagodage, Hannah E Juen Yong, Fabricio Da Silva Costa, Anthony J Borg, Bill Kalionis, Shaun P Brennecke, Padma Murthi
Preeclampsia (PE), a serious hypertensive disorder of pregnancy, remains a leading cause of perinatal morbidity and mortality worldwide. Perturbed trophoblast function and impaired placental development early in pregnancy are key features. Low-dose acetylsalicylic acid (LDA) administered before 16 weeks' gestation significantly reduces the risk for PE. However, the exact mechanisms of action of LDA, particularly on trophoblast function, are unclear. We hypothesized that LDA influences placental trophoblast function and reverses PE-associated abnormalities...
October 14, 2016: American Journal of Pathology
Odaro Huckstep, Adam J Lewandowski, Paul Leeson
Human clinical studies as well as laboratory animal studies demonstrate that offspring of pregnancies affected by common complications, such as preeclampsia and preterm birth, display developmental phenotypes that relate distinctly to the pregnancy disorder. Several studies have now found microvascular differences in offspring of hypertensive pregnancies, and there is interest in whether these may underlie epidemiologic associations between gestational hypertension and a higher risk of hypertension and stroke in the offspring...
October 15, 2016: American Journal of Epidemiology
Kozeta Miliku, Nienke E Bergen, Hanneke Bakker, Albert Hofman, Eric A P Steegers, Romy Gaillard, Vincent W V Jaddoe
BACKGROUND: Hypertensive disorders in pregnancy may affect the cardiovascular risk of offspring. We examined the associations of maternal blood pressure throughout pregnancy and hypertensive disorders in pregnancy with childhood blood pressure of offspring. Specific focus was on the comparison with paternal blood pressure effects, the identification of critical periods, and the role of birth outcomes and childhood body mass index in the observed associations. METHODS AND RESULTS: This study was embedded in a population-based prospective cohort study among 5310 mothers and fathers and their children...
October 14, 2016: Journal of the American Heart Association
Georgios Chrelias, Georgios-Marios Makris, Aristea-Maria Papanota, Aris Spathis, Georgios Salamalekis, Theodoros N Sergentanis, Demetrios Rizos, Petros Karakitsos, Charalampos Chrelias
BACKGROUND: Pre-eclampsia and eclampsia are parts of the broader spectrum of hypertensive disorders complicating pregnancy. This study aims to examine the association between serum inhibin and leptin levels and pre-eclampsia. METHODS: This study included 98 consecutive cases of pregnant women with pre-eclampsia, together with their 98 pregnant controls, matched for age, gestational week and time period of delivery. Maternal venous blood samples were obtained within 24h before delivery...
October 11, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
Orkun Cetin, Erbil Karaman, Harun Arslan, Ali Kolusarı, Recep Yıldızhan, Mesut Ozgokce, Abdussamet Batur, Ibrahim Akbudak
PURPOSE: To compare maternal liver elasticity scores by Acoustic Radiation Force Impulse (ARFI) elastosonography in healthy and preeclamptic pregnancies and its association with the severity of the disease. MATERIALS AND METHODS: Forty-two healthy, 33 mild, 33 severe preeclamptic and 28 pregnant women with Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome were included into the study. Maternal liver elasticity was measured by ARFI elastosonography at the first day of puerperium...
October 13, 2016: Journal of Maternal-fetal & Neonatal Medicine
Derek S Boeldt, Ian M Bird
Maternal vascular adaptation to pregnancy is critically important in order to expand the capacity for blood flow through the uteroplacental unit to meet the needs of the developing fetus. Failure of the maternal vasculature to properly adapt can result in hypertensive disorders of pregnancy such as preeclampsia (PE). Herein, we review the endocrinology of maternal adaptation to pregnancy and contrast this with that of PE. Our focus is specifically on those hormones with directly impact endothelial cell function and dysfunction, as endothelial cell dysfunction is a hallmark of PE...
October 11, 2016: Journal of Endocrinology
Sharona Vonck, Anneleen Simone Staelens, Ine Bollen, Lien Broekx, Wilfried Gyselaers
BACKGROUND: The maternal cardiovascular system adapts quickly when embryo implantation is recognized by the body. Those adaptations play an important role, as a normal cardiovascular adaptation is a requirement for a normal course of pregnancy. Disturbed adaptations predispose to potential hypertensive disorders further in pregnancy [1-3]. This report aims to briefly inform the obstetricians, general practitioners and midwives, who are the key players in detecting and treating hypertensive disorders during pregnancy...
October 12, 2016: BMC Pregnancy and Childbirth
Luís Guedes-Martins
Superimposed preeclampsia refers to women with chronic arterial hypertension (primary or secondary) who develop preeclampsia (PE). Because hypertension affects 5-15 % of pregnancies, it is itself a matter of concern. However, this concern should be permanent, given the increased risk of the hypertension worsening and, particularly, the appearance of superimposed PE. The search for factors that underlie or promote the development of this disorder has been the subject of intense research. However, despite the wealth of knowledge, the cause or causes remain to be determined...
October 9, 2016: Advances in Experimental Medicine and Biology
Umesh Ramadurg, Marianne Vidler, Umesh Charanthimath, Geetanjali Katageri, Mrutyunjaya Bellad, Ashalata Mallapur, Shivaprasad Goudar, Shashidhar Bannale, Chandrashekhar Karadiguddi, Diane Sawchuck, Rahat Qureshi, Peter von Dadelszen, Richard Derman
BACKGROUND: In India, the hypertensive disorders of pregnancy and postpartum haemorrhage are responsible for nearly 40 % of all maternal deaths. Most of these deaths occur in primary health settings which frequently lack essential equipment and medication, are understaffed, and have limited or no access to specialist care. Community health care workers are regarded as essential providers of basic maternity care; and the quality of care they provide is dependent on the level of knowledge and skills they possess...
September 30, 2016: Reproductive Health
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
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