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hypertensive disorder of pregnancy

Kate Duhig, Brooke Vandermolen, Andrew Shennan
Pre-eclampsia is a leading cause of maternal mortality, responsible annually for over 60,000 maternal deaths around the globe. Pre-eclampsia is a multisystem disease featuring hypertension, proteinuria, and renal, hepatic, and neurological involvement. Diagnosis is often elusive, as clinical presentation is highly variable. Even those with severe disease can remain asymptomatic. Angiogenic factors are emerging as having a role in the diagnosis of pre-eclampsia and in prognostication of established disease. In this article, we summarize new developments and focus on angiogenic biomarkers for prediction of disease onset...
2018: F1000Research
Renata Świątkowska-Stodulska, Piotr Kmieć, Katarzyna Stefańska, Krzysztof Sworczak
Hypertension occurs in 7-10% of pregnant women. Despite the continuous development of medicine, it is still an important risk factor for perinatal mortality of both mothers and fetuses. Pregnant women with hypertension are at greater risk of complications such as: placental abruption, cerebral and cardiac incidents, multiorgan failure, and disseminated intravascular coagulation. The aim of this review was to discuss multilevel disorders of the renin-angiotensin-aldosterone system in the etiopathogenesis of pregnancy-induced hypertension...
March 20, 2018: Experimental and Clinical Endocrinology & Diabetes
Sribalasubashini Muralimanoharan, Youn-Tae Kwak, Carole R Mendelson
Dysregulation of human trophoblast invasion and differentiation with placental hypoxia can result in preeclampsia, a hypertensive disorder of pregnancy. Herein, we characterized the role and regulation of miR-1246, which is markedly induced during human syncytiotrophoblast differentiation. miR-1246 is known to target GSK3β and AXIN2, inhibitors of WNT/β-catenin signaling, which is crucial for placental development, and is predicted to target JARID2, which promotes silencing of developmentally regulated genes...
March 13, 2018: Endocrinology
Jill Demirci, Mandy Schmella, Melissa Glasser, Lisa Bodnar, Katherine P Himes
BACKGROUND: Preeclampsia is a multi-system, hypertensive disorder of pregnancy that increases a woman's risk of later-life cardiovascular disease. Breastfeeding may counteract the negative cardiovascular sequela associated with preeclampsia; however, women who develop preeclampsia may be at-risk for suboptimal breastfeeding rates. In this case series, we present three cases of late-onset preeclampsia and one case of severe gestational hypertension that illustrate a potential association between hypertensive disorders of pregnancy and suboptimal breastfeeding outcomes, including delayed onset of lactogenesis II and in-hospital formula supplementation...
March 15, 2018: BMC Pregnancy and Childbirth
Evangelia Elenis, Alkistis Skalkidou, Agneta Skoog-Svanberg, Gunilla Sydsjö, Anneli Stavreus-Evers, Helena Åkerud
BACKGROUND: Preeclampsia and gestational hypertensive disorders are thought to occur due to endothelial cell dysfunction and abnormal placentation, triggered by angiogenesis-related factors yet undetermined. The aim of this study was to investigate whether a genetic polymorphism (SNP) of Histidine-rich glycoprotein (HRG), HRG C633T SNP, is associated with gestational hypertensive disorders. METHODS: It was performed a nested case-control study from the BASIC Cohort of Uppsala University Hospital comprising 92 women diagnosed with gestational hypertensive disorders without other comorbidities and 200 women with full term uncomplicated pregnancies, all genotyped regarding HRG C633T SNP...
March 14, 2018: BMC Medical Genetics
Lena Van den Eeden, Nathalie Lambrechts, Veerle Verheyen, Mario Berth, Greet Schoeters, Yves Jacquemyn
INTRODUCTION: Air pollution is a hot topic and is known to cause multiple health issues. Especially pregnant women seem to be vulnerable to environmental issues. There are data suggesting that exposure contributes to hypertensive disorders.This study aims to evaluate the effects of exposure to particulate matter (PM) and outdoor air pollutants on the clinical pregnancy outcome for mother and child and to determine which biochemical changes in maternal, placental and cord blood best explain this effect...
March 9, 2018: BMJ Open
Risto J Kaaja, M Gary Nicholls
Studies in the early 1990s suggested that a hormone identical to ouabain or an isomer of ouabain is secreted by the adrenal glands into the circulation and plays a role in the regulation of arterial pressure and cardiac and renal function. This hormone, known as endogenous ouabain (EO), was claimed to contribute to the pathophysiology of a number of disorders including heart failure, renal failure, pregnancy-induced, and essential hypertension. However, some research groups have been unable to confirm the presence of EO in the human circulation and the issue remains in dispute...
March 10, 2018: BioFactors
Thierry Brue, Vincent Amodru, Frédéric Castinetti
With fewer than 200 reported cases, Cushing's syndrome (CS) in pregnancy remains a diagnostic and therapeutic challenge. In normal pregnancies, misleading signs may be observed such as striae or hypokalemia, while plasma cortisol and urinary free cortisol may rise up to 2-3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. The predominant cause is adrenal adenoma (sometimes without decreased ACTH), rather than Cushing's disease. There are considerable imaging pitfalls in Cushing's disease...
March 9, 2018: European Journal of Endocrinology
Siaw Li Chan, Sarosh Rana, Sireesha Chinthala, Saira Salahuddin, Kiang-Teck J Yeo
BACKGROUND: Preeclampsia is one of the leading hypertensive disorders of pregnancy. Angiogenic biomarkers such as anti-angiogenic factor soluble fms-like tyrosine kinase 1 (sFlt1) and pro-angiogenic factor placental growth factor (PlGF) are involved in the pathophysiology of preeclampsia. OBJECTIVE: The aim of this study is to validate the analytical performance of sFlt1 and PlGF on the B·R·A·H·M·S KRYPTOR Compact Plus (ThermoFisher Scientific). STUDY DESIGN: We examined K2 -EDTA plasma samples from 50 patients on B·R·A·H·M·S KRYPTOR Compact Plus, an automated immunoassay platform...
January 2018: Pregnancy Hypertension
Zahra Bahadoran, Parvin Mirmiran, Fereidoun Azizi, Asghar Ghasemi
Inorganic nitrate (NO3 ) due to its potential endogenous conversion to nitric oxide (NO), is suggested as a compensatory fuel for disrupted NO pathways in the case of pathological stats during pregnancy. Dietary NO3 -rich supplement in the NO-deficient pregnant women is now suggested as a more appealing choice with fewer off-target effects which can attenuate hypertension and preeclampsia, improve placental blood flow and subsequently enhance maternal and neonatal health. There is also an increasing public interest and common health claims regarding beneficial effects of NO3 -rich dietary supplements like beetroot byproducts in pregnant women...
January 2018: Pregnancy Hypertension
Marianne Lønnebotn, Gerd Karin Natvig, Bryndís Benediktsdóttir, John A Burgess, Mathias Holm, Rain Jógi, Eva Lindberg, Ferenc Macsali, Vivi Schlünssen, Svein Magne Skulstad, Karl A Franklin, Eszter Vanky, Francisco Gòmez Real
OBJECTIVE: Some studies of women with polycystic ovary syndrome (PCOS) report increased prevalence of hypertensive disorders in pregnancy, while others do not. Several of these studies do not control for obesity. We aimed to study whether PCOS is associated with hypertensive disorders in pregnancy and whether it is dependent on body mass index (BMI). STUDY DESIGN: We present a cross-sectional analysis of 3732 women from Denmark, Estonia, Iceland, Norway and Sweden, born in 1945-72, who participated in the Respiratory Health In Northern Europe (RHINE) study and answered an extensive women's health questionnaire on menstruation, PCOS, infertility, pregnancy history and childbirth...
January 2018: Pregnancy Hypertension
Judette M Louis, Matthew A Koch, Uma M Reddy, Robert M Silver, Corette B Parker, Francesca L Facco, Susan Redline, Chia-Ling Nhan-Chang, Judith H Chung, Grace W Pien, Robert C Basner, William A Grobman, Deborah A Wing, Hyagriv N Simhan, David M Haas, Brian M Mercer, Samuel Parry, Daniel Mobley, Benjamin Carper, George R Saade, Frank P Schubert, Phyllis C Zee
BACKGROUND: Sleep-disordered breathing (SDB) is common in pregnancy, but there are limited data on predictors. OBJECTIVES: The objective of this study was to develop predictive models of sleep-disordered breathing during pregnancy. STUDY DESIGN: Nulliparous women completed validated questionnaires to assess for symptoms related to snoring, fatigue, excessive daytime sleepiness, insomnia, and restless leg syndrome. The questionnaires included questions regarding the timing of sleep and sleep duration, work schedules (eg, shift work, night work), sleep positions, and previously diagnosed sleep disorders...
February 2, 2018: American Journal of Obstetrics and Gynecology
Laura Schummers, Jennifer A Hutcheon, Michele R Hacker, Tyler J VanderWeele, Paige L Williams, Thomas A McElrath, Sonia Hernandez-Diaz
BACKGROUND: First deliveries in women older than 35, 40, or 45 are at increased risk for adverse pregnancy outcomes compared with those in younger women. However, specific relationships between each additional year of maternal age and pregnancy risks remain unclear, and absolute risks at each maternal age are not known. METHODS: Using a population-based cohort of nulliparous women in British Columbia, Canada, from 2004-2014 (n=203,414), We examined relationships between maternal age (modeled flexibly to allow curvilinear shapes) and pregnancy outcomes using logistic regression...
March 6, 2018: Epidemiology
Masaaki Sawada, Aiko Kakigano, Shinya Matsuzaki, Tsuyoshi Takiuchi, Kazuya Mimura, Keiichi Kumasawa, Masayuki Endo, Yutaka Ueda, Kiyoshi Yoshino, Tadashi Kimura
AIM: Previous studies have shown adverse obstetric outcomes of the laparoscopic resection of a rudimentary horn. Our study aimed to investigate the obstetric outcome in our institution and to review previous studies. METHODS: Using a retrospective analysis, data were reviewed from singleton pregnancies with maternal uterine anomalies at a medical center in Osaka, Japan, between January 2011 and March 2016. The uterine anomaly cases were divided into a 'postlaparoscopic resection of the rudimentary horn' group (study group) and an 'other uterine anomalies' (bicornuate uterus, uterine didelphys and unicornuate uterus) group (control group)...
March 8, 2018: Journal of Obstetrics and Gynaecology Research
Yuko Murakami, Kiyonori Miura, Shuntaro Sato, Ai Higashijima, Yuri Hasegawa, Shoko Miura, Koh-Ichiro Yoshiura, Hideaki Masuzaki
AIM: The aim of this study was to establish the reference values for circulating pregnancy-associated placental microRNAs in maternal plasma and clarify their clinical significance in patients with hypertensive disorder of pregnancy (HDP). METHODS: Blood samples were collected from 145 women with uncomplicated pregnancies (24, 26, 31 and 32 women at 12, 23, 30 and 36 weeks of gestation, respectively, and 32 women 1 day after delivery). Plasma concentrations of pregnancy-associated placental microRNAs (miR-515-3p, miR-517a, miR-517c and miR-518b) were measured by quantitative real-time reverse-transcription polymerase chain reaction...
March 8, 2018: Journal of Obstetrics and Gynaecology Research
Mayte E van Alebeek, Myrthe de Vrijer, Renate M Arntz, Noortje A M M Maaijwee, Nathalie E Synhaeve, Hennie Schoonderwaldt, Maureen J van der Vlugt, Ewoud J van Dijk, Roel de Heus, Loes C A Rutten-Jacobs, Frank-Erik de Leeuw
BACKGROUND AND PURPOSE: The study goal was to investigate the prevalence of pregnancy complications and pregnancy loss in women before, during, and after young ischemic stroke/transient ischemic attack. METHODS: In the FUTURE study (Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation), a prospective young stroke study, we assessed the occurrence of pregnancy, miscarriages, and pregnancy complications in 223 women aged 18 to 50 years with a first-ever ischemic stroke/transient ischemic attack...
March 6, 2018: Stroke; a Journal of Cerebral Circulation
Dimitrios-Rafail Kalaitzopoulos, Konstantinos Chatzistergiou, Anna-Lea Amylidi, Damianos G Kokkinidis, Dimitrios G Goulis
BACKGROUND: Methamphetamine hydrochloride is 1 of the most widespread psycho-stimulants in the world. Nevertheless, its effect on pregnant women and their neonates has not been investigated extensively. OBJECTIVE: To systematically review the literature for the effect of methamphetamine exposure during pregnancy to neonatal and pregnancy outcomes. MATERIALS AND METHODS: A meta-analysis of retrospective, case-control studies was conducted. Inclusion criteria were women who have used methamphetamine during pregnancy, determined by self-report, maternal or neonatal urine test, and/or meconium toxicology, compared with control women not taking methamphetamine...
March 5, 2018: Journal of Addiction Medicine
Katherine Leavey, Samantha L Wilson, Shannon A Bainbridge, Wendy P Robinson, Brian J Cox
Background: Preeclampsia (PE) is a heterogeneous, hypertensive disorder of pregnancy, with no robust biomarkers or effective treatments. We hypothesized that this heterogeneity is due to the existence of multiple subtypes of PE and, in support of this hypothesis, we recently identified five clusters of placentas within a large gene expression microarray dataset ( N  = 330), of which four (clusters 1, 2, 3, and 5) contained a substantial number of PE samples. However, while transcriptional analysis of placentas can subtype patients, we propose that the addition of epigenetic information could discern gene regulatory mechanisms behind the distinct PE pathologies, as well as identify clinically useful potential biomarkers...
2018: Clinical Epigenetics
Min Jeong Kim, Joo Hui Kim, Il Young Kim, Soo Bong Lee, In Seong Park, Mi Yeun Han, Harin Rhee, Sang Heon Song, Eun Young Seong, Ihm Soo Kwak, Dong Won Lee
Preeclampsia is the most common cause of proteinuria with hypertension during pregnancy. Primary kidney disease and kidney disease secondary to systemic disorders may rarely occur during pregnancy, resulting in proteinuria. A 34-year-old woman was admitted to our hospital with abdominal distention and lower extremity edema. The pregnancy was terminated at the 24th week of gestation due to preterm labor. Even after the delivery, proteinuria and renal deterioration continued to progress. The M-peak was not found on serum and urine protein electrophoresis...
March 2018: Iranian Journal of Kidney Diseases
Yan Han, Lei-Jing Mao, Xing Ge, Kun Huang, Shuang-Qin Yan, Ling-Ling Ren, Shu-Qing Hong, Hui Gao, Jie Sheng, Yuan-Yuan Xu, Wei-Jun Pan, Peng Zhu, Jia-Hu Hao, De-Fa Zhu, Fang-Biao Tao
OBJECTIVE: Hypertensive disorders of pregnancy (HDP) have been associated with adverse health outcomes for both mothers and children. Previous studies examining associations of maternal thyroid autoantibodies with HDP indicate conflicting results. The objective of this study was to examine associations of maternal thyroid autoantibodies positivity in the first and the second trimesters with the risk of HDP. DESIGN, PARTICIPANTS AND MEASUREMENTS: In the Ma'anshan Birth Cohort study, a population-based prospective study in China, a total of 3474 pregnant women were enrolled between May 2013 and September 2014...
March 5, 2018: Clinical Endocrinology
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