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Hypertension And Gestational

Ruth Martis, Caroline A Crowther, Emily Shepherd, Jane Alsweiler, Michelle R Downie, Julie Brown
BACKGROUND: Successful treatments for gestational diabetes mellitus (GDM) have the potential to improve health outcomes for women with GDM and their babies. OBJECTIVES: To provide a comprehensive synthesis of evidence from Cochrane systematic reviews of the benefits and harms associated with interventions for treating GDM on women and their babies. METHODS: We searched the Cochrane Database of Systematic Reviews (5 January 2018) for reviews of treatment/management for women with GDM...
August 14, 2018: Cochrane Database of Systematic Reviews
S K Abell, J A Boyle, A Earnest, P England, A Nankervis, S Ranasinha, G Soldatos, E M Wallace, S Zoungas, H J Teede
AIM: With no current randomized trials, we explored the impact of tight compared with standard treatment targets on pregnancy outcomes in gestational diabetes mellitus (GDM). METHODS: This cohort study of singleton births ≥ 28 weeks' gestation was conducted at two major Australian maternity services (2009-2013). Standardized maternal, neonatal and birth outcomes were examined using routine healthcare data and compared for women with GDM at Service One (n = 2885) and Service Two (n = 1887)...
August 13, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Elham Hosseini, Mohsen Janghorbani
BACKGROUND: There is an ongoing discussion about the optimal diagnostic strategy for gestational diabetes mellitus (GDM). OBJECTIVE: To assess the magnitude of the association between GDM diagnosed with the one-step (International Association of Diabetes and Pregnancy Study Groups criteria) or two-step (Carpenter and Coustan criteria) approach and selected adverse pregnancy outcomes. SEARCH STRATEGY: Five electronic databases were searched up to October 2017 using Medical Subject Headings for each adverse outcome combined with the term "gestational diabetes...
August 12, 2018: International Journal of Gynaecology and Obstetrics
Osamu Motoyama, Ken Sakai, Kikuo Iitaka
A 35-year-old woman with membranoproliferative glomerulonephritis type I had quintuplet gestation after induced ovulation. Her serum creatinine level and estimated glomerular filtration rate were 0.86 mg/dL and 61.5 mL/min/1.73 m2 before pregnancy. Blood pressure was normal and urinary protein to creatinine ratio was 0.2 g/gCr. Prednisolone 10 mg on alternate-day administration was continued during pregnancy. At 10 weeks of gestation transvaginal selective embryo reduction was performed and five embryos were reduced to twins...
August 12, 2018: CEN Case Reports
Konstantinos Nirgianakis, Maria Luisa Gasparri, Anda-Petronela Radan, Anna Villiger, Brett McKinnon, Beatrice Mosimann, Andrea Papadia, Michael D Mueller
OBJECTIVE: To study obstetric outcomes and complications in women with previously excised posterior deep infiltrating endometriosis (DIE) in comparison with women without endometriosis. DESIGN: Matched case-control study. SETTING: Tertiary-level academic center. PATIENT(S): All surgeries for endometriosis performed in the Department of Gynecology and Gynecological Oncology, University of Bern between March 2004 and July 2015, were assessed...
August 2018: Fertility and Sterility
Judy E Stern, Chia-Ling Liu, Howard J Cabral, Elliott G Richards, Charles C Coddington, Stacey A Missmer, Hafsatou Diop
OBJECTIVE: To quantify the effect of medical and obstetrical factors on the odds of cesarean delivery, comparing assisted reproductive technology (ART)-treated women and women with subfertility not treated with ART versus fertile women. DESIGN: Retrospective cohort. SETTING: Not applicable. PATIENT(S): Singleton deliveries to primiparous women; with the source of this data being the Massachusetts vital and hospital records linked to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System data (2004-2010)...
August 2018: Fertility and Sterility
Amihai Rottenstreich, Gabriel Levin, Geffen Kleinstern, Rani Haj Yahya, Misgav Rottenstreich, Simcha Yagel, Uriel Elchalal
INTRODUCTION: Previous reports have shown that suboptimal antenatal corticosteroids administration occurs in most cases. However, as multifetal gestations were either excluded or constituted a small proportion of the subjects in these studies, little is known about the patterns of use of antenatal corticosteroids in twin pregnancies. MATERIAL AND METHODS: We reviewed the records of women who received antenatal corticosteroids and delivered between 240/7 and 346/7 weeks of gestation during 2015-2017 at two university hospitals...
August 11, 2018: Acta Obstetricia et Gynecologica Scandinavica
Maya Ram, Howard Berger, Michael Geary, Sarah D McDonald, Beth Murray-Davis, Catherine Riddell, Haroon Hasan, Jon Barrett, Nir Melamed
OBJECTIVE: To assess whether routine induction of labor at 38 or 39 weeks in women with chronic hypertension is associated with the risk of superimposed preeclampsia or cesarean delivery. METHODS: We conducted a retrospective population-based study of women with chronic hypertension who had a singleton hospital birth at 38 0/7 weeks of gestation of gestation in Ontario, Canada, between 2012 and 2016. Women who underwent induction of labor at 38 0/7 to 38 6/7 weeks of gestation for chronic hypertension (n=281) were compared with those who were managed expectantly during that week and remained undelivered at 39 0/7 weeks of gestation (n=1,606)...
August 6, 2018: Obstetrics and Gynecology
Adela Urisarri, Marta Gil, Natalia Mandiá, Luís Aldamiz-Echevarría, Roca Iria, Domingo González-Lamuño, María-Luz Couce
To evaluate the prognostic significance of factors frequently associated with a reduction in renal mass, such as prematurity, low birth weight, and congenital anomalies of kidney and urinary tract (CAKUT), in patients with solitary functioning kidney (SFK) and investigate signs of early renal injury due to glomerular hyperfiltration damage or dysplasia in the remaining kidney.Retrospective observational study of congenital SFK diagnosed and followed at a tertiary care hospital over a period of 10 years in which 32,900 newborns underwent routine neonatal abdominal ultrasound screening...
August 2018: Medicine (Baltimore)
Denise C Cornelius, Jesse Cottrell, Lorena M Amaral, Babbette LaMarca
Preeclampsia (PE) is a hypertensive disorder that occurs after 20 weeks of gestation, implicating the placenta as a key offender. PE is associated with an imbalance among B lymphocytes, CD4+ T lymphocytes, natural killer (NK) cells, and increased inflammatory cytokines. During early on-set preeclampsia, trophoblast invasion and placentation are impaired, leading to reduced blood flow to the fetus. In all spectrums of this disorder, a shift toward a pro-inflammatory state where regulatory cells and cytokines are decreased occurs...
August 10, 2018: British Journal of Pharmacology
Alex Y Wang, Nadom Safi, Fathalla Ali, Kei Lui, Zhuoyang Li, Mark P Umstad, Elizabeth A Sullivan
BACKGROUND: While their incidence is on the rise, twin pregnancies are associated with risks to the mothers and their babies. This study aims to investigate the likelihood of adverse neonatal outcomes of twins following assisted reproductive technology (ART) compared to non-ART twins. METHODS: A retrospective population study using the Australian National Perinatal Data Collections (NPDC) which included 19,662 twins of ≥20 weeks gestational age or ≥ 400 g birthweight in Australia...
August 8, 2018: BMC Pregnancy and Childbirth
Karina L Arce-López, Juan Vicencio-Rivas, José Iglesias-Leboreiro, Isabel Bernárdez-Zapata, Mario E Rendón-Macías, Ariela Braverman-Bronstein
Introducción: El bajo peso neonatal (< 2.5 kg o < percentil 10) se atribuye a causas constitucionales (pequeño para la edad gestacional [PEG]) o a la restricción en el crecimiento intrauterino (RCIU), con riesgos posnatales diferentes. En ausencia de una valoración fetal-placentaria prenatal adecuada, resulta difícil establecerlo. El conocer los antecedentes maternos de enfermedades gestacionales (AMEG): hipertensión arterial (HTA), hipotiroidismo, Diabetes Mellitus (DM) gestacional y otra; pudiera orientar a la diferenciación y el manejo...
2018: Boletín Médico del Hospital Infantil de México
Carmen Giurgescu, Lara Fahmy, Jaime Slaughter-Acey, Alexandra Nowak, Cleopatra Caldwell, Dawn P Misra
Background: While maternal depressive symptoms during pregnancy have been linked to preterm birth (PTB; birth before 37 completed weeks of gestation), little has been reported on potential buffering factors, particularly specific to Black women who are at much higher risk. We examined the association between depressive symptoms and PTB in pregnant Black women, with father of the baby (FOB) support as a potential buffering factor. Methods: Data were obtained from the life-course influences on fetal environments study (2009-2011), a cohort of 1,410 Black women in metropolitan Detroit, Michigan (71% response rate) using maternal interviews and medical record abstraction collected during the postpartum hospitalization...
2018: AIMS Public Health
Elizabeth J Thompson, Krystle Perez, Christoph P Hornik, P Brian Smith, Reese H Clark, Matthew Laughon
OBJECTIVE:  Pulmonary hypertension causes substantial morbidity and mortality in infants. Although Food and Drug Administration approved to treat pulmonary arterial hypertension in adults, sildenafil is not approved for infants. We sought to describe sildenafil exposure and associated diagnoses and outcomes in infants. STUDY DESIGN:  Retrospective cohort of neonates discharged from more than 300 neonatal intensive care units from 2001 to 2016. RESULTS:  Sildenafil was administered to 1,336/1,161,808 infants (0...
August 6, 2018: American Journal of Perinatology
Whitney R Bender, Nathanael C Koelper, Mary D Sammel, Lorraine Dugoff
OBJECTIVE:  The objective of this study is to examine the relationship between fetal fraction and hypertensive disorders of pregnancy. STUDY DESIGN:  This is a retrospective cohort study of women with singleton pregnancies who had cell-free DNA (cfDNA) screening at 10 to 20 weeks of gestation. The primary outcome was the development of gestational hypertension (gHTN), preeclampsia (PEC), and PEC with severe features. Multinomial logistic regression was performed to assess the relationship between fetal fraction and pregnancy outcomes of interest while controlling for potential confounders...
August 6, 2018: American Journal of Perinatology
Merve Ateşoğlu, Tolga İnce, Duygu Lüleci, Alp Ergör, Adem Aydın
PURPOSE: Despite the fact that socioeconomic and environmental factors of a population are changing over time, there are few studies focusing on the effects of sociodemographic factors on the prevalence of febrile seizures (FS). This study was designed to find out the prevalence of FS and to investigate the effect of socio-cultural and economic factors on this prevalence among the Turkish school children. METHODS: A school-based, cross-sectional study was conducted in first and second-class children...
July 25, 2018: Seizure: the Journal of the British Epilepsy Association
Tuba Gunel, Nilufer Kamali, Mohammad K Hosseini, Ece Gumusoglu, Ali Benian, Kilic Aydinli
PURPOSE: Preeclampsia (PE) is a pregnancy specific disease soon after 20 weeks of gestation where major symptoms are hypertension and proteinuria. The underlying pathology is believed to be abnormal placentation. Epigenetic and genetic factors have significant roles in abnormal placental development. MicroRNA's (miRNAs), being one of the most important epigenetic regulators, take part in abnormal placentation. Hsa-miR-195 is a molecule associated with abnormal placental growth mechanisms such as impaired cellular proliferation, inadequate trophoblastic invasion causing defective spiral artery remodeling and apoptosis...
August 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
Allison R Walker, Bethany T Waites, Aaron B Caughey
BACKGROUND: Compared to singleton pregnancies, small for gestational age (SGA) and twin gestations experience adverse maternal and neonatal outcomes. Specific data regarding outcomes in late preterm SGA twin gestations are lacking. OBJECTIVE: Our study sought to compare pregnancy outcomes of late preterm (≥ 34 and < 37 weeks) SGA twins versus singletons. Additionally, we sought to stratify the comparisons by < 10%ile and < 5%ile categories. STUDY DESIGN: In this retrospective cohort of 1...
August 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
Chih-Chieh Yang, Pei-Ling Tang, Po-Yen Liu, Wei-Chun Huang, Ying-Yao Chen, Hsiao-Ping Wang, Jenn-Tzong Chang, Li-Te Lin
The utero-placental ischemia induced by pregnancy-induced hypertension (PIH) could lead to fetal hypoxia and proinflammatory cytokine release, which are associated with the development of neonatal necrotizing enterocolitis (NEC). However, a few studies have investigated the relationship between PIH and neonatal NEC and have produced controversial results. Therefore, we attempted to assess the relationship between PIH and the subsequent neonatal NEC risk and identify predictive risk factors.Patients with newly diagnosed PIH were recruited from the Taiwan National Health Insurance Research Database (NHIRD)...
August 2018: Medicine (Baltimore)
Rossella Attini, Isabelle Kooij, Benedetta Montersino, Federica Fassio, Martina Gerbino, Marilisa Biolcati, Elisabetta Versino, Tullia Todros, Giorgina Barbara Piccoli
BACKGROUND: Reflux nephropathy is a common urinary tract malformation, and a substantial cause of morbidity in women of childbearing age. While recent studies provide further new information on pregnancy-related outcomes, their results are heterogeneous and a systematic meta-analysis may help the interpretation. The aim of this review was to analyze pregnancy-related outcomes in the recent literature on reflux nephropathy (2000-2016), to perfect the estimation of risks, and to identify specific research needs...
July 31, 2018: Journal of Nephrology
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