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stroke in pregnant women

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https://www.readbyqxmd.com/read/28402512/defective-trophoblast-invasion-underlies-fetal-growth-restriction-and-pre-eclampsia-like-symptoms-in-the-stroke-prone-spontaneously-hypertensive-rat
#1
G Barrientos, M Pussetto, M Rose, A C Staff, S M Blois, J E Toblli
STUDY QUESTION: What is the impact of chronic hypertension on placental development, fetal growth and maternal outcome in the stroke-prone spontaneously hypertensive rat (SHRSP)? SUMMARY ANSWER: SHRSP showed an impaired remodeling of the spiral arteries and abnormal pattern of trophoblast invasion during placentation, which were associated with subsequent maternal glomerular injury and increased baseline hypertension as well as placental insufficiency and asymmetric fetal growth restriction...
April 11, 2017: Molecular Human Reproduction
https://www.readbyqxmd.com/read/28383382/maternal-cardiovascular-mortality-in-illinois-2002-2011
#2
Joan Briller, Abigail R Koch, Stacie E Geller
OBJECTIVE: To describe the demographic characteristics of women in Illinois who died from cardiovascular disease during pregnancy or up until 1 year postpartum, addressing specific etiologies, timing of death, proportion of potentially preventable mortality, and factors associated with preventability. METHODS: This is a retrospective analysis from the Illinois Department of Public Health Maternal Mortality Review process using International Classification of Diseases, 9th Revision codes that attributed cardiovascular disease as the immediate or underlying cause of maternal death in Illinois from 2002 to 2011...
April 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333820/committee-opinion-no-692-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#3
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333812/committee-opinion-no-692-summary-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#4
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#5
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28294444/effect-of-change-in-posture-on-maternal-functional-hemodynamics-at-35-37-weeks-gestation
#6
Gavin P Guy, Hua Z Ling, Mirian Machuca, Liona C Poon, Kypros H Nicolaides
OBJECTIVE: To evaluate the effect of posture change from the supine to sitting position and before and after passive leg raising on maternal functional hemodynamics in pregnant women at 35-37 weeks' gestation and to compare the changes in pregnancies that subsequently developed preeclampsia (PE) and gestational hypertension (GH) to those who remained normotensive. METHODS: In 3,013 singleton pregnancies at 35-37 weeks' gestation maternal cardiovascular parameters were measured using an automated non-invasive cardiac monitor...
March 13, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28261784/fatal-folic-acid-toxicity-in-humans
#7
Gerard Pradeep Devnath, Senthil Kumaran, R Rajiv, Kusa Kumar Shaha, Ashok Nagaraj
Folic acid is B-9 vitamin. Folic acid is prescribed commonly for pregnant women to prevent neural tube defects in the fetus, patients under chemotherapy, pernicious anemia and to reduce the risk of stroke and cardiovascular disease. Acute or chronic ingestion of a large dose of folic acid generally manifests as neurological complications, which are reversible. In this present case, a 23-year-old pregnant woman committed suicide by consuming folic acid tablets and succumbed to death within 36 h. Postmortem toxicological analysis detected folic acid in viscera...
March 6, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28242247/recurrent-pregnancy-loss-and-cardiovascular-disease-mortality-in-japanese-women-a-population-based-prospective-cohort-study
#8
Keiko Yamada, Hiroyasu Iso, Renzhe Cui, Akiko Tamakoshi
BACKGROUND: This study aimed to examine the association between recurrent pregnancy loss and the risk of cardiovascular disease mortality. METHODS: We identified 54,652 women who were pregnant during the Japan Collaborative Cohort Study. These women were 40-79 years at the date of cohort entry between 1988 and 1990. Participants received municipal health screening examinations and completed self-administered questionnaires. The cause of death was confirmed by annual or biannual follow-up surveys for a median of 18 years...
February 24, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#9
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28150433/impaired-maternal-hemodynamics-in-morbidly-obese-women-a-case-control-study
#10
D Vinayagam, J Gutierrez, J Binder, E Mantovani, B Thilaganathan, A Khalil
AIM: Maternal obesity is associated with significant pregnancy complications and is a risk factor for the development of hypertensive disorders of pregnancy as well as other adverse outcomes. There are few data regarding the hemodynamic aberrations observed in maternal obesity. The aim of this study was to investigate maternal hemodynamics in morbidly obese pregnant women. METHODS: This was a prospective, case-control study of morbidly obese women (BMI >40 kg/m(2) ) and controls (BMI 20-29...
February 2, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28121181/resting-heart-rate-trajectories-and-myocardial-infarction-atrial-fibrillation-ischaemic-stroke-and-death-in-the-general-population-the-troms%C3%A3-study
#11
Ekaterina Sharashova, Tom Wilsgaard, Maja-Lisa Løchen, Ellisiv B Mathiesen, Inger Njølstad, Tormod Brenn
Background Resting heart rate is an established risk factor for cardiovascular disease, but long-term individual resting heart rate trajectories and their effect on cardiovascular disease morbidity and mortality have not yet been described. Methods This large population-based longitudinal study included 14,208 men and women aged 20 years or older, not pregnant and not using blood pressure medications, who attended at least two of the three Tromsø Study surveys conducted between 1986-2001. Resting heart rate was measured using an automated Dinamap device...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28069909/pregnancy-increases-stroke-risk-up-to-one-year-postpartum-and-reduces-long-term-risk
#12
Chun-An Cheng, Jiunn-Tay Lee, Hung-Che Lin, Hui-Chen Lin, Chi-Hsiang Chung, Fu-Huang Lin, Chang-Huei Tsao, Yung-Fu Wu, Wu-Chien Chien, Hung-Wen Chiu
BackgroundThe incidence of stroke in pregnant women is low but trending upward. There are few studies of the topic in women of Asian ethnicity.AimWe aim to evaluate stroke risk in Asian women during and after pregnancy.DesignUsing the Taiwan National Health Insurance database (NHIRD), we designed a retrospective study that included 18-45-year-old pregnant women between the years 2000 and 2010. We selected a 1:1 age-matched control group of non-pregnant women. The endpoint was any type of stroke during pregnancy or the postpartum period; otherwise, the patients were tracked until December 31, 2010...
January 9, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/27966404/-ischemic-stroke-in-young-women
#13
M S Ekker, M J H Wermer, N P Riksen, C J M Klijn, F E de Leeuw
- In virtually all age groups, the incidence of ischemic stroke is higher in men. However, in women aged between 25-49 years the prevalence is higher than in men. Female-specific risk factors and disorders may explain this peak.- Pregnancy and the post-partum period are associated with physiological changes which can increase blood coagulation. Complications during pregnancy may also increase the risk of ischaemic stroke.- Migraine with aura and antiphospholipid syndrome are disorders which are also associated with an increased risk of ischaemic stroke...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27913487/venous-thromboembolism-and-stroke-in-pregnancy
#14
Kelley McLean, Mary Cushman
Pregnancy and the postpartum period substantially increase the risk for thrombotic events. Although the absolute risk for thrombosis is low, these events comprise a significant portion of maternal morbidity and mortality. The vast majority of such events are venous, although the risk for ischemic stroke also appears to be increased in pregnancy. This review will explore the overlapping and unique risk factors for venous and arterial thrombosis in pregnancy. Diagnosis and prevention will be discussed, and treatment will be briefly touched on...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27854379/longitudinal-maternal-haemodynamics-in-fetal-growth-restriction-in-pregnancies-at-high-risk-for-placental-insufficiency
#15
Daniel Stott, Papastefanou I, Daniela Paraschiv, Katherine Clark, Nikos A Kametas
OBJECTIVE: Fetal growth restriction is a powerful determinant of poor perinatal outcomes. Our previous work in pregnancies at high risk for the development of hypertension found that early in pregnancy maternal haemodynamics show impaired cardiovascular adaptation in gestations destined to deliver growth-restricted infants. In this study, we serially monitored maternal haemodynamics from the first through to the third trimester in a similar high-risk cohort, in order to determine if, in pregnancies complicated by growth-restriction, these distinct haemodynamic profiles found at presentation persisted throughout pregnancy...
October 31, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27803828/a-historic-case-of-cardiac-surgery-in-pregnancy
#16
Said Benlamkaddem, Adnane Berdai, Smael Labib, Mustapha Harandou
Background. Heart disease is the leading cause of nonobstetric mortality in pregnant women. Because of high risk, medical management represents the first line of treatment. However, when medical treatment fails, cardiac surgery becomes necessary. Case Presentation. A 27-year-old female who underwent successfully cardiac surgery three times within 3 years. At the first time, she had an aortic valve replacement at 25 weeks of gestation after an infectious endocarditis complicated with an ischemic stroke. At 39 weeks of gestation, she had delivered, vaginally, a healthy baby boy weighing 2800 g...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27775757/risk-of-pregnancy-associated-stroke-across-age-groups-in-new-york-state
#17
Eliza C Miller, Hajere J Gatollari, Gloria Too, Amelia K Boehme, Lisa Leffert, Mitchell S V Elkind, Joshua Z Willey
Importance: Older age is associated with increased risk of pregnancy-associated stroke (PAS). Data are limited on age-specific incidence ratios of PAS compared with stroke risk in nonpregnant women. Objectives: To assess the risk of stroke by age group in pregnant and postpartum women compared with their nonpregnant contemporaries and to compare risk factors across age groups in the exposed (pregnant/postpartum) and unexposed (nonpregnant) populations. Design, Setting, and Participants: International Classification of Diseases, Ninth Revision, billing codes from the calendar year 2003-2012 New York State Department of Health inpatient database and population data were used to identify all women aged 12 to 55 years with cerebrovascular events, including transient ischemic attack, ischemic and hemorrhagic stroke, cerebral venous thrombosis, and nonspecified PAS...
December 1, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27762457/longitudinal-hemodynamics-in-acute-phase-of-treatment-with-labetalol-in-hypertensive-pregnant-women-to-predict-need-for-vasodilatory-therapy
#18
D Stott, M Bolten, D Paraschiv, I Papastefanou, J B Chambers, N A Kametas
OBJECTIVE: Hypertensive pregnant women who do not respond to treatment with labetalol to control blood pressure (BP), but require vasodilatory therapy, progress rapidly to severe hypertension. This could be delayed by early recognition and individualized treatment. In this study, we sought to create prediction models from data at presentation and at 1 h and 24 h after commencement of treatment to identify patients who will not have a sustained response to labetalol and therefore need vasodilatory therapy...
January 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27733658/postnatal-cardiovascular-consequences-in-the-offspring-of-pregnant-rats-exposed-to-smoking-and-smoking-cessation-pharmacotherapies
#19
Kathirvel Gopalakrishnan, Amar S More, Gary D Hankins, Tatiana N Nanovskaya, Sathish Kumar
Approximately 20% of pregnant women smoke despite intentions to quit. Smoking cessation drugs, such as nicotine replacement therapy (NRT) and bupropion, are recommended treatments. Adverse cardiovascular outcomes in offspring have raised concerns about NRT's safety during pregnancy. However, the effect of bupropion is unknown. Using a rat model, we determined whether NRT and bupropion interventions during pregnancy are safer than continued smoking on offspring's cardiovascular function. Male offspring of controls and dams exposed to cigarette smoke (1...
October 12, 2016: Reproductive Sciences
https://www.readbyqxmd.com/read/27733586/role-of-tumor-necrosis-factor-%C3%AE-and-natural-killer-cells-in-uterine-artery-function-and-pregnancy-outcome-in-the-stroke-prone-spontaneously-hypertensive-rat
#20
Heather Yvonne Small, Ryszard Nosalski, Hannah Morgan, Elisabeth Beattie, Tomasz J Guzik, Delyth Graham, Christian Delles
Women with chronic hypertension are at increased risk of maternal and fetal morbidity and mortality. We have previously characterized the stroke-prone spontaneously hypertensive rat (SHRSP) as a model of deficient uterine artery function and adverse pregnancy outcome compared with the control Wistar-Kyoto. The activation of the immune system plays a role in hypertension and adverse pregnancy outcome. Therefore, we investigated the role of tumor necrosis factor-α in the SHRSP phenotype in an intervention study using etanercept (0...
November 2016: Hypertension
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