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Hypertension pregnancy

X-H Zhang, H-Y Zhang, S Lu, L-L Jiang, J Wu, Y-L Yang, S-A Zhang
OBJECTIVE: Gestational hypertension is a pregnancy complication that serious damages the maternal and child health. Early onset severe preeclampsia accounts for about 0.9% of the gestational hypertension disease. Conservative treatment is proposed in recent years to early onset severe preeclampsia through delay delivery. Therefore, it is particularly important to explore the pathogenesis of severe preeclampsia. Soluble endoglin (sEng) has been identified as a central factor to induce endothelium dysfunction of preeclampsia, while its specific mechanism is unclear...
March 2018: European Review for Medical and Pharmacological Sciences
Fatemeh Janani, Farahnaz Changaee
Introduction: Hypertension in pregnancy is one of the three factors of maternal mortality. Etiology of the disease is unknown, but the many factors contributing to the identification and control of it can be taken a step to prevent and reduce the symptoms of the disease. The purpose of this study was to determine the prevalence of preeclampsia (high-blood pressure) in different seasons of the year. Methods: The present retrospective cross-sectional study was conducted on more than 8,000 pregnant women visiting Assali specialized hospital from 2011 to 2013...
October 2017: Journal of Family Medicine and Primary Care
Lissette C Sánchez-Aranguren, Cindy T Espinosa-González, Laura M González-Ortiz, Sandra M Sanabria-Barrera, Carlos E Riaño-Medina, Andrés F Nuñez, Asif Ahmed, Jeannette Vasquez-Vivar, Marcos López
Preeclampsia is a maternal hypertensive disorder that affects up to 1 out of 12 pregnancies worldwide. It is characterized by proteinuria, endothelial dysfunction, and elevated levels of the soluble form of the vascular endothelial growth factor receptor-1 (VEGFR-1, known as sFlt-1). sFlt-1 effects are mediated in part by decreasing VEGF signaling. The direct effects of sFlt-1 on cellular metabolism and bioenergetics in preeclampsia, have not been established. The goal of this study was to evaluate whether sFlt-1 causes mitochondrial dysfunction leading to disruption of normal functioning in endothelial and placental cells in preeclampsia...
2018: Frontiers in Physiology
Andrea Negro, Angela Koverech, Paolo Martelletti
Migraine is an important socioeconomic burden and is ranked the sixth cause of years of life lost because of disability in the general population and the third cause of years of life lost in people younger than 50 years. The cornerstone of pharmacological treatment is represented by the acute therapy. The serotonin (5-hydroxytryptamine [5-HT]) receptor subtype 1B /1D agonists, called triptans, are nowadays the first-line acute therapy for patients who experience moderate-to-severe migraine attacks. Unfortunately, a high percentage of patients are not satisfied with this acute treatment, either for lack of response or side effects...
2018: Journal of Pain Research
Nobuyuki Takahashi, Feng Li, Tomofumi Fushima, Gen Oyanagi, Emiko Sato, Yuji Oe, Akiyo Sekimoto, Daisuke Saigusa, Hiroshi Sato, Sadayoshi Ito
Up to 8% of pregnant women suffer from preeclampsia (PE), a deadly disease characterized by high blood pressure (BP), blood vessel damage, called endotheliosis (vascular endothelial swelling with narrowing of capillary lumen), and high levels of protein in the urine. PE is often associated with premature delivery, which is a risk factor of cardiovascular and metabolic diseases among the offspring. Accordingly, establishing drug treatments of PE is in immediate needs. Currently, many of anti-hypertensive drugs cause malformation of the fetuses and are contraindicated for pregnant women...
2018: Tohoku Journal of Experimental Medicine
Arthur J Vaught, Evan M Braunstein, Jagar Jasem, Xuan Yuan, Igor Makhlin, Solange Eloundou, Andrea C Baines, Samuel A Merrill, Shruti Chaturvedi, Karin Blakemore, C John Sperati, Robert A Brodsky
BACKGROUND: HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome is a severe variant of hypertensive disorders of pregnancy affecting approximately 1% of all pregnancies, and has significant maternal and fetal morbidity. Previously, we showed that upregulation of the alternative pathway of complement (APC) plays a role in HELLP syndrome. We hypothesize that HELLP syndrome follows a 2-hit disease model similar to atypical hemolytic uremic syndrome (aHUS), requiring both genetic susceptibility and an environmental risk factor...
March 22, 2018: JCI Insight
Jennifer McCoy, Katheryne L Downes, Sindhu K Srinivas, Lisa D Levine
OBJECTIVE: To determine the risk of cesarean delivery associated with postdates induction (≥41 weeks) compared to term induction (37-40w6d) among women with an unfavorable cervix, and to examine the risk factors associated with cesarean among women undergoing postdates induction. METHODS: A planned secondary analysis of a large prospective cohort study on induction (n = 854) was performed. Women with a singleton gestation, intact membranes, and an unfavorable cervix (Bishop score of ≤6 and dilation ≤2 cm) who were undergoing a term (≥37 weeks) induction for any indication were included...
March 21, 2018: Journal of Maternal-fetal & Neonatal Medicine
Kimberley Jae Botting, Xin Yee Loke, Song Zhang, Johnnie B Andersen, Jens Randel Nyengaard, Janna L Morrison
Intrauterine growth restriction (IUGR) increases the risk of ischaemic heart disease in adulthood. Studies in rats suggest cardiac vulnerability is more pronounced in males and in offspring that were exposed to hypoxia in utero. Therefore, we aimed to test the hypotheses that 1) IUGR adolescent males, but not females, have fewer cardiomyocytes and altered expression of cardiometabolic genes compared to Controls and 2) IUGR due to hypoxia has a greater effect on these parameters compared to IUGR due to nutrient restriction...
March 21, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
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
H David McIntyre, Dorte M Jensen, Richard C Jensen, Henriette B Kyhl, Tina K Jensen, Dorte Glintborg, Marianne Andersen
OBJECTIVE: To define the prevalence and pregnancy outcomes related to elevated fasting venous plasma glucose (FVPG) in a Danish pregnancy cohort. RESEARCH DESIGN AND METHODS: This was an observational cohort study including 1,516 women without gestational diabetes mellitus (GDM) by Danish criteria. FVPG measured at 28 weeks' gestation was related to pregnancy outcomes. RESULTS: With use of the World Health Organization 2013 threshold of FVPG ≥5...
March 20, 2018: Diabetes Care
L Ormesher, E D Johnstone, E Shawkat, A Dempsey, C Chmiel, E Ingram, L E Higgins, J E Myers
OBJECTIVE: To evaluate the use of plasma Placental Growth Factor (PlGF), recommended by the recent NICE guidance, in women with suspected pre-eclampsia (PE) and/or fetal growth restriction (FGR). STUDY DESIGN: Non-randomised prospective clinical evaluation study in high-risk antenatal clinics in a tertiary maternity unit. METHODS: PlGF testing was performed in addition to routine clinical assessment in 260 women >20 weeks' gestation with chronic disease (hypertension, renal disease ± diabetes) with a change in maternal condition or in women with suspected FGR to determine the impact on clinical management...
March 13, 2018: Pregnancy Hypertension
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
Aisha Mansoor Ali, Abdulaziz Alobaid, Tasnim Nidal Malhis, Ahmad Fawzi Khattab
BACKGROUND: Vitamin D plays pivotal role in decidualization and implantation of the placenta. Recent researches have shown that low level of vitamin D3 "25-hydroxyvitamin D (25[OH]D)" in serum is a risk factor for pre-eclampsia. Latest evidence supports role of vitamin D3 deficiency treatment in reducing the risk of pre-eclampsia. The aim of this study is to determine the effect of antenatal supplementation of vitamin D3 on the risk of pre-eclampsia and to explore the dose effect in attaining the vitamin D3 normal level...
March 2, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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
Clara Barneo-Caragol, Eduardo Martínez-Morillo, Susana Rodríguez-González, Paloma Lequerica-Fernández, Ignacio Vega-Naredo, Francisco V Álvarez Menéndez
BACKGROUND: Preeclampsia (PE) is considered a specific vascular disease in which endothelial dysfunction may be the crucial factor of its pathogenesis. It has been suggested that strontium (Sr) may play a role in the pathophysiology of PE. Our group established in a previous study the serum levels of Sr in healthy pregnancies, and the main aim of the present study was to evaluate Sr concentrations and oxidative status in preeclamptic women. METHODS: The study population included women with early-onset PE (E-PE, n = 39), late-onset PE (L-PE, n = 67) and serial samples from a subset of preeclamptic women (PE-ss, n = 20)...
May 2018: Journal of Trace Elements in Medicine and Biology
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
Cathy Liu, Jade Lodge, Christopher Flatley, Alexander Gooi, Cameron Ward, Karen Eagleson, Sailesh Kumar
OBJECTIVE: To determine obstetric, intrapartum and perinatal outcomes for pregnancies with isolated fetal congenital heart defects (CHD). METHODS: This was a retrospective cohort study of women that delivered an infant with an isolated major CHD between January 2010 and April 2017 at a major Australian perinatal centre. The study cohort was compared with a cohort of women with infants without CHD. Cardiac abnormalities were broadly subdivided into the following five categories using the International Classification of Diseases Tenth Revision (ICD-10) as a guide - transposition of the great arteries (TGA), septal defects, right heart lesions (RHL), left heart lesions (LHL) and "other"...
March 16, 2018: Journal of Maternal-fetal & Neonatal Medicine
Gabriella Bröms, Ann Haerskjold, Fredrik Granath, Helle Kieler, Lars Pedersen, Ingegärd A Berglind
Studies on pregnancy and birth outcomes in women with psoriasis are scarce and the findings inconsistent. The effect of maternal psoriasis and its severity on the risk of adverse pregnancy and birth outcomes was examined. A cross-national population-based cohort study was performed using prospectively collected data from Denmark and Sweden. Singleton births in women with psoriasis were identified in the national health registers between April 2007 and December 2012 and classified according to disease severity...
March 15, 2018: Acta Dermato-venereologica
Marcelo R Luizon, Daniela A Pereira, Valeria C Sandrim
Hypertension is a leading cause of cardiovascular mortality, but only about half of patients on antihypertensive therapy achieve blood pressure control. Preeclampsia is defined as pregnancy-induced hypertension and proteinuria, and is associated with increased maternal and perinatal mortality and morbidity. Similarly, a large number of patients with preeclampsia are non-responsive to antihypertensive therapy. Pharmacogenomics may help to guide the personalized treatment for non-responsive hypertensive patients...
2018: Frontiers in Pharmacology
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
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