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Current developments in managing preeclampsia

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https://www.readbyqxmd.com/read/29113524/how-does-preeclampsia-affect-neonates-highlights-in-the-disease-s-immunity
#1
Lina R Marins, Leonardo B Anizelli, Ana L Sarquis, Mariana D Romanowski
INTRODUCTION: Preeclampsia (PE) is the primary obstetrical cause in one to four perinatal deaths. Although the etiology and pathogenesis of preeclampsia is not fully known, a proinflammatory immune state prevails and can disrupt fetal hematopoiesis. Some of the effects on the newborn include neonatal thrombocytopenia, neutropenia, a reduction in T regulatory cells and an increased cytotoxic natural killer cell profile. METHOD: Electronic databases were searched, and defined criteria were applied to select articles for review...
November 7, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29067240/benign-thyroid-disease-in-pregnancy-a-state-of-the-art-review
#2
REVIEW
Efterpi Tingi, Akheel A Syed, Alexis Kyriacou, George Mastorakos, Angelos Kyriacou
Thyroid dysfunction is the commonest endocrine disorder in pregnancy apart from diabetes. Thyroid hormones are essential for fetal brain development in the embryonic phase. Maternal thyroid dysfunction during pregnancy may have significant adverse maternal and fetal outcomes such as preterm delivery, preeclampsia, miscarriage and low birth weight. In this review we discuss the effect of thyroid disease on pregnancy and the current evidence on the management of different thyroid conditions in pregnancy and postpartum to improve fetal and neonatal outcomes, with special reference to existing guidelines on the topic which we dissect, critique and compare with each other...
December 2016: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29035901/ce-preeclampsia-current-approaches-to-nursing-management
#3
REVIEW
Cindy M Anderson, Mandy J Schmella
: Preeclampsia, one of four hypertensive disorders of pregnancy, has traditionally been characterized as new-onset hypertension and proteinuria developing after 20 weeks' gestation. It is, however, now understood to be a complex, progressive, multisystem disorder with a highly variable presentation and a number of potentially life-threatening complications. The American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy has refined preeclampsia diagnostic criteria accordingly, and as the disorder's pathogenesis has been more clearly defined, new targets for screening, diagnosis, prevention, and treatment have emerged...
November 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28961633/cardiovascular-origins-of-preeclampsia
#4
Erkan Kalafat, Basky Thilaganathan
PURPOSE OF REVIEW: To review the current data on maternal cardiovascular adaptation in normal pregnancy and preeclampsia. RECENT FINDINGS: Defective placentation causes early-onset preeclampsia, a disease entity that is considered more or less distinct from late-onset preeclampsia. The latter has been attributed as 'maternal' preeclampsia. There are inconsistencies with the placental origins hypothesis, especially when considering the lack of a causative association with abnormal placental histology or impaired fetal growth...
December 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28719896/update-on-the-diagnosis-and-prognosis-of-preeclampsia-with-the-aid-of-the-sflt-1-plgf-ratio-in-singleton-pregnancies
#5
Ignacio Herraiz, Elisa Llurba, Stefan Verlohren, Alberto Galindo
Preeclampsia (PE) is involved in a group of obstetrical conditions closely related by the presence of placental dysfunction (PD), which also includes intrauterine growth restriction and placental abruption. The timely and accurate recognition and management of PE are often challenging because diagnostic criteria are still based on nonspecific signs and symptoms and because common severity criteria correlate poorly with adverse maternal and fetal outcomes. The discovery of the role of angiogenesis-related factors - soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) - in the underlying pathophysiology of PD has marked an important step for improving its early diagnosis and prognosis assessment before gestational week 34...
July 19, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28558118/mosquito-borne-diseases-as-a-global-health-problem-implications-for-pregnancy-and-travel
#6
Khady Diouf, Nawal M Nour
Importance: Mosquitoes are the most common disease vectors worldwide. A combination of factors, including changes in public health policy, climate change, and global travel, has led to the resurgence and spread of these diseases in our modern world. Pregnant women are vulnerable to a number of these illnesses, and obstetricians are likely to encounter pregnant travelers who have been exposed. Objective: This review was conducted to summarize knowledge of mosquito-borne diseases and their relevance in pregnancy...
May 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28131123/update-in-the-management-of-patients-with-preeclampsia
#7
REVIEW
Nerlyne K Dhariwal, Grant C Lynde
Hypertensive disorders of pregnancy complicate approximately 10% of all deliveries in the United States and are a leading cause of maternal and fetal morbidity and mortality. Preeclampsia is defined as hypertension in association with proteinuria, thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, or new-onset cerebral or visual disturbances. The greatest risk factor for the development of preeclampsia is a history of preeclampsia. There currently is no effective means for the prevention of preeclampsia...
March 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27555797/current-best-practice-in-the-management-of-hypertensive-disorders-in-pregnancy
#8
REVIEW
Rosemary Townsend, Patrick O'Brien, Asma Khalil
Preeclampsia is a potentially serious complication of pregnancy with increasing significance worldwide. Preeclampsia is the cause of 9%-26% of global maternal mortality and a significant proportion of preterm delivery, and maternal and neonatal morbidity. Incidence is increasing in keeping with the increase in obesity, maternal age, and women with medical comorbidities entering pregnancy. Recent developments in the understanding of the pathophysiology of preeclampsia have opened new avenues for prevention, screening, and management of this condition...
2016: Integrated Blood Pressure Control
https://www.readbyqxmd.com/read/27432836/cardiovascular-risk-management-after-reproductive-and-pregnancy-related-disorders-a-dutch-multidisciplinary-evidence-based-guideline
#9
Karst Y Heida, Michiel L Bots, Christianne Jm de Groot, Frederique M van Dunné, Nurah M Hammoud, Annemiek Hoek, Joop Se Laven, Angela Hem Maas, Jeanine E Roeters van Lennep, Birgitta K Velthuis, Arie Franx
BACKGROUND: In the past decades evidence has accumulated that women with reproductive and pregnancy-related disorders are at increased risk of developing cardiovascular disease (CVD) in the future. Up to now there is no standardised follow-up of these women becausee guidelines on cardiovascular risk management for this group are lacking. However, early identification of high-risk populations followed by prevention and treatment of CVD risk factors has the potential to reduce CVD incidence...
July 18, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/26887677/in-utero-origins-of-hypertension-mechanisms-and-targets-for-therapy
#10
REVIEW
Jude S Morton, Christy-Lynn Cooke, Sandra T Davidge
The developmental origins of health and disease theory is based on evidence that a suboptimal environment during fetal and neonatal development can significantly impact the evolution of adult-onset disease. Abundant evidence exists that a compromised prenatal (and early postnatal) environment leads to an increased risk of hypertension later in life. Hypertension is a silent, chronic, and progressive disease defined by elevated blood pressure (>140/90 mmHg) and is strongly correlated with cardiovascular morbidity/mortality...
April 2016: Physiological Reviews
https://www.readbyqxmd.com/read/26255680/determinants-of-future-cardiovascular-health-in-women-with-a-history-of-preeclampsia
#11
REVIEW
Gerbrand A Zoet, Maria P H Koster, Birgitta K Velthuis, Christianne J M de Groot, Angela H E M Maas, Bart C J M Fauser, Arie Franx, Bas B van Rijn
Women who develop preeclampsia have an increased risk of cardiovascular disease (CVD) later in life. However, current guidelines on cardiovascular risk assessment and prevention are unclear on how and when to screen these women postpartum, and about the role of a positive history of preeclampsia in later-life CVD risk management. The aim of this review is to discuss the present knowledge on commonly used cardiovascular screening modalities available to women with a history of preeclampsia, and to discuss recent developments in early detection of CVD using cardiovascular imaging...
October 2015: Maturitas
https://www.readbyqxmd.com/read/25930479/dose-selection-of-antithrombin-recombinant-for-a-phase-3-trial-in-early-onset-preeclampsia-149
#12
Michael John Paidas, Johan Frieling, Joost de Jongh, Henk-Jan Drenth, James Streisand
INTRODUCTION: Acquired antithrombin deficiency is one of the distinguishing features of early-onset preeclampsia, the leading cause of maternal and perinatal morbidity and mortality. Antithrombin's pleiotropic effects suggest it may slow the progression of early-onset preeclampsia and extend pregnancy in patients being managed expectantly. Prior human studies demonstrate that maternal administration of antithrombin prolongs expectant management, but the source of antithrombin, human plasma, limits its use for early-onset preeclampsia...
May 2015: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/25916268/bioactive-factors-in-uteroplacental-and-systemic-circulation-link-placental-ischemia-to-generalized-vascular-dysfunction-in-hypertensive-pregnancy-and-preeclampsia
#13
REVIEW
Dania A Shah, Raouf A Khalil
Preeclampsia is a pregnancy-associated disorder characterized by hypertension, and could lead to maternal and fetal morbidity and mortality; however, the pathophysiological mechanisms involved are unclear. Predisposing demographic, genetic and environmental risk factors could cause localized abnormalities in uteroplacental cytoactive factors such as integrins, matrix metalloproteinases, cytokines and major histocompatibility complex molecules leading to decreased vascular remodeling, uteroplacental vasoconstriction, trophoblast cells apoptosis, and abnormal development of the placenta...
June 15, 2015: Biochemical Pharmacology
https://www.readbyqxmd.com/read/25734477/-thrombophilia-and-hellp-syndrome-in-pregnancy-case-report-and-overview-of-the-literature
#14
REVIEW
S Findeklee, S D Costa, S N Tchaikovski
Thrombophilia is a prothrombotic state that can be caused by genetic disorders, such as the factor-V-Leiden or prothrombin mutation, as well as by acquired changes like oestrogen-induced APC resistance and the antiphospholipid syndrome. Pregnancy induces multiple procoagulant changes in the haemostatic system, increasing the risk of venous thromboembolism in women with a thrombophilia even further. Additionally, thrombophilias are suggested to be associated with a number of pregnancy complications such as recurrent miscarriage, stillbirth, preeclampsia and HELLP syndrome...
February 2015: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/25670232/sex-differences-in-cardiovascular-risk-factors-and-disease-prevention
#15
REVIEW
Yolande Appelman, Bas B van Rijn, Monique E Ten Haaf, Eric Boersma, Sanne A E Peters
Cardiovascular disease (CVD) has been seen as a men's disease for decades, however it is more common in women than in men. It is generally assumed in medicine that the effects of the major risk factors (RF) on CVD outcomes are the same in women as in men. Recent evidence has emerged that recognizes new, potentially independent, CVD RF exclusive to women. In particular, common disorders of pregnancy, such as gestational hypertension and diabetes, as well as frequently occurring endocrine disorders in women of reproductive age (e...
July 2015: Atherosclerosis
https://www.readbyqxmd.com/read/25249978/maternally-sequestered-therapeutic-polypeptides-a-new-approach-for-the-management-of-preeclampsia
#16
Gene L Bidwell, Eric M George
The last several decades have seen intensive research into the molecular mechanisms underlying the symptoms of preeclampsia. While the underlying cause of preeclampsia is believed to be defective placental development and resulting placental ischemia, it is only recently that the links between the ischemic placenta and maternal symptomatic manifestation have been elucidated. Several different pathways have been implicated in the development of the disorder; most notably production of the anti-angiogenic protein sFlt-1, induction of auto-immunity and inflammation, and production of reactive oxygen species...
2014: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/25135649/treatment-of-preeclampsia-current-approach-and-future-perspectives
#17
REVIEW
Ecaterina Berzan, Ross Doyle, Catherine M Brown
Hypertension is the most common medical disorder encountered during pregnancy, occurring in about 6-8 % of pregnancies. Preeclampsia is a pregnancy-specific disorder that occurs after 20 weeks' gestation, characterized by hypertension and proteinuria. Preeclampsia can also occur superimposed upon chronic hypertension. Eclampsia is the convulsive form of preeclampsia, and affects 0.1 % of all pregnancies. In low-income and middle-income countries, preeclampsia and eclampsia are associated with 10-15 % of direct maternal deaths...
September 2014: Current Hypertension Reports
https://www.readbyqxmd.com/read/24688121/strategy-for-standardization-of-preeclampsia-research-study-design
#18
Leslie Myatt, Christopher W Redman, Anne Cathrine Staff, Stefan Hansson, Melissa L Wilson, Hannele Laivuori, Lucilla Poston, James M Roberts
Preeclampsia remains a major problem worldwide for mothers and babies. Despite intensive study, we have not been able to improve the management or early recognition of preeclampsia. At least part of this is because of failure to standardize the approach to studying this complex syndrome. It is possible that within the syndrome there may be different phenotypes with pathogenic pathways that differ between the subtypes. The capacity to recognize and to exploit different subtypes is of obvious importance for prediction, prevention, and treatment...
June 2014: Hypertension
https://www.readbyqxmd.com/read/24382555/diagnosis-and-management-of-obstetrical-antiphospholipid-syndrome-where-do-we-stand
#19
REVIEW
Tess Marchetti, Marie Cohen, Jean-Christophe Gris, Philippe de Moerloose
Obstetrical antiphospholipid syndrome (APS) is defined by obstetrical complications and the presence of antiphospholipid antibodies (aPL). Although the incidence of APS is still poorly known, this thrombophilia is now recognized as one of the most common acquired causes of recurrent fetal loss. The diagnosis of APS during pregnancy can be challenging because of its various clinical features. Mothers with APS have an increased risk of thrombosis, thrombopenia, and specific pregnancy‑related complications such as preeclampsia, eclampsia, and hemolysis elevated liver enzyme and low‑platelet syndrome...
2013: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/24283366/clinical-trial-of-expectant-management-of-severe-preeclampsia-that-develops-at-32-weeks-gestation-at-a-japanese-perinatal-center
#20
Shunji Suzuki, Manabu Shimada, Yoshie Shibata-Hiraizumi
OBJECTIVE: This study was to examine the clinical usefulness of expectant management of early-onset severe preeclampsia. METHODS: We reviewed the obstetric records of all Japanese singleton deliveries at ≥22 weeks' gestation managed at Japanese Red Cross Katsushika Maternity Hospital between 2007 and 2012. We compared the obstetric characteristics and perinatal outcomes between the cases of deliveries before (n = 19) and after completion of corticosteroids (n = 30) (immediate delivery versus expectant management)...
October 2014: Journal of Maternal-fetal & Neonatal Medicine
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