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antihypertensive and pregnancy

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https://www.readbyqxmd.com/read/28602773/frequency-and-consequences-of-ventricular-hypertrophy-in-pregnant-women-with-treated-chronic-hypertension
#1
Anne M Ambia, Jamie L Morgan, Karen L Wilson, Scott W Roberts, C Edward Wells, Donald D Mcintire, Monika Sanghavi, David B Nelson, F Gary Cunningham
BACKGROUND: Ventricular hypertrophy is a known sequelae of long-standing chronic hypertension with associated morbidity and mortality. OBJECTIVE: To assess the frequency and importance of left ventricular hypertrophy in women treated for chronic hypertension during pregnancy. STUDY DESIGN: This was a retrospective study of pregnant women with chronic hypertension who were delivered at our hospital from January 2009 to February 2015. All women who were given antihypertensive therapy underwent maternal echocardiography and were managed in a dedicated, high-risk prenatal clinic...
June 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28578148/contraception-and-reproductive-counseling-in-women-with-peripartum-cardiomyopathy
#2
Lindsey Rosman, Elena Salmoirago-Blotcher, Karl L Wuensch, John Cahill, Samuel F Sears
OBJECTIVES: Pregnancies following a diagnosis of peripartum cardiomyopathy (PPCM) are associated with increased risk for maternal morbidity and mortality. Yet patterns of contraceptive use and reproductive counseling have received little attention. This nationwide registry-based study sought to evaluate patterns and clinical characteristics associated with contraceptive use, and examine the prevalence of contraceptive counseling in women with PPCM. METHODS: From December 2015 to June 2016, 177 PPCM patients (mean age of 34...
May 31, 2017: Contraception
https://www.readbyqxmd.com/read/28515115/impact-of-antihypertensive-treatment-on-maternal-and-perinatal-outcomes-in-pregnancy-complicated-by-chronic-hypertension-a%C3%A2-systematic-review-and-meta-analysis
#3
REVIEW
Louise M Webster, Frances Conti-Ramsden, Paul T Seed, Andrew J Webb, Catherine Nelson-Piercy, Lucy C Chappell
BACKGROUND: Chronic hypertension complicates around 3% of all pregnancies. There is evidence that treating severe hypertension reduces maternal morbidity. This study aimed to systematically review randomized controlled trials of antihypertensive agents treating chronic hypertension in pregnancy to determine the effect of this intervention. METHODS AND RESULTS: Medline (via OVID), Embase (via OVID) and the Cochrane Trials Register were searched from their earliest entries until November 30, 2016...
May 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28506946/maternal-mortality-due-to-hypertensive-disorders-in-pregnancy-childbirth-and-the-puerperium-between-2012-and-2015-in-turkey-a-nation-based-study
#4
Bekir Keskinkılıç, Yaprak Engin-Üstün, Sema Sanisoğlu, Dilek Şahin Uygur, Hüseyin Levent Keskin, Selma Karaahmetoğlu, Ayşe Özcan, Meral Esen, Afra Alkan, Aysun Kabasakal, İrfan Şencan
OBJECTIVE: To analyze maternal deaths in Turkey due to hypertensive disorders. MATERIAL AND METHODS: In this retrospective study 812 maternal deaths were analyzed. Maternal demographic features, presence of antenatal care, medical and obstetric history, mode of delivery, and use emergency antihypertensive therapy were recorded. The delay model for each case was investigated. RESULTS: Hypertensive disorders accounted for 15.5% (n=126) out of all maternal mortality...
March 15, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28461600/myeloperoxidase-in-hypertensive-disorders-of-pregnancy-and-its-relation-with-nitric-oxide
#5
Lilliam Rocha-Penha, Mayara Caldeira-Dias, José Eduardo Tanus-Santos, Ricardo de Carvalho Cavalli, Valéria Cristina Sandrim
Elevated levels of myeloperoxidase have been demonstrated in women with preeclampsia where it may contribute to endothelial dysfunction mediated, in part, by nitric oxide impairment. In this study, we investigated myeloperoxidase in hypertensive disorders of pregnancy and its contribution to the impairment of the vasodilator nitric oxide. We found higher levels of myeloperoxidase in supernatant from human umbilical vein endothelial cells cultures incubated with plasma from preeclampsia group compared with healthy pregnant women...
June 2017: Hypertension
https://www.readbyqxmd.com/read/28426127/postpartum-hypertension-etiology-diagnosis-and-management
#6
Kathryn J Sharma, Sarah J Kilpatrick
Importance: Postpartum hypertension complicates approximately 2% of pregnancies and, similar to antepartum severe hypertension, can have devastating consequences including maternal death. Objective: This review aims to increase the knowledge and skills of women's health care providers in understanding, diagnosing, and managing hypertension in the postpartum period. Results: Hypertension complicating pregnancy, including postpartum, is defined as systolic blood pressure 140 mm Hg or greater and/or diastolic blood pressure 90 mm Hg or greater on 2 or more occasions at least 4 hours apart...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28400421/kidney-outcomes-and-risk-factors-for-nephritis-flare-de-novo-in-a-multiethnic-cohort-of-pregnant-patients-with-lupus
#7
Jill P Buyon, Mimi Y Kim, Marta M Guerra, Sifan Lu, Emily Reeves, Michelle Petri, Carl A Laskin, Michael D Lockshin, Lisa R Sammaritano, D Ware Branch, T Flint Porter, Allen Sawitzke, Joan T Merrill, Mary D Stephenson, Elisabeth Cohn, Jane E Salmon
BACKGROUND AND OBJECTIVES: Kidney disease is a critical concern in counseling patients with lupus considering pregnancy. This study sought to assess the risk of renal flares during pregnancy in women with previous lupus nephritis in partial or complete remission, particularly in those with antidouble-stranded DNA antibodies and low complement levels, and the risk of new-onset nephritis in patients with stable/mildly active SLE. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We assessed active nephritis (renal flares and de novo kidney disease) and associated predictors during pregnancy in patients with lupus with urine protein ≤1000 mg and serum creatinine <1...
June 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28391337/managing-glomerular-disease-in-pregnancy
#8
Michelle A Hladunewich, Kate Bramham, Belinda Jim, Sharon Maynard
Glomerular disease, especially lupus nephritis, is common in young women of childbearing age. As such, practicing nephrologists must have adequate knowledge and expertise to prepare these women for pregnancy, to diagnose and manage the numerous pregnancy-associated complications that are common in this vulnerable patient population and finally to support these young women who often struggle to manage both their young children along with an often onerous chronic disease. In this article we will review the pre-pregnancy counseling these women should ideally receive to allow them to make an informed decision about proceeding with a pregnancy, an approach to the diagnosis of pregnancy-associated worsening of kidney function and proteinuria as well as pregnancy-safe management strategies, including immunosuppression, antihypertensive agents and other medications necessary for the management of nephrotic syndrome...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28373593/maternal-antihypertensive-medication-use-and-congenital-heart-defects-updated-results-from-the-national-birth-defects-prevention-study
#9
Sarah C Fisher, Alissa R Van Zutphen, Martha M Werler, Angela E Lin, Paul A Romitti, Charlotte M Druschel, Marilyn L Browne
Previous NBDPS (National Birth Defects Prevention Study) findings from 1997 to 2003 suggested that maternal antihypertensive use was associated with congenital heart defects (CHDs). We re-examined associations between specific antihypertensive medication classes and specific CHDs with additional NBDPS data from 2004 to 2011. After excluding mothers missing hypertension information or who reported pregestational diabetes mellitus, a multiple birth, or antihypertensive use but no hypertension, we compared self-reported maternal exposure data on 10 625 CHD cases and 11 137 nonmalformed controls...
May 2017: Hypertension
https://www.readbyqxmd.com/read/28358601/pharmacogenetics-in-the-treatment-of-pre-eclampsia-current-findings-challenges-and-perspectives
#10
Marcelo R Luizon, Ana Ct Palei, Ricardo C Cavalli, Valeria C Sandrim
Pre-eclampsia (PE) is defined as pregnancy-induced hypertension and proteinuria, and is a major cause of maternal and perinatal morbidity and mortality. A large subgroup of pregnant women with PE is nonresponsive to antihypertensive drugs, including methyldopa, nifedipine and hydralazine. Pharmacogenomics may help to guide the individualized therapy for this nonresponsive subgroup. However, just a few pharmacogenetic studies examined the effects of genetic polymorphisms on response to antihypertensive drugs in PE, and the criteria of responsiveness used to define responsive or nonresponsive subgroups to antihypertensive therapy should be replicated by others...
March 30, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28356062/successful-multigravid-pregnancy-in-a-42-year-old-patient-on-continuous-ambulatory-peritoneal-dialysis-and-a-review-of-the-literature
#11
Thiam Seong Christopher Lim, Malini Shanmuganathan, Irene Wong, Bak Leong Goh
BACKGROUND: For peritoneal dialysis patients, the likelihood of conception is low and the probability of getting through the pregnancy successfully is even lower. Almost 60 years after the first reported case of a successful pregnancy in a dialysis patient, many issues concerning pregnancy in dialysis patients remain unresolved. Our patient's pregnancy is considered high risk as she has end stage renal failure and falls in the category of advance maternal age for pregnancy. We describe here the course of her uneventful pregnancy which we hope will contribute to the overall knowledge and management of pregnancy in elderly patients receiving peritoneal dialysis...
March 29, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28333820/committee-opinion-no-692-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#12
(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
#13
(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/28280642/severe-preeclampsia-in-the-setting-of-myasthenia-gravis
#14
Adam J Lake, Antoun Al Khabbaz, Renée Keeney
Myasthenia gravis (MG) is a rare autoimmune disease that leads to progressive muscle weakness and is common during female reproductive years. The myasthenic mother and her newborn must be observed carefully, as complications during all stages of pregnancy and the puerperium may arise suddenly. Preeclampsia is a common obstetrical condition for which magnesium sulfate is used for seizure prophylaxis. However, magnesium sulfate is strongly contraindicated in MG as it impairs already slowed nerve-muscle connections...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28279445/a-comprehensive-analysis-of-continuous-epidural-analgesia-s-effect-on-labor-and-neonates-in-maternal-hypertensive-disorder-patients
#15
Bin Han, Mingjun Xu
BACKGROUND: Maternal hypertensive disorder is one of the most common and severe medical complications during pregnancy. Epidural analgesia administration is widely used during labor process. AIM: To evaluate the potential advantage or disadvantage of continuous epidural analgesia's on labor and neonates for maternal hypertensive disorder patients comprehensively. METHODS: We have retrospectively analyzed 232 patients who diagnosed as maternal hypertensive disorder in our hospital since 2015...
January 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28257538/multidisciplinary-approach-to-complicated-pregnancy
#16
Josip Andelo Borovac, Josko Bozic, Tina Ticinovic Kurir, Nikola Zaja, Kresimir Kolic, Vedran Hrboka
A nulliparous pregnant woman in her mid-20s and in the 32nd week of gestation presented to the emergency department with severe headache and vomiting. She had an uneventful medical history; however, the physical examination upon hospital admission revealed a hypertensive emergency, papilledema, and 2+ dipstick proteinuria. Upon establishing the diagnosis of preeclampsia, aggressive therapy with corticosteroids, antihypertensive medication, and seizure prophylaxis was initiated. Hemodynamic stability was achieved within 24 hours and the patient remained in the observation unit located within the gynecology clinic...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28153655/early-standardized-treatment-of-critical-blood-pressure-elevations-is-associated-with-a-reduction-in-eclampsia-and%C3%A2-severe-maternal-morbidity
#17
MULTICENTER STUDY
Laurence E Shields, Suzanne Wiesner, Catherine Klein, Barbara Pelletreau, Herman L Hedriana
BACKGROUND: Hypertensive disorders of pregnancy result in significant maternal morbidity and mortality. State and national guidelines have been proposed to increase treatment of patients with hypertensive emergencies or critically elevated blood pressures. There are limited data available to assess the impact of these recommendations on maternal morbidity. OBJECTIVE: The purpose of this prospective quality improvement project was to determine if maternal morbidity would be improved using a standardized approach for treatment of critically elevated blood pressures...
April 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28137991/association-of-pregnancy-complications-and-characteristics-with-future-risk-of-elevated-blood-pressure-the-v%C3%A3-sterbotten-intervention-program
#18
Nisha I Parikh, Margareta Norberg, Erik Ingelsson, Sven Cnattingius, Ramachandran S Vasan, Magnus Domellöf, Jan Håkan Jansson, Anna-Karin Edstedt Bonamy
Pregnancy characteristics are associated with risk of cardiovascular diseases, but their independent associations with hypertension or blood pressure (BP) levels remain uncertain. We linked the Swedish Medical Birth Register with Västerbotten Intervention Program data (Northern Sweden). Using linear and logistic regression, we related pregnancy factors in any prior pregnancy with BP and hypertension at 40 years of age in 15 896 parous women free of prepregnancy hypertension. Pregnancy factors included parity, age at first delivery, preeclampsia, gestational diabetes mellitus, placental abruption, shortest gestational age small for gestational age baby (<third percentile for birth weight) or stillbirth...
March 2017: Hypertension
https://www.readbyqxmd.com/read/28125624/clonidine-versus-captopril-for-severe-postpartum-hypertension-a-randomized-controlled-trial
#19
Carlos Noronha Neto C, Sabina S B Maia, Leila Katz, Isabela C Coutinho, Alex R Souza, Melania M Amorim
BACKGROUND: Changes during the puerperium are still unclear, particularly in women with hypertension. The choice of antihypertensives, both to control very high blood pressure episodes and to keep blood pressure stable, also requires further elucidation. Currently, there are no clear data to guide the decision for the choice of postpartum antihypertensives. Captopril plays an important role in the treatment of very high blood pressure episodes and may be used postpartum. Clonidine has been used as an alternative in pregnant or postpartum women with contraindications to captopril, with satisfactory effect...
2017: PloS One
https://www.readbyqxmd.com/read/28120288/missed-opportunities-to-improve-the-health-of-postpartum-women-high-rates-of-untreated-hypertension-in-rural-tanzania
#20
Elysia Larson, Miriam Rabkin, Godfrey M Mbaruku, Redempta Mbatia, Margaret E Kruk
Objectives To assess the prevalence of high blood pressure amongst postpartum women in rural Tanzania, and to explore factors associated with hypertension prevalence, awareness, treatment, and control. Methods 1849 women in Tanzania's Pwani Region who delivered a child in the prior year participated in the study. We measured blood pressure, administered a structured questionnaire and assessed factors associated with the prevalence, awareness, treatment, and control of hypertension (HTN) using bivariable and multivariable logistic regressions...
March 2017: Maternal and Child Health Journal
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