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antihypertensive and pregnancy

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https://www.readbyqxmd.com/read/29187414/postpartum-management-of-hypertensive-disorders-of-pregnancy-a-systematic-review
#1
Alexandra E Cairns, Louise Pealing, James M N Duffy, Nia Roberts, Katherine L Tucker, Paul Leeson, Lucy H MacKillop, Richard J McManus
OBJECTIVES: Hypertensive disorders of pregnancy (HDP) affect one in ten pregnancies and often persist postpartum when complications can occur. We aimed to determine the effectiveness and safety of pharmacological interventions, other interventions and different care models for postpartum hypertension management. DESIGN: A systematic review was undertaken. Nine electronic databases, including Medline, were searched from inception to 16 March 2017. After duplicate removal, 4561 records were screened...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29181841/epidural-therapy-for-the-treatment-of-severe-pre-eclampsia-in-non-labouring-women
#2
REVIEW
Amita Ray, Sujoy Ray
BACKGROUND: Pre-eclampsia is a pregnancy-specific multi-organ disorder, which is characterised by hypertension and multisystem organ involvement and which has significant maternal and fetal morbidity and mortality. Failure of the placental vascular remodelling and reduced uteroplacental flow form the etiopathological basis of pre-eclampsia. There are several established therapies for pre-eclampsia including antihypertensives and anticonvulsants. Most of these therapies aim at controlling the blood pressure or preventing complications of elevated blood pressure, or both...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29153666/prevalence-risk-factors-and-associated-complications-of-postpartum-hypertension-in-rural-haiti
#3
Eleanor Kang, Rebekah Sugarman, Hadi Ramadan, Ariel Mueller, Sana Shahul, Joana Lopes Perdigao, David Jean Louis, Rulx Narcisse, Herriot Sannon, Laura Magee, Sarosh Rana
BACKGROUND: The prevalence of hypertensive disorders during pregnancy is high in developing countries such as Haiti, however little is known about postpartum hypertension (PPHTN). METHODS: This is a prospective study done at Hospital Albert Schweitzer in rural Haiti among pregnant women age 18 or older who were admitted for labor. Blood pressures were collected before and after delivery and medical charts were reviewed to gather delivery characteristics and fetal/neonatal outcomes...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29153663/prognostic-model-for-chronic-hypertension-in-women-with-a-history-of-hypertensive-pregnancy-disorders-at-term
#4
V S Visser, W Hermes, J Twisk, A Franx, M G van Pampus, C Koopmans, B W J Mol, C J M de Groot
INTRODUCTION: The association between hypertensive pregnancy disorders and cardiovascular disease later in life is well described. In this study we aim to develop a prognostic model from patients characteristics known before, early in, during and after pregnancy to identify women at increased risk of cardiovascular disease e.g. chronic hypertension years after pregnancy complicated by hypertension at term. METHODS: We included women with a history of singleton pregnancy complicated by hypertension at term...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29143739/an-inaccurate-automated-device-negatively-impacts-the-diagnosis-and-treatment-of-gestational-hypertension
#5
Diane Nzelu, Felicia Yeung, Delphine Couderq, Andrew Shennan, Nikos A Kametas
OBJECTIVES: Automated blood pressure devices are frequently introduced in maternity care without prior validation for their accuracy in pregnancy. Our objectives were to, firstly, establish the accuracy in pregnancy of a locally used device (Welch Allyn 300) and, secondly, to audit its impact on the diagnosis and treatment of hypertension. STUDY DESIGN: Validation study: The device was evaluated using the grading criteria of the European Society of Hypertension International Protocol (ESH-IP) (2010)...
May 3, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29133363/prevalence-of-hypertensive-phenotypes-after-preeclampsia-a-prospective-cohort-study
#6
Agnès Ditisheim, Grégoire Wuerzner, Belen Ponte, Yvan Vial, Olivier Irion, Michel Burnier, Michel Boulvain, Antoinette Pechère-Bertschi
Preeclampsia is associated with increased cardiovascular and renal risk. The aim of this prospective cohort study was to characterize the early postpartum blood pressure (BP) profile after preeclampsia. We enrolled 115 women with preeclampsia and 41 women with a normal pregnancy in a prospective cohort study. At 6 to 12 week postpartum, we assessed the prevalence of different hypertensive phenotypes using 24-hour ambulatory BP monitoring (ABPM), as well as the risk of salt sensitivity and the variability of BP derived from ABPM parameters...
November 13, 2017: Hypertension
https://www.readbyqxmd.com/read/29124624/maternal-hypertension-antihypertensive-medication-use-and-small-for-gestational-age-births-in-the-national-birth-defects-prevention-study-1997-2011
#7
Sarah C Fisher, Alissa R Van Zutphen, Paul A Romitti, Marilyn L Browne
Background Small for gestational age (SGA) birth is associated with poor long-term health outcomes. It is unclear whether maternal antihypertensive medication increases risk of SGA independently of maternal hypertension. Methods We analyzed associations between maternal hypertension and antihypertensive medication use and SGA among non-malformed singleton controls in the National Birth Defects Prevention Study. We defined SGA as birthweight < 10th percentile for a given gestational age, sex, race/ethnicity, and parity...
November 9, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29113921/antihypertensive-responses-of-vasoactive-androgens-in-an-in-vivo-experimental-model-of-preeclampsia
#8
Mercedes Perusquía, Andrea E Hanson, Claudia M Meza, Cris Kubli, Nieves Herrera, John N Stallone
Dehydroepiandrosterone (DHEA), testosterone (TES) and its 5-reduced metabolites induce a nongenomic vasorelaxation in several vascular beds of mammals; similarly these hormones produce systemic hypotensive and antihypertensive responses in normotensive and hypertensive male rats. Thus, it was hypothesized that the antihypertensive response of androgens, whose levels are elevated during gestation, protect against gestational hypertension. An animal model of preeclampsia was induced in female Wistar rats using DOCA-salt-treated pregnant (PT) and normal pregnant (NP) rats...
November 4, 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/29109631/comparative-evaluation-of-midazolam-dexmedetomidine-and-propofol-as-intensive-care-unit-sedatives-in-postoperative-electively-ventilated-eclamptic-patients
#9
Malik Rameez Rashid, Rukhsana Najeeb, Saima Mushtaq, Rizwana Habib
Background and Aims: Eclampsia is a common hypertensive disorder of pregnancy and treatment often includes termination of pregnancy with elective postoperative mechanical ventilation. The present study was aimed to compare midazolam, propofol, and dexmedetomidine for sedation and antihypertensive requirements of such patients admitted to Intensive Care Unit (ICU) after termination of pregnancy. Material and Methods: A total of ninety eclamptic patients administered general anesthesia for the termination of pregnancy through cesarean section and who also required postoperative ventilation were taken up for the study and were randomly allocated into three groups...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28994336/chronic-hypertension-effect-of-blood-pressure-control-on-pregnancy-outcome
#10
Anca M Panaitescu, Stephanie Roberge, Kypros H Nicolaides
CONTEXT: In pregnancies with chronic hypertension (CH), compared to those without CH, there is a 10-fold increase in the risk of preeclampsia (PE) and two-fold increase in risk of small for gestational age (SGA) neonates. OBJECTIVE: To examine the evidence of whether in patients with CH and mild to moderate hypertension the level of control of blood pressure during pregnancy has a beneficial or adverse effect on the risk of PE or SGA. METHOD: We performed a systematic review and meta-analysis of randomized controlled trials of patients with mild to moderate CH in pregnancy that reported the impact of different levels of control of blood pressure on the risk of PE or SGA...
October 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28946858/comparative-analysis-of-package-inserts-of-local-and-imported-antihypertensive-medications-in-palestine
#11
Sandra A Qatmosh, Amer A Koni, Baraa G Qeeno, Dina A Arandy, Maysa W Abu-Hashia, Bahaa M Al-Hroub, Sa'ed H Zyoud
BACKGROUND: Package inserts (PIs) as a reliable reference for patients and health care providers should provide accurate, complete and up-to-date information. The purpose of the current study is to assess and compare the PIs of antihypertensive agents locally produced in Palestine and their imported counterparts. METHODS: Thirty-five PIs were assessed for the presence of 31 information statements using a scoring method. Word counting of 20 headings and subheadings was used to evaluate and compare local and imported PIs for information quantity...
September 25, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28919617/response-side-effects-of-injectable-labetalol-in-pregnancy-induced-severe-hypertension
#12
F A Akter, K Nahar, M M Rahman, R A Ferdousi, M U Ahmed, F Begum, D Biswas, M Alom, M Z Hossain, R Z Razi
The study was performed to assess the response & side effects of injectable Labetalol in the treatment of pregnancy induced severe hypertension. This interventional study was carried out on 72 patients having pregnancy induced severe hypertension attended in the Department of Obstetrics & Gynaecology, Mymensingh Medical College & Hospital (MMCH), Mymensingh, Bangladesh from November 2009 to October 2010. All patients were treated with intravenous Labetalol 20mg & the dose was repeated at sequential escalating dosages every 15 minutes until a therapeutic goal of systolic blood pressure <160mm of Hg & diastolic blood pressure <105mm of Hg were achieved...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28919605/current-trend-of-using-anti-hypertensives-in-pregnancy-and-postpartum-period-in-a-tertiary-level-hospital
#13
M Sultana, S K Saha, A K Sarker, S Khatun, M M Sarker, T Sultana, F Noor, M M Faysal
Hypertensive disorders are one of the most common disorders in pregnancy. They are amongst the major cause of maternal and perinatal morbidity and mortality. Incidence is increasing in developing countries like Bangladesh. This cross sectional descriptive study has done to observe the utilization of antihypertensive drugs in hypertensive disorders of pregnancy and conducted from January 2016 to December 2016 in the department of Pharmacology in collaboration with department of Gynecology and Obstetrics in Mymensingh Medical College Hospital, Mymensingh, Bangladesh...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28894975/reperfusion-of-the-choriocapillaris-observed-using-optical-coherence-tomography-angiography-in-hypertensive-choroidopathy
#14
Miwa Saito, Akihiro Ishibazawa, Reiko Kinouchi, Akitoshi Yoshida
PURPOSE: Optical coherence tomography angiography (OCTA) can visualize the vascular status of the choriocapillaris noninvasively and separately from the other vascular beds. We describe focal ischemia in the choriocapillaris and reperfusion of the area in hypertensive choroidopathy using en-face OCTA. CASE: A 32-year-old woman diagnosed with pregnancy-induced hypertension presented with acute anorthopia in the right eye after delivery via Caesarian section. Fundus examination showed an Elschnig's spot and serous retinal detachment (SRD) in the inferior perifoveal region...
September 11, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28893900/labetalol-versus-nifedipine-as-antihypertensive-treatment-for-chronic-hypertension-in-pregnancy-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Louise M Webster, Jenny E Myers, Catherine Nelson-Piercy, Kate Harding, J Kennedy Cruickshank, Ingrid Watt-Coote, Asma Khalil, Cornelia Wiesender, Paul T Seed, Lucy C Chappell
Data from randomized controlled trials to guide antihypertensive agent choice for chronic hypertension in pregnancy are limited; this study aimed to compare labetalol and nifedipine, additionally assessing the impact of ethnicity on treatment efficacy. Pregnant women with chronic hypertension (12(+0)-27(+6) weeks' gestation) were enrolled at 4 UK centers (August 2014 to October 2015). Open-label first-line antihypertensive treatment was randomly assigned: labetalol- (200-1800 mg/d) or nifedipine-modified release (20-80 mg/d)...
November 2017: Hypertension
https://www.readbyqxmd.com/read/28893895/all-hypertensive-disorders-of-pregnancy-increase-the-risk-of-future-cardiovascular-disease
#16
Jane Tooher, Charlene Thornton, Angela Makris, Robert Ogle, Andrew Korda, Annemarie Hennessy
Hypertensive disorders of pregnancy are associated with vascular dysfunction in the pregnancy and an increased risk of long-term cardiovascular disease (CVD) in the mother. What remains to be understood is whether the length, severity of the disease, the treatment of hypertension in pregnancy, or the subtype of hypertensive disorders of pregnancy are significant predictors of future CVD. We undertook a retrospective cohort study to review all women who gave birth at a tertiary hospital in Sydney between the years 1980 and 1989 (n=31 656)...
October 2017: Hypertension
https://www.readbyqxmd.com/read/28806264/18f-fdg-pet-ct-of-brown-adipose-tissue-hyperactivation-associated-with-pregnancy-and-paraganglioma
#17
Anna Margherita Maffione, Lucia Rampin, Sotirios Chondrogiannis, Maria Cristina Marzola, Patrick M Colletti, Domenico Rubello
This 32-year-old woman presented with pregnancy-related arterial hypertension unresponsive to antihypertensive therapy. During cesarean delivery, a lobulated retroperitoneal mass was discovered. F-FDG PET/CT performed 18 days postpartum demonstrated the hyperactive retroperitoneal mass and extensive hyperactivated brown adipose tissue. The mass was surgically removed, revealing a para-aortic multicentric paraganglioma. After surgery, blood pressure normalized, and serum chromogranin A and urinary metanephrines normalized...
August 12, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28750427/environmental-risk-factors-for-type-1-diabetes-mellitus-development
#18
Boljat Antonela, Gunjača Ivana, Konstantinović Ivan, Vidan Nikolina, Boraska Perica Vesna, Pehlić Marina, Škrabić Veselin, Zemunik Tatijana
Background Although environmental factors induce development of type 1 diabetes mellitus (T1DM) in genetically susceptible individuals, many of those factors have been uncovered. Therefore, the aim of the present study was to analyze associations of T1DM with a wide range of environmental factors. Material and Methods A case-control study was conducted on 249 diabetic and 255 healthy individuals from the Dalmatian region of South Croatia. Data regarding risk factors during pregnancy and early life period of the child were evaluated...
September 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28716993/low-soluble-fms-like-tyrosine-kinase-1-endoglin-and-endothelin-1-levels-in-women-with-confirmed-or-suspected-preeclampsia-using-proton-pump-inhibitors
#19
Langeza Saleh, Raaho Samantar, Ingrid M Garrelds, Anton H van den Meiracker, Willy Visser, A H Jan Danser
Patients with preeclampsia display elevated placenta-derived sFlt-1 (soluble Fms-like tyrosine kinase-1) and endoglin levels and decreased placental growth factor levels. Proton pump inhibitors (PPIs) decrease trophoblast sFlt-1 and endoglin secretion in vitro. PPIs are used during pregnancy to combat reflux disease. Here, we investigated whether PPIs affect sFlt-1 in women with confirmed/suspected preeclampsia, making use of a prospective cohort study involving 430 women. Of these women, 40 took PPIs (6 esomeprazole, 32 omeprazole, and 2 pantoprazole) for 8 to 45 (median 29) days before sFlt-1 measurement...
September 2017: Hypertension
https://www.readbyqxmd.com/read/28711079/new-evidence-in-the-management-of-chronic-hypertension-in-pregnancy
#20
Tiina Podymow, Phyllis August
Chronic hypertension complicates 1% to 5% of all pregnancies, but debate continues regarding the benefits of lowering blood pressure in pregnancy as well as the optimal blood pressure targets. Women with chronic hypertension are at significant risk for maternal and fetal morbidity and mortality, yet it remains unclear whether antihypertensive treatment during pregnancy lowers these risks. Severe hypertension (systolic ≥ 160 mm Hg) should be treated, but there is considerable variability in the approach to mild-to-moderate hypertension (140-159/90-109 mm Hg)...
July 2017: Seminars in Nephrology
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