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antihypertensive and pregnancy

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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
#1
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...
July 17, 2017: Hypertension
https://www.readbyqxmd.com/read/28711079/new-evidence-in-the-management-of-chronic-hypertension-in-pregnancy
#2
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
https://www.readbyqxmd.com/read/28711073/lupus-nephritis-and-pregnancy-concerns-and-management
#3
Liz Lightstone, Michelle A Hladunewich
Pregnancy associated with lupus, especially lupus nephritis, is often fraught with concern for both the mother and fetus. Thus, it is paramount that care begins preconception so that proper planning in terms of optimizing the medical regimen, discontinuation of fetotoxic agents, and treatment of active disease can occur. It is well known that active nephritis at the time of conception is associated with poor outcomes. Even with quiescent disease, recent data indicate that being lupus anticoagulant-positive, nonwhite or Hispanic, and using antihypertensive medications were all predictors of worse pregnancy outcomes...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28701386/low-calcium-intake-in-midpregnancy-is-associated-with-hypertension-development-within-10-years-after-pregnancy-the-norwegian-mother-and-child-cohort-study
#4
Grace M Egeland, Svetlana Skurtveit, Solveig Sakshaug, Anne Kjersti Daltveit, Bjørn E Vikse, Margaretha Haugen
Background: Low dietary calcium intake may be a risk factor for hypertension, but studies conflict.Objective: We evaluated the ability to predict hypertension within 10 y after delivery based on calcium intake during midpregnancy.Methods: The Norwegian Mother and Child Cohort Study of women delivering in 2004-2009 was linked to the Norwegian Prescription Database (2004-2013) to ascertain antihypertensive medication usage >90 d after delivery. Women with hypertension before pregnancy were excluded, leaving 60,027 mothers for analyses...
July 12, 2017: Journal of Nutrition
https://www.readbyqxmd.com/read/28674618/higher-number-of-live-births-is-associated-with-left-ventricular-diastolic-dysfunction-and-adverse-cardiac-remodelling-among-us-hispanic-latina-women-results-from-the-echocardiographic-study-of-latinos
#5
Shivani R Aggarwal, David M Herrington, Catherine J Vladutiu, Jill C Newman, Katrina Swett, Franklyn Gonzalez, Jorge R Kizer, Michelle A Kominiarek, Karen M Tabb, Linda C Gallo, Gregory A Talavera, Barry E Hurwitz, Carlos J Rodriguez
INTRODUCTION: Female sex is a risk factor for heart failure with preserved ejection fraction (HFpEF). Previous literature suggests that some diastolic dysfunction (DD) develops during pregnancy and may persist postdelivery. Our objective was to examine the relationship between parity and cardiac structure and function in a population-based cohort. METHODS: Participants included 1172 Hispanic/Latina women, aged ≥45 years, enrolled in the Echocardiographic Study of Latinos from four US communities (Bronx, Miami, San Diego and Chicago)...
2017: Open Heart
https://www.readbyqxmd.com/read/28661961/in-utero-exposure-to-antihypertensive-medication-and-neonatal-and-child-health-outcomes-a-systematic-review
#6
Catherine A Fitton, Markus F C Steiner, Lorna Aucott, Jill P Pell, Daniel F Mackay, Michael Fleming, James S McLay
BACKGROUND: Although medication is generally avoided wherever possible during pregnancy, pharmacotherapy is required for the treatment of pregnancy associated hypertension, which remains a leading cause of maternal and fetal morbidity and mortality. The long-term effects to the child of in-utero exposure to antihypertensive agents remains largely unknown. OBJECTIVE: The aim of this study was to systematically review published studies on adverse outcomes to the child associated with in-utero exposure to antihypertensive medications...
July 11, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28602773/frequency-and-consequences-of-ventricular-hypertrophy-in-pregnant-women-with-treated-chronic-hypertension
#7
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 sequela of long-standing chronic hypertension with associated morbidity and mortality. OBJECTIVE: We sought to assess the frequency and importance of left ventricular hypertrophy in gravidas 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 through February 2015...
June 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28578148/contraception-and-reproductive-counseling-in-women-with-peripartum-cardiomyopathy
#8
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...
July 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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
(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
#19
(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
#20
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
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