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Hypertension in pregnancy

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https://www.readbyqxmd.com/read/28340492/hemolysis-elevated-liver-enzymes-low-platelets-syndrome-superimposed-on-hemolytic-uremic-syndrome
#1
Inês Martins, Madalena Gomes Conceição, Paulo Pereira Gomes, Nuno Clode
A pregnancy complicated by typical hemolytic uremic syndrome (HUS) and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome is reported. At 20 weeks of gestation, a case of HUS was diagnosed, with Shiga toxin-producing Escherichia coli identified. Plasmapheresis allowed continuation of the pregnancy for 5 weeks. Superimposed preeclampsia and HELLP syndrome were diagnosed after the establishment of nephrotic range proteinuria, hypertension and recurrence of hemolysis. This is a singular case, as it demonstrates that HELLP syndrome can superimpose upon HUS, a fact that can impact future research on reproductive immunology...
March 24, 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28338787/total-and-fetal-circulating-cell-free-dna-angiogenic-and-antiangiogenic-factors-in-preeclampsia-and-hellp-syndrome
#2
Rocío Muñoz-Hernández, Pablo Medrano-Campillo, Maria L Miranda, Hada C Macher, Jose Manuel Praena-Fernández, Antonio J Vallejo-Vaz, María J Dominguez-Simeon, Rafael Moreno-Luna, Pablo Stiefel
BACKGROUND: Preeclampsia (PE) is a hypertensive disorder of pregnancy characterized by hypertension and proteinuria. The HELLP syndrome is the most severe form of PE. The aim of the present study was to determine different potential biomarkers that may help us perform an early diagnosis of the disease, assess on the severity of the disease, and/or predict maternal or fetal adverse outcomes. METHODS: We measured serum levels of total and fetal circulating cell-free DNA (cfDNA), soluble endoglin, soluble form of vascular endothelial growth factor receptor, and placental growth factor in a healthy control group of pregnant women (n = 26), patients with mild (n = 37) and severe PE (n = 25), and patients with HELLP syndrome (n = 16)...
February 25, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28338750/association-of-maternal-plasma-folate-and-cardiometabolic-risk-factors-in-pregnancy-with-elevated-blood-pressure-of-offspring-in-childhood
#3
Hongjian Wang, Noel T Mueller, Jianping Li, Ninglin Sun, Yong Huo, Fazheng Ren, Xiaobin Wang
BACKGROUND: The prevalence of childhood elevated blood pressure (BP) has increased in the United States, particularly among African Americans. The influence of maternal plasma folate levels, alone or in combination with maternal cardiometabolic risk factors (hypertensive disorders, diabetes, and prepregnancy obesity), on child systolic BP (SBP) has not been examined in a prospective birth cohort. We hypothesize that adequate maternal folate levels can reduce the risk of elevated SBP in children born to mothers with cardiometabolic risk factors...
March 6, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28336818/increased-exposure-to-sodium-during-pregnancy-and-lactation-changes-basal-and-induced-behavioral-and-neuroendocrine-responses-in-adult-male-offspring
#4
Marcia S Silva, Fabiana Lúcio-Oliveira, Andre Souza Mecawi, Lucas F Almeida, Silvia G Ruginsk, Michael P Greenwood, Mingkwan Greenwood, Laura Vivas, Lucila L K Elias, David Murphy, José Antunes-Rodrigues
Excessive sodium (Na(+)) intake in modern society has been associated with several chronic disorders such as hypertension. Several studies suggest that early life events can program physiological systems and lead to functional changes in adulthood. Therefore, we investigated behavioral and neuroendocrine responses under basal conditions and after 48 h of water deprivation in adult (60-day-old Wistar rats) male, Wistar rats originating from dams were offered only water or 0.15 mol/L NaCl during pregnancy and lactation...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28335767/feasibility-acceptability-and-efficacy-of-a-web-based-computer-tailored-physical-activity-intervention-for-pregnant-women-the-fit4two-randomised-controlled-trial
#5
Melanie Hayman, Peter Reaburn, Matthew Browne, Corneel Vandelanotte, Stephanie Alley, Camille E Short
BACKGROUND: Physical activity (PA) during pregnancy is associated with a variety of health benefits including a reduced risk of pregnancy related conditions such as pre-eclampsia and pregnancy-induced hypertension and leads to greater control over gestational weight gain. Despite these associated health benefits, very few pregnant women are sufficiently active. In an attempt to increase health outcomes, it is important to explore innovative ways to increase PA among pregnant women. Therefore, the aim of this study was to assess the feasibility, acceptability and efficacy of a four week web-based computer-tailored PA intervention among pregnant women...
March 23, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28334811/causes-and-predictors-of-neonatal-post-neonatal-and-maternal-deaths-in-india-analysis-of-a-nationwide-district-level-household-survey-4-dlhs-4-2012-13
#6
Jaya P Tripathy, Sanskruti Mishra
Introduction: There is lack of reliable mortality estimates in India about maternal, neonatal and infant deaths. As we move towards achieving the targets under Sustainable Development Goals, information on cause of death is essential to prioritize our resources and planning. Therefore, the present study describes the causes and characteristics of neonatal, post-neonatal and maternal deaths in India. Methods: The study analysed nationwide District-Level Household Survey-4 conducted by the Ministry of Health and Family Welfare, Government of India, in 2014...
March 2, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28333820/committee-opinion-no-692-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#7
(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
#8
(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/28333696/a-universal-freeze-all-strategy-why-it-is-not-warranted
#9
Baris Ata, Emre Seli
PURPOSE OF REVIEW: There's some preclinical evidence of an adverse effect of multifollicular growth on endometrial function in assisted reproductive technology cycles. Universal elective frozen embryo transfer (eFET) in an unstimulated cycle is being promoted as a panacea, regardless of patient, and cycle characteristics. We review the clinical evidence on the effectiveness and safety of eFETs. RECENT FINDINGS: Randomized controlled trials (RCTs) comparing fresh and eFET yield contradictory results in terms of live birth rates...
March 22, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28333159/maternal-serum-markers-of-lipid-metabolism-in-relation-to-neonatal-anthropometry
#10
N S Boghossian, P Mendola, A Liu, C Robledo, E H Yeung
OBJECTIVE: The objective of this study is to examine associations between lipids (high-density lipoprotein, low-density lipoprotein, total cholesterol, triglycerides and lipoprotein (a)) measured on average three time points during pregnancy and neonatal anthropometrics. STUDY DESIGN: Stored samples from a preeclampsia trial measured as part of a case-control study from five US centers (1992 to 1995) were used. The sample included women without pregnancy complications (n=136) and cases of gestational diabetes (n=93), abnormal glucose tolerance (AGT; n=76), gestational hypertension (n=170) and preeclampsia (n=177)...
March 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28332106/inadequate-gestational-weight-gain-predicts-adverse-pregnancy-outcomes-in-mothers-with-inflammatory-bowel-disease-results-from-a-prospective-us-pregnancy-cohort
#11
May-Bente Bengtson, Christopher F Martin, Geir Aamodt, Morten H Vatn, Uma Mahadevan
BACKGROUND: Malnutrition and weight loss are common features of patients with inflammatory bowel disease (IBD). AIM: To explore the impact of inadequate gestational weight gain (GWG) on adverse outcomes among IBD mothers in the prospective US pregnancy in Inflammatory Bowel Disease and Neonatal Outcomes (PIANO) cohort. METHODS: The PIANO cohort comprises 559 and 363 pregnant mothers with Crohn's disease (CD) and ulcerative colitis (UC), respectively, enrolled between 2006 and 2014...
March 22, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28331377/management-of-systemic-lupus-erythematosus-during-pregnancy-challenges-and-solutions
#12
REVIEW
Caroline L Knight, Catherine Nelson-Piercy
Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal-neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28331199/influence-of-maternal-overweight-obesity-and-gestational-weight-gain-on-the-perinatal-outcomes-in-women-with-gestational-diabetes-mellitus
#13
Miao Miao, Mei Dai, Yue Zhang, Fang Sun, Xirong Guo, Guiju Sun
To assess the associations between maternal body mass index (BMI) as well as gestational weight gain (GWG) and pregnancy outcomes in women with gestational diabetes mellitus (GDM). This is a retrospective analysis involving 832 nulliparous women complicated with GDM. Multivariate logistic and restricted cubic logistic regression were used to investigate the association of interest. Overall, 178 (21.4%) women were overweight or obese, and 298 (35.2%) exhibited excessive GWG. Compared with women of normal weight, high pre-pregnancy BMI resulted in a higher risk of cesarean section with an adjusted odds ratio of 1...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28330551/-thalassaemia-and-pregnancy
#14
Viktoriya Luk'yanenko, Marjoes Droogh, Ulrik Malthe Overgaard
Global migration has resulted in a larger geographical spread of people with risk of hereditary anaemias. This leads to an increased incidence of pregnant women with rare diseases, including thalassaemia also in Scandinavia. Thalassaemia can cause severe anaemia and other complications during pregnancy, like risk of miscarriage, intrauterine fetal death, abruptio, intrauterine growth retardation, hypertension, gestational diabetes and pre-eclampsia. In this article, we focus on the aetiology, assessment, antenatal care and treatment of pregnant women with thalassaemia...
March 20, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28328031/post-traumatic-stress-disorder-and-antepartum-complications-a-novel-risk-factor-for-gestational-diabetes-and-preeclampsia
#15
Jonathan G Shaw, Steven M Asch, Jodie G Katon, Kate A Shaw, Rachel Kimerling, Susan M Frayne, Ciaran S Phibbs
BACKGROUND: Prior work shows that Post-traumatic Stress Disorder (PTSD) predicts an increased risk of preterm birth, but the causal pathway(s) are uncertain. We evaluate the associations between PTSD and antepartum complications to explore how PTSD's pathophysiology impacts pregnancy. METHODS: This retrospective cohort analysis of all Veterans Health Administration (VA)-covered deliveries from 2000-12 used the data of VA clinical and administration. Mothers with current PTSD were identified using the ICD-9 diagnostic codes (i...
March 22, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28327686/thyroid-hormone-profile-in-patients-with-chronic-kidney-disease-a-single-centre-study
#16
S Singh, A Verma, G Aryal, S Thapa, S Khakurel, K Shrestha
BACKGROUND: Chronic kidney disease (CKD) is a global burden and now recognized as a major public health problem worldwide. Patients with CKD have alteration in thyroid hormone metabolism. This study aims to evaluate the status of thyroid hormone profile in different stages of CKD. METHODS: The cross-sectional study included 103 CKD patients attending Nephrology and Dialysis unit of KIST Medical College Teaching Hospital, Lalitpur, Nepal. Serum creatinine, free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) were measured...
September 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28325085/risk-of-recurrence-of-small-for-gestational-age-foetus-after-first-pregnancy
#17
Sebastián Manzanares, M Teresa Maroto-Martín, Mariña Naveiro, Mar Sánchez-Gila, Setefilla López-Criado, Alberto Puertas
The aim of this study was to assess the incidence of and to analyse factors related to the recurrence of small-for-gestational-age (SGA) neonates in the second pregnancy. A prospective observational study was conducted at a tertiary university hospital in Granada, Spain. A total of 7896 women who delivered their first and second singleton pregnancies at the hospital from 2003-2013 were included and evaluated all birth weights. Women whose first pregnancy was complicated by a SGA birth had a fivefold increased risk of recurrence (23...
March 21, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28323969/early-pregnancy-associated-plasma-protein-a-concentrations-are-associated-with-third-trimester-insulin-sensitivity
#18
Clive J Petry, Ken K Ong, Ieuan A Hughes, Carlo L Acerini, Jan Frystyk, David B Dunger
Context: First or early second trimester pregnancy-associated plasma protein-A (PAPP-A) concentrations have previously been shown to be lower in women who subsequently develop gestational diabetes (GDM) and gestational hypertension. Objective: We therefore sought to investigate why circulating PAPP-A concentrations are related to the subsequent risk of GDM and gestational hypertension. Patients, Design and Setting: We measured serum PAPP-A concentrations around week 15 of pregnancy and related these to indices derived from week 28 oral glucose tolerance tests (OGTT) and blood pressures across pregnancy in the Cambridge Baby Growth Study cohort...
March 13, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#19
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28323629/effects-of-levothyroxine-on-pregnancy-outcomes-in-women-with-thyroid-dysfunction-a-meta-analysis-of-randomized-controlled-trials
#20
Jia Li, Jie Shen, Lan Qin
Context • Subclinical hypothyroidism (SCH) in pregnancy can be associated with increased complications in pregnant women and neurocognitive deficits in fetuses. Two recently published meta-analyses investigated the effects of levothyroxine (LT4) supplementation on pregnancy outcomes but did not report adverse complications and neonatal outcomes. Objectives • The study intended to assess the effects of LT4 supplementation in the treatment of pregnant women with thyroid dysfunction. Design • The research team performed a meta-analysis of randomized controlled trials (RCTs) published in PubMed, Embase, Web of Science, Chinese BioMedical Literature Service System, and China National Knowledge Infrastructure databases...
March 2017: Alternative Therapies in Health and Medicine
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