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Hypertension in pregnancy

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https://www.readbyqxmd.com/read/28737438/prenatal-exposure-to-angiotensin-ii-increases-blood-pressure-and-decreases-salt-sensitivity-in-rats
#1
Pavel Svitok, Tomas Senko, Zuzana Panakova, Lucia Olexova, Lucia Krskova, Monika Okuliarova, Michal Zeman
Renin angiotensin aldosterone system (RAAS) plays an essential role in the homeostatic control of arterial blood pressure, perfusion of tissues, and control of extracellular fluid. Its components are highly expressed in the developing kidney, general vasculature, brain, and heart. A modified intrauterine environment alters mechanisms controlling blood pressure (BP) and can lead to hypertension in the adult offspring and developmentally programmed RAAS can be involved in this process. There are very little data about the effects of increased angiotensin II (Ang II) concentrations during pregnancy on in utero development of the fetus...
July 24, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28733057/clinical-validation-of-non-invasive-cardiac-output-monitoring-in-healthy-pregnant-women
#2
Kelsey McLaughlin, Stephen P Wright, John C P Kingdom, John D Parker
OBJECTIVE: Non-invasive hemodynamic monitoring has the potential to be a valuable clinical tool for the screening and management of hypertensive disorders of pregnancy. The objective of this study was to validate the clinical utility of the non-invasive cardiac output monitoring (NICOM) system in pregnant women. METHODS: Twenty healthy pregnant women with a singleton pregnancy at 22 to 26 weeks' gestation were enrolled in this study. Measures of heart rate, stroke volume, and cardiac output were obtained through NICOM and compared with Doppler echocardiography...
July 18, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28731975/the-consensus-bundle-on-hypertension-in-pregnancy-and-the-anesthesiologist-doing-all-the-right-things-for-all-the-patients-all-of-the-time
#3
Mihaela Podovei, Brian T Bateman
No abstract text is available yet for this article.
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28731036/stroke-in-women-from-evidence-to-inequalities
#4
REVIEW
Charlotte Cordonnier, Nikola Sprigg, Else Charlotte Sandset, Aleksandra Pavlovic, Katharina S Sunnerhagen, Valeria Caso, Hanne Christensen
Stroke is the second largest cause of disability-adjusted life-years lost worldwide. The prevalence of stroke in women is predicted to rise rapidly, owing to the increasing average age of the global female population. Vascular risk factors differ between women and men in terms of prevalence, and evidence increasingly supports the clinical importance of sex differences in stroke. The influence of some risk factors for stroke - including diabetes mellitus and atrial fibrillation - are stronger in women, and hypertensive disorders of pregnancy also affect the risk of stroke decades after pregnancy...
July 21, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28729012/evidence-that-children-born-at-early-term-37-38-6-7-weeks-are-at-increased-risk-for-diabetes-and-obesity-related-disorders
#5
Dorit Paz Levy, Eyal Sheiner, Tamar Wainstock, Ruslan Sergienko, Daniella Landau, Asnat Walfisch
BACKGROUND: Prematurity is known to be associated with high rates of endocrine and metabolic complications in the offspring. Early term (37 0/7-38 6/7 weeks' gestation) born offspring were also shown to exhibit long term morbidity resembling that of late preterm, in several health categories. OBJECTIVE: We aimed to determine whether early term delivery impacts on the long-term endocrine and metabolic health of the offspring. STUDY DESIGN: A population-based cohort analysis was performed, including all term singleton deliveries occurring during 1991-2013 at a single regional tertiary medical center...
July 17, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28726716/new-insights-into-the-role-of-matrix-metalloproteinases-in-preeclampsia
#6
REVIEW
Salvador Espino Y Sosa, Arturo Flores-Pliego, Aurora Espejel-Nuñez, Diana Medina-Bastidas, Felipe Vadillo-Ortega, Veronica Zaga-Clavellina, Guadalupe Estrada-Gutierrez
Preeclampsia is a severe pregnancy complication globally, characterized by poor placentation triggering vascular dysfunction. Matrix metalloproteinases (MMPs) exhibit proteolytic activity implicated in the efficiency of trophoblast invasion to the uterine wall, and a dysregulation of these enzymes has been linked to preeclampsia. A decrease in MMP-2 and MMP-9 interferes with the normal remodeling of spiral arteries at early pregnancy stages, leading to the initial pathophysiological changes observed in preeclampsia...
July 20, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28726518/differential-responses-of-mesenteric-arterial-bed-to-vasoactive-substances-in-l-name-induced-preeclampsia-role-of-oxidative-stress-and-endothelial-dysfunction
#7
Taline A S Amaral, Dayane T Ognibene, Lenize C R M Carvalho, Ana Paula M Rocha, Cristiane A Costa, Roberto S Moura, Angela C Resende
To investigate the systemic and placental oxidant status as well as vascular function in experimental preeclampsia (PE) induced by nitro-L-arginine methyl ester (L-NAME). Fetal parameters and maternal blood pressure, proteinuria, mesenteric arterial bed (MAB) reactivity, and systemic and placental oxidative stress were compared between four groups: pregnant rats receiving L-NAME (60 mg/kg/day, orally) (P + L-NAME) or vehicle (P) from days 13 to 20 of pregnancy and nonpregnant rats receiving L-NAME (NP + L-NAME) or vehicle (NP) during 7 days...
July 20, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28726273/epigallocatechin-gallate-enhances-treatment-efficacy-of-oral-nifedipine-against-pregnancy-induced-severe-pre-eclampsia-a-double-blind-randomized-and-placebo-controlled-clinical-study
#8
D-D Shi, J-J Guo, L Zhou, N Wang
WHAT IS KNOWN AND OBJECTIVE: Oral nifedipine is commonly used to treat pre-eclampsia, one of the most severe complications during pregnancy, but its clinical efficacy is less than ideal. Epigallocatechin gallate (EGCG), a natural compound from green tea, could benefit cardiovascular health especially hypertension. We investigated the clinical efficacy of EGCG, when complemented with oral nifedipine, in treating pre-eclampsia. METHODS: A total of 350 pregnant women with severe pre-eclampsia were recruited and randomized to receive oral nifedipine, together with placebo (NIF+placebo) or EGCG (NIF+EGCG)...
July 20, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28723858/maternal-hepatitis-b-virus-infection-and-pregnancy-outcomes-a-hospital-based-case-control-study-in-wuhan-china
#9
Zhihua Wan, Aifen Zhou, Huiping Zhu, Xiaofang Lin, Dan Hu, Songxu Peng, Bin Zhang, Yukai Du
GOALS: To examine the impact of maternal hepatitis B virus infection on pregnancy outcomes. BACKGROUND: Studies regarding hepatitis B virus infection and pregnancy outcomes are limited with inconsistent results, and none of them have evaluated the effect of maternal viral load in pregnancy on pregnancy outcomes. STUDY: A hospital-based case-control study was conducted. In total, 1728 hepatitis B surface antigen (HBsAg)-positive women who delivered consecutively at Wuhan Women and Children Medical and Healthcare Center, Wuhan, China, from June 2008 to May 2015, were compared with 1497 HBsAg-negative women giving birth in the same hospital during the same period who were randomly identified and selected from the computerized medical record database in parallel...
July 18, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28723784/thrombocytopenia-in-pregnancy-with-different-diagnoses-differential-clinical-features-treatments-and-outcomes
#10
Xiaoyue Wang, Yan Xu, Wenxiang Luo, Hui Feng, Yizhou Luo, Yanli Wang, Hui Liao
To investigate the clinical features and perinatal treatment of thrombocytopenia induced by different causes during pregnancy.Clinical data from 195 pregnant women with thrombocytopenia attending 2 tertiary hospitals from January 2014 to October 2016 were retrospectively studied. The obtained data were analyzed with SPSS 19.0 software.There were 117 (60.0%), 55 (28.2%), and 23 cases (11.8%) of pregnancy-associated thrombocytopenia (PAT), idiopathic thrombocytopenia (ITP), and hypertensive disorder in pregnancy (PIH), respectively...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28721347/peliosis-hepatis-complicating-pregnancy-a-rare-entity
#11
Muhammad Osama Butt, Nasir Hassan Luck, Syed Mujahid Hassan, Zaigham Abbas, Muhammed Mubarak
Peliosis hepatis (PH) is a rare, benign condition of the liver characterized by the presence of blood-filled lacunar spaces in the parenchyma. It usually has a chronic presentation and is a rare cause of portal hypertension reported in adult patients. Its etiology is diverse and ranges from infectious agents to tumors to toxic substances and anabolic steroids; however, the cause remains unclear in 25-50% of patients. Similarly, the symptomatology and imaging findings are diverse. Biopsy is the definitive test to diagnose the condition...
June 2017: Journal of Translational Internal Medicine
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
#12
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/28715959/preeclampsia-and-maternal-risk-of-breast-cancer-a-meta-analysis-of-cohort-studies
#13
Meizhen Sun, Yongling Fan, Yuanyuan Hou, Yanyan Fan
BACKGROUND: Pregnancy-related hypertensive disorders, including preeclampsia (PE) and pregnancy-induced hypertension (PIH), may influence the maternal risk of breast cancer. However, results of the cohort studies were inconsistent. METHODS: An updated meta-analysis of cohort studies was performed to evaluate the association between PE, PIH and maternal breast cancer incidence. Relevant studies were identified via searching of PubMed and Embase databases. A random effect model was applied to synthesize the results...
July 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28715497/risk-of-gestational-hypertension-preeclampsia-in-women-with-preceding-endometriosis-a-nationwide-population-based-study
#14
Mei-Lien Pan, Li-Ru Chen, Hsiao-Mei Tsao, Kuo-Hu Chen
OBJECTIVE: To investigate the association between preceding endometriosis and gestational hypertension-preeclampsia (GH-PE). METHODS: In this nationwide population-based longitudinal study, data from 1998-2012 Taiwan National Health Insurance Research Database were used. We used ICD9-CM codes 617.X and 642.X respectively for the diagnoses of endometriosis and GH-PE, which were further confirmed by examining medical records of surgeries, blood pressure and urine protein to ensure the accuracy of the diagnoses...
2017: PloS One
https://www.readbyqxmd.com/read/28714660/maternal-mortality-in-the-developed-world-a-review-of-surveillance-methods-levels-and-causes-of-maternal-deaths-during-2006-2010
#15
Andreea A Creanga
This article provides an overview of surveillance methods, levels, and causes of maternal mortality in developed countries (Europe and the United States) during 2006-2010. Accurate identification of maternal deaths is not always possible, and no two countries in the world use the same surveillance methods for maternal mortality. Despite limitations (underestimation, missclassification), routine vital registration systems are the backbone of maternal mortality surveillance systems in developed countries. Enhanced surveillance methods involve linkages between deaths of women of reproductive age and births within the preceding year, or the use of additional data sources for maternal deaths...
July 17, 2017: Minerva Ginecologica
https://www.readbyqxmd.com/read/28714608/selective-serotonin-reuptake-inhibitors-during-pregnancy-do-we-have-now-more-definite-answers-related-to-prenatal-exposure
#16
REVIEW
Asher Ornoy, Gideon Koren
Despite extensive studies, there still seems to be uncertainty as to the possible reproductive risk of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SNRIs) in pregnancy. We, therefore, assess the current data on the risk/benefit of SSRI use in pregnancy. As the neurodevelopmental effects of SSRIs are discussed in another paper in this issue, we will not address the possible neurodevelopmental effects. Special emphasis is given to the newer, large population-based studies...
July 17, 2017: Birth defects research
https://www.readbyqxmd.com/read/28714317/prospective-observational-study-to-determine-the-accuracy-of-first-trimester-serum-biomarkers-and-uterine-artery-dopplers-in-combination-with-maternal-characteristics-and-arteriography-for-the-prediction-of-women-at-risk-of-preeclampsia-and-other-adverse-pregnancy
#17
Rebecca Allen, Joseph Aquilina
OBJECTIVES: To assess the efficacy of biomarkers, arteriography and uterine artery Dopplers for predicting hypertensive disease of pregnancy, small for gestational age and stillbirth. METHODS: This was a prospective first trimester study. Ultrasound was used to assess uterine artery Doppler. Maternal arteriography performed and serum taken for measurement of placental growth factor (PlGF), alpha fetoprotein (AFP), pregnancy associated plasma protein (PAPP-A) and beta human chorionic gonadotrophin (β-hCG) levels...
July 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28712949/role-of-early-second-trimester-uterine-artery-doppler-screening-to-predict-small-for-gestational-age-babies-in-nulliparous-women
#18
Samuel Parry, Anthony Sciscione, David M Haas, William A Grobman, Jay D Iams, Brian M Mercer, Robert M Silver, Hyagriv N Simhan, Ronald J Wapner, Deborah A Wing, Michal A Elovitz, Frank P Schubert, Alan Peaceman, M Sean Esplin, Steve Caritis, Michael P Nageotte, Benjamin A Carper, George R Saade, Uma M Reddy, Corette B Parker
BACKGROUND: Trophoblastic invasion of the uterine spiral arteries substantially increases compliance to accommodate increased blood flow to the placenta. Failure of this process impedes uterine artery blood flow, and this may be detected by uterine artery Doppler flow studies. However, the clinical utility of uterine artery Doppler flow studies in the prediction of adverse pregnancy outcomes in a general population remains largely unknown. OBJECTIVE: To determine the utility of early second trimester uterine artery Doppler studies as a predictor of small for gestational age (SGA) neonates...
July 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28712189/maternal-mortality-in-pakistan-is-there-any-metamorphosis-towards-betterment
#19
Nusrat Nisar, Razia Mustafa Abbasi, Shehla Raza Chana, Noushaba Rizwan, Razia Badar
BACKGROUND: Every year more than half million mother die due to pregnancy related preventable causes like haemorrhage, hypertensive disorders, sepsis, and obstructed labour and unsafe abortion. Among these deaths 99% occur in developing countries. The study was conducted to assess the maternal death rate and to analyse its trends over a period of 20 years in tertiary care hospital in Sindh Province Pakistan. METHODS: A retrospective analysis of maternal mortality records were carried out for a period of 20 years from 1986-1995 and 2011-2015 at the Department of Obstetrics and gynaecology Liaquat University of Medical and Health Sciences Hyderabad Sindh Pakistan...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
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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