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preeclampsia in postpartum

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https://www.readbyqxmd.com/read/27896245/differences-in-clinical-presentation-and-pregnancy-outcomes-in-antepartum-preeclampsia-and-new-onset-postpartum-preeclampsia-are-these-the-same-disorder
#1
Gustavo Vilchez, Luis R Hoyos, Jocelyn Leon-Peters, Moraima Lagos, Pedro Argoti
OBJECTIVE: New-onset postpartum preeclampsia is a poorly defined condition that accounts for a significant percentage of eclampsia cases. It is unclear whether new-onset postpartum preeclampsia is a different disorder from or belongs to the same spectrum of classic antepartum preeclampsia. The objective of this study was to compare the clinical presentation and pregnancy outcomes of antepartum preeclampsia and new-onset postpartum preeclampsia. METHODS: A retrospective study including 92 patients with antepartum preeclampsia and 92 patients with new-onset postpartum preeclampsia was performed...
November 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27892433/efficacy-of-prophylactic-b-lynch-suture-during-lower-segment-caesarian-section-in-high-risk-patients-for-atonic-postpartum-haemorrhage
#2
M Vijayasree
Background Postpartum Haemorrhage causes significant maternal mortality and morbidity all over the world. Active management of the third stage of labour with oxytocics is come into practice. If postpartum haemorrhage is anticipated conservative surgical procedures like B-lynch suture is being applied. Objective To evaluate the effect of elective B-Lynch suture in preventing atonic postpartum haemorrhage during emergency caesarian section with high risk factors for atonicity. Method Forty antenatal women undergoing emergency caesarean section with risk factors for atony of the uterus were selected in our study...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27887588/longitudinal-reference-ranges-for-maternal-plasma-laeverin-and-its-role-as-a-potential-biomarker-of-preeclampsia
#3
Mona Nystad, Vasilis Sitras, Kari Flo, Christian Widnes, Åse Vårtun, Tom Wilsgaard, Ganesh Acharya
BACKGROUND: Laeverin is a placenta-specific membrane-bound aminopeptidase. In this study we wanted to: 1) serially measure plasma levels of laeverin in healthy women during the second half of pregnancy and postpartum, 2) determine whether laeverin is differently expressed at 22-24 weeks in women who later develop preeclampsia compared to controls, 3) compare laeverin protein expression in placenta and umbilical vein serum in healthy and preeclamptic pregnancies at birth. METHODS: Plasma was obtained serially, approximately every 4-weeks, from 53 healthy women with uncomplicated pregnancies during 22(+0) to 39(+6) weeks of gestation, and at 22-24 weeks from 15 women who later developed preeclampsia...
November 25, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27871550/carbetocin-for-prevention-of-postcesarean-hemorrhage-in-women-with-severe-preeclampsia-a-before-after-cohort-comparison-with-oxytocin
#4
B Nucci, Agm Aya, E Aubry, J Ripart
STUDY OBJECTIVE: The aim of the study was to compare the incidence of the use of additional uterotonics before and after the change of carbetocin to oxytocin for the prevention of postpartum hemorrhage after cesarean delivery in women with severe preeclampsia. DESIGN: This was an observational retrospective before-and-after study. SETTING: Operating room, postoperative recovery area. PATIENTS: Sixty women with severe preeclampsia undergoing cesarean delivery under spinal anesthesia; American Society of Anesthesiologists 3...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27859887/preclinical-atherosclerosis-at-the-time-of-pre-eclamptic-pregnancy-and-up-to-10-years-postpartum-systematic-review-and-meta-analysis
#5
REVIEW
Natasa M Milic, Jelena Milin-Lazovic, Tracey L Weissgerber, Goran Trajkovic, Wendy M White, Vesna D Garovic
OBJECTIVES: Preeclampsia, a pregnancy-specific hypertensive disorder, has been associated with cardiovascular risk factors and vascular changes, such as acute atherosis in placental blood vessels, which are similar to early-stage atherosclerosis. The objective of this study was to determine whether women with preeclampsia have increased atherosclerotic burden, as determined by carotid intima-media thickness (CIMT), when compared to women without preeclampsia. METHODS: We conducted a systematic review and meta-analysis of studies that reported CIMT, a non-invasive, ultrasound-based measure of subclinical atherosclerosis, in women who did vs...
November 18, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27835048/furosemide-in-postpartum-management-of-severe-preeclampsia-a-randomized-controlled-trial
#6
P Veena, Lakshmideepthi Perivela, S Soundara Raghavan
BACKGROUND: Hypertension in the postpartum period is a common phenomenon and is often a cause for concern. Following delivery, fluid that has been sequestered in the extravascular space is mobilized, producing a large auto-infusion of fluid from the extravascular to the intravascular compartment. As a result of this fluid mobilization process, there is an increase in central venous pressure and pulmonary capillary wedge pressure, which might favor the development of pulmonary edema. Thus, diuretics logically might be a better choice as antihypertensive medication in such a scenario...
November 11, 2016: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27831835/imaging-of-neurologic-conditions-in-pregnant-patients
#7
Sangam Kanekar, Shante Bennett
A number of physiologic, hormonal, immunologic, and hemodynamic changes take place in the maternal body during pregnancy. The majority of these changes are essential for maintaining the normal course of pregnancy. However, these changes may also cause acute or chronic conditions that affect various biologic systems in the mother. In addition, conditions of the central and peripheral nervous systems can cause a variety of neurologic symptoms and complications. Neurologic signs and symptoms in pregnant and postpartum women may be due to the exacerbation of a preexisting medical condition, the initial manifestation of a primary central nervous system-related problem, or a neurologic problem unique to pregnancy and the postpartum period...
November 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27806675/investigation-of-maternal-psychopathological-symptoms-dream-anxiety-and-insomnia-in-preeclampsia
#8
Orkun Cetin, Pınar Guzel Ozdemir, Zehra Kurdoglu, Hanım Guler Sahin
PURPOSE: The aim of the current study was to investigate the psychopathological symptoms, psycho-emotional state, dream anxiety, and insomnia in healthy, mild and severe preeclamptic postpartum women and their relation to the severity of preeclampsia. MATERIALS AND METHODS: This observational study included forty-five healthy, 41 mild preeclamptic and 44 severe preeclamptic postpartum women. The 90-item Symptom Checklist Revised, Hospital Anxiety and Depression Scale, Insomnia Severity Index, and Van Dream Anxiety Scale were used to evaluate the psychopathological symptoms, psycho-emotional state, insomnia, and dream anxiety of the participants after delivery...
November 2, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27804179/preeclampsia-an-important-female-specific-risk-factor-for-asymptomatic-heart-failure
#9
Chahinda Ghossein-Doha, Jolijn van Neer, Brechtje Wissink, Nicolette Breetveld, Leon J de Windt, Arie Pj van Dijk, Maureen J van der Vlugt, Mirian Ch Janssen, Wieteke M Heidema, Ralph R Scholten, Marc Ea Spaanderman
OBJECTIVES: Preeclampsia (PE) is on the one hand associated with postpartum structural asymptomatic heart disease, consistent with heart failure (HF) stage-B, and on the other hand with conventional cardiovascular (CV) risk factors. With this study we aim to evaluate to which extent PE together with conventional CV risk factors are associated with asymptomatic cardiac abnormalities postpartum. METHODS: In this cross-sectional cohort study, formerly PE women (n = 107) and women with uneventful pregnancies (controls) (n = 41) were invited for CV risk-assessment 4-10 years postpartum...
November 1, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27802418/high-normal-estimated-glomerular-filtration-rate-in-early-onset-preeclamptic-women-10-years-postpartum
#10
Nina D Paauw, Jaap A Joles, José T Drost, Marianne C Verhaar, Arie Franx, Gerjan Navis, Angela H E M Maas, A Titia Lely
: Women with a history of preeclampsia have a 5- to 12-fold increased risk to develop end-stage kidney disease. Previous observations in small cohorts suggest that former preeclamptic (fPE) women have subtle abnormalities in renal hemodynamics and renal function, which might predispose them to renal failure in later life. In this study, we analyzed renal function in a cross-sectional cohort consisting of former early-onset preeclamptic (fPE, n=339) and former healthy pregnant women (fHP, n=332), overall with a mean age of 39 years at 10 years postpartum...
October 31, 2016: Hypertension
https://www.readbyqxmd.com/read/27786578/oral-labetalol-compared-to-oral-nifedipine-for-postpartum-hypertension-a-randomized-controlled-trial
#11
Kathryn J Sharma, Naomi Greene, Sarah J Kilpatrick
OBJECTIVE: To determine whether oral labetalol is associated with a shorter time to blood pressure control compared to oral extended release nifedipine for management of persistent postpartum hypertension. STUDY DESIGN: This randomized controlled trial conducted between June 2014 and June 2015 included women who delivered at ≥32 weeks' gestation with persistent postpartum hypertension (sustained blood pressure ≥150/100 mmHg) requiring an oral antihypertensive agent...
October 27, 2016: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27762324/maternal-and-live-birth-outcomes-of-pregnancies-following-assisted-reproductive-technology-a-retrospective-cohort-study
#12
Linling Zhu, Yu Zhang, Yifeng Liu, Runjv Zhang, Yiqing Wu, Yun Huang, Feng Liu, Meigen Li, Saijun Sun, Lanfeng Xing, Yimin Zhu, Yiyi Chen, Li Xu, Liangbi Zhou, Hefeng Huang, Dan Zhang
This study was carried out to explore associations between assisted reproductive technology (ART) and maternal and neonatal outcomes compared with similar outcomes following spontaneously conceived births. We conducted a retrospective cohort study of pregnancies conceived by ART (N = 2641) during 2006-2014 compared to naturally conceived pregnancies (N = 5282) after matching for maternal age and birth year. Pregnancy complications, perinatal complications and neonatal outcomes of enrolled subjects were investigated and analysed by multivariate logistic regression...
October 20, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27761482/immunology-of-neuromyelitis-optica-during-pregnancy
#13
Vahid Davoudi, Kiandokht Keyhanian, Riley M Bove, Tanuja Chitnis
Anti-aquaporin-4 (AQP4) autoantibody plays a key role in the pathogenesis of neuromyelitis optica (NMO). Studies have shown increased relapse rates in patients with NMO during pregnancy and postpartum. High estrogen levels during pregnancy can increase activation-induced cytidine deaminase expression, which is responsible for immunoglobulin production. Additionally, sex hormones may influence antibody glycosylation, with effects on antibody function. Estrogen decreases apoptosis of self-reactive B cells, through upregulation of antiapoptotic molecules...
December 2016: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/27756175/pregnancies-complicated-by-both-preeclampsia-and-growth-restriction-between-34-and-37-weeks-gestation-are-associated-with-adverse-perinatal-outcomes
#14
Kathryn J Sharma, Tania F Esakoff, Alyson Guillet, Richard M Burwick, Aaron B Caughey
OBJECTIVE: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. METHODS: This was a retrospective cohort study of 8,927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birthweight <10(th) percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27741996/diagnosis-of-acute-neurologic-emergencies-in-pregnant-and-postpartum-women
#15
Andrea G Edlow, Brian L Edlow, Jonathan A Edlow
Acute neurologic symptoms in pregnant and postpartum women may be caused by exacerbation of a preexisting neurologic condition, the initial presentation of a non-pregnancy-related problem, or a new neurologic problem. Pregnant and postpartum patients with headache and neurologic symptoms are often diagnosed with preeclampsia or eclampsia; however, other etiologies must also be considered. A team approach with close communication between emergency physicians, neurologists, maternal-fetal medicine specialists, and radiologists is the key to obtaining best outcomes...
November 2016: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27720092/evaluating-the-postpartum-maternal-health-clinic-how-patient-characteristics-predict-follow-up
#16
Christina M Nowik, Jessica Pudwell, Graeme N Smith
OBJECTIVE: At Kingston General Hospital, women who have pregnancy-related cardiovascular risk indicators (e.g., preeclampsia, gestational hypertension, gestational diabetes) are offered standardized six-month postpartum follow-up for cardiovascular disease risk screening and counselling. We sought to assess how patient characteristics predict attendance at follow-up. METHODS: We undertook a chart review of 650 patients who delivered between April 2011 and December 2014 and had preeclampsia, gestational hypertension, or gestational diabetes...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27680811/f5-skin-microvascular-dysfunction-in-preeclampsia-persists-to-the-postpartum-period
#17
Melanie Wittwer, Yann York Chow, Gus Dekker, Vicki Clifton, Margaret Arstall
INTRODUCTION: Preeclampsia is a multisystem disorder characterised by endothelial and microvascular dysfunction that develops in ∼10% of pregnancies. This study will characterise skin microvascular reactivity using laser Doppler flowmetry in women with preeclampsia compared to matched controls during pregnancy and early postpartum. METHODS: Women were recruited and studied on the diagnosis of preeclampsia and followed up for 6-months during postpartum period. Controls were matched for age, gestation and comorbidities...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27680806/e5-lung-ultrasound-and-echocardiography-for-peripartum-haemodynamic-monitoring-of-patients-with-severe-preeclampsia
#18
J Ambrozic, K Prokselj, M Lucovnik
INTRODUCTION: The ability to judge intravascular volume is fundamental in the management of patients with severe preeclampsia. Insufficient intravascular volume can result in decreased oxygen delivery to tissues and exacerbates organ dysfunction. On the other hand, fluid excesses can lead to fluid extravasation and pulmonary edema. Outside of pregnancy, transthoracic echocardiography and lung ultrasonography have become important diagnostic and monitoring tools in critically ill patients...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27680803/e2-preeclampsia-is-associated-with-persistent-arterial-stiffness-into-the-postpartum-period-despite-recovery-of-the-vasoconstrictive-state
#19
Y Chow, M Wittwer, G Dekker, Clifton, V M Arstall
INTRODUCTION: Preeclampsia is associated with vascular dysfunction and long-term cardiovascular disease. A novel technique, TensioMed measuring Pulse Wave Velocity (PWV) and Augmentation index (Aix) to estimate arterial stiffness and vasoconstriction respectively during pregnancy and 6 months postpartum. Targets: Our aim was to evaluate vascular function during pregnancy and the postpartum period in women with preeclampsia compared to uncomplicated pregnancy. We evaluated 11 preeclampsia women, diagnosed with hypertension (4140/90 mmHg) and proteinuria (spot urine protein/creatine ratio 430 mg/mmol) and 7 women with uncomplicated pregnancy...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27680796/c5-preeclampsia-in-twin-pregnancies
#20
Ogochukwu Chantelle Umadia, Dimuthu Vinayagam, Juan Gutierrez Henares, Asma Khalil
AIM: To identify the independent risk factors for PE development in twin pregnancies and explore the associated perinatal outcomes. METHODS: A retrospective cohort study of twin pregnancies was performed at St George's University Hospital, London. Maternal and neonatal data were obtained from the hospital's computerised database. The Chi-square test, Mann-Whitney U test and univariate and multiple-logistic regression analyses were performed. RESULTS: We identified a total of 1250 twin pregnancies who were under the care of SGH from 1999 to 2015...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
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