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postpartum hypertension

Michinari Hieda, Jeung-Ki Yoo, Dan-Dan Sun, Yoshiyuki Okada, Rosemary S Parker, Monique A Roberts-Reeves, Beverley Adams-Huet, David B Nelson, Benjamin D Levine, Qi Fu
Women with a history of gestational hypertensive disorders (GHD) are at increased risk for developing perinatal cardiovascular complications (e.g., gestational hypertension, preeclampsia, etc.) in subsequent pregnancies. The underlying mechanisms remain uncertain, but impaired maternal left ventricular function may be one contributing factor for these complications. We evaluated the time course of changes in left ventricular function before, during and after pregnancy in women with prior GHD. Sixteen women with a history of GHD (the high-risk group), and 25 women without such a history (controls) were enrolled...
June 13, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Obinnaya Odigboegwu, Lu J Pan, Piyali Chatterjee
Treatment of pregnancy-related hypertensive disorders, such as preeclampsia (PE), remain a challenging problem in obstetrics. Typically, aggressive antihypertensive drug treatment options are avoided to prevent pharmacological-induced hypotension. Another major concern of administering antihypertensive drugs during pregnancy is possible adverse fetal outcome. In addition, management of hypertension during pregnancy in chronic hypertensive patients or in patients with prior kidney problems are carefully considered...
2018: Frontiers in Cardiovascular Medicine
Maria Rita Bortolotto, Rossana Pulcineli Vieira Francisco, Marcelo Zugaib
PURPOSE OF REVIEW: The concept of resistant hypertension may be changed during pregnancy by the physiological hemodynamic changes and the particularities of therapy choices in this period. This review discusses the management of pregnant patients with preexisting resistant hypertension and also of those who develop severe hypertension in gestation and puerperium. RECENT FINDINGS: The main cause of severe hypertension in pregnancy is preeclampsia, and differential diagnosis must be done with secondary or primary hypertension...
June 11, 2018: Current Hypertension Reports
Yu-Ling Kuo, Te-Fu Chan, Chien-Yi Wu, Chin-Ru Ker, Hung-Pin Tu
OBJECTIVE: This study aims to examine the long-term cardiovascular and cerebrovascular risks in a large cohort of women with past history of preeclampsia and/or eclampsia. MATERIALS AND METHODS: This is a retrospective longitudinal study using National Health Insurance Research Database from 1996 to 2010. We identified 1295 women with preeclampsia and eclampsia. The control group was 5180 pregnant women without preeclampsia/eclampsia, who were matched for age and date of delivery...
June 2018: Taiwanese Journal of Obstetrics & Gynecology
Bibo Feng, Jianjun Zhai, Yu Cai
OBJECTIVE: This study aimed to determine the effect of twin pregnancy chorionic properties on pregnancy complications and fetal outcomes. MATERIALS AND METHODS: A total of 559 subjects with gemellary pregnancy were included in the retrospective analysis, and clinical data, such as monitoring data during pregnancy and maternal and fetal outcomes, were recorded in detail. Based on the ultrasound results and methods of the postpartum pathologic examination of the placental membranes, the subjects were divided into the twin group with monochorionic diamnion (MCDA group, n = 198) and twin group with dichorionic diamnion (DCDA group, n = 361)...
June 2018: Taiwanese Journal of Obstetrics & Gynecology
Kaushik L Ramaiya, Andrew Musa Swai, Theonest K Mutabingwa, Akwilina Wendelin Mwanri, Gibson B Kagaruki
AIMS: Gestational Diabetes Mellitus (GDM) remains a neglected cause of maternal and foetal morbidity and mortality in developing countries exacerbated by limited screening and management strategies. This study aimed to understanding how the RCH health system works in Tanzania, so as to provide opportunity for improving GDM screening and management. METHODS: A questionnaire was administered to facility staff and physical performance observed in 30 randomly selected public RCH facilities...
May 28, 2018: Diabetes Research and Clinical Practice
José P Guida, Maria L Costa, Mary A Parpinelli, Rodolfo C Pacagnella, Elton C Ferreira, Jussara Mayrink, Carla Silveira, Renato T Souza, Maria H Sousa, Lale Say, Doris Chou, Veronique Filippi, Maria Barreix, Kelli Barbour, Affette McCaw-Binns, Peter von Dadelszen, José G Cecatti
OBJECTIVE: To assess the scores of postpartum women using the WHO Disability Assessment Schedule 2.0 36-item tool (WHODAS-36), considering different morbidities. METHODS: Secondary analysis of a retrospective cohort of women who delivered at a referral maternity in Brazil and were classified with and without severe maternal morbidity (SMM). WHODAS-36 was used to assess functioning in postpartum women. Percentile distribution of total WHODAS score was compared across three groups: Percentile (P)<10, 10<P<90, and P>90...
May 2018: International Journal of Gynaecology and Obstetrics
Larissa Pereira Falavina, Rosana Rosseto de Oliveira, Emiliana Cristina Melo, Patrícia Louise Rodrigues Varela, Thais Aidar de Freitas Mathias
Objective To analyze the occurrence, profile and main causes of hospitalization during pregnancy according to the type of childbirth financial coverage. Method A cross-sectional population-based study carried out with puerperal women through a stratified sample, calculated according to the hospital and the type of childbirth financial coverage source: public sector (SUS) or private (not SUS). The sociodemographic profile, the rate of obstetric complications and the causes of hospitalization were analyzed, coded according to International Classification of Diseases...
2018: Revista da Escola de Enfermagem da U S P
Sajid Shahul, Hadi Ramadan, Junaid Nizamuddin, Ariel Mueller, Vijal Patel, John Dreixler, Avery Tung, Roberto M Lang, Lynn Weinert, Rabab Nasim, Sireesha Chinthala, Sarosh Rana
Women with hypertensive disorders of pregnancy have an increased risk of subsequent heart failure and cardiovascular disease when compared with women with normotensive pregnancies. Although the mechanisms underlying these findings are unclear, elevated levels of the biomarker activin A are associated with myocardial dysfunction and may have predictive value. We hypothesized that elevated levels of antepartum activin A levels would correlate with postpartum cardiac dysfunction in women with hypertensive disorders of pregnancy...
May 29, 2018: Hypertension
Nicole M Ventura, Terry Y Li, M Yat Tse, Logan Richard, Chandrakant Tayade, Albert Y Jin, R David Andrew, Stephen C Pang
Pregnancy evokes many challenges on the maternal cardiovascular system that may unmask predispositions for future disease. This is particularly evident for women who develop pregnancy-related disorders, for example, pre-eclampsia and gestational diabetes or hypertension. Such pregnancy-related syndromes increase the risk for cardiovascular disease (CVD) postpartum. As a result, pregnancy has been termed as a cardiovascular stress test and an indicator or marker to predict the development of CVD later in life...
May 25, 2018: Molecular and Cellular Biochemistry
Nasrin Fazel, Michael Kundi, Erika Jensen-Jarolim, Isabella Pali-Schöll, Asghar Kazemzadeh, Mojtaba Fattahi Abdizadeh, Habibollah Esmaily, Roya Akbarzadeh, Raheleh Ahmadi
BACKGROUND: Asthma is the most common potentially serious medical complication in pregnancy. The purpose of this study was to determine the association between maternal asthma and a spectrum of adverse neonatal and maternal outcomes. METHODS: Events during pregnancy and birth outcome were evaluated in 34 asthmatic as well as 1569 non-asthmatic pregnant women who were enrolled in a prospective cohort study undertaken at the antenatal clinics of Mobini Hospital in Iran...
May 24, 2018: Archives of Gynecology and Obstetrics
Mark A Clapp, Sarah E Little, Jie Zheng, Julian N Robinson, Anjali J Kaimal
OBJECTIVE: To determine the relative effects of patient and hospital factors on a hospital's postpartum readmission rate. STUDY DESIGN: This retrospective cohort study was conducted using State Inpatient Databases from California, Florida, and New York between 2004 and 2013. We compared patient and hospital characteristics among hospitals with low and high readmission rates using χ2 tests. Risk-adjusted 30-day readmission rates were calculated for patient, delivery, and hospital characteristics to understand factors affecting readmission using fixed and random effects models...
May 24, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Ajay K Gupta
No abstract text is available yet for this article.
May 13, 2018: Journal of the American Heart Association
Grace M Egeland, Svetlana Skurtveit, Anne Cathrine Staff, Geir Egil Eide, Anne-Kjersti Daltveit, Kari Klungsøyr, Lill Trogstad, Per M Magnus, Anne Lise Brantsæter, Margaretha Haugen
BACKGROUND: The association between pregnancy complications and women's later cardiovascular disease has, primarily, been evaluated in studies lacking information on important covariates. This report evaluates the prospective associations between pregnancy-related risk factors (preeclampsia/eclampsia, gestational hypertension, pregestational and gestational diabetes mellitus, preterm delivery, and fetal growth restriction) and pharmacologically treated hypertension within 10 years after pregnancy, while adjusting for a wide range of covariates...
May 13, 2018: Journal of the American Heart Association
Ronan Sugrue, Chloe Zera
Diabetes is a common chronic condition in women of reproductive age. Preconception care is crucial to reducing the risk of adverse maternal and fetal outcomes, such as hypertensive disorders, abnormal fetal growth, traumatic delivery and stillbirth, associated with poor glycemic control. Insulin is the preferred medication to optimize glucose control in women with pregestational diabetes. Frequent dose adjustments are needed during pregnancy to achieve glycemic goals, and team-based multidisciplinary care may help...
June 2018: Obstetrics and Gynecology Clinics of North America
Federico Mecacci, Serena Ottanelli, Felice Petraglia
Hyperglycemia is one of the most common medical conditions that women encounter during pregnancy and it is due to gestational diabetes (GDM) in the majority of cases [1]. GDM is associated with a higher incidence of maternal morbidity in pregnancy in term of hypertensive disorders/preclampsia and higher rate of cesarean delivery but also with long-term risk of type 2 diabetes and cardiovascular disease. Pregnancy can therefore be considered a stress test; diagnosis of HIP can unmask a preexisting susceptibility and consequently a future risk for type 2 diabetes and can be a useful marker of future cardiovascular risk...
May 3, 2018: Diabetes Research and Clinical Practice
Shristi Rawal, Sjurdur F Olsen, Louise G Grunnet, Ronald C Ma, Stefanie N Hinkle, Charlotta Granström, Jing Wu, Edwina Yeung, James L Mills, Yeyi Zhu, Wei Bao, Sylvia H Ley, Frank B Hu, Peter Damm, Allan Vaag, Michael Y Tsai, Cuilin Zhang
OBJECTIVE: To examine whether gestational diabetes mellitus (GDM), independent of subsequent diabetes, is an early risk factor for renal impairment long term after the index pregnancy. RESEARCH DESIGN AND METHODS: In the Diabetes & Women's Health (DWH) study (2012-2016), we examined the independent and joint associations of GDM and subsequent diabetes with long-term renal function among 607 women with and 619 women without GDM in the Danish National Birth Cohort (DNBC) index pregnancy (1996-2002)...
May 4, 2018: Diabetes Care
Yuechong Cui, Bin Zhu, Fei Zheng
The aim of the present meta-analysis study was to evaluate the efficacy of low-dose aspirin, commenced at ≤16 weeks of gestation, in preventing preterm and term preeclampsia, as well as associated maternal and neonatal adverse events in women at risk of preeclampsia. The Embase, PubMed, Cochrane Central Register of Controlled Trials and the Web of Science databases were searched for relevant random controlled trials (RCTs) published between January 1979 and October 2017. After quality assessment and data extraction, a meta-analysis was performed using RevMan 5...
May 2018: Experimental and Therapeutic Medicine
Carina R Angelini, Rodolfo C Pacagnella, Mary A Parpinelli, Carla Silveira, Carla B Andreucci, Elton C Ferreira, Juliana P Santos, Dulce M Zanardi, Renato T Souza, Jose G Cecatti
OBJECTIVE: To evaluate the occurrence of Post-Traumatic Stress Disorder among women experiencing a severe maternal morbidity event and associated factors in comparison with those without maternal morbidity. METHODS: In a retrospective cohort study, 803 women with or without severe maternal morbidity were evaluated at 6 months to 5 years postpartum for the presence of Post-Traumatic Stress Disorder. Interviews were conducted by telephone and electronic data was stored...
2018: Clinics
Qiu-Yue Zhong, Bizu Gelaye, Gregory L Fricchione, Paul Avillach, Elizabeth W Karlson, Michelle A Williams
BACKGROUND: Adverse obstetric and neonatal outcomes among women with psychosis, particularly affective psychosis, has rarely been studied at the population level. We aimed to assess the risk of adverse obstetric and neonatal outcomes among women with psychosis (schizophrenia, affective psychosis, and other psychoses). METHODS: From the 2007 - 2012 National (Nationwide) Inpatient Sample, 23,507,597 delivery hospitalizations were identified. From the same hospitalization, International Classification of Diseases diagnosis codes were used to identify maternal psychosis and outcomes...
May 2, 2018: BMC Pregnancy and Childbirth
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