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nifedipine in preeclampsia

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https://www.readbyqxmd.com/read/28441551/treating-normal-early-gestation-placentae-with-preeclamptic-sera-produces-extracellular-micro-and-nano-vesicles-that-activate-endothelial-cells
#1
Xirong Xiao, Fengyi Xiao, Mingzhi Zhao, Mancy Tong, Michelle R Wise, Peter R Stone, Lawrence W Chamley, Qi Chen
OBJECTIVES: Preeclampsia is characterised by systemic endothelial cell dysfunction thought to be triggered by toxic/dangerous factors from the placenta, including placental extracellular vesicles (EVs). Why placental EVs become toxic is unknown. We previously reported that preeclamptic sera produced toxic/dangerous placental macrovesicles but whether small EVs are also toxic/dangerous in preeclampsia is unknown. STUDY DESIGN: First trimester placental explants were treated with 10% preeclamptic or control sera (n=10) for 24h...
April 14, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28426127/postpartum-hypertension-etiology-diagnosis-and-management
#2
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/28333820/committee-opinion-no-692-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#3
(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
#4
(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/27835048/furosemide-in-postpartum-management-of-severe-preeclampsia-a-randomized-controlled-trial
#5
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...
February 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27786578/oral-labetalol-compared-to-oral-nifedipine-for-postpartum-hypertension-a-randomized-controlled-trial
#6
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...
February 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27753872/ish-aha-1-a-case-of-refractory-hypertension-controlled-by-repeated-renal-denervation-and-celiac-plexus-block-a-case-of-refractory-sympathetic-overload
#7
Chan Joo Lee, Yeongmin Woo, Byeong-Keuk Kim, Kyung Bong Yoon, Hae-Young Lee, Sungha Park
A 30-year-old woman was referred to our hospital due to high blood pressure, dizziness, headache and blurred vision. She had past history of preeclampsia and gestational hypertension 4 years ago but she had not taken antihypertensive medication in spite of remained hypertension after delivery. She was hospitalized for fever due to urinary tract infection and severe hypertension which was above 210/140 mmHg. Despite maximal medical treatment with telmisartan 80 mg, nifedipine 120 mg, carvedilol 50 mg, doxazocin 8 mg, chlorthalidone 50 mg, spironolactone 50 mg#2, isosorbide dinitrate 80 mg and intermittent intravenous administration of nicardipine and labetalol, her systolic blood pressure remained above 160 mmHg and repeatedly measured above 200 mmHg...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27680821/h5-second-trimester-vascular-function-parameters-in-women-with-chronic-hypertension-and-their-association-with-adverse-maternal-and-perinatal-outcomes
#8
L M Webster, J Fetherston, C Chmiel, C Nelson-Piercy, A Khalil, J Myers, L C Chappell
INTRODUCTION: Increased aortic systolic BP (SBPao), pulse wave velocity (PWVao) and augmentation index of the aorta (AIXao) are associated with increased cardiovascular morbidity. These measures may also be increased prior to the development of adverse maternal and perinatal outcomes. The aim of this study was to evaluate the association between haemodynamic parameters and adverse outcomes in women with chronic hypertension (CHT). METHODS: Women recruited to the PANDA study (Pregnancy And chronic hypertension: NifeDipine versus lAbetalol as antihypertensive treatment) had Arteriograph (Tensio Med) readings taken while sitting...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27643109/ish-aha-1-a-case-of-refractory-hypertension-controlled-by-repeated-renal-denervation-and-celiac-plexus-block-a-case-of-refractory-sympathetic-overload
#9
Chan Joo Lee, Yeongmin Woo, Byeong-Keuk Kim, Kyung Bong Yoon, Hae-Young Lee, Sungha Park
A 30-year-old woman was referred to our hospital due to high blood pressure, dizziness, headache and blurred vision. She had past history of preeclampsia and gestational hypertension 4 years ago but she had not taken antihypertensive medication in spite of remained hypertension after delivery. She was hospitalized for fever due to urinary tract infection and severe hypertension which was above 210/140 mmHg. Despite maximal medical treatment with telmisartan 80 mg, nifedipine 120 mg, carvedilol 50 mg, doxazocin 8 mg, chlorthalidone 50 mg, spironolactone 50 mg#2, isosorbide dinitrate 80 mg and intermittent intravenous administration of nicardipine and labetalol, her systolic blood pressure remained above 160 mmHg and repeatedly measured above 200 mmHg...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27554460/-management-of-arterial-hypertension-before-20weeks-gestation-in-pregnant-women
#10
Florent Seguro, Béatrice Duly Bouhanick, Bernard Chamontin, Jacques Amar
In the first 6 months of pregnancy, the primary goal of antihypertensive treatment is to prevent the complications of severe hypertension. Initiation of antihypertensive drug treatment is recommended in pregnant women with severe hypertension (blood pressure>160/110mmHg). Initiation of antihypertensive drug treatment should also be considered in pregnant women at high cardiovascular risk (diabetes, chronic kidney disease, personal history of cardiovascular disease) with moderate hypertension (blood pressure between 140-159/90-109mmHg)...
July 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27113951/nifedipine-induced-gingival-hyperplasia-in-pregnancy-a-case-report
#11
M S Brochet, M Harry, F Morin
BACKGROUND: It is known that calcium channel blockers are associated with a risk of gingival hyperplasia. These drugs are widely used in the management of gestational hypertensive disorders. CASE: A 27-year-old G1 woman presented with gingival hyperplasia at 27 weeks gestation during a hospitalisation for preeclampsia. She had been on nifedipine for hypertension for the last 9 weeks. Nifedipine was discontinued and replaced by methyldopa and already after 48 hours the gingival hyperplasia improved...
April 26, 2016: Current Drug Safety
https://www.readbyqxmd.com/read/27104347/the-effect-of-maternal-antihypertensive-drugs-on-the-cerebral-renal-and-splanchnic-tissue-oxygen-extraction-of-preterm-neonates
#12
Anne E Richter, Trijntje E Schat, Koenraad N J A Van Braeckel, Sicco A Scherjon, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: Drugs with antihypertensive action are frequently used in obstetrics for the treatment of preeclampsia (labetalol) and tocolysis (nifedipine) or for neuroprotection (MgSO4), and may affect the hemodynamics of preterm born neonates. OBJECTIVE: The aim of this study was to assess whether maternal antihypertensive drugs affect multisite oxygenation levels of the neonate. METHODS: Eighty preterm neonates of ≤32 weeks of gestational age were monitored using near-infrared spectroscopy...
2016: Neonatology
https://www.readbyqxmd.com/read/26829504/severe-maternal-morbidity-in-a-large-cohort-of-women-with-acute-severe-intrapartum-hypertension
#13
Sarah J Kilpatrick, Anisha Abreo, Naomi Greene, Kathryn Melsop, Nancy Peterson, Larry E Shields, Elliot K Main
BACKGROUND: Hypertensive diseases of pregnancy are associated with severe maternal morbidity and remain common causes of maternal death. Recently, national guidelines have become available to aid in recognition and management of hypertension in pregnancy to reduce morbidity and mortality. The increased morbidity related to hypertensive disorders of pregnancy is presumed to be associated with the development of severe hypertension. However, there are few data on specific treatment or severe maternal morbidity in women with acute severe intrapartum hypertension as opposed to severe preeclampsia...
July 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26803648/diabetic-nephropathy-in-women-with-preexisting-diabetes-from-pregnancy-planning-to-breastfeeding
#14
REVIEW
Lene Ringholm, Julie Agner Damm, Marianne Vestgaard, Peter Damm, Elisabeth R Mathiesen
In women with preexisting diabetes and nephropathy or microalbuminuria, it is important to deliver careful preconception counselling to assess the risk for the mother and the foetus, for optimizing glycaemic status and to adjust medical treatment. If serum creatinine is normal in early pregnancy, kidney function is often preserved during pregnancy, but complications such as severe preeclampsia and preterm delivery are still common. Perinatal mortality is now comparable with that in women with diabetes and normal kidney function...
February 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/26629148/berberine-alleviates-preeclampsia-possibly-by-regulating-the-expression-of-interleukin-2-interleukin-10-and-bcl-2-bax
#15
Ailan Wang, Qingcui Liu, Jin Zhang, Rui Zheng
The present study is to investigate the effect of berberine on the expression of inflammatory factors interleukin (IL)-2 and IL-10, and the expression of apoptosis proteins Bcl-2 and Bax. A total of 70 SD rats were randomly divided into 7 equal groups, including normal non-pregnant group, normal pregnant group, preeclampsia group, preeclampsia + berberine (50, 100, and 200 mg/kg/day) groups, and preeclampsia + nifedipine (20 mg/kg/day) group. Blood pressure was measured before pregnancy, and on day 15 and 21 of pregnancy...
2015: International Journal of Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/26012245/posterior-reversible-encephalopathy-syndrome-in-eclamptic-patients-neuroradiological-manifestation-pathogenesis-and-management
#16
Marija S Kutlesič, Ranko M Kutlesič, Goran P Koratevič
INTRODUCTION: Eclampsia is one of the most serious complications of hypertensive disorders of pregnancy, defined as the occurrence of one or more convulsions superimposed on preeclampsia. Besides the ordinary course of the disease, ranging from a mild to a severe form, with culmination in eclamptic seizures, there is a significant percent of cases where eclampsia starts unexpectedly, without typical premonitory symptoms and signs, which makes it difficult to prevent. NEURORADIOLOGICAL CHARACTERISTICS AND PATHOGENESIS OF ECLAMPSIA...
January 2015: Medicinski Pregled
https://www.readbyqxmd.com/read/25907222/the-reduction-of-circulating-levels-of-il-6-in-pregnant-women-with-preeclampsia-by-magnesium-sulphate-and-nifedipine-in%C3%A2-vitro-evidence-for-potential-mechanisms
#17
Q Chen, M Zhao, F Guo, Y X Yin, J P Xiao, P R Stone, L W Chamley
INTRODUCTION: Women with preeclampsia have elevated levels of inflammatory cytokines including IL-6. IL-6, which is known to activate endothelial cells and induce the production of necrotic trophoblastic debris from the placenta, may be important in the pathogenesis of preeclampsia. MgSO4 is a major therapy for the prevention of seizures in preeclampsia but it has been suggested to also have anti-inflammatory and vasodilatory properties. METHODS: 22 pregnant women with preeclampsia and 68 normotensive controls were recruited and circulating IL-6 levels in these women were measured before MgSO4 and nifedipine treatment and after delivery...
June 2015: Placenta
https://www.readbyqxmd.com/read/25787409/-58-or-to-study-the-changes-in-maternal-and-fetal-hemodynamics-with-intravenous-labetalol-or-nifedipine-in-acute-severe-hypertension
#18
Shalini Gainder, Monika Thakur, Subhas C Saha, Mahesh Prakash
OBJECTIVES: To compare the efficacy of intravenous labetalol or oral nifedipine in treatment of acute maternal hypertension and study the fetal and maternal hemodynamic changes using color Doppler ultrasound that follows treatment METHODS: Thirty women with severe preeclampsia having acute hypertension (more than or equal to 160/105mmHg) were randomized in 2 groups to receive intravenous labetalol or oral nifedipine until blood pressure was lowered to less than or equal to 140/90mmHg...
January 2015: Pregnancy Hypertension
https://www.readbyqxmd.com/read/25729662/attenuation-of-the-pressor-response-to-tracheal-intubation-in-severe-preeclampsia-relative-efficacies-of-nitroglycerine-infusion-sublingual-nifedipine-and-intravenous-hydralazine
#19
Mohammadreza Safavi, Azim Honarmand, Neda Azari
BACKGROUND: The pressor response to laryngoscopy is known to be exaggerated in patients with severe preeclampsia. OBJECTIVES: The aim of the present study was to compare the efficacies of continuous intravenous (IV) infusion of nitroglycerine, IV hydralazine, or sublingual nifedipine in modifying cardiovascular responses to endotracheal intubation, in women with severe preeclampsia undergoing cesarean delivery under general anesthesia. PATIENTS AND METHODS: A total of 120 patients undergoing cesarean delivery were randomly divided into 3 groups, each receiving one of the following drugs before intubation: 5 µg/min nitroglycerine administered by continuous IV infusion (Group NTG, n = 40); a 10-mg capsule of nifedipine deposited sublingually (Group NIF, n = 40); or 5-10 mg hydralazine intravenously (Group H, n = 40)...
2011: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/24754605/cerebral-perfusion-pressure-in-women-with-preeclampsia-is-elevated-even-after-treatment-of-elevated-blood-pressure
#20
Milan J Sonneveld, Ingrid A Brussé, Johannes J Duvekot, Eric A P Steegers, Frank Grune, Gerhard H Visser
Cerebral perfusion pressure (CPP) is elevated in preeclampsia, and may predispose to cerebrovascular complications and progression to eclampsia. We estimated zero flow pressure (ZFP) and CPP using simultaneously obtained arterial blood pressure and middle cerebral artery blood flow velocity in 10 women with preeclampsia, all treated with methyldopa with or without nifedipine, and 18 healthy pregnant controls. Mean ± SD ZFP was lower in women with preeclampsia than in controls (16.8 ± 10.9 vs. 31.7 ± 15.0 mmHg, p = 0...
May 2014: Acta Obstetricia et Gynecologica Scandinavica
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