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preeclampsia prevention

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https://www.readbyqxmd.com/read/28711078/preeclampsia-pathogenesis-prevention-and-long-term-complications
#1
Belinda Jim, S Ananth Karumanchi
Preeclampsia continues to afflict 5% to 8% of all pregnancies throughout the world and is associated with significant morbidity and mortality to the mother and the fetus. Although the pathogenesis of the disorder has not yet been fully elucidated, current evidence suggests that imbalance in angiogenic factors is responsible for the clinical manifestations of the disorder, and may explain why certain populations are risk. In this review, we begin by demonstrating the roles that angiogenic factors play in pathogenesis of preeclampsia and its complications in the mother and the fetus...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28693893/emerging-role-for-dysregulated-decidualization-in-the-genesis-of-preeclampsia
#2
Kirk P Conrad, Maria Belen Rabaglino, Emiel D Post Uiterweer
In normal human placentation, uterine invasion by trophoblast cells and subsequent spiral artery remodeling depend on cooperation among fetal trophoblasts and maternal decidual, myometrial, immune and vascular cells in the uterine wall. Therefore, aberrant function of anyone or several of these cell-types could theoretically impair placentation leading to the development of preeclampsia. Because trophoblast invasion and spiral artery remodeling occur during the first half of pregnancy, the molecular pathology of fetal placental and maternal decidual tissues following delivery may not be informative about the genesis of impaired placentation, which transpired months earlier...
June 9, 2017: Placenta
https://www.readbyqxmd.com/read/28689331/pathophysiology-and-current-clinical-management-of-preeclampsia
#3
REVIEW
Lorena M Amaral, Kedra Wallace, Michelle Owens, Babbette LaMarca
Preeclampsia is characterized by blood pressure greater than 140/90 mmHg in the second half of pregnancy. This disease is a major contributor to preterm and low birth weight babies. The early delivery of the baby, which becomes necessary for maintaining maternal well-being, makes preeclampsia the leading cause for preterm labor and infant mortality and morbidity. Currently, there is no cure for this pregnancy disorder. The current clinical management of PE is hydralazine with labetalol and magnesium sulfate to slow disease progression and prevent maternal seizure, and hopefully prolong the pregnancy...
August 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28663440/elabela-deficiency-promotes-preeclampsia-and-cardiovascular-malformations-in-mice
#4
Lena Ho, Marie Van Dijk, Sam Tan Jian Chye, Daniel M Messerschmidt, Serene C Chng, Sheena Ong, Ling Ka Yi, Souad Boussata, Grace Hui-Yi Goh, Gijs B Afink, Chin Yan Lim, N Ray Dunn, Davor Solter, Barbara B Knowles, Bruno Reversade
Pre-eclampsia (PE) is a gestational hypertensive syndrome affecting between 5 and 8% of all pregnancies. While PE is the leading cause of fetal and maternal morbidity/mortality, its molecular etiology is still unclear. Here, we show that ELABELA (ELA), an endogenous ligand of the apelin receptor (APLNR, or APJ), is a circulating hormone secreted by the placenta. Elabela but not Apelin knockout pregnant mice exhibit PE-like symptoms, including proteinuria and elevated blood pressure due to defective placental angiogenesis...
June 29, 2017: Science
https://www.readbyqxmd.com/read/28651448/adverse-pregnancy-outcomes-in-deliveries-prior-to-at-and-beyond-39%C3%A2-weeks-low-and-high-risk-women
#5
Hind N Moussa, Susan Hosseini Nasab, Farah H Amro, Jennifer Hoayek, Ziad A Haidar, Sean C Blackwell, Baha M Sibai
BACKGROUND: Hypertensive disorders are associated with maternal and neonatal complications. Though they are more common in women with history of prior preeclampsia, they can occur in uncomplicated pregnancies. OBJECTIVE: To determine the proportion of adverse pregnancy outcomes in deliveries prior to or at ≥39 weeks, in uncomplicated singleton nulliparous women (low-risk), as well as women with history of preeclampsia in a prior gestation (high-risk). STUDY DESIGN: This was a secondary analysis from the multicenter trials of low dose aspirin for preeclampsia prevention in low and high-risk pregnancies...
June 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28642294/mhc-class-ii-invariant-chain-peptide-or-gamma-delta-t-cell-depletion-ameliorates-experimental-preeclampsia
#6
Piyali Chatterjee, Valorie L Chiasson, Geetha Seerangan, Eugene De Guzman, Moheb Milad, Kelsey R Bounds, Olga Gasheva, Richard P Tobin, Mohamad Hatahet, Shelley Kopriva, Kathleen A Jones, M Karen Newell-Rogers, Brett Mitchell
Excessive innate immune system activation and inflammation during pregnancy can lead to organ injury and dysfunction and preeclampsia; however, the molecular mechanisms involved are unknown.  We tested the hypothesis that Toll-like receptor activation induces MHC class II invariant chain peptide (CLIP) expression on immune cells, makes them pro-inflammatory, and are necessary to cause preeclampsia-like features in mice.  Treatment with VG1177, a competitive antagonist peptide for CLIP in the groove of MHC class II, was able to both prevent and treat preeclampsia-like features in mice...
June 22, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28640441/adipose-tissue-derived-omentin-1-function-and-regulation
#7
Takuya Watanabe, Kaho Watanabe-Kominato, Yui Takahashi, Miho Kojima, Rena Watanabe
Omentin-1, also known as intelectin-1, is a recently identified novel adipocytokine of 313 amino acids, which is expressed in visceral (omental and epicardial) fat as well as mesothelial cells, vascular cells, airway goblet cells, small intestine, colon, ovary, and plasma. The level of omentin-1 expression in (pre)adipocytes is decreased by glucose/insulin and stimulated by fibroblast growth factor-21 and dexamethasone. Several lines of experimental evidence have shown that omentin-1 plays crucial roles in the maintenance of body metabolism and insulin sensitivity, and has anti-inflammatory, anti-atherosclerotic, and cardiovascular protective effects via AMP-activated protein kinase/Akt/nuclear factor-κB/mitogen-activated protein kinase (ERK, JNK, and p38) signaling...
June 18, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28626073/increased-vascular-and-uteroplacental-matrix-metalloproteinase-1-and-7-levels-and-collagen-i-deposition-in-hypertension-in-pregnancy-role-of-tnf
#8
Wei Li, Ning Cui, Marc Q Mazzuca, Karina M Mata, Raouf A Khalil
Preeclampsia is manifested as maternal hypertension-in-pregnancy (HTN-Preg) and fetal growth restriction. Placental ischemia could be an initiating event; however, the molecular targets and intermediary mechanisms are unclear. We tested the hypothesis that placental ischemia could target vascular and uteroplacental matrix metalloproteinases (MMPs) through cytokines-mediated mechanism. MMP levels and distribution were measured in aorta, uterus and placenta of normal pregnant rats (Preg), and pregnant rats with reduced uterine perfusion pressure (RUPP)...
June 16, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28619690/metformin-the-aspirin-of-the-21st-century-its%C3%A2-role-in-gestational-diabetes-mellitus-prevention-of-preeclampsia-and-cancer-and%C3%A2-the-promotion-of-longevity
#9
REVIEW
Roberto Romero, Offer Erez, Maik Hüttemann, Eli Maymon, Bogdan Panaitescu, Agustin Conde-Agudelo, Percy Pacora, Bo Hyun Yoon, Lawrence I Grossman
Metformin is everywhere. Originally introduced in clinical practice as an antidiabetic agent, its role as a therapeutic agent is expanding to include treatment of prediabetes mellitus, gestational diabetes mellitus, and polycystic ovarian disease and, more recently, experimental studies and observations in randomized clinical trials suggest that metformin could have a place in the treatment or prevention of preeclampsia. This article provides a brief overview of the history of metformin in the treatment of diabetes mellitus, reviews the results of metaanalyses of metformin in gestational diabetes mellitus, and the treatment of obese non-diabetic pregnant women to prevent macrosomia...
June 12, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28618048/transcriptomic-profiling-in-human-decidua-of-severe-preeclampsia-detected-by-rna-sequencing
#10
Jing Tong, Weixiu Zhao, Hong Lv, Wei-Ping Li, Zi-Jiang Chen, Cong Zhang
Maternal decidua plays a critical role in implantation and placentation. Impaired decidualization causes failed intravascular trophoblast invasion and inadequate placentation and then increases the risk of preeclampsia (PE). RNA sequencing (RNA-Seq) has achieved great advances in the characterization and quantification of transcriptomes, is a powerful tool for new transcript discovery, genome annotation and expression profiling. In the present study, we conducted a RNA-Seq analysis to compare gene expression between decidua of PE (n = 3, early-onset severe PE, EOSPE; n = 3, late-onset severe PE, LOSPE) and normal pregnancies (n = 3)...
June 15, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28616085/helicobacter-pylori-infection-old-and-new
#11
REVIEW
S Diaconu, A Predescu, A Moldoveanu, C S Pop, C Fierbințeanu-Braticevici
Helicobacter pylori is a spiral-shaped bacterium that grows in the digestive tract and may be present in more than half of the world's population. The clinical features of Helicobacter pylori range from asymptomatic gastritis to gastrointestinal malignancy. Mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade B-cell marginal zone lymphoma and Helicobacter pylori has been detected in more than 75% of the patients with MALT lymphoma. Many tests for the detection of Helicobacter pylori are available, including antibody tests, urea breath tests, stool antigen tests and endoscopic biopsies...
April 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28600028/ethnic-and-racial-disparities-in-hypertension-management-among-women
#12
Theresa M Beckie
Hypertension is a major independent risk factor for cardiovascular disease for all ethnic and racial groups. Compared with other lifestyle and metabolic risk factors, hypertension is the leading cause of death in women. Women with preeclampsia are three times more likely to develop chronic hypertension and have an elevated risk of future cardiovascular disease. The objective of this article is to provide a review of the factors related to racial and ethnic disparities in blood pressure control. This is followed by a summary of contemporary clinical practice guidelines for the prevention, through lifestyle behavioral modification, and treatment of hypertension with pharmacotherapy...
June 6, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28599894/impact-of-aspirin-on-fetal-growth-in-diabetic-pregnancies-according-to-white-classification
#13
Katlynn Adkins, Amanda A Allshouse, Torri D Metz, Kent D Heyborne
BACKGROUND: Current US Preventive Services Task Force and other guidelines recommend low-dose aspirin for all pregnant women with pregestational diabetes mellitus to prevent preeclampsia and small-for-gestational-age birth. The Maternal-Fetal Medicine Units High-Risk Aspirin trial did not show a reduction in either preeclampsia or small-for-gestational-age birth in diabetic women. OBJECTIVE: Our objective was to reassess the impact of aspirin on fetal growth in diabetic pregnancies overall and according to White classification...
June 30, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28593902/inverted-pyramid-of-prenatal-care-is-it-enough-should-it-be-extended-inverted-pyramid-of-prenatal-care
#14
Aleksandar Ljubić
In recent years, the idea of the inverted pyramid of prenatal care and monitoring has emerged, for the purpose of prediction and prevention, early detection and treatment of health disorders of the fetus. Is this enough? If we analyze the period behind us, progress has been made in the field of detection of multiple pregnancies, dating of pregnancy and prenatal detection of chromosomal and structural fetal disorders, as well as a small amount of progress in terms of prediction and prevention of preeclampsia...
April 7, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28589122/the-future-of-bronchopulmonary-dysplasia-emerging-pathophysiological-concepts-and-potential-new-avenues-of-treatment
#15
REVIEW
Jennifer J P Collins, Dick Tibboel, Ismé M de Kleer, Irwin K M Reiss, Robbert J Rottier
Yearly more than 15 million babies are born premature (<37 weeks gestational age), accounting for more than 1 in 10 births worldwide. Lung injury caused by maternal chorioamnionitis or preeclampsia, postnatal ventilation, hyperoxia, or inflammation can lead to the development of bronchopulmonary dysplasia (BPD), one of the most common adverse outcomes in these preterm neonates. BPD patients have an arrest in alveolar and microvascular development and more frequently develop asthma and early-onset emphysema as they age...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28570835/lifestyle-and-behavioral-management-of-polycystic-ovary-syndrome
#16
Leah Brennan, Helena Teede, Helen Skouteris, Jake Linardon, Briony Hill, Lisa Moran
Polycystic ovary syndrome (PCOS) is a common condition with serious physiological and psychological health consequences. It affects women across their reproductive lifespan and is associated with pregnancy complications, including gestational diabetes, preeclampsia, and large gestational-age babies. PCOS is associated with excess weight gain, which, in turn, exacerbates the health burden of PCOS. Therefore, weight management, including a modest weight loss, maintenance of weight loss, prevention of weight gain, and prevention of excess gestational weight gain, is a first-line treatment for women with PCOS during and independent of pregnancy...
June 1, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28565757/an-exploratory-study-into-the-role-of-mir-204-5p-in-pregnancy-induced-hypertension
#17
Zhixiong Mei, Baoqin Huang, Ying Mo, Jianhui Fan
The molecular mechanism that leads to pregnancy-induced hypertension (PIH), a pregnancy-specific syndrome, remains poorly understood. It has been suggested that microRNAs (miRNAs) may be potentially useful biomarkers for severe preeclampsia (PE), which is an important condition associated with PIH. The aim of the present study was to identify miR-204 by verifying differentially expressed serum miRNAs in patients with PIH during pregnancy compared with normal controls. Subsequently, the effects of miR-204 on proliferation and apoptosis of human choriocarcinoma (JAR) cells in hypoxic microenvironment were investigated...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28553027/a-ten-year-audit-of-maternal-mortality-millennium-development-still-a-distant-goal
#18
Anshuja Singla, Shalini Rajaram, Sumita Mehta, Gita Radhakrishnan
OBJECTIVE: To assess various causes of maternal mortality over a ten year period. DESIGN: Retrospective audit of hospital case records. SETTING: Tertiary care hospital. POPULATION: Pregnant women who expired in the premises of GTB Hospital. MATERIALS AND METHODS: A retrospective audit of case records of maternal deaths was conducted for a ten year period (January 2005 to December 2014). RESULTS: There were a total of 647 maternal deaths out of 1,16,641 live births...
April 2017: Indian Journal of Community Medicine
https://www.readbyqxmd.com/read/28549983/the-effect-of-omega-3-supplementation-on-pregnancy-outcomes-by-smoking-status
#19
Spencer G Kuper, Adi R Abramovici, Victoria C Jauk, Lorie M Harper, Joseph R Biggio, Alan T Tita
BACKGROUND: Smoking during pregnancy is associated with adverse maternal and neonatal outcomes such as preterm delivery, intrauterine growth restriction, stillbirth, and low birth weight. Because smoking causes oxidative stress, some have suggested using antioxidants to counteract the effects of oxidative stress. Smokers have lower serum levels of omega-3 fatty acids, an important antioxidant, and thus, investigating whether omega-3 supplementation in smokers reduces adverse maternal and neonatal outcomes represents an important area of research...
May 23, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28542803/early-gestational-age-at-preeclampsia-onset-is-associated-with-subclinical-atherosclerosis-12-years-after-delivery
#20
Martin Christensen, Camilla Skovhus Kronborg, Rasmus Kirkeskov Carlsen, Nikolaj Eldrup, Ulla Breth Knudsen
Women with a history of preeclampsia have increased risk of cardiovascular disease later in life. However, it is unclear if early gestational age at preeclampsia onset is associated with higher cardiovascular disease risk. This study aimed to test the association between gestational age at preeclampsia onset (including the early-onset/late-onset preeclampsia distinction) and subclinical atherosclerosis and arterial stiffness in age-matched women 12 years after index pregnancy MATERIAL AND METHODS: Eligible participants were identified in two Danish registries...
May 23, 2017: Acta Obstetricia et Gynecologica Scandinavica
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