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https://www.readbyqxmd.com/read/27906745/should-we-add-pravastatin-to-aspirin-for-preeclampsia-prevention-in-high-risk-women
#1
Caroline C Marrs, Maged M Costantine
Preeclampsia is a multisystem disorder that affects 3% to 5% of pregnant women and remains a significant source of short-term and long-term maternal and neonatal mortality and morbidity. Many professional societies recommend the use of low-dose aspirin to prevent preeclampsia in high-risk women. Owing to the similarities in pathophysiology between preeclampsia and atherosclerotic cardiovascular disease, and the encouraging data from preclinical and pilot clinical studies, pravastatin has been proposed for preventing preeclampsia...
November 30, 2016: Clinical Obstetrics and Gynecology
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/27879355/pregnancy-outcomes-in-women-with-diabetes-lessons-learned-from-clinical-research-the-2015-norbert-freinkel-award-lecture
#3
Elisabeth R Mathiesen
Among women with diabetes, the worst pregnancy outcome is seen in the subgroup of women with diabetic nephropathy. Development of severe preeclampsia that leads to early preterm delivery is frequent. Predictors and pathophysiological mechanisms for the development of preeclampsia among women with diabetes and observational studies that support antihypertension treatment for pregnant women with microalbuminuria or diabetic nephropathy preventing preeclampsia and early preterm delivery are presented here. Obtaining and maintaining strict glycemic control before and during pregnancy is paramount to prevent preterm delivery...
December 2016: Diabetes Care
https://www.readbyqxmd.com/read/27878553/magnesium-sulfate-provides-neuroprotection-in-eclampsia-like-seizure-model-by-ameliorating-neuroinflammation-and-brain-edema
#4
Xiaolan Li, Xinjia Han, Jinying Yang, Junjie Bao, Xiaodan Di, Guozheng Zhang, Huishu Liu
Eclampsia is a hypertensive disorder of pregnancy that is defined by the new onset of grand mal seizures on the basis of preeclampsia and a leading cause of maternal and fetal mortality worldwide. Presently, magnesium sulfate (MgSO4) is the most effective treatment, but the mechanism by which MgSO4 prevents eclampsia has yet to be fully elucidated. We previously showed that systemic inflammation decreases the seizure threshold in a rat eclampsia-like model, and MgSO4 treatment can decrease systemic inflammation...
November 22, 2016: Molecular Neurobiology
https://www.readbyqxmd.com/read/27876004/enoxaparin-for-the-prevention-of-preeclampsia-and-intrauterine-growth-restriction-in-women-with-a-prior-history-an-open-label-randomised-trial-the-eppi-trial-study-protocol
#5
K M Groom, L M McCowan, P R Stone, L C Chamley, C McLintock
BACKGROUND: Preeclampsia and intrauterine fetal growth restriction (IUGR) are two of the most common causes of maternal and perinatal morbidity and mortality. Current methods of predicting those at most risk of these conditions remain relatively poor, and in clinical practice past obstetric history remains the most commonly used tool. Aspirin and, in women at risk of preeclampsia only, calcium have been demonstrated to have a modest effect on risk reduction. Several observational studies and randomised trials suggest that low molecular weight heparin (LMWH) therapy may confer some benefit...
November 22, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27873232/evidence-based-revised-view-of-the-pathophysiology-of-preeclampsia
#6
Asif Ahmed, Homira Rezai, Sophie Broadway-Stringer
Preeclampsia is a life-threatening vascular disorder of pregnancy due to a failing stressed placenta. Millions of women risk death to give birth each year and globally each year, almost 300,000 lose their life in this process and over 500,000 babies die as a consequence of preeclampsia. Despite decades of research, we lack pharmacological agents to treat it. Maternal endothelial oxidative stress is a central phenomenon responsible for the preeclampsia phenotype of high maternal blood pressure and proteinuria...
November 22, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27871550/carbetocin-for-prevention-of-postcesarean-hemorrhage-in-women-with-severe-preeclampsia-a-before-after-cohort-comparison-with-oxytocin
#7
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/27854133/focusing-on-developmental-origins-and-disease-inception-for-the-prevention-of-pulmonary-hypertension
#8
Bradley A Maron, Steven H Abman
Despite the growing armamentarium of therapies, pulmonary vascular disease continues to cause significant morbidity and mortality in neonates, children and adults in diverse clinical settings. To address this challenge, a strategic shift is underway that emphasizes disease recognition prior to the onset of clinical signs and symptoms when substantial pulmonary vascular remodeling is already present. Specifically, there is growing interest regarding the i) molecular events that define pulmonary vascular disease inception, ii) range of early cardiopulmonary hemodynamic measures that are associated with adverse outcome, and iii) widening utility of exercise for risk-stratification...
November 17, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27853262/the-lnc-rna-spry4-it1-modulates-trophoblast-cell-invasion-and-migration-by-affecting-the-epithelial-mesenchymal-transition
#9
Qing Zuo, Shiyun Huang, Yanfen Zou, Yetao Xu, Ziyan Jiang, Shan Zou, Haoqing Xu, Lizhou Sun
Preeclampsia is a common, pregnancy-specific disease and a major contributor to maternal and foetal morbidity and mortality. Some placental abnormalities, including deficient implantation, abnormal trophoblast cell function, and improper placental vascular development, are believed to lead to preeclampsia. The long noncoding RNA SPRY4-IT1 is more highly expressed in preeclamptic human placentas than in normal placentas. We assessed the role of epithelial-mesenchymal transition (EMT)-associated invasion and migration in HTR-8/SVneo trophoblast cells...
November 17, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27836897/positive-versus-negative-effects-of-vegf165-on-ca2-signaling-and-no-production-in-human-endothelial-cells
#10
Derek S Boeldt, Jennifer Krupp, Fu-Xian Yi, Nauman Khurshid, Dinesh M Shah, Ian M Bird
The role increased vascular endothelial growth factor (VEGF) plays in vascular function during normal vs preeclamptic pregnancy has been a source of some controversy of late. In this study we seek to understand how VEGF165 influences vasodilator production via Ca(2+) signaling mechanisms in human endothelial cells. We utilize human umbilical vein endothelial cells (HUVEC) as well as intact ex vivo human umbilical vein (HUV Endo) to address direct stimulation of Ca(2+) and NO by VEGF165 alone, as well as the effect of VEGF165 on subsequent ATP-stimulated Ca(2+) signaling and NO production...
November 11, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27821757/nicotinamide-benefits-both-mothers-and-pups-in-two-contrasting-mouse-models-of-preeclampsia
#11
Feng Li, Tomofumi Fushima, Gen Oyanagi, H W Davin Townley-Tilson, Emiko Sato, Hironobu Nakada, Yuji Oe, John R Hagaman, Jennifer Wilder, Manyu Li, Akiyo Sekimoto, Daisuke Saigusa, Hiroshi Sato, Sadayoshi Ito, J Charles Jennette, Nobuyo Maeda, S Ananth Karumanchi, Oliver Smithies, Nobuyuki Takahashi
Preeclampsia (PE) complicates ∼5% of human pregnancies and is one of the leading causes of pregnancy-related maternal deaths. The only definitive treatment, induced delivery, invariably results in prematurity, and in severe early-onset cases may lead to fetal death. Many currently available antihypertensive drugs are teratogenic and therefore precluded from use. Nonteratogenic antihypertensives help control maternal blood pressure in PE, but results in preventing preterm delivery and correcting fetal growth restriction (FGR) that also occurs in PE have been disappointing...
November 22, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27817049/overexpression-of-endogenous-anti-oxidants-with-selenium-supplementation-protects-trophoblast-cells-from-reactive-oxygen-species-induced-apoptosis-in-a-bcl-2-dependent-manner
#12
Alisha Khera, Jessica J Vanderlelie, Olivia Holland, Anthony V Perkins
The human placenta provides life support for the developing foetus, and a healthy placenta is a prerequisite to a healthy start to life. Placental tissue is subject to oxidative stress which can lead to pathological conditions of pregnancy such as preeclampsia, preterm labour and intrauterine growth restriction. Up-regulation of endogenous anti-oxidants may alleviate placental oxidative stress and provide a therapy for these complications of pregnancy. In this study, selenium supplementation, as inorganic sodium selenite (NaSel) or organic selenomethionine (SeMet), was used to increase the protein production and cellular activity of the important redox active proteins glutathione peroxidase (GPx) and thioredoxin reductase (Thx-Red)...
November 5, 2016: Biological Trace Element Research
https://www.readbyqxmd.com/read/27810551/antiplatelet-therapy-before-or-after-16-weeks-gestation-for-preventing-preeclampsia-an-individual-participant-data-meta-analysis
#13
REVIEW
Shireen Meher, Lelia Duley, Kylie Hunter, Lisa Askie
BACKGROUND: The optimum time for commencing antiplatelet therapy for the prevention of preeclampsia and its complications is unclear. Aggregate data meta-analyses suggest that aspirin is more effective if given prior to 16 weeks' gestation, but data are limited because of an inability to place women in the correct gestational age subgroup from relevant trials. OBJECTIVE: The objective of the study was to use the large existing individual participant data set from the Perinatal Antiplatelet Review of International Studies Collaboration to assess whether the treatment effects of antiplatelet agents on preeclampsia and its complications vary based on whether treatment is started before or after 16 weeks' gestation...
November 1, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27809797/the-usefulness-of-cyfra-21-1-to-diagnose-and-predict-preeclampsia-a-nested-case-control-study
#14
Lorenz Kuessel, Harald Zeisler, Robin Ristl, Julia Binder, Petra Pateisky, Maximilian Schmid, Julian Marschalek, Thomas Perkmann, Helmuth Haslacher, Heinrich Husslein
BACKGROUND: The ability to identify patients at risk for developing preeclampsia is important for preventing morbidity and mortality in both the mother and child. Although CYFRA 21-1 (a fragment of Cytokeratin 19) is considered a promising biomarker for diagnosing preeclampsia, little is known regarding the levels of CYFRA 21-1 during pregnancy. Here, we measured serum CYFRA 21-1 levels in women with an uneventful pregnancy and in women whose pregnancy was complicated by preeclampsia...
November 3, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27789293/molecular-hydrogen-ameliorates-several-characteristics-of-preeclampsia-in-the-reduced-uterine-perfusion-pressure-rupp-rat-model
#15
Takafumi Ushida, Tomomi Kotani, Hiroyuki Tsuda, Kenji Imai, Tomoko Nakano, Shima Hirako, Yumiko Ito, Hua Li, Yukio Mano, Jingwen Wang, Rika Miki, Eiko Yamamoto, Akira Iwase, Yasuko K Bando, Masaaki Hirayama, Kinji Ohno, Shinya Toyokuni, Fumitaka Kikkawa
Oxidative stress plays an important role in the pathogenesis of preeclampsia. Recently, molecular hydrogen (H2) has been shown to have therapeutic potential in various oxidative stress-related diseases. The aim of this study is to investigate the effect of H2 on preeclampsia. We used the reduced utero-placental perfusion pressure (RUPP) rat model, which has been widely used as a model of preeclampsia. H2 water (HW) was administered orally ad libitum in RUPP rats from gestational day (GD) 12 to 19, starting 2 days before RUPP procedure...
October 24, 2016: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/27754163/sy-11-3-hypertension-in-women-more-dangerous-than-in-men
#16
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27751879/can-preeclampsia-be-considered-a-renal-compartment-syndrome-a-hypothesis-and-analysis-of-the-literature
#17
David G Reuter, Yuk Law, Wayne C Levy, Stephen P Seslar, R Eugene Zierler, Mark Ferguson, James Chattra, Tim McQuinn, Lenna L Liu, Mark Terry, Patricia S Coffey, Jane A Dimer, Coral Hanevold, Joseph T Flynn, F Bruder Stapleton
The morbidity and mortality associated with preeclampsia is staggering. The physiology of the Page kidney, a condition in which increased intrarenal pressure causes hypertension, appears to provide a unifying framework to explain the complex pathophysiology. Page kidney hypertension is renin-mediated acutely and ischemia-mediated chronically. Renal venous outflow obstruction also causes a Page kidney phenomenon, providing a hypothesis for the increased vulnerability of a subset of women who have what we are hypothesizing is a "renal compartment syndrome" due to inadequate ipsilateral collateral renal venous circulation consistent with well-known variation in normal venous anatomy...
September 15, 2016: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/27750048/low-dose-acetylsalicylic-acid-treatment-modulates-the-production-of-cytokines-and-improves-trophoblast-function-in-an-in%C3%A2-vitro-model-of-early-onset-preeclampsia
#18
Shanika Panagodage, Hannah E Juen Yong, Fabricio Da Silva Costa, Anthony J Borg, Bill Kalionis, Shaun P Brennecke, Padma Murthi
Preeclampsia (PE), a serious hypertensive disorder of pregnancy, remains a leading cause of perinatal morbidity and mortality worldwide. Perturbed trophoblast function and impaired placental development early in pregnancy are key features. Low-dose acetylsalicylic acid (LDA) administered before 16 weeks' gestation significantly reduces the risk for PE. However, the exact mechanisms of action of LDA, particularly on trophoblast function, are unclear. We hypothesized that LDA influences placental trophoblast function and reverses PE-associated abnormalities...
October 14, 2016: American Journal of Pathology
https://www.readbyqxmd.com/read/27747919/the-impact-of-small-for-gestational-age-births-in-early-and-late-preeclamptic-pregnancies-for-preeclampsia-recurrence-a-cohort-study-of-successive-pregnancies-in-sweden
#19
Sven Cnattingius, Anna-Karin Wikström, Olof Stephansson, Kari Johansson
BACKGROUND: Results from uterine artery Doppler investigations suggest that the aetiology of late preeclampsia with fetal growth restriction may be more similar to the aetiology of early preeclampsia than with late preeclampsia without fetal growth restriction. We hypothesised that a small-for-gestational-age (SGA) birth in a late preeclamptic pregnancy may be associated with increased subsequent risk of early preeclampsia. We also studied effects of maternal factors on risks of preeclampsia recurrence...
November 2016: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/27744389/invited-commentary-hypertension-during-pregnancy-and-offspring-microvascular-structure-insights-from-the-retinal-microcirculation
#20
Odaro Huckstep, Adam J Lewandowski, Paul Leeson
Human clinical studies as well as laboratory animal studies demonstrate that offspring of pregnancies affected by common complications, such as preeclampsia and preterm birth, display developmental phenotypes that relate distinctly to the pregnancy disorder. Several studies have now found microvascular differences in offspring of hypertensive pregnancies, and there is interest in whether these may underlie epidemiologic associations between gestational hypertension and a higher risk of hypertension and stroke in the offspring...
October 15, 2016: American Journal of Epidemiology
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