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diagnostic hypertension in pregnancy

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https://www.readbyqxmd.com/read/29150149/pregnancy-and-heart-disease-pregnancy-associated-hypertension-and-peripartum-cardiomyopathy
#1
Tobias Jonathan Pfeffer, Denise Hilfiker-Kleiner
Cardiovascular diseases are major complications in pregnancy worldwide and the number of patients who develop cardiac problems during pregnancy is increasing. Pregnancy-associated hypertensive complications such as pre-eclampsia (PE) or peripartum cardiomyopathy (PPCM) are potentially life-threatening heart diseases emerging during pregnancy, under delivery or in the first postpartal months in previously healthy women. Both disease entities display substantial morbidity and mortality in the acute phase. Long-term effects are just beginning to be evaluated...
October 31, 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29130350/podocyturia-as-an-early-diagnostic-marker-of-preeclampsia-a-literature-review
#2
Karolina Panek-Laszczyńska, Andrzej Konieczny, Ewa Milewska, Krystyna Dąbrowska, Remigiusz Bąchor, Wojciech Witkiewicz, Zbigniew Szewczuk
CONTEXT: Preeclampsia (PE) is a pregnancy-related disease, and it is a leading cause of maternal and neonatal morbidity and mortality. It is characterized by the new onset of hypertension after 20 weeks of gestation together with signs of organ damage, most commonly the kidneys. The treatment of PE is symptomatic and final intervention requires delivery, regardless of the gestational age of the foetus. Furthermore, PE is a risk factor for developing cardiovascular disease and chronic kidney disease - even many years after the delivery...
November 13, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#3
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy (HDP) is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in HDP considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVES: This study aimed to examine cardiovascular parameters in a cohort of patients affected by HDP according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of HDP...
November 1, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29080868/-features-of-the-urine-peptidome-under-the-condition-of-hypertensive-pathologies-of-pregnancy
#4
V A Sergeeva, K T Muminova, N L Starodubtseva, A S Kononikhin, A E Bugrova, M I Indeykina, V V Baibakova, Z S Khodzhaeva, N E Kan, V E Frankevich, R G Shmakov, E N Nikolaev, G T Sukhikh
In order to find a peptide panel to differentiate close hypertensive conditions a case-control study was designed for 64 women from 4 groups: preeclampsia (PE), chronic hypertension superimposed with PE, chronic hypertension, and healthy individuals. Chromatography coupled with mass-spectrometry and subsequent bioinformatic analysis showed several patterns in the changes of the urine peptidome. There were 36 peptides common for four groups. Twenty two of them 22 belonged to alpha-1-chain of collagen I, nine peptides were from alpha-1-chain of collagen III, two from alpha-2-chain of collagen I, one from alpha-1/2-chain of collagen I, one from alpha-1-chain of collagen I/XVIII and one from uromodulin...
October 2017: Biomedit︠s︡inskai︠a︡ Khimii︠a︡
https://www.readbyqxmd.com/read/29064366/spot-protein-creatinine-ratio-and-spot-albumin-creatinine-ratio-in-the-assessment-of-pre-eclampsia-a-diagnostic-accuracy-study-with-decision-analytic-model-based-economic-evaluation-and-acceptability-analysis
#5
Jason Waugh, Richard Hooper, Edmund Lamb, Stephen Robson, Andrew Shennan, Fiona Milne, Christopher Price, Shakila Thangaratinam, Vladislav Berdunov, Jenn Bingham
BACKGROUND: The National Institute for Health and Care Excellence (NICE) guidelines highlighted the need for 'large, high-quality prospective studies comparing the various methods of measuring proteinuria in women with new-onset hypertensive disorders during pregnancy'. OBJECTIVES: The primary objective was to evaluate quantitative assessments of spot protein-creatinine ratio (SPCR) and spot albumin-creatinine ratio (SACR) in predicting severe pre-eclampsia (PE) compared with 24-hour urine protein measurement...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29052046/headache-and-pregnancy-a-systematic-review
#6
A Negro, Z Delaruelle, T A Ivanova, S Khan, R Ornello, B Raffaelli, A Terrin, U Reuter, D D Mitsikostas
This systematic review summarizes the existing data on headache and pregnancy with a scope on clinical headache phenotypes, treatment of headaches in pregnancy and effects of headache medications on the child during pregnancy and breastfeeding, headache related complications, and diagnostics of headache in pregnancy. Headache during pregnancy can be both primary and secondary, and in the last case can be a symptom of a life-threatening condition. The most common secondary headaches are stroke, cerebral venous thrombosis, subarachnoid hemorrhage, pituitary tumor, choriocarcinoma, eclampsia, preeclampsia, idiopathic intracranial hypertension, and reversible cerebral vasoconstriction syndrome...
October 19, 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/29035901/ce-preeclampsia-current-approaches-to-nursing-management
#7
REVIEW
Cindy M Anderson, Mandy J Schmella
: Preeclampsia, one of four hypertensive disorders of pregnancy, has traditionally been characterized as new-onset hypertension and proteinuria developing after 20 weeks' gestation. It is, however, now understood to be a complex, progressive, multisystem disorder with a highly variable presentation and a number of potentially life-threatening complications. The American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy has refined preeclampsia diagnostic criteria accordingly, and as the disorder's pathogenesis has been more clearly defined, new targets for screening, diagnosis, prevention, and treatment have emerged...
November 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/29033611/stable-ischemic-heart-disease-in-women-current-perspectives
#8
REVIEW
Fatima Samad, Anushree Agarwal, Zainab Samad
Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD) in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] >25 kg/m(2)), smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28987249/significance-of-serum-uric-acid-in-pregnancy-induced-hypertension
#9
Apeksha Niraula, Madhab Lamsal, Shankar Majhi, Seraj Ahmed Khan, Pritha Basnet
BACKGROUND AND OBJECTIVE: Hypertension is one of the common medical complications of pregnancy and contributes significantly to maternal and perinatal morbidity and mortality. Uric acid (UA) is filtered, reabsorbed and secreted by the kidney. Thus, this study was conducted to assess the serum UA levels in PIH and to evaluate the diagnostic value of serum UA level in PIH. MATERIALS AND METHODS: This is a hospital based comparative cross-sectional study conducted in BPKIHS...
2017: Journal of the National Medical Association
https://www.readbyqxmd.com/read/28948451/a-diagnostic-approach-to-stroke-in-young-adults
#10
REVIEW
Christopher A Stack, John W Cole
Optimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the "standard" vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask is why did this patient have a stroke? A "heart to head" diagnostic approach is recommended...
September 25, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28924318/pre-eclampsia-molecular-events-to-biomarkers
#11
REVIEW
Kavita Sahai, Seema Saraswathy, Tribhuvan Pal Yadav, Devendra Arora, Manu Krishnan
Pre-eclampsia is a hypertensive disorder in pregnancy, which accounts for 10-15% of the maternal and perinatal mortality worldwide. Abnormal placental development and tissue hypoxia are its main etiologic factors. The present diagnostic methods of blood pressure monitoring and renal function evaluation are insufficient in the early detection of pre-eclampsia. Since molecular events portent well ahead of the disease onset, biomarker research for the early diagnosis of pre-eclampsia has recently generated ambitious clinical targets...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28903165/association-of-panic-disorder-generalized-anxiety-disorder-and-benzodiazepine-treatment-during-pregnancy-with-risk-of-adverse-birth-outcomes
#12
Kimberly Ann Yonkers, Kathryn Gilstad-Hayden, Ariadna Forray, Heather S Lipkind
Importance: Registry data show that maternal panic disorder, or anxiety disorders in general, increase the risk for adverse pregnancy outcomes. However, diagnoses from registries may be imprecise and may not consider potential confounding factors, such as treatment with medication and maternal substance use. Objective: To determine whether panic disorder or generalized anxiety disorder (GAD) in pregnancy, or medications used to treat these conditions, are associated with adverse maternal or neonatal pregnancy outcomes...
November 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28820409/-the-role-of-angiogenic-factors-in-the-diagnostics-of-pregnancy-complicated-with-preeclampsia
#13
I Tagiyeva, S Aliyeva, S Bagirova, N Shamsadinskaya, K Agaeva
The pathophysiology of preeclampsia remains largely unknown. It has been hypothesized that placental ischemia is an early event, leading to placental production of a soluble factor or factors that cause maternal endothelial dysfunction, resulting in the clinical findings of hypertension, proteinuria, and edema. Here, we confirm that placental soluble fms-like tyrosine kinase 1 (sFlt1), an antagonist of vascular growth factor (VEGF) and placental growth factor (PIGF), is upregulated in preeclampsia, leading to increased systemic levels of sFlt1...
July 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28816365/hypertensive-disorders-in-pregnancy-and-the-risk-of-subsequent-cardiovascular-disease
#14
Sonia M Grandi, Karine Vallée-Pouliot, Pauline Reynier, Maria Eberg, Robert W Platt, Roxane Arel, Olga Basso, Kristian B Filion
BACKGROUND: Hypertensive disorders in pregnancy (HDP) have been shown to predict later risk of cardiovascular disease (CVD). However, previous studies have not accounted for subsequent pregnancies and their complications, which are potential confounders and intermediates of this association. METHODS: A cohort of 146 748 women with a first pregnancy was constructed using the Clinical Practice Research Datalink. HDP was defined using diagnostic codes, elevated blood pressure readings, or new use of an anti-hypertensive drug between 18 weeks' gestation and 6 weeks post-partum...
August 17, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28793129/clinical-characteristics-of-women-with-gestational-diabetes-comparison-of-two-cohorts-enrolled-20-years-apart-in-southern-brazil
#15
COMPARATIVE STUDY
Angela Jacob Reichelt, Letícia Schwerz Weinert, Livia Silveira Mastella, Vanessa Gnielka, Maria Amélia Campos, Vânia Naomi Hirakata, Maria Lúcia Rocha Oppermann, Sandra Pinho Silveiro, Maria Inês Schmidt
CONTEXT AND OBJECTIVE: The prevalence and characteristics of gestational diabetes mellitus (GDM) have changed over time, reflecting the nutritional transition and changes in diagnostic criteria. We aimed to evaluate characteristics of women with GDM over a 20-year interval. DESIGN AND SETTING: Comparison of two pregnancy cohorts enrolled in different periods, in university hospitals in Porto Alegre, Brazil: 1991 to 1993 (n = 216); and 2009 to 2013 (n = 375). METHODS: We applied two diagnostic criteria to the cohorts: International Association of Diabetes and Pregnancy Study Groups (IADPSG)/World Health Organization (WHO); and National Institute for Health and Care Excellence (NICE)...
July 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28791264/prediction-of-pregnancy-complication-occurrence-using-fetal-cardiac-output-assessments-made-by-ultrasonography-at-20-to-24-weeks-of-gestation
#16
Ji Yeon Lee, Young Li Kim, Ji Eun Jeong, Jun Woo Ahn
OBJECTIVE: To evaluate the importance of assessment of fetal cardiac output (CO) for the prediction of complications of pregnancy. METHODS: We evaluated 65 fetuses and all of them had a fetal cardiac scan at 20 to 24 weeks of pregnancy. To measure CO, diameters (d) of the left right ventricle outflow tract were measured just above the valves. Each left CO (LCO) and right CO (RCO) was derived using the following equation: CO = velocity time integral × π × d(2)/4 × heart rate...
July 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28781906/cystatin-c-as-a-marker-for-renal-impairment-in-preeclampsia
#17
Apeksha Niraula, Madhab Lamsal, Nirmal Baral, Shankar Majhi, Seraj Ahmed Khan, Pritha Basnet, Kashyap Dahal
Preeclampsia is a devastating pregnancy-associated disorder characterized by the onset of hypertension, proteinuria, and edema with limited plausible pathophysiology known. Cystatin-C, a novel marker for the detection of renal impairment, is increased in preeclampsia at an early stage. This study was aimed to evaluate the diagnostic efficiency of Cystatin-C as an early marker of renal function in preeclampsia comparing it to the traditional renal markers. A hospital based comparative cross-sectional study was performed on 104 women (52 diagnosed cases of preeclampsia and 52 healthy pregnant women)...
2017: Journal of Biomarkers
https://www.readbyqxmd.com/read/28752697/clinical-features-of-pregnancy-associated-retinal-and-choroidal-diseases-causing-acute-visual-disturbance
#18
Young Joo Park, Kyu Hyung Park, Se Joon Woo
PURPOSE: To report clinical features of patients with retinal and choroidal diseases presenting with acute visual disturbance during pregnancy. METHODS: In this retrospective case series, patients who developed acute visual loss during pregnancy (including puerperium) and visited a tertiary hospital from July 2007 to June 2015, were recruited by searching electronic medical records. Patients were categorized according to the cause of visual loss. Clinical features and required diagnostic modalities were analyzed in the retinal and choroidal disease group...
August 2017: Korean Journal of Ophthalmology: KJO
https://www.readbyqxmd.com/read/28711073/lupus-nephritis-and-pregnancy-concerns-and-management
#19
Liz Lightstone, Michelle A Hladunewich
Pregnancy associated with lupus, especially lupus nephritis, is often fraught with concern for both the mother and fetus. Thus, it is paramount that care begins preconception so that proper planning in terms of optimizing the medical regimen, discontinuation of fetotoxic agents, and treatment of active disease can occur. It is well known that active nephritis at the time of conception is associated with poor outcomes. Even with quiescent disease, recent data indicate that being lupus anticoagulant-positive, nonwhite or Hispanic, and using antihypertensive medications were all predictors of worse pregnancy outcomes...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28672944/effective-prediction-of-preeclampsia-by-measuring-serum-angiotensin-ii-urinary-angiotensinogen-and-urinary-transforming-growth-factor-%C3%AE-1
#20
Lihong Zhang, Yunjiao Zhou, Qing Wu, Weifeng Fan, Jun Ye, Yaping Chen, Yun Wu, Jianying Niu, Yong Gu
The aim of the current study was to analyze serum angiotensin II (Ang II), urinary angiotensinogen (AGT) and urinary transforming growth factor β1 (TGFβ1) levels in relation to the clinical manifestation of preeclampsia, and to explore the effects of circulating and renal renin angiotensin system (RAS) in preeclampsia patients. An enzyme-linked immunosorbent assay was used to evaluate serum Ang II, urinary AGT and urinary TGFβ1 in preeclampsia, pregnancy-induced hypertension and normotensive pregnancy patients...
July 2017: Experimental and Therapeutic Medicine
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