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diagnostic hypertension in pregnancy

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https://www.readbyqxmd.com/read/28197344/from-bad-to-worse-paraganglioma-diagnosis-during-induction-of-labor-for-coexisting-preeclampsia
#1
Sasima Dusitkasem, Blair H Herndon, Dalton Paluzzi, Joseph Kuhn, Robert H Small, John C Coffman
Pheochromocytomas and extra-adrenal paragangliomas are catecholamine-secreting tumors that rarely occur in pregnancy. The diagnosis of these tumors in pregnancy can be challenging given that many of the signs and symptoms are commonly attributed to preeclampsia or other more common diagnoses. Early diagnosis and appropriate management are essential in optimizing maternal and fetal outcomes. We report a rare case of a catecholamine-secreting tumor in which diagnosis occurring at the time labor was being induced for concomitant preeclampsia with severe features...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28151819/epidemiology-of-cardiac-arrest-during-hospitalization-for-delivery-in-canada-a-nationwide-study
#2
Mrinalini Balki, Shiliang Liu, Juan Andrés León, Leyla Baghirzada
BACKGROUND: Cardiac arrest in pregnancy is a rare and devastating condition with high mortality and morbidity. The objective of this study was to generate information about maternal cardiac arrest in Canada by examining the frequency, temporal incidence, associated conditions, potential etiologies, and survival rates. METHODS: This retrospective population-based study used hospitalization data from the discharge abstract database of the Canadian Institute for Health Information relating to obstetric deliveries in Canada from April 1, 2002, to March 31, 2015...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28120427/oral-anti-diabetic-pharmacological-therapies-for-the-treatment-of-women-with-gestational-diabetes
#3
REVIEW
Julie Brown, Ruth Martis, Brenda Hughes, Janet Rowan, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is a major public health issue with rates increasing globally. Gestational diabetes, glucose intolerance first recognised during pregnancy, usually resolves after birth and is associated with short- and long-term complications for the mother and her infant. Treatment options can include oral anti-diabetic pharmacological therapies. OBJECTIVES: To evaluate the effects of oral anti-diabetic pharmacological therapies for treating women with GDM...
January 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28076672/prenatal-psychostimulant-and-antidepressant-exposure-and-risk-of-hypertensive-disorders-of-pregnancy
#4
D Jeffrey Newport, Amy L Hostetter, Sarah H Juul, Sunny M Porterfield, Bettina T Knight, Zachary N Stowe
OBJECTIVE: To investigate the association, if any, of prenatal mental illness and psychotropic exposure with the risk of hypertensive disorders of pregnancy (HDP). METHODS: A case-cohort analysis was conducted of 686 pregnant women participating in prospective, longitudinal observational studies in a tertiary referral center between January 1998 and May 2012. Risk estimates were produced using multivariate logistic regression modeling. Medication- and diagnosis-specific data were utilized to conduct post hoc confirmatory analyses of the risk estimates...
November 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28059847/angiogenic-and-antiangiogenic-markers-for-prediction-and-risk-classification-of-preeclampsia
#5
Amol K Malshe, Baha M Sibai
Preeclampsia is a pregnancy-specific hypertensive disorder with multisystem involvement and is a significant cause of obstetric morbidity and mortality worldwide. A major issue in the treatment of preeclampsia stems from its still significant rates of misclassification and misdiagnosis. Angiogenic factors have been speculated as a possible diagnostic modality due to a perceived imbalance in angiogenesis in preeclampsia. Factors currently studied include soluble fms-like protein kinase 1 and placental growth factor...
March 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28044196/maternal-fasting-glycemia-and-adverse-pregnancy-outcomes-in-a-mediterranean-population
#6
G Sesmilo, E Meler, V Perea, I Rodríguez, A Rodríguez-Melcón, M Guerrero, B Serra
AIMS: The hyperglycemia and adverse pregnancy outcome study demonstrated a continuous association between fasting plasma glucose (FPG) levels below those diagnostic of diabetes and adverse neonatal outcomes. We aimed to investigate whether the same association was found in a Mediterranean population. METHODS: A retrospective analysis of singleton pregnancies attended at our Hospital between 2008 and 2015 (n = 5203). FPG was evaluated in the second trimester, and it was divided into 7 categories (1 < 75, 2 75-79, 3 80-84, 4 85-89, 5 90-94, 6 95-99 and 7 100-124 mg/dL)...
January 3, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28005588/chronic-hypertension-in-pregnancy-diagnosis-management-and-outcomes
#7
Nana-Ama E Ankumah, Baha M Sibai
Chronic hypertension affects up to 5% of pregnancies. Women can be stratified into low-risk or high-risk chronic hypertension based on baseline laboratory and diagnostic work-up, comorbid conditions, and outcomes in prior pregnancies. Pregnancies complicated by chronic hypertension are at risk for increased adverse maternal and neonatal outcomes including superimposed preeclampsia, fetal growth restriction, placental abruption, and perinatal death. Mainstays of management include blood pressure control, close monitoring for development of superimposed preeclampsia, serial ultrasound assessment of fetal growth, and antenatal testing after 32 weeks...
March 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27990322/recent-advances-and-controversies-in-peripartum-depression
#8
Jennifer L Payne
PURPOSE OF REVIEW: The purpose of this review is to update readers on recent controversies and findings on the underlying biology and clinical management of peripartum depression. RECENT FINDINGS: Topics discussed include the discovery and replication of two epigenetic biomarkers of peripartum depression, two well controlled studies that do NOT find associations between in utero antidepressant exposure and cardiac defects and persistent pulmonary hypertension of the newborn and ongoing controversy on whether antidepressant use during pregnancy prevents peripartum depression and whether or not hormonal treatments have a place in the management of postpartum depression...
September 2016: Current Obstetrics and Gynecology Reports
https://www.readbyqxmd.com/read/27939492/prevalence-of-pregnancy-hypertensive-disorders-in-mongolia
#9
Nathalie E Marchand, Ganmaa Davaasambuu, Thomas F McElrath, Enkhmaa Davaasambuu, Tsedmaa Baatar, Rebecca Troisi
OBJECTIVE: To estimate the prevalence of preeclampsia in a contemporary population of Mongolian women living in urban and rural areas. We determined the sensitivity and specificity of diagnosis based on established diagnostic criteria and assessed whether local diagnostic criteria were similar to those used in the US. STUDY DESIGN: Cross-sectional study of urban and nomadic pregnant women recruited in Ulaanbaatar (n=136) and rural provinces (n=85). MAIN OUTCOME MEASURES: Preeclampsia defined as hypertension new to pregnancy after 20weeks and proteinuria (or protein creatinine ratio ⩾0...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27882748/-application-of-the-concetrations-ratio-of-soluble-receptor-tyrosine-kinase-type-1-and-placental-growth-factor-for-short-term-prediction-and-diagnosis-of-preeclampsia
#10
Š Bubeníková, A Cíchová, L Roubalová, V Durdová, R Vlk
OBJECTIVE: Bring a comprehensive overview of the available information about applications of the concetration ratio of soluble receptor tyrosine kinase type 1 (sFlt-1), and placental growth factor for short-term prediction and diagnosis of preeclampsia. DESIGN: Overview study. SETTINGS: Department of Midwifery, Faculty of Health Sciences, Olomouc; Department of Clinical Biochemistry, University Hospital Olomouc; Department of Obstetrics and Gynecology, University Hospital Olomouc; Department of Obstetrics and Gynecology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27766045/clinical-evaluation-of-thrombotic-microangiopathy-identification-of-patients-with-suspected-atypical-hemolytic-uremic-syndrome
#11
REVIEW
Yu-Min Shen
Atypical hemolytic uremic syndrome (aHUS) is a rare genetic disorder caused by defective complement regulation resulting in thrombotic microangiopathy (TMA). Patients can present as children or adults. The syndrome consists of hemolytic anemia with schistocytosis, thrombocytopenia, significant renal damage, and/or other organ system dysfunction(s). Patients with aHUS may succumb to the complications of the disease with the very first manifestation; surviving patients often suffer from progressive organ dysfunction with significant morbidity and mortality despite plasma infusion or plasma exchange...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27753020/characterization-of-human-pregnancy-specific-glycoprotein-psg-gene-copy-number-variations-in-pre-eclampsia-patients
#12
Chia Lin Chang, Chia Yu Chang, Da Xian Lee, Po Jen Cheng
Pre-eclampsia is a pregnancy-specific hypertensive disorder that affects 2-8 % of pregnancies. This disorder can lead to seizure, multi-organ failure and maternal death. The best approach to prevent pre-eclampsia-associated adverse outcomes is to be able to prevent pre-eclampsia as early as possible. Unfortunately, current diagnostic methods are ineffective at predicting the risk of pre-eclampsia during early pregnancy. In humans, low levels of a group of placenta-derived Pregnancy Specific Glycoproteins (PSGs) have been associated with intrauterine growth retardation and pre-eclampsia and there is a significant enrichment of cases with deletions in the PSG gene locus in pre-eclampsia patients...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27707553/preeclampsia-and-esrd-the-role-of-shared-risk-factors
#13
Andrea G Kattah, Dawn C Scantlebury, Sanket Agarwal, Michelle M Mielke, Walter A Rocca, Amy L Weaver, Lisa E Vaughan, Virginia M Miller, Tracey L Weissgerber, Wendy White, Vesna D Garovic
BACKGROUND: Several registry-based studies, using diagnostic codes, have suggested that preeclampsia is a risk factor for end-stage renal disease (ESRD). However, because the 2 diseases share risk factors, the true nature of their association remains uncertain. Our goals were to conduct a population-based study to determine the magnitude of the association between preeclampsia and ESRD and evaluate the role of shared risk factors. STUDY DESIGN: Population-based nested case-control study...
October 1, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27686495/coexisting-giant-splenic-artery-and-portal-vein-aneurysms-leading-to-non-cirrhotic-portal-hypertension-a-case-report
#14
Abidullah Khan, Maimoona Ayub, Iqbal Haider, Mohammad Humayun, Zakir Shah, Fahad Ajmal
BACKGROUND: Splenic artery aneurysms are the commonest visceral and third most common abdominal artery aneurysms, having a strong association with both pregnancy and multiparity. Here we report possibly the first case of a giant splenic artery aneurysm in association with a smaller portal vein aneurysm, in a woman who had never conceived, leading to non-cirrhotic portal hypertension. CASE PRESENTATION: A 40-year-old Pakistani Asian woman who had no evidence of liver cirrhosis presented in April 2016 for a diagnostic workup of ascites, massive splenomegaly, and pancytopenia...
September 29, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27685993/prenatal-clinical-assessment-of-nt-probnp-as-a-diagnostic-tool-for-preeclampsia-gestational-hypertension-and-gestational-diabetes-mellitus
#15
Pawel Sadlecki, Marek Grabiec, Malgorzata Walentowicz-Sadlecka
Common complications of pregnancy include preeclampsia (PE), gestational hypertension (GH) and gestational diabetes mellitus (GDM). Hypertensive disorders (PE/GH) and GDM may result in greater maternal, fetal and neonatal morbidity and mortality. Women with PE/GH, one of the most common causes of heart burden in an obstetrical setting, present with elevated serum levels of BNP and NT-proBNP. The aim of this study was to shed more light on the role of NT-proBNP in pathophysiology of PE, GH and GDM. The study included 156 pregnant women with singleton pregnancies...
2016: PloS One
https://www.readbyqxmd.com/read/27680806/e5-lung-ultrasound-and-echocardiography-for-peripartum-haemodynamic-monitoring-of-patients-with-severe-preeclampsia
#16
J Ambrozic, K Prokselj, M Lucovnik
INTRODUCTION: The ability to judge intravascular volume is fundamental in the management of patients with severe preeclampsia. Insufficient intravascular volume can result in decreased oxygen delivery to tissues and exacerbates organ dysfunction. On the other hand, fluid excesses can lead to fluid extravasation and pulmonary edema. Outside of pregnancy, transthoracic echocardiography and lung ultrasonography have become important diagnostic and monitoring tools in critically ill patients...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27680796/c5-preeclampsia-in-twin-pregnancies
#17
Ogochukwu Chantelle Umadia, Dimuthu Vinayagam, Juan Gutierrez Henares, Asma Khalil
AIM: To identify the independent risk factors for PE development in twin pregnancies and explore the associated perinatal outcomes. METHODS: A retrospective cohort study of twin pregnancies was performed at St George's University Hospital, London. Maternal and neonatal data were obtained from the hospital's computerised database. The Chi-square test, Mann-Whitney U test and univariate and multiple-logistic regression analyses were performed. RESULTS: We identified a total of 1250 twin pregnancies who were under the care of SGH from 1999 to 2015...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27651585/calcium-to-creatinine-ratio-in-a-spot-sample-of-urine-for-early-prediction-of-hypertensive-disorders-of-pregnancy-a-prospective-study
#18
Anita David, P Padmaja
BACKGROUND: Hypertensive disorders complicate 5-10 % of all pregnancies. Various methods for screening have been studied to identify pregnant women at risk of development of preeclampsia, but no ideal screening test has been identified so far. The objective of this study was to determine the efficacy of urinary calcium-to-creatinine ratio, in a spot urine sample, for the prediction of preeclampsia in asymptomatic pregnant women between 18 and 24 weeks of gestation. METHODS: This study was done on 112 patients presenting to the antenatal clinic in the Department of Obstetrics and Gynecology at Bangalore Baptist Hospital...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27638415/maternal-circulating-micrornas-and-pre-eclampsia-challenges-for-diagnostic-potential
#19
REVIEW
Malia S Q Murphy, Chandrakant Tayade, Graeme N Smith
Pre-eclampsia (PE) is a common hypertensive disorder of pregnancy with a significant impact on maternal and neonatal mortality and morbidity. While the pathogenesis of PE has been well described, identification of a biomarker(s) with robust predictive utility in identifying women at the highest risk of developing the condition has yet to be identified. In the search for diagnostic markers, those that may be obtained from the circulation are preferred alternatives to those derived from organ tissue samples. Because of their stability in plasma, microRNAs (miRNAs) have been explored as biomarkers in a host of disease states, although there is comparably little literature available on the circulating miRNAome of PE...
September 16, 2016: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/27606778/pregnancy-outcomes-in-women-with-preeclampsia-superimposed-on-chronic-hypertension-with-and-without-severe-features
#20
Hind N Moussa, Mateo G Leon, Ana Marti, Alissar Chediak, Claudia Pedroza, Sean C Blackwell, Baha M Sibai
Objective The American Congress of Obstetricians and Gynecologists (ACOG) task force on hypertension in pregnancy introduced a new definition of superimposed preeclampsia (SIP) adding severe features (SF) as new criteria to define severe disease. They also recommended that those with SIP be delivered ≥ 37 weeks, whereas those with SF be delivered ≤ 34 weeks. Our aim was to investigate the validity of this new definition by comparing adverse pregnancy outcomes in SIP with (SIP-SF) and without SF (SIP)...
September 8, 2016: American Journal of Perinatology
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