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diagnostic hypertension in pregnancy

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
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
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
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
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
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
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
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
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
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
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
Jyotsna Verma, Divya C Thomas, Geetu Jhingan, Ratna D Puri, I C Verma
OBJECTIVE: To determine the diagnostic accuracy of preeclampsia (PE) screening test offered in early pregnancy for the prediction of the risks for early-onset (requiring delivery <32 weeks gestation) and late-onset (requiring delivery ≥32 weeks gestation) disease. METHODS: In a retrospective study of 615 women with singleton pregnancy, the risk for PE was calculated by the combined effect of multiple variables: serum placental growth factor (PLGF) and pregnancy-associated plasma protein-A (PAPP-A), maternal age, parity, ethnicity, mean arterial pressure (MAP), body mass index (BMI), uterine artery-pulsatility index, and previous history of PE or hypertension (HT)...
September 6, 2016: Hypertension in Pregnancy
Sarwat I Gilani, Tracey L Weissgerber, Vesna D Garovic, Muthuvel Jayachandran
Preeclampsia is a hypertensive pregnancy disorder characterized by development of hypertension and proteinuria after 20 weeks of gestation that remains a leading cause of maternal and neonatal morbidity and mortality. While preeclampsia is believed to result from complex interactions between maternal and placental factors, the proximate pathophysiology of this syndrome remains elusive. Cell-to-cell communication is a critical signaling mechanism for feto-placental development in normal pregnancies. One mechanism of cellular communication relates to activated cell-derived sealed membrane vesicles called extracellular vesicles (EVs)...
September 2016: Current Hypertension Reports
Birgitte Møller Luef, Louise Bjørkholt Andersen, Kristina Martha Renäult, Ellen Aagaard Nohr, Jan Stener Jørgensen, Henrik Thybo Christesen
INTRODUCTION: Correct diagnosis of preeclampsia and gestational hypertension is important for treatment and epidemiological studies. Changes in diagnostic criteria and underreporting in certain subsets of patients may hamper validity of the diagnoses. MATERIALS AND METHODS: We validated the discharge diagnoses of preeclampsia and gestational hypertension, which are reported to the Danish National Patient Registry, in a cohort of 2,163 pregnant women by retrospective evaluation of electronic hospital data...
August 26, 2016: Acta Obstetricia et Gynecologica Scandinavica
Devika Rao, Nikulkumar Kumar Chaudhari, Robert Michael Moore, Belinda Jim
The HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome is believed to be part of the spectrum of pre-eclampsia, which falls within the category of hypertensive disorders of pregnancy. Maternal and fetal complications are more severe in HELLP as opposed to pre-eclampsia alone. We describe a 26-year-old primigravida woman with no medical history who presents with signs of HELLP with marked transaminitis and mild disseminated intravascular coagulation at 35 weeks of gestation who required emergent delivery of the fetus; the patient also sustained acute kidney injury requiring continuous veno-venous hemodiafiltration and a prolonged intensive care unit admission...
August 17, 2016: BMJ Case Reports
Mei-Chun Lu, Song-Shan Huang, Yuan-Horng Yan, Panchalli Wang
BACKGROUND: The influence of different diagnostic thresholds for gestational diabetes mellitus (GDM) on pregnancy outcomes is not fully understood. Degrees of glucose intolerance according to the Carpenter-Coustan (CC) criteria were less severe than the National Diabetes Data Group (NDDG) criteria for GDM. Recent studies have shown inconsistent results regarding the risk of adverse pregnancy outcomes between the NDDG and CC criteria. Therefore, the objective of this study was to investigate whether pregnant women who met only the CC criteria but not the NDDG criteria and those who met the NDDG criteria had increased risks of adverse pregnancy outcomes compared to a negative screening group...
2016: BMC Pregnancy and Childbirth
L Saleh, K Verdonk, A Kaya, A H Danser, A H van den Meiracker, W Visser
OBJECTIVE: The ratio of the maternal plasma angiogenic factors soluble Fms-kinase 1 (sFlt-1) and placental growth factor (PlGF) is a novel diagnostic tool for preeclampsia (PE), with a value <38 predicting short-term absence of PE in women in whom the syndrome is suspected clinically. The clinical implication of a single determination below the sFlt-1/PlGF ratio of 38 beyond 1 week remains to be established. We therefore assessed the evolution of the sFlt-1/PlGF ratio in patients suspected of PE on clinical grounds...
September 2016: Journal of Hypertension
T Cundy, R I G Holt
More than 7000 papers on gestational diabetes have been published in the last 15 years, but great uncertainty persists about its significance and how it should be diagnosed. This is reflected in a bewildering range of recommendations: the American Diabetes Association (ADA) now recommends three different ways of diagnosing gestational diabetes [1], the Canadian Diabetes Association two [2], the National Institute for Health and Care Excellence (NICE) recommendations differ from all others [3] and the WHO acknowledges the quality of evidence is 'very low' for its guidelines [4]...
August 9, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Ahmet Başaran, Mustafa Başaran, Betül Topatan, James N Martin
OBJECTIVE: To perform a meta-analysis for an assessment of the risk of preeclampsia or gestational hypertension following chorionic villus sampling (CVS). DATA SOURCE: PubMed was systematically searched from its inception through January 2016. MATERIAL AND METHODS: Nine reports were identified. A pre-specified scale was used to assess their quality. TABULATION INTEGRATION AND RESULTS: We performed pooling into three subgroups with respect to the control group: A) Patients with no invasive prenatal diagnostic procedure served as a control group for comparison...
2016: Journal of the Turkish German Gynecological Association
Hajieh Shahbazian, Sedigheh Nouhjah, Nahid Shahbazian, Shayesteh Jahanfar, Seyed Mahmoud Latifi, Armaghan Aleali, Nasrin Shahbazian, Najmieh Saadati
AIMS: Different approaches for screening and diagnosis of gestational diabetes mellitus(GDM) have great impact on all process of management of gestational diabetes and its future complications. The aims of this study were to evaluate rate, risk factors and outcomes of GDM based on International Association of Diabetes and Pregnancy Study Groups diagnostic criteria. MATERIALS: In a prospective study pregnant women attended 5 clinics in Ahvaz, screened for gestational diabetes mellitus using IADPSG criteria and followed up delivery from August 2014 to February 2015...
June 17, 2016: Diabetes & Metabolic Syndrome
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