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diagnostic hypertension in pregnancy

Ulrik Dolberg Anderson, Maya Jälmby, Marijke M Faas, Stefan R Hansson
OBJECTIVE: The aim of this study was to investigate how maternal cell-free fetal hemoglobin and heme impact the scavenger enzyme systems Hemopexin and Heme Oxygenase-1 in patients with preeclampsia (PE). The secondary aims were to evaluate these proteins as biomarkers for severity of the clinical manifestation i.e. hypertension, in early- and late onset PE. MATERIAL AND METHODS: Plasma samples taken within the last 24 h before delivery from 135 patients were analyzed, 89 PE and 46 normal pregnancies...
February 15, 2018: Pregnancy Hypertension
Thierry Brue, Vincent Amodru, Frédéric Castinetti
With fewer than 200 reported cases, Cushing's syndrome (CS) in pregnancy remains a diagnostic and therapeutic challenge. In normal pregnancies, misleading signs may be observed such as striae or hypokalemia, while plasma cortisol and urinary free cortisol may rise up to 2-3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. The predominant cause is adrenal adenoma (sometimes without decreased ACTH), rather than Cushing's disease. There are considerable imaging pitfalls in Cushing's disease...
March 9, 2018: European Journal of Endocrinology
B Vaňková, J Březina, S Pánková
OBJECTIVE: Diagnostics and solution to a case of subarachnoid hemorrhagie in a pregnant woman. Description of a subarachnoid hemmorage case in week 13 of pregnancy and pointing out to the insidiousness anamnestic examination. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Uherskohradišťská nemocnice a.s. CASE REPORT: The patient history describes a case of a 31-year-old hypertensive woman in week 38 of pregnancy, who experienced a complication during her pregnancy...
2018: Ceská Gynekologie
G Donatini, J L Kraimps, C Caillard, E Mirallie, F Pierre, Loïc De Calan, Hamy Antoine, O Larin, O Tovkay, S Cherenko
BACKGROUND: Pheochromocytoma (PHEO) in pregnancy is a life-threatening condition. Its management is challenging with regards to the timing and type of surgery. METHODS: A retrospective review of the management of ten patients diagnosed with pheochromocytoma during pregnancy was performed. Data were collected on the initial diagnostic workup, symptoms, treatment, and follow-up. RESULTS: PHEO was diagnosed in ten patients who were between the 10th and the 29th weeks of pregnancy...
February 27, 2018: Surgical Endoscopy
Debendra Pattanaik
Arthritis is a commonly encountered problem in daily clinical practice, and with an aging population it will be as prevalent as any other chronic illness, such as diabetes mellitus, hypertension, and hypercholesterolemia. Obstetrician-gynecologists often encounter patients with arthritic symptoms in their practices. They may find it challenging to identify the underlying cause of arthritis and provide recommendations, as well as provide obstetric care to patients with known arthritis. The monograph will discuss common forms of arthritis, diagnostic testing and appropriate management, and referral of patients who need specialized care...
March 2018: Obstetrics and Gynecology
Hélène Collinot, Carmen Marchiol, Isabelle Lagoutte, Franck Lager, Nathalie Siauve, Gwennhael Autret, Daniel Balvay, Gilles Renault, Laurent J Salomon, Daniel Vaiman
BACKGROUND: Preeclampsia is a major hypertensive disease caused by pregnancy, inducing proteinuria and increased blood pressure starting from the second half of pregnancy (early preeclampsia) or near the end of pregnancy (late preeclampsia). Pre-symptomatic diagnosis would allow for therapeutic interventions, such as with low-dose aspirin. Among non-invasive methods to explore organ physiology, Doppler ultrasonography (US) and functional blood oxygenation level-dependent (BOLD) MRI (which do not need radioactive contrast agents such as gadolinium) can be used in pregnant women...
February 20, 2018: Journal of Hypertension
Nurul Iftida Basri, Zaleha Abdullah Mahdy, Shuhaila Ahmad, Abdul Kadir Abdul Karim, Lim Pei Shan, Mohd Rizal Abdul Manaf, Nor Azlin Mohd Ismail
Background Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. The aim of this study was to compare the prevalence of GDM using the World Health Organization (WHO) criteria and the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in our population. We further compared the incidence of adverse maternal and neonatal outcomes in women diagnosed with GDM using these criteria and determined whether the IADPSG criteria is suitable in our population. Methods This randomized controlled trial was conducted at our antenatal clinic involving 520 patients from 1st February 2015 until 30th September 2017...
February 17, 2018: Hormone Molecular Biology and Clinical Investigation
Julie M Rosenthal, Mark W Johnson
Pregnancy leads to significant changes in the body, which potentially affect the retina. Pregnancy can induce disease, such as that seen in hypertensive retinopathy and choroidopathy. It can cause exudative retinal detachments in the HELLP syndrome (hemolysis, elevated liver enzymes and low platelets), disseminated intravascular coagulation (DIC), and thrombotic thrombocytopenic purpura (TTP), and provoke arterial and venous retinal occlusive disease. Pregnancy may also exacerbate pre-existing retinal disease, such as idiopathic central serous chorioretinopathy (ICSC) and diabetic retinopathy...
January 2018: Journal of Ophthalmic & Vision Research
Savino Sciascia, Massimo Radin, Giovanni Sanna, Irene Cecchi, Dario Roccatello, Maria Laura Bertolaccini
Objective: Recently, our group conceived a risk score for clinical manifestations of APS (the global APS score, or GAPSS) that takes into account the combination of independent cardiovascular risk factors and the aPL positivity profile. These include hyperlipidaemia, arterial hypertension, aCL, anti-β2 glycoprotein-I, aPS-PT and the LA. A complementary version, the adjusted GAPSS (aGAPSS), which excludes aPS-PT, was also designed. The aim of our study was to systematically review the literature to assess the clinical utility of the GAPSS and aGAPSS for risk stratification of any APS clinical manifestation...
January 12, 2018: Rheumatology
Ann M Gronowski, Melanie L Yarbrough
Pregnancy remains a significant health risk to women in both developed and underdeveloped countries. Worldwide, 10 to 20 million women have pregnancy complications including ectopic pregnancy, preterm birth, gestational diabetes mellitus, and hypertensive states, including preeclampsia. Despite advancements in women's health research, there is a large gap in the diagnostic tools available to screen, diagnose, and monitor these conditions. Herein, we examine existing diagnostic tools, such as the human chorionic gonadotropin discriminatory zone, cervicovaginal fetal fibronectin, sFlt-1:PlGF ratio, and glucose tolerance testing...
February 1, 2018: Endocrinology
Bianca Raffaelli, Eberhard Siebert, Jeannette Körner, Thomas Liman, Uwe Reuter, Lars Neeb
BACKGROUND: Acute headache is one of the most frequent neurological symptoms in pregnant women. The early diagnosis of underlying secondary conditions has a major influence on patient outcome, especially in emergency settings. However, at the time being no well-established guideline for diagnostic evaluation of acute headache during pregnancy exists. In this study, we aimed to characterize acute headache in pregnant women concerning demographic, clinical, and diagnostic features, and to determine predictors of secondary headache...
December 4, 2017: Journal of Headache and Pain
Lovney Kanguru, Affette McCaw-Binns, Jacqueline Bell, Novie Yonger-Coleman, Rainford Wilks, Julia Hussein
INTRODUCTION: Obesity is rising globally and is associated with increased risk of adverse pregnancy outcomes. This study aims to investigate overweight and obesity and its consequences among Jamaican women of reproductive age, particularly development of diabetes, hypertension and the risk of maternal death. MATERIALS AND METHODS: A national lifestyle survey (2007/8) of 1371 women of reproductive age provided data on the prevalence of high BMI, associated risk factors and co-morbidities...
2017: PloS One
Piyumi Sachindra Alwis Wijewickrama, Rohini Weerakoon
BACKGROUND: Melioidosis is an established endemic infection in Sri Lanka, caused by Burkholderia pseudomallei, a gram negative bacterium distributed in saprophytes in soil and surface water. Main mode of transmission is via percutaneous inoculation. Pneumonia is the most common presentation in acute disease. CASE PRESENTATION: We report a 33 year old previously healthy Sinhalese female with an occupational exposure to surface water in paddy fields, who was on postpartum day 6 following an uncomplicated pregnancy and delivery via an elective caesarian section...
November 29, 2017: BMC Research Notes
Fernanda Rodrigues Helmo, Angela Maria Moed Lopes, Anna Cecília Dias Maciel Carneiro, Carolina Guissoni Campos, Polyana Barbosa Silva, Maria Luíza Gonçalves Dos Reis Monteiro, Laura Penna Rocha, Marlene Antônia Dos Reis, Renata Margarida Etchebehere, Juliana Reis Machado, Rosana Rosa Miranda Corrêa
BACKGROUND: Pre-eclampsia is a multifactorial hypertensive disorder that is triggered by placental insufficiency and that accounts for up to 15% of maternal deaths. In normal pregnancies, this process depends on the balance between the expression of angiogenic factors and antiangiogenic factors, which are responsible for remodeling the spiral arteries, as well as for neoangiogenesis and fetal development. PURPOSE: The aim of this review is to discuss the main scientific findings regarding the role of angiogenic and antiangiogenic factors in the etiopathogenesis of preeclampsia...
January 2018: Pathology, Research and Practice
Sarah H Koning, Jelmer J van Zanden, Klaas Hoogenberg, Helen L Lutgers, Alberdina W Klomp, Fleurisca J Korteweg, Aren J van Loon, Bruce H R Wolffenbuttel, Paul P van den Berg
AIMS/HYPOTHESIS: Detection and management of gestational diabetes mellitus (GDM) are crucial to reduce the risk of pregnancy-related complications for both mother and child. In 2013, the WHO adopted new diagnostic criteria for GDM to improve pregnancy outcomes. However, the evidence supporting these criteria is limited. Consequently, these new criteria have not yet been endorsed in the Netherlands. The aim of this study was to determine the impact of these criteria on the number of GDM diagnoses and pregnancy outcomes...
November 22, 2017: Diabetologia
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
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 27, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in hypertensive disorders of pregnancy 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. OBJECTIVE: This study aimed to examine cardiovascular parameters in a cohort of patients affected by hypertensive disorders of pregnancy according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of hypertensive disorders of pregnancy...
November 2, 2017: American Journal of Obstetrics and Gynecology
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
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
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