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diagnostic hypertension in pregnancy

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https://www.readbyqxmd.com/read/29764001/hypertensive-disorders-of-pregnancy-overview-and-current-recommendations
#1
REVIEW
Diane M Folk
Hypertensive disorders of pregnancy include chronic hypertension, gestational hypertension, preeclampsia-eclampsia, and chronic hypertension with superimposed preeclampsia. These disorders are an important cause of maternal and fetal morbidity and mortality. Although advances in effective treatments have been made, current research has yet to identify a biochemical or diagnostic imaging marker to reliably predict preeclampsia. Despite current guidelines that address diagnosis and management of hypertensive disorders in pregnancy, health care providers may overlook or be unaware of signs that require immediate evaluation and treatment...
May 15, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29761167/phenotypic-spectrum-and-diagnostic-pitfalls-of-abcb4-deficiency-depending-on-age-of-onset
#2
Stephanie Barbara Schatz, Christoph Jüngst, Verena Keitel-Anselmo, Ralf Kubitz, Christina Becker, Patrick Gerner, Eva-Doreen Pfister, Imeke Goldschmidt, Norman Junge, Daniel Wenning, Stephan Gehring, Stefan Arens, Dirk Bretschneider, Dirk Grothues, Guido Engelmann, Frank Lammert, Ulrich Baumann
Genetic variants in the adenosine triphosphate-binding cassette subfamily B member 4 ( ABCB4 ) gene, which encodes hepatocanalicular phosphatidylcholine floppase, can lead to different phenotypes, such as progressive familial intrahepatic cholestasis (PFIC) type 3, low phospholipid-associated cholelithiasis, and intrahepatic cholestasis of pregnancy. The aim of this multicenter project was to collect information on onset and progression of this entity in different age groups and to assess the relevance of this disease for the differential diagnosis of chronic liver disease...
May 2018: Hepatology Communications
https://www.readbyqxmd.com/read/29737875/the-discovery-of-protein-biomarkers-in-pre-eclmmpsia-the-promising-role-of-mass-spectrometry
#3
Lina A Dahabiyeh
CONTEXT: Pre-eclampsia (PE) is a common hypertensive disorder of pregnancy that substantially affects maternal and neonatal morbidity and mortality worldwide. The etiology of the disease remains poorly understood with lack of reliable diagnostic tests. PE is a multisystem disorder so it is very unlikely that a single or a small group of biomarkers will accurately predict the disease. Mass spectrometry (MS) is indispensable analytical tool in protein analysis studies. MS-based proteomics have the ability to detect the entire protein complement to provide a useful window into a range of biological processes and allow the identification of differentially expressed proteins between samples...
May 8, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29702988/enteritis-as-initial-manifestation-of-systemic-lupus-erythematosus-in-early-pregnancy-a-case-report
#4
Anna Maria Bellou, Dominik Bös, Guido Kukuk, Ulrich Gembruch, Waltraut Maria Merz
RATIONAL: Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE). We report of a patient who presented with enteritis as manifestation of new-onset SLE during the first trimester of pregnancy. PATIENTS CONCERNS: The 23-year nulliparous patient was admitted to a district hospital with abdominal pain, nausea, vomiting and bloody diarrhea at a gestational age (GA) of 10 weeks. Her symptoms improved with symptomatic treatment and she was discharged a few days later...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29697379/-hypertension-of-pregnancy-associated-with-hypergomocysteinemia-of-the-first-trimester-of-pregnancy
#5
Ak Tussupkaliyev, A Gaiday, S Bermagambetova, R Aniuliene
In this study, the association of high homocysteine concentrations (>10 μmol/L) of pregnant women with hypertensive disorders during pregnancy was studied, as well as other complications of pregnancy, such as loss of pregnancy in the first half, premature birth, intrauterine growth retardation, congenital malformations development of the fetus. A single-center prospective cohort study was conducted. Depending on the concentration of homocysteine detected by the immunoenzyme assay with monoclonal antibodies Homocysteine EIA ELISA (Axis-Shield Diagnostics Ltd, Scotland), for a period of up to 14 weeks, the subjects were divided into 2 groups: with high concentrations (>10 μmol/L) and normal levels (<10 μmol/L)...
March 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29649540/incidence-risk-factors-and-pregnancy-outcomes-of-gestational-diabetes-mellitus-using-one-step-versus-two-step-diagnostic-approaches-a-population-based-cohort-study-in-isfahan-iran
#6
Elham Hosseini, Mohsen Janghorbani, Ashraf Aminorroaya
AIMS: To study the incidence, risk factors, and pregnancy outcomes associated with gestational diabetes mellitus (GDM) diagnosed with one-step and two-step screening approaches. METHODS: 1000 pregnant women who were eligible and consented to participate underwent fasting plasma glucose testing at the first prenatal visit (6-14 weeks). The women free from GDM or overt diabetes were screened at 24-28 weeks using the 50-g glucose challenge test (GCT) followed by 100-g, 3-h oral glucose tolerance test (OGTT) (two-step method)...
April 10, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29602298/the-perplexing-pregnancy-disorder-preeclampsia-what-next
#7
James M Roberts
Preeclampsia occurs in 3 to 5% of pregnancies and is a leading cause of deaths of mothers and their infants worldwide. It was initially described over 100 years ago as a pregnancy abnormality defined by new onset hypertension and proteinuria. Progress in understanding the pathophysiology was impeded by attention to these diagnostic findings. Hypertension and proteinuria were actually serendipitously recognized components of a complex multisystemic syndrome and not especially pertinent to outcome. With the recognition of inflammatory activation with consequent endothelial dysfunction 30 years ago redirection of research resulted in an explosive increase in understanding of the disorder...
March 30, 2018: Physiological Genomics
https://www.readbyqxmd.com/read/29588818/a-study-of-the-diagnostic-value-of-inhibin-a-tests-for-occurrence-of-preeclampsia-in-pregnant-women
#8
Farzaneh Broumand, Shaker Salari Lak, Farhad Nemati, Atefeh Mazidi
Background: Hypertensive disorders are common during pregnancy, and are among 3 important causes of maternal death. Preeclampsia occurs in 3 to 5% of pregnancies. Early diagnosis of this disorder can lead to better pregnancy outcomes. Objective: The aim of this study was to determine the relationship between inhibin A serum levels during second stage pregnancy screening tests, and incidence and severity of preeclampsia. Methods: In this study, 300 pregnant women who referred to Kowsar Hospital and carried out second stage pregnancy screening tests from September 2014 to March 2015 in Urmia city, Iran, were enrolled...
January 2018: Electronic Physician
https://www.readbyqxmd.com/read/29559508/gestational-diabetes-mellitus-does-one-size-fit-all-a-challenge-to-uniform-worldwide-diagnostic-thresholds
#9
H David McIntyre, Dorte M Jensen, Richard C Jensen, Henriette B Kyhl, Tina K Jensen, Dorte Glintborg, Marianne Andersen
OBJECTIVE: To define the prevalence and pregnancy outcomes related to elevated fasting venous plasma glucose (FVPG) in a Danish pregnancy cohort. RESEARCH DESIGN AND METHODS: This was an observational cohort study including 1,516 women without gestational diabetes mellitus (GDM) by Danish criteria. FVPG measured at 28 weeks' gestation was related to pregnancy outcomes. RESULTS: With use of the World Health Organization 2013 threshold of FVPG ≥5...
March 20, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29559205/a-clinical-evaluation-of-placental-growth-factor-in-routine-practice-in-high-risk-women-presenting-with-suspected-pre-eclampsia-and-or-fetal-growth-restriction
#10
L Ormesher, E D Johnstone, E Shawkat, A Dempsey, C Chmiel, E Ingram, L E Higgins, J E Myers
OBJECTIVE: To evaluate the use of plasma Placental Growth Factor (PlGF), recommended by the recent NICE guidance, in women with suspected pre-eclampsia (PE) and/or fetal growth restriction (FGR). STUDY DESIGN: Non-randomised prospective clinical evaluation study in high-risk antenatal clinics in a tertiary maternity unit. METHODS: PlGF testing was performed in addition to routine clinical assessment in 260 women >20 weeks' gestation with chronic disease (hypertension, renal disease ± diabetes) with a change in maternal condition or in women with suspected FGR to determine the impact on clinical management...
March 13, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29530745/the-hemoglobin-degradation-pathway-in-patients-with-preeclampsia-fetal-hemoglobin-heme-heme-oxygenase-1-and-hemopexin-potential-diagnostic-biomarkers
#11
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
https://www.readbyqxmd.com/read/29523633/management-of-endocrine-disease-management-of-cushing-s-syndrome-during-pregnancy-solved-and-unsolved-questions
#12
REVIEW
Thierry Brue, Vincent Amodru, Frederic 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- to 3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. Apart from gestational hypertension, differential diagnosis includes pheochromocytoma and primary aldosteronism...
June 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29510638/-woman%C3%A2-s-subarachnoid-hemmorage-in-pregnancy
#13
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...
December 0: Ceská Gynekologie
https://www.readbyqxmd.com/read/29488089/pheochromocytoma-diagnosed-during-pregnancy-lessons-learned-from-a-series-of-ten-patients
#14
G Donatini, J L Kraimps, C Caillard, E Mirallie, F Pierre, Loïc De Calan, A Hamy, 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
https://www.readbyqxmd.com/read/29470341/clinical-updates-in-women-s-health-care-summary-arthritis
#15
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
https://www.readbyqxmd.com/read/29465714/preeclampsia-induced-by-stox1-overexpression-in-mice-induces-intrauterine-growth-restriction-abnormal-ultrasonography-and-bold-mri-signatures
#16
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...
June 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29453924/the-world-health-organization-who-versus-the-international-association-of-diabetes-and-pregnancy-study-group-iadpsg-diagnostic-criteria-of-gestational-diabetes-mellitus-gdm-and-their-associated-maternal-and-neonatal-outcomes
#17
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
https://www.readbyqxmd.com/read/29403592/management-of-retinal-diseases-in-pregnant-patients
#18
REVIEW
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
https://www.readbyqxmd.com/read/29342292/clinical-utility-of-the-global-anti-phospholipid-syndrome-score-for-risk-stratification-a-pooled-analysis
#19
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
https://www.readbyqxmd.com/read/29325073/the-women-s-health-diagnostic-gap
#20
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
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