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diagnostic hypertension in pregnancy

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https://www.readbyqxmd.com/read/29325073/the-women-s-health-diagnostic-gap
#1
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
https://www.readbyqxmd.com/read/29285572/characteristics-and-diagnoses-of-acute-headache-in-pregnant-women-a-retrospective-cross-sectional-study
#2
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
https://www.readbyqxmd.com/read/29236710/the-burden-of-obesity-in-women-of-reproductive-age-and-in-pregnancy-in-a-middle-income-setting-a-population-based-study-from-jamaica
#3
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
https://www.readbyqxmd.com/read/29187254/acute-disseminated-melioidosis-giving-rise-to-pneumonia-and-renal-abscesses-complicated-with-thrombotic-thrombocytopenic-purpura-in-a-post-partum-woman-a-case-report
#4
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
https://www.readbyqxmd.com/read/29174227/angiogenic-and-antiangiogenic-factors-in-preeclampsia
#5
REVIEW
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...
October 31, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/29167927/new-diagnostic-criteria-for-gestational-diabetes-mellitus-and-their-impact-on-the-number-of-diagnoses-and-pregnancy-outcomes
#6
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
https://www.readbyqxmd.com/read/29150149/pregnancy-and-heart-disease-pregnancy-associated-hypertension-and-peripartum-cardiomyopathy
#7
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
#8
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
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#9
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
https://www.readbyqxmd.com/read/29080868/-features-of-the-urine-peptidome-under-the-condition-of-hypertensive-pathologies-of-pregnancy
#10
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
#11
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
#12
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
#13
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
#14
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/m2), 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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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