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hypertension during pregnancy

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https://www.readbyqxmd.com/read/29325773/how-safe-is-metformin-when-initiated-in-early-pregnancy-a-retrospective-5-year-study-of-pregnant-women-with-gestational-diabetes-mellitus-from-india
#1
Vanlalhruaii, Riddhi Dasgupta, Roshna Ramachandran, Jiji E Mathews, Annie Regi, Niranjan Thomas, Vijay Gupta, P Visalakshi, H S Asha, Thomas Paul, Nihal Thomas
BACKGROUND: The initiation of metformin in early pregnancy in Gestational Diabetes mellitus(GDM) remains controversial. The aim of our study was to assess the influence of Metformin on maternal and fetal outcomes when initiated within the first trimester of pregnancy in GDM. METHODS AND MATERIALS: A retrospective analysis of 540 women with diabetes complicating pregnancy (IADPSG criteria) over five years(January 2011 to May 2016)was done. The study population comprised of patients initiated on a)metformin within the first trimester (Group A:n=186),b) metformin after the first trimester(Group B:n=203) and c)insulin at any time during their pregnancy(Group C:n=151)...
January 8, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29325324/-obstetric-outcome-in-pregnancy-complained-with-pulmonary-hypertension
#2
C X Zhu, W Xiong, J Yang, H Q Chen, G Niu, Z L Wang
Objective: To identify whether pregnancy outcomes vary by the severity of pulmonary hypertension. Methods: A retrospective study was conducted on 78 cases of pregnancies complained with pulmonary hypertension who delivered in the First Affiliated Hospital, Sun Yat-sen University from 2006 to 2016.The selected cases were divided into three groups according to severity of pulmonary hypertension: mild pulmonary hypertension group (mild PAH group) was defined as a mean pulmonary artery pressure 30-49 mmHg, moderate pulmonary hypertension (moderate PAH group) as mean pulmonary artery pressure 50-69 mmHg and severe pulmonary hypertension (severe PAH group) as mean pulmonary artery pressure 70 mmHg or greater...
December 19, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29325266/-analysis-of-649-cases-of-stillbirth-in-third-trimester
#3
M N Hu, Y Zhang, W Zhao
Objective: To analyze the risk factors of stillbirth in third trimester. Methods: Clinical data of 649 cases of stillbirth in third trimester were analyzed retrospectively in 22 hospitals of Haidian district from October 2011 to September 2016, including the incidence, the maternal profile, the perinatal care during pregnancy and the causes of stillbirth. Results: (1) The incidence of stillbirth in third trimester in Haidian district from October 2011 to September 2016 was 0.293%(649/221 845). While the incidence in floating pregnant women (0...
December 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/29325073/the-women-s-health-diagnostic-gap
#4
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/29324613/racial-disparities-in-adverse-pregnancy-outcomes-and-psychosocial-stress
#5
William A Grobman, Corette B Parker, Marian Willinger, Deborah A Wing, Robert M Silver, Ronald J Wapner, Hyagriv N Simhan, Samuel Parry, Brian M Mercer, David M Haas, Alan M Peaceman, Shannon Hunter, Pathik Wadhwa, Michal A Elovitz, Tatiana Foroud, George Saade, Uma M Reddy
OBJECTIVE: To assess the relationships between self-reported psychosocial stress and preterm birth, hypertensive disease of pregnancy, and small-for-gestational-age (SGA) birth and to assess the extent to which these relationships account for racial and ethnic disparities in these adverse outcomes. METHODS: Self-reported measures of psychosocial stress (perceived stress, depression, racism, anxiety, resilience, and social support) were collected during pregnancy among a racially and ethnically diverse cohort of women enrolled in a prospective observational study of nulliparous women with singleton pregnancies, from eight clinical sites across the United States, between October 2010 and May 2014...
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29323940/elevated-blood-pressure-in-low-income-rural-preschool-children-is-associated-with-maternal-hypertension-during-pregnancy
#6
Paige Johnson, Michele Montgomery, Patrick Ewell
Hypertension (HTN) is a significant public health problem in adults, and rates of HTN are rising in children as well. The purpose of this study was to determine blood pressure (BP) and body mass index (BMI) levels in low-income, rural preschool children and investigate the relationship between child and maternal factors that impact BP and BMI in these children. Results indicated high rates of overweight/obesity and elevated BP levels in this sample. Maternal hypertension during pregnancy also emerged as a predictor of elevated BP in their children...
January 2018: Journal of Community Health Nursing
https://www.readbyqxmd.com/read/29321410/successful-management-of-pregnancy-in-a-patient-with-systemic-lupus-erythematosus-associated-pulmonary-arterial-hypertension
#7
Akio Kawabe, Kazuhisa Nakano, Yukiyo Aiko, Satoshi Aramaki, Takeshi Onoue, Dan Okura, Yoshiya Tanaka
Pregnancy in women with systemic lupus erythematosus (SLE)-associated pulmonary arterial hypertension (PAH) remains a high risk. We successfully managed a pregnancy in a patient with SLE-PAH. A 31-year-old pregnant woman with SLE-PAH had worsening PAH and SLE flare-up during pregnancy and a sudden increase in pulmonary arterial pressure after delivery. SLE-PAH was controlled by continuous intravenous epoprostenol and inhaled nitric oxide therapy combined with high-dose corticosteroids under close hemodynamic monitoring...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29320992/caesarean-delivery-related-blood-transfusion-correlates-in-a-tertiary-hospital-in-southwest-nigeria
#8
Fatimat M Akinlusi, Kabiru A Rabiu, Idayat A Durojaiye, Adeniyi A Adewunmi, Tawaqualit A Ottun, Yusuf A Oshodi
BACKGROUND: Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. METHODS: A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011...
January 10, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29319760/acute-kidney-injury-in-critically-ill-obstetric-patients-a-cross-sectional-study-in-an-intensive-care-unit-in-northeast-brazil
#9
Geraldo Bezerra da Silva Junior, Suzanne Vieira Saintrain, Gabriel de Castro Castelo, Vanessa Ribeiro de Vasconcelos, Juliana Gomes Ramalho de Oliveira, Amanda Maria Timbó Rocha, Adolfo Gomes Vasconcelos Júnior, Maria Vieira de Lima Saintrain, Elizabeth De Francesco Daher
INTRODUCTION: Acute kidney injury (AKI) is a complication still poorly studied in the setting of obstetric patients, which is associated with increased mortality. Objective: The aim of this study was to investigate the frequency and risk factors of AKI among critically ill obstetric patients. METHODS: A cross-sectional study was conducted with all patients admitted to an intensive care unit (ICU) due to obstetric complications, in Fortaleza, Brazil, in the period between January 2012 and December 2014...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29319147/factors-associated-with-low-birthweight-in-term-pregnancies-a-matched-case-control-study-from-rural-pakistan
#10
Muhammad A Habib, Camille R Greenow, Shabina Ariff, Sajid Soofi, Abid Hussain, Qamar Junejo, Amjad Hussain, Fariha Shaheen, Kirsten I Black
Low birthweight (LBW) remains a significant public health problem in Pakistan and further understanding of factors associated with LBW is required. We conducted a hospital-based matched case control study to identify risk factors associated with LBW in a rural district of Pakistan. We found that illiteracy (AOR: 2.68; 95% CI: 1.59 - 4.38), nulliparity (AOR: 1.82; 95% CI: 1.26-2.44), having a previous miscarriage/abortion (AOR: 1.22; 95% CI: 1.06-2.35), having < 2 antenatal care (ANC) visits during last pregnancy (AOR: 2...
January 2, 2018: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/29315230/maternal-high-fructose-intake-increases-the-vulnerability-to-post-weaning-high-fat-diet-induced-programmed-hypertension-in-male-offspring
#11
You-Lin Tain, Wei-Chia Lee, Kay L H Wu, Steve Leu, Julie Y H Chan
Widespread consumption of high-fructose and high-fat diets relates to the global epidemic of hypertension. Hypertension may originate from early life by a combination of prenatal and postnatal nutritional insults. We examined whether maternal high-fructose diet increases vulnerability to post-weaning high-fructose or high-fat diets induced hypertension in adult offspring and determined the underlying mechanisms. Pregnant Sprague-Dawley rats received regular chow (ND) or chow supplemented with 60% fructose (HFR) during the entire pregnancy and lactation periods...
January 9, 2018: Nutrients
https://www.readbyqxmd.com/read/29305253/chronic-hypertension-first-trimester-blood-pressure-control-and-likelihood-of-severe-hypertension-preeclampsia-and-small-for-gestational-age
#12
Diane Nzelu, Dan Dumitrascu-Biris, Kypros H Nicolaides, Nikos A Kametas
BACKGROUND: There is extensive evidence that pre-pregnancy chronic hypertension is associated with high risk of development of severe hypertension and preeclampsia and birth of small for gestational age neonates. However, previous studies have not reported whether anti-hypertensive use, blood pressure control or normalization of blood pressure during early pregnancy influence the rates of these pregnancy complications. OBJECTIVE: To stratify women with pre-pregnancy chronic hypertension according to the use of antihypertensive medications and level of blood pressure control at the first hospital visit during the first-trimester of pregnancy and examine the rates of severe hypertension, preeclampsia and birth of small for gestational age neonates according to such stratification...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29305116/urine-albumin-is-a-superior-predictor-of-preeclampsia-compared-to-urine-plasminogen-in-type-i-diabetes-patients
#13
Lise Hald Nielsen, Boye L Jensen, Jens Fuglsang, Lise Lotte Torvin Andersen, Dorte Møller Jensen, Jan Stener Jørgensen, Gitte Kitlen, Per Ovesen
Pregnant women with type I diabetes mellitus (T1DM) are at increased risk of developing preeclampsia (PE). Plasminogen is aberrantly filtrated from plasma into tubular fluid in PE patients and activated to plasmin. Plasmin activates the epithelial sodium channel in the collecting ducts potentially causing impaired sodium excretion, suppression of the renin-angiotensin-aldosterone system, and hypertension in PE. The objective of the study was to test whether urinary total plasmin(ogen)/creatinine ratio and plasma concentration of aldosterone were better predictors of PE in pregnant women with T1DM compared with urine albumin and haemoglobin A1C...
December 13, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/29304812/the-cradle-vital-signs-alert-qualitative-evaluation-of-a-novel-device-designed-for-use-in-pregnancy-by-healthcare-workers-in-low-resource-settings
#14
Hannah L Nathan, Helena Boene, Khatia Munguambe, Esperança Sevene, David Akeju, Olalekan O Adetoro, Umesh Charanthimath, Mrutyunjaya B Bellad, Annemarie de Greeff, John Anthony, David R Hall, Wilhelm Steyn, Marianne Vidler, Peter von Dadelszen, Lucy C Chappell, Jane Sandall, Andrew H Shennan
BACKGROUND: Vital signs measurement can identify pregnant and postpartum women who require urgent treatment or referral. In low-resource settings, healthcare workers have limited access to accurate vital signs measuring devices suitable for their environment and training. The CRADLE Vital Signs Alert (VSA) is a novel device measuring blood pressure and pulse that is accurate in pregnancy and designed for low-resource settings. Its traffic light early warning system alerts healthcare workers to the need for escalation of care for women with hypertension, haemorrhage or sepsis...
January 5, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29291357/associations-of-hypertensive-disorders-of-pregnancy-and-outcomes-of-labor-induction-with-prostaglandin-vaginal-inserts
#15
Lili Sheibani, Kyle Raymond, Olof Rugarn, Deborah A Wing
OBJECTIVE: To evaluate the association between hypertensive (HTNsive) disorders of pregnancy and outcomes of labor induction, in two cohorts of women induced with either misoprostol vaginal insert (MVI) or dinoprostone vaginal insert (DVI). STUDY DESIGN: This investigation was a post-hoc analysis of data from three Phase II and III, multi-center, double blind, randomized controlled trials of women induced with identical efficacy endpoints. A competing risk framework investigated the association between HTNsive disorders of pregnancy and the time-to-event endpoints of onset of active labor and vaginal delivery...
January 1, 2018: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/29290922/gestational-diabetes-from-a-to-z
#16
REVIEW
AbdelHameed Mirghani Dirar, John Doupis
Gestational diabetes mellitus (GDM) is defined as any degree of hyperglycaemia that is recognized for the first time during pregnancy. This definition includes cases of undiagnosed type 2 diabetes mellitus (T2DM) identified early in pregnancy and true GDM which develops later. GDM constitutes a greater impact on diabetes epidemic as it carries a major risk of developing T2DM to the mother and foetus later in life. In addition, GDM has also been linked with cardiometabolic risk factors such as lipid abnormalities, hypertensive disorders and hyperinsulinemia...
December 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/29289477/kidney-function-after-a-hypertensive-disorder-of%C3%A2-pregnancy-a-longitudinal-study
#17
Nina D Paauw, Anne Marijn van der Graaf, Rita Bozoglan, David P van der Ham, Gerjan Navis, Ron T Gansevoort, Henk Groen, A Titia Lely
BACKGROUND: Registry-based studies report an increased risk for end-stage kidney disease after hypertensive disorders of pregnancy (HDPs). It is unclear whether HDPs lead to an increased incidence of chronic kidney disease (CKD) and/or progression of kidney function decline. STUDY DESIGN: Subanalysis of the Prevention of Renal and Vascular Endstage Disease (PREVEND) Study, a Dutch population-based cohort with follow-up of 5 visits approximately 3 years apart. SETTING & PARTICIPANTS: Women without and with patient-reported HDPs (non-HDP, n=1,805; HDP, n=977) were identified...
December 28, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29285630/preeclampsia-and-hypertension-during-pregnancy-in-areas-with-relatively-low-levels-of-traffic-air-pollution
#18
Christian Madsen, Siri Eldevik Håberg, Geir Aamodt, Hein Stigum, Per Magnus, Stephanie J London, Wenche Nystad, Per Nafstad
Objectives Air pollution exposure may contribute to the development of preeclampsia and hypertension during pregnancy. However, the evidence for such a relation is still limited. We investigated the associations between exposure for moderate to low levels of air pollution during pregnancy and preeclampsia and gestational hypertension in selected urban and county areas of Norway. Methods This study used a sub-group of 17,533 women in the Norwegian Mother and Child Cohort Study. Air pollution levels at residential addresses were estimated using land use regression models and back-extrapolated to the period of each pregnancy...
December 28, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29285572/characteristics-and-diagnoses-of-acute-headache-in-pregnant-women-a-retrospective-cross-sectional-study
#19
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/29285448/maternal-and-neonatal-outcome-in-mothers-with-gestational-diabetes-mellitus
#20
G Thiruvikrama Prakash, Ashok Kumar Das, Syed Habeebullah, Vishnu Bhat, Suryanarayana Bettadpura Shamanna
Introduction: Gestational diabetes mellitus (GDM) is common and is accompanied with other comorbidities. Challenges to treatment exist at our institute as it serves women with low income. This study assessed the burden of comorbidities and the outcome of GDM. Methods: This was a prospective, observational study of women with gestational diabetes attending the obstetrics department from September 2012 to April 2014. GDM was diagnosed based on the International Association of Diabetes and Pregnancy Study Groups criteria...
November 2017: Indian Journal of Endocrinology and Metabolism
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