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preeclampsia post partum

G Barrientos, M Pussetto, M Rose, A C Staff, S M Blois, J E Toblli
STUDY QUESTION: What is the impact of chronic hypertension on placental development, fetal growth and maternal outcome in the stroke-prone spontaneously hypertensive rat (SHRSP)? SUMMARY ANSWER: SHRSP showed an impaired remodeling of the spiral arteries and abnormal pattern of trophoblast invasion during placentation, which were associated with subsequent maternal glomerular injury and increased baseline hypertension as well as placental insufficiency and asymmetric fetal growth restriction...
April 11, 2017: Molecular Human Reproduction
Brigitte Sophia Winkler, Ulrich Pecks, Laila Najjari, Nicola Kleine-Eggebrecht, Nicolai Maass, Markus Mohaupt, Geneviève Escher
BACKGROUND: The oxysterol 27-hydroxycholesterol (27-OHC) plays an important role in the regulation of cholesterol homeostasis. Pregnancy pathologies like preeclampsia (PE), HELLP-syndrome (HELLP), intrauterine growth restriction (IUGR) and intrahepatic cholestasis in pregnancy (ICP) are linked to disturbances in lipid metabolism. In the present study, we hypothesized a specific gestational regulation of 27-OHC and compromised 27-OHC levels due to placental and hepatic diseases in pregnancy resulting in a dysregulation of lipid metabolism...
April 4, 2017: BMC Pregnancy and Childbirth
Ton Lisman, William Bernal
Liver diseases may be accompanied by profound changes in the hemostatic system including thrombocytopenia, decreased plasma levels of pro- and anticoagulants, and alterations in plasma levels of fibrinolysis. The net effect of the hemostatic changes in chronic and acute liver diseases is a hemostatic system that is in relative balance due to the simultaneous decline in pro- and antihemostatic drivers. A unique category of liver diseases are those induced by pregnancy. In acute fatty liver of pregnancy, profound hemostatic changes occur, which may be caused by a combination of liver failure and disseminated intravascular coagulation...
March 2017: Thrombosis Research
Rossana Orabona, Edoardo Sciatti, Enrico Vizzardi, Ivano Bonadei, Federico Prefumo, Adriana Valcamonico, Marco Metra, Tiziana Frusca
OBJECTIVES: To assess endothelial function and arterial stiffness in women with a previous pregnancy complicated by haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and compare them with women with a previous preeclampsia (PE) without HELLP and controls with uncomplicated pregnancies. METHODS: Women who have had a singleton pregnancy complicated by PE with (n = 49) or without (n = 60) HELLP syndrome and controls (n = 60) underwent peripheral arterial tonometry (EndoPAT method) and pulse wave velocity (PWV) assessment at 6 months-4 years after delivery...
December 22, 2016: Ultrasound in Obstetrics & Gynecology
Gregory K Davis, Lynne Roberts, George Mangos, Amanda Henry, Franziska Pettit, Anthony O'Sullivan, Caroline S E Homer, Maria Craig, Samuel B Harvey, Mark A Brown
BACKGROUND: Women who have had hypertension in pregnancy are at greater risk of long term cardiovascular disease (CVD). Little is known about their cardiovascular risk postpartum or the effects on the woman's mental health and the outcomes of their infants. In this project we will study the physiological and psychological health of women and the physical health and development of their infants six months, two years and five years after birth. We will establish normal blood pressure (BP) and metabolic function for women who were normotensive in pregnancy and use these to assess women who had gestational hypertension (GH) or preeclampsia (PE)...
October 2016: Pregnancy Hypertension
Sander de Haas, Chahinda Ghossein-Doha, Sander Mj van Kuijk, Joris van Drongelen, Marc Ea Spaanderman
OBJECTIVE: The aim of this systematic review and meta-analyses was to comprehensively describe the physiological pattern of gestational plasma volume adjustments during human singleton pregnancies and compare this to the pattern of pregnancies complicated by pregnancy-induced hypertension, preeclampsia or fetal growth restriction. METHODS: We performed a meta-analysis of the current literature on plasma volume adjustments during physiological and complicated pregnancies...
November 11, 2016: Ultrasound in Obstetrics & Gynecology
Shikha Aggarwal, Neroli Sunderland, Charlene Thornton, Bei Xu, Annemarie Hennessy, Angela Makris
BACKGROUND: Preeclampsia can be caused by shallow trophoblast invasion and results in endothelial dysfunction. Angiotensin II type 1 receptor antibodies may have a role in both processes. Other angiogenic markers (placental growth factor, soluble fms-like tyrosine kinase-1, and soluble endoglin) alter before clinically evident preeclampsia. OBJECTIVE: The aim of this study is to assess the longitudinal changes and utility of biomarker angiotensin II type 1 receptor antibodies and angiogenic markers in hypertensive disorders of pregnancy, gestational hypertension, and preeclampsia...
October 26, 2016: American Journal of Obstetrics and Gynecology
Laxman G Jessani, Aumir Moin, Shivaprasad Karnati, Keshavamurthy
Here we report two patients with late post-partum eclampsia without pre-existing preeclampsia presenting with atypical features of posterior reversible encephalopathy syndrome (PRES) which was diagnosed by serial MRI with good outcome emphasizing the fact that early diagnosis and treatment can prevent complications.
February 2016: Journal of the Association of Physicians of India
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
Peeter Juhanson, Kristiina Rull, Triin Kikas, Hannele Laivuori, Pille Vaas, Eero Kajantie, Seppo Heinonen, Maris Laan
CONTEXT AND OBJECTIVES: The study represents the first comprehensive analysis of Stanniocalcin-1 (STC1) hormone in human pregnancy, assessing clinical, lifestyle, and genetic determinants of circulating STC1 at term. DESIGN, SETTING, AND PARTICIPANTS: Participants included women with (n = 50) and without (n = 316) preeclampsia (PE) at delivery, recruited in the REPROgrammed fetal and/or maternal METAbolism (REPROMETA) study (2006-2011, Estonia). Genetic association analysis combined PE cases (n = 597) and controls (n = 623) from the REPROMETA and Finnish Genetics of Preeclampsia Consortium (2008-2011) studies...
December 2016: Journal of Clinical Endocrinology and Metabolism
U Pecks, W Rath, N Kleine-Eggebrecht, N Maass, F Voigt, T W Goecke, M G Mohaupt, G Escher
OBJECTIVE: Lipids and steroid hormones are closely linked. While cholesterol is the substrate for (placental) steroid hormone synthesis, steroid hormones regulate hepatic lipid production. The aim of this study was to quantify circulating steroid hormones and lipid metabolites, and to characterize their interactions in normal and pathological pregnancies with a focus on hepatic and placental pathologies. METHODS: A total of 216 serum samples were analyzed. Group A consisted of 32 patients with uncomplicated pregnancies who were analyzed at three different time-points in pregnancy (from the first through the third trimester) and once post partum...
July 2016: Geburtshilfe und Frauenheilkunde
Renuka Shanmugalingam, Nina Reza Pour, Siang Chye Chuah, Thi Mong Vo, Roy Beran, Annemarie Hennessy, Angela Makris
BACKGROUND: Arterial dissection is a rare complication of pregnancy and puerperium. There have been reports of aortic, coronary and cervical artery dissection in association with preeclampsia, however, vertebral artery dissection is rarely reported particularly in the antenatal setting in the presence of a Hypertensive Disorder of Pregnancy (HDP).The general annual incidence of symptomatic spontaneous cervicocephalic arterial dissection is 0.0026 % and a data registry reported that 2...
2016: BMC Pregnancy and Childbirth
Martin Andreas, Lorenz Kuessel, Stefan P Kastl, Stefan Wirth, Kathrin Gruber, Franziska Rhomberg, Fatemeh A Gomari-Grisar, Maximilian Franz, Harald Zeisler, Michael Gottsauner-Wolf
BACKGROUND: Pregnancy associated cardiovascular pathologies have a significant impact on outcome for mother and child. Bioimpedance cardiography may provide additional outcome-relevant information early in pregnancy and may also be used as a predictive instrument for pregnancy-associated diseases. METHODS: We performed a prospective longitudinal cohort trial in an outpatient setting and included 242 pregnant women. Cardiac output and concomitant hemodynamic data were recorded from 11(th)-13(th) week of gestation every 5(th) week as well as at two occasions post partum employing bioimpedance cardiography...
2016: BMC Pregnancy and Childbirth
Justine Hugon-Rodin, Geneviève Plu-Bureau
Post-partum period is associated with specific characteristics in women with gestational disorders or preeclampsia. For breastfeeding women, the choice of antihypertensive treatment should take into account the impact on child health. The impact of breastfeeding on health mother must be also discussed. Moreover, for lactation inhibition, bromocriptine should not be used, especially in the context of gestational disorders. In post-partum period, the best contraceptive strategy is only-progestin contraception or non-hormonal contraceptives use...
July 2016: La Presse Médicale
Arsenio Spinillo, Fausta Beneventi, Elena Locatelli, Vèronique Ramoni, Roberto Caporali, Claudia Alpini, Giulia Albonico, Chiara Cavagnoli, Carlomaurizio Montecucco
OBJECTIVE: To evaluate the impact of preclinical systemic autoimmune rheumatic disorders on pregnancy outcome. METHODS: In this longitudinal cohort study, patients were enrolled during the first trimester of pregnancy if they reported having had connective tissue disorder symptoms, were found to be positive for circulating autoantibodies, and on clinical evaluation were judged to have a preclinical or incomplete rheumatic disorder. The incidence of fetal growth restriction (FGR), preeclampsia, and adverse pregnancy outcomes in patients with preclinical rheumatic disorders was compared with that in selected controls, after adjustment for confounders by penalized logistic regression...
October 2016: Arthritis & Rheumatology
Ivan Varga, Ladislav Urban, Marianna Kajanová, Štefan Polák
PURPOSE: Key discoveries of recent years comprise detection of telocytes. These cells of connective tissue have extremely long cytoplasmic processes through which they form functionally connected spatial networks. Through their processes they mutually contact and functionally connect also cells of the immune system, nerve fibres and smooth muscle cells. They are located in various parts of the female reproductive system where they can perform specifically significant functions, which are summarized in our literature review...
August 2016: Archives of Gynecology and Obstetrics
Josip Anđelo Borovac, Joško Božić, Nikola Žaja, Krešimir Kolić, Vedran Hrboka
A case is reported of a 26-year-old primiparous woman in the 32nd week of gestation who presented to the emergency department with the symptoms of a severe headache, nausea and vomiting. The patient was diagnosed with preeclampsia that later progressed to eclampsia. This state was characterized by a sudden onset of a headache and diplopia that advanced to cortical blindness and precipitated significant alterations in mental status, most notable being global amnesia that resolved within 48 h. A post-partum magnetic resonance imaging of the brain in FLAIR mode revealed multiple cortico-subcortical areas of hyperintense signals suggestive of edematous lesions that chiefly involved occipital and parietal lobes with additional atypical manifestations...
April 2016: Oxford Medical Case Reports
Cecile M Yelnik, T Flint Porter, D Ware Branch, Carl A Laskin, Joan T Merrill, Marta M Guerra, Michael D Lockshin, Jill P Buyon, Michelle Petri, Lisa R Sammaritano, Mary D Stephenson, Mimi Y Kim, Jane E Salmon
OBJECTIVE: To measure variance in antiphospholipid antibody (aPL) levels during pregnancy and to determine if variation affects pregnancy outcomes. METHODS: We used data from the PROMISSE (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) study, a multicenter prospective study of pregnant women with aPL and/or systemic lupus erythematosus (SLE). Antiphospholipid antibodies were considered present if any of the following were positive: anticardiolipin (aCL), anti-β2 -glycoprotein I (anti-β2 GPI) titers ≥40 IgG phospholipid (GPL) or IgM phospholipid (MPL) units, and/or lupus anticoagulant (LAC)...
August 2016: Arthritis & Rheumatology
P Berlit
Neurological disorders caused by pregnancy and puerperium include the posterior reversible encephalopathy syndrome, the amniotic fluid embolism syndrome (AFES), the postpartum angiopathy due to reversible vasoconstriction syndrome, and the Sheehan syndrome. Hypertension and proteinuria are the hallmarks of preeclampsia, seizures define eclampsia. Hemolysis, elevated liver enzymes and low platelets constitute the HELLP syndrome. Vision disturbances including cortical blindness occur in the posterior reversible encephalopathy syndrome (PRES)...
February 2016: Fortschritte der Neurologie-Psychiatrie
Florent Ymele Fouelifack, Jeanne Hortence Fouedjio, Jovanny Tsuala Fouogue, Zacharie Sando, Loic Dongmo Fouelifa, Robinson Enow Mbu
BACKGROUND: Obesity is a rising public health issue worldwide. Guidelines regarding maternal body mass index (BMI) and gestational weight gain (GWG) are missing in Cameroon where maternal mortality rate remains very high. We hypothesized that obesity and inappropriate GWG are associated with poor pregnancy outcomes. We aimed at assessing associations of BMI and GWG with pregnancy outcomes. METHODS: This was a retrospective cohort study at the Yaoundé Central Hospital...
2015: BMC Research Notes
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