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preeclampsia post partum

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https://www.readbyqxmd.com/read/28906533/cardiac-diastolic-function-after-recovery-from-pre-eclampsia
#1
P Soma-Pillay, M C Louw, A O Adeyemo, J Makin, R C Pattinson
BACKGROUND: Pre-eclampsia is associated with significant changes to the cardiovascular system during pregnancy. Eccentric and concentric remodelling of the left ventricle occurs, resulting in impaired contractility and diastolic dysfunction. It is unclear whether these structural and functional changes resolve completely after delivery. AIMS: The objective of the study was to determine cardiac diastolic function at delivery and one year post-partum in women with severe pre-eclampsia, and to determine possible future cardiovascular risk...
August 31, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28816629/a-cascade-model-of-mentorship-for-frontline-health-workers-in-rural-health-facilities-in-eastern-uganda-processes-achievements-and-lessons
#2
Judith Ajeani, Richard Mangwi Ayiasi, Moses Tetui, Elizabeth Ekirapa-Kiracho, Gertrude Namazzi, Ronald Muhumuza Kananura, Suzanne Namusoke Kiwanuka, Jolly Beyeza-Kashesya
BACKGROUND: There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers. OBJECTIVES: This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model...
August 2017: Global Health Action
https://www.readbyqxmd.com/read/28782324/congenital-perisylvian-syndrome-presenting-as-post-partum-seizures-with-preeclampsia
#3
Arun Agarwal, Manju Goyal, Jainendra Jain, Aakanksha Agarwal
Whether preceded by preeclampsia, or occuring without antecedent warning symptoms, eclamptic seizures usually occur in the antepartum period between 20 and 40 weeks of gestation or within a few hours to 2 days postpartum. We report the case of a patient with pre-eclampsia who developed seizures after more than 2 days of delivery. In view of late onset postpartum seizures and non-responsiveness to magnesium sulphate, she was further evaluated and diagnosed to have congenital perisylvian syndrome(CPS). In CPS, polymicrogyric cortex is distributed in variable extensions around the sylvian fissure i...
June 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28680468/a-rare-cause-of-hypertension-in-pregnancy-phaeochromocytoma
#4
Sonali Shah, Lindsay Edwards, Andrew Robinson, Amy Crosthwaite, Christine Houlihan, Kathy Paizis
A 26-year-old primigravida at 35 weeks' gestation was transferred to our institution from a regional hospital for management of presumed preeclampsia. Due to the labile nature of her hypertension, further investigation was undertaken which revealed a right-sided phaeochromocytoma. Alpha blockade was commenced, and an uncomplicated elective caesarean delivery was performed at 38 weeks' gestation under spinal anaesthetic. The patient underwent an elective right laparoscopic adrenalectomy six weeks post-partum...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28672769/reference-intervals-and-longitudinal-changes-in-copeptin-and-mr-proadm-concentrations-during-pregnancy
#5
Annemiek M C P Joosen, Ivon J M van der Linden, Lianne Schrauwen, Alisia Theeuwes, Monique J M de Groot, Antonius A M Ermens
BACKGROUND: Vasopressin and adrenomedullin and their stable by-products copeptin and midregional part of proadrenomedullin (MR-proADM) are promising biomarkers for the development of preeclampsia. However, clinical use is hampered by the lack of trimester-specific reference intervals. We therefore estimated reference intervals for copeptin and MR-proADM in disease-free Dutch women throughout pregnancy. METHODS: Apparently healthy low risk pregnant women were recruited...
June 16, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28637667/thrombocytopenia-in-pregnancy
#6
Douglas B Cines, Lisa D Levine
Thrombocytopenia develops in 5-10% of women during pregnancy or in the immediate post-partum period. A low platelet count is often an incidental feature, but it can also provide a biomarker of a coexisting systemic or gestational disorder and a potential reason for a maternal intervention or treatment that might pose harm to the fetus. This chapter reflects our approach to these issues with an emphasis on advances in understanding and managing the more common causes of thrombocytopenia in pregnancy made over the past 5-10 years...
June 21, 2017: Blood
https://www.readbyqxmd.com/read/28526027/description-of-inter-institutional-referrals-after-admission-for-labor-and-delivery-a-prospective-population-based-cohort-study-in-rural-maharashtra-india
#7
Archana B Patel, Amber Abhijeet Prakash, Camille Raynes-Greenow, Yamini V Pusdekar, Patricia L Hibberd
BACKGROUND: In 2008, the Indian government introduced financial assistance to encourage health facility deliveries. Facility births have increased, but maternal and neonatal morbidity and mortality have not decreased raising questions about the quality of care provided in facilities and access to a quality referral system. We evaluated the potential role of inter-institutional transfers of women admitted for labor and delivery on adverse maternal and neonatal outcomes in an ongoing prospective, population-based Maternal and Newborn Health Registry in Central India...
May 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28402512/defective-trophoblast-invasion-underlies-fetal-growth-restriction-and-preeclampsia-like-symptoms-in-the-stroke-prone-spontaneously-hypertensive-rat
#8
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 (FGR)...
July 1, 2017: Molecular Human Reproduction
https://www.readbyqxmd.com/read/28376740/maternal-27-hydroxycholesterol-concentrations-during-the-course-of-pregnancy-and-in-pregnancy-pathologies
#9
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
https://www.readbyqxmd.com/read/28262241/hemostatic-issues-in-pregnancy-induced-liver-disease
#10
REVIEW
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
https://www.readbyqxmd.com/read/28004456/maternal-endothelial-function-and-vascular-stiffness-after-hellp-syndrome-a-case-control-study
#11
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
https://www.readbyqxmd.com/read/27939485/postpartum-physiology-psychology-and-paediatric-follow-up-study-p4-study-study-protocol
#12
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
https://www.readbyqxmd.com/read/27854380/physiologic-adaptation-of-plasma-volume-during-pregnancy-a-systematic-review-and-meta-analysis
#13
REVIEW
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
https://www.readbyqxmd.com/read/27793555/a-longitudinal-analysis-of-angiotensin-ii-type-1-receptor-antibody-and-angiogenic-markers-in-pregnancy
#14
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) have been shown to 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...
February 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27730791/atypical-posterior-reversible-encephalopathy-syndrome-pres-in-de-novo-late-post-partum-eclampsia
#15
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
https://www.readbyqxmd.com/read/27680806/e5-lung-ultrasound-and-echocardiography-for-peripartum-haemodynamic-monitoring-of-patients-with-severe-preeclampsia
#16
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
https://www.readbyqxmd.com/read/27603899/stanniocalcin-1-hormone-in-nonpreeclamptic-and-preeclamptic-pregnancy-clinical-life-style-and-genetic-modulators
#17
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
https://www.readbyqxmd.com/read/27582578/maternal-serum-lipid-estradiol-and-progesterone-levels-in-pregnancy-and-the-impact-of-placental-and-hepatic-pathologies
#18
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
https://www.readbyqxmd.com/read/27422677/vertebral-artery-dissection-in-hypertensive-disorders-of-pregnancy-a-case-series-and-literature-review
#19
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
https://www.readbyqxmd.com/read/27251149/bioimpedance-cardiography-in-pregnancy-a-longitudinal-cohort-study-on-hemodynamic-pattern-and-outcome
#20
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
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