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https://www.readbyqxmd.com/read/27897107/hypertension-in-the-neonatal-period-an-update
#1
Anish Pillai, Deepak Sharma, Pratichi Kadam
There has been a growing interest among neonatologists and paediatricians regarding identification and evaluation of hypertension in the neonatal period. Despite the emergent normative data on blood pressure values in term and preterm neonates over the last two decades, there is still controversy regarding correct definition and classification of hypertension. This article will discuss the current definitions, the available normative data and etiology of neonatal hypertension. There is paucity of records in terms of efficacy of antihypertensive drugs in this specific population and management is usually experience based, causing considerable heterogeneity amongst different units...
November 29, 2016: Current Hypertension Reviews
https://www.readbyqxmd.com/read/27896911/the-timing-and-prevalence-of-intraoperative-hypotension-in-infants-undergoing-laparoscopic-pyloromyotomy-at-a-tertiary-pediatric-hospital
#2
Allan F Simpao, Luis M Ahumada, Jorge A Gálvez, Christopher P Bonafide, Elicia C Wartman, William Randall England, Arul M Lingappan, Todd J Kilbaugh, Abbas F Jawad, Mohamed A Rehman
BACKGROUND: Intraoperative hypotension may be associated with adverse outcomes in children undergoing surgery. Infants and neonates under 6 months of age have less autoregulatory cerebral reserve than older infants, yet little information exists regarding when and how often intraoperative hypotension occurs in infants. AIMS: To better understand the epidemiology of intraoperative hypotension in infants, we aimed to determine the prevalence of intraoperative hypotension in a generally uniform population of infants undergoing laparoscopic pyloromyotomy...
November 29, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27892756/use-of-high-non-invasive-respiratory-support-pressures-in-preterm-neonates-a-single-centre-experience
#3
Abdulaziz Binmanee, Salhab El Helou, Sandesh Shivananda, Christoph Fusch, Amit Mukerji
PURPOSE: To describe the incidence, indications and clinical outcomes following high pressures on non-invasive respiratory support (NRS) in preterm neonates. STUDY DESIGN: Retrospective cohort study of all neonates with BW < 1,500 g admitted from July 2012 to June 2014 and placed on high NRS, defined as mean airway pressure ≥ 10 cm H2O for at least 12 continuous hours using NCPAP and/or nasal high frequency ventilation (NIHFV). Clinical and physiological outcomes following high NRS were ascertained...
November 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27887594/first-trimester-serum-placental-growth-factor-and-hyperglycosylated-human-chorionic-gonadotropin-are-associated-with-pre-eclampsia-a-case-control-study
#4
Elina Keikkala, Sini Koskinen, Piia Vuorela, Hannele Laivuori, Jarkko Romppanen, Seppo Heinonen, Ulf-Håkan Stenman
BACKGROUND: To study whether maternal serum hyperglycosylated human chorionic gonadotropin (hCG-h) improves first trimester prediction of pre-eclampsia when combined with placental growth factor (PlGF), pregnancy-associated plasma protein-A (PAPP-A) and maternal risk factors. METHODS: Gestational-age-adjusted concentrations of hCG, hCG-h, PlGF and PAPP-A were analysed in serum samples by time-resolved immunofluorometric assays at 8-13 weeks of gestation. The case-control study included 98 women who developed pre-eclampsia, 25 who developed gestational hypertension, 41 normotensive women with small-for-gestational-age (SGA) infants and 177 controls...
November 25, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27852228/pregnancy-outcome-in-women-with-eisenmenger-s-syndrome-a-case-series-from-west-china
#5
Ruiqi Duan, Xiumei Xu, Xiaodong Wang, Haiyan Yu, Yong You, Xinghui Liu, Aiyun Xing, Rong Zhou, Mingrong Xi
BACKGROUND: Eisenmenger's syndrome (ES) consists of pulmonary hypertension with a reversed or bidirectional shunt at the atrioventricular, or aortopulmonary level. The cardiovascular changes that occur during the pregnancy contribute to the high maternal morbidity and mortality in patients with ES. This study is to assess maternal and fetal outcomes in patients with ES. METHODS: This study is a retrospective analysis of 11 pregnancies in women with ES who delivered at a tertiary care center in west China between 2010 and 2014...
November 16, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27821757/nicotinamide-benefits-both-mothers-and-pups-in-two-contrasting-mouse-models-of-preeclampsia
#6
Feng Li, Tomofumi Fushima, Gen Oyanagi, H W Davin Townley-Tilson, Emiko Sato, Hironobu Nakada, Yuji Oe, John R Hagaman, Jennifer Wilder, Manyu Li, Akiyo Sekimoto, Daisuke Saigusa, Hiroshi Sato, Sadayoshi Ito, J Charles Jennette, Nobuyo Maeda, S Ananth Karumanchi, Oliver Smithies, Nobuyuki Takahashi
Preeclampsia (PE) complicates ∼5% of human pregnancies and is one of the leading causes of pregnancy-related maternal deaths. The only definitive treatment, induced delivery, invariably results in prematurity, and in severe early-onset cases may lead to fetal death. Many currently available antihypertensive drugs are teratogenic and therefore precluded from use. Nonteratogenic antihypertensives help control maternal blood pressure in PE, but results in preventing preterm delivery and correcting fetal growth restriction (FGR) that also occurs in PE have been disappointing...
November 22, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27792243/prediction-of-progression-to-severe-disease-in-women-with-late-preterm-hypertensive-disorders-of-pregnancy
#7
Eva F Zwertbroek, Kim Broekhuijsen, Josje Langenveld, Gert-Jan van Baaren, Paul P van den Berg, Henk A Bremer, Wessel Ganzevoort, Aren J van Loon, Ben W J Mol, Maria G van Pampus, Denise A M Perquin, Robbert J P Rijnders, Hubertina Cj Scheepers, Marko J Sikkema, Mallory D Woiski, Henk Groen, Maureen T M Franssen
If hypertensive disorders of pregnancy (HDP) are diagnosed before term, the benefits of immediate delivery need to be weighed against the neonatal consequences of preterm delivery. If we are able to predict which women are at high risk of progression to severe disease, they could be targeted for delivery and maternal complications may be reduced. In addition, this may prevent unnecessary preterm births in women at low risk MATERIAL AND METHODS: We developed a prediction model using data from the HYPITAT-II trail, which evaluated immediate delivery versus expectant monitoring in women with non-severe HDP between 34 and 37 weeks of gestation...
October 28, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27788933/risk-of-aortic-dissection-in-pregnant-patients-with-the-marfan-syndrome
#8
Rafael Kuperstein, Tal Cahan, Rakefet Yoeli-Ullman, Sagit Ben Zekry, Amihay Shinfeld, Michal J Simchen
Patients with Marfan syndrome (MS) face a high risk of aortic dissection during pregnancy. A dilated aortic root (>40 to 45 mm) is considered a relative contraindication for pregnancy. We investigated the risk for aortic dissection and pregnancy outcome in patients with MS. Women with MS who attended our cardiology high-risk pregnancy clinic from 2006 to 2015 were followed clinically and with serial echocardiograms by a multidisciplinary team. Beta blockers were offered and titrated by blood pressure and heart rate...
September 30, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27760764/bnp-troponin-i-and-ykl-40-as-screening-markers-in-extremely-preterm-infants-at-risk-for-pulmonary-hypertension-associated-with-bronchopulmonary-dysplasia
#9
Kai König, Katelyn J Guy, Claudia A Nold-Petry, Charles P Barfield, Geraldine Walsh, Sandra M Drew, Alex Veldman, Marcel F Nold, Dan M Casalaz
Bronchopulmonary dysplasia (BPD) is often complicated by pulmonary hypertension (PH). We investigated three biomarkers potentially suitable as screening markers for extremely preterm infants at risk of BPD-associated PH. In this prospective observational cohort study conducted in a tertiary neonatal intensive care unit, 83 preterm infants with BPD born <28-wk gestation and still inpatients at 36-wk corrected age received an echocardiogram and blood tests of B-type natriuretic peptide (BNP), troponin I, and YKL-40...
December 1, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27759454/perinatal-outcome-in-pregnancies-complicated-with-gestational-diabetes-mellitus-and-very-preterm-birth-case-control-study
#10
E G Deryabina, G V Yakornova, L A Pestryaeva, N D Sandyreva
Preterm birth is defined as all births before 37 completed weeks of gestation. Preterm birth can be further sub-divided based on gestational age: extremely preterm (<28 weeks), very preterm (28 to <32 weeks) and moderate preterm (32 to <37 weeks). Retrospective observational case-control study review (1 year i.e., 2015) is to assess pregnancy outcome among women with gestational diabetes mellitus (GDM) delivering very preterm (28 + 0/7 to 31 + 6/7 weeks of gestation). The study group included all women diagnosed with GDM and were compared to a control group of women delivering at the same gestational age period but without GDM...
October 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27754451/association-between-maternal-zinc-status-dietary-zinc-intake-and-pregnancy-complications-a-systematic-review
#11
Rebecca L Wilson, Jessica A Grieger, Tina Bianco-Miotto, Claire T Roberts
Adequate zinc stores in the body are extremely important during periods of accelerated growth. However, zinc deficiency is common in developing countries and low maternal circulating zinc concentrations have previously been associated with pregnancy complications. We reviewed current literature assessing circulating zinc and dietary zinc intake during pregnancy and the associations with preeclampsia (PE); spontaneous preterm birth (sPTB); low birthweight (LBW); and gestational diabetes (GDM). Searches of MEDLINE; CINAHL and Scopus databases identified 639 articles and 64 studies were reviewed...
October 15, 2016: Nutrients
https://www.readbyqxmd.com/read/27754116/os-23-03-mid-trimester-risk-prediction-of-superimposed-pre-eclampsia-in-pregnant-women-with-chronic-hypertension
#12
Su-A Kim, Jeong Bae Park
OBJECTIVE: Superimposed pre-eclampsia (SPE) is resolved only with the termination of the pregnancy. Therefore, the risk prediction and prevention is very important. We aimed to evaluate the characteristics of patients who develop SPE and their controllable risk factors during mid-trimester. DESIGN AND METHOD: A total of 283 pregnant women with chronic hypertension were included for the study. Blood pressure (BP) and body weight were recorded at 10, 20, 24, 28, and 32 weeks of gestation and pregnancy outcomes were evaluated...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27744568/noradrenaline-in-preterm-infants-with-cardiovascular-compromise
#13
Kirsten Rowcliff, Koert de Waal, Abdel-Latif Mohamed, Tejasvi Chaudhari
: Noradrenaline (NA) is beneficial in the treatment of term newborns with cardiovascular compromise due to sepsis or pulmonary hypertension, but experiences with NA in preterm infants are limited. The aim of this study is to describe the efficacy and safety of NA in preterm infants. Patient records of preterm infants ≤32 weeks' gestation admitted to two hospitals between 2004 and 2015 and who received NA were reviewed for perinatal morbidities and mortality. Clinical details were collected at the time of NA use, and response on blood pressure, perfusion and oxygenation was documented as well as possible side effects...
October 15, 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27744389/invited-commentary-hypertension-during-pregnancy-and-offspring-microvascular-structure-insights-from-the-retinal-microcirculation
#14
Odaro Huckstep, Adam J Lewandowski, Paul Leeson
Human clinical studies as well as laboratory animal studies demonstrate that offspring of pregnancies affected by common complications, such as preeclampsia and preterm birth, display developmental phenotypes that relate distinctly to the pregnancy disorder. Several studies have now found microvascular differences in offspring of hypertensive pregnancies, and there is interest in whether these may underlie epidemiologic associations between gestational hypertension and a higher risk of hypertension and stroke in the offspring...
October 15, 2016: American Journal of Epidemiology
https://www.readbyqxmd.com/read/27735931/inhaled-hydrofluoalkane-beclomethasone-dipropionate-in-bronchopulmonary-dysplasia-a-double-blind-randomized-controlled-pilot-study
#15
A Kugelman, M Peniakov, S Zangen, Y Shiff, A Riskin, A Iofe, I Shoris, D Bader, S Arnon
OBJECTIVE: The efficacy of inhaled steroids in spontaneously breathing infants with established bronchopulmonary dysplasia (BPD) is debatable. The inhaled steroid hydrofluoalkane-beclomethasone dipropionate (QVAR) is unique in its small particle size that results in higher lung deposition. Our objective was to determine if inhaled QVAR could decrease respiratory rehospitalizations of infants with established BPD. STUDY DESIGN: Double-blind, randomized placebo-controlled, multicenter pilot study...
October 13, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27711045/non-invasive-inhaled-nitric-oxide-in-the-treatment-of-hypoxemic-respiratory-failure-in-term-and-preterm-infants
#16
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
October 6, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27664264/long-term-cardiovascular-outcome-following-fetal-anaemia-and-intrauterine-transfusion-a-cohort-study
#17
Alexandra H Wallace, Stuart R Dalziel, Brett R Cowan, Alistair A Young, Kent L Thornburg, Jane E Harding
OBJECTIVE: To compare long-term cardiovascular outcomes in survivors of fetal anaemia and intrauterine transfusion with those of non-anaemic siblings. DESIGN: Retrospective cohort study. SETTING: Auckland, New Zealand. PARTICIPANTS: Adults who received intrauterine transfusion for anaemia due to rhesus disease (exposed) and their unexposed sibling(s). EXPOSURE: Fetal anaemia requiring intrauterine transfusion...
September 23, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27650051/mid-childhood-outcomes-of-repeat-antenatal-corticosteroids-a-randomized-controlled-trial
#18
Caroline A Crowther, Peter J Anderson, Christopher J D McKinlay, Jane E Harding, Pat J Ashwood, Ross R Haslam, Jeffery S Robinson, Lex W Doyle
OBJECTIVE: To assess if exposure to repeat dose(s) of antenatal corticosteroids has beneficial effects on neurodevelopment and general health in mid-childhood, at 6 to 8 years' corrected age. METHODS: Women at risk for very preterm birth, who had received a course of corticosteroids ≥7 days previously, were randomized to intramuscular betamethasone (11.4 mg Celestone Chronodose) or saline placebo, repeated weekly if risk of very preterm birth remained. Mid-childhood assessments included neurocognitive function, behavior, growth, lung function, blood pressure, health-related quality of life, and health service utilization...
September 20, 2016: Pediatrics
https://www.readbyqxmd.com/read/27643043/os-23-03-mid-trimester-risk-prediction-of-superimposed-pre-eclampsia-in-pregnant-women-with-chronic-hypertension
#19
Su-A Kim, Jeong Bae Park
OBJECTIVE: Superimposed pre-eclampsia (SPE) is resolved only with the termination of the pregnancy. Therefore, the risk prediction and prevention is very important. We aimed to evaluate the characteristics of patients who develop SPE and their controllable risk factors during mid-trimester. DESIGN AND METHOD: A total of 283 pregnant women with chronic hypertension were included for the study. Blood pressure (BP) and body weight were recorded at 10, 20, 24, 28, and 32 weeks of gestation and pregnancy outcomes were evaluated...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27620393/the-chips-randomized-controlled-trial-control-of-hypertension-in-pregnancy-study-is-severe-hypertension-just-an-elevated-blood-pressure
#20
Laura A Magee, Peter von Dadelszen, Joel Singer, Terry Lee, Evelyne Rey, Susan Ross, Elizabeth Asztalos, Kellie E Murphy, Jennifer Menzies, Johanna Sanchez, Amiram Gafni, Michael Helewa, Eileen Hutton, Gideon Koren, Shoo K Lee, Alexander G Logan, Wessel Ganzevoort, Ross Welch, Jim G Thornton, Jean-Marie Moutquin
: To determine whether clinical outcomes differed by occurrence of severe hypertension in the international CHIPS trial (Control of Hypertension in Pregnancy Study), adjusting for the interventions of "less tight" (target diastolic blood pressure [dBP] 100 mm Hg) versus "tight" control (target dBP 85 mm Hg). In this post-hoc analysis of CHIPS data from 987 women with nonsevere nonproteinuric preexisting or gestational hypertension, mixed effects logistic regression was used to compare the following outcomes according to occurrence of severe hypertension, adjusting for allocated group and the influence of baseline factors: CHIPS primary (perinatal loss or high-level neonatal care for >48 hours) and secondary outcomes (serious maternal complications), birth weight <10th percentile, preeclampsia, delivery at <34 or <37 weeks, platelets <100×10(9)/L, elevated liver enzymes with symptoms, maternal length of stay ≥10 days, and maternal readmission before 6 weeks postpartum...
November 2016: Hypertension
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