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"Prediction" AND "pre-eclampsia"

Tiong Y Lim, Enoka Gonsalkorala, Mary D Cannon, Stella Gabeta, Leonie Penna, Nigel D Heaton, Michael A Heneghan
BACKGROUND: Liver transplantation (LT) is a successful treatment for both acute liver failure and end-stage liver disease. The number of women of reproductive age undergoing LT is increasing. Pregnancy outcomes are favourable but there is still a lack of prognostic markers. We aimed to identify factors predictive of adverse pregnancy outcomes in LT recipients. METHODS: An analysis of all pregnancies occurring in LT recipients from 1989-2016 at King's College Hospital was performed...
March 14, 2018: Liver Transplantation
M Y Tan, D Wright, A Syngelaki, R Akolekar, S Cicero, D Janga, M Singh, E Greco, A Wright, K Maclagan, L C Poon, K H Nicolaides
OBJECTIVE: To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines. METHODS: This was a prospective multicenter study (screening program for pre-eclampsia (SPREE)) in seven National Health Service maternity hospitals in England, of women recruited between April and December 2016...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
M E Rodríguez-Almaraz, I Herraiz, P I Gómez-Arriaga, P Vallejo, E Gonzalo-Gil, A Usategui, E A López-Jiménez, A Galindo, M Galindo
OBJECTIVE: To evaluate the usefulness of the uterine artery mean pulsatility index (mPI-UtA) and the sFlt-1/PlGF ratio in women with systemic lupus erythematosus (SLE) or antiphospholipid syndrome (APS) for the prediction of placental dysfunction-related adverse outcomes (AO), namely pre-eclampsia (PE) and intrauterine growth restriction (IUGR), and for differential diagnosis between PE and SLE flares. STUDY DESIGN: Observational prospective cohort study of 57 pregnant women with SLE or APS...
January 2018: Pregnancy Hypertension
Beatriz Manriquez Rocha, Francisco Mbofana, Osvaldo Loquiha, Chishamiso Mudenyanga, U Vivian Ukah, Laura A Magee, Peter von Dadelszen
In well-resourced settings, reduced circulating maternal free placental growth factor (PlGF) aids in either predicting or confirming the diagnosis of preeclampsia, fetal growth restriction, stillbirth, preterm birth, and delivery within 14 days of testing when pre-eclampsia is suspected. This operational pilot implementation of maternal plasma PlGF in women with suspected preeclampsia was conducted in six antenatal clinics in Maputo, Mozambique (six control clinics for comparison). The primary outcome was transfer to higher levels of care, following the informative PlGF assay...
January 2018: Pregnancy Hypertension
Louise Mary Webster, Carolyn Gill, Paul T Seed, Kate Bramham, Cornelia Wiesender, Catherine Nelson-Piercy, Jenny E Myers, Lucy C Chappell
Black ethnicity is associated with worse pregnancy outcomes in women with chronic hypertension. Pre-existing endothelial and renal dysfunction, and poor placentation may contribute but pathophysiological mechanisms underpinning increased risk are poorly understood. This cohort study aimed to investigate the relationship between ethnicity, superimposed pre-eclampsia and longitudinal changes in markers of endothelial, renal and placental dysfunction in women with chronic hypertension. Plasma concentrations of placental growth factor (PlGF), syndecan-1, renin, aldosterone, and urinary angiotensinogen:creatinine ratio (AGTCR), protein:creatinine ratio (PCR) and albumin:creatinine ratio (ACR) were quantified during pregnancy and postpartum in women with chronic hypertension...
March 7, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Enric Sabrià Bach, Paloma Lequerica-Fernández, Paula Lafuente-Ganuza, Edwin Eguia Ángeles, Ana I Escudero, Eduardo Martínez-Morillo, Carles Barceló Vidal, Francisco V Alvárez
OBJECTIVES: Short-term prediction of pre-eclampsia using the sFlt-1/PlGF ratio is characterized by frequent false positive results. As such, no treatment can be recommended to test positive patients. Multiple measurements are common in these patients. AIM: To evaluate the influence of NT-proBNP, uric acid and the sFlt-1/PlGF ratio in the prediction of delivery with pre-eclampsia within one week in singleton pregnancies from 24 weeks 0 days to 36 weeks 6 days of gestation, with signs and symptoms of pre-eclampsia and a sFlt-1/PlGF ratio above 38...
March 2, 2018: Ultrasound in Obstetrics & Gynecology
Dominique Mannaerts, Ellen Faes, Jan Gielis, Emeline Van Craenenbroeck, Paul Cos, Marc Spaanderman, Wilfried Gyselaers, Jerome Cornette, Yves Jacquemyn
BACKGROUND: Pre-eclampsia (PE) is related to an impaired endothelial function. Endothelial dysfunction accounts for altered vascular reactivity, activation of the coagulation cascade and loss of vascular integrity. Impaired endothelial function originates from production of inflammatory and cytotoxic factors by the ischemic placenta and results in systemic oxidative stress (OS) and an altered bioavailability of nitric oxide (•NO). The free radical •NO, is an endogenous endothelium-derived relaxing factor influencing endothelial function...
February 27, 2018: BMC Pregnancy and Childbirth
Tuangsit Wataganara, Jarunee Leetheeragul, Suchittra Pongprasobchai, Anuwat Sutantawibul, Chayawat Phatihattakorn, Surasak Angsuwathana
The benefit of the early administration of aspirin to reduce preterm pre-eclampsia among screened positive European women from multivariate algorithmic approach (ASPRE trial) has opened an intense debate on the feasibility of universal screening. This review aims to assess the new perspectives in the combined screening of pre-eclampsia in the first trimester of pregnancy and the chances for prevention using low-dose aspirin with special emphasis on the particularities of the Asian population. PubMed, CENTRAL and Embase databases were searched from inception until 15 November 2017 using combinations of the search terms: preeclampsia, Asian, prenatal screening, early prediction, ultrasonography, pregnancy, biomarker, mean arterial pressure, soluble fms-like tyrosine kinase-1, placental growth factor, pregnancy-associated plasma protein-A and pulsatility index...
February 14, 2018: Journal of Obstetrics and Gynaecology Research
Ruo-Ting Xu, Qing-Xian Chang, Qi-Qiong Wang, Jian Zhang, Lai-Xin Xia, Nanbert Zhong, Yan-Hong Yu, Mei Zhong, Qi-Tao Huang
Background: Autism spectrum disorder (ASD) is a common severe pervasive neurodevelopmental disorder of undetermined etiology. Environmental exposures, especially pregnancy complications, have been increasingly recognized as a potential risk factor for ASD. Our aim was to (1) systematically evaluate the association between hypertensive disorders of pregnancy (HDP) and the risk of ASD in offspring, (2) specifically draw a subgroup analysis of disease severity in patients with HDP to achieve more sufficient evidence on this issue...
January 2, 2018: Oncotarget
Allessandra Tramontana, Eleonore Pablik, Gerhard Stangl, Beda Hartmann, Hans Dieplinger, Erich Hafner
OBJECTIVE: Aim of the study was to assess the correlation of first trimester serum afamin levels with three-dimensional placental bed vascularization in pregnant women and its prognostic value for predicting pre-eclampsia and future fetal and maternal complications during pregnancy. METHODS: In this nested case-control study all pregnant women registered for delivery during a period of 3 years were routinely screened in the first trimester. Serum afamin levels were assessed in 764 women and correlated to 5 pregnancy outcome groups: gestational hypertension (n = 76), pre-eclampsia (n = 33), intrauterine growth restriction (n = 91), pre-term birth (n = 39), gestational diabetes mellitus (n = 170); In addition, measurements of first trimester myometrial vascularization index were performed and, in combination with afamin tested as a possible screening method to detect women at-risk for the development of adverse complications in low-risk pregnancies at the time of the first trimester...
February 2018: Placenta
Soon Leong Yong, Beng Kwang Ng, Muhammad Abdul Jamil Mohd Yassin, Syed Zulkifli Syed Zakaria, Nor Azlin Mohamed Ismail
This study was to assess the relationship between late pregnancy haemoglobin A1C (HbA1C) at 29-30 weeks of gestation and adverse pregnancy outcomes (APOs) in 272 pregnant women with pre-existing diabetes. HbA1C ≥6.1% was associated with significantly increased risk of preterm delivery, Caesarean section, large for gestational age (LGA), neonatal respiratory distress, neonatal hypoglycaemia, and composite adverse neonatal outcome (p < .05). The risk of pre-eclampsia increased significantly at the lower HbA1C cut-off of > 5...
February 1, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Sadia Bhatti, Mark Cordina, Leonie Penna, Roy Sherwood, Tracy Dew, Nikos A Kametas
INTRODUCTION: The replacement of 24-hour urine collection by protein-creatinine ratio (PCR) for the diagnosis of pre-eclampsia has been recently recommended. However, the literature is conflicting and there are concerns on the impact of demographic characteristics on the performance of PCR. MATERIALS AND METHODS: This was an implementation audit of the introduction of PCR in a London Tertiary obstetric unit. The performance of PCR in the prediction of proteinuria ≥300mg/day was assessed in 476 women with suspected pre-eclampsia who completed a 24-hour urine collection and an untimed urine sample for PCR calculation...
January 21, 2018: Acta Obstetricia et Gynecologica Scandinavica
Kazım Uckan, Hanım Guler Sahin
AIM: The aim of this study was to determine the relationship between serum amyloid A (SAA), procalcitonin (ProC), highly sensitive C reactive protein (hsCRP) and tumor necrosis factor (TNF) alpha activity in patients with pre-eclampsia, eclampsia and hemolysis, elevated liver enzymes, low platelet count (HELLP), and the pathogenesis and severity of the disease. METHOD: Ninety patients at ≥ 32 gestational weeks, according to the last date of menstruation and ultra-sonographic measurements, diagnosed with pre-eclampsia (30 patients), eclampsia (30 patients) or HELLP syndrome (30 patients) were included in the study...
March 2018: Journal of Obstetrics and Gynaecology Research
Daniel L Rolnik, Fabricio da Silva Costa, Timothy J Lee, Maximilian Schmid, Andrew C McLennan
AIMS: To evaluate the association of fetal fraction on cell-free DNA (cfDNA) testing with first trimester markers for pre-eclampsia and to investigate a possible association of low fetal fraction with increased risk for pre-eclampsia (PE) and fetal growth restriction (FGR). METHODS: This was a retrospective cohort study including all women with singleton pregnancies who had risk calculation for PE and FGR between 11+0 and 13+6 weeks' gestation and also decided to have cfDNA as a primary or secondary screening test for chromosomal abnormalities at any gestational age in two Fetal Medicine clinics in Sydney and Melbourne, Australia, between March 2013 and May 2017...
January 10, 2018: Ultrasound in Obstetrics & Gynecology
Hélène Caillon, Cécile Tardif, Erwan Dumontet, Norbert Winer, Damien Masson
BACKGROUND: Management of pregnant women at high risk of pre-eclampsia (PE) requires frequent monitoring, with referral to specialized perinatal care centers. Reliable tests are necessary to improve prediction of PE and related complications and to assess disease severity and progression. An imbalance in two biomarkers, soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF), is involved in PE pathogenesis. The sFlt-1 to PlGF ratio is increased in pregnant women before the onset of PE...
March 2018: Annals of Laboratory Medicine
U Vivian Ukah, Dane A De Silva, Beth Payne, Laura A Magee, Jennifer A Hutcheon, Helen Brown, J Mark Ansermino, Tang Lee, Peter von Dadelszen
BACKGROUND: The hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity. The ability to predict these complications using simple tests could aid in management and improve outcomes. We aimed to systematically review studies that reported on potential predictors of adverse maternal outcomes among women with a hypertensive disorder of pregnancy. METHODS: We searched MEDLINE, Embase and CINAHL (inception - December 2016) for studies of predictors of severe maternal complications among women with a hypertensive disorder of pregnancy...
November 21, 2017: Pregnancy Hypertension
Allessandra Tramontana, Benjamin Dieplinger, Gerhard Stangl, Erich Hafner, Hans Dieplinger
OBJECTIVE: Aim of this study was to assess the prognostic capability of afamin to predict pregnancy complications. METHOD: First-trimester screening was consecutively performed in 4948 pregnant women, of whom 474 women developed pregnancy complications [gestational hypertension (n=84), pre-eclampsia (n=30), intrauterine growth restriction (n=107), preterm birth (n=44), and gestational diabetes mellitus (n=209)]. To each woman with pregnancy complications an uncomplicated pregnancy was matched for body mass index...
January 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Hannah L Nathan, Paul T Seed, Natasha L Hezelgrave, Annemarie De Greeff, Elodie Lawley, John Anthony, David R Hall, Wilhelm Steyn, Lucy C Chappell, Andrew H Shennan
OBJECTIVES: To evaluate the association between blood pressure (BP) measurements and adverse outcomes in women with pre-eclampsia. STUDY DESIGN: A prospective cohort study of women with pre-eclampsia admitted to three South African tertiary facilities. BP was measured using the CRADLE Vital Signs Alert (VSA), incorporated with a traffic light early warning system; green: systolic BP <140 mmHg and diastolic BP <90 mmHg, yellow: systolic BP 140-159 and/or diastolic BP 90-109 mmHg (but neither is above the upper threshold), red: systolic BP ≥160 mmHg and/or diastolic BP ≥110 mmHg...
November 21, 2017: Pregnancy Hypertension
Wai Hang Chung, William Wing Kee To
OBJECTIVE: To examine maternal and neonatal outcomes of gestational proteinuria, and to identify maternal characteristics for progression to pre-eclampsia. STUDY DESIGN: Retrospective cohort. Included all pregnant women who delivered between Jan 2014-Feb 2017 with new onset proteinuria in a single obstetric unit. Demographic, maternal and neonatal outcomes were compared. RESULTS: Eighteen (25%) out of 73 women with new onset gestational proteinuria developed pre-eclampsia...
November 21, 2017: Pregnancy Hypertension
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