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Pregnancy Hypertension

Zhao Xiaobo 赵肖波, He Qizhi, Wu Zhiping, Duan Tao
OBJECTIVE: Endoglin is expressed in human placenta and plays an important role in the pathogenesis of preeclampsia. Dysregulation of microRNAs in placental tissues has been recently suggested to be involved in the pathogenesis of preeclampsia. Until now, few studies have shed light on the correlation between endoglin and microRNAs, the latter of which may regulate the expression of ENG, a gene encoding endoglin, in placenta. In this study, we aim to investigate the regulation of ENG by microRNAs...
January 10, 2019: Pregnancy Hypertension
D Berks, M Hoedjes, H Raat, A Franx, C W N Looman, M F Van Oostwaard, D N M Papatsonis, J J Duvekot, E A P Steegers
OBJECTIVES: To evaluate the feasibility and effectiveness of a postpartum lifestyle intervention after pregnancies complicated by preeclampsia, fetal growth restriction (FGR) and/or gestational diabetes mellitus (GDM) to improve maternal risk factors for future cardiometabolic disease. METHODS: Women following a complicated pregnancy were included six months postpartum in this specific pre-post controlled designed study. It has been conducted in one tertiary and three secondary care hospitals (intervention group) and one secondary care hospital (control group)...
January 2019: Pregnancy Hypertension
Leticia G Paula, Bartira E Pinheiro da Costa, Marta R Hentschke, Ivan C Antonello, Jorge H Luz, Edson V da Cunha Filho, Carlos E Poli-de-Figueiredo
OBJECTIVES: Eclampsia results in high morbidity and mortality, so it is important to identify clinical and laboratorial aspects that may be useful as potential markers to differentiate women at higher risk. Thus, we aim to identify, among women with preeclampsia, aspects that may increase the risk to develop eclampsia. STUDY DESIGN: Retrospective cohort study. The records of patients delivered at Hospital São Lucas/PUCRS were reviewed retrospectively; 733 pregnant women with hypertension were analyzed; 329 had preeclampsia, and 45 eclampsia...
January 2019: Pregnancy Hypertension
Wenjuan Sun, Yongping Xu, Qian Xin, Yuan Zhang, Baoxia Cui, Fanzhen Hong
OBJECTIVES: Cyclophilin A (CypA) plays important roles in inflammation and oxidative stress and is significantly increased in serum of preeclampsia (PE) patients. We aimed to investigate CypA genetic polymorphism and its serum and placenta expressions in severe PE of Han Chinese women. METHODS: A case-control study of 82 severe PE patients and 179 healthy pregnancies was conducted. Single-nucleotide polymorphism (SNP) sites of rs3735481, rs9638978 and rs11984372 were analyzed by TaqMan assay...
January 2019: Pregnancy Hypertension
Ida Näslund Thagaard, Paula L Hedley, Jens-Christian Holm, Theis Lange, Torben Larsen, Lone Krebs, Michael Christiansen
OBJECTIVE: Preeclampsia (PE) is a serious complication of pregnancy, the pathogenesis of which is largely unknown. We hypothesize that adipocytokines may play a role in the pathogenesis of PE, particularly in obese women, and evaluate leptin and adiponectin as potential first trimester markers for predicting PE. STUDY DESIGN: A cohort of 2503 pregnancies, containing 93 PE pregnancies, was divided into women with normal weight, moderate, or severe obesity. All pregnancies had serum adiponectin and leptin measured in first trimester...
January 2019: Pregnancy Hypertension
Mark W Cunningham, Venkata Ramana Vaka, Kristen McMaster, Tarek Ibrahim, Denise C Cornelius, Lorena Amaral, Nathan Campbell, Gerd Wallukat, Shyanne McDuffy, Nathan Usry, Ralf Dechend, Babbette LaMarca
Women with preeclampsia (PE) have increased mean arterial pressure (MAP), natural killer (NK) cells, reactive oxygen species (ROS), and agonistic autoantibodies to the angiotensin II type 1 receptor (AT1-AA). AT1-AA's administered to pregnant rodents produces a well-accepted model of PE. However, the role of NK cells and mitochondrial reactive oxygen species (mtROS) in AT1-AA mediated hypertension during pregnancy is unknown. We hypothesize that AT1-AA induced model of PE will exhibit elevated MAP, NK cells, and mtROS; while inhibition of the AT1-AA binding to the AT1R would be preventative...
January 2019: Pregnancy Hypertension
Ashlyn C Harmon, Tarek Ibrahim, Denise C Cornelius, Lorena M Amaral, Mark W Cunningham, Kedra Wallace, Babbette LaMarca
Preeclampsia (PE), new onset hypertension during pregnancy, is associated with a proinflammatory profile compared to normal pregnancy (NP). We hypothesize that CD4+ T cells from PE patient placentas cause PE symptoms during pregnancy compared to those from NP women. CD4+ T cells were isolated from placentas of PE and NP women using anti-CD4 magnetic separation, cultured in TexMACS medium at 37 °C in 5% CO2 , and injected intraperitoneally into nude-athymic rats on day 12 of gestation. On day 18, carotid catheters were implanted and on day 19, mean arterial pressure (MAP) was measured and blood and tissues were collected...
January 2019: Pregnancy Hypertension
Margaret B Sahu, Venkataraman Deepak, Stephen K Gonzales, Bassam Rimawi, Keiana K Watkins, Alicia K Smith, Martina L Badell, Neil Sidell, Augustine Rajakumar
Uterine stromal cell decidualization of maternal tissue is essential for implantation of and local adaptation to the fetal allograft, as well as growth and maintenance of the placenta in healthy pregnancies. Maternal defects in decidualization have been suggested as a possible driver of preeclampsia. Preeclampsia (PE) pregnancies demonstrate shallow implantation, inadequate spiral artery remodeling, and elevated levels of the anti-angiogenic protein, sFlt1. To test whether stromal cells (DSCs) isolated from PE placentas exhibit inadequate re-decidualization and increased expression of sFlt1, DSCs from normotensive (NT-DSCs) and PE (PE-DSCs) placentas were treated for 8 days (D8) with cAMP to induce decidualization and levels of decidualization markers (PRL, IGFBP1, VEGF) and sFlt1 were measured at day 0 (D0), D8, and after reversal of treatment...
January 2019: Pregnancy Hypertension
Freke A Wilmink, Joyce Reijnierse, Irwin K M Reiss, Eric A P Steegers, Rogier C J de Jonge
OBJECTIVE: Bronchopulmonary dysplasia (BPD) is a severe common complication of preterm birth with considerable short and long-term consequences. As more evidence is emerging that dysregulation of angiogenesis is implicated in the pathogenesis of preeclampsia as well as in fetal lung development, we assessed if preeclampsia is associated with development of BPD in very preterm neonates. STUDY DESIGN: A retrospective cohort study of 308 infants born between 24+0 and 31+6 weeks of gestation in 2011 and 2012...
January 2019: Pregnancy Hypertension
Emma von Wowern, Karin Källén, Per Olofsson
INTRODUCTION: It might in the future be valuable to screen for increased maternal arterial stiffness, i.e. low compliance, since it is associated with development of hypertensive complications in pregnancy. Digital pulse wave analysis (DPA) is an easy and manageable method for arterial stiffness assessment. We aimed to investigate gestational influence on DPA variables longitudinally, and establish gestational age-adjusted reference values in normal pregnancy. METHODS: DPA measurements were performed longitudinally up to five times during pregnancy in 139 healthy women...
January 2019: Pregnancy Hypertension
U Vivian Ukah, Beth Payne, Hanna Karjalainen, Eija Kortelainen, Paul T Seed, Frances Inez Conti-Ramsden, Vivien Cao, Hannele Laivuori, Jennifer Hutcheon, Lucy Chappell, J Mark Ansermino, Manu Vatish, Christopher Redman, Tang Lee, Larry Li, Laura A Magee, Peter von Dadelszen
The fullPIERS model is a risk prediction model developed to predict adverse maternal outcomes within 48 h for women admitted with pre-eclampsia. External validation of the model is required before implementation for clinical use. We assessed the temporal and external validity of the fullPIERS model in high income settings using five cohorts collected between 2003 and 2016, from tertiary hospitals in Canada, the United States of America, Finland and the United Kingdom. The cohorts were grouped into three datasets for assessing the primary external, and temporal validity, and broader transportability of the model...
January 2019: Pregnancy Hypertension
Josephus F M Van Den Heuvel, A Titia Lely, Arie Franx, Mireille N Bekker
OBJECTIVE: Self monitoring of blood pressure in pregnancy is increasingly popular with both health care professionals and patients. We assessed the validity of the iHealth Track and Omron HEM-9210T automated blood pressure devices (with Bluetooth connectivity) for the use in telemonitoring of blood pressure in pregnancy. METHODS: In this prospective observational study, the revised 2010 International Protocol of the European Hypertension Society (EHS) was used for the validation of the two devices against auscultatory sphygmomanometry by two independent observers who took 13 same arm measurements in 33 pregnant women, of which 10 were diagnosed with preeclampsia...
January 2019: Pregnancy Hypertension
Thomas P Bernardes, Ben W Mol, Anita C J Ravelli, Paul P van den Berg, H Marike Boezen, Henk Groen
OBJECTIVE: To estimate preeclampsia occurrence and recurrence risk in the 2nd pregnancy and analyze associated risk factors such as 1st pregnancy maximum diastolic blood pressure (maxDBP) and gestational age at delivery (GA). STUDY DESIGN: Linked cohort of 1st and 2nd pregnancies of 272,551 women from the Dutch Perinatal Registry collected between 2000 and 2007. We defined preeclampsia as hypertension (maxDBP ≥90 mmHg or documented hypertension) plus proteinuria (≥300 mg/24 h) and analyzed its 2nd pregnancy occurrence with logistic regression...
January 2019: Pregnancy Hypertension
Ankita Malik, Babban Jee, Satish Kumar Gupta
Preeclampsia is the cause of significant maternal and fetal mortality and morbidity. It is characterized by new-onset hypertension and proteinuria after 20 weeks of gestation. Preeclamptic women and children born from preeclamptic pregnancies are at greater risk to develop severe cardiovascular complications and metabolic syndromes later in life. The incidence of preeclampsia is estimated to be seven times higher in developing countries as compared to the developed countries. This review summarizes the pathophysiology of preeclampsia, emerging new hypothesis of its origin, risk factors that make women susceptible to developing preeclampsia and the potential of various biomarkers being studied to predict preeclampsia...
January 2019: Pregnancy Hypertension
Emily W Harville, Janet Catov, C Elizabeth Lewis, Kirsten Bibbins-Domingo, Erica P Gunderson
BACKGROUND: Renal insufficiency is associated with pregnancy complications including fetal growth restriction, preterm birth (PTB), and pre-eclampsia. OBJECTIVE: To determine the effect of preconception kidney function within the normal range on pregnancy outcome. METHOD: 1043 (50% black, 50% white) women who participated in the CARDIA study who had kidney function and biochemical analyses measured before at least one pregnancy delivered during the 20 years post-baseline period were included in analysis...
January 2019: Pregnancy Hypertension
Young Joo Lee, Sul Lee, Hyun Nyung Jo, Jin Mi Kim, Byung Su Kwon, Jong Kil Joo, Ki Hyung Kim, Seung Chul Kim
OBJECTIVES: We aimed to investigate alterations in transcranial Doppler indices (TCD) of the cerebral arteries between normotensive and preeclampsia (PE) pregnancies according to the presence of cerebral symptoms. STUDY DESIGN: This cross-sectional study included 48 PE and 20 normotensive pregnancies, respectively. Doppler indices of the anterior, middle, and posterior cerebral arteries (ACA, MCA, and PCA, respectively) were compared between the PE and normotensive group...
January 2019: Pregnancy Hypertension
Monica Zen, Suja Padmanabhan, Ngai Wah Cheung, Adrienne Kirby, Shilpa Jesudason, Thushari I Alahakoon, Vincent W Lee
OBJECTIVES: To determine if microalbuminuria can be used as a predictive marker of preeclampsia and adverse pregnancy and neonatal outcomes in women with pre-existing diabetes and to compare the prognostic utility of urinary albumin to creatinine ratio (uACR) and urinary protein to creatinine ratio (uPCR). STUDY DESIGN: Multicentre prospective cohort study. Antenatal Diabetes in Pregnancy clinics at three tertiary referral hospitals in Western Sydney, Australia...
January 2019: Pregnancy Hypertension
Hirotada Suzuki, Chikako Hirashima, Shiho Nagayama, Kayo Takahashi, Tatsuo Yamamoto, Shigeki Matsubara, Akihide Ohkuchi
No abstract text is available yet for this article.
January 2019: Pregnancy Hypertension
Asako Hoshino, Soichiro Obata, Azusa Tochio, Kazuo Seki, Etsuko Miyagi, Shigeru Aoki
OBJECTIVES: To investigate the effect of chronic hypertension on expectant management for preeclampsia (PE). STUDY DESIGN: Pregnant women who were diagnosed with severe PE before 34 weeks of gestation between 2005 and 2016 and managed at a tertiary center were the subjects of the study. Mothers were classified into two groups: a severe superimposed PE (SSP) group and a severe PE (SP) group. We compared the groups in terms of perinatal outcomes. MAIN OUTCOME MEASURES: Pregnancy prolongation from the diagnosis of severe PE to delivery...
January 2019: Pregnancy Hypertension
Kara K Hoppe, Makeba Williams, Nicole Thomas, Julia B Zella, Anna Drewry, KyungMann Kim, Thomas Havighurst, Heather M Johnson
OBJECTIVE: Investigate feasibility of telehealth with remote blood pressure monitoring for management of hypertension in postpartum women at risk of severe hypertension after hospital discharge. METHODS: In a single-center, prospective single-cohort feasibility study, women with hypertension in pregnancy participated in a postpartum telehealth intervention for blood pressure management after discharge. The primary feasibility outcome measures were recruitment and retention through 6 weeks postpartum...
January 2019: Pregnancy Hypertension
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