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Hypertension And Gestational

Sonia M Grandi, Kristian B Filion, Sarah Yoon, Henok T Ayele, Carla M Doyle, Jennifer A Hutcheon, Graeme N Smith, Genevieve C Gore, Joel G Ray, Kara Nerenberg, Robert W Platt
BACKGROUND: Women with a history of certain pregnancy complications are at higher risk for cardiovascular (CVD) disease. However, most clinical guidelines only recommend postpartum follow-up of those with a history of preeclampsia, gestational diabetes mellitus, or preterm birth. This systematic review was undertaken to determine if there is an association between a broader array of pregnancy complications and the future risk of CVD. METHODS: We systematically searched PubMed, MEDLINE and EMBASE (via Ovid), CINAHL, and the Cochrane Library from inception to September 22, 2017, for observational studies of the association between the hypertensive disorders of pregnancy, placental abruption, preterm birth, gestational diabetes mellitus, low birth weight, small-for-gestational-age birth, stillbirth, and miscarriage and subsequent CVD...
February 19, 2019: Circulation
Farnaz Dave, Stephen Cole, Megan Rees
Obstructive sleep apnoea (OSA) during pregnancy has been associated with gestational diabetes mellitus, hypertension and low birth weight. Multiple pregnancy is associated with similar adverse perinatal outcomes. Multiple pregnancy rates have risen with increased access to assisted conception; simultaneously, advancing maternal age and weight are also driving a rise in the incidence of OSA in pregnancy. The intersection of OSA and multiple pregnancy would be presumed to have significant maternal and fetal morbidity; however, specific data are sparse...
February 17, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Insook Lee, Kyung-Sook Bang, Hyojeong Moon, Jieun Kim
PURPOSE: The purpose of this study was to examine the multiple intergenerational risk factors of obesity among children aged 24 to 80 months using national cohort data. DESIGN AND METHODS: This is a retrospective longitudinal cohort study using the Korean National Health Insurance (KNHI) database, and the number of study participants was 1,001,775 families. Social-Economic Status (SES), parental and child-related factors were examined. Descriptive statistics and Chi-squared Automatic Interaction Detection (CHAID) for a decision tree analysis were conducted...
February 14, 2019: Journal of Pediatric Nursing
Antonio Brucato, Nikki Pluymaekers, Enrico Tombetti, Stefania Rampello, Silvia Maestroni, Marzia Lucianetti, Anna Valenti, Yehuda Adler, Massimo Imazio
BACKGROUND: Data concerning idiopathic recurrent pericarditis in pregnancy are scarce. OBJECTIVES: To evaluate the management and outcome of idiopathic recurrent pericarditis during pregnancy. METHODS AND RESULTS: Twenty-one pregnancies were evaluated in fourteen women with a history of recurrent idiopathic pericarditis (mean maternal age 31.5 years, mean gestational age 39.0 weeks), and subdivided in 2 cohorts: eight pregnancies were analyzed retrospectively (2002-2010), thirteen (2011-2017) prospectively and followed according a predefined management protocol...
February 6, 2019: International Journal of Cardiology
Kousalya Prabahar, Teja Katikam, Saranya Punniyakotti, Praveen Devanandan
To evaluate the anti-hypertensive drugs used in pregnancy induced hypertension and to determine the safety of the anti-hypertensive drugs administered in gestational hypertensive patients. Pregnancy induced hypertension are very common in women and if unnoticed may lead to severe complications. The appropriate therapy is very much essential for the welfare of both the mother and the child. Hence this study was undertaken to identify the commonly used and safe drugs in pregnancy induced hypertension. This retrospective study was carried out in the Medical Records Department of a specialized gynecological hospital...
January 2019: Pakistan Journal of Pharmaceutical Sciences
Anca Matei, Gabriele Saccone, Joshua P Vogel, Anthony B Armson
BACKGROUND: Preterm birth (PTB) is a leading cause of perinatal morbidity and mortality. Interventions aimed at preventing PTB can be classified as primary, secondary, or tertiary prevention. OBJECTIVE: To conduct a review of systematic reviews on the effectiveness and safety of primary and secondary preterm birth prevention interventions. SEARCH STRATEGY: A systematic literature search of the Cochrane, PubMed/Medline, EMBASE and CINAHL databases was conducted on 2 September 2015, and updated on 21 November 2016...
January 25, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Alejandro Gonzalez-Candia, Marcelino Veliz, Catalina Carrasco-Pozo, Rodrigo L Castillo, J Cesar Cárdenas, Germán Ebensperger, Roberto V Reyes, Aníbal J Llanos, Emilio A Herrera
Chronic hypobaric hypoxia during fetal and neonatal life induces neonatal pulmonary hypertension. Hypoxia and oxidative stress are driving this condition, which implies an increase generation of reactive oxygen species (ROS) and/or decreased antioxidant capacity. Melatonin has antioxidant properties that decrease oxidative stress and improves pulmonary vascular function when administered postnatally. However, the effects of an antenatal treatment with melatonin in the neonatal pulmonary function and oxidative status are unknown...
January 29, 2019: Redox Biology
Alyssa R Hersh, Ashley E Skeith, James A Sargent, Aaron B Caughey
BACKGROUND: A large, recent multicenter trial found that induction of labor at 39 weeks for low-risk nulliparous women was not associated with an increased risk of cesarean delivery or adverse neonatal outcomes. OBJECTIVE: We sought to examine the cost-effectiveness and outcomes associated with induction of labor at 39 weeks versus expectant management for low-risk nulliparous women in the United States. STUDY DESIGN: A cost-effectiveness model using TreeAge software was designed to compare outcomes in women who were induced at 39 weeks versus expectantly managed...
February 12, 2019: American Journal of Obstetrics and Gynecology
Teje Adane, Berihun Assefa Dachew
Background: Low birth weight is one of the public health problems in the globe and it is an indicator of the health of the newborn survival and the mother's nutrition and health status. This study was aimed to determine the prevalence of low birth weight and its associated factors among mothers who gave birth at Bahir Dar Felege Hiwot referral hospital. Methods: A cross-sectional facility based study was conducted from March 18 to May 18 / 2015. A total of 662 mothers were included in the study...
December 2018: African Health Sciences
Tracey L Weissgerber, Oscar Garcia-Valencia, Natasa M Milic, Elizabeth Codsi, Hajrunisa Cubro, Meryl C Nath, Wendy M White, Karl A Nath, Vesna D Garovic
Background The endothelial glycocalyx is a vasoprotective barrier between the blood and endothelium. We hypothesized that glycocalyx degradation is present in preeclampsia, a pregnancy-specific hypertensive disorder characterized by endothelial dysfunction and activation. Methods and Results We examined the sublingual glycocalyx noninvasively using sidestream dark field imaging in the third trimester among women with normotensive pregnancies (n=73), early (n=14) or late (n=29) onset preeclampsia, or gestational diabetes mellitus (n=21)...
February 19, 2019: Journal of the American Heart Association
Luigi Gagliardi, Olga Basso
OBJECTIVE: To describe the association between maternal hypertension (chronic and gestational, MH) and mortality in very preterm singletons and twins, focusing on how estimates depend on gestational age (GA) and size at birth. METHODS: We estimated relative risks of in-hospital death in 12,320 singletons (MH: 22.4%) and 4381 twins (MH: 10.6%) born at 23-29 weeks in the Italian Neonatal Network (89 hospitals, 2008-2016). RESULTS: Babies with MH had higher GA and were more frequently small-for-gestational age (SGA), especially singletons...
February 14, 2019: Pediatric Research
Sarah G Običan, Linda Odibo, Methodius G Tuuli, Alejandro Rodriguez, Anthony O Odibo
OBJECTIVE: To test the hypothesis that third-trimester uterine artery Doppler (UAD) predicts adverse pregnancy and neonatal outcomes in a high-risk population. STUDY DESIGN: This is a nested case control study of women with singleton gestations referred for a fetal growth ultrasound between 24 and 36 weeks. Third-trimester UAD was performed if estimated fetal weight (Hadlock's chart) was <20th percentile as these patients were considered high risk for poor pregnancy outcomes...
February 13, 2019: Journal of Maternal-fetal & Neonatal Medicine
Shaofang Lv, Shanlan Yu, Rongxiang Chi, Dongmei Wang
OBJECTIVES: To determine the effects of nutritional nursing intervention based on glycemic load (GL) for patients with gestational diabetes mellitus. MATERIAL AND METHODS: One hundred thirty-four patients diagnosed with gestational diabetes mellitus at our hospital were selected from March 2015 to March 2017 and randomly divided into the observation (n = 67) and control groups (n = 67). All of the patients in the observation and control groups received conventional nutritional nursing...
2019: Ginekologia Polska
Sika M Kumordzie, Seth Adu-Afarwuah, Rebecca R Young, Brietta M Oaks, Solace M Tamakloe, Maku E Ocansey, Harriet Okronipa, Elizabeth L Prado, Kathryn G Dewey
Background: In the International Lipid-Based Nutrient Supplements (iLiNS)-DYAD-Ghana trial, prenatal small-quantity lipid-based nutrient supplements (LNSs) had a positive effect on birth weight. Birth weight may be inversely related to blood pressure (BP) later in life. Objectives: We examined the effect of the intervention on BP at 4-6 y of age, and maternal and child factors related to BP. Methods: The iLiNS-DYAD-Ghana study was a partially double-blind, randomized controlled trial which assigned women (n = 1320) ≤20 weeks of gestation to daily supplementation with: 1) iron and folic acid during pregnancy and 200 mg Ca for 6 mo postpartum , 2) multiple micronutrients during pregnancy and postpartum, or 3) LNSs during pregnancy and postpartum plus LNSs for infants from 6 to 18 mo of age...
February 11, 2019: Journal of Nutrition
Nicole M Novielli-Kuntz, Meghan Jelen, Kevin Barr, Leon J Delailo, Qingping Feng, Brant E Isakson, Robert Gros, Dale W Laird
Connexins (Cxs) and pannexins (Panxs) are highly-regulated large-pore channel-forming proteins that participate in cellular communication via small molecular exchange with the extracellular microenvironment, or in the case of connexins, directly between cells. Given the putative functional overlap between single membrane-spanning connexin hemichannels and Panx channels, and cardiovascular system prevalence, we generated the first Cx40-/- Panx1-/- mouse with the anticipation that this genetic modification would lead to a severe cardiovascular phenotype...
February 11, 2019: Bioscience Reports
Amihai Rottenstreich, Gabriel Levin, Misgav Rottenstreich, Yossef Ezra, Ram Elazary, Uriel Elchalal
BACKGROUND: The effect of bariatric surgery (BS) on twin pregnancy outcomes is unclear. OBJECTIVES: We examined associations of BS with maternal and perinatal outcomes among women with twin gestation. SETTING: A university hospital. METHODS: A retrospective case-control study of twin deliveries during 2006 through 2017. The study group comprised all women with twin pregnancy who had undergone BS and delivered during the study period...
January 25, 2019: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Christina M Ackerman, Marissa H Platner, Erica S Spatz, Jessica L Illuzzi, Xiao Xu, Katherine H Campbell, Graeme N Smith, Michael J Paidas, Heather S Lipkind
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of pregnancy-related death in the United States. (1) Identification of short-term indicators of cardiovascular morbidity has the potential to alter the course of this devastating disease among women. It has been established that hypertensive disorders of pregnancy (HDP) are associated with increased risk of cardiovascular disease 10-30 years after delivery; however, little is known about the association of hypertensive disorders of pregnancy with cardiovascular (CV) morbidity during the delivery hospitalization...
February 8, 2019: American Journal of Obstetrics and Gynecology
George Osol, Nga Ling Ko, Maurizio Mandalà
Maternal cardiovascular changes during pregnancy include an expansion of plasma volume, increased cardiac output, decreased peripheral resistance, and increased uteroplacental blood flow. These adaptations facilitate the progressive increase in uteroplacental perfusion that is required for normal fetal growth and development, prevent the development of hypertension, and provide a reserve of blood in anticipation of the significant blood loss associated with parturition. Each woman's genotype and phenotype determine her ability to adapt in response to molecular signals that emanate from the fetoplacental unit...
February 10, 2019: Annual Review of Physiology
Anca Ciobanu, Alan Wright, Anca Panaitescu, Argyro Syngelaki, David Wright, Kypros H Nicolaides
BACKGROUND: In the weeks preceding the clinical onset of preeclampsia (PE) the maternal serum level of the angiogenic placental growth factor (PLGF) is decreased and that of the antiangiogenic factor soluble fms-like tyrosine kinase-1 (sFLT) is increased. Women presenting at specialist clinics with signs or symptoms of hypertensive disorders have been stratified according to concentrations of PLGF or the ratio of concentrations of sFLT and PLGF to determine clinical management for the subsequent 1-4 weeks...
February 7, 2019: American Journal of Obstetrics and Gynecology
Matthieu St-Jean, Jessica MacKenzie-Feder, Isabelle Bourdeau, André Lacroix
A 29-year-old G4A3 woman presented at 25 weeks of pregnancy with progressive signs of Cushing's syndrome (CS), gestational diabetes requiring insulin and hypertension. A 3.4 × 3.3 cm right adrenal adenoma was identified during abdominal ultrasound imaging for nephrolithiasis. Investigation revealed elevated levels of plasma cortisol, 24 h urinary free cortisol (UFC) and late-night salivary cortisol (LNSC). Serum ACTH levels were not fully suppressed (4 and 5 pmol/L (N: 2-11)). One month post-partum, CS regressed, 24-h UFC had normalised while ACTH levels were now less than 2 pmol/L; however, dexamethasone failed to suppress cortisol levels...
February 7, 2019: Endocrinology, Diabetes & Metabolism Case Reports
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