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Eclampsia, Preeclampsia and Hypertensive Disorders of Pregnancy

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Timothy Wen, Jason D Wright, Dena Goffman, Mary E DʼAlton, Frank J Attenello, William J Mack, Alexander M Friedman
OBJECTIVE: To analyze risk factors, temporality, and outcomes for women readmitted postpartum for a hypertensive indication who did not have a hypertensive diagnosis during their delivery hospitalization. METHODS: The Healthcare Cost and Utilization Project's Nationwide Readmissions Database for 2010-2014 was used to evaluate risk for postpartum readmission for preeclampsia and hypertension within 60 days of discharge from a delivery hospitalization among women without these diagnoses during delivery in this cohort study...
March 11, 2019: Obstetrics and Gynecology
Sarah A Robertson
New England Journal of Medicine, Volume 380, Issue 11, Page 1080-1082, March 2019.
March 14, 2019: New England Journal of Medicine
M Arigita
No abstract text is available yet for this article.
March 9, 2019: Hipertensión y Riesgo Vascular
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
Elizabeth A Phipps, Ravi Thadhani, Thomas Benzing, S Ananth Karumanchi
Pre-eclampsia is a complication of pregnancy that is associated with substantial maternal and fetal morbidity and mortality. The disease presents with new-onset hypertension and often proteinuria in the mother, which can progress to multi-organ dysfunction, including hepatic, renal and cerebral disease, if the fetus and placenta are not delivered. Maternal endothelial dysfunction due to circulating factors of fetal origin from the placenta is a hallmark of pre-eclampsia. Risk factors for the disease include maternal comorbidities, such as chronic kidney disease, hypertension and obesity; a family history of pre-eclampsia, nulliparity or multiple pregnancies; and previous pre-eclampsia or intrauterine fetal growth restriction...
February 21, 2019: Nature Reviews. Nephrology
Nnabuike C Ngene, Jagidesa Moodley
Measurement of blood pressure is essential for clinical management of patients. To obtain an accurate blood pressure reading, the use of a validated device and an appropriate technique are required. This is of particular importance in pregnancy where the physiological changes affect vessel wall compliance. Moreover, currently it is difficult to predict in early pregnancy (prior to 20 weeks of gestation) which women would develop hypertension or pre-eclampsia. For this reason, blood pressure devices require validation in pregnancy and in hypertensive disorders of pregnancy to ensure that accurate readings are obtained and utilised for clinical decisions, otherwise the safety of the mother or the foetus/neonate or both may be compromised...
January 23, 2019: Cardiovascular Journal of Africa
Annie G Cox, Sarah A Marshall, Kirsten R Palmer, Euan M Wallace
Preeclampsia is a disease specific to pregnancy characterised by new onset hypertension with maternal organ dysfunction and/or fetal growth restriction. It remains a major cause of maternal and perinatal morbidity and mortality. For fifty years, antihypertensives have been the mainstay of treating preeclampsia, reducing maternal morbidity and mortality. With increased knowledge of the mechanisms underlying the disease has come opportunities for novel therapies that complement antihypertensives by protecting the maternal vasculature...
February 1, 2019: Expert Opinion on Pharmacotherapy
Thomas P Bernardes, Eva F Zwertbroek, Kim Broekhuijsen, Corine Koopmans, Kim Boers, Michelle Owens, Jim Thornton, Maria van Pampus, Sicco Scherjon, Kedra Wallace, Josje Langenveld, Paul P van den Berg, Maureen Franssen, Ben W Mol, Henk Groen
BACKGROUND: Hypertensive disorders affect 3-10% of pregnancies. Delayed delivery carries maternal risks, while early delivery increases fetal risk so appropriate timing is difficult. OBJECTIVE: To compare immediate delivery and expectant management for prevention of adverse maternal and neonatal outcomes in hypertensive disease in pregnancy. SEARCH STRATEGY: We searched CENTRAL, PubMed, MEDLINE and SELECTION CRITERIA: Randomized controlled trials comparing immediate delivery to expectant management in women presenting with mild gestational hypertension or pre-eclampsia from 34 weeks of gestation...
January 29, 2019: Ultrasound in Obstetrics & Gynecology
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
February 2019: Obstetrics and Gynecology
James M N Duffy, Tracey Thompson, Lisa Hinton, Maria Salinas, Richard J McManus, Sue Ziebland
OBJECTIVE: To identify outcomes relevant to women with lived experience of pre-eclampsia. DESIGN: Qualitative interview study. SETTING: A national study conducted in the United Kingdom. SAMPLE: Purposive sample of women with lived experience of pre-eclampsia. METHODS: Thematic analysis of qualitative interview transcripts. RESULTS: Thirty women with lived experience of pre-eclampsia were interviewed...
January 17, 2019: BJOG: An International Journal of Obstetrics and Gynaecology
Krishna Dahiya, Seema Rohilla, Kriti Agarwal, Mahesh Rathod, Archit Dahiya
Objective: To correlate the Magnetic Resonance Imaging findings and clinical presentation in patients of eclampsia. Materials and methods: This one year prospective study was conducted in the HDU of Department of Obstetrics and Gynecology, PT.B.D.Sharma, PGIMS, Rohtak .A total of 50 women with eclampsia (both antepartum and postpartum) were divided into two groups: a) study group patients with abnormal MRI b) control group: b) control group: patients with normal MRI.Comparison was done using chi-square test and unpaired student 't' test...
March 2018: Journal of Family & Reproductive Health
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
February 2019: Obstetrics and Gynecology
Noémie Simon-Tillaux, Edouard Lecarpentier, Vassilis Tsatsaris, Alexandre Hertig
Preeclampsia is a hypertensive disorder of pregnancy and the clinical manifestation of severe endothelial dysfunction associated with maternal and foetal morbidity and mortality. The primum movens of the disease is the defect of invasion of the uterine arteries by foetal syncytiotrophoblasts, which causes a maladaptive placental response to chronic hypoxia and the secretion of the soluble form of type 1 vascular growth endothelial factor receptor, also called soluble fms-like tyrosine kinase 1 (sFlt-1), the major player in the pathophysiology of the disease...
November 6, 2018: Nephrology, Dialysis, Transplantation
Brian T Bateman, Uffe Heide-Jørgensen, Kristjana Einarsdóttir, Anders Engeland, Kari Furu, Mika Gissler, Sonia Hernandez-Diaz, Helle Kieler, Anna-Maria Lahesmaa-Korpinen, Helen Mogun, Mette Nørgaard, Johan Reutfors, Randi Selmer, Krista F Huybrechts, Helga Zoega
Background: β-Blockers are a class of antihypertensive medications that are commonly used in pregnancy. Objective: To estimate the risks for major congenital malformations associated with first-trimester exposure to β-blockers. Design: Cohort study. Setting: Health registries in the 5 Nordic countries and the U.S. Medicaid database. Patients: Pregnant women with a diagnosis of hypertension and their offspring...
November 20, 2018: Annals of Internal Medicine
David Churchill, Lelia Duley, Jim G Thornton, Mahmoud Moussa, Hind Sm Ali, Kate F Walker
BACKGROUND: Severe pre-eclampsia can cause significant mortality and morbidity for both mother and child, particularly when it occurs remote from term, between 24 and 34 weeks' gestation. The only known cure for this disease is delivery. Some obstetricians advocate early delivery to ensure that the development of serious maternal complications, such as eclampsia (fits) and kidney failure are prevented. Others prefer a more expectant approach, delaying delivery in an attempt to reduce the mortality and morbidity for the child that is associated with being born too early...
October 5, 2018: Cochrane Database of Systematic Reviews
Edgardo Abalos, Lelia Duley, D Wilhelm Steyn, Celina Gialdini
BACKGROUND: Antihypertensive drugs are often used in the belief that lowering blood pressure will prevent progression to more severe disease, and thereby improve pregnancy outcome. This Cochrane Review is an updated review, first published in 2001 and subsequently updated in 2007 and 2014. OBJECTIVES: To assess the effects of antihypertensive drug treatments for women with mild to moderate hypertension during pregnancy. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials...
October 1, 2018: Cochrane Database of Systematic Reviews
Madhusudan Upadya, Sumesh T Rao
Hypertensive disorders of pregnancy (HDP) remain among the most significant and intriguing unsolved problems in obstetrics. In India, the prevalence of HDP was 7.8% with pre-eclampsia in 5.4% of the study population. The anaesthetic problems in HDP may be due to the effects on the cardiovascular, respiratory, neurologic, renal, haematologic, hepatic and uteroplacental systems. The basic management objectives should be facilitating the birth of an infant who subsequently thrives and completes restoration of health to the mother, or the termination of pregnancy with the least possible trauma to mother and foetus in severe pre-eclampsia...
September 2018: Indian Journal of Anaesthesia
Lauren O'brien, Jennifer Duong, Tessa Winterton, Anna Haring, Zachary Kuhlmann
INTRODUCTION: Preeclampsia with severe hypertension, which occurs in 5% to 8% of pregnancies, is a leading cause of maternal and perinatal morbidity and mortality in the US. Early recognition and treatment of hypertensive crises can significantly reduce poor outcomes. A protocol to ensure prompt treatment with antihypertensive medication (intravenous labetalol) was implemented at our institution. OBJECTIVE: To determine adherence to this protocol on the Labor and Delivery Unit...
2018: Permanente Journal
Amir Afkham, Shadi Eghbal-Fard, Hanieh Heydarlou, Ramyar Azizi, Leili Aghebati-Maleki, Mehdi Yousefi
Toll-like receptors (TLRs) are innate immune cells receptors. They are expressed on leukocytes, epithelial cells, and more particularly on placental immune cells and chorion trophoblast. Upregulation of innate immune response occurs during normal pregnancy, but its excessive activity is involved in the pathology of pregnancy complications including pregnancy-induced hypertension and pre-eclampsia (PE). The recent studies about the overmuch inflammatory responses and aberrant placentation are associated with increased expression of TLRs in PE patients...
March 2019: Journal of Cellular Physiology
Jenny E Myers, Marcus Green, Lucy C Chappell
No abstract text is available yet for this article.
September 12, 2018: BMJ: British Medical Journal
2018-09-16 07:53:11
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