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Collections Eclampsia, Preeclampsia, HELLP...

Eclampsia, Preeclampsia, HELLP Syndrome and Hypertensive Disorders of Pregnancy

https://read.qxmd.com/read/36683540/hypertension-in-pregnancy-what-we-now-know
#21
REVIEW
Sonali Gupta, Lohana Petras, Muhammad Umer Tufail, Juan Diego Rodriguez Salazar, Belinda Jim
PURPOSE OF REVIEW: Hypertensive disorders of pregnancy remain a highly morbid condition that affects both the mother and fetus, complicate approximately 10% of pregnancies worldwide, and contribute to immediate and long-term cardiovascular outcomes. There is still much to learn regarding pathogenesis and treatment goals. RECENT FINDINGS: There is updated information on the pathogenesis of preeclampsia and treatment thresholds for HTN in pregnancy. l-Kynurenine, a metabolite of the essential amino acid l-tryptophan, has been implicated in preeclampsia as decreased levels were found in a uninephrectomized pregnant mouse model of preeclampsia, where replacement of l-kynurenine rescued the preeclamptic state...
March 1, 2023: Current Opinion in Nephrology and Hypertension
https://read.qxmd.com/read/36635411/the-role-of-immune-cells-and-mediators-in-preeclampsia
#22
REVIEW
Evangeline Deer, Owen Herrock, Nathan Campbell, Denise Cornelius, Sarah Fitzgerald, Lorena M Amaral, Babbette LaMarca
Preeclampsia is a hypertensive disorder of major concern in pregnancy than can lead to intrauterine growth restriction, placental abruption and stillbirth. The pathophysiology of preeclampsia is multifactorial, including not only kidney dysfunction but also endothelial dysfunction, as the maternal endothelium becomes exposed to placental factors that are released into the circulation and increase systemic levels of vasoconstrictors, oxidative stress, anti-angiogenic factors and inflammatory mediators. Importantly, inflammation can lead to insufficient placental perfusion and low birthweight in offspring...
April 2023: Nature Reviews. Nephrology
https://read.qxmd.com/read/36352102/micronutrient-supplementation-interventions-in-preconception-and-pregnant-women-at-increased-risk-of-developing-pre-eclampsia-a-systematic-review-and-meta-analysis
#23
REVIEW
Sowmiya Gunabalasingam, Daniele De Almeida Lima Slizys, Ola Quotah, Laura Magee, Sara L White, Jessica Rigutto-Farebrother, Lucilla Poston, Kathryn V Dalrymple, Angela C Flynn
BACKGROUND: Pre-eclampsia can lead to maternal and neonatal complications and is a common cause of maternal mortality worldwide. This review has examined the effect of micronutrient supplementation interventions in women identified as having a greater risk of developing pre-eclampsia. METHODS: A systematic review was performed using the PRISMA guidelines. The electronic databases MEDLINE, EMBASE and the Cochrane Central Register of Controlled trials were searched for relevant literature and eligible studies identified according to a pre-specified criteria...
July 2023: European Journal of Clinical Nutrition
https://read.qxmd.com/read/36283479/comparative-effectiveness-of-prophylactic-strategies-for-preeclampsia-a-network-meta-analysis-of-randomized-controlled-trials
#24
REVIEW
Yuan-Hui Liu, Ye-Shen Zhang, Jia-Yi Chen, Zhi-Jian Wang, Yao-Xin Liu, Jia-Qi Li, Xiao-Ji Xu, Nian-Jin Xie, Stephen Lye, Ning Tan, Chong-Yang Duan, Yan-Xing Wei, Peng-Cheng He
OBJECTIVE: Preeclampsia is a common disease during pregnancy that leads to fetal and maternal adverse events. Few head-to-head clinical trials are currently comparing the effectiveness of prophylactic strategies for preeclampsia. In this network meta-analysis, we aimed to compare the efficacy of prophylactic strategies for preventing preeclampsia in pregnant women at risk. DATA SOURCES: Articles published in or before September 2021 from PubMed, Embase, Web of Science, Cochrane Library, and ClinicalTrials...
May 2023: American Journal of Obstetrics and Gynecology
https://read.qxmd.com/read/36324072/incidence-and-predictors-of-acute-kidney-injury-among-women-with-severe-pre-eclampsia-at-mbarara-regional-referral-hospital
#25
JOURNAL ARTICLE
Mariam Hassan, Roland Mayanja, Wasswa G M Ssalongo, Natumanya Robert, Lugobe Henry Mark, Okello Samson, Rose Muhindo
BACKGROUND: The presence of acute kidney injury (AKI) in pre-eclampsia complicates treatment including; increasing length of hospital stay and a need to access services like dialysis which are largely expensive in resource-limited settings. We aimed to determine incidence and predictors of acute kidney injury among women with severe pre-eclampsia at Mbarara Regional Referral Hospital in southwestern Uganda. METHODS: We carried out a hospital-based prospective cohort study from 16 November  2018 to 18 April 2019, among pregnant women with severe pre-eclampsia followed up in the hospital...
November 2, 2022: BMC Nephrology
https://read.qxmd.com/read/36249647/eclampsia-and-its-treatment-modalities-a-review-article
#26
REVIEW
Shivani Akre, Kapil Sharma, Swarupa Chakole, Mayur B Wanjari
Hypertension in pregnancy is one of the major contributors to mortality and morbidity. Pregnant women and fetuses are both at high risk of the severe complications of preeclampsia known as eclampsia. Eclampsia is a disorder that requires immediate detection and treatment. Eclampsia and preeclampsia during pregnancy are known to cause morbidity and even death in both the mother and fetus if not properly diagnosed. Chronic hypertension, prenatal hypertension, preeclampsia on top of chronic hypertension, and eclampsia are the four types of hypertension...
September 2022: Curēus
https://read.qxmd.com/read/36239909/lessons-for-the-clinical-nephrologist-dialysis-decisions-in-early-pregnancy-for-acute-kidney-injury-due-to-post-infectious-glomerulonephritis-pign
#27
JOURNAL ARTICLE
Laura De Souza, Ibrahim Ismail, Robert Baade, Murty Mantha
No abstract text is available yet for this article.
December 2022: Journal of Nephrology
https://read.qxmd.com/read/36209504/risk-factors-for-pre-eclampsia-in-clinical-practice-guidelines-comparison-with-the-evidence
#28
JOURNAL ARTICLE
Terteel Elawad, Georgia Scott, Jeffrey N Bone, Helen Elwell, Cristina Escalona Lopez, Veronique Filippi, Marcus Green, Asma Khalil, Mai-Lei W Kinshella, Hiten D Mistry, Kelly Pickerill, Reshma Shanmugam, Joel Singer, Rosemarie Townsend, Eleni Z Tsigas, Marianne Vidler, Marie-Laure Volvert, Peter von Dadelszen, Laura A Magee
OBJECTIVE: To compare pre-eclampsia risk factors identified by clinical practice guidelines (CPGs) with risk factors from hierarchical evidence review, to guide pre-eclampsia prevention. DESIGN: Our search strategy provided hierarchical evidence of relationships between risk factors and pre-eclampsia using Medline (Ovid), searched from January 2010 to January 2021. SETTING: Published studies and CPGs. POPULATION: Pregnant women...
October 9, 2022: BJOG: An International Journal of Obstetrics and Gynaecology
https://read.qxmd.com/read/36199391/therapeutic-plasma-exchange-in-hellp-syndrome-a-life-savior
#29
JOURNAL ARTICLE
Mohit Chowdhry, Soma Agrawal, Shiva Prasad Gajulapalli, Uday Kumar Thakur
BACKGROUND: HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome occurs in about 0.5%-0.9% of all pregnancies, but its prevalence is higher in patients with severe preeclampsia, accounting for a substantial maternal and perinatal morbidity and mortality. According to the latest American Society for Apheresis guidelines, Therapeutic plasma exchange (TPE) performed for postpartum cases and antepartum HELLP syndrome cases fall in Categories III and IV, respectively. MATERIALS AND METHODS: Retrospective analysis was done at our tertiary care center from January 2014 to June 2019 for patients diagnosed with HELLP syndrome...
2022: Asian Journal of Transfusion Science
https://read.qxmd.com/read/36178502/association-between-proteinuria-and-adverse-pregnancy-outcomes-a-retrospective-cohort-study
#30
JOURNAL ARTICLE
Minjie Hu, Junfeng Shi, Wei Lu
Proteinuria during pregnancy is closely related to the occurrence of adverse pregnancy outcomes. One hundred and forty-two women with proteinuria during pregnancy and followed between January 2018 and December 2020 were evaluated. Based on the 24-h proteinuria value, they were divided as mild ( n  = 76, 300-1000 mg/day), moderate ( n  = 39, 1000-3500 mg/day) and severe ( n  = 27, >3500 mg/day) proteinuria. The rates of prematurity, low birth weight and neonatal asphyxia were significantly higher in the severe proteinuria group than in the mild and moderate groups, while the rates of foetal growth restriction and neonatal intensive care unit admission were significantly higher in the severe compared with the mild proteinuria group (all p  < ...
December 2023: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://read.qxmd.com/read/35943814/impaired-renal-reserve-contributes-to-preeclampsia-via-the-kynurenine-and-soluble-fms-like-tyrosine-kinase-1-pathway
#31
JOURNAL ARTICLE
Vincent Dupont, Anders H Berg, Michifumi Yamashita, Chengqun Huang, Ambart E Covarrubias, Shafat Ali, Aleksandr Stotland, Jennifer E Van Eyk, Belinda Jim, Ravi Thadhani, S Ananth Karumanchi
To understand how kidney donation leads to an increased risk of preeclampsia, we studied pregnant outbred mice with prior uninephrectomy and compared them with sham-operated littermates carrying both kidneys. During pregnancy, uninephrectomized (UNx) mice failed to achieve a physiological increase in the glomerular filtration rate and during late gestation developed hypertension, albuminuria, glomerular endothelial damage, and excess placental production of soluble fms-like tyrosine kinase 1 (sFLT1), an antiangiogenic protein implicated in the pathogenesis of preeclampsia...
October 17, 2022: Journal of Clinical Investigation
https://read.qxmd.com/read/35928078/the-impact-of-secondary-hypertension-in-pregnancy-on-maternal-and-fetal-outcomes-a-42-month-observational-study-from-south-india
#32
JOURNAL ARTICLE
Audrin Lenin, Reeta Vijayaselvi, Sudha Jasmine Rajan, Swati Rathore, Kavitha Abraham, Bijesh Yadav, Sowmya Satyendra
OBJECTIVES: To examine the prevalence, etiology, and clinical outcomes of secondary hypertension in pregnancy in a high-risk tertiary care hospital. STUDY DESIGN: This retrospective study used data from patient records between January 2015 and July 2018. Of 52,293 pregnant women admitted during this period, those with hypertension were included. Patient demographics, diagnosis of secondary hypertension, investigations, suspected etiologies of secondary hypertension, maternal and neonatal outcomes and discharge conditions were included...
August 2022: Journal of Obstetrics and Gynaecology of India
https://read.qxmd.com/read/35855764/demographic-characteristics-and-risk-factors-affecting-the-development-of-postpartum-acute-kidney-injury-in-somalia-single-center-experience
#33
JOURNAL ARTICLE
Nasteho Mohamed Sheikh Omar, Marian Muse Osman, Ifrah Adan Hilowle, Betul Erismis, Abdirahman Abdikadir Osman, Osman Abubakar Fiidow, Ahmed Muhammad Bashir
BACKGROUND AND AIM: Although postpartum acute kidney injury (PPAKI) is declining in developing countries, it is still a leading cause of maternal and fetal morbidity and mortality. The study aimed to determine the causes, risk factors, and the outcomes of patients with postpartum acute kidney injury managed at Mogadishu Somali Turkey Training and Research Hospital, in Mogadishu, Somalia over a two years period. METHODS: This study was conducted retrospectively at Mogadishu Somali-Turkey Training and Research Hospital, Somalia's largest teaching and referral hospital...
2022: International Journal of Women's Health
https://read.qxmd.com/read/35777368/acute-kidney-injury-in-pregnancies-complicated-by-late-onset-preeclampsia-with-severe-features
#34
JOURNAL ARTICLE
Aldeboran N Rodriguez, David B Nelson, Catherine Y Spong, Donald D McIntire, Meghana T Reddy, F Gary Cunningham
OBJECTIVE:  Acute kidney injury (AKI)-complicating pregnancy is used as a marker of severe maternal morbidity (SMM) and frequently associated with obstetric hypertensive disorders. We examined AKI in pregnancies complicated by late-onset preeclampsia with severe features (SPE) using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We compared outcomes of pregnancies with and without AKI and stratified by stage of disease. We further differentiated renal dysfunction at the time of admission and compared outcomes to those who developed AKI after admission...
July 1, 2022: American Journal of Perinatology
https://read.qxmd.com/read/35544388/preeclampsia
#35
REVIEW
Laura A Magee, Kypros H Nicolaides, Peter von Dadelszen
New England Journal of Medicine, Volume 386, Issue 19, Page 1817-1832, May 2022.
May 12, 2022: New England Journal of Medicine
https://read.qxmd.com/read/35503345/effect-of-self-monitoring-of-blood-pressure-on-blood-pressure-control-in-pregnant-individuals-with-chronic-or-gestational-hypertension-the-bump-2-randomized-clinical-trial
#36
RANDOMIZED CONTROLLED TRIAL
Lucy C Chappell, Katherine L Tucker, Ushma Galal, Ly-Mee Yu, Helen Campbell, Oliver Rivero-Arias, Julie Allen, Rebecca Band, Alison Chisholm, Carole Crawford, Greig Dougall, Lazarina Engonidou, Marloes Franssen, Marcus Green, Sheila Greenfield, Lisa Hinton, James Hodgkinson, Layla Lavallee, Paul Leeson, Christine McCourt, Lucy Mackillop, Jane Sandall, Mauro Santos, Lionel Tarassenko, Carmelo Velardo, Hannah Wilson, Lucy Yardley, Richard J McManus
IMPORTANCE: Inadequate management of elevated blood pressure is a significant contributing factor to maternal deaths. The role of blood pressure self-monitoring in pregnancy in improving clinical outcomes for the pregnant individual and infant is unclear. OBJECTIVE: To evaluate the effect of blood pressure self-monitoring, compared with usual care alone, on blood pressure control and other related maternal and infant outcomes, in individuals with pregnancy hypertension...
May 3, 2022: JAMA
https://read.qxmd.com/read/35490442/prevalence-of-long-term-metabolic-cardiovascular-cerebrovascular-and-renal-disease-in-patients-with-hypertensive-disorders-in-pregnancy-remote-from-pregnancy-pomch
#37
JOURNAL ARTICLE
Jade Elizabeth Schroers, Renuka Shanmugalingam, Gaksoo Lee, David Rutherford, Angela Makris
BACKGROUND: Hypertensive disorders of pregnancy (HDP) are associated with an increased risk of long-term cardiovascular, cerebrovascular, and adverse renal outcomes. Biomarkers including soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF) are predictive of the development of preeclampsia. Their long-term value in predicting which women will develop cardiovascular complications remote from pregnancy is not yet established. OBJECTIVES: To determine the prevalence and incidence of Cardio-renal-metabolic outcomes at 10 years follow-up in a cohort of women screened for suspected preeclampsia from 2008 to 2009 and assess the relationship between pregnancy biomarkers and long-term outcomes...
June 2022: Pregnancy Hypertension
https://read.qxmd.com/read/35363951/treatment-for-mild-chronic-hypertension-during-pregnancy
#38
RANDOMIZED CONTROLLED TRIAL
Alan T Tita, Jeff M Szychowski, Kim Boggess, Lorraine Dugoff, Baha Sibai, Kirsten Lawrence, Brenna L Hughes, Joseph Bell, Kjersti Aagaard, Rodney K Edwards, Kelly Gibson, David M Haas, Lauren Plante, Torri Metz, Brian Casey, Sean Esplin, Sherri Longo, Matthew Hoffman, George R Saade, Kara K Hoppe, Janelle Foroutan, Methodius Tuuli, Michelle Y Owens, Hyagriv N Simhan, Heather Frey, Todd Rosen, Anna Palatnik, Susan Baker, Phyllis August, Uma M Reddy, Wendy Kinzler, Emily Su, Iris Krishna, Nicki Nguyen, Mary E Norton, Daniel Skupski, Yasser Y El-Sayed, Dotum Ogunyemi, Zorina S Galis, Lorie Harper, Namasivayam Ambalavanan, Nancy L Geller, Suzanne Oparil, Gary R Cutter, William W Andrews
BACKGROUND: The benefits and safety of the treatment of mild chronic hypertension (blood pressure, <160/100 mm Hg) during pregnancy are uncertain. Data are needed on whether a strategy of targeting a blood pressure of less than 140/90 mm Hg reduces the incidence of adverse pregnancy outcomes without compromising fetal growth. METHODS: In this open-label, multicenter, randomized trial, we assigned pregnant women with mild chronic hypertension and singleton fetuses at a gestational age of less than 23 weeks to receive antihypertensive medications recommended for use in pregnancy (active-treatment group) or to receive no such treatment unless severe hypertension (systolic pressure, ≥160 mm Hg; or diastolic pressure, ≥105 mm Hg) developed (control group)...
May 12, 2022: New England Journal of Medicine
https://read.qxmd.com/read/35260416/which-antihypertensive-treatment-is-better-for-mild-to-moderate-hypertension-in-pregnancy
#39
JOURNAL ARTICLE
(no author information available yet)
No abstract text is available yet for this article.
March 8, 2022: BMJ: British Medical Journal
https://read.qxmd.com/read/34884331/maternal-perinatal-variables-in-patients-with-severe-preeclampsia-who-develop-acute-kidney-injury
#40
JOURNAL ARTICLE
Patrocinio Rodríguez-Benitez, Irene Aracil Moreno, Cristina Oliver Barrecheguren, Yolanda Cuñarro López, Fátima Yllana, Pilar Pintado Recarte, Coral Bravo Arribas, Melchor Álvarez-Mon, Miguel A Ortega, Juan A De Leon-Luis
Introduction: At present, we are witnessing an increase in preeclampsia, especially the most severe forms, which are associated with an increased risk of maternal-perinatal morbidity and mortality. As a severity criterion, acute kidney injury (AKI) has been associated with a worse prognosis, and for this reason, the maternal and perinatal variables associated with AKI in patients with severe preeclampsia (SP) were analysed in this study. Methods: An observational, retrospective, single-centre study of patients with SP treated at a tertiary hospital between January 2007 and December 2018 was conducted...
November 29, 2021: Journal of Clinical Medicine
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