OBJECTIVE: To assess the risks and potential benefits of low-dose angiotensin-converting enzyme (ACE) inhibitor treatment in pregnancies complicated by severe hypertension. METHODS: A retrospective review of pregnant women treated with ACE inhibitors was conducted. Hemodynamics before and after treatment were assessed by using Doppler technique to measure cardiac output. Data ...

OBJECTIVE: To compare the incidence of pregnancy-induced hypertension in patients with and without polycystic ovary disease (PCOD). STUDY DESIGN: We conducted a retrospective, case-control analysis of patients who achieved singleton pregnancies with human menopausal gonadotropin (hMG) therapy. Twenty-two PCOD patients were compared to 27 infertility patients without PCOD who were ...

To determine tissue kallikrein (TK) activity in black African women with hypertensive disorders of pregnancy; 140 women were recruited and divided into the following groups: group A--35 preeclamptic women, group B--35 mild to moderate hypertensive pregnant women and group C--35 normotensive pregnant women, and group D--35 normotensive non-pregnant healthy women. ...

OBJECTIVE: To conduct a systematic review of evidence relating to management of mild chronic hypertension during pregnancy, including associated risks, benefits, and harms of treatment with antihypertensive agents, nonpharmacologic measures, and aspirin and benefits of various monitoring strategies. DATA SOURCES: Using four broad search strategies, we searched English and non-English-language ...

Hypertension arising during pregnancy remains one of the two most frequently-cited causes of maternal death in the UK. In some cases, pregnancy is unmasking underlying hypertension, which manifests itself in later life. Pregnant women who develop de novo proteinuric hypertension (pre-eclampsia, PE) can share many risk factors with patients with ...

OBJECTIVE: The purpose of this study was to determine whether second-trimester plasma homocysteine levels are elevated among women whose pregnancies are subsequently complicated by pregnancy-induced hypertension, preeclampsia, or intrauterine growth restriction. STUDY DESIGN: Women with normal but relatively low plasma zinc levels were randomly assigned to receive zinc supplementation or ...

OBJECTIVE: We sought to compare the end-tidal carbon monoxide breath levels in pregnant women with and without pregnancy-induced hypertension and preeclampsia. STUDY DESIGN: We prospectively performed end-tidal carbon monoxide measurements corrected for ambient carbon monoxide in nonsmoking women during late gestation (>31 weeks). The study group included 22 women with ...

Hypertension affects 10% of pregnancies in the United States and remains a leading cause of both maternal and fetal morbidity and mortality. Hypertension in pregnancy includes a spectrum of conditions, most notably preeclampsia, a form of hypertension unique to pregnancy that occurs de novo or superimposed on chronic hypertension. Risks ...

BACKGROUND: An increase in total body water is common in normal pregnancy. It is thought to be an important mechanism of maternal adaptation to pregnancy. OBJECTIVE: The aim of the present study was to assess longitudinal changes in body water compartments in pregnant women and to correlate these measurements with ...

OBJECTIVE: To evaluate nitric oxide (NO) production in patients with pregnancy-induced hypertension or preeclampsia and in controls. METHODS: Four groups of pregnant women were included: 17 patients with pregnancy-induced hypertension, ten with mild or moderate preeclampsia, 17 with severe preeclampsia, and 44 normotensive women matched for weeks of gestation at ...

OBJECTIVE: To evaluate C to T substitution at nucleotide 677 of N(5), N(10)-methylenetetrahydrofolate reductase gene in women with prior preeclamptic or normotensive pregnancies. METHODS: Methylenetetrahydrofolate reductase genotypes were determined in 113 Finnish women with preeclamptic first pregnancies and 103 controls with one or more normotensive pregnancies, using polymerase chain reaction ...

Preeclampsia is pregnancy-induced hypertension. The hypoxia at high altitude increases the incidence of preeclampsia. Endothelin is released in response to hypoxia and is associated with other hypertensive states at high altitude. Endothelin may play a major role in preeclampsia for individuals residing at high altitude. Endothelin antagonists may prove useful ...

An association between preeclampsia (PE) and a common missense mutation of the methylenetetrahydrofolate reductase gene (MTHFR), a C to T substitution at nucleotide 677 (C677T), which converts an alanine to a valine residue, has been reported in Italian and Japanese populations. We examined 101 cases of hypertension in pregnancy (HP), ...

Leon C. Chesley's first paper opened with the title 'Pregnancy in the patient with hypertensive disease'(1). Leon C. Chesley PhD, John E. Annitto, MD, MSc (Med), Jersey City, NJ, USA (from the Margaret Hague Maternity Hospital) [Am J Obstet Gynecol 1947;53:372-381]. We quote some lines from this important paper and ...

OBJECTIVE: To determine whether nifedipine or prazosin is the more appropriate second-line antihypertensive agent in pregnancy. DESIGN: Randomised controlled trial. SETTING: Tygerberg Hospital, a tertiary referral centre. POPULATION: Women with early, severe pre-eclampsia or hypertension in pregnancy, whose blood pressure could not be adequately controlled by methyldopa 2 g/day, but ...

This study compares the red blood cell (Rbc) levels of lead (Pb), calcium (Ca), and magnesium (Mg) in relation to blood pressure in 39 pregnant women in the third trimester of pregnancy. The study population included 20 women with normal pregnancies, 15 with mild hypertension, and 4 with severe hypertension ...

OBJECTIVE: This study was undertaken to compare rates and severity of gestational hypertension and preeclampsia, as well as perinatal outcomes when these complications develop, between women with twin gestations and those with singleton gestations. STUDY DESIGN: This was a secondary analysis of prospective data from women with twin (n = ...

OBJECTIVE: To determine whether there is a difference in peripheral vascular reactivity between normal women and those with pregnancy-induced hypertension. METHODS: Capillary blood flow (flux) was recorded in the skin over the ankle in 26 pregnant women with pregnancy-induced hypertension at term. Twelve of these women had proteinuria, and 14 ...

One of the reason of PIH problems may be due to exposition to placental trophoblast. The objective of the work was to evaluate the number of trophoblast cells deported into maternal peripheral blood of patients with PIH (pregnancy induced hypertension) as compared to normal pregnancy. Trophoblasts have been detected, by ...

OBJECTIVES: To determine if pregnancy-induced hypertension (PIH) is associated with a narrow anion gap. METHODS: Chart review of women with uncomplicated pregnancies and those with PIH and varying degrees of proteinuria. Electrolytes, total protein, albumin, creatinine, uric acid, a qualitative or quantitative measurement of urine protein were required for inclusion ...

Vitamin E, a potent antioxidant, may play a role in preventing preeclampsia. Maternal blood samples were collected between 28 and 40 weeks' gestation from women with mild preeclampsia (n=17), women with severe preeclampsia (n=16) and the control group (n=15). This control group was consisted of 15 pregnant women without hypertension ...

The changes induced by transient hypertension upon cardiac geometry (G) are unclear. Pregnancy-induced hypertension (PIH) offers a natural and spontaneous model of this condition. To assess geometric changes according to two-dimensionally guided M-mode echocardiography, we compared patients with PIH with normal pregnant women (NPW). Fifty-five women, aged 28.5 +/- 7.5 ...

The aim of this study is to evaluate the hemodynamics and pregnancy outcome of women with prior orthotopic liver transplantation. Hemodynamic measurements by Doppler technique were performed on pregnant subjects with prior orthotopic liver transplantation. Maternal characteristics, renal function, pregnancy complications, delivery indications, delivery mode, and neonatal outcomes were evaluated. ...

Two women who first had the clinical features of primary aldosteronism in the postpartum period are described. Their gestations were virtually uneventful. After delivery, however, progressively severe hypertension (Joint National Committee VI, stage 3) with hypokalemia developed. Pregnancy may conceal the clinical symptoms of primary aldosteronism that causes unexpected severe ...

Preeclampsia is a hypertensive disorder unique to pregnancy and is of unknown cause. It is both a maternal as well as fetal syndrome. It affects 2%-10% of nulliparas, and is more prevalent when preexisting hypertension, renal disease, or diabetes is present. The main clinical features of the disorder are maternal ...

Hypertension in pregnancy includes a group of distinct disorders that require special consideration in both prevention and pharmacologic treatment. In recent years, there have been few advances regarding the pathophysiology and prevention of preeclampsia, or in recommendations for first-line drug therapy of the hypertensive complications of preeclampsia. Similarly, the recommendations ...

The role of vitamin A therapy in pregnancy induced hypertension (P.I.H.) on free radical cascade was studied in P.I.H. patients of third trimester. It was found that vitamin A therapy causes statistically significant decrease in lipid peroxidation. However it has no effect on superoxide dismutase and catalase. This indicates that ...

BACKGROUND: Pregnancy associated with primary pulmonary hypertension is an uncommon observation, with maternal mortality > 50%. Experience treating this condition is limited. Past reports have emphasized the need for pregnancy termination. In the last few years there has been considerable interest in long-term intravenous use of epoprostenol (prostacyclin) in patients ...

OBJECTIVE: To report a case of a patient treated with an angiotensin-converting enzyme (ACE) inhibitor with a good neonatal outcome. CASE REPORT: A 39-year-old African-Caribbean patient who had chronic hypertension presented at 18 weeks' gestation with acute hypertension. She was being treated for chronic hypertension with lisinopril, but had self-discontinued ...

When they became aware that many of their internal medicine residents were not being routinely exposed to a representative range of medical illnesses in pregnancy, the authors set out to develop and implement a brief practical curriculum on the medical problems of pregnancy. They began with a retrospective chart review ...

Glucocorticoid-remediable aldosteronism (GRA) is a hereditary form of primary hyperaldosteronism that presents with hypokalemia and hypertension from childhood onward. GRA is characterized by the ectopic production of aldosterone in the cortisol-producing zona fasciculata under the regulation of adrenocorticotrophic hormone. Despite the early age of onset, no previous reports of pregnancy ...

BACKGROUND: We investigated the relation between fetoplacental growth and the use of oral antihypertensive medication to treat mild-to-moderate pregnancy hypertension. METHODS: The study design was a metaregression analysis of published data from randomised controlled trials. Data from a paper that was regarded as an extreme statistical outliner were excluded from ...

GENERAL INTRODUCTION In the past fifty years, mother and child care in many parts of the world has developed to a high standard, and maternal and perinatal mortality figures have declined dramatically. As complications of illegal abortions, infections and death from postpartum haemorrhage are rarely seen these days in developed ...

BACKGROUND: Very high blood pressure during pregnancy poses a serious threat to women and their fetuses. The use of drugs to lower blood pressure may reduce this risk. OBJECTIVES: The objective of this review was to compare different antihypertensive drugs used for rapid treatment of severe hypertension during pregnancy. SEARCH ...

STUDY OBJECTIVE: Our purpose was to study the relationship between snoring and pregnancy-induced hypertension and growth retardation of the fetus. DESIGN: Retrospective, cross-sectional, consecutive case series. SETTING: The Department of Gynecology and Obstetrics, University Hospital, Ume?, Sweden. Participants and measurements: On the day of delivery, 502 women with singleton pregnancies ...

BACKGROUND: Hypertension is a common complication of pregnancy. Antihypertensive drugs are widely used in the belief these will improve outcome for both the woman (such as decreasing the risk of stroke or eclampsia) and her baby (such as decreasing the risk of preterm birth and its complications). Beta-blockers are a ...

A number of laboratory tests are available for evaluation of hypertension in pregnancy. These tests can be used to either predict and/or prognosticate preeclampsia and other hypertensive disorders of pregnancy. The aim of this study was to evaluate alterations in fibronectin homeostasis in normotensive pregnancy and in hypertensive disorders of ...

Fertility is restored following renal transplantation, and the potential for motherhood can be realised. This retrospective study reviews the outcome of 53 pregnancies, in 24 patients, between 1988 and 1995. All patients underwent transplant surgery, and received antenatal care at a single centre. The mean age at first conception was ...

OBJECTIVE: Examine the benefits/risks of beta-blockers for pregnancy hypertension. STUDY DESIGN: Meta-analysis of relevant trials identified by comprehensive literature review (1966-97). RESULTS: Included were 30 trials for pregnancy hypertension, and four others for perinatal outcomes only. For mild chronic hypertension treated throughout pregnancy (n=2 trials), oral beta-blockers (compared with no ...

We determined the serum levels of leptin in 96 pregnant women with body mass index between 20 to 30, 30 normal (NP), 26 with mild preeclampsia (MPE), 27 with severe preeclampsia (SPE), 6 with chronic hypertension plus preeclampsia (CHT+PE) and 7 with chronic hypertension (CHT). A significant (p < 0.01) ...

The purpose of this study was to determine the association between maternal plasma purine bases levels and fetal well-being indices. The research included pregnant women with pregnancy-induced hypertension (PIH) and women with physiologic pregnancy between 32nd and 41st week of gestation. To characterize the pregnant women, their age, number of ...

OBJECTIVE: To determine maternal and perinatal outcomes in nulliparas with pregnancy-associated hypertension or preeclampsia. METHODS: We conducted (and reported elsewhere) a randomized, double-masked, placebo-controlled trial calcium supplementation of 4589 healthy nulliparas assigned at 13-21 weeks' gestation. This well-defined and characterized data set provided an opportunity to detail more precisely adverse ...

OBJECTIVES: To assess the prevalence of subsequent hypertension in women with hypertensive pregnancies and evaluate it according to the subclassifications of hypertension in pregnancy. METHODS: A survey was carried out in 476 women with hypertensive pregnancies (cases) and 226 normotensive controls delivered between 1973 and 1991 in a tertiary-level teaching ...

Preeclampsia is a multisystem disorder specific to pregnancy with a high maternal and perinatal morbidity and mortality. The cause of this disorder is unknown. Preeclampsia likely represents the clinical end point of multiple contributory factors, and it is unlikely that any single cause will be found. The blueprint for the ...

OBJECTIVES: To study the possibility of identifiable factors at or close to pregnancy that could predict hypertension later in life. To evaluate if women with hypertensive disease in their first pregnancy and who later develop hypertension also have characteristics of the metabolic syndrome. METHODS: Case control study of a cohort ...

OBJECTIVE: To assess obstetric outcomes in women in their second pregnancy after preeclampsia in the first pregnancy. METHODS: We utilized population-based birth registry data of Kuopio University Hospital to investigate pregnancy outcome measures in 123 nonpreeclamptic parous women with prior preeclampsia and 21 women with repeat preeclampsia in their second ...

Constricting effect of indomethacin on the ductus arteriosus of the fetus is well known. The fetal effects of other nonsteroid anti-inflammatory drugs (NSAIDs) like naproxen are not well reported. We report here a case of a 3,790-g term neonate who developed persistent pulmonary hypertension after birth with a closed ductus ...

Our objective was to study the urinary levels of orotic acid in normal pregnancy and in pregnancy-induced hypertension. Such levels were measured using high-performance liquid chromatography with column-switching. The levels of urinary orotic acid (micromol/g creatinine) in normal pregnancy (n = 14) were 6.9 +/- 2.3 (first trimester), 10.1 +/- ...

BACKGROUND: Systemic hypertension and degenerative vascular disease are more common in multigravidae than in primigravidae. The present study investigated whether the known ocular hypotensive effect of late pregnancy is influenced by the number of pregnancies. METHODS: Intraocular pressure (IOP) was measured in normotensive third-trimester primigravidae and multigravidae along with nulligravida ...

Hypertension in pregnancy is a frequent complication that has substantial adverse perinatal outcomes. Hypertension may be preexisting (chronic) essential or secondary hypertension; a second entity is pregnancy induced (gestational hypertension, preeclampsia). Recent advances have identified newer markers for pregnancy hypertension: several potential candidate genes may explain the apparent family inheritance ...