Women with a history of previous preeclampsia are at increased risk of preeclampsia and other adverse pregnancy outcomes in subsequent pregnancies. The magnitude of this risk is dependent on gestational age at time of disease onset, severity of disease, and presence or absence of preexisting medical disorders. The objective in ...

OBJECTIVE: To evaluate and identify the risk factors associated with the pathogenesis of congenital hydrocephalus in a large specific population. METHODS: An International Classification of Diseases (ICD)-9 database search of patients with congenital hydrocephalus treated at the University of Mississippi Medical Center between 1998 and 2007 was performed. All recruited ...

Preeclampsia, a pregnancy-exclusive hypertensive disorder, is the major cause of maternal and perinatal mortality, with a greater importance in developing countries. The role of inflammation in the pathogenesis of preeclampsia has been the object of recent studies by our group. We have described elevated levels of inflammatory markers (tumor necrosis ...

Deficient NO formation has been implicated in hypertensive disorders of pregnancy. However, no previous study has compared the circulating nitrite concentrations in healthy pregnant women with those found in hypertensive disorders of pregnancy. Moreover, 2 antiangiogenic factors produced in the placenta (soluble fms-like tyrosine kinase-1 and soluble endogline) may affect ...

Preeclampsia is a syndrome characterized by hypertension, proteinuria and edema in a pregnant female after 20 weeks of gestation, including occurring in the postpartum period. Delivery of the infant is usually considered the definitive treatment for preeclampsia. Preeclampsia in a prior pregnancy is associated with an increased risk of recurrence ...

OBJECTIVE: The purpose of this study was to identify morbidity that is associated with sickle cell disease (SCD) in pregnancy. STUDY DESIGN: The Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality for the years 2000-2003 was queried for all pregnancy-related ...

Gestational diabetes is often compounded by hypertensive disease of pregnancy. Women diagnosed as suffering from gestational diabetes were subdivided into two groups: those found to be suffering from some form of hypertension during their pregnancy [n = 78]; and those who did not develop hypertension [n = 345]. The maternal ...

The aim of this study was to determine if insertion-deletion polymorphism of angiotensin-converting enzyme is a risk factor for the development of preeclampsia. Sixty women with preeclampsia and 50 normotensive pregnant women were included in this study. Preeclampsia was defined as blood pressure >140/90 mmHg in a previously normotensive women ...

The lower risk of preeclampsia observed in parous women has prompted a hypothesis that cardiovascular adaptation from a first pregnancy has ongoing benefits which contribute to a reduced risk of preeclampsia in the second pregnancy. However, how the interpregnancy interval affects mean arterial pressure (MAP) as an indicator of cardiovascular ...

Preeclampsia is a serious complication during pregnancy that includes potentially life-threatening risks to the mother and fetus. It may be challenging to distinguish this from other causes of rapidly escalating hypertension, especially in women with end-stage renal disease, because current diagnostic criteria for preeclampsia cannot be easily applied. We report ...

OBJECTIVES: To examine women with renal transplants who became pregnant, and delivered at our hospital. METHODS: Twenty-six women who had undergone renal transplantation between 1977 and 2002 became pregnant, and delivered at Osaka University Hospital. Complete medical records of twenty of them were retrieved and retrospectively analyzed. RESULTS: Overall, twenty-nine ...

BACKGROUND/AIMS: Esophageal varices bleeding is a fatal complication of portal hypertension. The model for end-stage liver disease (MELD) has been used as a tool to predict mortality risk in cirrhotic patients. It is currently unknown if MELD score can be applied to predicting late esophageal varices rebleeding. The predictive ability ...

OBJECTIVES: To compare the circulating levels of matrix metalloproteinase (MMP)-2, MMP-9, tissue inhibitors of metalloproteinase (TIMP)-1, TIMP-2, and the MMP-9/TIMP-1 and MMP-2/TIMP-2 ratios in preeclampsia and gestational hypertension with those found in normotensive pregnancies. DESIGN AND METHODS: We studied 83 pregnant women (30 healthy pregnant women with uncomplicated pregnancies, 26 ...

OBJECTIVE: To determine the frequency of placental infarcts and its effects on the fetal outcome in pregnancies complicated by hypertension. STUDY DESIGN: Case control. PLACE AND DURATION OF STUDY: Obstetrics Unit of North Colombo Teaching Hospital, Ragama, Sri Lanka, from January 2003 to January 2004. PATIENTS AND METHODS: Placentae of ...

PURPOSE OF REVIEW: Hypertensive disorders of pregnancy, particularly the preeclampsia/eclampsia syndrome, remain the leading causes of worldwide pregnancy-related maternal and neonatal mortality and morbidity. This group of conditions are a 'riddle wrapped in a mystery inside an enigma' to quote Winston Churchill. We are fortunate to have contributions from leading ...

To clarify the role of TAFI in hypertensive disorders in pregnancy, 22 subjects, including 10 with pre-eclampsia (PE) and 12 with gestational hypertension were examined for the levels of TAFI and thrombin-antithrombin (TAT) complex. Thirty normal pregnant women served as controls. ELISA was employed for the detection. The results showed ...

The aim of the present study was to evaluate the histopathology in placentas from patients with severe preeclampsia with and without hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. An additional aim was to compare the prevalence of infants born small for gestational age in the 2 groups. The ...

Hyperuricemia is a common finding in preeclamptic pregnancies evident from early pregnancy. Despite the fact that elevated uric acid often pre-dates the onset of clinical manifestations of preeclampsia, hyperuricemia is usually considered secondary to altered kidney function. Increased serum uric acid is associated with hypertension, renal disease and adverse cardiovascular ...

We assessed whether fetal growth restriction without pregnancy-induced hypertension (PIH) is associated with the different clinical subgroups of PIH in the subsequent pregnancy. We also assessed the maternal and paternal contributions to this effect. Pairs of first and second, second and third, third and fourth, and fourth and fifth births ...

This study aimed to determine the performance of screening for preeclampsia (PE) by maternal medical history and mean arterial pressure (MAP) at 11(+0) to 13(+6) weeks. In 5590 women with singleton pregnancies attending for routine care at 11(+0) to 13(+6) week's gestation we recorded maternal variables and measured the MAP. ...

OBJECTIVE: Placental soluble fms-like tyrosine kinase-1 may contribute to the pathogenesis of preeclampsia. Here we describe alterations in serum angiogenic factor levels in women with multiple gestation pregnancies, a major preeclampsia risk factor. STUDY DESIGN: We collected serial serum specimens from 101 pregnant women at high preeclampsia risk between 22 ...

OBJECTIVE: This study was undertaken to validate a self-administered questionnaire in verifying the diagnosis of preeclampsia, eclampsia, or toxemia in a group of women with a greater than 20-year history of preeclampsia. STUDY DESIGN: Questionnaires were mailed to a random sample of 144 women who received a diagnosis of any ...

In this case-control study, we examined the perinatal outcome in 272 pregnancies complicated by hypertension and compared the result with that of 816 control cases. The overall prevalence of hypertensive disorders in pregnancy (HDP) was 7.2%. There was significantly higher perinatal mortality rate (PMR) of 110.3 per 1000 deliveries in ...

This prospective study aimed at examining the effect of maternal hypertension in pregnancy on rate of preterm delivery and anthropometric indices in the resultant newborn infants. The gestational ages and anthropometric indices of 265 live-born babies of hypertensive mothers (BHM) were determined and the results compared with those of 804 ...

OBJECTIVE: To assess role of systolic hypertension during pregnancy in long-term mortality. METHOD: A total of 4,090 Finnish women who delivered in the period from 1954 to 1963 were followed up for an average of 44 years. Mortality data were obtained from the Finnish cause-of-death registry. Cox-proportional hazard models were ...

BACKGROUND: Preeclampsia is a major cause of maternal and perinatal mortality and morbidity. The etiology of preeclampsia remains unclear. Recently, it was shown that misregulation of fms-like tyrosine kinase-1 (Flt-1) in the peripheral blood mononuclear cells of pregnant women results in over-expression of the soluble splice variant of Flt-1, sFlt-1, ...

BACKGROUND: Altered maternal inflammatory responses play a role in the development of preeclampsia and the hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome. We examined whether allelic variants of the innate immune receptors Toll-like receptor 4 (TLR4) and nucleotide-binding oligomerization domain 2 (NOD2), that impair the inflammatory response to ...

The decision to treat elevated arterial pressure in pregnancy depends on the risk and benefits imposed on the mother and the fetus. Treatment for mild-to-moderate hypertension during pregnancy may not reduce maternal or fetal risk. Severe hypertension, on the other hand, should be treated to decrease maternal risk. Methyldopa and ...

OBJECTIVE: To derive a prediction index based on the most salient patient history, laboratory, and clinical parameters for identifying women at high risk for developing preeclampsia (PE). METHODS: Nonpregnant women with a history of PE (n = 101) were compared with nonpregnant parous women with a history of one or ...

OBJECTIVES: To assess the effects of applying a tight vs. a less tight control of mild chronic essential or gestational non-proteinuric hypertension in pregnancy. METHODS: A randomized trial was conducted in 2006-2007 in the University of Ain Shams, Egypt. Eligible participants (n=125) were randomly assigned to either tight or less ...

BACKGROUND: To assess whether the frequency pf pregnancy-induced hypertension is low, and vegetables intake and physical activity are protective against pregnancy-induced hypertension onset among rural women from Democratic republic of Congo. METHOD: This hospital-based and longitudinal study was carried out within the rural hospital of Kimpese, DR Congo were monitored ...

Preeclampsia is specific to pregnancy and is still a leading cause of maternal and perinatal mortality and morbidity, affecting about 3% of women, but the underlying pathogenetic mechanisms still remain unclear. Immune maladaptation, placental ischemia and increased oxidative stress represent the main components discussed to be of etiologic importance, and ...

OBJECTIVE: To estimate the prevalence of maternal hypertensive disorders in Portugal and to assess their impact on obstetric outcomes. METHODS: A national survey on hypertension in pregnancy was conducted in Portuguese public maternity wards and included 6726 pregnancies. RESULTS: Six percent of women presented with a hypertensive disorder during pregnancy ...

OBJECTIVE: To evaluate associations between maternal serum uric acid (UA) levels, maternal status, and fetal outcome. METHODS: Maternal UA, urinary protein-creatinine ratio (P/C), blood pressure (BP), gestational age at delivery, and birth weight were evaluated in hypertensive pregnant women (n = 58). These were divided into two groups: high UA ...

Pregnancy increases plasma cystatin C, but levels are much higher in preeclampsia. Previous studies have not quantified preeclampsia risk with varying cystatin C concentrations or adjusted for confounders. We performed a case-control study of 100 preeclampsia cases and 100 random pregnancies uncomplicated by hypertension (controls). All women were free of ...

BACKGROUND: Microparticles (MP) are pro-coagulant vesicles derived from various cells. Evidence is accumulating that MP are of pathophysiological relevance in autoimmune, cardiovascular, and thromboembolic diseases and inflammatory disorders. Therefore, their role in the development of preeclampsia was investigated and MP from preeclamptic patients influenced endothelial-dependent vasodilatation. Knowledge about changes in ...

Preeclampsia is new-onset hypertension with proteinuria during pregnancy. The initiating event in preeclampsia has been postulated to involve reduced placental perfusion, which leads to widespread dysfunction of the maternal vascular endothelium. The main objective of this brief review was to highlight some of the recent advances in our understanding of ...

Takayasu's arteritis is a chronic, idiopathic, inflammatory disease of the arteries, which primarily involves the aorta, its main branches such as the brachiocephalic, carotid, subclavian, vertebral, and renal arteries, as well as the coronary and pulmonary arteries. It has been suggested that pregnancy, although not usually associated with an exacerbation ...

OBJECTIVE: To assess the accuracy of hypertensive disorders of pregnancy reporting in birth and hospital discharge data compared with data abstracted from medical records. METHODS: Data from a validation study of 1200 women provided the 'gold standard' for hypertension status. The validation data were linked to both hospital discharge and ...

Dramatic and vascular bed-specific hemodynamic changes occur in pregnancy and hypertension of pregnancy (HtP). Because myosin phosphatase (MP) is the primary effector of smooth muscle relaxation and a key target of signaling pathways that regulate vascular tone, we hypothesized that MP expression would be altered in these conditions. The abundance ...

Hypertensive pregnancy disorders complicate 10% of all pregnancies. In this article we discuss the spectrum of hypertensive conditions that may occur during pregnancy. Recent studies have consistently shown that hypertensive disorders in pregnancy implicate a two-fold higher risk for the development of hypertension and cardiovascular disease later in life. To ...

HELLP syndrome is a multisystemic disorder with an incidence of 0.17-0.85% of all pregnancies. Its etiopathogenesis is not completely understood. The most widely accepted hypotheses are: a change in the immune feto-maternal balance, platelet aggregation, endothelial dysfunction, arterial hypertension and an inborn error of the fatty acid oxidative metabolism. Hepatic ...

To study whether the development of hypertensive disorder complicating pregnancy is associated with -308G-->A, -850C-->T mutation at promoter of TNF-alpha gene, the -308G-->A, -850C-->T polymorphism was examined in patients and healthy pregnant women by PCR-RFLP technique. The frequencies of genotype and allele were compared between the two groups. The results ...

Expression of endogenous ouabain in placenta and the concentrations of serum ET-1 and NO were examined in 30 patients with hypertensive disorder complicating pregnancy (HDCP) and 30 healthy pregnant women to investigate the effect of endogenous ouabain on HDCP. Compared with the healthy pregnant group, the expression of endogenous ouabain ...

Preeclampsia (PE) is a major cause of perinatal materno-foetal morbidity and pregnancy-associated-mortality in industrialized countries. Clinically, PE associates maternal pregnancy-induced hypertension with proteinuria. PE is often considered as a two-stage disease. The first stage is a shallow cytotrophoblastic invasion which induces cycles of hypoxia-reoxygenation at the placental level. Subsequently an ...

BACKGROUND: The mechanisms leading to pregnancy-related hypertensive disorders, and pregnancy-induced hypertension (PIH) and pre-eclampsia (PE) in particular, are still not clear. Diagnostic criteria are clinical because specific markers of the condition are lacking. A role of the fibrinolytic system has been suggested. OBJECTIVES: We aimed to evaluate the behavior of ...

Hypertensive disorders of pregnancy (proteinuric hypertension, eclampsia, chronic hypertension, HELL P syndrome) are the commonest direct causes of maternal deaths in South Africa. Six hundred and twenty-eight (19.1%) of the 3 406 maternal deaths in a three-year period (2002-2004) were associated with hypertensive disorders of pregnancy. Cerebral complications, mainly cerebral ...

OBJECTIVE: To determine the pregnancy outcomes associated with maternal chronic hypertension. STUDY DESIGN: Retrospective, population-based cohort study of maternal and infant discharge records linked to birth records in California from 1991 to 2001 were examined for demographics and pregnancy outcomes, and comparisons were made between those with and without chronic ...

Increasing evidence indicates that hypertension in pregnancy is an under-recognized risk factor for cardiovascular disease (CVD). Compared with women who have had normotensive pregnancies, those who are hypertensive during pregnancy are at greater risk of cardiovascular and cerebrovascular events and have a less favorable overall risk profile for CVD years ...

Intracerebral hemorrhage (ICH) is an infrequent but severe complication in pregnant women with hypertension. The authors describe a patient with chronic hypertension who developed superimposed preeclampsia and spontaneous ICH during the thirty-fifth week of pregnancy. ICH was diagnosed by computed tomographic scan. She underwent successful emergent cesarean section and neurosurgical ...