OBJECTIVES: This study was undertaken to determine the influence of increased prepregnancy body mass index (BMI) on pregnancy outcome in women with mild gestational hypertension remote from term. STUDY DESIGN: A matched cohort design was used. A total of 365 pregnant women with mild gestational hypertension and a normal prepregnancy ...

OBJECTIVE: The aim of the study was to determine the risk factors, prevalance, epidemiological parameters and maternal-perinatal outcome in pregnant women with hypertensive disorder. MATERIALS AND METHODS: A retrospective analysis was undertaken on 255 consecutive cases of hypertensive disorder in pregnancy who were managed at Kocaeli University, School of Medicine, ...

OBJECTIVES: To determine population-based rates and outcomes of hypertensive disorders in pregnancy. DESIGN: Cross-sectional study using linked population databases. SETTING AND PARTICIPANTS: All women, and their babies, discharged from hospital following birth in New South Wales, between 1 January 2000 and 31 December 2002. MAIN OUTCOME MEASURES: Rates of hypertensive ...

BACKGROUND: Women referred to secondary care with suspected pregnancy-induced hypertension (PIH) are commonly investigated with blood tests and cardiotocography (CTG), regardless of the clinical severity of their condition. Over-investigation might lead to inappropriate intervention. AIMS: To investigate how often abnormal blood test and CTG results occur in women with pre-eclampsia ...

OBJECTIVE: Little is known about the association between fetal thrombophilias and severe preeclampsia. The objective of this study was to examine the association between fetal genotype for factor V Leiden, prothrombin, and methylene tetrahydrofolate reductase (MTHFR) mutations and severe preeclampsia. METHODS: Patients with severe preeclampsia or HELLP (hemolysis, elevated liver ...

Preeclampsia is a hypertensive disorder unique to pregnancy with consistent involvement of the kidney. The renin-angiotensin system (RAS) has been implicated in the pathogenesis of preeclampsia. In the gravid state, in addition to the RAS in the kidney, there is a tissue-based RAS in the uteroplacental unit. Increased renin expression ...

BACKGROUND: The significance of dipstick or microscopic hematuria in pregnancy is uncertain, with some studies suggesting this is associated with a greater risk for preeclampsia. We sought to determine the prevalence and clinical significance of microscopic hematuria during pregnancy. METHODS: This was a prospective case-control study in the antenatal Clinic ...

OBJECTIVES: To explore the relationship, if any, between dietary intake of the antioxidant vitamins C and E, and the development of pre-eclampsia and gestational hypertension. STUDY DESIGN: A prospective cohort study of pregnant women attending the antenatal clinic of the Women's and Children's Hospital in Adelaide, Australia, was carried out ...

OBJECTIVE: To evaluate the potential relationship between placental disruption in weeks 13 and 14 and the subsequent development of gestational hypertension or preeclampsia. METHODS: Using subjects recruited during a randomized trial funded by the National Institute of Child Health and Human Development, which compared early amniocentesis and late transabdominal chorionic ...

The purpose of the study was to investigate the influence that pregnancy has on the progression of primary nephrotic syndrome (NS). We investigated in pregnant rats the clinical characteristics of NS, including urinary protein concentration, serum albumin, cholesterol, triglycerides, urea, creatinine and electrolytes (potassium, sodium, calcium). Proteinuria and edema increasing ...

A meta-analysis of randomized controlled trials suggests that nifedipine appears to be a reasonable agent for treatment of acute severe hypertension in pregnancy. However, in a 1999 survey of Canadian practitioners, most stated that they rarely or never use nifedipine capsules for treatment of acute severe pregnancy hypertension. Also, there ...

ACE inhibitors are commonly used drugs in the management of adult hypertension. However their use in pregnant women can have serious effects on the fetus. In this manuscript we report a case of fatal neonatal renal failure associated with maternal intake of enalapril during third trimester and review the related ...

Context: The presence of significant proteinuria in Pregnancy Induced Hypertension is associated with worse maternal and fetal outcome. Unfortunately, Dipstick strips, currently used widely for detection and quantitation of proteinuria, have been shown to be unreliable. This creates the need for a more accurate method for early detection and quantitation ...

BACKGROUND: Both hemodynamic abnormalities and thrombophilia predispose to pregnancy-associated vascular complications such as fetal growth restriction, stillbirth, preeclampsia, and placental abruption. Antithrombotic treatment may reduce the risk for these events. In this study we tested the hypothesis that in normotensive thrombophilic formerly preeclamptic women certain alterations in hemodynamic function as ...

OBJECTIVE: Secondary hypertension during pregnancy usually carries high maternal and fetal morbidity and mortality rates. A rare form of monogenic hypertension is familial hyperkalemia and hypertension, which is caused by mutations in the kinases WNK1 or WNK4 and other unknown molecular defects. The purpose of the study was to examine ...

In the US, it is currently estimated that 3% of pregnant women have chronic hypertension, or more than 100,000 pregnant women each year. The aim of our study was to investigate the adaptation of autonomic control during pregnancy based on heart rate variability analysis and to determine whether chronic hypertension ...

OBJECTIVE: We conducted a systematic review to examine the hypothesized mechanism through which homocysteine could lead to preeclampsia. DATA SOURCES: We searched MEDLINE, EMBASE, BIOSIS, SciSearch, and bibliographies of primary and review articles, and we contacted experts. METHODS OF STUDY SELECTION: Of the 25 relevant primary articles, 8 studies measured ...

Pregnancy-induced hypertension (PIH), also known as preeclampsia, remains one of the leading causes of maternal death worldwide. The term preeclampsia describes the development of hypertension with proteinuria and/or pathologic edema after the 20th week of gestation. The parturient with PIH usually has multiple organ alterations, which may affect the selection ...

BACKGROUND: Preeclampsia is a pregnancy-specific disease which is one of the leading causes of maternal and fetal morbidity and mortality. The etiology of preeclampsia remains elusive. The underlying pathology may be related to a generalized intravascular hyperinflammatory state. Since the placental histopathologic lesions of acute atherosis, seen in preeclampsia, bear ...

Studies based on conventional office blood pressure (BP) measurements concluded that both maternal age and parity have significant effects on BP during pregnancy. Previous results have also indicated predictable trends of BP variability with gestational age. Accordingly, we have evaluated possible differences in the circadian pattern of ambulatory BP as ...

A thorough understanding of the renal and cardiovascular adaptations to normal gestation is essential for proper diagnosis and management of hypertensive disorders and renal diseases during pregnancy. Here, we briefly review the renal hemodynamic changes of normal pregnancy. In addition, we present new findings and current concepts related to the ...

Hypertension is the most common medical disorder during pregnancy. Approximately 70 percent of women diagnosed with hypertension during pregnancy will have gestational hypertension-preeclampsia. The term gestational hypertension-preeclampsia is used to describe a wide spectrum of patients who may have only mild elevation in blood pressure to those with severe hypertension ...

OBJECTIVE: One of the major complications of pregnancy, preeclampsia makes pregnancy termination inevitable in most cases. Similarities exist between the mechanisms that maintain normal pregnancy, allograft transplants, and, it is postulated, peripheral self-tolerance. In addition, the critical role of the cytotoxic T-lymphocyte antigen-4 (CTLA-4) molecule in maintaining self-tolerance has been ...

OBJECTIVE: To investigate whether first trimester maternal serum sex hormone-binding globulin (SHBG) concentrations are altered in women who subsequently develop preeclampsia or other pregnancy complications. POPULATION: Women undergoing first trimester combined ultrasound and biochemical screening for chromosomal anomalies. We searched the database and identified 32 pregnancies resulting in miscarriage, 64 ...

OBJECTIVE: The aim of this study is to evaluate whether pregnancy-induced hypertension (PIH) among nondiabetic patients is associated with glucose intolerance. MATERIALS AND METHODS: A retrospective case-control study was designed including a study group who had pregnancy-induced hypertension or preeclampsia. Patients with normal pregnancy were used as a control group ...

BACKGROUND: Bed rest or restriction of activity, with or without hospitalisation, have been advocated for women with hypertension during pregnancy to improve pregnancy outcome. However, benefits need to be demonstrated before such interventions can be recommended since restricted activity may be disruptive to women's lives, expensive, and increase the risk ...

INTRODUCTION: Hypertension in pregnancy and vascular placental insufficiency are considered common pathogenic factors in human intrauterine growth retardation (IUGR). IUGR neonates experience higher mortality, and the surviving infants have a higher incidence of neurological and intellectual impairment. METHODS: To mimic this condition, we used pregnant spontaneously hypertensive rats (SHR) and ...

OBJECTIVES: We compared second pregnancy outcomes among women with and without preeclampsia in their first pregnancies who all had second pregnancies without preeclampsia. METHODS: One hundred thirty women with and 6148 without preeclampsia in their first pregnancies, who all had nonpreeclamptic second pregnancies, were included. Outcomes, including delivery gestational age, ...

BACKGROUND: Pregnancy induced hypertension may indicate a tendency towards endothelial and metabolic abnormalities leading to future cardiovascular disease. Childhood socioeconomic adversity is associated with increased cardiovascular disease risk but the association with pregnancy induced hypertension is unknown. AIM: To examine the association of childhood and adulthood socioeconomic position with pregnancy ...

Benign intracranial hypertension (BIH) or idiopathic intracranial hypertension (IIH) is a rare disorder of unknown etiology that is most often seen in obese women of reproductive age (19.3/100,000) and is reported only occasionally during pregnancy. Both pregnancy and exogenous estrogens are thought to promote IIH or worsen it. It can ...

OBJECTIVE: To report a child born with renal impairment following severe anhydramnios due to maternal exposure to an angiotensin II receptor type 1 (AT1) antagonist, valsartan, and hydrochlorothiazide during the first 28 weeks of pregnancy. CASE SUMMARY: A hypertensive woman treated with valsartan 80 mg/day, hydrochlorothiazide 12.5 mg/day, prazosin 10 ...

BACKGROUND: The aim of this study was to investigate the prostanoid production in pregnancies at high risk for hypertensive disorders, and the effect of low-dose acetylsalicylic acid (ASA) on prostanoids. MATERIAL AND METHODS: Ninety women with a bilateral notching in uterine arteries screened by Doppler ultrasound at 12-14 gestational weeks ...

Preeclampsia is the disorder of pregnancy with the highest rate of both maternal and neonatal morbidity and mortality. The maternal syndrome is characterized by oxidative stress and activation of the vascular endothelium that may originate from placental release of lipid peroxidation products, cytokines, and microparticles leading to an acute inflammatory ...

The pattern and factors affecting the outcome of pregnancy in hypertensive patients at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria between January 1997 and December 2002 were studied. There were 2,393 deliveries, with 127 (5.3%) patients fulfilling the criteria for hypertensive disorder of pregnancy. 26.2% had de-novo (gestational) hypertension, ...

AIM: To study dynamic changes in the hemodynamic parameters in pregnant women during different weeks of gestation and to comprehend changes to the cardiovascular system in normal pregnant women and in patients with pregnancy-induced hypertension (PIH), with the object of finding predictors of pregnancy-induced hypertension. METHODS: Radialis artery pulse waves ...

Normal pregnancy is associated with a systemic inflammatory response. The response is exacerbated in preeclampsia and can account for its clinical features. Many of the physiologic changes of normal pregnancy are part of an acute-phase reaction, which is generated by an inflammatory response. The placenta is the proximal cause of ...

A 31-year-old woman with end-stage renal disease was referred to the Toronto General Hospital (Ontario, Canada) for conversion from conventional hemodialysis (CHD; 4 h/session, 3 sessions/wk) to nocturnal hemodialysis (NHD; 7 h/session, 5 to 6 treatments/wk) because of refractory hypertension. As expected, blood pressure control was superior with NHD therapy, ...

The benefits of antihypertensive therapy in pregnancy remain uncertain. Blood pressure control to prevent or correct severe hypertension can avert maternal target organ damage and may allow obstetricians to prolong pregnancy or avoid hospitalization. Several factors limit the conclusions derived from systematic review of the available studies, including failure to ...

BACKGROUND: The etiology of preeclampsia remains obscure. To study the role of insulin resistance in preeclampsia, we compared fasting insulin and glucose changes during the second and third trimesters in preeclamptic women with a normal control group. PATIENTS AND METHODS: In a nested case-control study, subjects were selected from a ...

OBJECTIVE: To examine the consequence of prior abortion and preterm and term birth on the occurrence of gestational hypertension in the subsequent pregnancy. STUDY DESIGN: A population-based, retrospective, cohort study was conducted based on 140,773 pregnancies delivered between 1993 and 1999 in 49 hospitals in northern and central Alberta, Canada. ...

OBJECTIVES: This study was undertaken to determine the prevalence of hypertensive disorders of pregnancy and evaluate their effects on the mothers and fetuses at Jahrom, a city in southern Iran. METHODS: A retrospective survey was performed on 2300 pregnant women who had referred to Shahid Motahhari Hospital of Jahrom School ...

The purpose of this study was to determine the association between insulin resistance and hypertension during pregnancy with the homeostatic model assessment (HOMA-IR). A longitudinal prospective study was carried out. One hundred sixty normotensive pregnant women were followed from the first trimester until delivery. HOMA-IR levels were determined each trimester. ...

There have been many attempts to produce animal models that mimic the hypertensive disorders of pregnancy, especially preeclampsia, but most are incomplete when compared to the full spectrum of the human disease. This review assesses a number of these models, organized according to the investigators attempt to focus on a ...

AIM: To investigate the influence of maternal corticosteroid administration on neutrophil apoptosis in early onset preeclampsia. METHODS: We investigated five groups: early onset preeclampsia (EOPET, <34 weeks, n = 10); late-onset preeclampsia (LOPET, > or =34 weeks, n = 7); normotensive intrauterine growth restriction (nIUGR, n = 11); normal pregnancy ...

This article examines the management and outcomes of pregnant women with cystic fibrosis, primary pulmonary hypertension, and sarcoidosis. Pregnancy and the puerperium are associated with important cardiopulmonary changes that can adversely affect the clinical condition. Management of pregnant women with CF should be done with careful attention to complications of ...

Hypertensive pregnancy disorders are a leading cause of perinatal and maternal morbidity and mortality. Heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS) are relevant predictors of cardiovascular risk in humans. The aim of the study was to evaluate whether HRV, BPV, and BRS differ between distinct ...

BACKGROUND: There have been conflicting reports about pregnancy outcome in the hypertensive disorders of pregnancy. The present study was undertaken to examine outcomes using a population database. AIMS: To examine for differences in a range of pregnancy outcomes between three different groups of hypertensive women and normotensive women in South ...

Hypertension in pregnancy represents a spectrum of clinical entities, including pregnancy-induced hypertension (PIH), preeclampsia, eclampsia, and hemolysis, elevated liver enzyme levels, low platelet count syndrome. Although hypertension is a common denominator in this group of disorders, the pathogenesis, clinical features, and clinical course of these disorders is variable and somewhat ...

OBJECTIVE: This study was undertaken to analyze prospectively circulating vascular endothelial growth factor (VEGF) and its soluble receptor, (s) Flt-1, throughout normotensive and preeclamptic pregnancies and to assess the importance of these proteins in the development of preeclampsia. STUDY DESIGN: In this longitudinal cohort study, serum samples were collected from ...

Idiopathic intracranial hypertension (IIH) is a syndrome of increased intracranial pressure without hydrocephalus or mass lesion with elevated cerebrospinal fluid (CSF) pressure but otherwise normal CSF composition. It has been found that pregnancy occurs in IIH patients at about the same rate as in the general population, that IIH can ...