Objectives- To determine the feasibility of obtaining adequate 3-dimensional (3D) data sets to examine the fetal secondary palate during the second-trimester anatomy scan. Methods- During a 3-month period, 3D data sets of the fetal secondary palate were obtained from consecutive women undergoing routine second-trimester scans. Only structurally normal singleton fetuses ...

OBJECTIVE: To determine whether systematic examination of the primary and secondary palate with 3D ultrasound aids in the identification of orofacial clefts in the first trimester. METHODS: 3D datasets were acquired prospectively from women undergoing first-trimester ultrasound screening for aneuploidy. Multiplanar mode display was used for off-line analysis of (1) ...

BACKGROUNDFew epidemiological studies have explored the relationship between orofacial clefts and bronchodilators. We assessed whether mothers who used bronchodilators during early pregnancy were at an increased risk of delivering infants with orofacial clefts.METHODSWe used National Birth Defects Prevention Study case-control data from mothers of 2711 infants with orofacial clefts and ...

To investigate the accuracy of prenatal axial three-dimensional (3D) ultrasound in predicting the absence or presence of cleft palate in the presence of cleft lip. Between March 2005 and January 2009, there were 81 cases with a prenatal two-dimensional (2D) ultrasound screening diagnosis of unilateral or bilateral cleft lip at ...

Selected antiepileptic drugs (AEDs) increase the risk of birth defects. To assess the impact of influencing AED prescribing practices on spina bifida and cleft palate we searched the literature for estimates of the association between valproic acid or carbamazepine use during pregnancy and these defects and summarized the associations using ...

Percutaneous device closure of patent foramen ovale has developed into a therapeutic option for patients with presumed cryptogenic stroke. The appropriate use of these therapies relies on appropriate clinical assessment, as well as an understanding of the potential advantages of certain closure devices. Pregnancy is an uncommon scenario for stroke, ...

: Prior studies of the association between physical activity and risk of hypertensive disorders of pregnancy have been conflicting, failed to assess total physical activity, and included few Hispanic women, the largest minority group in the United States with the highest birth rates. : We examined this association among 1043 ...

Ischemic stroke during pregnancy and puerperium represents a rare occurrence but it could be a serious and stressful event for mothers, infants, and also families. Whenever it does occur, many concerns arise about the safety of the mother and the fetus in relation to common diagnostic tests and therapies leading ...

Background and purpose:  Although pregnancy and postpartum have long been associated with stroke, there is a dearth of information in Latino-American populations. The aim of this study was to describe the cerebrovascular complications occurring during pregnancy/postpartum and compare the characteristics amongst stroke types occurring in this period in Hispanic women. ...

Stroke is a rare but potentially devastating disease during pregnancy and puerperium. Pregnancy is well recognized as a risk factor for stroke. Accurate and timely identification of stroke is crucial for clinical practice. However, the optimal management of pregnant women with stroke remains a clinical challenge. Thus, identification of risk ...

The aim of this study was to determine the association between inherited thrombophilias and pregnancy-related hypertension recurrence. In this case-control study, blood samples were obtained from patients who had at least two pregnancies complicated with pregnancy-related hypertension (n = 41) and healthy, normotensive pregnancies delivered without any complication (n = 38). Following the DNA ...

To investigate (i) if kisspeptin administration alters heart rate (HR) or blood pressure (BP) in healthy male and female volunteers, (ii) whether circulating plasma kisspeptin concentrations in healthy pregnant women and women with hypertensive diseases of pregnancy correlate with BP and (iii) whether women with hypertensive diseases of pregnancy have ...

Preeclampsia (PE) is a major contributor to maternal and fetal mortality. The cause of preeclampsia remains unclear, but oxidative stress on the endothelium leading to endothelial dysfunction is said to be the root cause of the disease. The aim of this study was to measure and determine the plasma levels ...

Low-dose aspirin therapy could improve remodelling of maternal spiral arteries during early placentation and prevent subsequent pregnancy-related hypertensive disorders. We investigated whether low-dose aspirin therapy reduces the incidence of hypertensive pregnancy complications in unselected IVF and ICSI patients when medication was started prior to pregnancy. A total of 487 patients ...

OBJECTIVE: To estimate the association between maternal pregnancy-related hypertension and offspring hypertension later in life in a birth cohort from New England. METHODS: Covariate and exposure data were collected between 1959 and 1966 through the Collaborative Perinatal Project. Follow-up information was obtained through the New England Family Study between 2001 ...

We determined whether postnatal pulmonary hypertension induced by 70% of pregnancy at high altitude (HA) persists once the offspring return to sea level and investigated pulmonary vascular mechanisms operating under these circumstances. Pregnant ewes were divided into two groups: conception, pregnancy, and delivery at low altitude (580 m, LLL) and ...

This study aims to determine the influence of previous abortions and new paternity on the risk of hypertension in a cohort of nulliparous women. A prospective cohort study was conducted with development of hypertension in pregnancy as outcome variable. Explanatory variables were previous abortions and paternity. Univariate analysis was by ...

The benefits of appropriate blood pressure (BP) control include reductions in proteinuria and possibly a slowing of the progressive loss of kidney function. Overall, medication therapy to lower BP during pregnancy should be used mainly for maternal safety because of the lack of data to support an improvement in fetal ...

The aim of this study was to evaluate maternal and fetal outcome of the subsequent pregnancy of primiparous women with a history of early-onset intrauterine growth restriction (IUGR), prompting delivery before 34 weeks of gestation, without concomitant maternal hypertensive disease. Retrospective cohort study. Tertiary center in the Netherlands. Women with ...

BACKGROUND: Whether pregnancy impacts on the long-term outcome of immunoglobulin A (IgA) nephropathy is unknown. This study aims to compare the long-term outcome of kidney disease in women with IgA nephropathy and preserved kidney function who did and did not become pregnant. STUDY DESIGN: Multicenter longitudinal cohort study. SETTING & ...

OBJECTIVE: To examine seasonality of pregnancy hypertension rates, and whether they related to sunlight levels around conception. STUDY DESIGN: Data were obtained for 424,732 singleton pregnancies conceived from 2001 through 2005 in Australia. We analyzed monthly rates of pregnancy hypertension and preeclampsia in relation to monthly solar radiation. RESULTS: Pregnancy ...

Idiopathic pulmonary arterial hypertension is a rare condition associated with significant maternal mortality. We report the management of a 37-year-old multigravida with severe disease using epoprostenol, a multidisciplinary approach, and a planned delivery. Although the patient survived the pregnancy, her pulmonary function significantly worsened. Epoprostenol, a pulmonary vasodilator, should be ...

OBJECTIVE: To reduce maternal and perinatal morbidity and mortality associated with the hypertensive disorders of pregnancy by using an active model of guideline implementation. METHODS: This study used a preintervention and postintervention cohort comparison design. We interrogated the British Columbia Perinatal Database Registry for 6 years of existing prospectively gathered ...

Hypertensive disorders in pregnancy can be chronic, pregestational or just diagnosed before the 20th week, or newly diagnosed in the second half of pregnancy. Any type of hypertension is more frequent in diabetic pregnancies with a different distribution among different types of diabetes. Most of the evidence is for pre-eclampsia ...

OBJECTIVE: To estimate the potential association of chorionic villus sampling (CVS) with subsequent development of hypertensive disorders of pregnancy and to evaluate whether any such potential association remains significant after adjusting for maternal characteristics and components of first-trimester screening. METHODS: We included live singleton pregnancies at 11 0/7 to 13 ...

To compare the maternal bone mineral density (BMD) changes in gestational hypertensive and normotensive pregnancies using quantitative ultrasound. Consecutive patients were recruited from a general obstetric clinic over a period of 9 months. BMD measurements were performed at the os calcis in early pregnancy before 20 weeks and in the late third ...

Preeclampsia is a life-threatening pregnancy syndrome of uncertain origin. To elucidate the pathogenesis, we evaluated the temporal relationships between changes in vascular function and circulating biomarkers of angiogenic activity before and after the onset of preeclampsia and gestational hypertension. Maternal mean arterial pressure, uterine artery pulsatility index, brachial artery flow-mediated ...

An intronic single nucleotide polymorphism (SNP) in the CYP3A5 gene (CYP3A5*3; SNP rs776746) affects RNA splicing and enzymatic activity. The CYP3A5*3 frequency increased with distance from the equator and natural selection has been proposed to explain the worldwide distribution of this allele. CYP3A activity has been related with the risk ...

The purpose of this study was to determine the value of bilateral uterine artery notching in the second trimester in the risk assessment for preeclampsia, gestational hypertension, and small-for-gestational-age (SGA) without preeclampsia. This prospective cohort study included 4190 singleton pregnancies that underwent ultrasound examination between 23 and 25 weeks' gestation. ...

Hypertensive disorders of pregnancies remain a central public health concern throughout the world, and are a major cause of maternal mortality in the developing world. Although treatment options have not significantly changed in recent years, insight on the pathogenesis of preeclampsia/eclampsia has been remarkable. With improved animal models of preeclampsia ...

Hypertension remains the most commonly encountered medical condition in pregnant women, complicating up to 15% of all pregnancies. It results in frequent hospital admissions, maternal morbidity and mortality and iatrogenic preterm birth with concomitant neonatal morbidity and mortality. Hypertensive disorders of pregnancy comprise a spectrum of severity ranging from a ...

To investigate the relationship between levels of insulin-like growth factors 1 and 2 (IGF-1, IGF-2) and insulin-like growth factor binding protein 3 (IGFBP-3) in antenatal maternal serum and gestational hypertension and pre-eclampsia (PET). Prospective cohort study of 1650 low-risk Caucasian women in a University teaching hospital in London. Statistical analysis ...

Pregnancy is a cardiovascular and metabolic challenge to the human female body. This review summarizes current knowledge on the regulation of blood pressure and plasma volume in normal and hypertensive pregnant women. During pregnancy, systemic vascular resistance and blood pressure decrease, whereas cardiac output and blood volume increase to safeguard ...

Hypertensive disorders of pregnancy are associated with an increased risk of maternal and fetal morbidity and mortality. The cause and the pathogenesis of the pregnancy-induced syndrome, preeclampsia, is still poorly understood. Published evidence of altered biomarkers for the endothelial dysfunction suggests that the initiating event in preeclampsia is the reduced ...

The physiological changes of pregnancy may predispose females to develop sleep-disordered breathing (SDB) or protect against it. Studies evaluating outcomes of SDB symptoms in pregnancy are scarce. The goal of this study was to evaluate the prevalence of SDB symptoms in pregnancy and their relationship with pregnancy and neonatal outcomes. ...

An intronic single nucleotide polymorphism (SNP) in the CYP3A5 gene (CYP3A5 *3; SNP rs776746) affects RNA splicing and enzymatic activity. The CYP3A5 *3 frequency increased with distance from the equator and natural selection has been proposed to explain the worldwide distribution of this allele. CYP3A activity has been related with ...

Preeclampsia is a common complication of pregnancy with potentially devastating consequences to both the mother and the baby.It is the leading cause of maternal deaths in developing countries. In developed countries it is the major cause of iatrogenic premature delivery and contributes significantly to increasing health care cost associated with ...

Most epidemiological studies demonstrate that women suffering from migraine note a significant improvement in their headaches during pregnancy. Both headache specialists and gynecologists commonly hold that migraine does not involve any risks to either the mother, or the fetus. Despite this, recent studies into the medical complications of pregnancy in ...

OBJECTIVE: The objective of this study was to examine first-trimester maternal serum placental growth factor (PlGF) levels in pregnancies which later develop hypertensive and growth complications. METHODS: In this case-control study, PlGF levels were measured by AutoDELFIA immunoassay platform. There were 47 cases of at least one of the following ...

OBJECTIVE: Pregnancy-related hypertensive disorders (PRHDs) are a leading cause of maternal and perinatal morbidity and mortality in developed countries. This study investigated a possible association of PRHDs with menstrual abnormalities. MATERIALS AND METHODS: We contacted all women with PRHDs who delivered in our clinic between 2004 and 2007 as well ...

Takayasu's syndrome is a chronic inflammatory arteriopathy of unknown origin which primarily affects women of reproductive age. We report the course and outcome of 37 pregnancies in 15 women with Takayasu arteritis during the period 1999-2008. A retrospective analysis of 9 years was carried out in a tertiary hospital in ...

Offspring born to mothers with hypertensive pregnancy have higher childhood blood pressure. We hypothesized this relates to prenatally programmed differences in the underlying vascular pathophysiology of the offspring and that these would be most apparent in those born preterm because of severe hypertension. We carried out a 20-year follow-up study ...

Prenatal diagnosis of pheocromocytoma, although rare, is important as it allows a reduction in both maternal mortality and foetal loss. Pheocromocytoma operated on in the first trimester of pregnancy with survival of both patient and foetus is rare in literature. Our case was operated on with success after a correct ...

Oxidative stress has been proposed as a mechanism linking the poor placental perfusion characteristic of preeclampsia with the clinical manifestations of the disorder. We assessed the effects of antioxidant supplementation with vitamins C and E, initiated early in pregnancy, on the risk of serious adverse maternal, fetal, and neonatal outcomes ...

OBJECTIVE: To assess the challenges associated with the diagnosis, management, and prevention of hypertensive disease during pregnancy in low-income countries, following the success of the Magpie Trial. METHODS: Descriptive review of the literature from 1990 to 2009 on the diagnosis, management, and prevention of hypertensive disease in pregnancy. RESULTS: In ...

Pregnancy induced hypertension (PIH) is a major complication of pregnancy and is associated with high maternal and perinatal morbidity and mortality. The aim of this study was to investigate the possible causal association of PIH with maternal serum PAPP-A and urinary protein-creatinine ratio (UPCr) as well as to evaluate the ...

OBJECTIVE: Ambulatory BP monitoring (ABPM) has been proposed as a logical approach to overcoming many of the problems associated with clinical BP measurement. The extent of its use in diagnosing hypertension in pregnancy is unknown. The objective of this study was to identify the practices surrounding use of ABPM by ...

Idiopathic pulmonary arterial hypertension (IPAH) is characterized by a progressive increase in pulmonary vascular resistance, which may lead to right ventricular failure and death. Major cardiovascular and pulmonary alterations occur during pregnancy and therefore worsen or increase the complications of pulmonary arterial hypertension (PAH). A patient diagnosed with IPAH after ...

Pregnancies complicated by new-onset hypertension are associated with increased sensitivity to angiotensin II, but it is unclear whether this sensitivity persists postpartum. We studied pressor response to infused angiotensin II in 25 normotensive postpartum women in both high- and low-sodium balance. Ten women had a history of hypertensive pregnancy (5 ...

Objective. In patients with preeclampsia maternal plasma concentration of plasminogen activator inhibitor-2 (PAI-2) is reduced. The objective of the study was to determine if the altered levels of PAI-2 precede the onset of the disease. Methods. Plasma PAI-2 was measured at 11-13 weeks of gestation in 119 pregnancies that developed ...