Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: EC:2.7.10.1 (ERK)
 95,504 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Disorders associated with hypertension during pregnancy, which are often linked with oedema and/or proteinuria and are variously termed toxaemia of pregnancy, EPH gestosis, pre-eclampsia, and eclampsia, are of unknown etiology, although they have been known for a long time and many attempts have been made to classify and explain them. In this paper, the author draws attention to the problems of standardizing values for blood pressure, proteinuria, and oedema and of determining their value in the diagnosis of the disorder. Different classification schemes are described and the problems of comparison between them are stressed. The frequency of the hypertensive disorders of pregnancy in different countries and groups at special risk are discussed. Finally, recommendations are made on the types of research and health care needed to combat the problem.
 ...
PMID:Epidemiology of the hypertensive disorders of pregnancy. 31 51

The maternal deaths occurring in the Kilimanjaro Christian Medical Center (KCMC), which serves as a supraregional reference hospital for the 5 regions of Northern and Central Tanzania, are reviewed for the 1971-1977 period and avoidable factors are discussed. All deaths occurring within the hospital during pregnancy or the first 6 weeks of the puerperium were included in this survey. Postmortem examination was performed in 35% of the cases. In the remaining cases the diagnosis was made on clinical grounds. During the period under review, there were 10 deaths among 83 cases, a mortality of 12%. The major cause of rupture was obstructed labor associated with a contracted pelvis or abnormal lie. 25% of the patients had had a previous cesarean section scar give way. 2 other deaths were attributed to anesthetic accidents and 1 was probably due to pulmonary embolism. The primary cause of death in the 7 remaining cases was hemorrhage (4) and sepsis (3). If deaths from ruptured uterus are to be avoided, early diagnosis is essential. 1044 cases of moderate and severe EPH gestosis (preeclampsia) were treated in KCMC during the period under review together with 54 cases of eclampsia. There were 5 deaths among the patients with eclampsia, a mortality of 9%. In addition to the 11 sepsis deaths there were 3 others included among the cases of ruptured uterus. There were 4 cases of septic abortion and 3 of those admitted to criminal interference. Preexisting anemia was a complicating factor in 5 cases, all of whom died within 15 minutes of arrival. There were 4 deaths among 251 cases of ruptured ectopic pregnancy. There were 10 deaths associated with cesarean section among 1271 sections peformed during the period under review. Deaths from associated diseases included the following: enterocolitis (12 deaths); renal and hypertensive disease (4 deaths); cardiac disease (2 deaths); anemia (2 deaths); malaria (2 deaths); tuberculous meningitis (2 deaths); and miscellaneous associated conditions (11 deaths).
 ...
PMID:Maternal deaths in the Kilimanjaro region of Tanzania. 47 24

The courses of the following three groups of pregnancies were studied in the context of 146 women, with twelve years, on average, having elapsed from their first pregnancies: 1. Normal pregnancies without EPH gestosis (58 cases); 2. Pregnancies with EPH gestosis (58 cases); 3. Pregnancies with eclampsia (30 cases). - All clinical findings and statistical calculations were evaluated by means of electronic data processing. - Average systolic and diastolic blood pressures were established in follow-up checks, usually twelve years from pregnancy. They were normal, following normal pregnancies. Statistically secured blood pressures measured from patients with gestosis or eclampsia during their first pregnancy were higher than those recorded from patients in a control group, but pathological values were established in but few cases. - The following, more specialised checks proved or particular importance for an evaluation of EPH gestosis and its effects on liver function following pregnancy: serum electrophoresis, thymol test, SGOT, SGPT, direct and indirect bilirubin, blood and urinary sugar, serum cholesterol, and total fats. - The above results are likely to show that EPH gestosis and its effects are relatively well tolerated by the liver. However, discrete disorders characterised by dysproteinaemia without cellular decay and icterus may occur in certain instances.
 ...
PMID:[Late sequels EPH gestosis (author's transl)]. 53 46

This study demonstrates that uric acid serum levels are of importance in the prognosis of pregnancy complicated by hypertension. In early pregnancy the uric acid level probably is the most sensitive parameter to select the risk-prone pregnancies with EPH-gestosis to conduct the further course of pregnancy under medical care. Pregnant hypertensives with high uric acid levels develop more often retardation of the fetus, the incidence of eclampsia increases. In case of hypertension in pregnancy complicated by high uric acid levels careful monitoring and normalizing high blood pressure under medical observation improves the prognosis for fetus and mother.
 ...
PMID:[The clinical significance of hyperuricemia for the prognosis of pregnancy toxemia]. 62 Sep 63

A 31-year-old secundipara with eclampsia developed the HELLP syndrome after delivery. Clinically, along with very high blood pressure values (29.3/17.3 kPa) and eclamptic attacks, an intense pain in the upper abdomen and nausea were dominant. The patient also had severe thrombocytopenia (18 x 10(9)/L), hemolysis, and increased liver enzymes (SGOT up to 220 U/L and SGPT up to 100 U/L). An intensive therapy, including--together with usual interventions in serious EPH gestoses--also plasmapheresis, antithrombin III substitution, freshly frozen plasma, and transfusion of blood and thrombocytes, proved successful in achieving the normalization of the blood pressure, blood count and liver enzymes, as well as a clinical improvement, so that 18 days after delivery it was possible for the patient to go home, provided with necessary instructions.
 ...
PMID:[The HELLP syndrome--a case report]. 174 83

In 521 pregnancies complicated by hypertensive disorders (PHD) and in 200 control cases, we studied the incidence of intrauterine growth retardation (IUGR), depression in the newborns, general morbidity of live newborns requiring admission and perinatal mortality. We also analyzed the relationship between these conditions and the type and severity of hypertension, gestational age, presence of symptoms of the classic EPH triad and of abnormal uric acid values, hemoconcentration, and low urinary estriol values. Perinatal mortality (especially antepartum) was significantly increased in severe pre-eclampsia, chronic hypertension and chronic hypertension with superimposed pregnancy-induced hypertension (PIH); in all the cases with PHD it was three times higher than that of the control group (59% versus 20% and five times higher than the global perinatal mortality of the 25,763 deliveries attended during the same period (12% General morbidity reached 44% in severe pre-eclampsia and 75% in antepartum eclampsia. But the preterminal deliveries were also more frequent in PHD, especially in severe pre-eclampsia-eclampsia. Nevertheless, the perinatal morbidity and mortality in general increased when proteinuria and edema plus proteinuria were associated with hypertension, and the incidence was significantly higher when proteinuria surpassed 100 mg/dl. Morbimortality also increased in the presence of hemoconcentration, hyperuricemia, and low estrioluria.
 ...
PMID:Perinatal morbidity and mortality in pregnancy hypertensive disorders: prognostic value of the clinical and laboratory findings. 197 14

EPH-gestosis (pre-eclampsia-eclampsia) characterized by edema, proteinuria and hypertension occurs primarily in the nullipara, usually after the 20th gestational week. As in normal pregnancy there is striking change in both renal blood flow and glomerular filtration rate a slight increase in urinary protein secretion is not considered abnormal until it exceeds 300 mg/day. Abnormal proteinuria commonly accompanies pre-eclampsia and may be minimal, moderate or severe (even exceeding greater than 25 g/l). Proteinuria was typed mainly of nonselective glomerular origin by using the SDS-disc-electrophoresis. Additionally the clearance ratio of IgG to transferrin in all patients with abnormal proteinuria was evaluated. In none of the patients studied the ratio was less than 0.1 (highly selective). As severe proteinuria is associated with fetal growth retardation, preterm deliveries and prenatal mortality the quantitation and typing of early proteinuria is essential for considering patients who are at risk for developing EPH-gestosis.
 ...
PMID:[Proteinuria in normal pregnancy and in EPH gestosis]. 265 75

Our report concerns the incidences of pre-eclampsia and eclampsia in 147 sisters, 248 daughters, 74 granddaughters, and 131 daughters-in-law of women who have had eclampsia. The disorder is highly heritable. We have analysed the data in two ways, firstly, as a single gene condition and, secondly, as a multifactorial condition. The observed incidences fit closely with the single gene model with frequency of the putative gene being 0.25. When Falconer's method of estimating heritabilities of discrete characters is used, estimates of 120% (sisters), 88% (daughters), and 105% (granddaughters)--none significantly different from 100%-are obtained. Insofar as possible, our definition of pre-eclampsia corresponds with EPH in the descriptive classification of the Organisation Gestosis and to 'severe pre-eclampsia' in Nelson's classification. The women were delivered in many different hospitals, however, and many records fail to provide all of the essential information.
 ...
PMID:Genetics of hypertension in pregnancy: possible single gene control of pre-eclampsia and eclampsia in the descendants of eclamptic women. 376 85

In a primigravida of 25 years of age who had an attack of eclampsia seven hours after Caesarean section we found an abnormally low oncotic pressure (i.e. colloid osmotic pressure, COP) in the plasma, namely, 14.5 mm Hg instead of the normal value which is greater than 20mm Hg. In EPH-gestosis there is a pathogenetic dependence of the oedemas, hypovolaemia, haemoconcentration and insufficient perfusion of parenchymatous organs, on the transcapillary colloid osmotic pressure gradient. As a result of colloid substitution with human albumin (20-40 g per day) effected with oncometric control, the COP increased stepwise to 18.3 mm Hg within one week and the distribution of fluid between the intravascular and extravascular space normalised. Repeated direct measurement of the colloid osmotic pressure (in our case by Onkometer BMT 921, Thomae) proved extremely helpful especially as a means of therapy control.
 ...
PMID:[Extremely low oncotic pressure in postpartum eclampsia]. 407 14

Because intravascular fibrin deposition is found in the glomerular capillaries of patients who have died of eclampsia, it was long assumed that a chronic form of intravascular clotting represents the decisive cause of the condition. Fibrin deposition is also typically observed in the uteroplacental bloodstream. The occurrence of high levels of soluble fibrin and fibrin(ogen) degradation products, which in severe cases can also include fibrin oligomers, in combination with thrombocytopenia and factor VIII consumption were interpreted as additional evidence for the significance of intravascular clotting in the pathogenesis of EPH gestosis. The hemolysis of the microangiopathologic type, which occurs in severe cases, was attributed to the resulting impairment in microcirculation. Doubts regarding this theory arose when it was noted that the course of EPH gestosis is not altered by the use of heparin, and that even in severe cases of eclampsia with hemolysis and thrombocytopenia the plasmatic clotting system is involved only to a small extent and probably only secondarily. More recent investigations have yielded the first evidence of reduced prostacyclin synthesis in maternal and fetal vessels in patients with EPH gestosis. Since prostacyclins lower arterial resistance yet at the same time are strong inhibitors of thrombocyte aggregation, this prostacyclin deficiency could account for the hypertension and the occurrence of platelet thrombi in the placental bloodstream associated with EPH gestosis. The observation of a reduction in the number of thrombocytes as a consequence of increased platelet breakdown, which precedes a rise in the level of fibrin(ogen) degradation products, also points to the significance of an abnormal interrelation between platelets and endothelium. In addition to the plasmatic and thrombocytic hypercoagulability and impaired prostacyclin synthesis, hemoconcentration with increased microvascular permeability is also observed. Early detection of disturbances of the vessel wall and vessel contents may provide a means of prophylaxis.
 ...
PMID:Recent aspects of hemostasis, hematology and hemorheology in preeclampsia-eclampsia. 637 2


1 2 Next >>