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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors studied 43 cases of arterial hypertension in pregnancy in an attempt to determine the efficiency and safety of different anti-hypertensive drugs. The patients were divided into two major groups: arterial hypertension which revealed itself during pregnancy (true toxaemias of pregnancy and relapsing toxaemias), and arterial hypertensions which were added on to a pre-existing pathology (arterial hypertension, diabetes, chronic nephritis). The cases in these different classes were then divided into two definite groups according to the need for therapy: the first group was treated by rest and hydrallazine as a single therapeutic agent. In the second group multiple agents were needed because of the arterial hypertension, and one was a beta-blocker. Complications were found particularly in the second group of true toxaemias of pregnancy where unfortunately 5 fetal deaths occurred that were attributable to the severity of the hypertension more than to the beta-blockers, which were administered for longer and in higher doses without major complications in recurrent toxaemias and pre-existing arterial hypertension cases.
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PMID:[The influence of present therapeutic methods and especially of beta-blockers on fetal and maternal prognosis in hypertensive syndromes in pregnancy. 43 case records (author's transl)]. 3 53

We validated a mid-pregnancy screening mean arterial pressure (MAP2) of 85 mmHg or higher as a significant predictor of hypertension in pregnancy. During the 17-month period from October 1984 through February 1986, 730 women, or 16% of all women cared for and delivered at our institution, were screened at or near 20 weeks of amenorrhea. Of the 139 women with a MAP2 of 85 mmHg or higher, 21.6% developed antepartum hypertension, compared with only 0.7% of the 591 women with a MAP2 below 85 mmHg. The screening MAP2 level of 85 mmHg was the optimal cutoff for MAP2 as a screening test. Controlling for the value of the screening MAP2, the only other important predictors of antepartum hypertension were chronic hypertension and diabetes mellitus. Using these three variables, the probability that an individual pregnant woman will develop antepartum hypertension can be assessed with a high degree of accuracy (84.5%) by 20 weeks of amenorrhea. This assessment is noninvasive and simple to use. Three distinct levels of risk have been defined; the moderate- and high-risk groups warrant careful surveillance during pregnancy and may be reasonable groups in which to test preventive interventions.
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PMID:Early prediction of antepartum hypertension. 272 14

The development of Doppler ultrasound evaluation of the uteroplacental and fetoplacental circulations is one of the most important achievements of modern obstetrics. For the first time, the obstetrician has the ability to evaluate, in a noninvasive way, circulatory systems critical to fetal development and the outcome of pregnancy and to obtain information of great value for the management of complicated pregnancies. At this time, Doppler examination of the umbilical artery has become a fundamental part of the evaluation of pregnancies complicated by retarded fetal growth. Doppler examination of the umbilical and uterine arteries has become the most accurate test to establish a fetal prognosis in patients with hypertension in pregnancy. Other indications for the use of this methodology (twins, diabetes, Rh isoimmunization, etc.) are being studied, and the role of Doppler ultrasound probably will extend significantly beyond the now well-established indications for its use.
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PMID:The use of Doppler waveform analysis in the evaluation of the high-risk fetus. 306 67

The interim results of a case-control study of myocardial infarction in women below age 55 years conducted in northern Italy since January 1983 are presented, based on 168 cases of acute myocardial infarction and 251 hospital controls. Cigarette smoking was strongly related to myocardial infarction, with risk estimates elevated more than 10-fold for heavy (more than 25 cigarettes per day) smokers. Smoking-related relative risks were of similar magnitude in younger (less than 45 years) and in perimenopausal (45-54 years) women and were largely unaffected by allowance for several potential distorting factors. Other factors independently and strongly related to the risk of myocardial infarction were diabetes, hypertension, and history of coronary heart disease in more than one first-degree relative. Relative risks were also elevated in women who gave birth to their first child earlier (below age 20 years) and in oral contraceptive users. However, these estimates were not significant. The apparent positive associations with clinical history of hyperlipidemia, hypertension in pregnancy, and heavy coffee consumption could be explained largely in terms of confounding, but the protection conveyed by moderate alcohol consumption remained after multivariate analysis. Thus, the interim results of this investigation in a low incidence population confirm the importance of several risk factors previously described in data collected in Northern Europe and the United States. Furthermore, possibly because of the low baseline risk, the proportion of cases attributable to smoking in middle-aged women in this population may be even larger than that previously reported from higher incidence areas.
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PMID:Risk factors for myocardial infarction in young women. 356 57

Pregnancy hypertension, blood pressure during labor, and the umbilical cord blood lead concentration were assessed in 3851 women for whom additional demographic, medical, and personal information was available. Lead levels correlated with both systolic (Pearson r = 0.081, p = 0.0001) and diastolic (r = 0.051, p = 0.002) blood pressures during labor. The incidence of pregnancy hypertension increased with lead level. Multivariate models of pregnancy hypertension and systolic blood pressure as a function of maternal age, parity, hematocrit, ponderal index, race, and diabetes were improved by including lead as a predictor variable. At these observed levels of exposure (mean blood lead, 6.9 +/- 3.3 [SD] micrograms/dl), lead appears to have a small but demonstrable association with pregnancy hypertension and blood pressure at the time of delivery, but not with preeclampsia.
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PMID:Pregnancy hypertension, blood pressure during labor, and blood lead levels. 365 74

The influence on neonatal morbidity of factors such as maternal duration of diabetes, third trimester blood glucose control, gestational age at delivery, mode of delivery, and hypertension in pregnancy was analyzed in 92 consecutive diabetic pregnancies (White B35, C22, D26, F9). In a subgroup of 52 diabetic pregnancies the analysis was extended to the influence of hemoglobin A1c at the start and end of pregnancy, blood glucose control during delivery, and fetal insulin secretion at birth. The infants were divided into 3 groups according to the degree of neonatal morbidity: either no (n = 37), minor (n = 27), or severe morbidity (n = 28). There were no significant differences between the groups with no and minor morbidity. Compared to the no-morbidity group, the group with severe morbidity had significantly longer duration of maternal diabetes (p less than 0.05), shorter gestational age at delivery (p less than 0.025), higher frequency of cesarean section (p less than 0.05), and higher frequency of toxicosis (p less than 0.01). The 3 groups did not differ significantly with regard to maternal blood glucose control during pregnancy and delivery. Discriminant analysis revealed that the most significant (p less than 0.001) influence on severe morbidity came from gestational age at delivery. After correction for this factor, there were no other factors with a significant influence on severe morbidity. Within the actual range (mean values 3.9-8.5 mmol/l), blood glucose control during the third trimester had no significant influence on morbidity.
Diabetes Res 1986 Feb
PMID:Factors influencing neonatal morbidity in diabetic pregnancy. 369 82

The author presents his observations made on the behavior of an auditory evoked response of the human fetus during labor, elicited by a standardized sound stimulus at 1500 cycles/second. The method was applied to 233 women during labor and the pattern of responses evoked by sound stimulation was studied in all clinical conditions present in this high-risk population. A fair number of observations was made on vigorous/depressed newborns by Apgar rating, in the presence of definite cardiotocographic signals of fetal distress, in cases of intact or ruptured membranes, in cephalo-pelvic disproportion, in the presence of maternal risk factors, in cases of cord entaglement, in cases of meconium present in amniotic fluid, in intra-uterine growth retardation, hypertensive disease of pregnancy, and in familial and class A diabetes. A significant decrease in the response to sound stimulation was observed in cases of fetuses born in a depressed condition, after more than 2 hours following membrane rupture, in the presence of maternal obstetric risk factors, and in cases of hypertension in pregnancy. Women with intra-uterine growth retardation and cephalo-pelvic disproportion presented smaller changes and in cases of umbilical cord entaglement, presence of meconium in amniotic fluid and with history of familial or class A diabetes, no differences in the patterns of responses to sound stimulation as compared with normal could be observed. The author observed a good correlation between the auditory evoked response and fetal conditions during the course of labor and suggests that this method should be further developed as a simple method of evaluating the cerebral function of the unborn human fetus. In the first published part of this study (19) we described the modifications in the auditory evoked response of the human fetus caused by the progress of labor. A closer scrutiny of our data revealed the influence of several other factors acting upon the pattern of fetal response to sound stimulation. The present paper describes studies on those factors influencing the behavior of the human fetus following sound stimulation.
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PMID:Auditory evoked responses in the human fetus. II. Modifications observed during labor. 401 84

3 cases of women becoming hypertensive while taking oral contraceptives are presented. The first was a 35-year-old mother of 4 who had developed hypertensive kidney disease in her last pregnancy. Before contraception her blood pressure was 130/75; it rose to 140/80 in 3 months and 160/100 in 6 months after taking Ovariostat (2.5-mg lynestrenol and .075-mg mestranol, combined). 2 months after discontinuing usage her pressure was 140/80. The second was a 45-year-old mother of 2 whose pressure climbed from 120/70 to 180/120 within 3 months of starting Planor (2-mg norgestrienone and .05-mg ethinyl estradiol, combined), and fell to 130/80 3 weeks after discontinuing usage. The third was a 32-year-old woman with blood pressure of 120/70 before taking Ovaristat. Within 15 days her pressure was 170/90, accompanied by severe headaches. 1 month after discontinuing usage it returned to 120/70. The discussants mention several cases in their experience, and agree with the authors that women with hypertension in pregnancy, obesity, or diabetes should not be given the pill. Normal patients should be followed carefully and advised to keep a low salt diet and normal weight.
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PMID:[Arterial hypertension during treatment with estro-progestative drugs]. 515 54

The pathophysiology of preeclampsia has not been fully clarified. A variety of factors have been implicated with this disease including vasoactive peptides and hormones during the last 20 years. Inadequate generation of atrial natriuretic peptide (ANP) has been one of the mechanisms discussed as to possibly contribute to the development of hypertension. In human pregnancy multiple studies of ANP-plasma-concentration in normal or hypertensive pregnancies showed conflicting results. The complexity of the clinical findings of hypertension in pregnancy makes it very difficult to carry out comparative clinical and biochemical studies in humans. In an animal experience genetic as environmental influences could be excluded. Therefore, the present study shows an experimental preeclampsia-like syndrome in the rat by reduction of the utero-placental flow. We observed a significant increase of plasma ANP in pregnant rats with experimentally induced hypertension. Furthermore, our results suggest that the ventricles could be an important source of ANP gene expression.
Exp Clin Endocrinol Diabetes 1995
PMID:Atrial natriuretic peptide (ANP) in preeclampsia-like syndrome in a rat model. 853 57

Several diseases are known or suspected to be associated with altered levels of hormones and growth factors that may influence breast cancer risk. To elucidate this possibility, we studied the relationship between 23 medical conditions or procedures and breast cancer risk by means of data from a multicentric case-control study conducted between 1991 and 1994 in six Italian areas. The study included 2569 histologically confirmed incident cases of breast cancer (median age 55 years, range 23-74 years) and 2588 control women (median age 56 years, range 20-74 years) admitted to the same hospitals as cases for a variety of acute conditions unrelated to known or suspected risk factors for breast cancer. After allowance for education, parity and body mass index, elevated odds ratios (ORs) emerged for history of diabetes mellitus in post-menopausal women (OR = 1.5, 95% CI 1.1-2.0), hypertension in pregnancy (OR = 1.8, 95% CI 1.0-3.4) and breast nodules (OR = 1.3, 95% CI 1.0-1.7). Risk decreases were associated with ovarian ablation for ovarian cysts (OR = 0.5, 95% CI 0.3-0.7) and with thyroid nodules (OR = 0.7, 95% CI 0.5-0.9) but not with the combination of any type of benign thyroid disease. While most examined conditions seemed unrelated to breast cancer risk, the association with late-onset diabetes is of special interest as it suggests a role of hyperinsulinaemia and insulin resistance in breast cancer promotion. It also points to preventive lifestyle modifications.
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PMID:Selected medical conditions and risk of breast cancer. 918 90


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