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Query: UMLS:C0020538 (
hypertension
)
170,190
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Anticardiolipin antibodies, immunoglobulin G, and M (IgG, IgM) have been associated with recurrent
abortion
and with maternal death. This study tested whether anticardiolipin titers would be a useful prenatal screening test to determine high-risk pregnancies. Titers were obtained at the first clinic visit in 686 patients, mean gestation, 20 weeks. The outcome variables were taken from a medical records computer data base. IgG anticardiolipin correlated inversely with birthweight (p less than 0.025), but not with gestation. IgM anticardiolipin correlated strongly with the inverse of patient age (p less than 0.0002) and with chronic
hypertension
(p less than 0.01), but not with preeclampsia. There was a weak correlation with the 1-minute Apgar score (p less than 0.05). Thirty-seven patients had titers of IgG or IgM greater than 3 standard deviations above the mean for nonpregnant patients. Sixteen of these patients were studied for antinuclear antibody and coagulopathy (prothrombin time, partial thromboplastin time, viper venom time) and all were normal. Six of eight patients tested had low range elevated antibody titers to double-stranded DNA. Ten placentas were examined and showed no infarctions. None of the correlations were of practical clinical utility. The biologic basis of the correlations found is of further interest. The value of anticardiolipin titers with lupus erythematosus, or with coagulopathy, was not tested.
...
PMID:Prenatal screening for anticardiolipin antibody. 237 31
In a population of 134 hypertensive pregnant women, 66 per cent of whom had chronic (permanent) arterial
hypertension
, the frequency of essential hypertension in the pregnant women's fathers or mothers was 60 per cent. The rate of unfavourable foetal outcome, i.e. late
abortion
, still-birth, neonatal death, birth weight below 1,500 g, severe prematurity or severely stunted growth, was 21 per cent. This rate was the same in the presence or absence of a family history of essential hypertension. It was higher in women with hypertension in pregnancy than in women with chronic
hypertension
(30 vs 16 per cent; p less than 0.05), but a family history of
hypertension
(mostly in the mother) was more frequent among pregnant women with chronic
hypertension
(69 vs 43 per cent; p less than 0.01). A multivariate analysis of the entire population studied showed that a family history of
hypertension
was not an independent variable predictive of foetal outcome; however,
hypertension
in the father was such a variable. The influence of family history of
hypertension
on the foetal outcome was studied separately in women with chronic
hypertension
and in those with hypertension in pregnancy. The results showed statistically significant differences the other way round: a better foetal outcome was observed in cases of hypertension in pregnancy with a family history of
hypertension
(more rarely associated with pre-eclampsia), and a poorer foetal outcome was observed in cases of chronic
hypertension
with a similar family history (mostly in the father, and associated with a more severe
hypertension
). This study suggests that a family history of essential hypertension and the type of
hypertension
observed in the patient must be taken into account when evaluating the severity of
hypertension
in pregnant women.
...
PMID:[Relations between family history of essential hypertension and fetal prognosis in hypertension in pregnancy]. 253 33
The Dialysis Centre at the Lagos University Teaching Hospital became operational in November 1981 and caters for acute haemodialysis, chronic maintenance haemodialysis and continuous arteriovenous haemofiltration. In the past 5 years, over 600 patients had presented out of whom 245 could be accommodated within the realities of available facilities and patients' financial status. Of the 245 patients, 25 were discharged against medical advice and five were transferred to hospitals abroad but did not survive. There were 117 patients in end-stage renal failure (ESRF), 75 males, 42 females, ratio M:F 1.8:1, age range 13-69 years, mean 37.5. There were 51 males and 47 females in acute renal failure (ARF), ratio 1.1:1, age range 13-76 years, mean age 32.3 (Table 1). All patients in ESRF had moderate to severe
hypertension
(diastolic pressure of greater than or equal to 120 mmHg or 22.1 kPa) and a creatinine clearance of less than or equal to 5 ml/min and about 75% had established cardiac decompensation. Full pertinent investigations were precluded or contra-indicated in most patients in ESRF because of late presentation. In only 13 patients was renal biopsy performed and the pathohistologies were end stage renal disease (8), chronic glomerulonephritis (4) and glomerulosclerosis (1). In ARF the cause of the renal damage was multifactorial in 66.7%, with sepsis being the direct cause of death in 60.0%. The commonest conditions were septicaemia (61.4%), nephrotoxin (17.2%), trauma (31.3%), septic
abortion
(33.3%) and toxaemia of pregnancy (29.0%) (Table 2). The dialysis associated complications which were encountered included shunt infection (7%), burst membrane (9%), suspected pyrogen reaction (5.6%) and femoral vein perforation (0.9%).(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Five years experience of haemodialysis at the Lagos University Teaching Hospital--November 1981 to November 1986. 255 Nov 60
This study was designed to test the hypothesis that vigorous aerobic exercise during both the periconceptional period and early pregnancy increases the incidence of abnormal early pregnancy outcome. Exercise performance was prospectively monitored before and during pregnancy in 47 recreational runners, 40 aerobic dancers, and 28 physically active, fit controls. Pregnancy was diagnosed by an early test for beta-subunit human chorionic gonadotropin and viability was confirmed by ultrasonography at 40 days' conceptional age.
Spontaneous abortion
occurred in 19% of the pregnancies. The incidence was 17% in the runners, 18% in the aerobic dancers, and 25% in the controls. At term, one congenital abnormality was detected in each of the three groups. Late pregnancy events, potentially related to abnormalities of placentation, were limited to two cases of mild pregnancy-induced
hypertension
. We conclude that, in physically fit women, continuation of these types of aerobic activity at intensities between 50% and 85% of maximum during the periconceptional period and early pregnancy does not appreciably alter early pregnancy outcome.
...
PMID:The effects of maternal exercise on early pregnancy outcome. 240 48
A case of severe vasoconstriction treated as cardiorespiratory collapse in a woman given extraamniotic PGF2alpha for midtrimester
abortion
is described, with comments on management of this rare reaction. The patient was having elective termination because of confirmed spina bifida with hydrocephalus by ultrasound and elevated AFP at 18 weeks gestation. She was given a 4 mg test dose of PGF2alpha (Dinoprost, Upjohn Pty, Ltd) in viscous gel (Tylose MH300, Hoechst Australia Ltd) via extraamniotic Foley catheter. She immediately developed dyspnea, abdominal and breast pain, hypotension of 50 mm Hg systolic, peripheral vasoconstriction, cyanosis and confusion. She was treated with iv Hartmann's solution 600 ml, oxygen 8 1/min, and sc adrenaline 1/1000 0.5 ml. She seemed to improve after receiving 500 ml 3.5% polygeline colloid (Haemaccel, Behringwerke AG), and 5 ml 1/10,000 adrenaline iv, as her systolic blood pressure rose to 70 mm Hg measured indirectly. 500 ml more iv colloid was given, and blood pressure rose to 90 mm Hg. Then she suddenly deteriorated with florid pulmonary edema. Oxygen saturation fell and positive pressure ventilation was begun. She was given furosemide 160 mg iv and hydrocortisone 500 mg iv. Anaphylactic reaction was ruled out on the basis of blood count; amniotic fluid embolism was ruled out because of minor changes in clotting parameters. The events seen here most likely occurred as a result of inadvertent injection of PGF2alpha into the arterial circulation, causing increased pulmonary arterial pressure and vascular resistance, systemic vasoconstriction interpreted as hypotension, all exacerbated by adrenaline and exogenous fluid load. Severe
hypertension
after extraamniotic PGF2alpha has been reported before in a similar case of apparent hypotension treated with agents to increase blood pressure. PGF2a should not be used without facilities to treat such adverse reactions.
...
PMID:Cardiorespiratory collapse and pulmonary oedema due to intravascular absorption of prostaglandin F2 alpha administered extraamniotically for midtrimester termination of pregnancy. 260 61
The sudden drop of circulating estrogen in the premenopausal phase causes somatic and psychosomatic symptoms in women around the age of 40, which necessitates hormonal substitution and also reliable contraception because of the risk of pregnancy owing to irregular cycles. At this age the risks of pregnancy-related thrombosis,
hypertension
, and diabetes, perinatal mortality congenital anomalies, and maternal mortality are higher. Only 6.3-7.3% of women giving birth are over 35 years of age in Austria, but still 26% of women having an
abortion
are 36 years old or older. The rate of conception ranges between 2% and 5%, and when it falls below 1%, contraception is no longer necessary (around age 45-49). The IUD is acceptable and safe, and pelvic inflammatory disease does not play a significant role at this age. The most frequent side effects are spotting, hypermenorrhea, lower abdominal pain, and difficulties with intercourse. The introduction of micropills with an ethinyl estradiol dose of under 50 mcg and several agents, such as desogestrel, gestoden, and norgestimate, has made it possible to use them over the age of 40, provided no risk factors, such as metabolic disorders or smoking, are present. However, prior determination of lipid status is required. Sterilization is a final form of contraception when an increase of family size is no longer desired; whether the husband or the wife should be sterilized also poses a question. For female sterilization laparoscopy is used almost exclusively with bipolar diathermy, thermocoagulation, or binding with clips or rings. Hysterectomy is recommended in the case of myomatous uterus with cycle irregularities and hypermenorrhea. The condom, the diaphragm, or the natural temperature, Billings, or symptothermal methods have much higher failure rates. The physician has to advise women about the most suitable method.
...
PMID:[Contraception and the climacteric]. 262 31
An investigation was done to clarify the pathological background of pre-eclampsia. Thirty four placentae were studied immunopathologically in comparison to control cases. The results showed slightly positive stains of hCG containing alpha- and beta-subunits in syncytiocytotrophoblastic layers especially in severe pre-eclampsia cases. The placentae in mild pre-eclampsia showed only weakly and partly positive by those stains. Other control cases were negative except earlier
abortion
ones. No any positive stains of hCG series could be seen in two placentas from mothers with spontaneous
hypertension
. Stains by hPL and SP 1 were all positive and increased gradually in their staining pattern and degree from early pregnancy toward term. It supports the findings that maternal serum hCG series increased slightly in pre-eclampsia and that those changes might occur before clinical onset of pre-eclampsia. Then, the placenta has an important role in developing pre-eclampsia.
...
PMID:An immunopathological study on the placenta in pre-eclampsia. 263 86
2 studies have been done in China: 1) a longitudinal study on maternal mortality in Beijing from 1949 to 1983; and 2) a cross-sectional study on maternal mortality in the year 1984 in 21 of 29 provinces, municipalities, and autonomous regions. A maternal and child health network for care and referral of abnormal cases was set up with ambulances and transfusion facilities in place and training for traditional birth attendants. Aseptic delivery reduced the number of deaths due to sepsis from 213/100,000 live births to 4.2 in 5 years and to 0 in 9 years. Deaths from hemorrhage (including ruptured uterus) dropped by 86% in 5 years. With legalized
abortion
came a dramatic fall in maternal mortality from 685,100/000 live births to 15, a decrease of 98%. In 1949, 27% of women who died in childbirth had received hospital care; another 27% had no cure. In 1958, however, 80% of the fetal cases had obtained hospital care; the remaining 20% had been seen by a traditional practitioner or health worker. From 1959-68, the total maternal mortality was 1.3-28.1/1 00,000. From 69-78, the turmoil of the cultural revolution had "ill effects" on maternal and child health but by 1979, order was brought back again. The cross-sectional study covered a population of about 177 million. About 2.5 million live births occurred. 1211 maternal deaths were registered for a maternal mortality rate of 48.4/100,000. Maternal mortality varied a good deal in different parts of the country--from 17.7 in Shanghai to 108.2 in the region of the Hai people in Ningxia in northwest China. Maternal mortality rates correspond roughly to the level of economic development. The 5 main causes of death were hemorrhage, heart failure, pregnancy- induced
hypertension
(including eclampsia), postpartum infection and liver failure.
...
PMID:Maternal mortality in China. 263 3
Prostaglandin E2 gel is a useful agent for ripening and dilating the cervix. Since it is not available in the US, it must be prepared by thawing and grinding a 20 mg prostaglandin E2 suppository, mixing in a small amount of methylcelulose gel, and blending. The resulting gel is stored frozen in a 3 ml plastic syringe. The gel may be administered intracervically, intravaginally, or extraamniotically. Cervical administration of .5 mg prostaglandin E2 in 2-3 ml of viscous gel is most popular, but intravaginal administration is easiest, although it requires a higher dose (1-5 mg prostaglandin E2 in 2-10 ml of gel). The condition of the cervix is usually favorable for labor induction within 12 hours (range 4-24 hours). 59 clinical trials were conducted among 3313 pregnancies. In patients with unfavorable cervix induction of labor was successful in 83% of those treated with the gel but in only 53% of untreated patients. In women with an unfavorable cervix the gel is more effective if administered intracervically. In patients with favorable cervix, 66% of nulliparas and 82% of multiparas were delivered without oxytocin. Prostaglandin E2 gel has been used successfully even in women with prolonged pregnancy,
hypertension
, ruptured membranes, and fetal death. It can also be used to induce late 1st trimester
abortion
. Side effects of the gel are mild and minor. Prostaglandin E2 gel has thus been shown to effect cervical ripening and dilatation, reduce induction failures, shorten the induction-delivery interval, reduce oxytocin use, and lower the need for cesarean sections. Prefabricated prostaglandin E2 delivery systems should be approved by the Food and Drug Administration for commercial use.
...
PMID:Prostaglandin E2 gel for cervical ripening and induction of labor: a critical analysis. 264 30
The distinctive aspects of adolescent pregnancy in the U.S. are reviewed under the rubric of the "new morbidity": illnesses caused by social and life-style conditions. Quantitative trends in adolescent pregnancy are reviewed with statistics such as the annual U.S. Pregnancy rate for girls under 15, 5/1000, 4 times as high as Canada, the only other Western nation with a rate over 1/1000. Other countries pinpoint teen pregnancy, not sexual activity, as the key problem. Some social factors that have increased teen pregnancy are earlier menarche, increasing poverty, more single parent households. Determinants of sexually activity can be classed as individual, family and developmental. Individual factors include economic disadvantage, lack of opportunity and hopelessness and other problem behaviors. Family factors include race and female head of family. Development factors include pre- operational thinking, which prevents future planning and may require experience with sex to learn about it, and egocentricism, which implies an imaginary audience and the personal fable that "it will never happen to me." Teen pregnancy entails the medical risks of higher maternal mortality, cephalopelvic disproportion, anemia, toxemia and
hypertension
, resulting in prematurity and low birth weight. Social detriments are associate with teen childbearing, such as lower educational achievement, lower lifetime work accomplishment and income, larger families, cognitive delays in child development, lower school success and emotional problems for the child and higher risk for neglect and abuse. The cost of just Aid for Families with Dependent Children, Food Stamps and Medicaid for adolescent headed families is over $16 billion per year. The current administration has approached the problem by cutting funds, teaching the immorality of
abortion
, reducing the contraceptive availability and recommending teenage abstinence. The most effective programs in the U.S. are comprehensive school-based clinics.
...
PMID:Pregnancy in adolescents. 266 90
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