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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of 18 pregnancies in 11 renal transplant recipients, three were terminated and in the remaining 15 (in 8 women) there were 10 live births (including one set of twins), five intrauterine deaths, and one spontaneous abortion. Graft function deteriorated in six women, from obstruction of the transplanted ureter in two, recurrent glomerulonephritis in two, rejection in one, and pelvi-ureteric junction obstruction in one. Hypertension worsened or developed in all but one of the pregnancies and proteinuria appeared in eight. Of the 10 live births only one reached 38 weeks gestation (mean 35 weeks) and four neonates were small for gestational age. One infant died early from intraventricular hemorrhage and hyaline membrane disease, one fetus had hydrocephalus, and the others were normal. Factors associated with a poor fetal outcome were deterioration in graft function during pregnancy, pre-existing hypertension, or the development of hypertension before the third trimester.
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PMID:Problems associated with pregnancy in renal allograft recipients. 266 32

The Authors review the epidemiological data about increasing prevalence of claudication intermittents between women, mainly describing the hypoplastic aorto-iliac syndrome. Sixteen patients were studied and operated on. They presented high incidence of cigarette smoking (87%) and hypertension (72%), and 5 patients (32%) were premenopausal. The incidence of abortion was higher in hypoplastic women (12.5%) than in atherosclerotic women (0.3%). After the surgical treatment there were no complications or hospital mortality, and the patency was 100% at a mean follow-up of 5 years (min. 1-max. 7).
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PMID:[Hypoplasia of the abdominal aorta: epidemiology, analysis of risk factors and surgical treatment]. 273 39

A total of 1501 women who delivered is the Civil Hospital in Karachi over a 2-year period Pakistan, were investigated retrospectively to ascertain the degree of complications in multiparous women. 431 (28.7%) women were grandmultiparae who had delivered 5 times or more, and 1070 (71.2%) were para fewer times. The youngest grandmultipara was 17 years old, and 26% were under 30, although most (38.3%) were in the 35-39 age group. There was a higher incidence of various complications in grandmultiparae: anemia in 64.3% vs. 45.7% in less parous women, abortion rate of 16% vs. 6.5%, abruptio placentae in 14.4% vs. 6w, and postpartum hemorrhage in 6% vs. 3%. Some complications were less frequent in grandmultiparae than in the other group: cephalopelvic disproportion in 2% vs. 10% in less parous women, obstructed labor in 2.3% vs. 10.5%, and cesarean section in 16.5% vs. 23.5% The 2% rate of uterine rupture in grandmultiparae was the result of obstructed labor, misuse of oxytoxics, and ineptness of midwives, whereas the 1% rate in the other group was caused by previous cesarean section. there was an 18% rate of stillbirths in grandmultiparae vs. 12.5% in others, most of them attributable to placental abruption, hypertension, or obstructed labor. The maternal mortality rate was 8/1000 births for grandmultiparae and 7/1000 births for less parous women, most of the deaths were the result of hemorrhage and uterine rupture. These data indicate a higher rate of incidence of serious complications in grandmultiparae whose frequency is even higher in rural areas. Excessive deliveries can endanger the lives of both the mother and the fetus.
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PMID:Grandmultiparity: a continuing problem in developing countries. 275 75

Health agents, representatives of women's organizations, and political authorities from 22 francophone African countries met in Niamey, Niger, in June 1989 to examine why maternal mortality rates are still so high in their countries. Representatives of the World Bank, World Health Organization, UNFPA, and nongovernmental organizations such as the International Planned PArenthood Federation and of several bilateral aid organizations also attended. Each year around 150,000 women die in Africa of complications related to pregnancy and delivery. The maternal mortality rate is the highest in the world, some 700/100,000 live births vs. 10/100,000 in Western Europe. A videocassette shown by the WHO traced 1 case of death in childbirth to illustrate the multiple failures of the health system. A woman rendered seriously anemic by malnutrition and parasite infections began to hemorrhage during her 8th pregnancy but was not transferred for several hours to the district hospital, which had no blood with which to save her. The shocking problem of maternal mortality has not attracted much attention in Africa until recently because death related to pregnancy have been considered normal and because women have been valued chiefly for their reproductive functions. The causes of death are the same ones that have afflicted women through the ages: excessive blood loss, difficult delivery, infections, eclampsia due to hypertension, and complications of abortion. Family planning would help lower maternal mortality rates by preventing abortions and by reducing risks from closely spaced pregnancies and those at the extremes of the reproductive period. Many such pregnancies are undesired, which increases their risks. Women in Africa do not necessarily want to be reduced to continuous pregnancies, but the entire value system of the family and society puts pressure on them to have children. Women can help effect change by not transmitting these traditional values to their own children. The condition of African women reflected in their low educational levels, their long hours of work, and their frequent inability to feed themselves adequately despite the fact that women produce 80% of foodstuffs in Africa is a factor in their high mortality. Despite considerable effort over the past decade to develop primary health care programs, only 36% of births occur in the presence of a qualified health agent. Regardless of developments in women's status and in society in general, an adequately functioning system of health care for all is considered an absolute necessity. the World Bank has estimated that an investment of $2 per person per year would lead to a 2/3 decline in maternal mortality. The goal of reducing maternal mortality by the year 2000 is technically within reach but will require political will.
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PMID:[Motherhood without risk. A new hope for Africa]. 276

In order to evaluate the structural potentialities of the placenta, we analyzed placentas in the following conditions: normal full term gestation, hypertensive status, twin pregnancy and abortion at 8-12 weeks of gestation, comparing cell structures, surface organization and tissue reaction. We quantitatively evaluated (1) the arborization of the placental villous tree, and (2) the microvillous density per unit of surface area, paralleling these data with ultrastructural and immunohistochemical features. In early gestation (8-12 weeks of pregnancy) the limited degree of branching of placental villi parallels a reduced number of clefts per unit of surface area (0.7/1,000 microns2), if compared with controls (2.7/1,000 microns2). In the full term twin placenta, the number of furrows is 2.26/1,000 microns2: this value reflects a low arborization potentiality, testifying to a low placental maturity. On the contrary, a high branching of the placental villous tree is present at term in hypertension. In this gestational condition, the number of sulci of 3.1/1,000 microns2 reveals a compensatory attitude of the placenta, aiming to sustain the impaired fetal-maternal metabolic interchange. In all these cases, syncytiotrophoblastic microvilli are reduced in number in comparison with the normal placenta, and this is likely to be an expression of a low trophoblastic maturation degree. The placenta is a barrier with a highly specialized function that conditions fetal outgrowth, and microenvironmental modifications are promptly faced by this structure through morphofunctional modulations.
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PMID:Morphological development of the human placenta in normal and complicated gestation: a quantitative and ultrastructural study. 279 15

Reproductive history events may be risk factors for sudden coronary death (SCD) among women. A retrospective case-control study of SCD among women aged 25-64 was conducted in Allegheny County, Pennsylvania. The present analysis focused on a description and analysis involving the childbearing and reproductive history of 67 ever-married female SCD cases and 73 ever-married neighbourhood controls with a mean age of 54.6 and 53.4 years respectively. Information included: age and number of years married, number of children, age at first birth, cardiovascular risk factors, obstetric and gynaecological history. Age and the risk factors, history of hypertension or diabetes, cigarette intake, death of significant other and psychiatric disease, were controlled for in the analysis. More cases than controls experienced their first birth before age 20 (14 of the SCD and 7 controls). However, after adjustment for cigarette smoking status, a strong predictor of sudden cardiac death, the effect of early childbearing did not remain significant for this population. In women less than or equal to 50 years of age, childlessness was not a risk factor for SCD (1 of 16 cases and 2 of 26 controls were childless). However in women greater than 50 years of age, childlessness was a significant predictor of SCD (OR = 6.7 (1.3-32] 12 of 51 cases were childless compared to 2 of 46 controls. After adjustment for aged and other coronary heart disease (CHD) risk factors, the relationship of nulliparity with sudden cardiac death remained in this age group. There was no difference in hysterectomy or miscarriage history or in the total years married between cases and controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Reproductive history of women dying of sudden cardiac death: a case-control study. 280 61

We studied 500 women who conceived after investigation and treatment for different infertility problems and compared the outcome of the 5 infertility groups (Group 1 to 5), the ovulatory dysfunction (Group 1), male infertility (Group 2), A.I.D. (Group 3), tubal surgery and IVF (Group 4) and no treatment (Group 5) with the outcome in the hospital group during a period of 3 years. The incidence of abortion in Group 3 is significantly higher (13.8%), the incidence of ectopic pregnancy is significantly higher in Group 4 (21.7%) as compared with the incidence in the hospital group (P less than 0.01). The rate of pre-existing hypertension and gestational diabetes is significantly higher in all the 5 infertility groups as compared with the incidence in the hospital group (P less than 0.05). The incidence of preterm labor in general is less in the infertility group as compared with the incidence in the hospital group (P greater than 0.05). The incidence of older women, multiple pregnancy, induction of labor, operative deliveries, fetal distress, low Apgar score, babies with birth weight below the tenth centile were higher in the infertility groups (P less than 0.05). But the perinatal mortality or major or minor fetal anomalies were not significantly different in the infertility groups as compared with the rate in the hospital groups (P greater than 0.05).
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PMID:Outcome of pregnancy following investigation and treatment of infertility. 288 35

In a representative questionnaire investigation covering all of Denmark, 3,152 women provided information about their health during a recent pregnancy. Of these, 1,411 (45%) had been ill or had experienced severe complaints related to the pregnancy and 625 (20%) had been hospitalized during pregnancy. The average duration of hospitalization was two weeks with great variations in the various conditions. Women with multiple pregnancies were hospitalized for an average of six weeks. Increased incidence of hypertension and placental insufficiency were found among women over the age of 35 years whereas preeclampsia was most common among primigravidae. Women who had previously had a spontaneous abortion had an increased frequency of haemorrhage, threatened abortion and threatened premature delivery. Previous infertility was not associated with increased occurrence of complications of pregnancy-related morbidity were observed between women who had work outside the home and women who worked in their homes. Women with work outside the home who reported illness or severe pregnancy-related symptoms had an average period of sick-leave of six weeks for health reasons. The most prolonged periods of sick-leave were in cases of threatened abortion, threatened premature delivery and multiple pregnancies. The right to take leave with pay or maintenance allowance prior to the expected date of delivery is not utilized to any great extent more by women with illness during pregnancy. On the other hand, women with long educations utilized this right to a greater extent than unskilled women, who had, on the other hand increased leave on account of health reasons.
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PMID:[Self-reported pattern of illness and hospitalization during pregnancy. Results from a nation-wide questionnaire study]. 292 29

We are in the early phase of a period when the increased numbers of women born during the 1947 to 1965 baby boom are entering their later child-bearing years. They are also part of a generation of women who are increasingly delaying childbirth until their 30s. These two factors will likely increase the proportion of total births accounted for by this 35- to 49-year age group by 72 per cent, from 5.9 per cent in 1982 to 8.6 per cent by the turn of the century. There are important and specific risks related to pregnancies for older women as compared to younger women. It is likely that a woman's ability to conceive declines steadily to where it has been estimated that 34 to 46 per cent of women age 35 and older are unable to become pregnant. Hypertension, preeclampsia, and diabetes mellitus are not only more common but seem to carry an even greater risk for older women, resulting more frequently in fetal demise. Although there are conflicting findings, older women seem to have more babies weighing under 2,500 gm and more over 4,000 gm. It appears that there are more problems with abnormal labor patterns and a definite higher incidence of cesarean section. The literature seems to support the finding of high incidences of late pregnancy bleeding from placenta previa and abruptio placenta. Many of those factors contribute to a several-fold increase in maternal mortality for older compared to younger pregnant women. The fetus, likewise, is at greater risk. There appears to be a greater risk for spontaneous abortion, although the magnitude of the risk is unclear because of the potential confounding from gravidity, birth order, and reduced fecundity. The stillbirth rate seems to double by the late 30s and increases to 3- to 4-fold by the mid-40s. The neonatal mortality rate seems to have a mild association with maternal age. Chromosome abnormalities, especially trisomies 13, 18, and 21, and sex chromosome aneuploidies, increase exponentially with maternal age starting in the 30s, reaching levels of 1.4 per cent at age 35, 1.9 per cent at 40, and 8.9 per cent at 45, according to amniocentesis data. Some of those contribute to the higher stillbirth rate resulting in a slightly smaller incidence of chromosome abnormalities in newborns. Overall, the literature supports the finding that women and their offspring experience significant increased problems as maternal age progresses through the mid-30s and beyond.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Older maternal age and pregnancy outcome: a review of the literature. 295 Mar 47

Angiotensin converting-enzyme inhibitors cross the placenta and modify the maternal, foetal and utero-placental renin-angiotensin system. Eight cases of pregnancy in women taking captopril have been published, 7 other cases being reported in this review paper. There were one spontaneous and 2 therapeutic abortions, one of which disclosed a malformation of uncertain diagnosis and imputation. One intrauterine death at 28 weeks was probably due to the severity of the maternal disease. Two children born to mothers also treated with frusemide died of neonatal anuria. Delivery or caesarean section occurred before term in 8 cases, and there were 3 cases of neonatal respiratory distress with a favourable outcome. Finally, one mother gave birth at term to twins of normal weight. The cases with respiratory distress can be attributed to the mother's hypertension, to prematurity and/or to concomitant treatment with beta-blockers, while the cases with anuria seem to be due to inhibition of the effects of angiotensin on renal haemodynamics, with salt depression as a possible aggravating factor. Treatment with angiotensin converting enzyme inhibitors does not seem to warrant therapeutic abortion. However, these drugs are contra-indicated in pregnancy and should only be given to women wishing to become pregnant if they present with resistant and dangerous arterial hypertension. A programme of pharmacovigilance is being set up to follow up such pregnancies.
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PMID:[Inhibition of angiotensin converting enzyme in human pregnancy. 15 cases]. 300 90


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