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

In a series of 26,209 patiens, the incidence of pre-eclampsia was 9.3%, being significantly higher in primiparae (14.1%) than multiparae (5.7%) (P less than 0.001). In patients with early-onset pre-eclampsia there were highly significant (P less than 0.001) increases in the incidences of proteinuria, severe hypertension, placental abruption, fetal growth retardation, neonatal asphyxia and perinatal mortality. There were no significant differences between the incidences of these complications in primiparae and multiparae. The incidence of subnormal oestriol excretion was increased before the emergence of early-onset pre-eclampsia with equal to significance (P less than 0.001) in primiparae and multiparae. Eclampsia was more common in patients with late-onset pre-eclampsia, but not significantly so.
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PMID:Parity and pre-eclampsia. 29 36

Oedema of the umbilical cord, defined as visible oedema in a cord wish a minimal cross sectional area of 1-3 cm-2, is found in 10 per cent of deliverieo. It is seen more frequently in cetain complications of pregnancy such as abrupti placentage, maternal diabetes, macerated intrauterine death and in conditions affectint the infant including prematurity, rhesus isoimmunization, respiratory distress syndrome (RDS) and transient respiratory distress (TRD). There is a higher incidence in infants delivered by Caesarean section. There is no significant association between cord oedema and either fetal distress or neonatal asphyxia nor is there any correlation with maternal hypertension or oedema. The mechanism of production of the odema is discussed; low oncotic pressure, raised hydrostatic pressure in the placenta and umbilical cord, and an increase in total water in the feto-placental unit are considered. The presence of oedema of the cord may reflect similar changes in the lungs which antenatally predispose aninfant whose pathway for production of surfactant is immature to develop RDS and the mature infant to develop TRD. The value of cord oedema as a warning sign is stressed.
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PMID:Oedema of the umbilical cord and respiratory distress in the newborn. 80 96

This is a study of heat-stable alkaline phosphatase (HSAP65degreesC) concentrations in the serum of pregnant women with hypertension (42 cases), mild preeclampsia (40 cases) and severe pre-eclampsia (22 cases). The results are seen in relationship to the occurrence of intrauterine fetal death, growth retardation, intrauterine and neonatal asphyxia as well as the respiratory distress syndrome (RDS) in the newborn. The importance of a precise clinical classification of the patients is stressed. Pathological HSAP values are those which lie either over or under the normal range for HSAP activity. In addition "zig-zag" curves with values within the normal range are characterized as abnormal. Thus, serial estimations give the most reliable results. Serial estimations of HSAP are especially valuable in severe pre-eclampsia. Abnormal HSAP values in the 28th-38th week of pregnancy are a serious prognostic sign. False abnormal HSAP results were found in all 3 patient groups. One possible false normal HSAP curve also occurred.
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PMID:Serum alkaline phosphatase in pregnancy. II. Serial HSAP65degreesC estimations in pregnancy complicated with hypertension and pre-eclampsia. 93 83

The study on the hazard of passive smoking to the fetus during pregnancy was carried out in 188 cases. The rate of SGA, premature labor and neonatal asphyxia in this group were higher than that of 65 cases without passive smoking. The data was analysed by logistic multifactor regression analysis. The result showed that, for those patients with hypertension and husband smoking, the risk of SGA, and neonatal asphyxia were 1.6, 2.8 and 3.2 times higher than those without hypertension and husband smoking. In the group of passive smoking, their blood CoHb and umbilical venous CoHb levels were obviously higher than those of the normal control. The possible cause of hazard of passive smoking to the fetus was also analysed and discussed.
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PMID:[Influence of passive smoking on the fetus during pregnancy]. 130 Feb 79

From Oct 1985 through Sept 1986 and from Oct 1988 through Sept 1989, a total of 1,704 cases were clinically diagnosed as having fetal distress. The results of analysis showed no significant differences (P greater than 0.05) between fetal distress and fetal sex, and age of pregnancy women respectively (P greater than 0.05), but there was a significant difference between fetal distress and gestational weeks. (P less than 0.01) and birth weight (P less than 0.05). The highest incidence occurred in postterm pregnancy. The number of neonatal asphyxia cases with fetal distress accounted for 61.08% of the total of neonatal asphyxia. The more indexes of the fetal distress, the higher is the incidence rate of asphyxia neonatorum. Among the complications of pregnancy, the fetal distress rate due to pregnancy induced hypertension is the highest. The results suggested that by using multiple item examinations, early diagnosis of fetal distress and prompt management are possible to decrease the asphyxia rate and the prevention of complications of pregnancy is important to reduce the fetal distress.
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PMID:[Clinical analysis of 1704 cases of fetal distress]. 187 58

The differential leukocyte count was studied within the first 24 hours of life in 115 infants of diabetic mothers (IDMs) appropriate for gestational age (AGA), 16 IDMs large for gestational age (LGA), 104 infants of non-diabetic mothers (INM's) AGA, and 22 INMs-LGA. A significant "shift to the left" was found in IDM's-LGA only. The usual cause of "shift to the left" such as maternal hypertension or fever, respiratory distress syndrome, meconium aspiration, neonatal asphyxia, sepsis, convulsions, or hypoglycemia could not explain this finding. It is hypothesized that increased glucocorticoid secretion may possibly play a role.
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PMID:Differential leukocyte count in infants of diabetic mothers. Increased band count associated with macrosomia. 373 70

Gestosis index score at delivery was compared with factors reflecting the fetal development in a series of 95 patients with EPH-gestosis collected in Okayama University Medical School in 1975-1979. The prediction of small for date (SFD) was performed by means of multivariate analysis of 10 variables, i.e. gestosis index, maternal body weight, height, uterine fundal length, abdominal circumference, maternal age at delivery and urinary estriol within one week prior to delivery. The result was that gestosis index was as useful as uterine fundal length in predicting SFD. The more gestosis index score increased, the more markedly the fetal development ws disturbed. Especially in the cases with scoring above 4 and in those with hypertension and proteinuria, the incidence of SFD increased obviously. No correlation between gestosis index and neonatal asphyxia was noticed. From the growth pattern of uterine fundal length and BPD, intrauterine growth retardation (IUGR) in pregnancy with EPH-gestosis occurred mainly within the third trimester of pregnancy. The functional development of the fetus with EPH-gestosis was evaluated with the use of urinary estriol level and fetal heart rate (FHR) monitoring. In the cases with EPH-gestosis scoring above 4, extreme disturbance of functional development of the fetus was observed.
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PMID:Estimation of gestosis of pregnancy (EPH-gestosis), relationship between fetal development and gestosis index. 719 59

This account provides a description for Miyun County (outside Beijing), China, of the number of maternal deaths, access to maternal health services, and system improvements during 1985-88. Maternal health care in Miyun County is provided through local township hospitals, county hospitals, and maternity hospitals. Community education is provided locally by village doctors and birth attendants at health stations. Health procedures were changed to include the application of Ministry of Public Health rules on strengthening referrals between village health stations, township hospitals, and county hospitals. Case management procedures were established for caring for postpartum hemorrhage, severe pregnancy-induced hypertension, amniotic embolism, shock, and neonatal asphyxia. Maternal health records were standardized, monitoring procedures for perinatal care were widely promoted, and high-risk pregnancies were identified and referred according to specific procedures. Six pilot areas were identified for testing the success of program implementation. Findings of this evaluation were that 27.3% (33) of maternal deaths were not reported. Maternal mortality was adjusted to account for these deficiencies (114/100,000). 60% of deaths were obstetrically-related. The leading causes were hemorrhage, followed by postpartum infections and pregnancy-induced hypertension. 63% of deaths involved insufficient prenatal care. Almost 40% of deaths were unnecessary, and about 66% were preventable. In the pilot townships hospitals showed improvements in hospital equipment and staff training. Only in the pilot areas did mortality rates improve. The maternal mortality rate in pilot areas declined by over 75%.
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PMID:China: lowering maternal mortality in Miyun County, Beijing. 757 2

To examine the relative importance of some risk factors and neurological prognosis in the first year of life, 37 small-for-gestational age newborns were followed prospectively to 1 year of conceptional age. An abnormal neurological examination was found in 51.3% of the newborns and, at 12 months, 32.5% were still considered abnormal. Only 8.1% of the group had severe neurological sequelae at 1 year of corrected age. The developmental tests showed little changes during the first year, with abnormality rates varying from 16.1 to 25%. The following risk factors were analyzed concerning their relation to neurological and developmental abnormalities: high-risk pregnancy, maternal hypertension, social class, pre-term birth, neonatal asphyxia and weight and height less than 2.5 percentile at the age of 1 year. The statistical analysis showed a high correlation between subnormal weight gain and neurological (p = 0.0001) and developmental (p = 0.001) abnormalities at 1 year. None of the other risk factors were statistically related to neurological prognosis at 1 year.
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PMID:Neurological follow-up of small-for-gestational age newborn infants. A study of risk factors related to prognosis at one year of age. 821 31

Diabetes mellitus during pregnancy could result in severe or fatal complications to mother or the unborn product, like polyhydramnios, preeclampsia, abortion, neonatal asphyxia, macrosomia, stillbirth, and others, therefore is very important the early detection and treatment of diabetes. Gestacional Diabetes Mellitus (GDM) is the carbohydrate intolerance of variable severity first recognized during pregnancy. The screening test consist of 50 g of oral glucose and a plasma glucose measurement at one hour, regardless of the time of the last meal, and this may do in all pregnancies between 24 and 28 weeks of gestation. If plasma glucose level above 140 mg/dl results, a oral glucose tolerance test with 100 g must be done. This is the GDM diagnostic test. The risk factors for gestacional diabetes (older than 30 years of age, obesity, arterial hypertension, glucosury, previous GDM, family history of diabetes, family history of macrosomia) identify only 50% of pregnancies with gestacional diabetes, therefore, is necessary to screen all pregnancies who become pregnant, a strict control before pregnant is indispensable, with aim to slow congenital malformations probability and another complications. Gestacional diabetes prevalence in hispanic women in the U.S.A. is 12.3 percent. Diabetes mellitus prevalence in Mexico is about 2-6 percent. The goal of management of diabetes during pregnancy is the maintainance of fasting plasma glucose 105 mg/dl and 120 mg/dl two hours after meals. Treatment consist in diabetes education, diet with caloric needs calculation, exercise, and occasionally insulin. Is necessary the prenatal monitoring, the supervision of delivery or cesarean metabolic changes, and the postnatal monitoring of the mother and product.
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PMID:[Diabetes and pregnancy]. 967 96


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