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

From Sept. 1987 to Oct. 1988, a collaborative program of preventing and treating the common complications of nulliparous twin gestations, namely pregnancy induced hypertension, anemia, premature labour and postpartum hemorrhage was carried out in nine hospitals according to the same plan. There were 91 subjects who met the above criteria (treated group) and 99 cases not included in the plan (control group). The incidence of pregnancy induced hypertension was 33%, anemia 13.2%, postpartum hemorrhage 6.6%, and perinatal mortality 22%, in the treated group. The mean duration of pregnancy was 38.38 weeks (268.7 days) and the mean neonatal birth weight was 2725.8 g. The rate of maternal and fetal complications and prenatal mortality in the treated group were significantly lower than those of the control group.
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PMID:[Prevention and treatment of complications in twin gestation]. 220 20

Pregnancy outcome was followed in 123 women showing maternal serum alpha-fetoprotein, less than or equal to 0.50 MOM. In 28 cases AFP was secondarily considered as normal either after ultrasonography and correction of gestation age or after a second sample normal result. In 95 cases AFP level was confirmed lowered; perinatal outcome was normal in 70 cases and abnormal in 25. Among these 25 cases, 3 autosomal trisomies occurred, 2 trisomies 18 and 1 trisomy 21; in the 22 other cases, we observed antepartum risk factors (10 cases with impending premature labor or premature labor, 9 cases with chronic hypertension, 2 cases with Ag HBs hepatitis and 1 case with diabetes).
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PMID:[Results of pregnancies characterized by a decrease in the level of alpha-fetoprotein in the maternal blood]. 246 77

In this study from the city of Trondheim during 1979-81 nulliparae were found to be younger, higher educated, and more actively working outside the home than parous women. Most women were examined by their GP during the first trimester, and were seen about 10 times on average during the pregnancy. Women who smoked tended to consult later in pregnancy than the non-smokers. Drugs were prescribed for 33% of the women during their pregnancy, 10% during the first trimester. Medication was most frequently prescribed for genitourinary disorders. Sick leave was often the result of low-back-pain and lasted on average 5 weeks longer in parous women. Hospitalization was most often due to hypertension and threatened premature labour and lasted on average longer among nulliparae. Controlled trials are needed to evaluate future antenatal care provision in the light of pregnancy outcome.
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PMID:Antenatal care in general practice, Trondheim, Norway. 265 54

Digoxin-like substances (endoxin) are found in increasing concentrations in serum and urine with advancing pregnancy. Some high-risk pregnant women with hypertension and/or in premature labor have increased levels of endoxin. Both nifedipine and antidigoxin serum are proposed as specific therapy in abnormal pregnancies with high levels of endoxin. Urinary endoxin levels may indicate otherwise unsuspected high-risk pregnancies.
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PMID:Fetal endoxin and pregnancy complication. 283 18

Maternal endoxin (digoxinlike substance) is proposed as arising in the fetal area of the fetal adrenal cortex. Its function may be to sensitize the uterus for labor, much as does cortisol in the sheep fetus. Because endoxin is a sodium-potassium-adenosine triphosphatase inhibitor, however, it may also induce maternal vasoconstriction. On our service, normal pregnant women have detectable endoxin after 35 weeks with increasing amounts at term. Specimens of cord blood often have "digoxin" in the therapeutic range. We find that about 40% of women in premature labor and 65% of pregnant women with hypertension have elevated levels of serum endoxin. Postdate gravid women sometimes have very low endoxin levels. Pregnant women with complications and elevated digoxin (endoxin) levels could have specific antidigoxin therapy if endoxin proves to be a modulator of their symptoms. Digoxinlike substances are also sometimes elevated in ill nonpregnant persons, such as those with renal, liver, or heart failure, or hypertension.
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PMID:Fetal endoxins and complications of pregnancy. 284 75

Von Recklinghausen's neurofibromatosis is an illness that quite often has visceral and neurological side-effects (the former in turn as its side-effects on the blood vessels). Although the patients' fertility is maintained the numbers of spontaneous abortions, of premature births and of perinatal mortality are raised. In fact one of the principal effects of this disease on pregnancy is on the blood vessels, giving rise to hypertension and to a drop in the circulation through the placenta, which in turn has well-known consequences. These are: intra-uterine growth retardation, chronic fetal distress and premature labour. As far as vascular aneurysms are concerned, they constitute an indication for termination of pregnancy. We here give a case history of the condition drawing attention yet once more to the need for a multidisciplinary care of the pregnancy in women who have neurofibromatosis.
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PMID:[Recklinghausen's disease and vascular complications during pregnancy]. 314 2

The Ca++-antagonist nifedipine has been successfully employed in the treatment of non-gravid hypertension, and was found to inhibit uterine contractions in the perimenstrual period, as well as during premature labour in animal models. The use of antihypertensive drugs in pregnancy introduces the possibility of iatrogenic foetal distress. It has been established that nifedipine crosses the placental barrier in the sheep and causes a fall in mean arterial pressure and tachycardia in both the ewe and the foetus. This paper examines the effects of nifedipine on the foetus when administered to the pregnant ewe. Catheters and electrodes were implanted by surgical procedures in 15 ewes and foetal lambs between days 118 and 122 of gestation. The redistribution of foetal blood flow was measured by the radioactive microsphere injection technique. The infusion of nifedipine caused a 9% increase in the combined ventricular output (CVO) from 446 to 509 ml/min/kg in the foetus. Foetal lung blood flow increased from 29 +/- 6 to 69 +/- 14 ml/min/kg while figures for the skeletal muscle flow were 109 +/- 34 and 141 +/- 41.6 ml/min/kg. Heart and brain blood flow, expressed as percentages of CVO showed variations of 4.3 and 5.6 per cent, respectively. Blood flow in the gut, placental membranes, skin, kidney and spleen was reduced. The present results show that nifedipine, in addition to its known effects causes a redistribution of the foetal circulation.
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PMID:Effects of calcium channel-blocker tokolysis on the foetal circulation. 320 40

The incidence of spontaneously occurring premature labor in insulin-dependent diabetic pregnancies is unclear, because previous studies have been confounded by a high rate of iatrogenic prematurity. The purpose of this study was to determine, in a large population of insulin-dependent diabetic pregnant women, the rate of spontaneous occurrence of premature labor and the various factors that may affect it. We hypothesized a priori that spontaneously occurring premature labor occurs at a high rate in insulin-dependent diabetic pregnant women, mainly because of poor control of diabetes during pregnancy, and is related to the presence of polyhydramnios and hypomagnesemia. One hundred forty-five insulin-dependent diabetic women undergoing 181 pregnancies were recruited since 1978 in an interdisciplinary prospective study. The goals of glucose control were a fasting blood glucose less than 100 mg/dL and a 90-minute postprandial glucose less than 140 mg/dL. The rate of spontaneous premature labor, 31.1%, was significantly higher (P less than .01) than that in a control population managed by the same obstetricians in similar clinical settings (20.2%). The following variables were not significantly associated with the onset of premature labor: maternal age, parity, gravidity, diabetic class according to White, presence of renal disease or retinopathy, previous elective abortion, chronic hypertension or pregnancy-induced hypertension, cigarette smoking, first-trimester or post-20 weeks' gestation vaginal bleeding, maternal serum magnesium concentration, or polyhydramnios.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:High spontaneous premature labor rate in insulin-dependent diabetic pregnant women: an association with poor glycemic control and urogenital infection. 339 60

Plasma CRH was measured in maternal plasma throughout the third trimester of pregnancy, during labor, and postpartum. CRH levels were also measured in arterial and venous umbilical cord plasma samples. In normal pregnant women, plasma CRH increased from 50 +/- 15 (+/- SEM) pg/mL at 28 weeks gestation (n = 41) to 1462 +/- 182 pg/mL at 40 weeks (n = 55) and 1680 +/- 101 pg/mL (n = 65) in labor. Women with pregnancy-induced hypertension (n = 49) had plasma CRH levels significantly elevated above this normal range. Similarly, women who subsequently went into premature labor had raised levels several weeks before the onset of labor. After delivery, plasma CRH returned to normal within 15 h. Total plasma cortisol levels varied little throughout the third trimester, but increased during labor and remained elevated 2-3 days postpartum. There was, therefore, no correlation between plasma cortisol and CRH, implying that this placental CRH is not primarily involved in the control of the maternal hypothalamo-pituitary adrenal axis during pregnancy. The concentrations of CRH in umbilical cord plasma samples were considerably lower than those in the maternal circulation and were close to those in normal nonpregnant adults.
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PMID:Plasma corticotropin-releasing hormone concentrations during pregnancy and parturition. 349 36

Contractile activity and vascular resistance in the female genital tract are influenced by several smooth muscle tissues with individual mechanisms for control of mechanical activation. Calcium channel blockers have potent relaxant effects on preparations of human myometrium. The myometrial arteries utilize multiple sources of calcium for contractile activation, and excitation-contraction coupling in isolated vessels from non-pregnant uteri seems comparatively less sensitive to nifedipine than in corresponding myometrial preparations. Contractile activation of myometrial and placental arteries at term is inhibited by nitrendipine and nifedipine. Human oviductal smooth muscle depends on superficially bound calcium for mechanical activation, but only phasic contractions can be abolished by nifedipine, while tonic contractions induced by various agents are more resistant to the calcium channel blocker. Menstrual uterine contractions and pain are effectively counteracted by nifedipine in normal and dysmenorrhoeic women. Such therapy may represent an alternative principle in the treatment of dysmenorrhea. Nifedipine has potent relaxant effects on the mid-term pregnant and the post-partum uterus and calcium channel blockers may prove useful in the treatment of premature labor. Nifedipine and related compounds may further show effective in the treatment of pregnancy-associated hypertension. Whether such treatment in late pregnancy involves maintained or even improved placental perfusion could be assumed from in vitro data but needs further studies.
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PMID:Effects of calcium channel blockers on the female genital tract. 352 Nov 96


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