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

Recovery of gonadotropin-secreting function of the pituitary has been studied in 4 puerperal women with episodes of eclampsia during the last pregnancy, delivery and/or the first 24 hours after delivery. On day 20 postpartum, hypertension, edema and proteinuria were improved in all the puerperal women. Serum FSH and LH responses to LH-RH on day 20 postpartum in 3 puerperal women with less than 6 eclamptic attacks during pregnancy or delivery were at a comparable level to those on day 20 postpartum in 4 puerperal women with premature labor between 31 and 33 weeks' gestation and in 9 normal puerperal women. Serum FSH response to LH-RH on day 20 postpartum in a puerperal woman with 10 eclamptic attacks during pregnancy and the first 24 hours after delivery was lower than those in 4 puerperal women with premature labor and in 9 normal puerperal women. In the puerperal woman with 10 eclamptic attacks, the lowered FSH response to LH-RH on day 20 postpartum was apparently improved on day 55 postpartum. However, the FSH response to LH-RH on day 55 postpartum was still lower in the puerperal woman with 10 eclamptic attacks than in 7 normal puerperal women. These results indicate that many eclamptic attacks during pregnancy, delivery and/or the first 24 hours after delivery may cause perturbation to some extent in recovery of FSH-secreting function of the pituitary during the puerperium.
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PMID:[Recovery of gonadotropin-secreting function of the pituitary in the puerperal women with eclampsia]. 642 68

The Ehlers-Danlos syndrome (EDS) is a disorder of the connective tissue characterized by hyperextensible skin, loose jointedness, fragile tissues, bruising and bleeding diathesis. At least eight subtypes of EDS are recognized, each one with different clinical manifestations. On rare occasions EDS is associated with pregnancy. These patients are at risk for bleeding disorders and vascular, surgical and anesthetic complications as well as for premature labor, postpartum hemorrhage, bladder and uterine prolapse, abdominal hernias and wound dehiscence. We treated a pregnant patient for type 1 EDS and pregnancy-induced hypertension.
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PMID:Complications of the Ehlers-Danlos syndrome in pregnancy. A case report. 651 86

Four pregnancies in three patients with spinal cord injury are presented. The major complications encountered include anemia, pyelonephritis, decubiti, premature labor, precipitate labor, and autonomic hyperreflexia. Autonomic hyperreflexia, a severe mass autonomic reflex response to labor, is associated with tachycardia, hypertension, headache, diaphoresis, and severe anxiety. It is probably due to increased norepinephrine release, as very high urinary metanephrines were measured in the latter two cases presented. Maternal and fetal physiology in labor are altered. Despite severe maternal and fetal stress responses, no fetal depression was observed.
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PMID:Pregnancy after spinal cord injury: altered maternal and fetal response to labor. 685 24

A concern of the obstetrician is whether any single event or combination of events before delivery places a prematurely born infant at increased risk of developing periventricular-intraventricular hemorrhage, a form of intracranial hemorrhage in 40 to 45% of all low birth weight infants. In this three-year retrospective study, 103 infants weighing less than 1500 g and delivering on or before the 35th gestational week showed evidence of intraventricular hemorrhage by routine cranial ultrasound scan. The finding of maternal hypertension, vaginal bleeding, or preterm ruptured membranes was similar in infants with intraventricular hemorrhage and a matched group of infants without hemorrhage. Premature labor, breech presentation, mode of delivery, and outborn birth also were not significantly different between the two groups. The finding of intraventricular hemorrhage in the low birth weight infant is related less to any one or combination of two prior obstetric events than to extreme prematurity and accompanying neonatal complications.
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PMID:Obstetric care and intraventricular hemorrhage in the low birth weight infant. 688 17

To evaluate the impact of renal infection on pregnancy outcome, we studied a group of pregnant women with asymptomatic renal bacteriuria and another group who had acute pyelonephritis. In 248 women with asymptomatic bacteriuria, infection was localized by the antibody-coated bacteria method. These women were prospectively matched with abacteriuric control subjects and we found no adverse effects of treated renal or bladder infection. Specifically, the number of women with hypertension and anemia in each group was similar, and infants born to these women were comparable regarding perinatal mortality, mean gestational age, and birth weight, as well as indices of maturity. A total of 487 women with acute pyelonephritis were evaluated in a case-control study and observations of the correlation of maternal anemia and pyelonephritis were confirmed. Women with antepartum infection had no increased adverse perinatal outcome; however, in some women with intrapartum infection, pyelonephritis appeared to have initiated premature labor. We concluded that treated renal infection, whether symptomatic or asymptomatic, does not significantly modify pregnancy outcome.
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PMID:Renal infection and pregnancy outcome. 731 97

Hypertension complicates 10-15% of pregnancies and is associated with an increased rate of fetal loss at all stages of gestation, intrauterine fetal growth retardation and prematurity, either because of spontaneous premature labour or of the occasional necessity for early delivery.
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PMID:Hypertension in pregnancy. 736 58

The pregnancies achieved up to April 1994 among 162 recipients who participated in our oocyte donation programme were studied. Of these, 113 were > 45 years old and 49 were < 45 years old (25-44); approximately 300 women were not admitted to our programme for various reasons. The 113 recipients considered in this study were divided into two age groups: group A, 45-49 years old (54 patient cycles); and group B, 50-60 years old (58 patient cycles); there was also one case of a 63 year old woman. Overall, 44 clinical pregnancies were established in 113 recipient cycles (38.9%) and 44 healthy babies have been delivered; 10 babies were lost (eight miscarriages, one abruptio placentae and one severe gestational proteinuria hypertension at 25 weeks). There was also one case of medium hypertension (at 32 weeks) and four cases of mild hypertension (30, 32, 33 and 35 weeks). There were no cases of maternal diabetes among the pregnant women due to the strict selection criteria. There were no maternal deaths associated with these pregnancies. Regarding neonatal morbidity and mortality, there was one premature labour in the 31st week in a 53 year old woman because of an accidental fall in an airport, and another one in a 51 year old woman in the 25th week. The remaining babies had good Apgar scores and good weights. There were no child deaths and to date there have been no reports of fetal malformation. All babies delivered are in good health.2
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PMID:Fetal and maternal morbidity and mortality in menopausal women aged 45-63 years. 776 80

A total of 199 patients participated in the oocyte donation programme in 336 replacement cycles in whom 69 clinical pregnancies were achieved, of which 53 reached term and delivery. Data concerning the evolution and outcome of pregnancies were retrieved in 52 cases, which involved 39 women with ovarian failure and 18 with functional ovaries. The most frequent complications of pregnancy were uterine bleeding in the first trimester in 18 cases (34.6%), hypertension in 17 (32.7%) and intra-uterine growth retardation (IUGR: 11.5%). These complications were more prominent in twin pregnancies. The Caesarean section rate was 63.5% and a high percentage of elective sections (54.5%) was observed. Of singleton pregnancies, 54.6% had a birth weight of > 3000 g at full term (> 37 weeks), while 62.5% of twins weighed between 2000 and 3000 g. One intra-uterine death occurred, so that the perinatal mortality was 1.7% and one newborn was operated on for stenosis of the pulmonary artery, while the incidence of premature labour was low (1.9%). A comparison of complications between pregnancies associated with ovarian failure and with functional ovaries revealed a higher frequency of bleeding in the first trimester (38.2% and 27.8% respectively) and of hypertension (38.2% and 22.2% respectively) in those with ovarian failure, although the differences were not statistically significant. In conclusion, women who become pregnant after oocyte donation and especially those with ovarian failure should be considered as high-risk obstetric patients.
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PMID:The evolution and outcome of pregnancies from oocyte donation. 771 73

Clinicians should counsel continuous ambulatory peritoneal dialysis (CAPD) patients about contraceptive use. Hypertension contraindicates the pill. CAPD patients should not use IUDs, since they increase the risk of peritonitis. They can use barrier methods. Pregnancy is often not detected until late. The literature shows that 16 CAPD patients have had 17 pregnancies. 65% of the pregnancies resulted in surviving infants. Pregnancies of all women who conceived before starting dialysis were successful, compared to just 4 of 10 women who conceived after starting dialysis. CAPD patients have a more successful pregnancy rate than do hemodialysis patients, but the numbers are too small to be significant and selection bias may exist. Clinicians placed 11 catheters in 8 of the 16 CAPD patients between 4-29 weeks gestation. Fetal position contributed to outflow obstruction. Just 1 patient had dialysate leak. 3 peritonitis episodes occurred. Cephradine, gentamicin, cefadyl, and vancomycin were used to treat peritonitis. 2 women went into labor and delivered shortly after the onset of peritonitis. The infant delivered at 34 weeks survived, while the one delivered at 24 weeks was stillborn. Bloody dialysate was present in 3 pregnancies. It signaled abruptio placentae and subsequent fetal loss in 1 case, severe subserosal hemorrhage of the uterine wall in another case, and laceration of uterine vessels by the catheter. Hypertension complicated 9 pregnancies, but physicians managed it well and it did not cause premature delivery. 6 women had serum hemoglobin levels between 5.4 and 9 g/L. Just 2 received erythropoietin during pregnancy. Premature labor occurred in 9 pregnancies. CAPD infants are small for their gestational age. Cesarean section with no need for catheter removal was the delivery mode for 6 live born infants. Physicians had to hold dialysis for 24-72 hours after surgery. Smaller exchange volumes and increased frequency of dialysis are major changes in the usual regimen for pregnant CAPD patients.
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PMID:Pregnancy and birth control in CAPD patients. 810 17

The use of drugs for common pregnancy complications like premature labor, hypertensive diseases, and premature rupture of membranes with chorioamnionitis is reviewed. In addition, new publications on antiviral drugs in HIV-positive pregnant patients are also discussed. Among the drugs, suppressing premature labor side-effects of beta-mimetics are of growing concern. The effectiveness of other agents like magnesium, indomethacin, and sulindac are addressed. The various mechanisms explaining the beneficial effect of magnesium in pre-eclampsia are reviewed and new data on antihypertensives, such as labetalol, calcium channel blockers, and methyldopa are presented. The evidence from various clinical trials on the value of low-dose aspirin as a prophylactic agent against pregnancy-induced hypertension, pre-eclampsia, and intrauterine growth retardation in high-risk and low-risk patients is compared. Pharmacokinetic data including transplacental transfer of antibiotics and anti-HIV nucleosides are part of this review.
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PMID:Drug treatment in pregnancy. 818 Mar 51


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