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

In order to quantify the frequency of placental tissue changes in pregnancies complicated by hypertension and the correlation with the severity of the disease we studied 15 term-placentas of healthy women and 33 placentas of patients with pregnancy hypertension using phase contrast microscopy. Applying microscopy (phase contrast) a total of 50 fields were inspected from 5 different, representative areas of each placenta. We counted the (absolute) number of fields with trophoblastic hyperplasia; trophoblast sprouts; with interstitial edema; with hemorrhagia and with fibrinoid degeneration and necrosis. Trophoblastic hyperplasia as well as interstitial edema were rare in term-placentas of healthy women. Typically in hypertensive pregnancies these findings together with trophoblast sprouts increased proportionally to severity. We conclude that these results indicate a retardation of maturation of placenta tissues in hypertensive pregnancy. Although hemorrhagia and fibrinoid degeneration were observed in all placentas they were more frequent in pregnancies complicated by hypertension. This might be a consequence of changed placental perfusion of the intervillous space. In immature placentas hemorrhagia and fibrinoid degeneration induce additional restriction of placental capacity which seems to be responsible for decreased fetal birth weight and arterial cord pH. When morphological alterations of placenta tissue, e.g. trophoblast sprouts, trophoblast hyperplasia, stroma edema, hemorrhagia and fibrinoid degenerations were quantified and correlated to blood pressure of the mother, we found a positive correlation. Increased numbers of trophoblastic sprouts and trophoblastic hyperplasia indicate a placental immaturity whereas edema, hemorrhagia and degenerations can be taken as the result of elevated blood pressure.
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PMID:Placental morphology and clinical correlations in pregnancies complicated by hypertension. 390 46

The laryngeal chemoreflex was studied during quiet and REM sleep and wakefulness in premature newborn lambs. The response to reflex stimulation with a 5 sec-water infusion was evaluated during 30 sec, as % change in ventilation, heart rate and blood pressure. Apnea, hypertension and bradycardia were more pronounced during sleep than during wakefulness, when arousal was not associated with the stimulation. The response was similar during quiet and REM sleep. Arousal, which occurred in 24 and 31% of the tests respectively, resulted in a response comparable to that seen during wakefulness. The respiratory drive was evaluated by measurement of the mean inspiratory flow and was found to be decreased during both sleep states when compared to wakefulness. We propose that during sleep in the newborn period there is a decreased ability to respond to asphyxia possibly due to a functional immaturity of the arterial chemoreceptors. This results in a low incidence of arousal and a delayed termination of the pronounced poststimulus apnea resulting from laryngeal chemoreflex stimulation.
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PMID:Reflex apnea from laryngeal chemo-stimulation in the sleeping premature newborn lamb. 711 Jul 84

Investigations on singleton and twin pregnancies show different functional behaviour on maternal-fetal relationship. In some ways twin pregnancies may be considered at risk and they may develop associated pathologies such as hypertension. The aim of this work was to evaluate the morpho-functional behaviours of umbilical cord veins in twin and singleton gestations to better understand the role of these extra-embryonic tissues in the regulation of pregnancies. The umbilical cords were studied from singleton pregnancies and from dichorionic twin pregnancies. Biochemical and morphological investigations were carried out. A significant decrease in the anisotropy values was observed in endothelial cells from twins compared with singletons. Our ultrastructural data show immaturity features at the vein vessel wall level in twins. Furthermore, immunohistochemical investigations showed a lower degree of expressivity concerning adhesion molecules such as ICAM-1 and ELAM. Morphogenetic extracellular glycoproteins like fibronectin and tenascin seem over-expressed in twin pregnancies. Our morpho-functional data well testify the lower maturation degree of umbilical cord veins in twins with respect to singletons.
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PMID:Umbilical veins in dichorionic twins. A morpho-functional assessment. 755 55

Pre-eclampsia/toxemia (PET) is an idiopathic hypertensive disorder of pregnancy elicited in susceptible mothers by exposure to placental trophoblast. Three facts regarding the placenta in PET are known: an association with large placentas (excessive trophoblast), a tendency for superficial implantation, and inappropriate trophoblastic immaturity, as assessed by ultrastructural and biochemical criteria. A unitary hypothesis is that PET is related to a maturation defect leading to excessive accumulation of inappropriately immature intermediate trophoblast in the placental implantation site. We studied the implantation site of PET and control placentas from three gestational age groups (25 to 30, 30 to 35, and 36 to 40 weeks old [five per group]) by morphometry and immunohistochemistry using antibodies to three phenotypic markers (cytokeratin, human placental lactogen (HPL), and beta 2-microglobulin) and two markers of cell dynamics (proliferating cell nuclear antigen [PCNA] and bcl-2]). Implantation sites in the PET group had increased amounts of intermediate trophoblast (cell number and longitudinal extent) with an increased proliferative index (percentage of PCNA positive) and evidence of phenotypic immaturity (HPL negative). Intermediate trophoblast from both groups was uniformly bcl-2 negative and beta 2-microglobulin positive. Based on these data and the findings of other investigators, we propose that the diagnostic term "atypical implantation site" be added to acute atherosis, villous infarction, and increased syncytial knotting as a characteristic of placentas from pre-eclamptic pregnancies.
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PMID:Pre-eclampsia is associated with an excess of proliferative immature intermediate trophoblast. 777 87

During the 12-month period from 1 September 1986 to 31 August 1987 an attempt was made to collect information on all perinatal deaths occurring on the island of Jamaica. Of the 2069 late fetal and early neonatal deaths identified, 19% fell into the Wigglesworth definition of 'deaths from immaturity'. Twins were 11 times more likely to die of immaturity than were singletons, and twins comprised 18% of all deaths in this group. Comparison of the singleton deaths from immaturity, with 9919 singletons born on the island during the 2-month period of September and October 1987 and who survived the first 7 days, revealed several strong risk factors. These included history of previous miscarriages, stillbirth, early neonatal death or preterm delivery, and complications of bleeding and hypertension (highest diastolic, proteinuria and eclampsia all having independent associations). None of these factors 'explained' a strong negative relationship with the number of young children in the household. There was an apparent protective effect of maternal folic acid ingestion which warrants further investigation.
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PMID:Perinatal deaths as a result of immaturity in Jamaica. 807 94

The frequencies of 10 diseases in a cadmium (and zinc) contaminated region in The Netherlands were analysed by comparing hospital admissions with those of a non-contaminated region and with national values. No significant differences were found for diseases which are commonly associated with increased cadmium uptake such as renal insufficiency, nephrolithiasis, hypertension, cancer, immaturity of the new-born. For the contaminated region a significantly higher frequency was only found for atherosclerosis; this was relatively strong for men aged > 40 yrs. However, no higher death frequency for atherosclerosis was observed. The results are discussed in relation to limitations in the evaluation techniques used. The absence of major health risks in the contaminated area is obvious, but the possible influence of long term-low level cadmium uptake on atherosclerosis requires more attention.
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PMID:Prolonged low-level cadmium intake and atherosclerosis. 825 93

The relationship between young maternal age and preterm delivery was investigated in a subsample of 605 primigravidas enrolled in the Camden (New Jersey, US) Study. Included were 366 adolescents under 16 years of age (cases) and 239 women 18-29 years of age (controls). 36.3% of young mothers had a low gynecological age (i.e., their chronological age was 2 or fewer years more than their age at menarche). After adjustment for ethnicity, cigarette smoking, weight gain rate, height, fetal sex, gestational diabetes mellitus, and pregnancy-induced hypertension, the odds ratio (OR) of preterm labor among young adolescents was 1.74 (95% confidence interval (CI), 1.07-2.84) and that of preterm delivery was 2.08 (95% CI, 1.08-4.00). There was a modest decreased risk of preterm delivery attributable to other causes (e.g., premature rupture of the membranes) among the youngest women (OR, 0.70; 95% CI, 0.28-1.75). Young age with low gynecological age was associated with a 2.15 OR (95% CI, 1.19-3.89) of preterm labor and a 2.64 OR (95% CI, 1.23-5.65) of preterm delivery with preterm labor. The risk associated with young age and higher gynecological age was increased only moderately. These findings suggest that it is the biological immaturity often associated with young age, rather than young maternal age per se, that increases the risks of adolescent pregnancy. The association between low gynecological age and preterm labor is presumed to reflect an irritability of the adolescent uterus, a sensitivity to dehydration, and/or an altered hormonal milieu that promotes maternal development at the expense of fetal well-being.
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PMID:Young maternal age and preterm labor. 927 49

Sixty two samples of amniotic fluid were submitted to biochemical investigation including 31 samples from women with pregnancy complicated by hypertension (studied group with blood pressure -65 +/- 15/95 +/- 5 mm Hg) and 31 samples deriving from healthy pregnant women (control group with mean blood pressure 118 +/- 10/74 +/- +/- 9 mm Hg). The following parameters of amniotic fluid were measured: 1) aminotransferases: alanine AlAT and aspartate AspAT, 2) alkaline phosphatase (APt) and its thermostable isoenzyme (APh), 3) ceruloplasmin (Crlp), 4) alpha-amylase (alpha-Amy). The study showed pregnancy complicated by hypertension is related to fetal salivary gland's immaturity presenting decreased activity of alpha amylase in amniotic fluid. Amniotic fluids deriving from women with pregnancy complicated by hypertension showed normal activities of AlAT, AspAT, APt, APh and Crlp.
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PMID:[Evaluation of fetal condition in pregnancy complicated by hypertension--biochemical assessment of amniotic fluid. II. Enzymes]. 928 52

Fetal head compression during labor may increase intracranial pressure (ICP) and decrease cerebral perfusion pressure (CPP). An increase in mean arterial pressure (MAP) associated with the Cushing response normally acts to mitigate an ischemic insult when the increase in ICP approaches MAP. However, the premature fetus may be limited in its ability to increase MAP. We compared the efficacy of the pressor response in sustaining CPP, cerebral blood flow (CBF), and cerebral O2 consumption (CMRO2) in chronically catheterized fetal sheep at 0.6 gestation (92 d; n = 7) and 0.9 gestation (133 d; n = 7). When fetal ICP was increased to baseline MAP (41 +/- 3 mm Hg; +/-SEM) in 92-d fetuses, MAP increased by 7 +/- 2 mm Hg and remained stable during 30 min of constant ICP elevation; CBF decreased by 72% and CMRO2 decreased by 46%. In 133-d fetuses, MAP increased from 53 +/- 2 to 65 +/- 4 mm Hg at 3 min of elevated ICP; CBF decreased by 62% and CMRO2 decreased 30%. However, MAP continued to increase after 3 min and reached a stable level of 75 +/- 3 mmHg at 30 min in 133-d fetuses. The additional increase in MAP restored CBF and CMRO2 to baseline values. Plasma epinephrine and vasopressin concentrations increased between 6 and 33 min of elevated ICP to levels, exceeding those in 92-d fetuses. We conclude that the arterial pressure response to intracranial hypertension is present at 0.6 gestation but is less well developed than at 0.9 gestation in fetal sheep, possibly due to immaturity of the sympathoadrenal and vasopressin systems. Consequently, CBF and CMRO2 are not as well defended at mid-gestation against elevated ICP as might occur during difficult labor.
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PMID:Efficacy of the cushing response in maintaining cerebral blood flow in premature and near-term fetal sheep. 943 12

Clinical and morphological analysis was made to assess 9 cases of minimal change disease (MCD) and 30 cases of mesangial glomerulonephritis (GNMES) recognized by light microscopy with unfavourable course. Case selection was based exclusively on the clinical course suggesting a possibility of early sclerosis (long-term steroid resistance, frequent recurrences, rare short-lasting remissions, hypertension, renal failure). It was found that the unfavourable clinical course was clearly more frequently associated with electron microscopic than light microscopic changes. Marked increase of the matrix was observed also in those glomeruli in which light microscopy did not reveal any changes or only the signs of immaturity. It was also noticed that in those cases in which the assessment of mesangial matrix increase (which means the onset of sclerosis) is not certain, it is useful to make a morphometric analysis of electron microscopic material.
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PMID:Clinical and morphological (including morphometric) aspects of minimal change disease and mesangial glomerulonephritis with unfavourable course in children. 1062 18


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