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

Twenty hypertensive gravid women who had their pregnancies terminated for maternal indications because of the severity of pre-eclampsia or chronic hypertension were studied. They were treated at 27 to 33 weeks of gestation with 48 hours of betamethasone therapy prior to delivery. There was one antepartum fetal death, and it is believed that this death was preventable. There was an incidence of respiratory distress syndrome (RDS) of 23% with two neonatal deaths secondary to RDS, for a treated neonatal survival of 85.7%. All losses were from mothers with pre-eclampsia. Pregnancy-related hypertension is not thought to be an absolute contraindication to glucocorticoid therapy for the induction of pulmonary maturity.
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PMID:Glucocorticoid therapy for the induction of pulmonary maturity in severely hypertensive gravid women. 58 26

One hundred and thirty-one women with chronic hypertension were studied serially during pregnancy to determine the sequence of events in the development of superimposed pre-eclampsia and to discover the time of onset. Twenty-seven women developed a sustained rise in plasma urate concentrations, which began at about 28 weeks' gestation and which is characteristic of pre-eclampsia. The mean platelet count was already significantly reduced and continued to fall until delivery, which was on average at 36 weeks' gestation. A comparable but smaller decrease in platelet count was seen in 55 women who had borderline but consistent increases in plasma urate concentrations. In 49 women whose plasma urate concentrations remained steady the platelet count did not change significantly before delivery. The reduced platelet count in women who develop pre-eclampsia suggests that increased platelet consumption is an early feature of the disorder.
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PMID:Early platelet consumption in pre-eclampsia. 62 36

The results of 2 studies to determine the relationship between hormonal contraceptive (h.c.) use, hypertension, and nephritis are reported. 828 women, 16-50 years of age, were divided into 3 groups. 1 group had never used h.c.s., 1 group was presently using h.c.s., and 1 group had used h.c.s. for the last time more than a year prior to the study. Women 26-35 years of age who were using h.c.s. at the time of the study more often developed hypertension than other groups. The h.c. users who developed hypertension more often had a family history of hypertension or diabetes mellitus, more often had diabetes themselves, and more often suffered from preeclampsia or eclampsia during pregnancy. In a second study, ethinyl estradiol, norethisterone acetate, epsilon aminocapronic acid, desoxycorticosterone acetate, and table salt were administered singly or in combinations to 2 groups of rats. In one group, a Goldblatt-type hypertension was induced with a clamp on the nephric artery. No increase in blood pressure was observed in animals which received only an estrogenic or progestagenic agent. Significant increases in blood pressure were observed in animals that were given combinations of estrogenic and progestagenic agents, however. Significantly increased plasma-resin activity was observed in all animals which were given estrogen, while animals receiving desoxycorticosterone acetate showed a highly significant decrease in plasma-renin activity.
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PMID:[Oral contraceptives, hypertension and nephrosclerosis]. 62 80

One thousand and ninety-three obstetricians answered a questionnaire on the management of pregnant women with pre-existing hypertension and pre-eclampsia. They reported that they frequently used antihypertensive drugs (most often methyldopa and diuretics) in severe essential hypertension but tended to give sedatives in mild cases. Renal impairment was considered more important that raised blood pressure as an indication for terminating pregnancy; but even without a raised blood urea concentration over a quarter of respondents (especially the more senior obstetricians) would have considered it. The more junior obstetricians were more likely to admit the least severely affected patients to hospital. Pre-eclampsia was usually treated with bed rest and sedatives (most frequently diazepam); but the choice of drug varied with the seniority of the respondents, the more senior obstetricians tending to confine themselves to the more familial drugs. There was considerable unanimity in the replies, even though most of the treatments and practices have not been validated by controlled trials, and two-thirds of the obstetricians gave the same answers to most of the questions.
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PMID:How obstetricians manage hypertension in pregnancy. 63 Feb 63

Total cortisol levels were measured in 81 samples of amniotic fluid obtained from 72 patients in the third trimester of pregnancy; 19 of them had pre-eclampsia and the remainder had no pre-eclampsia, hypertension or renal disease. In accordance with previous studies, there was a rise in the concentration of amniotic fluid cortisol with advancing gestation; the rise was steepest after 40 weeks, the amniotic fluid cortisol levels invariably being above 700 nmol/l between 41 and 43 weeks of pregnancy. Amniotic fluid cortisol may thus be of value in diagnosing postmaturity. A relatively low correlation was found between total cortisol levels and lecithin/sphingomyelin ratios in amniotic fluid unless results were ranked for gestational age. Total cortisol concentrations in amniotic fluid obtained from patients with pre-eclampsia were significantly higher than in controls. The concentration of free cortisol in amniotic fluid changed much less than total cortisol. Thus total cortisol should be measured in studies of the fetal capacity to synthesize corticosteroids.
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PMID:Total and free cortisol in amniotic fluid during late pregnancy. 65 49

The contraction stress test (CST) has become widely used to assess antepartum fetal well-being over the past 5 years. A summary of 14 reports in the literature revealed seven fetal deaths in 1739 patients within 1 week of a negative CST, an incidence of 0.4%. This prompted an investigation of our results for comparison. During the period January 1, 1975, to February 28, 1977, 746 patients underwent 1119 CSTs. Seven fetal deaths occurred in 680 patients within 1 week of a negative CST, an incidence of 1.0%. Although maternal conditions associated with fetal demise within 1 week of a negative CST include diabetes mellitus, prolonged pregnancy, chronic hypertension, and pre-eclampsia, fetal death in most instances resulted from factors other than uteroplacental insufficiency (UPI). Conditions commonly associated with fetal demise following a negative CST were umbilical cord accidents, severe congenital anomalies, and abruptio placentae. The low incidence of fetal death after a negative CST supports continued use of the CST in evaluation of high-risk pregnancies.
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PMID:Fetal demise following negative contraction stress tests. 66 43

The renin-angiotensin system has been implicated in the genesis of pre-eclampsia. To avoid fetal toxicity, five women were studied who developed hypertension, proteinuria, and edema in the last trimester of pregnancy and whose BP elevation persisted immediately postpartum. At about 6 hours after delivery the CE enzyme inhibitor (SQ 20,881) was given in incremental doses ranging from 0.25 to 3.0 mg. per kilogram intravenously, before and after diuresis with furosemide, 40 mg. intravenously. BP was measure every 2 minutes and PRA and angiotensin II concentration before treatment, 30 minutes after 0.25 to 0.30 mg. per kilogram, and 30 minutes after 2.0 to 3.0 mg. per kilogram. Echocardiographic assessment of CI and PVR was performed before treatment and after a maximum dose in three patients. Before diuresis, CE blockade had no effect on heart rate, BP, CI, PVR, or PRA, regardless of whether the patient was in positive or negative fluid balance or was sodium loaded or restricted over the preceding 24 hours. Angiotensin II fell by 77 and 10 per cent, respectively, after 0.25 mg. per kilogram was given to two patients, but rose slightly in the other three patients, then fell an average of 46 per cent after 1.0 to 3.0 mg. per kilogram were given. After diuresis, 1.0 mg. per kilogram resulted in a 24 per cent fall in BP which persisted for 3 hours in two patients and a 14 per cent fall which lasted for 30 minutes after 1.0 or 3.0 mg. per kilogram in a third patient. It is concluded that the BP elevation which persists after delivery in certain patients with pre-eclampsia is not angiotensin II dependent.
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PMID:SQ 20,881: effect on eclamptic--pre-eclamptic women with postpartum hypertension. 68 62

The formation, measurement, and excretion of uric acid are reviewed. Since fluctuations in serum uric acid may be as high as 40% over a 24-hour period, a single value must be evaluated with caution. Alterations in the renal handling of uric acid are responsible for the pronounced decrease in serum uric acid over the first 20 weeks of gestation, its gradual increase in the latter part of pregnancy, and its further increase with pregnancy-induced hypertension. Although there is a fair degree of overlap between a normotensive control and a preeclamptic group, the level of serum uric acid generally correlates with the severity of preeclampsia. Possible intrarenal mechanisms that could produce these changes are discussed.
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PMID:Metabolism of uric acid in normal and toxemic pregnancy. 71 3

Severe edema-proteinuria-hypertension (EPH) gestosis (pre-eclampsia) appears in at least two forms (A and B). The A type is mostly complicated by fits, while the B type is characterized by multiple organ failure. The perinatal mortality rate is especially high in the B group. All gravid women with severe EPH gestosis benefit from blood volume expansion therapy.
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PMID:Severe edema-proteinuria-hypertension gestosis. 71 64

Fetal heart rate (FHR) was recorded and maternal blood pressure measured in 104 patients in whom lumbar epidural analgesia was induced in labour. Fifty-one patients received an intravenous load of 11 of Hartmann's solution immediately before the epidural injection. This infusion significantly reduced the incidence of abnormalities of FHR from 34% to 12% and of maternal hypotension from 28% to 2%. We did not study mothers with pre-eclampsia and hypertension, but we conclude that there is a strong case for preloading all other mothers in whom lumbar epidural analgesia is induced in labour.
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PMID:Fluid loading to reduce abnormalities of fetal heart rate and maternal hypotension during epidural analgesia in labour. 71 63


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