Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Women with severe pregnancy-induced hypertension or chronic hypertension with superimposed preeclampsia are at risk for the development of hypertensive crisis. Hypertensive crisis is an emergent situation that carries great maternal and fetal morbidity and mortality. Effective assessment and comprehensive care of the patient in hypertensive crisis requires a thorough understanding of the underlying disease preeclampsia, common hemodynamic findings, and therapies available. Nurses in any perinatal environment must be prepared to respond immediately to this critical obstetrical circumstance.
 ...
PMID:Perinatal hypertensive crisis. 138 95

Epidemiologists compared data on 434 cases of fatal stroke which occurred between 1986-88 in England and Wales with data on 1268 living matched controls to determine the association between use of the newer, low dose oral contraceptives (OCs) and the risk of stroke. History of hypertension was significantly associated with a 9-fold rise in the risk of subarachnoid hemorrhage (p.001) and an 8-fold rise in the risk of any hemorrhagic stroke. History of preeclampsia was also significantly associated with subarachnoid hemorrhage (p.01) and any hemorrhagic stroke. Cigarette smoking had a 2.6-fold increased risk of subarachnoid hemorrhage (p.001). The epidemiologists found an estimated relative risk of subarachnoid hemorrhage related to current OC use to be only 1.1 and when they controlled for confounding factors it was still small and insignificant (1.3). The power of the study showed the lowest significant increased relative risk of subarachnoid hemorrhage related to OC use that epidemiologists could have detected with 90% certainty to be 1.6. When the epidemiologists controlled for confounding factors, the insignificant relative risk of occlusive stroke associated with OC use was 4.4 while the power of the study indicated it to be 28.4. This was consistent with other studies, but other studies found the association to be significant. These findings revealed a possible small increase in the risk of subarachnoid hemorrhage associated with OC use.
 ...
PMID:Fatal stroke and use of oral contraceptives: findings from a case-control study. 141 30

The influence of pregnancy on the evolution of primary renal disease is still a matter of controversy. Hypertension and derangement of renal function may occur. The pathophysiology of these complications is poorly understood. In the present study, we assessed the influence of pregnancy on the evolution of adriamycin (Adr) nephropathy. Four groups of animals were studied: 1) control virgin rats (C), 2) normal pregnant rats (NP), 3) virgin rats with nephropathy (Adr), and 4) pregnant rats with nephropathy (Adr-P). Inulin clearance measured at the end of pregnancy in awake rats was similar in NP (1.68 +/- 0.20 ml/min) and C (1.39 +/- 0.03 ml/min). In Adr-P rats, it tended to decrease (1.22 +/- 0.7 vs. 1.93 +/- 0.44 ml/min in Adr rats). Mean arterial pressure was increased in Adr-P rats (137 +/- 2.5 vs. 95 +/- 3.2 mmHg in NP; P < 0.001). Urinary protein excretion was 216 +/- 61 mg/day in Adr-P compared with 28.7 +/- 18 mg/day in Adr (P < 0.001). A significant increase in the glomerular thromboxane B2-to-prostaglandin E2 ratio was found in Adr-P rats (1.15 +/- 0.26 vs. 0.52 +/- 0.12 in Adr rats; P < 0.03). In NP rats, no change was observed. Kidneys and placentas were normal on light and electron microscopy. Thus pregnant rats with adriamycin nephropathy developed a clinical picture with several features of preeclampsia. Changes in glomerular prostanoid synthesis might play a role in the development of this complication.
 ...
PMID:Adriamycin nephropathy: a model to study effects of pregnancy on renal disease in rats. 141 42

Obstetric management of severe preeclampsia between 26 and 32 weeks' gestation presents a significant management dilemma. We examined the antenatal courses and perinatal outcomes of 67 such affected pregnancies and compared them with a group of 134 patients, matched for gestational age, who delivered after preterm rupture of membranes or preterm labor. Although the severe preeclamptic group had more patients with chronic hypertension and renal disease, 67% had no prior medical problems. The obstetric and other medical characteristics of both groups were similar. Neonatal outcomes in the severe preeclampsia group differed from those in the control group: they had lower mean birthweight, 5-minute Apgar score and umbilical arterial pH were lower, and their rates of respiratory distress syndrome and perinatal death were higher. Temporization for more than 72 hours was not possible in 60 of 67 preeclamptic pregnancies due to rapid deterioration of the mother (56 cases) or fetus (4 cases). The rate of poor neonatal outcomes in severe preeclampsia exceeded that expected with preterm delivery alone and may reflect preexisting fetal compromise, served better by early intervention and delivery.
 ...
PMID:Severe preeclampsia in preterm pregnancy between 26 and 32 weeks' gestation. 141 33

Researchers analyzed data on 47 black, pregnant women of more than 33 weeks gestation who had preeclampsia with diastolic blood pressure of at least 110 mm Hg and 1+ of proteinuria and were in the delivery department of King Edward VIII Hospital in Durban, South Africa to compare antihypertensive effects of dihydralazine infusion with that of epoprostenol sodium infusion. Overall, both treatments reduced the patient's systolic and diastolic blood pressures. No significant differences in the hypertensive effects existed between the 2 groups. Yet the reduction in blood pressures occurred much more quickly in the epoprostenol group than in the dihydralazine group (51.1 minutes vs. 86.8 minutes;p=.0072). Epoprostenol reduced high blood pressure in all 22 patients while dihydralazine did not adequately control blood pressure in 2 of 25 patients. Physicians had to perform a cesarean section in these 2 cases due to considerable deceleration of the fetal heart rate. They had to 1st administer the rapidly acting ganglion blocking agent, trimetaphan, before placing the women under general anesthesia. Their blood pressures returned to normal after delivery. Even though both groups experienced tachycardia after treatment, the pulse rate of dihydralazine patients was significantly higher than that of epoprostenol patients (102.68/minute vs. 88.36/minute; p=.0024). Only 2 women suffered from side effects. The epoprostenol patient experienced nausea and vomiting. The other patient received dihydralazine and experienced a severe headache. The researchers concluded that physicians should use epoprostenol in patients with severe hypertension and tachycardia and those who need acute control of severe hypertension on the operating table before endotracheal intubation (which tends to cause considerable increases in blood pressure) and administration of general anesthesia.
 ...
PMID:A comparative study of the use of epoprostenol and dihydralazine in severe hypertension in pregnancy. 142 10

An unusual case of pre-eclampsia is presented, where a previously normotensive primigravida suddenly developed hypertension which evolved to subarachnoidal hemorrhage and coma within minutes. Delivery by cesarean section was followed by progressive and complete recovery in the next few days.
 ...
PMID:Fulminant subarachnoidal hemorrhage and coma subsequent to sudden-presenting hypertension. 142 16

In a prospective, randomized, double-blind study for the prevention of pregnancy-induced hypertension and preeclampsia, 41 primigravidae with positive roll-over test (28th-32nd week of pregnancy) received 80 mg aspirin/day or placebo until the end of the 37th week. In the patients treated with acetylsalicylic acid (n = 22), 3 cases of proteinuria occurred, but no hypertensive pregnancy complication. In the placebo group (n = 19), 10 patients developed pregnancy-induced hypertension (6 of them preeclampsia). Group-specific differences concerning the occurrence of hypertension were statistically highly significant (p = 0.0004). No relevant differences were observed with regard to pregnancy duration, birth weight and umbilical artery pH value. The placebo group included 1 intrauterine death. No increased tendency to maternal or fetal bleeding was noticed.
 ...
PMID:Low-dose aspirin in primigravidae with positive roll-over test. 142 14

The literature dealing with screening for hypertension in pregnancy was reviewed. No level of blood pressure or any other factor provides a guarantee of no risk for the development of preeclampsia. However, higher blood pressure in early pregnancy and a failure to decrease blood pressure in mid-pregnancy are both associated with the development of preeclampsia. The development of proteinuria, rather than the level of blood pressure, is the best predictor of poor pregnancy outcome. Multiparas, especially those with severe chronic hypertension who develop preeclampsia, are at greatest risk of poor pregnancy outcome.
 ...
PMID:Screening for hypertension in pregnancy. 142 47

Standardized conditions for blood pressure measurements and strict definitions of systolic and diastolic blood pressure are essential for a consequent management of hypertension during pregnancy. In Sweden, it has been agreed to measure blood pressure with the pregnant women sitting in upright position. Home-monitoring of blood pressure is recommended in women at risk of preeclampsia.
 ...
PMID:Diagnostic methods for pregnancy hypertension. Significance of standardized conditions. 142 48

During pregnancy the placenta is both the source and target for the actions of steroid hormones. In fact, an intact feto-placental unit is capable of elaborating increasing levels of a wide variety of steroid hormones and many other substances. The falling levels of steroid hormones, like estrogens and progesterone in serum and urine have been reported during pregnancy induced hypertension and/or preeclampsia. The purpose of this study was to determine the concentration of 17 beta-estradiol and progesterone in cytosol, nucleic fraction and particulate fraction of term placentae of normal and hypertensive patients by radioimmunoassay. Data from this study reveal the concentrations of 17 beta-estradiol (E2) and progesterone (P) in various cellular fractions from six placentae of normal patients (NP) and five placentae of hypertensive patients (HP). In HP overall concentrations of E2 (75.8 ng/gm) and P(46.5 micrograms/gm) is greater than those in NP, 32.6 ng/gm and 25.0 micrograms/gm respectively. The concentration of E2 in nuclear fraction of NP and HP remains unchanged while P concentration of nuclear fraction of HP (25.4 micrograms/gm) is much greater than those of NP (8.8 micrograms/gm). Moreover, the E2 concentration (55.5 ng/gm) in cytosol of HP is much greater than those of NP (12.3 ng/gm). Therefore, this study indicates that the abnormal concentrations of E2 and P of placentae are associated with pregnancy induced hypertension.
 ...
PMID:Quantitative determination of 17 beta-estradiol and progesterone in cellular fractions of term placentae of normal and hypertensive patients. 143 87


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>