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

In a placebo controlled, partially double-blinded, clinical trial, a combination of evening primrose oil and fish oil was compared to Magnesium Oxide, and to a Placebo in preventing Pre-Eclampsia of Pregnancy. All were given as nutritional supplements for six months to a group of primiparous and multiparous pregnant women. Some of these women had personal or family histories of hypertension (21%). Only those patients who received prenatal care at the Central Maternity Hospital for Luanda were included in the study. Compared to the Placebo group (29%), the group receiving the mixture of evening primrose oil and fish oil containing Gamma-linolenic acid (GLA), Eicosapentaenoic acid (EPA), and Docosahexaenoic acid (DHA) had a significantly lower incidence of edema (13%, p = 0.004). The group receiving Magnesium Oxide had statistically significant fewer subjects who developed hypertension of pregnancy. There were 3 cases of eclampsia, all in the Placebo group.
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PMID:Effects of a combination of evening primrose oil (gamma linolenic acid) and fish oil (eicosapentaenoic + docahexaenoic acid) versus magnesium, and versus placebo in preventing pre-eclampsia. 149 8

Postpartum hemolytic uremic syndrome (HUS) is described in a woman with a history of spontaneous abortions and both circulating lupus anticoagulant and anticardiolipin antibody (ACA). After termination of her pregnancy because of severe preeclampsia, ACA blood levels increased simultaneously with the onset of a microangiopathic process associated with severe hypertension and renal failure. Plasma exchange resulted in a rapid decline in ACA levels and immediate improvement in her clinical condition. This case strongly suggests an important causal relationship between ACA and postpartum HUS. The possible mechanisms of ACA-related postpartum HUS and the potential role of plasmapheresis in its treatment are reviewed and discussed.
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PMID:Postpartum hemolytic uremic syndrome associated with antiphospholipid antibodies. A case report and review of the literature. 149 77

The authors revealed during dispensarization of pregnant women suffering from essential hypertension that the disease is relatively frequently associated with some metabolic disorders, i. e. obesity, gestational diabetes or impaired glucose tolerance. They draw attention to a similarity with Reaven's syndrome in non-pregnant women. The authors recommend to screen for diabetes all obese pregnant women and those with hypertension to detect an impaired glucose metabolism and prevent foetopathies in neonates of thus affected mothers. The authors consider obesity one of the subsidiary criteria in the differential diagnosis of essential hypertension and preeclampsia.
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PMID:[Gestational diabetes mellitus and disorders of glucose tolerance in pregnant women with essential hypertension]. 149 70

During a period of 3 months, a nationwide perinatal census was carried out covering a total of 30 obstetric wards in 27 Israeli hospitals, and the records of all births from a questionnaire were prospectively examined. There were 22,815 births in the country. 90.4% of the deliveries were completed vaginally and 9.6% by Cesarean section (80% as an emergency procedure). The perinatal mortality rate was 13.5/1000. 1080 women who had one previous Cesarean birth were compared to 14,703 women with a previous vaginal birth. From those with one previous Cesarean section, 55.1% delivered vaginally and 44.9 abdominally. According to a logistic regression analysis, breech presentation and one uterine scar were the most important risk factors for Cesarean section as opposed to breech presentation, maternal disease, and multiple pregnancy for perinatal mortality. The national Cesarean section rate in breech presentation was 57.8%. The chance for vaginal delivery was 67.2%, provided the woman had delivered vaginally. The indication for a repeated cesarean section were a previous Cesarean section (28.7%) and malpresentation (12.8%). Uterine rupture ensued in 1.2% (13 cases) of post Cesarean women giving vaginal birth and in only .02% (4 cases) among those who had no previous Cesarean section (P0.001). Comparison between primiparas (42000 deliveries or 18.4% of the total) and multiparas showed that preeclampsia, hypertension, and diabetes mellitus were significantly more frequent among older patients. Preeclampsia and hypertension were more common among primiparas than multiparas (P0.001). In grand multiparity (7th or more parity) diabetes, hypertension, malpresentations, multiple births, large-for gestation age deliveries, and perinatal deaths were significantly more common. The mean birth weight was 3,222 +or- 551 g and the low birth weight (less than 2500 g) was 6.9% with nonsignificant differences between the various ethnic groups. Perinatal mortality was higher for infants born in breech presentation than in cephalic presentation, 23/1000 compared to 3.2/1000, respectively. The level of obstetrics in Israel was measured by the perinatal mortality and the Cesarean section rate was comparable to that of Great Britain, Norway, the Netherlands, and France.
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PMID:The Israel perinatal census. 150 38

Antihypertensive treatment in pregnancy is needed to protect the mother from the dangers of severe hypertension (greater than or equal to 170/110mm Hg), particularly cerebral haemorrhage in the context of preeclampsia. There is no evidence that treatment of the hypertension confers any other benefit; the onset and progression of preeclampsia is neither prevented nor ameliorated. Therefore, there are no indications for treating mild-to-moderate hypertension (140 to 169/90 to 109mm Hg). Intravenous hydralazine and oral nifedipine are effective drugs to treat severe hypertension acutely, the latter having the advantage of ease of administration. For long term therapy, methyldopa is the only drug which has been fully assessed and shown to be safe for the neonate and infant. beta-Adrenoceptor antagonists are safe to use in the third trimester but cause significant intrauterine growth retardation when used for longer periods. ACE inhibitors are contraindicated and diuretics should be avoided. Although calcium antagonists appear to have much potential they require further assessment of their use in pregnancy.
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PMID:Comparative risk-benefit assessment of drugs used in the management of hypertension in pregnancy. 150 69

We have studied renal function during pregnancy using plasma clearance of iohexol to determine the glomerular filtration rate (GFR). In normal pregnancy, GFR was elevated by 40% throughout pregnancy and during the first week post partum, and fell to levels similar to those in non-pregnant women within 1 month. The development of GFR in diabetic pregnant women and in women with gestational hypertension was similar to that recorded in normal pregnancy. In subjects with preeclampsia the rise in GFR observed in normal pregnancy was absent, and no change in GFR was recorded after delivery. We conclude that the development of proteinuria and fluid retention typical of preeclampsia is paralleled by a deterioration of GFR.
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PMID:Glomerular filtration rate in pregnancy: a study in normal subjects and in patients with hypertension, preeclampsia and diabetes. 151 17

Intrauterine growth retardation (IUGR) is an important cause of small stature in children presenting to paediatric endocrinologists. IUGR has to be differentiated from familial ('constitutional') short stature, where the growth deficit is genetically determined and/or induced by smallness of the mother (maternal constraint). Intrinsic fetal anomalies such as chromosomal abnormalities, primary growth failure syndromes, congenital infections and congenital anomalies are of equal importance with maternal disorders, in particular chronic use of alcohol, tobacco and narcotics, and pregnancy complications like hypertension and pre-eclampsia, in causing fetal growth retardation. The relative importance of placental abnormalities and environmental factors (with the exception of malnutrition) appears to be small. Some catch-up growth of children with IUGR has been observed in about 70% of all cases during the first year of life. Many IUGR children show major or minor birth defects which may be predisposing factors or may also coexist because of common underlying factors producing both small stature and structural anomalies. Since in most children with IUGR adult heights to be expected are below the population range, growth hormone treatment has been tried for many years, but the data available from the literature are not encouraging to date and need to be re-evaluated in controlled long-term trials.
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PMID:Intrauterine growth retardation and familial short stature. 152 54

Pregnancy is associated with marked changes in renal functions. Hypertensive disorders in pregnancy are frequently accompanied by deteriorated renal functions and by pathological lesions in the glomeruli. Using a pulsed Doppler ultrasound, we measured the resistance to flow in the renal artery in normal and hypertensive pregnant patients. We performed 176 pulsed Doppler ultrasound measurements of the renal arteries at various stages of gestation in 60 low risk pregnant patients. Another 111 Doppler measurements of the same vessels were obtained from 80 hypertensive pregnant patients throughout the third trimester. Twenty-six patients had preeclampsia, 35 patients had pregnancy-induced hypertension, and 19 patients had chronic hypertension. The resistance to flow in the renal arteries (expressed by the resistance index, RI) did not change significantly during pregnancy. The renal artery RI was not significantly different between the hypertensive group (RI = 0.61 +/- 0.06) and the low risk group (RI = 0.605 +/- 0.04). The RI values were also similar in all hypertensive patient categories: preeclampsia (RI = 0.62 +/- 0.07), pregnancy-induced hypertension (RI = 0.60 +/- 0.06), and chronic hypertension (RI = 0.61 +/- 0.05). The renal artery RI did not correlate with the severity of the hypertensive disease or with the status of renal functions. The outcome of pregnancy was worse in patients with abnormally elevated resistance index in the renal arteries. Patients with abnormally elevated resistance to flow in the uterine arteries also had a significant increase in the resistance index in the renal vessels.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal artery flow velocity waveforms in normal and hypertensive pregnant women. 152 66

Pre-eclampsia is a common complication of the second half of pregnancy that is associated with substantial fetal and maternal morbidity. Although the genetic basis of the disorder is unclear, epidemiological studies suggest that it occurs predominantly in the first pregnancies of women who are homozygous for a relatively common susceptibility gene. Using this epidemiological model, we have begun to construct an exclusion map by using both candidate genes and random DNA markers on a panel of two-generation families in which pre-eclampsia was rigorously defined. No evidence was found for linkage to the HLA region or to several genes implicated in the pathogenesis of hypertension.
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PMID:An exclusion map for pre-eclampsia: assuming autosomal recessive inheritance. 848 31

To evaluate prenatal and perinatal risk factors for development of germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH), we conducted a prospective epidemiologic study of 449 babies whose birth weight was less than 1501 grams. This study permitted us to test our previously generated hypothesis that babies born to mothers with preeclampsia were at substantially reduced risk of developing GMH-IVH. Seventy-two (16%) of the babies in this population developed GMH-IVH. One (2.5%) of the 40 mothers with a diagnosis of preeclampsia and 71 (17.4%) of 409 mothers without preeclampsia gave birth to babies who developed GMH-IVH. GMH-IVH was seen in 6/107 (5.6%) of babies born to women with hypertension including 4/69 (5.8%) of babies born to women with pregnancy-induced hypertension, compared to 66/352 (18.8%) of babies born to mothers who did not have hypertension. Only 7.3% (8/108) of babies born to women who had proteinuria had GMH-IVH, compared to 18.3% (64/350) of babies whose mothers did not have proteinuria. GMH-IVH was seen in 5/89 (5.6%) of babies whose mothers had both hypertension and proteinuria, whereas 63/332 (19%) of babies born to mothers who lacked both factors, developed GMH-IVH. In stepwise logistic regression analysis, these significant findings were not explained by the presence of labor, postnatal acidemia, need for intubation, antenatal administration of steroids, birth weight, or gestational age. In addition, we found that maternal receipt of magnesium sulfate was associated with diminished risk of GMH-IVH even in those babies born to mothers who apparently did not have preeclampsia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Maternal toxemia is associated with reduced incidence of germinal matrix hemorrhage in premature babies. 155 56


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