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

Out of 136 placentas with vascular obliterations, 25 cases were placentas of children born alive, in 92 cases the placentas belonged to children born dead. In 19 cases we had no data on the baby. In placentas of babies born alive, the same vascular changes (subtotal and total obliterations, septal partitions of vascular lumina) were found as in those of dead-born children, although considerably less severe. Vascular obliterations should not be considered as post-mortal alterations of the placenta blood vessels, since only quantitative differences could be proved. Septum-like partitions are hardly ever found in placentas of babies born alive, in dead-born babies they are more frequent. They seem to present recanalizations, and are understood as a compensation mechanism for a placental insufficiency caused by vascular obliterations. The accentuated collagenization of the placental periphery, noticed in placentas of babies born alive, is being interpreted as the consequence of an impaired blood circulation, caused by partial and total vascular obliterations. The high collagen rate in the placental periphery in placentas of the dead-born is probably a reaction to the diminished fetal circulation. Endangitis obliterations in 73 placentas out of 4600 pregnancies of cases with late abortions, premature deliveries, perinatal death, underweigh and small for gestational age babies, impaired adaptation in newborns of mothers with proteinuria and hypertension speak strongly for assuming that endangitis obliterans presents a form of placental insufficiency. Endangitis obliterans of the placental blood-vessels has, however, been discovered frequently after Rubella infection in early pregnancy. The etiological factors of the endovascular process can be multiple, the morphological and the pathophysiological reactions are the same.
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PMID:[Obliterative angiopathy of placental stem villi (author's transl)]. 99 57

Certain hemodialysis patients need to be made anephric, either surgically or physiologically. Bilateral renal infarction with shredded absorbable gelatin sponge (Gelfoam) was performed on a woman with malignant hypertension being maintained on chronic center dialysis who was too great a surgical risk for bilateral nephrectomy. Peripheral embolization complicated the procedure resulting in a forefoot amputation for dry gangrene two months later. Her postinfarction peripheral plasma renins remained elevated, and she remained hypertensive but was more easily managed with fewer drugs. This technique has been successfully used by others in 1 patient with chronic renal failure and heavy proteinuria and another with hypertension and a solitary kidney. If, as in our case, postinfarction plasma renins remain elevated and hypertension persists, bilateral nephrectomy could be performed at a later date or infarction could be repeated.
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PMID:Treatment of uncontrolled hypertension by therapeutic renal infarction. 99 56

A prospective study of 10,074 white gravidas and 2,880 black gravidas carried out during the years 1959 to 1967 has been analyzed with respect to the impact of elevated blood pressures and/or proteinuria upon pregnancy outcome. Edema was not considered because no evidence is available to indicate that its occurrence increases risk. The mean arterial pressure exhibited during the fifth and sixth months of pregnancy was found to be of significance, as well as the absolute levels of blood pressure attained prior to labor and delivery. The degree of rise in blood pressure was not of importance in itself. However, categories with significant proteinuria had greater increases in mean arterial pressure than did comparable categories without it. Significant proteinuria alone but especially with hypertension was also detrimental to pregnancy outcome. Eight categories incorporating early and late hypertension with and without proteinuria were created, and these were given descriptive diagnostic labels. Only "gestational hypertension," as defined, proved to be essentially devoid of risk to the fetus. In all other non-normotensive categories there was an increase in the stillbirth rate, the perinatal mortality rate, the frequency of intrauterine growth retardation, and neonatal morbidity. In every category, each of these untoward events was greater in black than in white gravidas, and a higher percentage of blacks was noted in each of the hypertensive categories. It is believed that hypertension, significant proteinuria, or both are associated with decreased uteroplacental blood flow which is the common denominator for all of these deleterious effects. The study suggests that "gestational hypertension" occurring late but without proteinuria may or may not represent an early stage of "pre-eclampsia" but does not, at least, place the infant at any substantially increased risk.
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PMID:Influence of blood pressure changes with and without proteinuria upon outcome of pregnancy. 99 75

A report is given on seventeen cases of spontaneous regression of diabetic retinopathy. The diabetes became manifest, without exception, at an early age, particularly in childhood. Regression came on slowly and inconspicuously, retinopathy disappearing completely in two thirds of the cases. Of the other forms of diabetic angiopathy only arterial hypertension was found. No case of specific nephropathy, but frequently chronic infections of the urinary tract, and intermittent proteinuria were observed.
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PMID:[Spontaneous regression of diabetic retinopathy (author's transl)]. 100 40

Compared with a group of normal pregnant women, matched for age, parity, posture, and length of gestation, women with hypertension and proteinuria in the last trimester had significantly lower plasma concentrations of renin, renin substrate and angiotensin II. Plasma aldosterone and DOC concentrations were also lower in the hypertensive group. The plasma levels of cortisol, corticosterone, and ADH showed no significant difference. Plasma renin concentration was raised throughout normal pregnancy, and part of this increase appeared to be due to the presence of an inactive form of renin. Plasma concentrations of renin substrate, angiotensin II, and aldosterone were also raised in normal pregnant women, but concurrent measurement of these substances showed no significant relationship between them, renin, and plasma electrolytes in mid- or late gestation. A study of five women in the weeks immediately after conception showed increases in plasma angiotensin II and aldosterone concentrations, which were significantly related at this very early stage of pregnancy. Total 24-hour urinary sodium increased gradually from about two weeks after gestation to the end of the study five weeks later. This increase was due mainly to a rise in overnight sodium excretion, with a fall in the day/night ratio. No relationship was found between plasma angiotension II or aldosterone concentrations and day, night, or total 24 hour sodium excretion.
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PMID:Studies of the renin-angiotension-aldosterone system, cortisol, DOC, and ADH in normal and hypertensive pregnancy. 100 39

Several methods were used in an attempt to produce preeclampsia in the pregnant rat. Desoxycorticosterone acetate plus increased NaCl intake produced hypertension, proteinuria, rapid weight gain, convulsions, decreased litter size, decreased offspring weight, increased fetal and maternal mortality, and renal lesions similar to those seen in human preeclampsia. Injection of placenta in Freund's adjuvant produced mild blood pressure elevation and proteinuria in the pregnant rat. Rabbit antirat placenta serum produced hypertension in the pregnant rat but not in the nonpregnant rat. Liver congestion and renal glomerular congestion were observed in both pregnant and non-pregnant rats. Pregnancy in the rat reduced hypertension produced by applying a Goldblatt clamp prior to breeding. Uterine ischemia produced by wrapping the uterus in cellophane produced mild blood pressure elevation and proteinuria. A vitamin-E-deficient diet that contained substantial amounts of partially perioxidized, polyunsaturated fatty acids produced morphological lesions in the pregnant rat similar to those seen in human preeclampsia, but hypertension, edema, and proteinuria were absent. None of the maneuvers was effective in producing a complete model of human preeclampsia, but they do provide material for study that could answer somebasic questions about preeclampsia.
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PMID:The rat as a model for preeclampsia. 100 52

Radiological findings of segmental renal hypoplasia are reported, based on the observation of 6 children aged between 8 and 14. The leading clinical symptom is arterial hypertension. Urinary tract infection and proteinuria are additional common findings. Cases with bilateral disease often have renal failure. The intravenous urogram shows unilateral or bilateral small kidneys with segmental renal scarring and transverse lobulation. In the pathological areas the calyces are ectatic or clubbed and their infundibulum is elongated. Vesico-ureteral reflux is frequent. In angiography the lobulated segments appear hypovascular. Diagnosis was verified by histological examination.
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PMID:Segmental renal hypoplasia in childhood. 101 4

The frequency distributions of blood pressures in large populations fail to show two groups, one normotensive and the other hypertensive. In the spectrum of pressures, some people merely have higher levels than others and division of abnormal from normal is artificial and arbitrary, although it is useful for prognosis. The blood pressure of 140/90 as the conventional dividing line does not seem to be appropriate in pregnant women. From the standpoint of fetal prognosis, a level of 125/75 before the thirty-second week and 125/85 thereafter seems more reasonable. Moreover, those levels are close to the 120/80 that Robinson and Brucer specified as the upper limit of normal for all adults and are close to the 130/70 and 120/80 that the eminent British authority, F.J. Browne, used successively in the diagnosis of hypertensive disorders in pregnancy. If the standard of 125/75 were adopted, however, a quarter of all pregnant women would be hypertensive in the second trimester and half in the last month, which are disturbingly high proportions. For the diagnosis of preeclampsia, a rise in blood pressure probably is more significant than an arbitrary level. The usual blood pressure in midpregnancy merely defines the patient's place in the spectrum. Figure 9-1 indicates that in white nulliparas the diastolic pressure rises an average of 10 mm. Hg in the middle of the third trimester. If the mean and median are close together, greater increases would occur in half of the women. The classification of the American Committee on Maternal Welfare and of the Committee on Terminology of the American College of Obstetricians and Gynecologists specify increases of 30 mm. Hg or more in the systolic or 15 mm. Hg or more in the diastolic pressures as criteria of preeclamptic hypertension. pperhaps the rise in diastolic pressure should be set at some greater value. Our analysis of data made thus far cannot decide that issue. The next phase of the study will include analyses in individual women of the times, magnitudes, persistence or transience, and the like of changes in blood pressure, edema, and proteinuria. Such data will afford much more information than can be derived from the preliminary studies reported here. Although edema of the hands and face may be more common in preeclamptic than in normal women, such edema is so common in normal pregnancy as to suggest that it usually is normal. In our data, edema seems to bear no relation to hypertension or proteinuria. The triad of signs -- hypertension, proteinuria, and edema -- is generally accepted as characteristic, though far from specific for preeclampsia. Our data support Hytten's conclusion that edema should by dropped from the triad. There is some indication, however, that some edema is abnormal and that it is associated with an adverse effect when it coincides with proteinuria late in pregnancy.
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PMID:Blood pressure, edema and proteinuria in pregnancy. 9. Proposal for classification. 103 Jul 94

The manifestations, clinical course and treatment of 14 patients with non-malignant renal vein thrombosis are described. Most patients (10 of 14) had generalized vague illness and nephrotic syndrome but 4 were initially seen with acute symptoms of flank pain, hematuria or hypertension. Renal vein thrombosis affected young men 2.5 times more often than women and occurred on the left side 2.6 times more commonly than on the right or both sides. Red blood cell casts in the urinary sediment, heavy proteinuria and hypoalbuminemia were useful indicators of the disease. Excretory urographic signs were suggestive of renal vein thrombosis in all patients and these were corroborated by angiographic studies. Systemic anticoagulation with or without a renal failure program and diuretics, or simply a combination of the last 2 modalities, was used in 9 patients. In 2 of the 9 patients who were unresponsive the adjuvant use of cyclophosphamide and steroids effected a cure. The remaining 5 patients underwent nephrectomy or thrombectomy. All 14 patients were followed for 1 to 7 years (mean 1.6 years). Ten patients were cured or improved, 1 patient was unchanged, and in the remaining 3 patients the condition deteriorated and they subsequently required a renal allograft. The rationale for various forms of treatment is discussed.
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PMID:Renal vein thrombosis. 105 24

The transient nephrotic syndrome was observed in 24 pregnancies in 23 patients, over a five-year period, in a base hospital obstetric unit. The clinical and biochemical features of this syndrome were similar to the nephrotic syndrome observed in non-pregnant patients. In only half the episodes was the patient a primigravida. In three multigravida patients, previous pregnancies were normal. In 10 of the 24 pregnancies, a perinatal death occurred. A bad fetal prognosis was associated with an early onset of the nephrotic syndrome. Of 11 pregnancies in nine patients occurring after the pregnancy complicated by the transient nephrotic syndrome, seven were normal. One pregnancy was complicated by heavy proteinuria, one by hypertension and intra-uterine death, one by an hydatidiform mole, and one was terminated.
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PMID:The transient nephrotic syndrome of pregnancy. 105 92


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