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

The aim of this study was to test the hypothesis that isolated oligohydramnios in the otherwise normal term pregnancy does not indicate fetal compromise. Women undergoing labor induction for isolated oligohydramnios between 37 and 41-6/7 weeks gestation were matched by gestational age and parity to women with normal amniotic fluid index measurements who presented in spontaneous labor. Pregnancies complicated by hypertension, diabetes, fetal anomalies, or suspected fetal growth restriction were excluded. The primary outcome variable was route of delivery. Secondary outcomes examined included presence of meconium, acidosis, low Apgar score, and NICU admission. A total of 183 women underwent induction for isolated oligohydramnios. When compared to the control group, neonatal outcome measures did not differ in the group induced for oligohydramnios. However, the women who were induced had significantly more cesarean deliveries (15.8% vs. 6.6%, P < 0.01, odds ratio 2.7). The increased need for operative delivery was not attributable to more fetal distress in the oligohydramnios group. We conclude that isolated oligohydramnios in the otherwise normal term pregnancy may not be a marker for fetal compromise, and induction of labor may not be warranted in most cases.
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PMID:Isolated oligohydramnios in the term pregnancy: is it a clinical entity? 973 Apr 87

The aim of our study was to evaluate the pregnancy outcomes of late selective multifetal reduction (MFPR). We performed a 3 year, prospectively-designed study in which 28 patients underwent MFPR at a mean gestational age of 20.2 +/- 3.9 weeks (range 14-29 weeks). The indications for MFPR included: multiple gestation (> or = 3) (57%), structural anomaly (29%), and chromosomal abnormality (14%). The procedure was performed using ultrasonographically-guided intracardiac injection of potassium chloride. The mean gestational age at delivery was 36.6 +/- 2.2 weeks (range 31-40 weeks). Nine patients (32%) delivered before 36 weeks of gestation. The mean birth weight was 2370 +/- 614 g (range 1510-3250 g). Discordancy was evident in four twins (14%), and intrauterine growth retardation in four pregnancies. One case (3.5%) presented with oligohydramnios, and one with pregnancy-induced hypertension. One case of late abortion due to passive cervical dilatation 4 weeks after the MFPR was observed. Procedure-related amnionitis followed by late abortion occurred in one case. A total of 57% of the patients delivered vaginally and 43% delivered by Caesarean section. We concluded that late selective MFPR is associated with favourable perinatal outcome. Late MFPR may facilitate the detection of structural and chromosomal anomalies prior to the procedure, and the accomplishment of selective reduction of the affected fetus.
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PMID:A 3 year, prospectively-designed study of late selective multifetal pregnancy reduction. 974 Apr 64

Aside from recognized overgrowth syndromes, instances of visceromegaly are not uncommon at perinatal autopsy. The database of the University of Michigan Teratology Unit was screened for individual viscera exceeding the 90th centile for body and brain weight standards. The data were stratified for several maternal (hypertension, diabetes, obesity), gestational (chorioamnionitis, oligohydramnios, amniorrhaea, polyhydramnios), and fetal (body wall defect, cardiac malformation, renal malformation, diaphragmatic hernia, nonimmune hydrops, twin transfusion syndrome) characteristics and tested for statistically significant excessive numbers of heavy organs. The most striking associations were heavy adrenal glands and liver with chorioamnionitis, heavy heart with polyhydramnios and in the twin transfusion syndrome, and heavy heart and liver with nonimmune hydrops. Excessive brain weight for body weight had a number of correlations, each most likely reflecting growth restriction with sparing of brain growth.
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PMID:Correlates of prenatal visceromegaly. 978 3

Isosorbide dinitrate (ISDN), a nitric oxide donor, was applied transdermally for 4-16 days to 4 preeclamptic women with oligohydramnios, intrauterine fetal growth retardation (IUGR), and elevated resistance of blood flow in the uterine arteries. Pulsed Doppler ultrasonography revealed immediate and drastic improvement of pulsatility index (PI) of uterine arteries following treatment with ISDN. The average PI in uterine arteries of the 4 patients was reduced to approximately 67% of that of the untreated state. In 2 patients the amniotic fluid gradually increased over a few days which suggested improvement of fetoplacental circulation during administration of ISDN. This study suggests that long-term transdermal ISDN is an effective therapy, at least in a portion of preeclamptic women, to avoid maternal hypertension, fetal distress, oligohydramnios, and IUGR, and consequentially to prolong the gestational period.
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PMID:Clinical experience of long-term transdermal treatment with nitric oxide donor for women with preeclampsia. 985 86

Renal agenesia is one of the more common urinary malformations. Renal agenesia can be unilateral, more frequently, or bilateral. This malformation can be isolated or present with other urinary and/or extra urinary anomalies. We report a family with renal agenesia. The proband was a fetus. Ultrasonographic examination at 15 weeks of gestation showed a left renal agenesia and a right multicystic kidney, absence of bladder and oligohydramnios. The same features were found at 19 weeks of gestation. The couple asked for termination of pregnancy. On pathologic examination the absence of left kidney was confirmed whereas the right kidney which measured 3.5 cm was filled with numerous cysts of 0.2 cm to 1 cm. of diameter and fibrosis. According to the Potter's classification these images are characteristic of a dysplasia type II. There was no hepatic fibrosis. Family history revealed that the mother is in good health, she had previously a normal son. The father had a unilateral renal agenesia which was diagnosed after he had arterial hypertension when he was 25-years-old. The paternal grand father and his brother had unilateral renal agenesia which was shown by screening. This family shows that renal agenesia can be autosomal dominantly inherited and that the expressivity of this anomaly is variable.
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PMID:Hereditary renal adysplasia in a three generations family. 1054 96

Antiphospholipid antibodies have been reported to be associated with many common clinical settings. Many gynaecologists and obstetricians have suggested their role in the pathogenesis of infertility, recurrent spontaneous abortions (RSA), ectopic pregnancy, intrauterine growth retardation (IURG), intrauterine foetus decay, pregnancy induced hypertension (PIH), preterm rupture of the membranes (PROM) and preterm labour and premature detachment of the placenta and oligohydramnios and abnormalities of the foetus. Based on our trials and many papers it can be assumed that regular treatment, initiated as early as possible, with using acetylsalicylic acid, heparin, prednisone and IgG allows to prevent diseases above-mentioned.
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PMID:[Clinical consequences of antiphospholipid antibodies in obstetrics and gynecology]. 1100 45

The obstetrical and neonatal courses in pregnancies following orthotopic liver transplantation were studied. Maternal and neonatal records were reviewed from six patients (eight pregnancies), cared for by a single practitioner, who had undergone orthotopic liver transplantation prior to pregnancy between 1984 and 1999. Demographic data, reason for transplantation, interval from transplantation to pregnancy, immunosuppressive agents, antepartum complications, and maternal and neonatal outcomes were reviewed. Many reasons for transplantation were noted, and no acute graft rejection occurred. Maternal complications noted were mild renal insufficiency, chronic hypertension, pregestational diabetes, and erythema nodosum. Antepartum complications included oligohydramnios, preterm labor, premature rupture of membranes, severe preeclampsia, fetal growth restriction, multiple congenital anomalies, and intra-amniotic infection. There was one miscarriage at 8 weeks, one previable and one periviable delivery, and the remainder delivered after 34 weeks. In our cohort of patients, once fetal viability was achieved, patients with a prior liver transplant had reasonable maternal and neonatal outcomes.
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PMID:Obstetrical and neonatal outcome in pregnancies after liver transplantation. 1114 11

A case of gravid uterus in an incisional hernia is reported. The pregnancy was further complicated by intrauterine growth restriction, oligohydramnios and pregnancy induced hypertension. The management of the case is discussed.
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PMID:Gravid uterus in an incisional hernia. 1139 42

In spite of active perinatal management, twin-twin transfusion syndrome (TTTS) remains a severe disease with a high risk of neonatal mortality and morbidity. TTTS initially results from an unbalanced blood flow from a donor to a recipient twin. However, its pathogenesis remains unclear, although cardiovascular disturbances and regulation of fetal volemia and diuresis seem central in this syndrome. Previously, we demonstrated that the renin-angiotensin system (RAS) was up-regulated in donor twins as a consequence of hypovolemia, and down-regulated in recipients. This was the first evidence of the implication of the RAS in TTTS. We hypothesize that the RAS plays a key role in the pathogenesis of TTTS. In the donor, RAS up-regulation aggravates oligohydramnios and may increase arterial resistance, which could contribute to placental dysfunction leading to intrauterine growth restriction. In the recipient, paradoxical RAS activation, due to transfer of effectors such as angiotensin II through placental shunts, could explain fetal vascular disturbances and cardiomyopathy. According to our hypothesis, TTTS would appear similar to the classical model of hypertension referred to as '2 kidneys-1 clip' with a donor twin, comparable to the clipped kidney, intoxicating its cotwin, comparable to the normal kidney.
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PMID:Pathogenesis of twin-twin transfusion syndrome: the renin-angiotensin system hypothesis. 1139 88

In India, maternal and child deaths account for 60% of total mortality. Reductions in maternal mortality require the identification of all pregnant women in the community, prenatal care, the early detection of medical problems and pregnancy-related complications, tetanus toxoid immunization, identification of the most appropriate setting for delivery, prevention of maternal malnutrition, and motivation to practice breastfeeding and birth spacing in the postpartum period. To reduce child mortality, infants should be breastfed, immunization against common infectious diseases should be provided, and growth should be monitored at regular check-ups. As part of the village health worker's regular household visits, pregnant women should be motivated to seek prenatal care. Ideally, there should be a prenatal visit monthly for the 1st 7 months of pregnancy, once every 2 weeks until 36 weeks, and weekly thereafter. If long distance from a medical facility or the loss of wages make this impossible, there should be at least 4-5 visits at the 10th, 20th, 30th, 35th, and 35th weeks of gestation. Care should be taken to identify the major factors in high-risk pregnancies: moderate to severe toxemia, chronic hypertension, significant rental or heart disease, hydramnios or oligohydramnios, and uterine rupture. In areas where financial and human resources in the primary health care sector are limited, inputs should be targeted to high-risk groups and activities of preventive and therapeutic value that are most cost- effective. All interventions should be based on a thorough analysis of the major determinants of mortality, the incidence of specific diseases, the responsiveness of diseases to available technologies, the community's nutritional status, and the cultural milieu. Rather than create new schemes and categories of workers, existing health facilities should be fully utilized.
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PMID:Strategies for promoting child health. 1231 87


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