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

Oocyte donation was applied initially to women with hypergonadotrophic hypogonadism or 'premature menopause'. Later, therapy was extended to recipients > 40 years old and to post-menopausal women. In all cases, enhanced implantation and pregnancy rates were obtained by many investigators. Post-menopausal women must be informed about in-vitro fertilization results, obstetric risks for themselves and their newborn babies. They must be screened and investigated as accurately as possible for any existing medical contraindication. Results are encouraging because these patients become pregnant as easily as young donors, with pregnancy rates of 58, 34.6 and 37.9% per patient, per synchronization cycle and per transfer respectively. Abortion rates (5%) are very low considering the women are > 45 years old. The post-menopausal uterus can sustain implantation, grow and carry pregnancy to term and reduce adequately after labour. The incidence of maternal morbidity during pregnancy is less encouraging. A higher incidence of pregnancy-related diseases, e.g. gestational diabetes, hypertension, moderate and severe pre-eclampsia have been reported.
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PMID:Counselling post-menopausal women for donor in-vitro fertilization and hormone replacement therapy. 765 73

Cushing syndrome in pregnancy is rare. This is explained by the syndrome's association with amenorrhoea, oligomenorrhoea, infertility and abortions. Cushing syndrome commonly presents with hypertension, weight gain, diabetes, striae or truncal obesity, all of which can be consistent with pregnancy in women without Cushing syndrome. We describe a case of Cushing syndrome in pregnancy secondary to an adrenal cortical tumour which was discovered after an abnormal glucose tolerance test. The woman developed classical features of Cushing syndrome including gestational diabetes and hypertension and was managed successfully to term after a unilateral adrenalectomy at 23 weeks. The case is reported not only because of its rarity but also because the diagnosis was made after a routine screening test for gestational diabetes. Early diagnosis and treatment of adrenal adenoma causing Cushing syndrome in pregnancy reduces maternal and fetal morbidity and mortality.
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PMID:Cushing syndrome in pregnancy secondary to an adrenal cortical adenoma. 767 97

70 women with previous (1983-1993) history of gestational diabetes mellitus (GDM) were examined in order to assess their present carbohydrate metabolism. The through examination together with oral glucose tolerance test (OGTT) according to WHO were performed. Also the level of glycosylated hemoglobin HbA1c was measured. The following risk factors were analysed: obesity; arterial hypertension; family history of diabetes; number of past pregnancies; time that passed since the pregnancy with GDM; trimester in which GDM was diagnosed. In result 54% of all subjects were diagnosed as having diabetes mellitus, 19% had impaired glucose tolerance (IGT). The presence of diabetes or IGT significantly correlated with the number of past pregnancies, observation time and indirectly with family history of diabetes. Using both measurements of fasting blood glucose and glycosylated hemoglobin enables to diagnose nearly 80% of diabetes following GDM and as a diagnostic method is worth recommending for screening. Women who had GDM should be subjected to control examinations towards diabetes mellitus at least once a year.
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PMID:[Evaluation of carbohydrate metabolism in women with previous gestational diabetes mellitus]. 778 56

Our objective was to study the influence of chronic hypertension on pregnancy outcome in women with gestational diabetes (GDM). 418 women with GDM (30 with chronic hypertension and 388 nonhypertensives) were referred to our diabetes in pregnancy program. All patients were followed and assessed biweekly until delivery. When hypertensive GDM women (n = 30) wer compared to all nonhypertensive GDM (n = 388), there were significant (p < 0.05) differences in mean maternal age (34 +/- 4.1 vs. 30 +/- 4.6 years), maternal weight (90 +/- 21.2 vs. 70.6 +/- 14.9 kg) and gestational age at delivery (38.5 +/- 1.2 vs. 39.6 +/- 1.2 weeks). The mean birth weight for the hypertensive GDM group was significantly higher than that of the nonhypertensive GDM (3,360 +/- 578 vs. 3,293 +/- 581 g; p < 0.05). The frequencies of LGA (23.3 vs. 9.8%) and induction prior to onset of spontaneous labor were significantly (p < 0.05) higher in the hypertensive GDM group when compared to the nonhypertensive GDM. There were no differences with respect to the average blood glucose and frequencies of SGA deliveries. However, when the 30 hypertensive GDM pregnancies were compared to a control group of 60 nonhypertensive GDM women matched for age, weight and height, the only significant difference was a higher rate of inductions of labor (36.7 vs. 6.6%, p < 0.05) in hypertensive diabetic women. There were no significant differences in the incidence of LGA, low Apgar scores and SGA deliveries when hypertensive GDM were compared to nonhypertensive GDM women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic hypertension in gestational diabetes: influence on pregnancy outcome. 778 11

All fetuses benefit from ultrasonographic estimation of gestational age and evaluation of growth patterns. Monitoring the pregnancies of obese women is perceived as more difficult than monitoring those of nonobese women. The aim of this study was to determine if maternal obesity affects the growth and Doppler resistance indices (RI) of the fetus. Twenty-eight women with a preconception weight > 90.7 kg underwent obstetric ultrasonographic evaluations from the 20th week of gestation. Their ultrasonographic data were compared with those of controls. Ten of the obese women developed gestational diabetes and had lower umbilical artery RIs for a given gestational age (P < .0001) than did those obese women without other medical complications, those with medically controlled pregnancy-induced hypertension or those from the control population. The relation between fetal unit weight and umbilical artery RIs was established. The pattern of RI changes was similar in all groups when estimated fetal weight instead of gestational age was used as the covariant. Fetal growth and Doppler velocimetry can be monitored adequately in obese women. Gestational diabetes significantly influences the pattern of fetal growth and the impedance to flow in the umbilical artery.
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PMID:Ultrasonographic growth and Doppler hemodynamic evaluation of fetuses of obese women. 780 81

During 1990-1991 in Ada-a district, Ethiopia, female secondary school students and 2 health assistants interviewed and took height, blood pressure, and urine albumin measurements of 567 pregnant women living in 15 urban kebeles and 293 rural villages. Researchers wanted to determine the extent of high risk pregnancies. 28.6% of the pregnant women were in a high risk age group (i.e., 15-19 years and 35-49 years). 85% married when they were younger than 20. The illiteracy rate was 39.2%. 42.9% had a very low income. 45.1% were either nulliparous or multiparous (5 pregnancies). 13.1% had experienced infant death. 14.6% had had an abortion. 1.4% had a history of still-births. 6.3% had a history of postpartum hemorrhage. 1.1% had suffered antepartum hemorrhage with a previous pregnancy. 52.3% did not receive prenatal care. 11.5% had protein in their urine. 9.2% had gestational diabetes. 18.5% were too short. 12.2% had high diastolic blood pressure. 2.9% had pre-eclampsia, all of whom lived in urban areas. 9.2% had gestational hypertension. 85% of all pregnant women had at least 1 risk factor and therefore were considered as high risk pregnancies. These findings suggest the need for an improved social environment, appropriate training of community health workers, and strengthening maternity services, including family planning services.
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PMID:High-risk pregnancies in urban and rural communities in central part of Ethiopia. 782 Dec 47

Cord blood samples were estimated for serum fibronectin (Fn) by immunoelectrophoresis (IE) and enzyme linked immuno sorbent assay (ELISA) in 250 newborn healthy and sick infants classified into 6 categories: i.e., term appropriate for date (TAFD), preterm appropriate for date (PTAFD), term small for date (TSFD), preterm small for date (PTSFD), birth asphyxia (BA) and septicemia (SEP). TAFD infants were assayed for plasma Fn in addition. Comparison of Fn levels in the different groups by the Wilcoxan rank sum test indicated no significant difference between term and preterm infants, between PTAFD and PTSFD, TAFD and TSFD and in infants with and without birth asphyxia. Babies with septicemia had a significantly (P < 0.01) lower Fn level (29.97 +/- 29.03 mg/l) than those with no septicemia (42.77 +/- 30.20 mg/l). TAFD infants had Fn levels (serum 41.44 +/- 31.08 mg/l, plasma 85.20 +/- 33.38 mg/l) that are less than half the levels reported in the Western literature for newborn term infants. A possible cause could be the associated medical problems in mothers as 41 per cent of mothers of TAFD infants had conditions such as pregnancy induced hypertension, gestational diabetes, rheumatic heart disease, infection etc.
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PMID:Fibronectin levels in Indian neonates in health & disease. 792 72

To determine the perinatal impacts of one abnormal oral glucose tolerance test (GTT) value, we conducted a retrospective study of pregnancy outcome in our population. Pregnant women (4314) were screened for gestational diabetes (GDM) between 24 and 32 weeks with the 50-g glucose challenge test and 183 were directly tested with the 100-g GTT. The subjects who had a serum glucose value equal or greater than 7.8 mmol/L 1 h after a 50-g glucose challenge were scheduled for a 100-g GTT (904). Another 32 subjects, who were not screened, were found to have gestational diabetes identified by repeated fasting and postprandial serum glucose measurements. Retrospectively, the study population was divided in four groups: I, normal (4138); II, GDM (237); III, subjects with one abnormal GTT value treated like GDM (85); IV, subjects with one abnormal GTT value untreated (69). Patient characteristics of groups II, III, and IV were similar. The area under the glycemic curve was similar between groups III and IV and was statistically inferior to that of Group II. GTT periodicity was the greatest in group II. Group II showed a higher rate of delivery before 37 weeks, of chronic and pregnancy induced hypertension, and of cesarian section but groups III and IV were not statistically different from group I.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Glucose tolerance test during pregnancy: the significance of one abnormal value. 800 Dec 92

In order to assess the clinical consequences of gestational diabetes in the index pregnancy, a group of patients with positive oral glucose challenge test and their matched controls have been closely followed up. No differences in perinatal outcome have been pointed out, except for the higher rate (p < 0.01) among diabetic patients of preterm delivery and pregnancy-induced hypertension. The prevalence of the latter has shown no relationship to maternal obesity. In view of these data, the future risk of cardiovascular disease of this cohort of patients needs to be assessed with a follow-up study.
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PMID:Does gestational diabetes represent an obstetrical risk factor? 805 Jul 27

Overweight is associated with a higher risk of cardiovascular and metabolic disease. Pregnancy in obese women frequently results in an increased incidence of maternal complications (gestational diabetes, hypertension, toxemia) and adverse perinatal outcome (macrosomia, perinatal mortality). Cesarean deliveries are also more frequent in obese women, mainly because of cephalopelvic dysproportion due to macrosomia. Optimal treatment for gestational diabetes is difficult to achieve, although hyperglycemia further impairs maternofoetal prognosis. The incidence of intrauterine growth retardation is not increased in obese pregnancy. A successful obstetrical outcome may be achievable through multidisciplinary antenatal management.
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PMID:[Obstetrical complications of maternal overweight]. 819 42


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