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

Total cortisol levels were measured in 81 samples of amniotic fluid obtained from 72 patients in the third trimester of pregnancy; 19 of them had pre-eclampsia and the remainder had no pre-eclampsia, hypertension or renal disease. In accordance with previous studies, there was a rise in the concentration of amniotic fluid cortisol with advancing gestation; the rise was steepest after 40 weeks, the amniotic fluid cortisol levels invariably being above 700 nmol/l between 41 and 43 weeks of pregnancy. Amniotic fluid cortisol may thus be of value in diagnosing postmaturity. A relatively low correlation was found between total cortisol levels and lecithin/sphingomyelin ratios in amniotic fluid unless results were ranked for gestational age. Total cortisol concentrations in amniotic fluid obtained from patients with pre-eclampsia were significantly higher than in controls. The concentration of free cortisol in amniotic fluid changed much less than total cortisol. Thus total cortisol should be measured in studies of the fetal capacity to synthesize corticosteroids.
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PMID:Total and free cortisol in amniotic fluid during late pregnancy. 65 49

One hundred and ten women conceived 143 times following induction of ovulation by gonadotrophins. The abortion rate was 21 per cent. Some bleeding occurred in 38-7 per cent of pregnancies and 54 per cent of them ended in abortion. For the 112 pregnancies reaching 20 weeks, the multiple pregnancy rate was 26-8 per cent (21 twins, 5 triplets, 3 quadruplets and 1 sextuplet). Hypertension was present in 8-9 per cent of patients and in 3-3 per cent of those with multiple pregnancy. The length of gestation was related to the number of fetuses at birth and postmaturity did not occur. The Caesarean section rate was 32-1 per cent. The birth weight of the infants was normal and the male to female sex ratio was 0-64 for singleton births and 0-78 for twins. The fetal loss was 15-9 per cent (7-1 per cent for pregnancies of over 28 weeks). Growth and development of the children were apparently normal. The incidence of all congenital malformations was 7 per cent.
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PMID:The outcome of pregnancy after gonadotrophin therapy. 100 34

Seven hundred sixty-seven oxytocin challenge tests (OCT) were performed on 333 high-risk maternity patients. All of the patients had pregnancies complicated by diabetes mellitus, suspected postmaturity, preeclampsia, intrauterine growth retardation, hypertension and other disorders. In conjunction with OCT, 24-hour urinary estriol determinations were performed. Negative OCT's were reassuring for fetal well-being. There were 26 positive OCT's on 24 patients. A positive test was significant in identifying endangered fetuses existing in a markedly unfavorable environment. In our experience, we found the OCT more reliable and more predictable than urinary estriol determination. The oxytocin challenge test proved to be significant in the successful management of these 333 high-risk patients.
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PMID:Oxytocin challenge test in high-risk pregnancy. 125 May 37

122 cases of high risk pregnancies, consisting of mainly pregnancy-induced hypertension (PIH), medical complications, postmaturity and suspected distress were periodically monitored with 11 biophysical and biochemical assays. Positive prediction accuracy rate was analyzed with a neonatal UA pH less than 7.20 as the criterion of fetal hypoxia and ischemia. A number of predicting items together, namely: NST, the other Manning's 4 items, internal monitoring with abnormal Cardiotocography, meconium deeply stained amniotic fluid, FBS pH less than 7.2, uterine contraction time lasting greater than 37 sec and interval shorter than 70 sec, gave the best sensitivity, specificity, positive and negative prediction rates and total accuracy rate of 71.69%, 84.06%, 77.55%, 79.45% and 78.68% respectively. The causes for false positive and false negative cases were discussed. Special attention must be paid to those cases with low UA pH al though normal Apgar scores during the neonatal period.
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PMID:[Early diagnosis of fetal distress and neonatal asphyxia]. 191 52

The obstetric outcome of 1328 deliveries in a tertiary level hospital was examined, focusing on the results of the women over 35. The study group were all pregnant women over 20 primarily cared for and delivered at the New York Hospital-Cornell Medical Center from September 1984- February 1985, excluding those transferred from other institutions for complications. Among the older women, there was a higher incidence of previous abdominal operations, cesarean sections, previous perinatal death, infertility and alcohol abuse, but relatively few had comorbid conditions or obesity. Most were of higher socioeconomic status and had private physicians. The older group tended to begin prenatal care early, and elect to have amniocentesis. They had a higher risk of gestational glucose intolerance, hypertension and hospitalization during this pregnancy. 45% had cesarean delivery, and their hospital stays were longer. Their rates of vertex presentation, prematurity, postmaturity, macrosomia, induced or augmented labor were similar to those of younger women. There were no maternal deaths. The older group had 1 multiple birth, fewer than the younger women. Perinatal mortality was lowest in the older women. There was 1 intrauterine death and 1 congenital anomaly, lower rates than seen in younger women. This series demonstrates that women over 35 are not at greater risk of adverse pregnancy outcomes if they are cared for early and carefully.
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PMID:Impact of advanced maternal age on the outcome of pregnancy. 238 14

An open-label study was undertaken to assess the clinical impact of multiple doses of intacervical prostaglandin E2 (0.5mg) gel administered at 6-hour intervals. 50 women in Canada with low Bishop scores requiring induction of labor were recruited. The prestudy mean Bishop score was 2.3 +or-1.1 and changed significantly with 1 (p 0.001), 2 (p 0.001), and 3 (p 0.002) doses. The mean gestational age of patients receiving 3 doses was significantly less than that of patients receiving 1 dose, (38.5 versus 40.1 weeks, p 0.005). Prostaglandin E2 gel induced labor in 55% of patients, but 14% required subsequent oxytocin (Syntocinon) augmentation. Cesarean section was performed in 6% of patients. No deleterious fetal, neonatal, or maternal effects occurred. 80% of the study group fell into the categories of postmaturity, pregnancy-induced hypertension, and intrauterine growth retardation. There appeared to be a trend toward a higher mean change in Bishop score from 6 to 12 hours in the primiparous women, but a statistically significant difference was not achieved. Surgical amniotomy was performed in 25 patients after labor was established. 47 of the patients achieved vaginal delivery. 3 Cesarean sections were performed because of cord prolapse, fetal distress, and failure to progress. Postpartum hemorrhage occurred in 3 patients.
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PMID:Clinical utility of multiple-dose administration of prostaglandin E2 gel. 346 15

The outcome of pregnancy of 1303 women admitted for delivery (including those transferred after admission) at an isolated general practitioner maternity unit over the period 1978-85 was studied. The outcome following change of booking before admission was also assessed for the years 1982-85. The crude perinatal mortality rate was 1.5 per 1000 for all admissions between 1978 and 1985. Of the women admitted in 1978-85 7.4% were transferred after admission while for those booked at the unit in 1982-85 11.3% had their place of booking changed. A higher proportion of nulliparous women than multiparous women were transferred or had their place of booking changed. The main reasons for transfer after admission were delay in the first stage of labour (21.9%), spontaneous rupture of membranes not in labour (16.7%) and hypertension (15.6%), and for change of booking postmaturity (26.9%) and hypertension (16.4%).Sufficient information concerning risk of transfer and change of booking may now be available from studies of isolated general practice maternity units for pregnant women at low risk to make an informed choice of place for delivery.
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PMID:Outcome of women booked into an isolated general practice maternity unit over eight years. 350 38

Between November 1979 and April 1984, 790 consecutive pregnant women who considered themselves as having a "normal" pregnancy were followed in private practice from 9 weeks' gestation until 6 weeks post partum. The women had no pre-existing disease or problem classified as a risk to the pregnancy at the time of their first visit, had a singleton pregnancy and gave birth at Notre-Dame Hospital, Montreal. Maternal complications occurred during the course of pregnancy in 181 women (23%). Complications were mostly related to obstetric conditions (10%), such as preterm labour, intrauterine growth retardation (IUGR) and antepartum hemorrhage, or to medical conditions (12%), the most prevalent of which was hypertension (77% of medical conditions). Neonatal complications occurred in 183 infants (23%). The corrected perinatal death rate was 2.5 per 1000. Prematurity, IUGR and dysmaturity/postmaturity accounted for nearly half of the complications. Hyperbilirubinemia occurred in 7% of the cases. Among women without any maternal complications during pregnancy, the frequency rate of neonatal complications was 19%, compared with 23% among the entire group of 790 women. Our results suggest that the absence of maternal complications does not protect the infant from a neonatal complication. Further refinement is needed to identify markers of obstetric, medical and neonatal complications in pregnancies with no risk factors.
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PMID:Maternal and neonatal outcome in pregnancies with no risk factors. 365 44

Early and intensive intervention can have a profound impact on the quality of life for children at risk for autism. Hence a high degree of suspicion towards babies exposed to known risk factors is warranted. Previous studies have shown that different perinatal factors like antepartum bleeding, postmaturity, birth asphyxia, meconium aspiration syndrome, anaemia in early infancy and exposure to toxins of various origins makes an infant susceptible to development of autism; attention deficit hyperactivity disorder (ADHD) and other neurodevelopmental disorders in later life.This study aims to find out the association of perinatal risk factors in relation to development of autism spectrum disorders. All babies who are at least three years of age, attending the neurodevelopment and early intervention clinic at SSKM Hospital at Kolkata taken as cases. Age matched controls were taken from general paediatric OPD of the same hospital. After history taking, physical and neurological examination, developmental maturity was assessed by the Denver Developmental Screening Test (DDST) and Vineland Social Maturity Scale (VSMS). A semi-structured parent's questionnaire and the modified checklist for autism in toddlers (M-CHAT) was used to screen for autism. Diagnosis was confirmed by DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition, Text Revision) criteria. Significant correlation was found between presence of antepartum haemorrhage, pregnancy induced hypertension, preterm delivery and autism in the baby. Perinatal complications are important risk factor for autism. Knowing the risk factors will help clinicians to be aware of the avoidable complications, and to undertake either preventive steps or intense intervention to reduce the degree of disability.
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PMID:Perinatal complications associated with autism--a case control study in a neurodevelopment and early intervention clinic. 2374 15