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

The maternally perceived fetal movements counts of 273 hypertensive patients were compared to normal controls and their degree of fetal activity was related to perinatal outcome. Pregnancy induced hypertension was associated with fetal activity which was significantly lower than controls at the beginning of the third trimester and significantly higher at term. In cases of chronic hypertension patients, 8 had cessation or marked reduction of fetal movements to less than 4 in 12 hours, and all had poor fetal outcome. The remaining 265 hypertensive patients had a 92% incidence of good fetal outcome. Markedly reduced fetal movements in hypertensive patients are highly suggestive of fetal distress and following verification by additional tests the appropriate clinical measures should be undertaken.
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PMID:Fetal movements in hypertensive pregnancies. 386 55

To evaluate the incidence and the foetal effects of gestational hypertension, we studied 2 996 pregnancies with a single live birth in mothers selected on the basis of 1) a documented diastolic blood pressure (DBP) less than 90 mmHg before the 16th week of amenorrhea and 2) no history of hypertension or kidney disease. In 38,4% of the gravidas, the highest DBP during pregnancy was greater than or equal to 90 mmHg, and in 15,4% this level was reached twice or more. Gestational hypertension (two DBP readings greater than or equal to 90 mmHg) was more frequent in nullipara than in mothers with previous pregnancies (17,9 versus 12,4%, p less than 0,01) and its incidence tended to decrease with increasing maternal age. Irrespective of parity or maternal age, a significant increase in the percentage of small for gestational age infants was associated with increasing DBP levels: 3,2, 6,4 and 8,5% when the highest recorded DBP was less than 90 mmHg, equal to 90 mmHg (even at one single reading), or greater than or equal to 100 mmHg respectively (p less than 0,001). Very similar percentages were obtained in non-proteinuric pregnancies: 3,3, 6,5 and 7,8 respectively (p less than 0.001). Non-proteinuric gestational hypertension, even mild or transitory, is indicative of a high risk pregnancy and requires close medical supervision.
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PMID:[Incidence and fetal impact of hypertension in pregnancy: study of 2996 pregnancies]. 681 Aug 28

The diagnosis of preeclampsia is often erroneous in primigravidas and usually so in multiparas. Gestational hypertension, defined as acute hypertension without proteinuria or abnormal edema, is often misdiagnosed as mild preeclampsia. Several follow-up studies are cited as evidence for the conclusions that (1) eclampsia and "true" preeclampsia seldom if ever cause chronic hypertension in women who otherwise never would have developed it; (2) gestational hypertension often is a sign of latent essential hypertension unmasked by pregnancy, and as such it often portends later chronic hypertension; and (3) normotensive pregnancies indicate a low prevalence of later chronic hypertension, and if it does develop, it usually does so at an age later than the average time of onset.
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PMID:The remote prognostic significance of the level of blood pressure in pregnancy. 700 Apr 71

The clinical diagnosis of preeclampsia is often erroneous, for it may be confused with latent hypertension, acute or chronic renal disease, or frank essential hypertension that had abated during much of pregnancy. Eclampsia and "true" preeclampsia run in families with a frequency suggesting that a single recessive gene may be responsible. Eclampsia and "true" preeclampsia do not cause chronic hypertension, whatever their durations. Gestational hypertension is merely hypertension without proteinuria or abnormal edema. It often has been the basis for the diagnosis of mild preeclampsia, although renal biopsy samples almost never show the characteristic lesion in the absence of proteinuria. Gestational hypertension is often a sign of latent hypertension unmasked by pregnancy. Women with gestational hypertension ultimately have a high prevalence of chronic hypertension, whereas all those whose pregnancies are normotensive ultimately have a low prevalence.
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PMID:Hypertension in pregnancy: definitions, familial factor, and remote prognosis. 700 1

Pregnancy induced hypertension (PIH) is a common complication in pregnancy and prenatal stage. Because the direct and indirect relationship between low calcium intake and many diseases, such as rachitis, young age myopia and hypertension, calcium supplementation has been a hot topic among nutritionists. Randomized trials of calcium supplementation during pregnancy were conducted in 212 healthy primipara. They were divided into 4 groups and gave 120mg, 240mg, 1g or 2g of calcium daily from 20 to 28 wks of gestation up to delivery respectively. As a result, the incidence of PIH was 8.9%, 7.5%, 8% and 4% respectively in these groups. The control group (106 pregnant women) who did not receive calcium gave an incidence of 18%. Supplementation of 2g of calcium daily showed significant results in lowering the incidence of PIH (P < 0.05) without any adverse effects. In 1992 calcium supplementation was widely used in antenatal-clinic. 200 cases with intake of 2g calcium were compared with corresponding non-calcium supplementation cases, and the incidence of PIH was 7.5% and 16.5% (P < 0.005) respectively. Mediating parathyroid hormone and renin activity are thought to be the effect of calcium on decreasing the incidence of PIH.
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PMID:Calcium supplementation during pregnancy for reducing pregnancy induced hypertension. 771 43

This is the first report of the largest study of blood pressure measurement in pregnancy in a New Zealand population using standardized definitions and methodology. Over 3,800 women who delivered in an 8-month period in the Wellington region were included in the study. Blood pressure measurement and the presence of oedema and proteinuria were recorded from booking until delivery and in the puerperium. Only 2.7% of women were unable to be contacted after delivery for details on outcomes. The results established normal ranges for blood pressure throughout pregnancy. The data show that blood pressure greater than 140/90 until 35 weeks' gestation is outside 2 standard deviations at all gestations and justifies using these measurements as the definition of hypertension in pregnancy. The fall in blood pressure in the 2nd trimester was less than 1 mm Hg per week in both the systolic and diastolic pressures. This fall was smaller than previously recorded in other studies. Gestational hypertension was the commonest blood pressure abnormality occurring in 15.2% of the population. This represented 69% of the pregnant women with a hypertensive disorder. The overall incidence of both gestational hypertension and preeclampsia was 18.5% which is higher than reported in other parts of the world. In this study obesity was significantly associated with hypertensive disorders in pregnancy. An arm circumference of > 33 cm, one of the measurements of obesity, was found in 6.8% of the study population. Even after the effect of arm circumference was taken into account, hypertensive disorders were also more common in Pacific Island women.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Measurements of blood pressure, oedema and proteinuria in a pregnant population of New Zealand. 777 96

Pregnancy-induced hypertension and preeclampsia are relatively common in nulliparous, inner-city, African-American, pregnant women and contribute to considerable maternal, fetal, and neonatal morbidity and mortality in that population. Recently, insulin resistance has been related to the development of hypertension in young African-Americans and hyperinsulinemia and elevated insulin-to-glucose ratios, suggesting insulin resistance, have been demonstrated in women with preeclampsia. To investigate whether insulin resistance existed postpartum and, therefore, independently of the pregnant state, the hyperinsulinemic, euglycemic technique was used 3 to 6 months postpartum to assess insulin sensitivity in 10 young, black, primiparous, inner-city women with recent preeclampsia and seven age-, weight- and body-mass-index-matched black women with healthy pregnancies. The age, weight, body-mass index, waist-to-hip ratio, the duration since parturition, and fasting plasma glucose and insulin were similar in the preeclamptic and control groups. During the clamp procedure, the insulin levels and mean diastolic blood pressure and mean arterial pressure were also similar for both groups; however, the mean systolic blood pressure of the preeclamptic group (123 +/- 3 mm Hg) was higher than that of the control group (114 +/- 2 mm Hg) (P < .05). Insulin-stimulated glucose disposal was not different between the preeclamptic (5.6 +/- 0.3 mg/kg/min) and control groups (5.7 +/- 0.7 mg/kg/min). This suggests that the elevation in postpartum systolic blood pressure may reflect a persistent abnormality of blood pressure homeostasis which is not associated with insulin resistance.
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PMID:Postpartum blood pressure and insulin sensitivity in African-American women with recent preeclampsia. 782 58

Pregnancy-induced hypertension (PIH) is a placental disease that mainly occurs in primigravidae, but its precise etiology is not yet known. It has long been considered that the protective effect of multiparity may be due to immunological factors. Here, we review epidemiologic data from the literature supporting the idea of a possible immunological basis of PIH. There are conflicting reports in the literature regarding the involvement of cellular and humoral mechanisms in the etiology of PIH, the impact of histocompatibility and the interactions between maternal and fetal genotype. Finally, the evidence for a common immunologic cause for pregnancy-induced hypertension and miscarriage is discussed.
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PMID:[The role of immunologic factors in the etiology of pregnancy-induced hypertension]. 787 59

To investigate the use of uterine artery flow velocity waveforms in predicting gestational hypertension (GH), preeclampsia (PE) and intrauterine growth retardation (IUGR), Colour Doppler ultrasound of the uterine arteries was performed at 19-24 weeks gestation in 51 women with known renal disease. On four consecutive waveforms, peak systolic (A), end-diastolic (B) and early diastolic (C) velocities were measured. Resistance index (RI) was calculated as (A-B)/A, and the severity of the waveform notch expressed as the AC ratio (A/C). Gestational hypertension was defined as a blood pressure (BP) > or = 140/90 mmHg with an increase of at least 15 mmHg in diastolic BP. PE included women with gestational hypertension and proteinuria > 300 mg/24 h or a doubling of early gestation protein excretion. IUGR was defined as a birthweight less than the 10th percentile for gestation. RI and/or AC ratio in 14 women (27%) exceeded the 90th percentile for gestational age of our low risk control population. Of the women with an abnormal test, 11 (79%) developed complications, 8 (57%) developed GH or PE, 3 (21%) IUGR alone, 2 (14%) GH and IUGR, and in one women intrauterine fetal death of an IUGR infant occurred, and 3 (21%) had an uncomplicated pregnancy. Of the women with a normal test, 34 (92%) had an uncomplicated pregnancy, and only 3 (8%) developed GH or IUGR. In summary, uterine artery waveform indices at 19-24 weeks gestation may be useful for the prediction of pregnancy complications in woman with underlying renal disease.
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PMID:Uterine artery waveform as a predictor of pregnancy outcome in women with underlying renal disease. 788 99

Pregnancy-induced hypertension affects at least 10% of all pregnancies. An association with first pregnancy or a change in paternity for subsequent pregnancies has been suggested. We studied the duration of sexual cohabitation with the father prior to conception and the incidence of pregnancy-induced hypertension. During a five-month period, 1011 consecutive women who delivered in an obstetric unit were interviewed about paternity and duration of sexual cohabitation before conception. Obstetric charts were abstracted to identify three groups: those with pregnancy-induced hypertension, chronic hypertension, and normal blood pressure. The incidence of pregnancy-induced hypertension was 11.9% among primigravidae, 4.7% among same-paternity multigravidae, and 24.0% among new-paternity multigravidae. For both primigravidae and multigravidae, length of sexual cohabitation before conception was inversely related to the incidence of pregnancy-induced hypertension (p < 0.0001). Similar results were observed after control for race, education, maternal age, marital status, and number of pregnancies. Pregnancy-induced hypertension may be a problem of primipaternity rather than primigravidity. Furthermore, an extended duration of sexual cohabitation before conception may protect against pregnancy-induced hypertension.
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PMID:Association of pregnancy-induced hypertension with duration of sexual cohabitation before conception. 859 45


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