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

The authors studied 43 cases of arterial hypertension in pregnancy in an attempt to determine the efficiency and safety of different anti-hypertensive drugs. The patients were divided into two major groups: arterial hypertension which revealed itself during pregnancy (true toxaemias of pregnancy and relapsing toxaemias), and arterial hypertensions which were added on to a pre-existing pathology (arterial hypertension, diabetes, chronic nephritis). The cases in these different classes were then divided into two definite groups according to the need for therapy: the first group was treated by rest and hydrallazine as a single therapeutic agent. In the second group multiple agents were needed because of the arterial hypertension, and one was a beta-blocker. Complications were found particularly in the second group of true toxaemias of pregnancy where unfortunately 5 fetal deaths occurred that were attributable to the severity of the hypertension more than to the beta-blockers, which were administered for longer and in higher doses without major complications in recurrent toxaemias and pre-existing arterial hypertension cases.
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PMID:[The influence of present therapeutic methods and especially of beta-blockers on fetal and maternal prognosis in hypertensive syndromes in pregnancy. 43 case records (author's transl)]. 3 53

The relation of perinatal mortality to plasma-urate concentrations and blood-pressure was studied in 332 pregnant patients with hypertension. Perinatal mortality was markedly increased when maternal plasma-urate concentrations were raised, generally in association with severe pre-eclampsia of early onset. Plasma-urate was a better indicator than blood-pressure of prognosis for the fetus. Maternal hypertension, even severe, without hyperuricaemia, was associated with an excellent prognosis for the fetus. Conversely, when maternal hypertension was mild and hyperuricaemia was severe, the prognosis for the fetus was poor. These findings suggest that, in terms of fetal health, changes in renal handling of urate may be a more important feature of pre-eclampsia than the hypertension.
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PMID:Plasma-urate measurements in predicting fetal death in hypertensive pregnancy. 5 13

Concurrent hypertension in pregnancy alters the diagnosis and prognosis of both the vascular disease and the gestation. Insight into the physiologic and pathophysiologic changes is essential to assessing the patient's status and to determining what antenatal care may yield the best outcome of the pregnancy. In this monograph we have presented (1) a classification, which correlates well with those currently in use, of the types of hypertension and their causes; (2) a brief review of current fact and theory regarding the effect of hypertension on maternal and perinatal morbidity and mortality; (3) a detailed approach to monitoring the physical and laboratory parameters of the parturient; (4) a rational approach to monitoring the fetoplacental unit; and (5) an analysis of currently available therapeutic regimens that may alter the course of hypertension in pregnancy sufficiently to increase fetal salvage and decrease maternal complications. Certainly more research into the mechanisms of CHP will be forthcoming as will newer and more precise diagnostic aids. Pharmacologic agents with varied hypotensive actions are constantly being developed, and combinations of these may yield more beneficial results.
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PMID:Concurrent hypertension and pregnancy. 15 13

A total of 242 women with moderate hypertension in pregnancy completed a controlled trial of methyldopa (Aldomet). The hypotensive effect of methyldopa was similar to its action in non-pregnant individuals and greatly reduced the frequency of severe hypertension occurring antenatally and in labour. As pregnancy advanced, an increasing daily dose of methyldopa was needed and there was a greater use of additional hypotensive therapy. Seventeen (14-5 per cent) women assigned to methyldopa had to be transferred to another drug or had to stop treatment completely because of minor side effects, of which the commonest were lack of energy and dizziness. No serious side effects were encountered. Nine per cent of the untreated women developed severe hypertension which required treatment later in their pregnancies. Six weeks after delivery, nearly all the patients were able to stop treatment.
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PMID:Treatment of hypertension in pregnancy with methyldopa: blood pressure control and side effects. 32 59

Ten patients with hypertensive pregnancy were studied in hospital for 3 weeks. Plasma renin activity (PRA), the daily urinary excretion of aldosterone (dU-Aldo) and electrolytes were studied before and during dihydralazine therapy (25 mg 3 times daily). In one week the supine blood pressure decreased (p less than 0.05) without any discernible tachycardia. PRA increased in 3 days of the treatment by 50% (p less than 0.05) and this mean level was maintained. In dU-Aldo no change was found, however, during the study; and the excretions of sodium and potassium remained unchanged as well. In patients without diuretic therapy the basal PRA level before dihydralazine therapy was lower than in normal pregnancy. Also, in patients with preceding diuretic therapy the basal level of PRA was lower than during diuretics in gravidas without hypertension. Judging from the animal experiments, the rise in PRA might be seen as favorable for uteroplacental circulation in pregnancy hypertension.
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PMID:The renin-aldosterone system in dihydralazine therapy during hypertensive pregnancy. 36 99

The concentrations of the vasoactive substance, 5-hydroxytryptamine (5-HT), were estimated in whole blood samples from 12 pregnant women with hypertension in the third trimester. These were compared with a control group of 15 normotensive pregnant women of the same gestation. The hypertensive patients were admitted for observation and the whole blood 5-HT estimated again after four days bed rest: in all patients the blood pressure had, by this time, returned to within the normal range. No significant difference was found between the mean blood 5-HT concentrations of the hypertensive and the normotensive groups. A small, but not statistically significant, rise occurred in the hypertensive group after four days bed rest. Thus this study gave no evidence that 5-HT is implicated in hypertension in pregnancy.
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PMID:The possible relation between late pregnancy hypertension and 5-hydroxytryptamine levels in maternal blood. 46 98

The authors have carried out research in 58 cases to see whether the findings of high uric acid levels in the blood are of prognostic value in all cases of arterial hypertension in pregnancy whatever the aetiology. The material studied consisted of 30 true cases of toxaemia of pregnancy, 13 cases of recurrent toxaemia and 15 cases of the vasculo-renal syndrome on top of the pre-existing pathological condition. In 37 cases where the blood uric acid level was lower than 300 micromoles there were only 4 minor complications. Serious complications were found in 6 cases in which the patients had a blood uric acid level highthan 480 micromoles. This study confirms the prognostic value of blood uric acid levels. The estimation of these levels, however, seems to be of less value in making a differential diagnosis between the various kinds of toxaemia and hypertension found in pregnant women due to different aetiologies.
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PMID:[The prognostic value of raised uric acid in the blood in arterial hypertension in pregnancy. 58 cases (author's transl)]. 47 19

The role of plasma volume in hypertension in pregnancy (pre-eclampsia) was investigated. Significant volume expansion from non-pregnant levels (16.5 +/- 1.60 ml/cm height) was present throughout pregnancy in 189 normal women, reaching 23.1 +/- 1.21 ml/cm at 33-36 weeks amenorrhoea. In another 40 initially normotensive pregnant women who developed hypertension, similar early volume expansion was followed by significant volume contraction in the third trimester, before evaluation of blood pressure in 29 (20.6 +/- 1.26 ml/cm), after it in 11 (18.6 +/- 1.27 ml/cm). Equivalent volume contraction was present in another 44 women studied only after hypertension developed in the third trimester. Oedema had no value as a clinical sign. In another 30 women with chronic hypertension, blood pressure was inversely related to plasma volume (r = 0.822) and to fetal growth (r = -0.710), which was directly related to plasma volume (r = 0.701). Plasma volume depletion plays a significant role in hypertension in pregnancy.
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PMID:Plasma volume contraction: a significant factor in both pregnancy-associated hypertension (pre-eclampsia) and chronic hypertension in pregnancy. 53 21

This study demonstrates that uric acid serum levels are of importance in the prognosis of pregnancy complicated by hypertension. In early pregnancy the uric acid level probably is the most sensitive parameter to select the risk-prone pregnancies with EPH-gestosis to conduct the further course of pregnancy under medical care. Pregnant hypertensives with high uric acid levels develop more often retardation of the fetus, the incidence of eclampsia increases. In case of hypertension in pregnancy complicated by high uric acid levels careful monitoring and normalizing high blood pressure under medical observation improves the prognosis for fetus and mother.
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PMID:[The clinical significance of hyperuricemia for the prognosis of pregnancy toxemia]. 62 Sep 63

Aspects of primary or secondary hypertension in relation to oral contraceptive use and pregnancy are discussed. Possible mechanisms of oral contraceptive-induced secondary hypertension and contraindications to the pill are listed. Hypertension as a contraindication to pregnancy is weighed in relation to sterilization and cases of term pregnancies in hypertensive patients are cited. Misdiagnosis of secondary hypertension as toxemia in most pregnant patients with elevated blood pressure is characterized in a review of a clinical study involving 4273 patients (Table 1). A method for differential diagnosis of hypertension in pregnancy which includes ophthalmoscopic examination and urinalysis is outlined (Figure 1). Suggested treatment for the pregnant patient with hypertension is a low sodium diet for the first 20 weeks of pregnancy followed by the stepped care program (Figure 2). The most desirable therapy for pregnant women with toxemia are diuretics during the early pathological phase (sodium retention and edema) with edema in the periorbital areas and hands as diagnostic indicators for this phase. The efficacy of diuretics (alone or combined with hypotensive agents) in hypertensive patients is evaluated with regard to maternal and fetal risks. Indications for termination of pregnancy or induction of labor in hypertensive or toxemic women are summarized.
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PMID:Contraception and pregnancy in the young female hypertensive patient. 62 59


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