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

Primary renal candidiasis and hydronephrosis were diagnosed in two premature neonates in whom systemic hypertension developed. The clinical course in these patients and in 16 patients with renal candidiasis described in the literature indicated that prematurity, use of broad-spectrum antibiotics, and use of intravenous (IV) catheters are predisposing factors. Anuria and flank mass were the initial manifestations in the reviewed cases. Only four of the 16 patients survived following either antifungal therapy or nephrectomy. Both of our patients survived after antifungal therapy with amphotericin B and flucytosine for systemic effect as well as topical instillation of amphotericin B solution via a nephrostomy. We believe that a high index of suspicion in infants at risk and early institution of antifungal therapy for systemic as well as topical effect can improve the outcome in infants with renal candidiasis.
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PMID:Primary renal candidiasis in two preterm neonates. Report of cases and review of literature on renal candidiasis in infancy. 647 53

A concern of the obstetrician is whether any single event or combination of events before delivery places a prematurely born infant at increased risk of developing periventricular-intraventricular hemorrhage, a form of intracranial hemorrhage in 40 to 45% of all low birth weight infants. In this three-year retrospective study, 103 infants weighing less than 1500 g and delivering on or before the 35th gestational week showed evidence of intraventricular hemorrhage by routine cranial ultrasound scan. The finding of maternal hypertension, vaginal bleeding, or preterm ruptured membranes was similar in infants with intraventricular hemorrhage and a matched group of infants without hemorrhage. Premature labor, breech presentation, mode of delivery, and outborn birth also were not significantly different between the two groups. The finding of intraventricular hemorrhage in the low birth weight infant is related less to any one or combination of two prior obstetric events than to extreme prematurity and accompanying neonatal complications.
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PMID:Obstetric care and intraventricular hemorrhage in the low birth weight infant. 688 17

1. Defining prematurity as applying to LBW infants of less than 37 weeks' gestation and classifying those LBW infants of greater than 37 weeks as having IUGR provides an improved means of analyzing different risk factors. 2. In accordance with the method of D'Angelo and Sokol, risk factors have been assigned to the various disease entities and social factors (8). 3. There is a suspicion in some disease entities, such as chronic hypertension, that prematurity is of equal frequency to IUGR, and in others, such as renal disease, that IUGR may not be increased at all, at least in term or near-term gestation. A reevaluation of the relationship of some disease entities to IUGR and prematurity is needed, probably in the sophisticated manner of Hoffman et al (15).
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PMID:Epidemiology of preterm delivery. 698 28

The Edinburgh Register of the Newborn 1964-1968 and the Edinburgh Scoliosis Clinic 1964-1971 have been used to establish the population frequency in the city of the idiopathic forms of talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile scoliosis. A survey of 165 patients now aged 7 to 11 years showed an aetiological relationship, but with differing environmental factors. These factors were established by comparison with the Edinburgh Register control group of 692 normal infants born over the same period, giving a unique opportunity to obtain more accurate antenatal data than has previously been possible. The principal associations were: talipes equinovarus with antepartum haemorrhage and maternal hypertension; metatarsus varus with twin pregnancies; congenital dislocation of the hip with first born children, older than average fathers, breech presentation, a significant lack of menstrual problems in the mother, and maternal upper respiratory infection during pregnancy; infantile idiopathic scoliosis with breech presentation, prematurity, and the onset of the curve in the winter months. No significant association with raised intrauterine pressure (hydramnios or oligohydramnios) was found among these simple idiopathic deformities. It is concluded that the multifactorial genetic background in likely to be similar in all, but that the additional environmental element is variable.
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PMID:Aetiology and interrelationship of some common skeletal deformities. (Talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile idiopathic scoliosis). 714 83

This prospective investigation attempts to determine whether the maternal recording of perceived fetal motion is useful for fetal assessment in pregnancies complicated by hypertension. During a 21 month period, 124 patients whose pregnancies were complicated by either chronic or pregnancy-induced hypertension participated. The number of perceived movements per hour (24 +/- 11, mean +/- S.D.) and evidence for fetal inactivity (7 cases, 6%) did not vary significantly from a control group of normotensive pregnancies (p greater than 0.05). Fetal inactivity was predictive of an unfavorable perinatal outcome in 6 of 7 cases, including the three stillborn infants. No perinatal deaths occurred among the 117 hypertensive pregnancies with active fetuses, and the 6 cases with an unfavorable outcome were associated with mild intrauterine growth delay, prematurity, or acute changes such as placental abruption or umbilical cord accidents. Realizing these limitations, a record of fetal inactivity is worthwhile in managing the pregnancy complicated by hypertension.
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PMID:Fetal activity patterns in hypertensive pregnancies. 718 63

Of 27.978 newborns delivered at the University Hospital Department of Gynecology and Obstetrics in Beogradu, from 1978 to 1980, 2218 (7.92%) were born by cesarean sections. Clinical-biochemical and morphological elements of hypoxic and ischemic CNS lesions were found in 107 (4.82%) cases out of the infants born by cesarean section and in 1301 (5.05%) cases out of the infants born by vaginal delivery. The difference is not statistically significant. Investigations of the causes, i. e. risk factors of CNS lesions in infants born by cesarean section, in correlation with the control group consisting of 670 cesarean sections performed in 1980 without CNS lesions, have revealed: a) high risk factor (p less than 0.01) appeared to involve parity (para III and more), maternal diseases (hypertension, diabetes mellitus, EPH gestosis), placenta praevia, premature rupture of the membranes, prematurity birth weight below 2500 g, and low Apgar score (1-7); b) significant risk factors (p less than 0.05) are some social factors (unemployed mothers and mothers from rural areas), duration of labor (more than 10 hours), transverse presentation, hydramnion, previous spontaneous abortions and stillbirths. The analysis has shown that CNS lesions in infants born by cesarean section may result from different factors; medical, biological, and social.
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PMID:[Analysis of causes of CNS damages in neonates delivered by cesarean section (author's transl)]. 734 21

Hypertension complicates 10-15% of pregnancies and is associated with an increased rate of fetal loss at all stages of gestation, intrauterine fetal growth retardation and prematurity, either because of spontaneous premature labour or of the occasional necessity for early delivery.
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PMID:Hypertension in pregnancy. 736 58

Hypertension in pregnancy probably has many causes. Increasing blood pressure carries an increasing risk to mother and fetus, particularly when associated with proteinuria and hyperuricaemia. Insufficient attention has been paid to a normal fall in diastolic blood pressure during early and mid-pregnancy; hence standards of normality need to be set. Antihypertensive treatment may reduce perinatal mortality and improve fetal and placental growth. Alpha- and beta-adrenergic blockers may be better than alpha-methyldopa. Pregnancy should be terminated as soon as risk from hypertension is greater than risk of fetal prematurity. Successful management depends upon a careful clinical, biochemical, and biophysical assessment of maternal and fetal condition and fetal maturity. Examination of amniotic fluid for surfactant, the use of dexamethasone to accelerate pulmonary maturity, and intravaginal PGE2 for cervical ripening and induction of labour are significant advances. With critical observation, timely intervention and sympathetic care a successful and happy outcome can be achieved in most pregnancies.
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PMID:The management of hypertension in pregnancy. 742 92

A retrospective review of adolescent deliveries (maternal age range: 12-19 years) at the maternity unit of the main General Hospital, Grenada, was undertaken for the years 1987 and 1988 using the delivery room register and hospital medical records. These mothers were compared with women who delivered during the same period but were aged between 20 and 30 years. Of the 3203 deliveries which occurred during the study period, 613 (20%) involved adolescents, giving a prevalence rate of one in five pregnancies. chi 2 and Fisher's exact test analyses revealed that pregnancies occurring in younger adolescents (age less than 16 years, n = 58) carried an increased risk of preterm labour, operative delivery, prematurity, small-for gestational age infants, asphyxia and perinatal mortality when compared with the 'optimum reproductive age group'. Older adolescents (16-19 years, n = 555) had a higher risk of pregnancy induced hypertension but otherwise compared well with the optimal reproductive age group. Adolescent pregnancy is very prevalent in Grenada and the reproductive outcome for young adolescents < 16 years of age is relatively poor.
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PMID:Adolescent pregnancy in Grenada. 750 87

The leukocyte glycoprotein L-selectin mediates an early step in the recruitment of leukocytes to sites of inflammation. L-Selectin surface expression is rapidly down-regulated by inflammatory signals in vitro. In a prospective study, we found L-selectin expression on umbilical cord blood granulocytes and monocytes to be significantly decreased in newborn infants with acute bacterial infection compared with controls (p < 0.01). A significantly reduced L-selectin expression of both granulocytes and monocytes was also found to be associated with an increased neutrophil immature/total ratio (p < 0.01) but not with other laboratory markers of neonatal sepsis. There was no apparent impact of prematurity, low birth weight, gestational hypertension, or gestational diabetes on L-selectin expression. Although the mode of delivery did not affect granulocyte L-selectin expression, umbilical cord blood monocytes showed an increased L-selectin expression after emergency cesarean delivery compared with samples obtained after elective cesarean or vaginal delivery (p < 0.01). We conclude that acute systemic inflammation results in down-regulation of granulocyte and monocyte L-selectin expression in vivo similar to that observed in vitro.
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PMID:L-selectin is down-regulated in umbilical cord blood granulocytes and monocytes of newborn infants with acute bacterial infection. 753 4


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