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

Based on ophthalmoscopic findings, 30 toxemic patients were divided into three types: R-type; retinal vascular occlusion type, C-type; choroidal vascular occlusion type, R + C-type; mixed vascular occlusion type. R-type (5 cases) and R + C-type (7 cases) significantly correlated to superimposed preeclampsia. C-type (18 cases) significantly correlated to preeclampsia (pregnancy-induced hypertensive disorder: PIH). Clinical examinations (urine protein, platelet, fibrinogen, fibrin degradation product, partial thromboplastin time and prothrombin time) had no relation to the types of ophthalmoscopic classification. It was concluded that preeclampsia (PIH) and superimposed preeclampsia have different influences on the ocular fundus.
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PMID:[The relationship between ophthalmoscopic changes and classification of toxemia in toxemia of pregnancy]. 224 73

A retrospective study was made to determine the incidence of pregnancy-induced hypertension (PIH, pre-eclampsia) in Iceland. One-fourth of all births in Iceland in 1985 were selected from the national birth registry files by random number allocation, a total of 904 women. Maternity records were found in 97.9% of the cases. The criteria used to define PIH were met in 17.4% of the women. There were 146 (16.5%) with mild PIH (blood pressure of greater than or equal to 140/90 mmHg with or without proteinuria after the 20th gestational week). Eight (0.9%) had severe PIH (blood pressure of greater than or equal to 160/110 mmHg with or without proteinuria after the 20th gestational week). Primigravid women formed one-third of the group and of these 20.9% had PIH compared with 15.4% of the parous women. The incidence in parous women was higher than usually reported.
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PMID:Incidence and relation to parity of pregnancy-induced hypertension in Iceland. 263 27

Aloka Color-Doppler, model SSD-860, was used to observe the blood velocity waveforms in the umbilical artery and in the fetal descending thoracic aorta in 139 normal pregnant women from 16th to 40th week and 30 patients suffering from pregnancy induced hypertension (PIH syndrome). The ratio of systolic to diastolic peak flow (A/B) reflected the fetoplacental vascular resistance and peripheral resistance. The results demonstrated that the placental resistance in PIH syndrome and IUGR were much higher than that in normal pregnancy. The placental resistance decreased when patients condition improved after treatment and vice versa. This suggests that fetal blood velocity waveforms (FVW) is of great value in the intensive monitoring of IUGR fetuses. The blood velocity FVW was also of great value in evaluating the curative effects on PIH patients.
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PMID:[Color-Doppler for predicting vascular resistance to feto-placental blood flow and fetal well-being]. 263 66

Recent investigations suggest angiotensin converting enzyme (ACE) activity is generally decreased in normotensive pregnancy, but less is known about the level of activity of this enzyme in hypertensive pregnant subjects. The primary source of ACE is vascular endothelium and it can be measured in serum or plasma. In a preliminary investigation, we measured and compared diastolic blood pressure and serum ACE activity in 14 uncomplicated pregnant subjects during the third trimester, and in 16 subjects of similar gestation duration hospitalized with pregnancy-induced hypertension PIH. No patient had a positive history for, or evidence of, pulmonary or other metabolic disease. Compared with levels in normal pregnancy, serum ACE activity was found to be significantly elevated in PIH. In this study, this increase was not due to differences between the groups in maternal chronologic age or gestational duration. Further studies are necessary to determine if the increase in ACE activity precedes or follows development of clinically apparent PIH. If the former is the case, ACE activity might be a useful indicator of risk for PIH.
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PMID:Angiotensin converting enzyme activity in hypertensive pregnancy. 282 97

Pregnancy is a hypervolaemic situation with early expanded plasma volume, a high cardiac output and a decrease in the vascular and rheological resistance. The increase in plasma volume correlates better with fetal size than maternal size. The hypervolaemic and vasodilated state that accompanies normal pregnancy results in a high flow in the uterine arteries. In contrast, patients with PIH (pregnancy-induced hypertension) or placental insufficiency may have a contracted plasma volume secondary to diffuse vasoconstriction. In spite of the intense vasospasm and hypovolaemia, pre-eclampsia has generally a cardiac output which may be equal, higher or lower compared with non-eclamptic pregnancy. Hypovolaemia is reflected in a higher haematocrit than normal. In the case of a hypovolaemic state, haemoconcentration is associated with high red cell aggregation. In fetal distress and severe PIH, the rheological status (haemoconcentration and elevated red cell aggregation) has a high predictive value for perinatal complications. In patients with severe PIH, erythrocyte filtration is impaired. The increased leukocyte count in patients with PIH may occlude small vessels and could be a factor impairing intervillous blood flow. The increased erythrocyte rigidity may result from a re-distribution of cellular calcium metabolism (Blaustein concept). We conclude that there is an optimal haematocrit during pregnancy between 30% and 38%. The presence of a high haematocrit and in addition elevated red cell aggregation should alert the physician to an increased risk of fetal compromise.
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PMID:Blood rheology and pregnancy. 332 65

Plasma renin activity (PRA) and aldosterone concentrations were measured simultaneously with urinary excretion of kallikrein and of four prostaglandins (PGE2, PGF2 alpha, 6-keto-PGF1 alpha and TXB2) in 23 patients with pregnancy-induced hypertension (PIH; 17 with permanent PIH (PH) and six with labile PIH (LH), i.e. patients whose hypertension was controlled only by home bed-rest) and in 16 normotensive pregnant women. Plasma renin activity was lower in PH than in controls or in LH. No difference between the three groups was observed for plasma aldosterone and urinary excretion of kallikrein and prostaglandins except that TXB2 was higher in LH than in PH. Thus patients with LH have a different biological profile from that of PH, since they have higher PRA and higher TXB2 excretion, an association that suggests a more pronounced ureteral compression by the gravid uterus in this group. Although no decreased synthesis of vasodilating prostaglandins was found in PH, a dysregulation of the renin-angiotensin-prostacyclin loop is suggested by a negative correlation between PRA and 6-keto-PGF1 alpha. An independent vasopressive substance which would stimulate PGI2 and suppress renin secretion is therefore postulated.
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PMID:Renin-angiotension-aldosterone system, urinary prostaglandins and kallikrein in pregnancy-induced hypertension: evidence for a dysregulation of the renin-angiotensin-prostacyclin loop. 347 17

The mean heart weight as a measure of arterial hypertension of patients who died from spontaneous intracerebral hemorrhage (primary intracerebral hemorrhage or PIH) was compared with that of controls from the same autopsy population. All patients with valvular or congenital heart disease or disease processes associated with myocardial infiltration were excluded. In 206 cases of PIH, hypertension was diagnosed if heart weight greater than or equal to the mean heart weight of autopsy controls for either sex, plus 1.5 SD. Only 94 (46%) of all cases of PIH were hypertensive by this criterion. However, hypertension was five times more frequent in the cases than in the controls. The site of hemorrhage was clearly defined in 183 cases (88.8%) only. Of these, 80 (43.7%) had lobar hemorrhage and 69 (37.7%) bled in the basal ganglia. Only 26 cases (12.6%) had evidence of previous cerebral or myocardial infarction and there was no instance of previous intracerebral hemorrhage. These data show that arterial hypertension was present in about half the cases of PIH and suggest that other as yet unidentified risk factors for PIH may be more common than is realized. Patients who died from PIH had been healthy all their lives with no evidence of cardiovascular or cerebrovascular disease, and the PIH was their first evidence of disease.
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PMID:Primary intracerebral hemorrhage and heart weight: a clinicopathologic case-control review of 218 patients. 356 15

Twenty-six patients manifesting severe pregnancy-induced (PIH) or pregnancy-aggravated (PAH) hypertension who presented for emergency Caesarean section under general anaesthesia were studied. All patients came from a previously identified high risk group--namely greater than 25 yr, multiparous and with diastolic arterial pressures sustained at greater than 120 mm Hg. Our standard accelerated induction technique for the management of severely hypertensive mothers was modified to include the use of fentanyl and droperidol before induction. This modification of the induction sequence produced a clinically significant amelioration of the reflex sympathetic hypertensive response to laryngoscopy and intubation in most mothers receiving antihypertensive therapy, without apparent deleterious effect in the immediate postoperative period to those neonates unaffected by intrauterine asphyxia.
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PMID:Fentanyl-droperidol supplementation of rapid sequence induction in the presence of severe pregnancy-induced and pregnancy-aggravated hypertension. 368 12

Possibility of early diagnosis of pregnancy-induced hypertension via mean arterial pressure (MAP-2) and roll-overtest (ROT) was investigated in 80 normal, overweight or underweight primigravidae. The positive and negative predictability, the sensitivity, specificity and effectivity did not correspond to the efficiency of a good screening method. Obese primigravidae have more positive tests than normal. In the MAP-2 this was due to methodical errors, whereas in the ROT hydrostatic mechanisms interferet according to the overweight of the tested person. With these two screening tests, very early PIH diagnosis is generally not possible.
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PMID:[Significance of mean arterial blood pressure in the 2d trimester and the roll-over test for gestosis screening in normal, overweight and underweight primigravid patients]. 372 Nov 59

Hypertension during pregnancy is a disorder which is associated with high maternal and foetal morbidity. Whilst the aetiology remains unknown, a generalized microcirculatory disorder must be presumed as a joint pathophysiological fundamental concept. Vascular, haemorheological and haemostasiological disorders are combined here. For the haemorheological changes, the reduction in plasma volume along with haemoconcentration and pathological erythrocyte aggregation stands out as a significant factor. The overall flow behavior of the blood is impaired, whereby leucocytosis is of particular significance in cases of PIH. A series of observations exist which closely connect rheological changes with the foetal state. No conclusive statement can as yet be made as to the extent to which erythrocyte deformability is impaired, due to the highly susceptible laboratory procedures.
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PMID:Rheological studies on patients with pregnancy-induced hypertension (PIH). 378 57


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