Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An analysis of 2280 puerperas who delivered newborns with the birth weight of 2500 g up to over 4000 g in the first half of 1989 at the Clinic for Obstetrics and Gynecology in Sarajevo had been conducted. Age, parity, body weight increase during pregnancy, and their socio-economic status was investigated. All newborns were divided into several groups according to birth weight: 2500-3000 g, 3000-3500 g, 3500-4000 g and over 4000 g. Puerperas with hypertension before pregnancy, EPH gestosis, anaemia and pyelonephritis were excluded. It has been found that newborns with birth weight between 3000-3500 g, the most desirable weight, were delivered by mothers who had a body weight increase of about 12.6 kg during pregnancy. Their average age was 25 years among primiparas, and 27 among multiparas; they were high-school graduates. American authors consider a weight increase of 8 kg during pregnancy as the most ideal for a good outcome. Vitality of newborns measured by the Apgar score was satisfying, with minor deviations in the group with birth weight over 4000 g.
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PMID:[Correlation between certain parameters in pregnancy and body weight and the vitality of the neonate]. 209 47

A 43-year-old multiparous woman (ninth childbirth) with the EPH-gestosis not observed during pregnancy, first came to the hospital in the 40th week of gestation due to the rupture of membranes and weak labor pains. Having lain down in the delivery room, the patient immediately lapsed into a coma and developed hemiplegia on the right side of the body. Suspecting a cerebrovascular insult caused by hypertension within the pre-existing EPH-gestosis, the C-section was performed in the best interest of both mother and child. Following the operation, the CT of the brain showed massive intracerebral and intraventricular hemorrhage. The patient was moved to the Intensive Care Unit, where she died six days after the insult.
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PMID:[Intracerebral hemorrhage in a grand multipara with EPH gestosis]. 221 59

In this study, plasma levels of magnesium, calcium, zinc and copper were simultaneously determined in pregnancies complicated by either abortion, intrauterine growth retardation (IUGR), diabetes or EPH (edema, proteinuria, hypertension) gestosis. The levels of the four cations in non-pregnant women and in healthy, pregnant women were also determined. Compared with controls, a significant decrease in magnesium, with increase of the Ca/Mg ratio, was found in spontaneous abortions, but not when patients had a successful continuation of pregnancy. In EPH gestosis, total calcium was reduced, with a significant decrease of the plasma Ca/Mg ratio. A slight, but significant, increase in plasma zinc was observed in women affected by either diabetes or IUGR, probably as a result of reduced zinc uptake by the fetus. In addition, higher copper levels were found in the pathologies studied, with the exception of missed abortions. The possible role of an altered Ca/Mg ratio homeostasis in relation to gestational pathologies is discussed.
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PMID:Maternal plasma concentrations of magnesium, calcium, zinc and copper in normal and pathological pregnancies. 227 Apr 73

EPH-gestosis (pre-eclampsia-eclampsia) characterized by edema, proteinuria and hypertension occurs primarily in the nullipara, usually after the 20th gestational week. As in normal pregnancy there is striking change in both renal blood flow and glomerular filtration rate a slight increase in urinary protein secretion is not considered abnormal until it exceeds 300 mg/day. Abnormal proteinuria commonly accompanies pre-eclampsia and may be minimal, moderate or severe (even exceeding greater than 25 g/l). Proteinuria was typed mainly of nonselective glomerular origin by using the SDS-disc-electrophoresis. Additionally the clearance ratio of IgG to transferrin in all patients with abnormal proteinuria was evaluated. In none of the patients studied the ratio was less than 0.1 (highly selective). As severe proteinuria is associated with fetal growth retardation, preterm deliveries and prenatal mortality the quantitation and typing of early proteinuria is essential for considering patients who are at risk for developing EPH-gestosis.
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PMID:[Proteinuria in normal pregnancy and in EPH gestosis]. 265 75

The coexistence of arterial hypertension and disturbances of haemostasis in pregnant women with EPH-gestosis allow to expect a role of fibrinolysis and kinin-forming systems in pathomechanism of this syndrome. For these reasons blood plasma of 34 patients with EPH-gestosis, 23 patients with normal pregnancy and 19 nonpregnant women was investigated. All pregnant women were in third trimester of pregnancy. The following parameters were investigated: kinin-forming system compounds (kininogens and prokininogenases - biological methods), fibrinolytic activity (plasma euglobulin fibrinolysis time), total plasma protein and fibrinogen concentration, protease inhibitors - antithrombin III, C1-esterase inhibitor, alpha 2-antiplasmin, alpha 1-protease inhibitor and alpha 2-macroglobulin (by electroimmunodiffusion). Furthermore hematocrit was measured. In pregnant women with EPH-gestosis significant increase of high molecular weight kininogen concentration was found (p less than 0.02), decreased fibrinolytic activity (p less than 0.01) and (except alpha 2-antiplasmin) decreased concentration of protease inhibitors (p less than 0.005 - p less than 0.01) were observed. Further statistical analysis demonstrated positive correlation between the concentrations of kininogens and prokallikrein-prokininogenases and between low molecular weight kininogen and plasma euglobulin fibrinolysis time. On the other hand negative correlation between concentrations of those proenzymes and severity of gestosis was observed. The above described phenomena indicate on significance of disturbances of proteolytic enzyme activation in pathogenesis of EPH-gestosis.
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PMID:[Plasma kininogenesis and fibrinolysis in the pathogenesis of EPH gestosis]. 321 8

A rather unusual but dramatic form of EPH gestosis or pregnancy-induced hypertension is presented via the case of a 30-year old second gravida in the 30th week of pregnancy. This is a case of pre-eclampsia combined with haemolysis, elevated liver function tests and low platelet counts. Diagnostic features, pattern and pathophysiology are discussed with regard to international literature.
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PMID:[HELLP syndrome: a life-threatening form of pre-eclampsia]. 356 37

From the pre-natal follow-up it was remarkable that cases have been admitted relatively late. Hints to a possible development of preeclampsia could be seen from patients history or the routine check up, for example the registration of edema, fetal growth retardation and oligohydramnios. For early diagnosis of preeclampsia we recommend: Calculation of mean arterial blood pressure or its non-invasive measurement; determination of hematocrit, uric acid and total plasma protein (in particular hemorheologic measurements). Hypomagnesemia in preeclampsia, as described by some authors, was also seen in our cases. The complex symptomatology of preeclampsia could be attributed to a generalised disturbance of microcirculation, which leads to definite reactions of the organs concerned. The microcirculatory failure is caused by vasoconstriction, hemoconcentration, hyperviscosity and hypercoagulation (up to DIC and consumption coagulopathy). The resulting symptoms and syndromes can be: EPH, HELLP, hemolytic-uremic Syndrome, hepato-renal Syndrome, thrombocyte and antithrombin III deficiency etc. The drug of choice for treatment of preeclampsia is magnesium sulfate. Its application is based on long-term clinical experience and new aspects on the physiologic and pharmacologic role of magnesium. The recommendations of the German High Blood Pressure League to use calcium antagonists as a basis in the treatment of high blood pressure can be fulfilled particularly in pregnancy by the physiologic calcium antagonist Mg++. Magnesium sulfate should be given in a dosage of 24-72 g daily. The dose should also be made dependent from urinary output. Further treatment patterns of preeclampsia should be adjusted according to each case. The present results also support our hypothesis that magnesium deficiency (besides predisposing factors) could be responsible for the development of preeclampsia (present model shown in detail). Consequently, the early and long-term substitution of magnesium in pregnancy could help reduce preeclampsia.
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PMID:[Pathophysiology and clinical aspects of pre-eclampsia]. 404 84

Because intravascular fibrin deposition is found in the glomerular capillaries of patients who have died of eclampsia, it was long assumed that a chronic form of intravascular clotting represents the decisive cause of the condition. Fibrin deposition is also typically observed in the uteroplacental bloodstream. The occurrence of high levels of soluble fibrin and fibrin(ogen) degradation products, which in severe cases can also include fibrin oligomers, in combination with thrombocytopenia and factor VIII consumption were interpreted as additional evidence for the significance of intravascular clotting in the pathogenesis of EPH gestosis. The hemolysis of the microangiopathologic type, which occurs in severe cases, was attributed to the resulting impairment in microcirculation. Doubts regarding this theory arose when it was noted that the course of EPH gestosis is not altered by the use of heparin, and that even in severe cases of eclampsia with hemolysis and thrombocytopenia the plasmatic clotting system is involved only to a small extent and probably only secondarily. More recent investigations have yielded the first evidence of reduced prostacyclin synthesis in maternal and fetal vessels in patients with EPH gestosis. Since prostacyclins lower arterial resistance yet at the same time are strong inhibitors of thrombocyte aggregation, this prostacyclin deficiency could account for the hypertension and the occurrence of platelet thrombi in the placental bloodstream associated with EPH gestosis. The observation of a reduction in the number of thrombocytes as a consequence of increased platelet breakdown, which precedes a rise in the level of fibrin(ogen) degradation products, also points to the significance of an abnormal interrelation between platelets and endothelium. In addition to the plasmatic and thrombocytic hypercoagulability and impaired prostacyclin synthesis, hemoconcentration with increased microvascular permeability is also observed. Early detection of disturbances of the vessel wall and vessel contents may provide a means of prophylaxis.
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PMID:Recent aspects of hemostasis, hematology and hemorheology in preeclampsia-eclampsia. 637 2

Immunofluorescent findings are revealing EPH-gestosis as an immunological disease similar to graft rejection. Deposits of immunoglobulins, complement, and fibrinogen/fibrin are localized in the glomerular capillaries, mesangium of the kidney and in the decidual arteries resembling findings in transplanted organs with signs of rejection. Fibrinoid changes of the villous stroma are found in greater amounts in placentae after gestosis revealing a more lively humoral reaction of the immune system. By mixed lymphocyte culture a cellular hyperreactivity of the mother against her fetus can be demonstrated. In conclusion, gestosis is a disease of humoral and cellular hyperreactivity finally resulting in the well-known peripheral symptoms edema, hypertension, and proteinuria. Early diagnosis followed by an effective therapy is desirable in preventing these secondary effects.
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PMID:[Immunological concepts of the etiology of EPH-gestosis]. 644 14

With enzyme linked immunosorbent assays, using a solid phase Clq method, we determined free circulating immunocomplexes (CIC) in the serum of 47 pregnant women. In 30 normal pregnant women without EPH gestosis no CIC could be found. 3 normal pregnant women showed temporary CIC after viral infections. In 7 women with slight gestosis no traceable CIC concentrations were present. All 7 patients with medium or severe gestosis had clearly positive CIC levels simultaneous with hypertension and during the further course of the pregnancy. Hospitalisation and antihypertensive therapy had to be carried out because of increasing symptoms of gestosis. Thus only in medium and severe gestoses clearly demonstrable CIC concentrations could be measured. The presence of free circulating CIC might be a prognostically unfavourable indication for the further course of an EPH gestosis.
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PMID:[Detection and clinical significance of free circulating IgG immune complexes in EPH (edema, proteinuria, hypertension) gestosis]. 655 Dec 97


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