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Query: UMLS:C0033687 (proteinuria)
24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pregnancy complication characterized by proteinuric hypertension is called preeclampsia. Preeclampsia, an important cause of maternal and perinatal death, has an onset and progression impossible to predict. Termination of pregnancy is the only cure of preeclampsia. It is indicated when the fetus can survive outside the uterus or when the maternal condition deteriorates to such a condition that continuation would bring greater harm to the mother. The etiology of preeclampsia is unknown. Preeclampsia appears to be linked to abnormal trophoblastic implantation. In normal pregnancies, implantation effects changes in the spiral arteries that supply the intervillous space and fibrin-containing trophoblast, and amorphous matrix replace the endothelium and the internal elastic lamina. These changes do not occur or are limited in pre-eclamptic women. There appears to be a familial tendency to preeclampsia. Impaired formation of blocking antibodies to antigenic sites on the placenta increases the risk of pre-eclampsia. Risk factors are primigravidity, short duration of sexual cohabitation before conception, abundance of trophoblastic tissue (e.g., multifetal and molar pregnancies), and underlying vascular disease as in diabetes. Poor placental perfusion may account for the increase in maternal blood pressure. Preeclampsia can lead to eclampsia, cerebral hemorrhage, coagulopathy, and death. Poor utero-placental circulation retards fetal growth and causes fetal distress and maybe even perinatal death. When the diastolic blood pressure is higher than 110 mmHg, pre-eclamptic women should be administered antihypertensive drugs (e.g., methyldopa, beta-blockers, calcium channel blockers, hydralazine, labetatol, or diazoxide) to prevent maternal complications, but these drugs do not improve utero-placental blood flow nor do they prevent proteinuria. Diuretics should not be administered. Proteinuria indicates that the kidneys have been affected. A large randomized trial shows that aspirin does not effectively prevent preeclampsia. Routine calcium supplementation does appear to prevent it and preterm delivery.
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PMID:Pre-eclampsia. 875 7

We report the case of a 39-year-old para-4 gravida-4 who received polychemotherapy 5-fluorouracil 600 mg/m2, cyclophosphamide 600 mg/m2 and epirubicin 50 mg/m2 for invasive breast cancer (pT2N2Mo) with extensive metastatic involvement of all 23 axillary lymph nodes removed at 29 gestational weeks. Soon after the second course of chemotherapy at 35 weeks, she developed two eclamptic tonic-clonic seizures which were treated by antihypertensive and anticonvulsive drugs and delivery of a healthy infant, 1650 g (< 10th percentile) by cesarean section. That this patient indeed suffered from eclampsia was supported by the findings of transient postpartum severe hypertension (peak 170/110 mmHg), proteinuria (peak 3.2 g/24 h), incomplete features of the HELLP syndrome (thrombocytopenia 81,000/mm3, haptoglobin < 10 mg/dl) and of DIC, and by the results of cerebral CT scanning showing two 1-cm ischemic lesions. Since the detrimental effect of antineoplastic agents on the rapidly proliferating trophoblast is well known and as abnormal placental function, such as in triploidy, trisomy or hydatiform mole, has been associated with an increased risk for preeclampsia/eclampsia, a possible causal relationship between polychemotherapy and the subsequent development of this rare disorder is suggested.
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PMID:Eclampsia after polychemotherapy for nodal-positive breast cancer during pregnancy. 884 12

We compared the serum levels of beta-carotene, vitamin A (retinol), and vitamin E (alpha-tocopherol) in healthy pregnant women and their counterparts who exhibited the signs and symptoms of preeclampsia or eclampsia, including: systolic blood pressure greater than 160 mm Hg, edema, and proteinuria. The study was conducted in the cities of Maiduguri and Bauchi, which are located in the semi-arid northeastern region of Nigeria. Most of the pregnant subjects: (1) were teenagers, though they ranged in age from 14 to 25 years; (2) had 2 or fewer prior pregnancies; and (3) were predominantly of the Muslim faith and members of the Hausa, Fulani, or Kanuri ethnic groups. Few of the women had received prenatal care. Serum levels of vitamins A and E and betacarotene were quantified using high pressure liquid chromatography. The serum vitamin A levels of the 9 preeclamptic women (15.3 mg/dL) and the 7 eclamptic women (8.3 mg/dL) were significantly reduced (p < 0.01) relative to the serum vitamin A levels of healthy women in the third trimester (24.2 mg/dL). For the healthy pregnant controls, the levels of vitamins A and E and beta-carotene were relatively constant throughout pregnancy. The mean serum beta-carotene levels for both the preeclamptic and eclamptic groups of subjects were half as high as those of healthy control women in the third trimester (p = 0.004). The serum vitamin E levels of the preeclamptic and eclamptic women were 15% and 30% lower, respectively, than those of the corresponding controls (p < 0.01). The serum levels of these three lipids in the healthy pregnant and non-pregnant women we studied are similar to values reported by others for North American and European women of childbearing age. These results support the hypothesis that preeclampsia-eclampsia deplete natural lipid antioxidants and suggest that the reduced levels of vitamin A in such women experiencing hypertension of pregnancy, if they happen to be infected with the HIV-1 virus, may place them at increased risk for mother-child transmission of the virus.
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PMID:Serum vitamin A, vitamin E, and beta-carotene levels in preeclamptic women in northern nigeria. 886 47

Data from 1981 to 1993 (excluding 1990-1991 due to Iraqi invasion) obtained from the Maternity Hospital in Kuwait were analyzed to examine pregnancy outcomes of eclamptic women and the risk factors for eclampsia in Kuwait. During the study period, 101 of 167,080 mothers had eclampsia for an incidence rate of 6/10,000. Eclampsia incidence did not change significantly during the study period. The incidence was 33/1000 for preeclampsia and 32/1000 for hypertension. Strong, significant risk factors for eclampsia included primiparity (relative risk [RR] = 8.93), age 30 years or younger (RR = 3.86), multiple pregnancy (RR = 4.15), preeclampsia (RR = 8.69), and low birth weight of 2500 g or less (RR = 13.96). Eclamptic women were significantly more likely to experience stillbirth, early neonatal death, and cesarean section. Maternal complications included need for intubation, disseminated intravascular coagulation, postpartum hemorrhage, maternal death, persistent increase in blood pressure, and proteinuria 1 week postpartum. One woman died from eclampsia for a maternal mortality rate of 0.99%, which is significantly higher than that for preeclampsia and for hypertension (0.0405 and 0.0396%, respectively). These findings show that risk factors for eclampsia are primiparity, young maternal age, multiple pregnancy, and presence of preeclampsia, and that eclamptic mothers experienced poorer pregnancy outcomes than other mothers.
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PMID:Eclampsia in Kuwait 1981-1993. 888 46

We measured plasma catecholamine concentrations on admission (after eclamptic fit) and after 6 days of delivery in 21 eclamptic patients and on admission in 15 normotensive pregnant women in Bangladesh. Plasma epinephrine and norepinephrine concentrations in eclamptic patients were significantly higher on admission than those of normotensive pregnant women (P < 0.0001). Plasma catecholamine concentrations and mean arterial blood pressure had return to be almost normal as normotensive pregnant women after 6 days of delivery, resulting in no correlation between mean arterial blood pressure and plasma catecholamines. On admission (after eclamptic fit) mean arterial blood pressure was positively correlated with plasma epinephrine (r = 0.626, P < 0.002) and norepinephrine (r = 0.553, P < 0.008) concentrations in patients with eclampsia. The amount of proteinuria was also significantly correlated with plasma epinephrine (r = 0.515, P < 0.02) and norepinephrine (r = 0.606, P < 0.003) concentrations. Number of convulsions was significantly correlated with concentrations of plasma epinephrine (r = 0.514, P < 0.02), norepinephrine (r = 0.521, P < 0.01) and mean arterial blood pressure (r = 0.535, P < 0.01). A positive correlation was found between time passed after convulsion with plasma epinephrine (r = 0.515, P < 0.02) and norepinephrine (r = 0.570, P < 0.006) concentrations. These suggested that the increased plasma levels of epinephrine and norepinephrine in eclamptic patients were well correlated with the severity of the clinical features of eclampsia.
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PMID:Increased concentrations of plasma epinephrine and norepinephrine in patients with eclampsia. 924 13

The HELLP-Syndrom (hemolysis, elevated liver enzymes, low platelet count) is considered as a severe complication of eclampsia with unpredictable development of pregnancy including high maternal and fetal risk. The result of retrospective analysis of all deliveries of the years 1986-1991 at the UFK Marburg were 28 cases of proved HELLP-Syndrom. Medical history, correlation of clinical and laboratory findings as well as the development of the disease and the neonatal dates were evaluated by computerized documentation. The incidence of HELLP-Syndrom was 28 of 8111 deliveries at all (0,34%). 82% of the women with HELLP-Syndrom were primiparae. The leading symptom was right upper abdominal pain in 75%, which lasted already 5,7 days before presentation in the clinic. Hypertonus, edema and proteinuria were present in 71%, 61% and 89% of the cases. The diagnosis indicating laboratory finding was the thrombocytopenia (mean 62 G/l). In comparison to the thrombocytes, which were at the 4.-7. day pp in 89% within the normal range, the liver function tests normalized just between the 9. and 13. day pp (SGOT 89%, SGPT 77%). The shortening of the prepartal hospitalization from 6 days in 1986/87 to 8 hours in 1990/91 decreases the periand postnatal complication rate from 43% to 23%. 26/28 patients (92%) were delivered by caesarean section from healthy babies through which were 75% premature infants and in 27% of the cases small for gestational age additionally. We conclude that the decrease of the diagnosis-delivery interval and the intensive medical care are responsible for the diminution of the maternal and neonatal mortality rate to 0%.
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PMID:[Clinical and chemical laboratory course of HELLP syndrome--a retrospective analysis]. 896 82

An imbalance between oxidants and antioxidants in the circulation is blamed to cause preeclampsia and eclampsia. In this study plasma ascorbic acid level was analysed in 13 eclamptic, 14 mild preeclamptic, 12 severe preeclamptic and 20 uncomplicated pregnancies to see whether there is any correlation with blood pressure, proteinuria, serum triglyceride level, erythrocyte fragility and leukocyte count. Plasma ascorbic acid level was normal and had no significant difference among the groups. Fasting serum triglyceride level was significantly higher in the study group than in the control group but it did not differ among the three study groups. Erythrocyte fragility was found to be increased in all three study groups. Blood leukocyte count was increased in the study groups, especially in the eclampsia group. However, plasma ascorbic acid level and erythrocyte fragility were found to have no significant correlation with blood pressure and proteinuria. It was concluded that though the ascorbic acid levels were normal in both the study and the control groups, erythrocyte fragility increased probably due to an elevation in peroxide and free radical levels in preeclampsia and eclampsia groups, but without any correlation with the severity of the clinical picture.
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PMID:Plasma ascorbic acid level and erythrocyte fragility in preeclampsia and eclampsia. 903 58

Preeclampsia and eclampsia are very important health problems because they are the main contributors to maternal and perinatal morbidity and mortality. These disorders are unique in pregnancy and are characterized by oedema, proteinuria and hypertension. they occur in 0.5% to 30% of all pregnancies, primarily in primigravidas, after the 20-th week of gestation. Preeclampsia and eclampsia are diseases of undetermined cause. Many different factors might play an important role in the development of these diseases. One of them is nutrition. Recent studies have emphasized the possible role of general nutritional deficiency or imbalance of several specific nutrients in the aetiology of the disease. Deficiency of a variety of nutrients has been reported in patients with preeclampsia. The obtained results are contradictory and further study is necessary. Nevertheless, some evidence is highly suggestive of a relationship between nutritional status and the onset or progress of the disease. The article reviews the study that correlates the role of several nutritional elements with the pathophysiology of preeclampsia and eclampsia: proteins, lipids, calcium, vitamin D, sodium, magnesium and zinc. The evidence that supports or rejects the role of each of these nutrients is presented. In this way a guideline for general nutritional counseling in the prenatal period that will promote a healthier pregnancy, is offered.
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PMID:[The role of nutritional factors in pre-eclampsia and eclampsia]. 910 38

We measured plasma catecholamine concentrations on admission (after eclamptic fit) and after 6 days of delivery in 21 eclamptic patients and on admission in 15 normotensive pregnant women in Bangladesh. Plasma epinephrine and norepinephrine concentrations in eclamptic patients were significantly higher on admission than those of normotensive pregnant women (P < 0.0001). Plasma catecholamine concentrations and mean arterial blood pressure had return to be almost normal as normotensive pregnant women after 6 days of delivery, resulting in no correlation between mean arterial blood pressure and plasma catecholamines. On admission (after eclamptic fit) mean arterial blood pressure was positively correlated with plasma epinephrine (r = 0.626, P < 0.002) and norepinephrine (r = 0.553, P < 0.008) concentrations in patients with eclampsia. The amount of proteinuria was also significantly correlated with plasma epinephrine (r = 0.515, P < 0.02) and norepinephrine (r = 0.606, P < 0.003) concentrations. Number of convulsions was significantly correlated with concentrations of plasma epinephrine (r = 0.514, P < 0.02), norepinephrine (r = 0.521, P < 0.01) and mean arterial blood pressure (r = 0.535, P < 0.01). A positive correlation was found between time passed after convulsion with plasma epinephrine (r = 0.515, P < 0.02) and norepinephrine (r = 0.570, P < 0.006) concentrations. These suggested that the increased plasma levels of epinephrine and norepinephrine in eclamptic patients were well correlated with the severity of the clinical features of eclampsia.
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PMID:Increased concentrations of plasma epinephrine and norepinephrine in patients with eclampsia. 890 34

Hypertension remains a leading cause of perinatal morbidity and mortality. Classification of the hypertensive disorders of pregnancy is 1) preeclampsia-eclampsia, 2) chronic hypertension, 3) chronic hypertension with superimposed preeclampsia-eclampsia. Preeclampsia is characterized by the triad of hypertension, proteinuria, and edema but these findings are not specific. Although the etiology and pathogenesis of preeclampsia remain unknown, several factors such as abnormalities in prostaglandin systems, in coagulation process, derangements of the endothelium and so on. Management of preeclampsia is bed rest, aspirin administration, antihypertensive agents (beta-blockers, hydralazine, alpha-methyldopa) would be used for reduction of blood pressure.
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PMID:[Pregnancy induced hypertension]. 928 34


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