Perinatal outcomes associated with abnormal cardiac remodeling in women with treated chronic hypertension

2018 ◽  
Vol 218 (5) ◽  
pp. 519.e1-519.e7 ◽  
Author(s):  
Anne M. Ambia ◽  
Jamie L. Morgan ◽  
C. Edward Wells ◽  
Scott W. Roberts ◽  
Monika Sanghavi ◽  
...  
Keyword(s):  
Cardiac Remodeling ◽  
Perinatal Outcomes ◽  
Chronic Hypertension

scholarly journals 63: Perinatal outcomes associated with abnormal cardiac remodeling measured by echocardiography during pregnancy in women with treated chronic hypertension

2018 ◽  
Vol 218 (1) ◽  
pp. S47
Author(s):  
Anne M. Ambia ◽  
Jamie L. Morgan ◽  
Scott W. Roberts ◽  
C. Edward Wells ◽  
David B. Nelson ◽  
...  
Keyword(s):  
Cardiac Remodeling ◽  
Perinatal Outcomes ◽  
Chronic Hypertension

The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study

2020 ◽  
Vol 48 (4) ◽  
pp. 317-321
Author(s):  
Rodney McLaren ◽  
Bharati Kalgi ◽  
Chima Ndubizu ◽  
Peter Homel ◽  
Shoshana Haberman ◽  
...  
Keyword(s):  
High Risk ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Repeated Measures ◽  
Adverse Outcome ◽  
Perinatal Outcomes ◽  
Low Risk ◽  
Doppler Velocity ◽  
Chronic Hypertension ◽  
Adverse Perinatal Outcomes

AbstractObjectiveThe aim of this study was to compare position-related changes in fetal middle cerebral artery (MCA) Doppler pulsatility indices (PI).MethodsA prospective study of 41 women with conditions associated with placental-pathology (chronic hypertension, pregestational diabetes, and abnormal analytes) and 34 women without those conditions was carried out. Fetal MCA Doppler velocity flow waveforms were obtained in maternal supine and left lateral decubitus positions. MCA PI Δ was calculated by subtracting the PI in the supine position from the PI in the left lateral position. Secondary outcomes included a composite of adverse perinatal outcomes (fetal growth restriction, oligohydramnios, and preeclampsia). χ2 and Student t-tests and repeated-measures analysis of variance were used.ResultsMCA PI Δ was significantly less for high-risk pregnant women ([P = 0.03]: high risk, left lateral PI, 1.90 ± 0.45 vs. supine PI, 1.88 ± 0.46 [Δ = 0.02]; low risk, left lateral PI, 1.90 ± 0.525 vs. supine PI, 1.68 ± 0.40 [Δ = 0.22]). MCA PI Δ was not significantly different between women who had a composite adverse outcome and women who did not have a composite adverse outcome (P = 0.843).ConclusionOur preliminary study highlights differences in position-related changes in fetal MCA PI between high-risk and low-risk pregnancies. These differences could reflect an attenuated ability of women with certain risk factors to respond to physiologic stress.

scholarly journals Group B Streptococcus (GBS) Colonization and Disease among Pregnant Women: A Historical Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
James M. Edwards ◽  
Nora Watson ◽  
Chris Focht ◽  
Clara Wynn ◽  
Christopher A. Todd ◽  
...  
Keyword(s):  
Cohort Study ◽  
Group B Streptococcus ◽  
Perinatal Outcomes ◽  
Chronic Hypertension ◽  
Short Cervix ◽  
Historical Cohort ◽  
Historical Cohort Study ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
Group B

Background. Maternal GBS colonization is associated with early-onset neonatal sepsis and extensive efforts are directed to preventing this complication. Less is known about maternal risks of GBS colonization. We seek to provide a modern estimate of the incidence and impact of maternal GBS colonization and invasive GBS disease. Methods. A single center historical cohort study of all births between 2003 and 2015 was performed. Data was collected via electronic health record abstraction using an institutional specific tool. Descriptive statistics were performed regarding GBS status. Inferential statistics were performed comparing risk of adverse pregnancy outcomes in cohorts with and without GBS colonization as well as cohorts with GBS colonization and invasive GBS disease. Results. A total of 60,029 deliveries were included for analysis. Overall, 21.6% of the population was GBS colonized and 0.1% had invasive GBS disease. GBS colonization was associated with younger maternal age, Black race, non-Hispanic ethnicity, chronic hypertension, preexisting diabetes, and tobacco use (p<0.01). In the adjusted analyses, there was an increased risk of gestational diabetes (aRR 1.21, 95% CI 1.11-1.32) in colonized pregnancies and a decreased incidence of short cervix (aRR 0.64, 95% CI 0.52-0.79), chorioamnionitis (aRR 0.76, 95% CI 0.66-0.87), wound infection (aRR 0.75, 95% CI 0.64-0.88), and operative delivery (aRR 0.85, 95% CI 0.83-0.88). Conclusions. This modern-day large cohort of all births over a 12-year period demonstrates a GBS colonization rate of 21.6%. This data reflects a need to assess maternal and perinatal outcomes in addition to neonatal GBS sepsis rates to inform decisions regarding the utility of maternal vaccination.

750: Adverse maternal and perinatal outcomes in women with chronic hypertension: a retrospective study of 362 patients

2011 ◽  
Vol 204 (1) ◽  
pp. S294 ◽  
Author(s):  
Edouard Lecarpentier ◽  
Gilles Kayem ◽  
Vassilis Tsatsaris ◽  
Francois Goffinet ◽  
Baha Sibai ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Perinatal Outcomes ◽  
Chronic Hypertension

scholarly journals Hypertensive disorders in pregnancy at the federal medical centre, Yenagoa, South-South Nigeria: a 5 year review

2021 ◽  
Vol 9 (10) ◽  
pp. 2923
Author(s):  
Peter Chibuzor Oriji ◽  
Dennis Oju Allagoa ◽  
Akaninyene Eseme Ubom ◽  
Amos Kattey Kattey ◽  
Datonye Christopher Briggs ◽  
...  
Keyword(s):  
Perinatal Outcomes ◽  
Case Fatality ◽  
Medical Centre ◽  
Morbidity And Mortality ◽  
Chronic Hypertension ◽  
Maternal Deaths ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Gestational Age At Delivery ◽  
In Pregnancy

Background: Hypertensive disorders complicate 5.2%-8.2% of pregnancies, and contribute significantly to perinatal and maternal morbidity and mortality worldwide. To determine the incidence, clinical characteristics, maternal and perinatal outcomes of hypertensive disorders in pregnancy at the Federal medical centre, Yenagoa, Bayelsa State, South-South Nigeria.Methods: This retrospective study was conducted between 1 January, 2016 and 31 December, 2020. Relevant data was retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0.Results: Out of the 4,571 obstetric patients that were managed in our Centre in the period under review, 335 of them had HDP, giving an incidence rate of 7.32%.The most common HDP were pre-eclampsia (189, 56.4%) and eclampsia (82, 24.5%), while the least common was chronic hypertension (3, 0.9%). A little more than one-half (171, 51.0%) of the women delivered preterm, with a mean gestational age at delivery of 35.5 weeks. The most common route of delivery was emergency Caesarean section (205, 61.2%). There were three maternal deaths, giving a case fatality rate of 0.9%. Two of the maternal deaths were due to eclampsia, and one, from pre-eclampsia.Conclusions: Women should be adequately counseled to embrace preconception care, and early and regular antenatal care visits, with proper monitoring of blood pressure and urine protein. Prompt diagnosis and management are key in preventing the maternal and perinatal morbidity and mortality that are associated with these disorders. 

scholarly journals Correlation Between Divided Doses of Chronic Antihypertensive Drugs and Pregnancy Outcomes

2017 ◽  
Vol 8 (3) ◽  
pp. 328-332
Author(s):  
Safura Hatamipour Dehno ◽  
Simin Taghavi ◽  
Nayyereh Ayati
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Antihypertensive Drugs ◽  
Gestational Hypertension ◽  
Blood Pressure Monitoring ◽  
Perinatal Outcomes ◽  
Chronic Hypertension ◽  
Pressure Monitoring ◽  
Fetal Complications

Objectives: Hypertension, as a common problem during pregnancy, is a major cause of maternal and fetal morbidity and mortality. Anti-hypertensive drugs are used to prolong the pregnancy or modify perinatal outcomes in pregnant women with hypertensive disorders. Severe monitoring of blood pressure is subsequently essential in these mothers. The aim of this study was to evaluate the correlation between divided doses of chronic hypertensive drugs and the end of pregnancy in mothers with gestational hypertension. Materials and Methods: In this prospective research, 99 pregnant women with chronic hypertension, who were treated with antihypertensive medicines, were studied during pregnancy. During routine follow-up of these mothers, the number of the drug and the divided doses were recorded. The incidence of maternal and fetal outcomes were evaluated according to the number of less or more than 5 divided doses. Results: Maternal and fetal-baby complications were observed in 5.50 and 5.53% cases, respectively. The incidence of maternal and fetal complications were significantly enhanced by increasing the number of up-taken anti-hypertensive drugs. The maternal and fetal-baby complications were higher in mothers who received more than five divided doses compared to those who received less than five doses. Conclusion: Based on our results, chronic hypertension was associated with maternal and fetal-baby complications in half of the cases. It is clarified that precise blood pressure monitoring and regularly taking of anti-hypertensive medicine may decrease the hypertension side effects. The awareness about this field in the pre-pregnancy consulting is considered as the patients’ rights and should be respected.

Perinatal Outcomes in Women With a History of Chronic Hypertension but Normal Blood Pressures Before 20 Weeks of Gestation

2018 ◽  
Vol 131 (5) ◽  
pp. 827-834 ◽  
Author(s):  
Mallory Youngstrom ◽  
Alan Tita ◽  
Janatha Grant ◽  
Jeff M. Szychowski ◽  
Lorie M. Harper
Keyword(s):  
Perinatal Outcomes ◽  
Normal Blood ◽  
Chronic Hypertension ◽  
History Of ◽  
Blood Pressures

scholarly journals miR-154-5p Functions as an Important Regulator of Angiotensin II-Mediated Heart Remodeling

2019 ◽  
Vol 2019 ◽  
pp. 1-16 ◽  
Author(s):  
Que Wang ◽  
Xiaoxue Yu ◽  
Lin Dou ◽  
Xiuqing Huang ◽  
Kaiyi Zhu ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Cardiac Remodeling ◽  
Structural Changes ◽  
Molecular Mechanisms ◽  
Heart Function ◽  
Left Ventricular ◽  
Cardiomyocyte Hypertrophy ◽  
Left Ventricular Myocardium ◽  
Chronic Hypertension ◽  
Arylsulfatase B

Chronic hypertension, valvular heart disease, and heart infarction cause cardiac remodeling and potentially lead to a series of pathological and structural changes in the left ventricular myocardium and a progressive decrease in heart function. Angiotensin II (AngII) plays a key role in the onset and development of cardiac remodeling. Many microRNAs (miRNAs), including miR-154-5p, may be involved in the development of cardiac remolding, but the underlying molecular mechanisms remain unclear. We aimed to characterize the function of miR-154-5p and reveal its mechanisms in cardiac remodeling induced by AngII. First, angiotensin II led to concurrent increases in miR-154-5p expression and cardiac remodeling in adult C57BL/6J mice. Second, overexpression of miR-154-5p to a level similar to that induced by AngII was sufficient to trigger cardiomyocyte hypertrophy and apoptosis, which is associated with profound activation of oxidative stress and inflammation. Treatment with a miR-154-5p inhibitor noticeably reversed these changes. Third, miR-154-5p directly inhibited arylsulfatase B (Arsb) expression by interacting with its 3′-UTR and promoted cardiomyocyte hypertrophy and apoptosis. Lastly, the angiotensin type 1 receptor blocker telmisartan attenuated AngII-induced cardiac hypertrophy, apoptosis, and fibrosis by blocking the increase in miR-154-5p expression. Moreover, upon miR-154-5p overexpression in isolated cardiomyocytes, the protective effect of telmisartan was partially abolished. Based on these results, increased cardiac miR-154-5p expression is both necessary and sufficient for AngII-induced cardiomyocyte hypertrophy and apoptosis, suggesting that the upregulation of miR-154-5p may be a crucial pathological factor and a potential therapeutic target for cardiac remodeling.

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