Human chorionic gonadotropin, fetal sex and risk of hypertensive disorders of pregnancy: A nested case-control study

2016 ◽  
Vol 6 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Qizhen Zheng ◽  
Yuqing Deng ◽  
Shilin Zhong ◽  
Yu Shi
2017 ◽  
Vol 21 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Ann A Wang ◽  
Linda M Ernst ◽  
Emily S Miller

Introduction Basal plate myometrium (BPMYO), the pathological presence of myometrial fibers in the basal plate, is a common finding on pathological examination of the placenta, yet its clinical correlates are not well studied. As myometrial fibers are frequently located in proximity to poorly converted maternal spiral arteries, our objective was to determine whether BPMYO is associated with hypertensive disorders of pregnancy (HDP), a well-known clinical sequela of abnormal maternal artery remodeling. Methods This case–control study included women who delivered a live-born singleton gestation whose placentas were sent for pathological examination. Cases were women with HDP (gestational hypertension, preeclampsia, or HELLP syndrome) as defined by American College of Obstetricians and Gynecologists. Controls were women without HDP. Women with chronic hypertension were excluded. The primary outcome was the presence of BPMYO. Secondary outcomes included the pathologic stage of BPMYO and the incidence of pathologically defined accreta. Each outcome was compared between cases and controls in bivariable and multivariable analyses. Results Of the 306 women who met inclusion criteria, 230 (75%) had HDP. BPMYO was present in 99 (32%) of placentas. Compared to controls, cases were younger, had higher body mass index, and were more likely to have diabetes, be nulliparous, deliver preterm, and have had a prior cesarean. There were no differences in the incidence of BPMYO, stage of BPMYO, or incidence of pathologically defined accreta between cases and controls. These findings persisted after controlling for potential confounders. Conclusions Although BPMYO may be more common in the setting of abnormal placental vasculature, there is no significant association between BPMYO and HDP.


Author(s):  
Kushla Pathania ◽  
S. K. Verma ◽  
Shaina Chamotra ◽  
Ankit Chaudhary

Background: Hypertensive disorders of pregnancy are a major cause of both maternal and foetal morbidity and mortality. Although pregnancy induced hypertension (PIH) is still regarded as a disease of theories and unknown etiology, elevated homocysteine level has been hypothesized as a key risk factor. Abnormally raised homocysteine has been significantly associated with increased risk of PIH, abruption, intrauterine growth restriction, recurrent pregnancy loss, intrauterine death and prematurity.Methods: The present case control study was conducted among 180 pregnant women (90 cases and 90 controls) in Kamla Nehru State Hospital for Mother and Child, IGMC Shimla, Himachal Pradesh with an objective of ascertaining the role of homocysteine in pregnancy related hypertensive disorders. Socio-demographic, clinical, biochemical including homocysteine level, laboratory and ultrasonographic parameters of all the participants were documented.Results: The mean homocysteine level of cases (18.30±10.81) was significantly higher than the controls (8.70±2.64).  About 62.2% cases had abnormally raised homocysteine level (>15 µmol/L), while only 1.1% controls had such level. The odds of a case having abnormally elevated homocysteine level were 146.6 (CI: 19.52-1101) times to that of controls. Eclamptics had the highest homocysteine level followed by preeclamptics and controls.Conclusions: The present study significantly associates the abnormally elevated homocysteine levels with pregnancy related hypertensive ailments and demands much needed robustly designed studies to further explore the phenomenon. A simple intervention like estimating the much neglected homocysteine levels prior to pregnancy can definitely aid in predicting and preventing perinatal outcomes.


Sign in / Sign up

Export Citation Format

Share Document