Are Haemostatic and Fibrinolytic Parameters Predictors of Preeclampsia in Pregnancy-Associated Hypertension?

SummaryThe plasma levels of several haemostatic and fibrinolytic parameters were measured before and after delivery in 61 hypertensive pregnant women of whom 22 developed preeclampsia, and compared to the results obtained in 42 normal pregnant women. In the two last weeks before delivery (D ≤ –15) tPA antigen, PAI-1 activity, vWF: Ag/FVIII: C ratio, ATIII activity and platelet count were found to be significantly different in the hypertensive pregnant women with and without preeclampsia. Combined all together, an association of three of these five parameters were found to be pathological (i.e.: tPA: Ag ≥19 ng/ml, PAI-1 activity ≥58 IU/ml, vWF: Ag/FVIII: C ratio 5≥2.6, ATIII activity ≤73%) in none of the hypertensive women without preeclampsia and in only 35% of the preeclamptic group. A positive correlation was demonstrated between vWF:Ag/FVIII:C ratio and tPA:antigen levels suggesting that both tPA and vWF: Ag could be considered as early indicators of a possible micro angiopathy occurring in preeclampsia. However, due to the high dispersion of the results, it appears that the investigated haemostatic and/or fibrinolytic criteria give only presumptive arguments before assigning risk for preeclampsia development among hypertensive pregnant women.

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Changes in Clotting and Fibrinolytic Parameters Produced by Venous Stasis

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/107602969600200113 ◽

1996 ◽

Vol 2 (1) ◽

pp. 64-68

Author(s):

Raul Altman ◽

Alejandra Scazziota ◽

Jorge Rouvier

Keyword(s):

Sodium Citrate ◽

Vascular Endothelial Cells ◽

Protein S ◽

Venous Occlusion ◽

Venous Stasis ◽

Clot Lysis ◽

Before And After ◽

Fibrinolytic Parameters ◽

Pai 1

Vascular endothelial cells have thrombosis- prevention properties through the release of some fibri nolytic factors. This capacity of endothelium was studied using the venous occlusion test (VOT) and measuring proteins released during stasis. Blood samples were col lected before and after 10 and 20 min VOT in tubes con taining sodium citrate at pH 7.0 or 4.3. A significant shortening of the euglobulin clot lysis time (ECLT) was obtained 10 and 20 min after VOT in plasma collected in citrate pH 7.0 or 4.3. No statistical difference was noted between results obtained 10 and 20 minutes after VOT. The shortening was related to the increase of tissue plas minogen activator (t-PA) released during VOT. No differ ence was detected in the concentration of tissue plasmin ogen activator inhibitor 1 (PAI-1), but PAI-1 activity mea sured in plasma from blood collected in citrate pH 7.0 decreased progressively from 10.8 ± 9.2 arbitrary units (AU)/ml to 3.76 ± 4.5 AU/ml and 0.8 ± 1.02 AU/ml (p < 0.001) after 10 and 20 min, respectively, of stasis. When the PAI-1 activity was determined in blood collected in citrate pH 4.3 for preventing in vitro complexing of PAI-1 and t-PA, results were different: PAI-1 activity decreased from a basal value of 29.2 ± 15.3 AU/ml to 24.9 ± 12.2 ( p = NS) and 18.7 ± 11.5; p < 0.02) 10 and 20 min after VOT. As result of fibrinolytic activation, other factors were modified: increase of plasminogen activators, de crease of plasminogen, and increase of D-dimer. Fibrin ogen, fibronectin, protein C, protein S, von Willebrand factor, and tissue factor pathway inhibitor concentration remained unchanged after VOT. According to our find ings, VOT can be performed with a stasis of 10 min. Good responders are related to the endothelial capacity for re leasing t-PA and urokinase-type PA (u-PA) and defined as those with an ECLT of <60 min after 10 min VOT when blood was collected in sodium citrate pH 7.0.

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A Study on Fundus changes in Pregnancy-induced hypertension: A Four-year Observation

International Journal of Retina ◽

10.35479/ijretina.2021.vol004.iss002.165 ◽

2021 ◽

Vol 4 (2) ◽

pp. 162

Author(s):

Elluru Pandu Rangaiah ◽

Madhavi Latha Gangisetty ◽

Sandhya K ◽

Latha A ◽

Meena Syed

Keyword(s):

Pregnant Women ◽

Pregnancy Termination ◽

Renal Diseases ◽

Hypertensive Retinopathy ◽

Pregnancy Induced Hypertension ◽

Important Indicator ◽

Positive Correlation ◽

Induced Hypertension ◽

Changes In Pregnancy ◽

In Pregnancy

Introduction: Hypertensive disorders complicate 5-10% in all pregnant and together form the deadly triad and hemorrhage and heart disease that contribute greatly to maternal morbidity or mortality. This study aims to identify retinal changes in pregnancy-induced hypertension and analyze the association between retinal changes and hypertension severity. Method: A total of 100 pregnant admitted with pregnancy-induced hypertension(PIH) were included. Patients with pre-existing hypertension, diabetes mellitus, and renal diseases were excluded from the study. The vision, anterior segment, and Fundus were examined. Result: Higher number of PIH were recorded in the 21-30 years age group. Fifty-four pregnant women suffered from mild preeclampsia, 40 pregnant women with severe preeclampsia, and six pregnant women with eclampsia with seizures. 41% of pregnant had normal fundus, and 24% of pregnant had hypertensive retinopathy. Whereas grade 2,3, and 4 retinopathy was observed in 22%, 6%, and 2% of pregnant women. Two percent of pregnants had macular edema, and 3% had central serous retinopathy. No association was observed between the fundus findings with age/gravida. Whereas a significant positive correlation was observed between the fundus findings and hypertension severity (P < 0.001). Conclusion: Overall, 54% of pregnants were recorded with hypertensive retinopathy. A positive correlation was observed between fundus changes with the hypertension severity. This study reports the importance of routine fundus examination in pregnant with hypertension. Retinal change during pregnancy is an important indicator to decide the pregnancy termination or any other opt.

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KONSUMSI RUMPUT LAUT DAPAT MENGATASI ANEMIA KEHAMILAN

Jurnal Ilmiah Kebidanan (Scientific Journal of Midwifery) ◽

10.33023/jikeb.v6i1.562 ◽

2020 ◽

Vol 6 (1) ◽

pp. 68-74

Author(s):

Melly Damayanti

Keyword(s):

Pregnant Women ◽

Blood Cells ◽

White Blood Cells ◽

Third Trimester ◽

Work Area ◽

Before And After ◽

The Status ◽

Post Test ◽

Anemia In Pregnancy ◽

In Pregnancy

ABSTRACT Anemia in pregnancy is a condition in pregnant women with hemoglobin levels less than 11gr% during pregnancy. An increased of anemia often occurs in the third trimester of pregnancy. Pregnant women needs to be supported with nutritional patterns which contain some necessary intermediate in the synthesis of hemoglobin, which is seaweed. Seaweed type Euchoma sp contains iron, a mixture of which is needed in the synthesis of hemoglobin, has a high bioavailability of substances and is able to stabilize the number of red blood cells, white blood cells, and hemoglobin. The purpose of the study was to determine the status of anemia before and after the study. The study design is the pre-post test design. The population of the study was 30 third trimester pregnant women in the Tanjung Pinang City Primary Health Care Work Area. Respondents were given seaweed as much as 200 gram for 7 days and the 8th day repeated hemoglobin levels were measured. After being given an intervention, there was an increase in hemoglobin levels in pregnant women by 1.2gr% and there were no more respondents suffering anemia. Keywords : consumption of seaweed, anemia in pregnancy

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Anemia and Low Birth Weight Risk After Fe Therapy in Pregnancy, Puskesmas Kecamatan Kebayoran Baru

Jurnal Ilmu Keperawatan (Journal of Nursing Science) ◽

10.21776/ub.jik.2021.009.01.14 ◽

2021 ◽

Vol 9 (1) ◽

pp. 109-115

Author(s):

Dyah Ponco Sudarmaningsih ◽

◽

Febrial Hikmah ◽

N Sri Widada ◽

Rustiana Tasya Ariningpraja

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Pregnant Women ◽

Physiological Changes ◽

Cross Sectional ◽

Before And After ◽

In Pregnancy

Physiological changes in pregnant women have an impact on reducing the hemoglobin (Hb) level so that they can experience anemia. Anemia in pregnant women is still a high case and be one of the factors of low birth weight (LBW). Iron (Fe) is consumed routinely is thought to help reduce the risk of anemia, but it's still not known yet between the relation of Fe consumed to LBW incidents. Data were taken by cross sectional as many as 150 samples of pregnant women. The results obtained that 56% of pregnant women had anemia. After Fe therapy doses 60-120 mg/day, Hb levels increased by 0.3 g/dL. Although there were significant differences before and after Fe therapy in pregnant women with anemia, about 74% of pregnant women still had experience anemia despite Fe therapy. Provision of Fe therapy for pregnant women either with a dose of 60-120 mg/day, had not been effective enough in increasing Hb levels. LBW cases were also found in this study, which is around 9.3%. Pregnant women with anemia have a higher risk of LBW. This indicates that offering Fe to pregnant women has not been effective.

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Factor VIII and Factor VIII Related Antigen in Normal Pregnancy

10.1055/s-0039-1682485 ◽

1977 ◽

Author(s):

G. O. S. de Melo

Keyword(s):

Factor Viii ◽

Pregnant Women ◽

Blood Group ◽

Normal Pregnancy ◽

Clear Tendency ◽

Factor Viii Related Antigen ◽

Blood Group A ◽

Significant Difference ◽

Group A ◽

In Pregnancy

Factor VIII and factor VIII related antigen were found to change proportionately during normal pregnancy. There was a clear tendency for levels of activity and antigen to increase as the duration of the pregnancy advanced. In the pregnant women studied a significant difference was observed in factor VIII levels between Blood Group A and Blood Group O. A similar difference was found in factor VIII related antigen levels. Age, weight and previous use of contraceptives seems to have no influence on factor VIII and factor VIII related antigen values in pregnancy.

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Continuous Exercise Coaching Through Smartphone to Improve Quality of Sleep for Pregnant Women: A Prospective Cohort Study (Preprint)

10.2196/preprints.18988 ◽

2020 ◽

Author(s):

Guiying Wang ◽

Xiao-Xian Yang ◽

Ziyu Xiong ◽

Daniel J Corsi ◽

Shi Wu Wen ◽

...

Keyword(s):

Sleep Quality ◽

Pregnant Women ◽

Categorical Variables ◽

Global Score ◽

Subjective Sleep Quality ◽

Continuous Exercise ◽

Group A ◽

Improve Sleep Quality ◽

Group B ◽

In Pregnancy

BACKGROUND Sleep quality is often affected by pregnancy, and exercise may improve sleep quality in pregnancy. However, the literature on the effect of integrating smartphones with continuous exercise coaching to improve sleep is sparse. OBJECTIVE This study aimed to explore the effect of continuous exercise coaching through smartphone on sleep quality for pregnant women. METHODS Pregnant women who met the eligibility criteria and agreed to participate at their first prenatal visit were enrolled and divided into two groups: group A (with continuous exercise coaching through smartphone) and group B (without exercise coaching). Pittsburgh Sleep Quality Index (PSQI) scale was used to measure the sleep quality. Chi-square test was used for categorical variables and t-test was used for continuously distributed variables for the comparison between the two groups. RESULTS In the 2nd trimester, means (SDs) of global score (9.46 (SD 3.46)), subjective sleep quality score (1.64 (SD 0.72)), and daytime dysfunction score (0.98 (SD 0.82) in group A (50 women)) were lower than in group B (50 women): 11.34 (SD 3.93), 2.02 (SD 0.74), and 1.48 (SD 0.84), respectively. In the 3rd trimester, means (SDs) of global score (10.16 (SD 3.00)), sleep efficiency score (1.64 (SD 0.72)), and daytime dysfunction score (1.86 (SD 0.67)) in group A were lower than in group B: 12.10 (SD 3.51), 1.82 (SD 0.80), and 1.78 (SD 0.76), respectively. In group A, global score of PSQI decreased from the 1st to 2nd trimester and from the 2nd to 3rd trimester. No inter-trimester change in global score of PSQI was observed in group B. CONCLUSIONS Our preliminary analysis suggests that continuous exercise coaching through smartphone by health professionals may be an effective way to improve sleep quality in pregnancy.

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Platelet count estimation: a prognostic index in pregnancy induced hypertension

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180158 ◽

2018 ◽

Vol 7 (2) ◽

pp. 476

Author(s):

Aakriti Gupta ◽

Jyoti Hak ◽

Isha Sunil ◽

Amita Gupta

Keyword(s):

Platelet Count ◽

Pregnant Women ◽

Prognostic Index ◽

Disease Process ◽

Late Pregnancy ◽

Control Group ◽

The Mean ◽

The Difference ◽

And Control ◽

In Pregnancy

Background: Hypertension in pregnancy is one of the serious complications of pregnancy with an incidence of 5% to 7% of all pregnancies, particularly in cases with preeclampsia and eclampsia. Though platelet count during pregnancy is within the normal non pregnant reference values, there is a tendency for the platelet count to fall in late pregnancy. The frequency and intensity of maternal thrombocytopenia varies and is dependent on the intensity of the disease process and duration of PIH syndrome.Methods: A prospective observational study was conducted on 200 pregnant women attending OPD Or Inpatients in the Department of Obstetrics and Gynecology, SMGS Hospital, GMC Jammu from November 2015 to October 2016. Pregnant women beyond 28 weeks gestation of pregnancy are included and divided into two groups i.e. the study and control group. Platelet counts will be done every 4 weeks in controls and weekly in subjects from 28 weeks till delivery.Results: The mean platelet count observed among cases of mild preecclampsia, severe preeclampsia and ecclampsia was 2.26, 1.63 and 0.99 lakh/mm3 respectively. The difference in mean platelet count among cases and controls was statistically significant. The association of platelet count with severity of different categories of PIH was analysed statistically and was highly significant.Conclusions: Platelet count is a very important investigation for the antenatal mother having PIH, as it is directly related to maternal and perinatal outcome. Routine and regular monitoring of platelet count can be included in the routine antenatal checkup among the pregnant women with PIH.

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Low platelet counts in pregnancy: an alarm signal for abruption!

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180916 ◽

2018 ◽

Vol 7 (3) ◽

pp. 1191 ◽

Cited By ~ 1

Author(s):

Anjali Mundkur ◽

K. P. Murali Krishnan Nambiar ◽

Lavanya Rai

Keyword(s):

Platelet Count ◽

Pregnant Women ◽

Connective Tissue Disorder ◽

Severe Thrombocytopenia ◽

Related Condition ◽

Alarm Signal ◽

Hematologic Disorder ◽

Gestational Thrombocytopenia ◽

In Pregnancy ◽

Do So

Background: Thrombocytopenia, defined as a platelet count less than 150 million/mm3, affects 6% to 10% of all pregnant women and other than anemia is the most common hematologic disorder in pregnancy.Methods: We studied all patients with thrombocytopenia in pregnancy from June 2012 to May 2013. There were 86 patients recruited into the study. Pregnant women with preeclampsia and suspected connective tissue disorder were also screened for thrombocytopenia. All women with platelet count of <1.50,000/µl during the study period were included.Results: Patients were grouped in to mild thrombocytopenia (platelet 100,000-149,999/µl), moderate thrombocytopenia (platelet 50,000-99,999/µl) and severe thrombocytopenia (platelet <49,999/µl. Pregnancy specific cause of thrombocytopenia was in 63 (73.2%) women and non-pregnancy specific were in 23(26.7%) patients.Conclusions: Preeclampsia and HELLP syndrome is more common cause of thrombocytopenia in pregnancy. Abruption can occur in patients with severe thrombocytopenia. Though platelet count is not routinely done in pregnancy it is advisable to do so as it may help in detecting gestational thrombocytopenia or other immune related condition.

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The Effect of Artemisinin-based Combination Therapy (ACT) Antimalaria Drugs on Liver Enzymes in Pregnancy

Journal of Advances in Medical and Pharmaceutical Sciences ◽

10.9734/jamps/2018/v19i430093 ◽

2019 ◽

pp. 1-6

Author(s):

Ajibade Oluwagbenga Oyeyemi ◽

Ayobola Abimbola Sonuga

Keyword(s):

Pregnant Women ◽

Malaria Parasite ◽

Harmful Effect ◽

Antenatal Clinic ◽

Significant Difference ◽

Group A ◽

Student’S T ◽

Group B ◽

And Control ◽

In Pregnancy

Aims: Artemisinin-based Combination Therapies (ACTs) are employed as first-line agents in malaria chemotherapy. This study is aimed at assessing the effects of ACTs on renal function of pregnant women. Study Design: Comparative study. Place and Duration of Study: Pregnant women aged 18 to 50 years were recruited from antenatal clinic of Obstetrics and Gynecology Department of Ekiti State Hospital, Ado Ekiti, Nigeria between 2016 and 2018 Methodology: One hundred and eighty pregnant women were grouped into three which include: Sixty pregnant women with malaria parasite on ACT drugs (Group A), sixty pregnant women with malaria parasite not on ACT drugs (Group B), sixty pregnant women without malaria parasite (Group C/control). Plasma Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), Alanine Transaminase (ALT) and Lactate Dehydrogenase (LDH) activities were evaluated by standard methods. The data collected were analyzed using one-way analysis of variance (ANOVA) and Student’s t test to compare the data between the test groups and control. Results: Results showed there was a significant decrease (P=.05) in Body Mass Index in the pregnant women with malaria on ACT and those that were not on ACT when compared with control (24.1± 0.32 versus (25+ 2.30 vs 27± 1.62). A significant increase (P=.05) occurred in the levels of ALP,AST, ALT and LDH in pregnant women with malaria not on ACT drugs when compared the control (168.45±0.19, 10.0±0.27, 8.19±0.25, 4.5±0.21) versus (143.20±0.12, 8.71±0.30, 5.99±0.21, 2.08±0.19),while no significant difference occurred in the levels of ALP,AST, ALT and LDH in pregnant women with malaria on ACT when compared with control (141.60±0.78, 8.02±0.32, 6.10±0.30, 2.75+ 0.20) vs (143.20±0.12, 8.71±0.30, 5.99±0.21, 2.08±0.19). Conclusion: Normal therapeutic dose of ACT has no harmful effect on the liver in pregnancy.

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Increase of PlGF (Placental Growth Factor) Level After Administration of Dydrogesterone in Pregnancy

KnE Medicine ◽

10.18502/kme.v1i1.530 ◽

2016 ◽

Vol 1 (1) ◽

Cited By ~ 1

Author(s):

Dewi Karlina Rusly

Keyword(s):

Folic Acid ◽

Controlled Clinical Trial ◽

Randomized Controlled ◽

Significant Difference ◽

Before And After ◽

Group A ◽

Study Population ◽

The Mean ◽

Group B ◽

In Pregnancy

Aim: To observe the effect of Dydrogesterone administration in pregnancy on PlGF levelMethods: This is a randomized controlled clinical trial. Study population has been divided into two groups. Group A consists of 20 women who receive only Folic acid 5 mg a day for 4 weeks time. Group B consists of 20 women who receive Dydrogesterone 2x10 mg a day and Folic acid 5 mg a day for 4 weeks. PlGF has been measured twice. First measurement was done before drug administration, while the second measurement has been done during 18th weeks of pregnancy. The changes on PlGF level before and after treatment from each group has been analyzed using SPSS 17.Results: 40 pregnant women have been recruited for this study. There are no differences based on the patient’s age, number of pregnancy and parity, gestational age and body weight between each group. The mean levels of PlGF in both groups before intervention shows no significant difference (p = 0091 or p> 0.05), 40.80 pg/mL vs. 25.95 pg / mL. The mean levels of PlGF in group A after 4 weeks administration of Folic acid is 89.60 pg / mL. It shows the escalation of 48.8 pg / mL. The elevation of PlGF level in group A shows significant difference (p = 0.000 or p <0.05) after 4 weeks Folic acid treatment.The mean levels of PlGF in group B after 4 weeks administration of Dydrogesterone and Folic acid is 212.15 pg / mL. It shows the escalation of 186.20 pg / mL. The elevation of PlGF level in group B shows significant difference (p = 0.000 or p <0.05) after 4 weeks Dydrogesterone and Folic acid treatment.Conclusion: Dydrogesterone treatment can increase the level of PlGF.

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