Placental hypoplasia and maternal organic vascular disorder in pregnant women with gestational hypertension and preeclampsia

2019 ◽  
Vol 34 (3) ◽  
pp. 353-359 ◽  
Author(s):  
Yuki Owaki ◽  
Kazushi Watanabe ◽  
Ai Iwasaki ◽  
Takuya Saitou ◽  
Hiroshi Matsushita ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Hypertension ◽  
Vascular Disorder

scholarly journals The Association of Familial Hypertension and Risk of Gestational Hypertension and Preeclampsia

2021 ◽  
Vol 18 (13) ◽  
pp. 7045
Author(s):  
Małgorzata Lewandowska
Keyword(s):  
Risk Factor ◽  
Pregnant Women ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
Gestational Hypertension ◽  
First Trimester ◽  
Chronic Hypertension ◽  
Modifiable Factors ◽  
The Family ◽  
Maternal Hypertension

It has not been established how history of hypertension in the father or mother of pregnant women, combined with obesity or smoking, affects the risk of main forms of pregnancy-induced hypertension. A cohort of 912 pregnant women, recruited in the first trimester, was assessed; 113 (12.4%) women developed gestational hypertension (GH), 24 (2.6%) developed preeclampsia (PE) and 775 women remained normotensive (a control group). Multiple logistic regression was used to calculate adjusted odds ratios (AOR) (and 95% confidence intervals) of GH and PE for chronic hypertension in the father or mother of pregnant women. Some differences were discovered. (1) Paternal hypertension (vs. absence of hypertension in the family) was an independent risk factor for GH (AOR-a = 1.98 (1.2–3.28), p = 0.008). This odds ratio increased in pregnant women who smoked in the first trimester (AOR-a = 4.71 (1.01–21.96); p = 0.048) or smoked before pregnancy (AOR-a = 3.15 (1.16–8.54); p = 0.024), or had pre-pregnancy overweight (AOR-a = 2.67 (1.02–7.02); p = 0.046). (2) Maternal hypertension (vs. absence of hypertension in the family) was an independent risk factor for preeclampsia (PE) (AOR-a = 3.26 (1.3–8.16); p = 0.012). This odds ratio increased in the obese women (AOR-a = 6.51 (1.05–40.25); p = 0.044) and (paradoxically) in women who had never smoked (AOR-a = 5.31 (1.91–14.8); p = 0.001). Conclusions: Chronic hypertension in the father or mother affected the risk of preeclampsia and gestational hypertension in different ways. Modifiable factors (overweight/obesity and smoking) may exacerbate the relationships in question, however, paradoxically, beneficial effects of smoking for preeclampsia risk are also possible. Importantly, paternal and maternal hypertension were not independent risk factors for GH/PE in a subgroup of women with normal body mass index (BMI).

scholarly journals PREVALENCE, ASSOCIATED FACTORS AND ROLE OF VITAMIN D AND GLUTATHIONE REDUCTASE OF PRE-ECLAMPSIA IN PREGNANT WOMEN

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Simerpreet Kukreja
Keyword(s):  
Fatty Acids ◽  
Vitamin D ◽  
Pregnant Women ◽  
Glutathione Reductase ◽  
Gestational Hypertension ◽  
Multiple Pregnancy ◽  
Vitamin D Supplementation ◽  
Research Centre ◽  
Biochemical Basis

Introduction: In maternal and neonatal cases, preeclampsia is a multi-organ, heterogeneous pregnancy condition associated with significant morbidity and mortality. Since preeclampsia is a progressive disease, in some cases, delivery is necessary to stop the progression to the benefit of the mother and foetus. However, the need for early delivery has adverse effects on significant neonatal outcomes that are not limited to the most premature babies. The results include oxidative stress in the disease and invoke the biochemical basis for antioxidant clinical trials to prevent and treat hypertension caused by pregnancy. In the management of preeclampsia, supplementation of antioxidants along with polyunsaturated fatty acids, particularly omega-3 fatty acids, may be useful. This describes vitamin Ds potential role in the pathogenesis of preeclampsia. However, the role of vitamin D supplementation and dosing is controversial in preventing preeclampsia. Method: The study was carried out from March 2019 to April 2020 at Shalinitai Meghe Hospital and Research Centre using institutional-based cross-sectional study design among women whose age was greater than or equal to eighteen. Data were collected using a standardised and pretested questionnaire from 150 participants by face-to - face interview technique. Using Chemiluminiscent Immunoassay (CLIA), vitamin D estimation was performed. The behaviour of Glutathione Reductase was calculated according to the Goldberg et al 1983 procedure. To classify the factors associated with the development of preeclampsia, logistic regression analysis was used. Result: With a mean age of 30.28, a total of 150 participants were enrolled in the study. Evaluation of vitamin D and glutathione levels The prevalence of preeclampsia among current pregnant women attending ANC at Shalinitai Meghe Hospital was 16 with a 95 % CI. The current preeclampsia was significantly correlated with predictive variables such as the age of the respondents, current multiple pregnancy, and history of diabetes mellitus. Conclusion: The findings of this study showed that preeclampsia was present in a large proportion of women. For both urban and rural residents, health seeking actions towards pregnant women should be promoted, offering an opportunity to detect preeclampsia as early as possible and preventing the coming complication of preeclampsia. The role of antioxidants is controversial in the prevention of preeclampsia. Vitamin D deficiency is associated with preeclampsia in a major way. To document the role of vitamin D supplementation in the prevention of preeclampsia, further studies are required.  Keywords: Gestational hypertension, Pre-eclampsia, Vitamin D, GSH

Prevalence and Predictors of Gestational Hypertension: a Cross-Sectional Study among Moroccan Pregnant Women

2021 ◽  
Vol 13 (1) ◽  
pp. 1-9
Author(s):  
A. El Kardoudi ◽  
K. Kaoutar ◽  
A. Chetoui ◽  
K. Boutahar ◽  
S. Elmoussaoui ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Household Income ◽  
Gestational Hypertension ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

The objective of this study was to assess the prevalence of gestational hypertension, and to determine its predictors among pregnant women attending primary health care facilities in Beni Mellal city in Morocco. The prevalence of gestational hypertension was 18.7%. The low monthly household income (Adjusted Odds Ratio (AOR) = 7.874; IC 95% = [1.788–34.67]), gestational age less than 37 weeks (AOR = 6.860; IC 95% = [1.285–36.626]), limited knowledge on gestational hypertension (AOR = 12.719; IC 95% = [3.386–47.785]), and primigravidity (AOR = 9.047; IC 95% = [1.595–51.324]), were significantly associated with gestational hypertension.

P2639The influence of non-dipping pattern of blood pressure in gestational hypertension on early onset of hypertension later in life

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Ilic ◽  
S Stojsic ◽  
J Papovic ◽  
D Grkovic ◽  
T Miljkovic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Regression Analysis ◽  
Left Ventricle ◽  
Pregnant Women ◽  
Preterm Delivery ◽  
Gestational Hypertension ◽  
Systolic Function ◽  
Blood Pressure Monitoring ◽  
Night Time ◽  
Lv Mass

Abstract Background It is known that gestational hypertension (GH) and preeclampsia have been associated with the onset of hypertension later in life. We wondered if the blood pressure (BP) pattern affects the incidence of hypertension in the future. Purpose The aim of this study was to determine whether hypertension occurs more frequently if a non-dipping pattern was registered during GH, but also if non-dipping pattern in GH afects deterioration of systolic function of the left ventricle (LV) later in life. Methods This longitudinal study included 56 pregnant women with gestational hypertension (of which 28 met criteria for non-dipping pattern of BP, according to the values registrated by the ambulatory blood pressure monitoring (ABPM) – non-dippers, while other 28 were classified in dippers) and 27 normotensive pregnant women, as control. All of women became normotensive after delivery, but they continued to be periodically controlled in term of values of blood pressure. The function and morphology of the left ventricle (LV) were analyzed by echocardiography exam in the third trimester of pregnancy and 5 years after delivery, as well as ABPM, while 2D longitudinal strain (LS) was performed only after delivery in order to evaluate systolic function of the LV. All echo and ABPM parameters recorded during pregnancy, also as parameters of pregnancy outcome – intrauterine growth restriction (IUGR) and preterm delivery, were analyzed, in order to relate them with later onset of hypertension. Results After, average 5 years, diagnosis of hypertension was determined in 8 women (2 from dipper group – during pregnancy – 7,1%, and 6 from non-dipper group 21,4%). Those 8 hypertensive women had significantly reduced LS: −18,12±1,3 compared to normotensive −19,9±1,4 (p=0,001). It is very interesting that, 5 years after delivery, values of 2D LS were, although in reference values, significantly reduced in women who were non-dippers (−19,32±1,38) during GH, compared with both, normotensive (−20,69±1,18; p<0,0005) and dippers (−20,10±1,29; p=0,026). Univariate regression analysis revealed that higher values of day and night BP, the mean arterial BP, LV mass index, preterm delivery and IUGR were associated with onset of hypertension later in life, while parameters of systolic and diastolic function of the LV during pregnancy, didn't affect occurrence of it. As revealed by multivariate regression analysis, the peak value of night-time diastolic blood pressure during pregnancy (p=0,016; OR=1,127; 95% CI: 1,022–1,242) and the LV mass index, also during pregnancy (p=0,041; OR=1,099; 95% CI: 1,004–1,203) had strong relation with hypertension in future life. Conclusion The non-dipping pattern of blood pressure in gestationl hypertension is significant associate with onset of hypertension later in life, but also with decreased systolic function of the left ventricle. Acknowledgement/Funding Provincial Secretariat for Health of the Autonomous Province of Vojvodina

scholarly journals A Proposed Plan for Prenatal Care to Minimize Risks of COVID-19 to Patients and Providers: Focus on Hypertensive Disorders of Pregnancy

2020 ◽  
Vol 37 (08) ◽  
pp. 837-844 ◽  
Author(s):  
John R. Barton ◽  
George R. Saade ◽  
Baha M. Sibai
Keyword(s):  
Pregnant Women ◽  
Disease Progression ◽  
Complete Blood Count ◽  
Gestational Hypertension ◽  
Epigastric Pain ◽  
Signs And Symptoms ◽  
Health Care Facilities ◽  
Hypertensive Disorder ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Hypertensive disorders are the most common medical complications of pregnancy and a major cause of maternal and perinatal morbidity and death. The detection of elevated blood pressure during pregnancy is one of the cardinal aspects of optimal antenatal care. With the outbreak of novel coronavirus disease 2019 (COVID-19) and the risk for person-to-person spread of the virus, there is a desire to minimize unnecessary visits to health care facilities. Women should be classified as low risk or high risk for hypertensive disorders of pregnancy and adjustments can be accordingly made in the frequency of maternal and fetal surveillance. During this pandemic, all pregnant women should be encouraged to obtain a sphygmomanometer. Patients monitored for hypertension as an outpatient should receive written instructions on the important signs and symptoms of disease progression and provided contact information to report the development of any concern for change in status. As the clinical management of gestational hypertension and preeclampsia is the same, assessment of urinary protein is unnecessary in the management once a diagnosis of a hypertensive disorder of pregnancy is made. Pregnant women with suspected hypertensive disorders of pregnancy and signs and symptoms associated with the severe end of the disease spectrum (e.g., headaches, visual symptoms, epigastric pain, and pulmonary edema) should have an evaluation including complete blood count, serum creatinine level, and liver transaminases (aspartate aminotransferase and alanine aminotransferase). Further, if there is any evidence of disease progression or if acute severe hypertension develops, prompt hospitalization is suggested. Current guidelines from the American College of Obstetricians and Gynecologists (ACOG) and The Society for Maternal-Fetal Medicine (SMFM) for management of preeclampsia with severe features suggest delivery after 34 0/7 weeks of gestation. With the outbreak of COVID-19, however, adjustments to this algorithm should be considered including delivery by 30 0/7 weeks of gestation in the setting of preeclampsia with severe features. Key Points

Impact of physical activity and traumatic exposure on occurrence of gestational hypertension: a survey of pregnant women in an armed-conflict region in Nigeria

2020 ◽  
Vol 39 (3) ◽  
pp. 295-301
Author(s):  
Aliyu Lawan ◽  
Cecelia Apeyemi ◽  
Muhammad Chutiyami ◽  
Umar Muhammad Bello ◽  
Dauda Salihu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pregnant Women ◽  
Armed Conflict ◽  
Gestational Hypertension ◽  
Traumatic Exposure

scholarly journals Pre-Pregnancy Obesity, Excessive Gestational Weight Gain, and the Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus

2020 ◽  
Vol 9 (6) ◽  
pp. 1980 ◽  
Author(s):  
Małgorzata Lewandowska ◽  
Barbara Więckowska ◽  
Stefan Sajdak
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Pregnancy Complications ◽  
Gestational Hypertension ◽  
Institute Of Medicine ◽  
Maternal Weight ◽  
Odds Ratios ◽  
Gestational Weight ◽  
The Relationship

Excessive pre-pregnancy weight is a known risk factor of pregnancy complications. The purpose of this analysis was to assess the relationship between several categories of maternal weight and the risk of developing hypertension and diabetes in pregnancy, and the relationship of these complications with the results of the newborn. It was carried out in a common cohort of pregnant women and taking into account the influence of disturbing factors. Our analysis was conducted in a prospective cohort of 912 Polish pregnant women, recruited during 2015–2016. We evaluated the women who subsequently developed diabetes with dietary modification (GDM-1) (n = 125) and with insulin therapy (GDM-2) (n = 21), as well as the women who developed gestational hypertension (GH) (n = 113) and preeclampsia (PE) (n = 24), compared to the healthy controls. Odds ratios of the complications (and confidence intervals (95%)) were calculated in the multivariate logistic regression. In the cohort, 10.8% of the women had pre-pregnancy obesity (body mass index (BMI) ≥ 30 kg/m2), and 36.8% had gestational weight gain (GWG) above the range of the Institute of Medicine recommendation. After correction for excessive GWG and other confounders, pre-pregnancy obesity (vs. normal BMI) was associated with a higher odds ratio of GH (AOR = 4.94; p < 0.001), PE (AOR = 8.61; p < 0.001), GDM-1 (AOR = 2.99; p < 0.001), and GDM-2 (AOR = 11.88; p <0.001). The threshold risk of development of GDM-2 occurred at lower BMI values (26.9 kg/m2), compared to GDM-1 (29.1 kg/m2). The threshold point for GH was 24.3 kg/m2, and for PE 23.1 kg/m2. For GWG above the range (vs. GWG in the range), the adjusted odds ratios of GH, PE, GDM-1, and GDM-2 were AOR = 1.71 (p = 0.045), AOR = 1.14 (p = 0.803), AOR = 0.74 (p = 0.245), and AOR = 0.76 (p = 0.672), respectively. The effect of maternal edema on all the results was negligible. In our cohort, hypertension and diabetes were associated with incorrect birth weight and gestational age at delivery. Conclusions: This study highlights the importance and influence of excessive pre-pregnancy maternal weight on the risk of pregnancy complications such as diabetes and hypertension which can impact fetal outcomes.

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