Hypertension in pregnancy

2010 ◽  
pp. 2093-2102 ◽  
Author(s):  
C.W.G. Redman
Keyword(s):  
Blood Pressure ◽  
Renal Insufficiency ◽  
Arterial Pressure ◽  
Diastolic Pressure ◽  
Gestational Hypertension ◽  
Systolic Pressure ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Pregnancy Induced Hypertension ◽  
In Pregnancy

In normal pregnancy the arterial pressure falls in the second half of the first trimester: systolic pressure then remains unchanged throughout pregnancy, with diastolic pressure tending to rise gradually towards its prepregnancy level in the later weeks. Definitions, epidemiology and clinical features—(1) Pregnancy-induced hypertension (PIH), transient hypertension of pregnancy, or gestational hypertension describe new hypertension, defined as blood pressure equal to or in excess of 140/90 mmHg, which without proteinuria affects up to 10% of women after mid term (20 weeks) and resolves after delivery. (2) Pre-eclampsia, which affects 3 to 5% of pregnancies, is defined by the presence of PIH and pregnancy-induced proteinuria arising after 20 weeks gestation that both improve after delivery. Other features include (a) renal insufficiency; (b) hepatocellular dysfunction and/or severe epigastric/right upper quadrant pain; (c) neurological problems—convulsions (eclampsia), severe headaches, persistent scotomata; (d) haematological disturbances—thrombocytopenia, disseminated intravascular coagulation, haemolysis; (e) fetal growth restriction....

scholarly journals Effects of transient intrathoracic pressure changes (hiccups) on systemic arterial pressure

1997 ◽  
Vol 83 (2) ◽  
pp. 371-375 ◽  
Author(s):  
Oommen P. Mathew
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Stroke Volume ◽  
Systolic Blood Pressure ◽  
Cardiac Cycle ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Intrathoracic Pressure ◽  
Systemic Arterial Pressure ◽  
Pressure Changes

Mathew, Oommen P. Effects of transient intrathoracic pressure changes (hiccups) on systemic arterial pressure. J. Appl. Physiol. 83(2): 371–375, 1997.—The purpose of the study was to determine the effect of transient changes in intrathoracic pressure on systemic arterial pressure by utilizing hiccups as a tool. Values of systolic and diastolic pressures before, during, and after hiccups were determined in 10 intubated preterm infants. Early-systolic hiccups decreased systolic blood pressure significantly ( P < 0.05) compared with control (39.38 ± 2.72 vs. 46.46 ± 3.41 mmHg) and posthiccups values, whereas no significant change in systolic blood pressure occurred during late-systolic hiccups. Diastolic pressure immediately after the hiccups remained unchanged during both early- and late-systolic hiccups. In contrast, diastolic pressure decreased significantly ( P < 0.05) when hiccups occurred during diastole (both early and late). Systolic pressures of the succeeding cardiac cycle remained unchanged after early-diastolic hiccups, whereas they decreased after late-diastolic hiccups. These results indicate that transient decreases in intrathoracic pressure reduce systemic arterial pressure primarily through an increase in the volume of the thoracic aorta. A reduction in stroke volume appears to contribute to the reduction in systolic pressure.

scholarly journals Late diagnosis of pheochromocytoma in pregnancy with poor fetal outcome

2021 ◽  
Vol 27 (1) ◽  
pp. 9-11 ◽  
Author(s):  
Gauri Bapayeva ◽  
Milan Terzic ◽  
Karlygash Togyzbayeva ◽  
Aigerim Bekenova ◽  
Sanja Terzic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Fetal Lung ◽  
Abdominal Ultrasound ◽  
First Trimester ◽  
Maternal Blood ◽  
Fetal Outcome ◽  
Hypertensive Disorder ◽  
Emergency Cesarean ◽  
In Pregnancy

Pheochromocytomas are rare tumors producing catecholamines that could be a cause of secondary hypertension. On that basis, pheochromocytoma can occur as an extremely rare cause of hypertension in pregnancy and if diagnosed late can lead to adverse maternal-fetal outcome. In this case report we describe a case of pheochromocytoma affected pregnancy with poor fetal outcome. A 27-year-old pregnant woman was admitted for severe pre-eclampsia due to pre-gestational hypertension that was diagnosed during the first trimester. Due to high and uncontrolled maternal blood pressure and the worsened maternal-fetal condition after the admission induction of fetal lung maturity and emergency cesarean section were performed, but with poor fetal outcome. Later, an adrenal gland mass was identified using abdominal ultrasound and confirmed by computed tomography. After surgical adrenalectomy blood pressure of the patient was normalized. Pheochromocytoma should be considered as a possible cause of hypertensive disorder during pregnancy, particularly in cases of severe and unresponsive hypertension in order to provide for timely and appropriate treatment.

BLOOD PRESSURE BEFORE, DURING, AND AFTER OVIPOSITION IN THE HEN

1962 ◽  
Vol 40 (2) ◽  
pp. 177-180
Author(s):  
W. G. Hunsaker ◽  
P. D. Sturkie
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Marked Change ◽  
Maximum Level ◽  
Minimum Level ◽  
Pressure Pattern ◽  
Average Decrease ◽  
Large Fluctuations

The central arterial pressure was recorded continuously in eight hens before, during, and after oviposition. Blood pressure remained relatively stable for the 2-hour period prior to oviposition. Approximately 30 seconds prior to oviposition, there was a marked change in the pressure pattern. While there was no marked increase in the maximum level of systolic pressure or decrease in the minimum level of the diastolic pressure, there were large fluctuations within this range. Immediately after oviposition there was a decrease in pressure in seven of the eight birds studied. The average decrease in systolic pressure was 17.6 mm Hg and in diastolic pressure 7.6 mm Hg. There were indications of an increase in pressure within about 15 minutes after oviposition.

scholarly journals Normal pregnancy: mechanisms underlying the paradox of a ouabain-resistant state with elevated endogenous ouabain, suppressed arterial sodium calcium exchange, and low blood pressure

2012 ◽  
Vol 302 (6) ◽  
pp. H1317-H1329 ◽  
Author(s):  
Brandiese E. Jacobs ◽  
Yong Liu ◽  
Maria V. Pulina ◽  
Vera A. Golovina ◽  
John M. Hamlyn
Keyword(s):  
Blood Pressure ◽  
Vascular Resistance ◽  
Normal Pregnancy ◽  
Pregnancy Induced Hypertension ◽  
Sodium Calcium ◽  
Endogenous Ouabain ◽  
Induced Hypertension ◽  
Calcium Exchange ◽  
Resistant State ◽  
In Pregnancy

Endogenous cardiotonic steroids (CTS) raise blood pressure (BP) via vascular sodium calcium exchange (NCX1.3) and transient receptor-operated channels (TRPCs). Circulating CTS are superelevated in pregnancy-induced hypertension and preeclampsia. However, their significance in normal pregnancy, where BP is low, is paradoxical. Here we test the hypothesis that vascular resistance to endogenous ouabain (EO) develops in normal pregnancy and is mediated by reduced expression of NCX1.3 and TRPCs. We determined plasma and adrenal levels of EO and the impact of exogenous ouabain in pregnancy on arterial expression of Na+ pumps, NCX1.3, TRPC3, and TRPC6 and BP. Pregnant (embryonic day 4) and nonpregnant rats received infusions of ouabain or vehicle. At 14–16 days, tissues and plasma were collected for blotting and EO assay by radioimmunoassay (RIA), liquid chromatography (LC)-RIA, and LC-multidimensional mass spectrometry (MS3). BP (−8 mmHg; P < 0.05) and NCX1.3 expression fell (aorta −60% and mesenteric artery −30%; P < 0.001) in pregnancy while TRPC expression was unchanged. Circulating EO increased (1.14 ± 0.13 nM) vs. nonpregnant (0.6 ± 0.08 nM; P < 0.05) and was confirmed by LC-MS3 and LC-RIA. LC-MS3 revealed two previously unknown isomers of EO; one increased ∼90-fold in pregnancy. Adrenal EO but not isomers were increased in pregnancy. In nonpregnant rats, similar infusions of ouabain raised BP (+24 ± 3 mmHg; P < 0.001). In ouabain-infused rats, impaired fetal and placental growth occurred with no BP increase. In summary, normal pregnancy is an ouabain-resistant state associated with low BP, elevated circulating levels of EO, two novel steroidal EO isomers, and increased adrenal mass and EO content. Ouabain raises BP only in nonpregnant animals. Vascular resistance to the chronic pressor activity of endogenous and exogenous ouabain is mediated by suppressed NCX1.3 and reduced sensitivity of events downstream of Ca2+ entry. The mechanisms of EO resistance and the impaired fetal and placental growth due to elevated ouabain may be important in pregnancy-induced hypertension (PIH) and preeclampsia (PE).

BLOOD PRESSURE BEFORE, DURING, AND AFTER OVIPOSITION IN THE HEN

1962 ◽  
Vol 40 (1) ◽  
pp. 177-180
Author(s):  
W. G. Hunsaker ◽  
P. D. Sturkie
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Marked Change ◽  
Maximum Level ◽  
Minimum Level ◽  
Pressure Pattern ◽  
Average Decrease ◽  
Large Fluctuations

The central arterial pressure was recorded continuously in eight hens before, during, and after oviposition. Blood pressure remained relatively stable for the 2-hour period prior to oviposition. Approximately 30 seconds prior to oviposition, there was a marked change in the pressure pattern. While there was no marked increase in the maximum level of systolic pressure or decrease in the minimum level of the diastolic pressure, there were large fluctuations within this range. Immediately after oviposition there was a decrease in pressure in seven of the eight birds studied. The average decrease in systolic pressure was 17.6 mm Hg and in diastolic pressure 7.6 mm Hg. There were indications of an increase in pressure within about 15 minutes after oviposition.

scholarly journals RETINAL CHANGES IN PREGNANCY INDUCED-HYPERTENSION

2021 ◽  
pp. 18-20
Author(s):  
MANDAR ZADE ◽  
V. PANIMALAR A. VEERAMANI ◽  
DIVYA N. ◽  
BINDU BHASKARAN
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Tertiary Hospital ◽  
The Body ◽  
Hypertensive Retinopathy ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Induced Hypertension ◽  
Changes In Pregnancy ◽  
In Pregnancy

Objective: The aim is to determine the prevalence of retinal changes in Pregnancy Induced Hypertension (PIH) and its association with age, parity, proteinuria, blood pressureand severity of PIH. Methods: This is a tertiary hospital based Cross-Sectional study including all patients, clinically diagnosed with Pregnancy Induced Hypertension. General demographic details along with age, gravida, gestation period, proteinuria, blood pressure and severity of PIH were noted. Ophthalmic examination was performed and detailed fundus examination was done. Results: A total of 52 patients were included in this study. Their mean age was 24.9 y; 32 out of 52 patients were primigravida (61%) and 20 patients were multi gravida (39%). Out of 52 patients 34 (65.38%) had Gestational Hypertension, 16 (30.76%) had preeclampsia, and 2 (3.8%) had eclampsia. 3 (5.76%) out of 29 patients with BP<160/100 mmHg and 10 (19.23%) out of 23 patients with BP>160/100 mmHg had developed Hypertensive Retinopathy. Hypertensive Retinopathy was seen in 13 (25%). Proteinuria was seen in 10 (19.23%) patients ranging between+to+++on the dipstick. Conclusion: Statistically significant correlation between retinal changes and proteinuria, blood pressure and severity of Disease.The most important requisite in a case of Pregnancy Induced Hypertension is Fundoscopic examination of retina. The retinal vessels during PIH form a gateway to visualize changes in the body and placental vessels, and may play a key role in early detection and treatment of PIH for protection of the mother as well as the fetus.

PROSTACYCLIN PRODUCTION BY UMBILICAL ARTERIES FROM PREGNANCIES COMPLICATED BY SEVERE PREGNANCY INDUCED HYPERTENSION

1987 ◽  
Author(s):  
M McLaren ◽  
I T A Greer ◽  
C D Forbes
Keyword(s):  
Blood Pressure ◽  
Diastolic Pressure ◽  
Well Being ◽  
Normal Pregnancy ◽  
Significant Rise ◽  
Pregnancy Induced Hypertension ◽  
Platelet Poor Plasma ◽  
Normal Platelet ◽  
Induced Hypertension ◽  
Umbilical Arteries

Approximately ten per cent of allpregnancies are complicated by some degree of hypertensive disease. Since the level of blood pressure is closely related to foetal well-being, if the blood pressure is consistentlyelevated during pregnancy, there is an associated increase in perinatal mortality. Various workers have suggested involvement of prostaglandins in the pathogenesis of pregnancy induced hypertension (PIH). One of our previous studies showed unrecordablelevels of plasma prostacyclin metabolites (PGI2m) of <5pg/ml in all hypertensive patients during the third trimester, whereas none of the normalgroup developed unrecordable levels at any stage.In this study we used an umbilical artery perfusion model to compare the ability of normal platelet poor plasma, which has been shown to contain a PGI2 stimulating factor, to stimulate production of PGI2 from arteries from normal pregnancies and pregnancies complicated by PIH. Arteries from two patients suffering from PIH with persistent diastolic pressure of >90mm mercury were exhausted of spontaneous PGI2 production beforeperfusion with normal platelet poor plasma. In each case an artery from a normal pregnancy was used as a control. In each experiment levels of PGI2 rose from a baseline level of<50pg/ml to <1000 pg/ml in the normal arteries, whereas the arteries from PIH patients showed no significant rise. It would seem therefore that ourfinding of unrecordable levels of plasma PGI2m in hypertensive pregnancies may be related to defective endothelial cell production.

DESIGN AN “IN HOUSE” SOFTWARE FOR SCREENING PREECLAMPSIA BY MATERNAL FACTORS AND MEAN ARTERIAL PRESSURE AT 11 – 13 WEEKS IN COMMUNE HEALTH CENTERS.

2015 ◽  
pp. 115-126
Author(s):  
Viet Nhan Nguyen ◽  
Ngoc Thanh Cao ◽  
Thi Minh Thi Ha ◽  
Van Duc Vo ◽  
Quang Vinh Truong ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Gestational Hypertension ◽  
Area Under The Curve ◽  
Health Centers ◽  
Maternal Factors ◽  
Good Tool ◽  
Uterine Artery Doppler ◽  
Study Results ◽  
In Pregnancy

Objective: Design an “in house” software for screening preeclampsia by maternal factors and mean arterial pressure at 11 – 13 gestational weeks in commune health centers. Methods: Based on the algorithms for calculating the risk of preeclampsia (PE) by maternal factors and mean artirial pressure at 11 - 13 gestational weeks in the study results of the authors, an “in house” software was deigned in Excel. The results of prediction preeclampsia by The Fetal Medicine Foundation (FMF)(version 2.3) were compared with the results by “in house” software in 1110 singleton pregnant women. Results: The “in house” software met the requirements for calculating the risks of PE and save data. FMF risk for gestational hypertension disorder in pregnancy by maternal factors, mean arterial pressure,uterine artery Doppler and PAPP-A has an area under the curve of 0.68 (95%CI: 0.59 – 0.78). The “in house” software risk for gestational hypertension in pregnancy by maternal factors, mean arterial pressure has an area under the curve of 0.643 (0.55 – 0.73) There was no statistically significant different between two programs (p:0.52). The risk cut-off 1:50 in the prediction of gestational hypertension of the “in house” software was used to identify the group of high risk with detetion rate (DR) 28.6% (95%CI: 14.9-42.2) comparing to 40.5% (95%CI:25.6-55.3) of FMF. Conclusion: The FMF version 2.3 is better but in the absence of Doppler ultrasound and PAPP-A test in the commune health cares, the “in house” software for screening PE is a good tool for councelling, following up and early intervention for PE.

scholarly journals Telomere Length as a Biomarker for Race-Related Health Disparities

Genes ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 78
Author(s):  
Vaithinathan Selvaraju ◽  
Megan Phillips ◽  
Anna Fouty ◽  
Jeganathan Ramesh Babu ◽  
Thangiah Geetha
Keyword(s):  
Blood Pressure ◽  
Telomere Length ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Single Copy ◽  
Normal Weight ◽  
Length Ratio ◽  
Hierarchical Regression ◽  
Significant Difference ◽  
The Usa

Disparities between the races have been well documented in health and disease in the USA. Recent studies show that telomere length, a marker of aging, is associated with obesity and obesity-related diseases, such as heart disease and diabetes. The current study aimed to evaluate the connection between telomere length ratio, blood pressure, and childhood obesity. The telomere length ratio was measured in 127 children from both European American (EA) and African American (AA) children, aged 6–10 years old. AA children had a significantly high relative telomere to the single copy gene (T/S) ratio compared to EA children. There was no significant difference in the T/S ratio between normal weight (NW) and overweight/obese (OW/OB) groups of either race. Blood pressure was significantly elevated in AA children with respect to EA children. Hierarchical regression analysis adjusted for race, gender, and age expressed a significant relationship between the T/S ratio and diastolic pressure. Low T/S ratio participants showed a significant increase in systolic pressure, while a high T/S ratio group showed an increase in diastolic pressure and heart rate of AA children. In conclusion, our findings show that AA children have high T/S ratio compared to EA children. The high T/S ratio is negatively associated with diastolic pressure.

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