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

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.

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Perinatal outcomes in women with a history of bariatric surgery

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2006.10.749 ◽

2006 ◽

Vol 195 (6) ◽

pp. S208 ◽

Cited By ~ 1

Author(s):

Molly Heinzen ◽

Mahmoud Ismail ◽

Jennifer Ahn

Keyword(s):

Bariatric Surgery ◽

Perinatal Outcomes ◽

History Of

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Epidemiological Profile and Postpartum Outcome for Severe Preeclamptic Patients

Khalij-Libya Journal of Dental and Medical Research ◽

10.47705/kjdmr.215207 ◽

2021 ◽

pp. 45-50

Author(s):

Suher Dafaus ◽

Amel Morgham ◽

Nasreen Osman

Keyword(s):

Caesarean Section ◽

Positive Family History ◽

Previous History ◽

Severe Preeclampsia ◽

Intrauterine Fetal Death ◽

Chronic Hypertension ◽

Hypertensive Disorder ◽

Adequate Treatment ◽

History Of ◽

The Mean

Background and objective. Preeclampsia is a multisystemic disorder, which involves the placenta, liver, blood, neurological and cardiovascular systems. It is one of the leading causes of maternal and fetal morbidity and mortality. This study aimed at describing the characteristic features for mothers who had severe preeclampsia and to know the complications during puerperium. Methods. A prospective study conducted over a period from February 2009 up to November 2009 involving 100 pre-eclampsia patients admitted and delivered in Aljalaa Maternity Hospital, Tripoli, Libya. Results. The patients mean age was 33.3 +5.9 years. The mean gestational age at admission time was 36.8+3.2 weeks and 64% of them were term. 58% of the patients with severe preeclampsia had a positive family history of chronic hypertension whereas 42% of patients had a previous history of preeclampsia. 40% of patients were primigravida. The mean systolic blood pressure at admission was 164+15.4 mmHg and the mean diastolic pressure was 113+6 mmHg. The common symptoms were headache, abdominal pain, and blurred vision (54%, 37%, and 31% respectively), whereas 9% of the patients presented with the eclamptic fit. The pregnancy in 66% patients ended by caesarean section, 78% of them were emergency caesarean section. The birth weight of 13% of new-borns was less than 1500 grams. Furthermore, 10% diagnosed with intrauterine fetal death (IUFD) antenatally and 9% died after admission to nursery intensive care unit post-delivery. Conclusion. the effects of hypertensive disorder associated with pregnancy could be prevented by close antenatal care particularly for whose had previous history of preeclampsia. In addition; early recognition and adequate treatment, and timely delivery can prevent preeclampsia and will improve maternal and neonatal outcomes.

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Pushing behavior and hemiparesis: which is critical for functional recovery in pusher patients ? Case report

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2007000300035 ◽

2007 ◽

Vol 65 (2b) ◽

pp. 536-539 ◽

Cited By ~ 9

Author(s):

Taiza E.G. Santos-Pontelli ◽

Octávio M. Pontes-Neto ◽

José Fernando Colafêmina ◽

Dráulio B. de Araújo ◽

Antônio Carlos Santos ◽

...

Keyword(s):

Case Report ◽

Barthel Index ◽

Functional Improvement ◽

Chronic Hypertension ◽

Acute Hemorrhage ◽

Lateral Posterior ◽

History Of ◽

Lateral Posterior Nucleus ◽

Neuroimaging Study ◽

The Right

We report a sequential neuroimaging study in a 48-years-old man with a history of chronic hypertension and lacunar strokes involving the ventral lateral posterior nucleus of the thalamus. The patient developed mild hemiparesis and severe contraversive pushing behavior after an acute hemorrhage affecting the right thalamus. Following standard motor physiotherapy, the pusher behavior completely resolved 3 months after the onset and, at that time, he had a Barthel Index of 85, although mild left hemiparesis was still present. This case report illustrates that pushing behavior itself may be severely incapacitating, may occur with only mild hemiparesis and affected patients may have dramatic functional improvement (Barthel Index 0 to 85) after resolution pushing behavior without recovery of hemiparesis.

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Relationship Parity and Contraception with Mild Preeclampsia at Puskesmas Jagir

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v4i12016.100-112 ◽

2016 ◽

Vol 4 (1) ◽

pp. 100

Author(s):

Rizky Pradana Setiawan

Keyword(s):

Diabetes Mellitus ◽

Body Weight ◽

Family History ◽

Pregnant Women ◽

Calcium Supplementation ◽

Chronic Hypertension ◽

Family History Of Diabetes ◽

Maternal Characteristics ◽

History Of ◽

Mild Preeclampsia

Mild preeclampsia is the frequent disease experienced by pregnant women in Puskesmas Jagir in 2011-2014. The number of mild preeclampsia in Puskesmas Jagir keep increase significantly. The purpose of this study is to analyze the association between the characteristics, family history and calcium supplementation in pregnant women with mild preeclampsia at Puskesmas Jagir Surabaya. The type of research is non-reactive research with case control design. Subjects was taken from the population using simple random sampling. The variables studied were age, body weight changes, parity, family history of preeclampsia, contraception, family history of diabetes mellitus, family history of chronic hypertension, and calcium supplementation. The statistical test was Chi-square test with α = 0.05, odds Ratio is calculated by value with 95% confidence interval (CI 95%). Variables associated with mild preeclampsia is a maternal characteristics such as parity (p = 0.001, OR 0.17) and contraception (p = 0.019, OR = 5.636). Variables that are not associated with mild preeclampsia is a maternal characteristics such as the form of changes in body weight during pregnancy, age, and family history of diabetes mellitus in the form of family history and family history of hypertension and calcium supplementation. There is a association between parity and contraception with mild preeclampsia.Keywords: mild preeclampsia, parity, contraception

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Pregnancy and delivery in a patient with a 40-year history of type 1 diabetes mellitus and antiphospholipid syndrome

Journal of obstetrics and women s diseases ◽

10.17816/jowd67693-99 ◽

2018 ◽

Vol 67 (6) ◽

pp. 93-99

Author(s):

Roman V. Kapustin ◽

Natalia V. Borovik ◽

Ekaterina V. Musina ◽

Olga N. Arzhanova ◽

Maria I. Yarmolinskaya ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Antiphospholipid Syndrome ◽

Perinatal Outcomes ◽

Increased Risk ◽

Pregnancy And Delivery ◽

Perinatal Center ◽

History Of

Type 1 diabetes mellitus is a condition associated with an increased risk of adverse perinatal outcomes such as spontaneous abortions, preterm birth, placental insufficiency, congenital malformations, and perinatal mortality. Diabetes mellitus combined with cardiovascular diseases in women during pregnancy often leads to hypertensive disorders and pre-eclampsia. The severity of the microvascular diabetic complications and frequency of hypoglycemic episodes, particularly in early pregnancy, are related to the risk of pre-eclampsia. We report the case of pregnancy and delivery of a live newborn in a 42-year-old woman with type 1 diabetes mellitus, pre-existing hypertension, heritable thrombophilia, and antiphospholipid syndrome. She had a 40-year history of type 1 diabetes mellitus with well-controlled diabetic nephropathy and retinopathy. The woman had been receiving continuous subcutaneous insulin therapy for the last five years, which allowed maintaining an appropriate glycemic control during pregnancy. Multidisciplinary supervision of course of pregnancy was carried out from the pre-gravidity stage until delivery and postpartum. In spite of the severe pre-eclampsia and preterm delivery by cesarean section at 36 weeks, she and newborn could avoid the intensive unit care and discharge from perinatal center without any complications.

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Upper Normal Blood Pressures Predict Incident Atrial Fibrillation in Healthy Middle-Aged Men

Hypertension ◽

10.1161/hypertensionaha.111.179713 ◽

2012 ◽

Vol 59 (2) ◽

pp. 198-204 ◽

Cited By ~ 84

Author(s):

Irene Grundvold ◽

Per Torger Skretteberg ◽

Knut Liestøl ◽

Gunnar Erikssen ◽

Sverre E. Kjeldsen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Normal Blood ◽

Middle Aged ◽

Blood Pressures

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Association between insulin resistance and preeclampsia in obese non-diabetic women receiving metformin

Obstetric Medicine ◽

10.1177/1753495x17725465 ◽

2017 ◽

Vol 10 (4) ◽

pp. 170-173 ◽

Cited By ~ 5

Author(s):

Jyoti Balani ◽

Steve Hyer ◽

Argyro Syngelaki ◽

Ranjit Akolekar ◽

Kypros H Nicolaides ◽

...

Keyword(s):

Insulin Resistance ◽

Pregnant Women ◽

Significant Contribution ◽

Randomised Trial ◽

Secondary Analysis ◽

Chronic Hypertension ◽

Model Assessment ◽

Gestational Weight ◽

Metformin Group ◽

History Of

Objectives To examine whether the reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is mediated by changes in insulin resistance. Methods This was a secondary analysis of obese pregnant women in a randomised trial (MOP trial). Fasting plasma glucose and insulin were measured in 384 of the 400 women who participated in the MOP trial. Homeostasis model assessment of insulin resistance (HOMA-IR) was compared in the metformin and placebo groups and in those that developed preeclampsia versus those that did not develop preeclampsia. Results At 28 weeks, median HOMA-IR was significantly lower in the metformin group. Logistic regression analysis demonstrated that there was a significant contribution in the prediction of preeclampsia from maternal history of chronic hypertension and gestational weight gain, but not HOMA-IR either at randomisation ( p = 0.514) or at 28 weeks ( p = 0.643). Conclusions Reduced incidence of preeclampsia in non-diabetic obese pregnant women treated with metformin is unlikely to be due to changes in insulin resistance.

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Closed Chest Cardiac Massage in the Newborn Infant

PEDIATRICS ◽

10.1542/peds.81.4.552 ◽

1988 ◽

Vol 81 (4) ◽

pp. 552-554

Author(s):

Ronald David

Keyword(s):

American Heart Association ◽

American Heart ◽

Heart Association ◽

Cardiac Massage ◽

Systemic Blood ◽

Closed Chest ◽

Cardiac Compression ◽

History Of ◽

Blood Pressures ◽

In Infants And Children

The recommended techniques for external cardiac compression during cardiopulmonary resuscitation of the newborn are reviewed. The American Heart Association advises the rescuer to depress the infant's midsternum with the index and forefingers. An alternative recommendation is to encircle the chest with both hands and appose the thumbs on the midsternum. The cases reported here prove the superiority of the latter maneuver over the former in improving cardiac output and systemic blood pressures. The history of external cardiac compression in infants and children is briefly reviewed, further supporting the conclusion that the technique of encircling the chest with thumbs at midsternum is more efficacious and hence the preferred approach to closed chest cardiac massage in the newborn.

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