Chronic hypertension in pregnancy stratified by first trimester blood pressure control and adverse perinatal outcomes: a prospective observational study

2021 ◽  
Author(s):  
Dan Dumitrascu‐Biris ◽  
Diane Nzelu ◽  
Theodore Dassios ◽  
Kypros Nicolaides ◽  
Nikos A Kametas
Keyword(s):  
Blood Pressure ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Perinatal Outcomes ◽  
Pressure Control ◽  
First Trimester ◽  
Chronic Hypertension ◽  
Hypertension In Pregnancy ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Adverse Perinatal Outcomes Associated with Stage 1 Hypertension in Pregnancy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Elizabeth Norton ◽  
Frances Shofer ◽  
Hannah Schwartz ◽  
Lorraine Dugoff
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Perinatal Outcomes ◽  
Hypertensive Disorder ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
Hypertensive Disorder Of Pregnancy ◽  
Adverse Perinatal Outcomes ◽  
Stage 1 ◽  
In Pregnancy

Objective To determine if women who newly met criteria for stage 1 hypertension in early pregnancy were at increased risk for adverse perinatal outcomes compared with normotensive women. Study Design We conducted a retrospective cohort study of women who had prenatal care at a single institution and subsequently delivered a live infant between December 2017 and August 2019. Women with a singleton gestation who had at least two prenatal visits prior to 20 weeks of gestation were included. We excluded women with known chronic hypertension or other major maternal illness. Two groups were identified: (1) women newly diagnosed with stage 1 hypertension before 20 weeks of gestation (blood pressure [BP] 130–139/80–89 on at least two occasions) and (2) women with no known history of hypertension and normal BP (<130/80 mm Hg) before 20 weeks of gestation. The primary outcome was any hypertensive disorder of pregnancy; secondary outcomes were indicated preterm birth and small for gestational age. Generalized linear models were used to compare risk of adverse outcomes between the groups. Results Of the 1,630 women included in the analysis, 1,443 women were normotensive prior to 20 weeks of gestation and 187 women (11.5%) identified with stage 1 hypertension. Women with stage 1 hypertension were at significantly increased risk for any hypertensive disorder of pregnancy (adjusted risk ratio [aRR]: 1.86, 95% confidence interval [CI]: 1.12–3.04) and indicated preterm birth (aRR: 1.83, 95% CI: 1.12–3.02). Black women and obese women with stage 1 hypertension were at increased for hypertensive disorder of pregnancy compared with white women and nonobese women, respectively (aRR: 1.32, 95% CI: 1.11–1.57; aRR: 1.69, 95% CI: 1.39–2.06). Conclusion These results provide insight about the prevalence of stage 1 hypertension and inform future guidelines for diagnosis and management of hypertension in pregnancy. Future research is needed to assess potential interventions to mitigate risk. Key Points

Midgut volvulus secondary to congenital malrotation in pregnancy

2020 ◽  
Vol 13 (5) ◽  
pp. e234664 ◽  
Author(s):  
Eelyn Chong ◽  
David S Liu ◽  
Vishnupriya Rajagopal ◽  
Neil Strugnell
Keyword(s):  
Perinatal Outcomes ◽  
First Trimester ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Midgut Volvulus ◽  
Threatening Condition ◽  
Life Threatening ◽  
Uncommon Condition ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Prompt investigation and definitive surgical treatment are required when pregnant women present with bilious vomiting and new-onset abdominal or back pain especially beyond the first trimester.

scholarly journals Luaran Ibu dan Perinatal pada Kehamilan dengan Preeklampsia Berat di RSUP Prof. Dr. R. D. Kandou Manado Periode 1 Januari - 31 Desember 2016

e-CliniC ◽  
2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Chaerul Kalam ◽  
Freddy W. Wagey ◽  
Suzanna P. Mongan
Keyword(s):  
Maternal Mortality ◽  
Visual Impairment ◽  
Perinatal Mortality ◽  
Hellp Syndrome ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Maternal Outcomes ◽  
Chronic Hypertension ◽  
Hypertension In Pregnancy ◽  
In Pregnancy

Abstract: Maternal mortality in Indonesia is still dominated by three main causes: bleeding (30.3%), hypertension in pregnancy (27.1), and infection (7.3%). Hypertension in pregnancy is one of the main causes for maternal and perinatal mortality and morbidity. This tsudy was aimed to obtain maternal and perinatal outcomes in pregnancies with severe preeclampsia (sPE) at Prof. Dr. R. D. Kandou Hospital Manado from January to December 2016. This was a descriptive retrospective study using patients’ medical record data. The results showed that the characteristics of pregnant woman with sPE included mother age 20-35 years old (69.2%), primigravida (50.8%), pregnancy interval ≥5 years (65.6%), preeclampsia history (25%), overweight (55.4%), and history of chronic hypertension (10.8%). The results of maternal outcomes included maternal mortality (1.5%), HELLP syndrome (4.6%), visual impairment (4.6%), eclampsia (6.2%), ICU care (1.5%), and sepsis (1.5%). The results of perinatal outcomes included perinatal mortality (4.6%), IUGR (6.2%), LBW (35.4%), asphyxia (7.7%), fetal distress (20%), and prematurity (26.2%). Conclusion: Maternal outcomes in pregnancy with sPE included mortality, HELLP syndrome, visual impairment, eclampsia, ICU care, sepsis meanwhile perinatal outcomes included perinatal mortality, IUGR, LBW, asphyxia, fetal distress, and prematurity.Keywords: sPE, maternal outcome, perinatal outcome Abstrak: Kematian ibu di Indonesia masih didominasi oleh tiga penyebab utama yaitu perdarahan (30,3%), hipertensi dalam kehamilan (27,1), dan infeksi (7,3%). Hipertensi dalam kehamilan merupakan salah satu penyebab utama mortalitas dan morbiditas pada maternal dan perinatal. Penelitian ini bertujuan untuk mengetahui luaran ibu dan perinatal pada kehamilan dengan preeklampsia berat (PEB) di RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2016 - 31 Desember 2016. Jenis penelitian ialah retrospektif deskriptif menggunakan data rekam medik pasien PEB. Hasil penelitian pada kehamilan dengan PEB memperlihatkan karakteristik usia ibu 20-35 tahun (69,2%), primigravida (50,8%), jarak hamil ≥5 tahun (65,6%), riwayat preeklampsia (25%), overweight (55,4%), dan riwayat hipertensi kronis (10,8%). Luaran ibu meliputi mortalitas ibu (1,5%), sindrom HELLP (4,6%), gangguan penglihatan (4,6%), eklampsia (6,2%), rawat ICU (1,5%), dan sepsis (1,5%). Luaran perinatal meliputi mortalitas perinatal (4,6%), IUGR (6,2%), BBLR (35,4%), asfiksia (7,7%), gawat janin (20%) dan prematur (26,2%). Simpulan: Luaran ibu pada kehamilan dengan PEB berupa mortalitas, sindrom HELLP, gangguan penglihatan, eklampsia, rawat ICU, dan sepsis sedangkan luaran perinatal berupa mortalitas perinatal, IUGR, BBLR, asfiksia, gawat janin, dan prematur.Kata kunci: PEB, luaran ibu, luaran perinatal

scholarly journals The effect of labetalol and nifedipine MR on blood pressure in women with chronic hypertension in pregnancy

2018 ◽  
Vol 11 ◽  
pp. 92-98 ◽  
Author(s):  
E. Shawkat ◽  
H. Mistry ◽  
C. Chmiel ◽  
L. Webster ◽  
L. Chappell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Chronic Hypertension ◽  
Hypertension In Pregnancy ◽  
In Pregnancy
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