Neonatal and maternal platelet cytosolic calcium in normotensive and hypertensive pregnancies.

A prospective study investigated platelet cytosolic calcium in non-pregnant volunteers (n = 30) and samples from the umbilical veins of babies from both normotensive (n = 18) and hypertensive (n = 15) primigravidae, and their mothers. There was no significant difference between the neonatal umbilical venous platelet cytosolic calcium concentration (p[Ca2+]i) in babies born to normotensive primigravidae or to those whose pregnancies were complicated by gestational hypertension (88 x 9 (SE) 2 x 5) in normotensive primagravidae, 80 x 6 (2 x 8) in pregnancy induced hypertension without proteinuria, and 89 x 3 (3 x 2) nmol/l in pre-eclampsia. There was also no significant difference in the p[Ca2+]i from the umbilical veins of the pregnancies studied and those of non-pregnant female volunteers in the follicular phase of their menstrual cycle. This was despite a gradual and significant rise in p[Ca2+]i with increasing severity of disease in the mothers of the babies studied (119 x 9 (4 x 1) in normotensive primagravidae, 130 x 8 (7 x 3) in pregnancy induced hypertension without proteinuria, and 148 x 2 (4 x 5 ) nmol/l in pre-eclampsia). The mean maternal p[Ca2+]i in the three samples returned to concentrations comparable with those in non-pregnant subjects by 12 weeks after birth. These data demonstrate no significant difference between the mean p[Ca2+]i in non-pregnant women and those obtained from the umbilical venous blood of normotensive or hypertensive primigravidae. They suggest that the functional hypoactivity of neonatal platelets is probably not secondary to a decrease in basal p[Ca2+]i. They also suggest that the progressively raised p[Ca2+]i in normal and hypertensive pregnancies might be due to a pregnancy specific factor that does not cross the placenta,

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Study of Gross Anatomy of Human Placenta in Pregnancy Induced Hypertension

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v10i2.25923 ◽

2015 ◽

Vol 10 (2) ◽

pp. 55-61

Author(s):

Nasrin Begum ◽

Roxana Ferdousi

Keyword(s):

Placental Weight ◽

Group Method ◽

Control Group ◽

Pregnancy Induced Hypertension ◽

Absolute Volume ◽

Significant Difference ◽

Induced Hypertension ◽

The Mean ◽

Medical University ◽

In Pregnancy

Introduction: Pregnancy induced hypertension (PIH), also referred to as Gestational hypertension is a condition of high blood pressure during pregnancy. Progression the disease causes preeclampsia and eclampsia, which are the commonest causes of maternal and fetal morbidity and mortality.Objective: The objectives of the study were to observe and measure the macroscopic changes in the placenta in pregnancy induced hypertension and to compare the placental findings of the control group. .Method: This descriptive observational study was carried out in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU). Forty placentas were collected from Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) and Bangabandhu Sheikh Mujib Medical University. Out of forty placentas, twenty were from non-hypertensive mother considered as controls and twenty from PIH mothers. Mother who had Rh-negative blood group, positive for VDRL and HbsAg and mother delivered multiple babies or babies with any visible congenital malformation were excluded. All women included in the study gave birth to a live born baby after 35 weeks of gestation by caesarian section. The macroscopic features of placentas were recorded and after that specimen was fixed in 10% formol saline. After two week of fixation, a point counting method was used on placental slices for estimation of the volume of parenchyma and non-parenchyma.Results: The general features of the control and PIH mother were statistically matched. As compared with the control group, PIH group showed no statistically significant difference in values of placental weight, volume and diameter.Mean placental weight (gm), mean volume (ml) and the mean diameter (cm) of the placental, mean absolute volume of parenchyma, mean proportional and mean absolute volume of non-parenchyma were lower in PIH group than the control group. The mean number of cotyledon of the placenta and mean proportional volume of parenchyma were higher in PIH group than control group and. These differences did not reach statistically significant level.Conclusion: Several authors has concluded that the changes in the placenta in diabetic and toxaemic mother are the reflection of some compensatory mechanism, but the present study fails to identify any statistically significant changes in PIH group in favour of such statement.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014

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Doppler ultrasound of umbilical artery in prediction of fetal outcome in pregnancy induced hypertension Sudanese population

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195890 ◽

2019 ◽

Vol 8 (1) ◽

pp. 96

Author(s):

Rihab A. Yousif ◽

Awadia G. Suliman ◽

Raga A. Aburaida ◽

Ibrahim M. Daoud ◽

Naglaa E. Mohammed

Keyword(s):

Flow Velocity ◽

Umbilical Artery ◽

Fetal Outcome ◽

Fetal Mortality ◽

Pregnancy Induced Hypertension ◽

Diastolic Flow ◽

Induced Hypertension ◽

The Mean ◽

Doppler Indices ◽

In Pregnancy

The pregnancy induced hypertension increase the fetal mortality and morbidity and the using of Doppler umbilical artery indices decrease the fetal mortality and morbidity however, there is few complete data about the most frequently altered Doppler US parameters to predict fetal outcome in pregnancy induced hypertension . Methods This ia cohort prospective study done in two hundred and six women of second and third trimester presenting to antenatal clinic in Soba University Hospital at the department of Obstetrics & Gynecology, in the fetus unit and critical pregnancy in the period From June 2008 to April 2013 to assess the Doppler indices of umbilical artery in pregnancy induced hypertension for prediction of prenatal outcome; 105 pregnancy induced hypertension patients and 101 women with uneventful pregnancies as normal control group included in this study . Baseline investigations and color Doppler of umbilical artery were done. Statistical analysis of data were done using SPSS, Receiver Operating Characteristic (ROC) curve analysis was performed and the area under the curve (AUC) used to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of umbilical artery Doppler indices to predict fetal outcome.Results The study determine that there was significant difference in Doppler indices in PIH and control group ( p<0.01, the mean indices of umbilical artery is higher in PIH group compared with normal pregnancy group , the mean different of S/D ratio was 0.40, mean difference of RI was 0.06 and the mean different of PI index was 0.16, high percentage of adverse fetal outcome had been reported in in Pregnancy Induced Hypertension group than in control , which was more in absent and reversed flow velocity in umbilical artery in Pregnancy Induced Hypertension compared with group of Pregnancy Induced Hypertension with present end diastolic flow velocity. Systolic/Diastolic ratio was most accurate in predicting adverse outcome in pregnancy induced hypertension patients, followed by the Pulastility index then the Resistance index (75%, 66% and 57% respectively).ConclusionThis study concluded that pregnancy induced hypertension leads to worsen placental insufficiently, which appears on the higher Doppler indices of umbilical artery to PIH patients when compared with normal pregnancy. A low diastolic flow and higher indices characterized the pregnancies with abnormal outcomes. Doppler of the umbilical artery was useful to predict fetal well being in PIH patients, high percentage of adverse fetal outcome had been reported in absent and reversed end diastolic flow velocity in umbilical artery compared with group of present flow velocity.

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Neutrophil Platelet-Activating Factor in Normal and Hypertensive Pregnancy and in Pregnancy-Induced Hypertension

Clinical Science ◽

10.1042/cs0850063 ◽

1993 ◽

Vol 85 (1) ◽

pp. 63-70 ◽

Cited By ~ 3

Author(s):

L. J. Beilin ◽

K. D. Croft ◽

C. A. Michael ◽

J. Ritchie ◽

L. Schmidt ◽

...

Keyword(s):

Pregnant Women ◽

Platelet Activating Factor ◽

Calcium Ionophore ◽

Normal Pregnancy ◽

Pregnancy Induced Hypertension ◽

Uncomplicated Hypertension ◽

Control Subjects ◽

Significant Difference ◽

Induced Hypertension ◽

In Pregnancy

1. Platelet-activating factor is a phospholipid with potent vasodilator and platelet-activating properties. To test the hypothesis that a generalized change in cellular platelet-activating factor metabolism may be involved in the systemic vasodilatation of normal pregnancy or pregnancy-induced hypertension, we studied platelet-activating factor and eicosanoid synthesis in isolated leucocytes obtained from pregnant women before and after delivery compared with age-matched non-pregnant control subjects. Parallel observations were carried out in age- and gestation-matched women with uncomplicated hypertension in pregnancy and in women with pregnancy-induced hypertension and a further set of normotensive pregnant control subjects. 2. Leucocyte counts were higher in all pregnant groups compared with non-pregnant control subjects. Neutrophil production of platelet-activating factor and metabolites of prostacyclin, prostaglandin E2 and thromboxane in response to calcium ionophore stimulation were all lower in pregnant women compared with non-pregnant control subjects, but returned to similar levels 6 weeks post partum. There was no significant difference between essential hypertensive and normotensive groups. When women with pregnancy-induced hypertension were a priori subdivided into those with or without proteinuria, subjects with proteinuria showed significantly lower levels of neutrophil platelet-activating factor synthesis. 3. Plasma levels of the platelet-activating factor metabolite (lyso-platelet-activating factor) were also lower in pregnancy, suggesting alterations in the activity of enzymes controlling synthesis or degradation of this phospholipid in pregnancy. In pregnancy-induced hypertension the levels of plasma lyso-platelet-activating factor were higher than in normal pregnancy. 4. Thus this study demonstrates a reduction in the maximum capacity of neutrophils to synthesize platelet-activating factor and the three main classes of eicosanoids in vitro and a reduction in plasma lyso-platelet-activating factor levels in normotensive and essential hypertensive pregnancies. Contrary to expectation neutrophil prostacyclin metabolite generation was reduced in normal pregnancy. In pregnancy-induced hypertension with proteinuria the suppression of neutrophil platelet-activating factor synthesis was more pronounced. The results do not support the involvement of platelet-activating factor in the vasodilatation of pregnancy, but indicate profound changes in cellular phospholipid metabolism in normal pregnancy with further disturbances in pregnancy-induced hypertension by as yet unexplained mechanisms.

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The significance of uteroplacental ratio in the prediction of perinatal outcome in pregnancy-induced hypertension

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i3.1368 ◽

2019 ◽

Vol 10 (3) ◽

pp. 1756-1762

Author(s):

Iman Allami M

Keyword(s):

Confidence Interval ◽

Perinatal Outcome ◽

Umbilical Vein ◽

Reference Ranges ◽

Pregnancy Induced Hypertension ◽

Third Trimester ◽

Induced Hypertension ◽

Doppler Waveform ◽

The Mean ◽

In Pregnancy

Doppler investigations of placental and maternal flow have picked up a wide prominence as it could give significant data with respect to fetal prosperity and could be utilized to distinguish embryos in danger of bleakness and mortality, in this manner giving a chance to improve fetal results. In such manner, the accessible typical reference estimations of proportion () for example uterine corridor Doppler waveform parameters to those of umbilical course and impact of hypertension on Doppler waveform of the obstetric populace of various countries, were not unequivocally illustrated. The examination incorporates 60 pregnant ladies (in two periods 33-36 weeks and 37-40 weeks of incubation, 40 of them with pregnancy instigated hypertension and 20 as a control. The uterine courses and umbilical corridor files were determined just as proportions () for the RI and S/D, subsequent to gating the normal estimations of both uterine conduits files, the proportion between the uterine supply route and umbilical vein records was taken(normal uterine supply route/umbilical vein proportion, ). The mean ± SD of parameters expressed in the following manner:For PIH group At 33-36 weeks: RI =0.89 ± 0.26, PI = 0.94 ± 0.41and S/D =0.86 ± 0.31. The 95% confidence interval of the mean for four weeks were 0.77-1.0, 0.78-1.11, 0.74-0.99, respectively. At 37-40 weeks: RI= 1.00 ± 0.26, PI =1.05 ± 0.43 and S/D =1.03 ± 0.36. The 95% confidence interval of the mean for four weeks were 0..61, 0..31 and 0.81-1.25 respectively. For control group:At 33-36 weeks : RI =0.69 ± 0.08,PI= 0.73 ±0.13, and S/D=0.67 ± 0.09. The 95% confidence interval of the mean for four weeks were 0..80, 0..90 and0..78 respectively. At 37-40 weeks : RI= 0.99 ± 0.31, PI=0.95 ± 0.33, and S/D=0.92 ± 0.25. The 95% confidence interval of the mean for four weeks were 0..80, 0.76-1.13 and0.78-1.06respectively. A starter foundation of proportion ( of RI, PI and S/D) of Iraqi obstetric populace in and PIH at third trimester is most likely settled. The present investigation gave reference ranges in regards to uterine and umbilical supply routes , and S/ at 33-36 and 37-40 weeks of incubation in both.

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Fetomaternal Outcome in Women with Pregnancy Induced Hypertension versus Normotensive Pregnancy

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v17i4.2103 ◽

2020 ◽

Vol 17 (4) ◽

pp. 495-500

Author(s):

Amarnath Thakur ◽

Ganesh Dangal

Keyword(s):

Prothrombin Time ◽

Preterm Labor ◽

Gestational Hypertension ◽

Mode Of Delivery ◽

Hypertensive Disorder ◽

Age Group ◽

Pregnancy Induced Hypertension ◽

Maternal Complication ◽

Induced Hypertension ◽

In Pregnancy

Background: A hypertensive disorder in pregnancy comprises one of the deadly triad along with hemorrhage and infection-that contributes greatly to maternal morbidity and mortality. The aim of this study was to compare the feto-maternal outcome in pregnancy induced hypertension with normotensive pregnant women.Methods: A cross sectional prospective study was conducted in Paropakar Maternity and Women’s Hospital from 1st February 2018 to 1st May 2018. All pregnant women seeking help for hypertension during this period was included in the study and were followed up to six weeks of postpartum period.Results: Total 40 patients were enrolled in each arm. The highest number of pregnancy induced hypertension cases was seen in age group 20-24years (32.5%) and were mostly primigravidas (60%). The commonest symptom in Pregnancy induced hypertension was headache 47.5 %. The mean hemoglobin value was 11.91 gm/dl, mean SGPT (Gestational hypertension 25.44 IU/L, preeclampsia 55.25 IU/L and eclampsia 32.17 IU/L) and mean platelet count was 1, 95,140 lakh/cumm in pregnancy induced hypertension. Mean prothrombin time in gestational hypertension was 13.78±0.7 seconds. Most common maternal complication was preterm labor and fetal complication was prematurity. The most common mode of delivery was vaginal.Conclusions: Pregnancy induced hypertension was more common in primigravida with young age group of 20-24 years and presented commonly with complain of headache. Preterm labor was the most common maternal complication similarly prematurity was the commonest fetal complication seen in pregnancy induced hypertension. Vaginal delivery was the commonest mode of delivery. Blood investigation showed significant thrombocytopenia in eclampsia and decreased prothrombin time in gestational hypertension.Keywords: Fetal outcome; maternal complications; pregnancy induced hypertension.

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Platelet Count and Its Prognostic Value in Pregnancy Induced Hypertension

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v18i1.35131 ◽

2020 ◽

Vol 18 (1) ◽

pp. 8-14

Author(s):

Nirmala Sharma ◽

Sheela Kumari ◽

Durga BC ◽

Merina Shrestha

Keyword(s):

Platelet Count ◽

Gestational Hypertension ◽

Estimation Method ◽

College Teaching ◽

Pregnancy Induced Hypertension ◽

Hypertensive Disorders ◽

Undiagnosed Hypertension ◽

Induced Hypertension ◽

Low Platelet Count ◽

In Pregnancy

Introduction: Hypertensive disorders of pregnancy is one of the maternal diseases that cause the most detrimental effects to the mother and the fetus.1 It is the leading cause of direct maternal death along with hemorrhage and infections. Approximately 70% of hypertensive disorders are due to gestational hypertension, preeclampsia and eclampsia whereas other 30% are due to preexisting or undiagnosed hypertension.2 Out of all the hematological abnormalities that occur in PIH, thrombocytopenia is the most common seen to occur in 11% to 29% of patients.3 Thrombocytopenia occurs more commonly in patients with eclampsia (30%) compared to patients with both mild and severe forms of pre-eclampsia (15%-18%).4 Aims :To find out the severity of disease with platelet count in pregnancy induced hypertension. Methods: This is a hospital- based descriptive cross sectional study, conducted in the department of Obstetrics and Gynecology at Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal, conducted over a period of one year from September 2018 to August 2019. Fifty pregnant women were enrolled in study after getting informed written consent and assessing for inclusion and exclusion criteria. Results: Incidence of Pre-eclampsia/eclampsia is 2.3% in this study. Majority of the women belong to age group 21-25(40%), followed by 15-20(38%) with mean age 23.18±5.45. 62% constituted primigravidas and 38% were multigravidas. 33 (66%) cases were at term (37-42 weeks of gestation), 11(22%) at 34-36 weeks of gestation and 6 (12%) were at 28-33 weeks of gestation with mean gestational age 36.38±3.17. Eclampsia cases were found more i.e. 48%, followed by pre-eclampsia 38% and Gestational hypertension 14%. Moderately low platelet count was seen in 11.76% of Gestational hypertension, 47% of pre-eclampsia and 41.17% of eclampsia and severely low platelet count in 21.4% pre-eclampsia and 64.70% of eclampsia. Conclusion: PIH continues to be a leading cause of Maternal and perinatal morbidity and Mortality. The disease accounts of 40,000 maternal deaths worldwide per year5. It is one of the common causes of iatrogenic preterm delivery. Etiology of Pre-eclampsia/Eclampsia is complex and not completely understood. A combination of abnormal Placentation and predisposing maternal factor contribute to widespread endothelial dysfunctions which lead to the syndrome of PIH. To date there has been no screening test that has been widely adopted in clinical practice. Platelet estimation method is reliable, rapid, cheaper, and simple lab method. Prognosis of diseases could be monitored by measuring platelet count and level of platelet count can predict the severity of PIH. Therefore assessment of platelet count has special place in management of PIH.

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RETINAL CHANGES IN PREGNANCY INDUCED-HYPERTENSION

International Journal of Current Pharmaceutical Research ◽

10.22159/ijcpr.2021v13i1.40797 ◽

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.

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EFFECTIVENESS OF ANTENATAL CARE PACKAGE ON KNOWLEDGE OF PREGNANCY INDUCED HYPERTENSION FOR ANTENATAL MOTHERS IN SELECTED HOSPITALS OF MANGALORE

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703625 ◽

2013 ◽

Vol 03 (01) ◽

pp. 08-10

Author(s):

Sr. Jolly Joseph ◽

Sabitha Nayak ◽

Philomena Fernandes ◽

Vandana Suvarna

Keyword(s):

Antenatal Care ◽

Knowledge Score ◽

Educational Status ◽

Pregnancy Induced Hypertension ◽

Knowledge Questionnaire ◽

Significant Difference ◽

Induced Hypertension ◽

Post Test ◽

Care Package ◽

The Mean

AbstractThe study was conducted on effectiveness of antenatal care package on knowledge of pregnancy induced hypertension for antenatal mothers from 7/09/2009 to 10/10/2009. The research design was an evaluative approach using one group pretest post test the experimental design 40 antenatal mothers were selected by purposive sampling. Data was collected using structured knowledge questionnaire. Antenatal care package was developed.The pre test knowledge questionnaire was administered on the first day followed by an antenatal care package. The post test was conducted after five days using the same tool. The pretest knowledge data showed that maximum number of mothers 26(65.5%) scored between the range of 11-20% (average).The mean knowledge score was 14.88 where as the maximum possible score was 30.Among seven areas, the mean percentage knowledge in the area of basic factors of PIH was 43.75%, clinical features 41%, diagnosis 44%, management 57.5%, diet 50%, complication 50%, and prevention 58%.The 't” value showed the significant difference in the posttest, ('t' calculated value of pretest and post test knowledge scores = 14.22 p<0.05 which showed that antenatal care package was effective in improving the knowledge of antenatal mothers on pregnancy induced hypertension.There was significant association between pretest level of knowledge and age, educational status, occupation, monthly income, parity, gestational age, history of hypertension in previous pregnancy.

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