Plasma markers of angiogenesis in pregnancy induced hypertension

2005 ◽  
Vol 94 (11) ◽  
pp. 1071-1076 ◽  
Author(s):  
Sunil Nadar ◽  
Ioannis Karalis ◽  
Eman Al Yemeni ◽  
Andrew Blann ◽  
Gregory Lip
Keyword(s):  
Study Groups ◽  
Normal Pregnancy ◽  
Cross Sectional Study ◽  
Fixed Number ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Induced Hypertension ◽  
Post Hoc ◽  
Endothelial Growth Factor ◽  
In Pregnancy

SummaryThis study tests the hypothesis that abnormalities in plasma indices of angiogenesis, such as Vascular Endothelial Growth Factor (VEGF) and angiopoietins (Ang-1, Ang-2), as well as their soluble receptors Flt-1 (sflt-1) and Tie 2 (sTie-2) respectively, are present in women with in pregnancy-induced hypertension (PIH). We also measured platelet levels of VEGF and Ang-1 (pVEGF and pAng-1 respectively). We studied 69 consecutive women with PIH (34 without proteinuria, and 35 with proteinuria, i.e. preeclampsia) who were compared to 64 consecutive women with normotensive pregnancies and 30 normotensive non-pregnant women, in a cross-sectional study. Using ELISA, we measured levels of plasma VEGF, Ang-1 &2, Tie-2 and sflt-1, and also the levels of angiogenic markers within the platelet [platelet VEGF (pVEGF) and platelet Ang-1 (pAng1)] by lysing a fixed number of platelets with 0.5% tween. Results show that levels of plasma VEGF, Ang-1, Ang2, sFlt-1 and Tie-2 were significantly different between the study groups. Post hoc analyses revealed plasma Ang-1 was highest in the preeclampsia group (p<0.001), whilst Ang-2 was highest in the normotensive pregnant group (p-=0.018). Plasma Tie-2 was highest in the PIH group. VEGF levels were significantly different between the preeclampsia group and the PIH group (p<0.05). Platelet VEGF levels were higher in the non-pregnant group than in the pregnant group, but there were no significant differences in the platelet levels of Ang-1 between the different groups. Ang-2, sFlt-1 and Tie-2 were undetectable in the platelet lysate in any of the patient groups or controls. Blood pressure was a major determinant of the different angiogenic factors studied. Abnormal indices of angiogenesis are evident in PIH and preeclampsia, with higher levels of sFlt-1 and lower levels ofVEGF; in PIH, increased levels of Ang-1 and Tie-2, but reduced Ang-2, are evident compared to normal pregnancy. These abnormalities may have implications for the pathogenesis of PIH and preeclampsia.

scholarly journals Fetoplacental Weight Relationship in Normal Pregnancy and Pregnancy Complicated by Pregnancy-Induced Hypertension and Abruption of Placenta among Mothers Who Gave Birth in Southern Ethiopia, 2018

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Tsegaye Mehare ◽  
Daniel Kebede
Keyword(s):  
Normal Pregnancy ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Normal Group ◽  
Southern Ethiopia ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Weight Relationship ◽  
Induced Hypertension ◽  
In Pregnancy

Introduction. Placenta is a complex multifunctional organ that maintains pregnancy and promotes normal fetal development. The fetal outcome is adversely influenced by pathological changes in the placenta because it is a mirror that reflects the intrauterine status of the fetus. Placental abnormalities are considered a leading cause of maternal and prenatal mortality. This study aimed to assess the fetoplacental weight relationship in pregnancy-induced hypertension and abruption placenta and compare with the normal one. Objective. This study designed to assess fetoplacental weight relationships in normal pregnancy and pregnancy complicated by pregnancy-induced hypertension and abruption of placenta among mothers who gave birth in Dilla University Referral Hospital, southern Ethiopia, 2018. Materials and Methods. Institution-based comparative cross-sectional study was used on 50 placentas from mothers with pregnancy-induced hypertension, 50 placentas from mothers with abruption of placenta, and 50 placentas from mothers with normal pregnancy (control) with an age range of 19–34 years. The weight of the placenta and newborn were taken and the fetoplacental ratio was calculated. Results. Placental index as well as the weight of the newborn shows statistically significant (p<0.001) difference in pregnancy-induced hypertension and abruption placenta group compared with the normal group. The mean of the fetoplacental ratio in the normal group was 5.52 ± 0.07, in pregnancy-induced hypertension was 5.15 ± 0.11, whereas the abruption placenta was 4.99 ± 0.82. Conclusion. Both PIH and abruption placenta were associated with remarkable changes in the placenta index such as small placental weight and diameter and results in different kinds of congenital anomalies and low birth weight of the baby. Hence, fetoplacental ratio was altered. The lowest fetoplacental ratio was 4.99 for abruption placenta, and the highest was for a normal group of the placenta which was 5.52. Therefore, an examination of the placenta before and after birth guarantees for feto-maternal health.

scholarly journals Perinatal Findings in Pregnancy Induced Hypertension: A Study in a Tertiary Teaching Hospital in Dhaka City

2017 ◽  
Vol 2 (1) ◽  
pp. 10-13
Author(s):  
Zobaida Sultana Susan ◽  
Surayea Bulbul ◽  
Jannat Ara Ferdows ◽  
Abu Nayeem
Keyword(s):  
Cross Sectional Study ◽  
Fetal Mortality ◽  
Pregnancy Induced Hypertension ◽  
College Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Tertiary Teaching ◽  
Induced Hypertension ◽  
Questionnaire Result ◽  
In Pregnancy

Background: Hypertensive disorders are common complication occurring during pregnancy which are responsible for maternal and fetal mortality and morbidity. Objective: The purpose of the present study was to determine the perinatal outcome in pregnancy induced hypertension. Methodology: This study was designed as cross-sectional study and was conducted from April 2013 to September 2013 for a period of six (06) moths. Patients admitted in the Department of Obstetrics and Gynaecology at Shaheed SuhrawardyMedical College Hospital, Dhaka. Data were collected by interview, physical examintions (blood pressure, pulse rate, oedema, heart and lungs auscultation) and lab investigations using a structural questionnaire. Result: Majority of the women belonged to age group 21-25 year. Maximum were (56%) primigravida. The mean gestational age was 34.6 weeks with the range from 28 to 40 weeks. Hyperurecaemia was frequent among patients with pregnancy induced hypertension. Intrauterine growth retardation (IUGR) was secondary to pregnancy induced hypertension which was associated with significantly increased perinatalmortality. Conclusion: In this study, prematurity is frequent in pregnancy induced hypertension and convulsion in nonresponsive patients is associated with significantly increased perinatal mortality.Journal of National Institute of Neurosciences Bangladesh, January 2016;2(1): 10-13

scholarly journals Assessment of Protein C and Protein S of Pregnancy Loss Victims

2019 ◽  
pp. 1-7
Author(s):  
Igwe, Chioma Ada ◽  
Adias Teddy Charles ◽  
Eze Evelyn Mgbeoma ◽  
Nwachuku Edna Ogechi
Keyword(s):  
Protein C ◽  
Pregnancy Loss ◽  
Objective Assessment ◽  
Protein S ◽  
Study Groups ◽  
Normal Pregnancy ◽  
Cross Sectional Study ◽  
Protein C Deficiency ◽  
Cross Sectional ◽  
In Pregnancy

Background: The haemostatic changes that result in thrombophilia during the pregnant state have been linked to pregnancy loss. Objective: Assessment of Protein S, and Protein C assays in pregnancy loss victims in Abia State, South East, Nigeria. Materials and Methods: This was a cross-sectional study involving women in their reproductive years. Study population was stratified into 3 groups and the Protein C and Protein S concentrations measured and compared among the three groups. Results: A total of 130 apparently healthy Nigerian women of child-bearing age were enrolled in the study. The study groups consisted of 70 women who had just lost a pregnancy, 30 women                  with normally progressing pregnancy and 30 nonpregnant women. The protein C concentration for the pregnancy-loss subjects was significantly lower than that of the normal pregnancy at p ≤ 0.01 while that of Protein S showed non-significance (p > 0.05). Conclusion: Protein C deficiency is associated with increase in pregnancy loss.

Atrial natriuretic factor in pregnancy and pregnancy-induced hypertension

1991 ◽  
Vol 69 (10) ◽  
pp. 1601-1608 ◽  
Author(s):  
Albert Fournier ◽  
I. Gregoire ◽  
N. El Esper ◽  
J. D. Lalau ◽  
P. F. Westeel ◽  
...  
Keyword(s):  
Atrial Natriuretic Factor ◽  
Normal Pregnancy ◽  
Sequential Data ◽  
Pregnancy Induced Hypertension ◽  
Third Trimester ◽  
Aldosterone Secretion ◽  
Cross Sectional ◽  
Induced Hypertension ◽  
Cardiac Filling ◽  
In Pregnancy

In normal pregnancy, cross-sectional clinical data do not consistently show plasma ANF concentration differences between early pregnancy and the nonpregnant state. Sequential data in the baboon (but not in rat) show a significant decrease in plasma ANF concentration and in cardiac filling pressures in early pregnancy. The latter data support the view that pregnancy is an underfill state secondary to a primary vasodilatation. Cross-sectional and longitudinal studies in normal pregnancy in humans show that plasma ANF levels tend rise to values that are, in the third trimester, higher than in the nonpregnant state. However, late postpartum sequential data (1.5–3 months) in humans do now show a significant drop in plasma ANF concentrations, suggesting that plasma ANF is not actually increased in normal pregnancy. In the baboon (but not in the rat) there is a steady rise in plasma ANF levels to values that are significantly higher in third trimester than before pregnancy. These data suggest that in human pregnancy, in contrast with the baboon, the plasma volume expansion induced by normal pregnancy is not sensed as such by the atria probably because of an isopressive adaptation of plasma volume to an enlarged vascular bed. However, acute decrease or increase of venous return induced by low sodium diet, changing position or infusion of isotonic saline are sensed as such by the atria in normal pregnancy as in the nonpregnant state. In humans and rats, a steady rise in plasma ANF concentration is observed during the first few days after delivery suggesting that at this time the atria sense an effective hypervolemia; the latter occurring through a decrease in the functional size of the intravascular compartment owing to the elimination of the placenta as well as by the autotransfusion carried out by the emptied uterus. The resulting increase in central venous pressure may stimulate ANF release that, together with a decrease in renin and aldosterone secretion, may thus contribute to the diuretic crisis observed after delivery. In pregnancy-induced hypertension, plasma ANF levels are usually increased but may remain normal in mild hypertension. In preeclampsia, plasma ANF concentration is more consistently increased, specially in the severe form. Plasma ANF decreases to normal levels after delivery when hypertension has disappeared. Plasma ANF concentration is directly correlated to blood pressure. A deficiency in ANF secretion can not, therefore, be the primary cause of pregnancy-induced hypertension or preeclampsia. On the contrary, ANF may play a compensatory role preventing further increase of blood pressure. However, because of the suppressive effect of ANF on renin and aldosterone secretion and by promoting a shift of the plasma fluid into the interstitial space, ANF elevation in preeclampsia may actually contribute to worsen the hypovolemia and explain the paradoxical association of hypovolemia with the hypostimulation of the renin–aldosterone system. The mechanism underlying the increased ANF secretion in preeclampsia is not clear since cardiac filling pressures in untreated preeclampsia are decreased and hence increased ANF release through atrial stretch seems unlikely. It is possible that neuroendocrine mechanisms yet to be identified are responsible for this observation.Key words: atrial natriuretic factor, pregnancy, preeclampsia, pregnancy-induced hypertension.

Incidence of Pregnancy Induced Hypertensive Women and its Associated Factors

2021 ◽  
Vol 15 (12) ◽  
pp. 3307-3309
Author(s):  
Samia Saifullah ◽  
Maryam Shoaib ◽  
Muhammad Sohail Tareen ◽  
Nosheen Sikander Baloch
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Renal Diseases ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Induced Hypertension ◽  
Keywords Pregnancy

Background: Pregnancy induced hypertension is a fetal disease resulting into morbidity and mortality of female as well as its neonate. Objective: To find the incidence of pregnancy induced hypertension in Pakistani women. Study Design: Cross sectional study Place and Duration of the Study: Department of Obstetrics & Gynaecology, Sandeman Provincial Hospital, Quetta from 1st March 2019 to 31st March 2021. Methodology: Seven hundred and twenty eight females were identified with pregnancy induced hypertension from all the pregnant women attending the outdoor were enrolled. Each female was checked for their protein urea as well as systolic and diastolic blood pressure according to standard operating protocol. Socio-demographic, clinical and family history were documented. Results: Among all pregnant women, 150 were identified as pregnancy induced hypertensive with a 20.6% incidence of pregnancy induced hypertension. The mean value systolic blood pressure value was 144.3±5.2 and of diastolic as 83.1±5.2 in pregnancy induced hypertension women. Conclusion: Family history, obesity and renal diseases are the main factors associated with pregnancy induced hypertension with an incidence of 20.6% among pregnant women. Keywords: Pregnancy induced hypertension, Body mass index, Pregnant women, Hypertension

Assessment of Prevalence of Hypertension in pregnant women with its Complications: A Cross Sectional Study

2021 ◽  
pp. 3805-3808
Author(s):  
Hemalatha S. ◽  
S. M. Shaheedha ◽  
Ramakrishna Borra
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
World Health ◽  
Chronic Hypertension ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Gynecology And Obstetrics ◽  
Induced Hypertension ◽  
History Of

Introduction: World Health Organization has reported that pregnancy induced hypertension is one of the main causes for mortality and morbidity in maternal and fetal deaths. About 60% of deaths accounted of eclampsia. Aims and Objectives: To diagnose for hypertension in pregnant women. To evaluate the knowledge of pregnancy induced hypertension among the pregnant women. To investigate the complications reported in Pregnancy induced hypertension (PIH) women, during and after labor. Study area and period: The present study was conducted in Chittoor government hospital, Chittoor, during the period of Jan 2016 and Dec 2017. The information and materials required for the study have been collected from the gynecology and obstetrics departments of the respective hospital. Results: During the study period of Jan 2016 and Dec 2017, about 2234 number of pregnant women have visited the obstetrics and gynecology department. All the 2234 pregnant women were tested for blood pressure. Among which 198 women were found to have hypertension, which may be of early onset PIH or chronic hypertension (HTN). Different variables of the study population like period of gestation [<20 weeks, ≥20 weeks], previous cesarean section if present, previous preterm delivery if present, hypertension in previous pregnancy, history of paternal hypertension, history of abortions if have been, history of any still births, family history of PIH have been noted and reported in table 2. More than 8% of women were found to been falling in <20 weeks of gestational age (GA). Conclusion: The study included 2234 pregnant women, in which 198 women were diagnosed with hypertension. Thus, prior investigation and identification hypertension in pregnant women helps in better management of PIH and to overcome the complications that are reported due to PIH during and after labor. Better knowledge and treatment is required for managing hypertension in maternal women in gynecology and obstetrics department for maternal and fetal care.

scholarly journals Risk factors and potential protective factors of pregnancy‐induced hypertension in China: A cross‐sectional study

2019 ◽  
Vol 21 (5) ◽  
pp. 618-623 ◽  
Author(s):  
Caixia Zhuang ◽  
Jinsong Gao ◽  
Juntao Liu ◽  
Xietong Wang ◽  
Jing He ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Cross Sectional Study ◽  
Pregnancy Induced Hypertension ◽  
Sectional Study ◽  
Cross Sectional ◽  
Induced Hypertension

scholarly journals Maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes: A cross-sectional study

2020 ◽  
Author(s):  
Akramsadat Dehghani Firoozabadi ◽  
Razieh Dehghani Firouzabadi ◽  
Maryam Eftekhar ◽  
Afsar Sadat Tabatabaei Bafghi ◽  
Farimah Shamsi
Keyword(s):  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Pregnant Women ◽  
Polycystic Ovary ◽  
Cross Sectional Study ◽  
Neonatal Outcomes ◽  
Pregnancy Induced Hypertension ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Induced Hypertension

Background: Pregnancy is a process associated with various metabolic and hormonal changes, and polycystic ovary syndrome (PCOS) can affect this process. Objective: This study aimed to evaluate and compare the maternal and neonatal outcomes among pregnant women with different polycystic ovary syndrome phenotypes. Materials and Methods: In this cross-sectional study, 200 pregnant women with PCOS according to the 2003 ESHRE/ASRM criteria were categorized into four phenotype groups (A-D). The maternal outcomes include gestational diabetes mellitus, pregnancy-induced hypertension, premature rupture of membranes, preterm labor, small-for-gestational age birth, intrauterine growth restriction, intrauterine mortality, preeclampsia, abortion, amniotic fluid disorders, delivery method, and cause of cesarean section were studied between groups. Additionally, neonatal outcomes such as neonatal weight, neonatal recovery, 5-min Apgar score, neonatal icter, the need for NICU admission, the cause of hospitalization, and infant mortality rate were investigated and compared among the groups. Results: According to the results, phenotype D (37%) was the most common phenotype among the participants. The risk of gestational diabetes was more common in phenotype A than in the other phenotypes, whereas pregnancy-induced hypertension was most common in phenotype B. No significant differences were observed in the neonatal complications among the PCOS phenotypes. Conclusion: Considering the higher risk of gestational diabetes mellitus and pregnancy-induced hypertension in PCOS phenotypes A and B, women with these phenotypes need more precise prenatal care. Key words: Pregnancy outcome, Polycystic ovary syndrome, Phenotype, Pregnancy.

scholarly journals Antenatal Complications in Grand Multipara Presented at Tertiary Care Hospital

2021 ◽  
Vol 15 (1) ◽  
pp. 69-72
Author(s):  
Sadia Kadir ◽  
Keyword(s):  
Tertiary Care Hospital ◽  
Placenta Previa ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Cross Sectional ◽  
Grand Multiparity ◽  
Induced Hypertension ◽  
Pregnancy And Birth

Background: Grand multiparity considered as a risk factor of obstetrics because of the recorded complications linked to the condition. Grand multiparity typically considered as the distinctive reason for the raised, maternal and fetal morbidity and mortality because of expanded incidence of adverse outcome during pregnancy and birth. Objective: To determine frequency of antenatal complications in grand multipara. Study Design: Cross-sectional study. Settings: Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre, Karachi Pakistan. Duration: Study duration was six months from March 2016 September 2016. Methodology: Total 212 patients were included in this study. Anemia was taken as Hb of 11g/dl, PIH was taken as BP of >140/90mmHg after 20 weeks of gestation with or without proteinuria on two or more occasion 6 hours apart and placenta previa was confirmed via ultrasonography. All the information was collected via study proforma. Results: Patients mean age was 34.90±3.51 years. Most of the patients 96.7% had parity 5-9. Anemia was found 69.8% and pregnancy induced hypertension was 22.2%, while placenta previa was found to be 18.9%. Antenatal complications including anemia, pregnancy induced hypertension and placenta previa were found to be statistically insignificant according to age, parity and BMI, (p->0.05). Conclusion: Most common antenatal complication in this study was anemia followed by hypertension and placenta previa. Grand multiparity is at a greater risk of antenatal complications.

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