scholarly journals Hypertension in pregnancy: Pathophysiology and treatment

2019 ◽  
Vol 7 ◽  
pp. 205031211984370 ◽  
Author(s):  
Stephanie Braunthal ◽  
Andrei Brateanu
Keyword(s):  
Gestational Hypertension ◽  
Severe Hypertension ◽  
Organ Damage ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
In Pregnancy ◽  
The Ideal

Hypertensive disorders of pregnancy, an umbrella term that includes preexisting and gestational hypertension, preeclampsia, and eclampsia, complicate up to 10% of pregnancies and represent a significant cause of maternal and perinatal morbidity and mortality. Despite the differences in guidelines, there appears to be consensus that severe hypertension and non-severe hypertension with evidence of end-organ damage need to be controlled; yet the ideal target ranges below 160/110 mmHg remain a source of debate. This review outlines the definition, pathophysiology, goals of therapy, and treatment agents used in hypertensive disorders of pregnancy.

scholarly journals Dopamine in the Pathophysiology of Preeclampsia and Gestational Hypertension: Monoamine Oxidase (MAO) and Catechol-O-methyl Transferase (COMT) as Possible Mechanisms

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Wendy N. Phoswa
Keyword(s):  
Monoamine Oxidase ◽  
Gestational Hypertension ◽  
Morbidity And Mortality ◽  
Therapeutic Interventions ◽  
Hypertensive Disorders Of Pregnancy ◽  
Methyl Transferase ◽  
Hypertension In Pregnancy ◽  
Health Burden ◽  
Hypertensive Disorders ◽  
In Pregnancy

Purpose of the Review. Hypertension in pregnancy is the global health burden. Amongst the hypertensive disorders of pregnancy, preeclampsia and gestational hypertension are the world’s leading disorders that lead to both maternal and fetal morbidity and mortality. Recent Findings. Dopamine inactive metabolites, namely, monoamine oxidase (MAO) and catechol-O-methyl transferase (COMT), have been reported to be associated with hypertensive disorders of pregnancy such preeclampsia and gestational hypertension. Summary. This review discusses the involvement of MAO and COMT in the pathophysiology of both conditions in order to have a better understanding on the pathogenesis of both conditions, suggesting promising therapeutic interventions and subsequently reducing maternal and fetal morbidity and mortality.

Depression, Antidepressants and Hypertensive Disorders of Pregnancy: A Systematic Review

2019 ◽  
Vol 14 (2) ◽  
pp. 102-108 ◽  
Author(s):  
Sabrina Youash ◽  
Verinder Sharma
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Gestational Hypertension ◽  
Research Question ◽  
Current Evidence ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
The Relationship ◽  
In Pregnancy

Background: Hypertensive disorders of pregnancy including gestational hypertension, preeclampsia and eclampsia are conditions that cause significant perinatal and maternal morbidity and mortality. </P><P> Objective: This is a systematic review of the current evidence examining the relationship between both depression and antidepressants on pregnancy-related hypertensive conditions. </P><P> Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, six databases were searched for articles published between January 1990 and December 2017 (PubMed, Embase, PsycINFO, Cochrane Database of Systematic Reviews, MEDLINE and ClinicalTrials. gov). Randomized control trials, cohort studies and case-control studies were included in this review. Studies that measured the following exposures were included: Antidepressant exposure or diagnosis of depression. Studies that measured the following outcomes were included: Gestational hypertension, preeclampsia or eclampsia. A combination of keywords, as well as Medical Subject Headings (MeSH) index terms, was used for three general categories: antidepressants, depression and hypertensive disorders of pregnancy. A total of 743 studies were identified and 711 were excluded based on relevance to the research question. Twenty studies were included in the final systematic review. </P><P> Results: Of the twenty relevant studies, ten specifically examined the relationship between depression and hypertension in pregnancy. Only two of these did not find a significant association. Of the ten studies that concentrated on antidepressant medications, all except one found an association with hypertension in pregnancy to varying degrees. </P><P> Conclusion: Review of the literature suggests a possible association between depression and antihypertensive medications with pregnancy-related hypertension, but further studies are needed.</P>

Hypertensive Disorders in Pregnancy

2017 ◽  
Author(s):  
Kavitha Vellanki ◽  
Susan Hou
Keyword(s):  
Blood Pressure ◽  
Organ Damage ◽  
The United States ◽  
Blood Pressure Target ◽  
Maternal Complications ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Few Data ◽  
In Pregnancy ◽  
New Onset

Hypertensive disorders are the second leading cause of maternal mortality in the United States. Hypertension in pregnancy is defined as blood pressure greater than or equal to 140 mm Hg systolic or greater than or equal to 90 mm Hg diastolic, measured on at least two separate occasions. Preeclampsia, as per the new guidelines, is characterized by the new onset of hypertension and either proteinuria or other end-organ dysfunction, more often after 20 weeks of gestation in a previously normotensive pregnant woman. New-onset proteinuria is not required for diagnosis of preeclampsia if there is evidence of other end-organ damage—a change from previous classifications. Although no screening test has yet proven accurate enough to predict preeclampsia, the use of a combination of the serologic factors seems promising. There are few data to support any specific blood pressure target in pregnancy. Although there is a general consensus on treating severe hypertension in pregnancy, there is a difference of opinion on treating mild to moderate hypertension in pregnancy. Avoiding uteroplacental ischemia and minimizing fetal exposure to adverse effects of medications are as important as avoiding maternal complications from high blood pressure during pregnancy. This review contains 2 figures, 4 tables, and 73 references.

scholarly journals Study of maternal and perinatal outcome of referred patients in tertiary health centre

2017 ◽  
Vol 6 (12) ◽  
pp. 5363
Author(s):  
. Jyotsana ◽  
Lalit D. Kapadia ◽  
Hafsa Vohra
Keyword(s):  
Care Center ◽  
Health Centre ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Child Health Services ◽  
Tertiary Care Center ◽  
Perinatal Morbidity ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Common Diagnosis

Background: Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. The aim of this study was to review the pattern of obstetric cases referred to tertiary care center, to identify their clinical course, mode of delivery, maternal and perinatal outcomes.Methods: It is a prospective observational study carried out from January 2017 to July 2017. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of B.J Medical College, Ahmedabad, Gujarat, India a tertiary care center during the study period.Results: The total number of referred cases in above study period was 100. Mode of transport used by the referred patients was by 108 ambulances (75%) and private vehicles (25%). Most common diagnosis at the time of referral was hypertensive disorders of pregnancy (31%). Out of the total referred cases, 57% had vaginal delivery, 42% had caesarean section. Hypertensive disorders of pregnancy constitute the leading cause of maternal deaths amongst the referred cases.Conclusions: The present study has shown that inadequate antenatal and intra-natal care at the periphery level is responsible for increased maternal and perinatal morbidity and mortality. Even today, hypertensive disorders of pregnancy are the leading cause of maternal mortality. Health education to the community will definitely reduce maternal and perinatal morbidity and mortality.

scholarly journals Hipertensi pada Kehamilan

2019 ◽  
Vol 2 (2) ◽  
pp. 27
Author(s):  
Haidar Alatas
Keyword(s):  
Gestational Hypertension ◽  
Organ Damage ◽  
Antihypertensive Drug Therapy ◽  
Chronic Hypertension ◽  
First Line ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Hipertensi pada kehamilan sering terjadi (6-10 %) dan meningkatkan risiko morbiditas dan mortalitas pada ibu, janin dan perinatal. Pre-eklampsia/eklampsia dan hipertensi berat pada kehamilan risikonya lebih besar. Hipertensi pada kehamilan dapat digolongkan menjadi pre-eklampsia/ eklampsia, hipertensi kronis pada kehamilan, hipertensi kronis disertai pre-eklampsia, dan hipertensi gestational. Pengobatan hipertensi pada kehamilan dengan menggunakan obat antihipertensi ternyata tidak mengurangi atau meningkatkan risiko kematian ibu, proteinuria, efek samping, operasi caesar, kematian neonatal, kelahiran prematur, atau bayi lahir kecil. Penelitian mengenai obat antihipertensi pada kehamilan masih sedikit. Obat yang direkomendasikan adalah labetalol, nifedipine dan methyldopa sebagai first line terapi. Penatalaksanaan hipertensi pada kehamilan memerlukan pendekatan multidisiplin dari dokter obsetri, internis, nefrologis dan anestesi. Hipertensi pada kehamilan memiliki tingkat kekambuhan yang tinggi pada kehamilan berikutnya. Hypertension complicates 6% to 10% of pregnancies and increases the risk of maternal, fetal and perinatal morbidity and mortality. Preeclampsia / eclampsia and severe hypertension in pregnancy are at greater risk. Four major hypertensive disorders in pregnancy have been described by the American College of Obstetricians and Gynecologists (ACOG): chronic hypertension; preeclampsia-eclampsia; chronic hypertension with superimposed preeclampsia; and gestational hypertension. The current review suggests that antihypertensive drug therapy does not reduce or increase the risk of maternal death, proteinuria, side effects, cesarean section, neonatal and birth death, preterm birth, or small for gestational age infants. The quality of evidence was low. Recommendations for treatment of hypertension in pregnancy are labetalol, nifedipine and methyldopa as first line drugs therapy. Although the obstetrician manages most cases of hypertension during pregnancy, the internist, cardiologist, or nephrologist may be consulted if hypertension precedes conception, if end organ damage is present, or when accelerated hypertension occurs. Women who have had preeclampsia are also at increased risk for hypertension in future pregnancies.

scholarly journals High blood pressure in pregnancy // Hipertenzija u trudnoći

2018 ◽  
Vol 5 (1) ◽  
pp. 28
Author(s):  
Marijana Bucalo ◽  
Anastasija Stojšić Milosavljević ◽  
Bojana Babin
Keyword(s):  
Blood Pressure ◽  
Literature Review ◽  
High Blood Pressure ◽  
Gestational Hypertension ◽  
Morbidity And Mortality ◽  
Significant Problem ◽  
Hypertension In Pregnancy ◽  
Gynecology And Obstetrics ◽  
Increased Risk ◽  
In Pregnancy

High blood pressure in pregnancy is a significant problem and has long been causing the attention of perinatologists. Hypertensive disorders in pregnancy are the leading cause of morbidity and mortality of mothers and fetuses. About 8% of pregnancies complicate high blood pressure. It is estimated that 192 women die daily due to hypertensive complications during pregnancy. Hypertension in pregnancy is not a single entity but it includes: pre-existing hypertension; gestational hypertension; pre-pregnancy existing hypertension complicated by gestational hypertension with proteinuria; prenatally unclassified hypertension. The aim of this paper is to point to the problem of hypertension in pregnancy and the importance of its early detection.It’s a literature review. The literature review period is from 2003-2013. The literature review was carried out in the Hinari, Pubmed and Google Scholar databases.A total of 50 scientific and professional papers in English and Serbian have been examined, of which work is included. 17. By reviewing the summary of each paper, all articles that did not report hypertension in pregnancy were excluded. Through research that was conducted, it was concluded that pregnancy is a significant problem in pregnancy and is therefore the leading cause of morbidity and mortality of both mothers and fetuses. However, the decision to introduce antihypertensive therapy and the choice of an adequate drug during pregnancy should be based on the assessment of the benefits and risks for each pregnant woman individually. Thus, the role of the health care nurse in gynecology and obstetrics has the primary goal and task to preserve and improve the health of women through a series of preventive-promotional activities, all of which are covered through primary, secondary, and tertiary prevention.A literature review lists the risk factors that can cause hypertension in pregnancy, including: age of the patient - under 20 and over 35 years, vascular and renal pathology, gestational diabetes, obesity or malnutrition, pheochromocytoma, systemic lupus, poor living conditions, there is and increased risk in first-born patients. Women who have been hypertensive during their first pregnancy have a higher risk of subsequent pregnancy.

scholarly journals Gestational Hypertension -An Ayurvedic Prespective

2021 ◽  
Vol 5 (01) ◽  
Author(s):  
Pooja Pande
Keyword(s):  
Early Detection ◽  
Gestational Hypertension ◽  
Causative Factor ◽  
Morbidity And Mortality ◽  
Common Complication ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Appropriate Treatment ◽  
The Common

Hypertensive disorders of pregnancy is one of the common complication met during pregnancy, which contributes to significant maternal and fetal morbidity and mortality. They are preventable by early detection and appropriate treatment and possibly by prevention of disease itself. Ayurveda can definitely contribute in this regard. On looking to the symptoms and understanding etiopathogenesis with an Ayurvedic approach. Vata dusti is main causative factor in the manifestation of the disease. As disease progresses involvement of other Dosha is seen. As Dushya are Hridaya, Dash dhamanya, Sira, Ras raktvaha strotasa, Manovaha strotasa, Ras dhatu, Rakt dhatu and Manna, treatment should be Vaatashaman, Pittashamana, Hridya, Shothahara, Raktashaman, Balya, Anulomana .

scholarly journals Electrocardiographic profile of patients with hypertensive disorders in pregnancy

2017 ◽  
Vol 6 (6) ◽  
pp. 2569
Author(s):  
Devika Desai ◽  
Madhva Prasad S.
Keyword(s):  
Sinus Tachycardia ◽  
Gestational Hypertension ◽  
Age Distribution ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Simple Tool ◽  
Hypertensive Disorders In Pregnancy ◽  
Ecg Abnormalities ◽  
Electrocardiographic Abnormalities ◽  
In Pregnancy

Background: Preeclampsia in pregnancy is a frequently encountered entity. Recent evidence suggests that preeclampsia can be considered as a screening test for future cardiovascular problems and abnormalities in pregnancy may help in counselling patients regarding future risk of cardiovascular problems. Electrocardiography (ECG) is a simple tool for detecting cardiovascular problems. While physiological changes in the ECG in pregnancy have been documented, the pattern of ECG in hypertensive disorders of pregnancy is not adequately studied in India. This formed the basis of the study.Methods: 140 patients who have been diagnosed as gestational hypertension and pre-eclampsia during the pregnancy were studied in the antenatal period. An ECG (non-portable, standard, 12 lead) available in the hospital was done, and the ECG was reported by the physician on-call.Results: The average age distribution of the patients was 28.26 years. Majority of the patients in the study were primigravidae. 35% of the patients were more than 37 weeks of gestation. 20 patients showed electrocardiographic abnormalities. The most common abnormality was sinus tachycardia and left axis deviation.Conclusions: ECG abnormalities are seen in 14.2% of preeclamptic women. ECG abnormalities in preeclamptic women studied had no relation to the maternal age, gestational age; parity and use of antihypertensives.

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