scholarly journals Intrauterine foetal demise in pre-eclampsia - role of mifepristone: a case series

2018 ◽  
Vol 7 (7) ◽  
pp. 2952
Author(s):  
Kanika Chopra ◽  
Suchitra . ◽  
Prbha Lal
Keyword(s):  
Oxidative Stress ◽  
Uric Acid ◽  
Single Dose ◽  
Case Series ◽  
Fetal Outcome ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
The Cost ◽  
Progesterone Antagonist

Mifepristone is a steroid, which is a progesterone antagonist and is widely used for termination of pregnancies in all the trimester. It increases the sensitivity of the uterus to prostaglandins and ripens the cervix. Its role in inducing women with intra uterine demise is on the rise with varying dose regimen either alone or in combination with misoprostol. Among the various causes of intrauterine demise, one of the most important is hypertensive disorders of pregnancy complicating around 10% of pregnancies worldwide, Serum uric acid, a marker of oxidative stress is an important parameter in defining poor fetal outcome in women with pre-eclampsia. Induction of labour in women diagnosed with intrauterine demise is again a challenge in such women and mifepristone helps to a larger extent. In present case series, authors present six women presenting with pre-eclampsia with intrauterine demise, their clinical and biochemistry profile and responding to single dose of mifepristone of 200 mg with mean induction to delivery interval being 40 hours. Henceforth, authors conclude that even single dose of mifepristone can work wonders taking into consideration the cost of the drug and thus can be definitely employed in daily clinical practice.

scholarly journals Raised Uric Acid Level and Fetal Outcome in Hypertensive Disorders of Pregnancy

2014 ◽  
Vol 9 (1) ◽  
pp. 78-81
Author(s):  
A Singh ◽  
P Sharma ◽  
R Malla ◽  
S Singh
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Uric Acid Level ◽  
Acid Level ◽  
Serum Uric Acid Level ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Aims: This study was done to find the relation of raised uric acid with fetal outcome in hypertensive disorders of pregnancy and to compare the fetal outcome with normal and raised uric acid level . Methods: This was a hospital based cross-sectional prospective comparative study done in Paropakar maternity and Women’s hospital conducted over three month period. Results: During the study period, a total of 126 cases of hypertensive disorders of pregnancy were identified among 3819 obstetric cases. The incidence of hypertensive disorders of pregnancy in this study was 3.3%. Fifty seven of them were found to have serum uric acid level <5.5 mg% (Group A), 43 of them were found to have serum uric acid level ≥5.5mg% (Group B). In those developing hyperuricemia 54.81% had mild hypertension, 40.91% had severe hypertension. Adverse perinatal outcome with serum uric acid level ≥5.5mg/dl had stillbirth in 7%, had low birth weight in 27.9%, 11.6 % were admitted in special care baby unit and 18.6 % had apgar <7 at five minute. Conclusions: Perinatal morbidity and mortality was increased in women with raised uric acid level except admission to special baby care unit Hypertensive disorders of pregnancy are associated with high maternal and perinatal morbidity and mortality. DOI: http://dx.doi.org/10.3126/njog.v9i1.11196 NJOG 2014 Jan-Jun; 2(1):78-81

scholarly journals Revisiting the Role of First Trimester Homocysteine as an Index of Maternal and Fetal Outcome

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mariano Mascarenhas ◽  
Syed Habeebullah ◽  
M. G. Sridhar
Keyword(s):  
Pregnancy Loss ◽  
First Trimester ◽  
Fetal Outcome ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Serum Homocysteine ◽  
Significant Difference ◽  
History Of ◽  
Meconium Stained Amniotic Fluid

Aim.To revisit the role of first trimester homocysteine levels with the maternal and fetal outcome.Methods.This was a cohort study comprising 100 antenatal women between 8 and 12 weeks of gestation. Serum homocysteine levels were checked after overnight fasting.Results.There were significantly elevated homocysteine levels among women with prior history of hypertensive disorders of pregnancy and prior second or third trimester pregnancy losses. There was no significant difference in homocysteine levels among women with previous gestational diabetes mellitus, preterm deliveries, or fetal malformations. Homocysteine levels were significantly elevated in those who developed hypertensive disorder of pregnancy, oligohydramnios, and meconium stained amniotic fluid, had a pregnancy loss, or delivered a low birth weight baby. There was no significant difference in homocysteine levels for those who developed gestational diabetes mellitus.Conclusions.Increased first trimester serum homocysteine is associated with history of pregnancy losses, hypertensive disorders of pregnancy, and preterm birth. This is also associated with hypertensive disorders of pregnancy, pregnancy loss, oligohydramnios, meconium stained amniotic fluid, and low birth weight in the current pregnancy. This trial is registered with ClinicalTrials.govCTRI/2013/02/003441.

scholarly journals The Role of Oxidative Stress in Hypertensive Disorders of Pregnancy (Preeclampsia, Gestational Hypertension) and Metabolic Disorder of Pregnancy (Gestational Diabetes Mellitus)

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Wendy N. Phoswa ◽  
Olive P. Khaliq
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Gestational Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Placental Perfusion ◽  
Hypertensive Disorders ◽  
Body Tissues

Purpose of the Review.To highlight the role of oxidative stress in hypertensive disorders of pregnancy (HDP) and metabolic disorders of pregnancy (gestational diabetes mellitus). Recent Findings. In both preeclampsia (PE) and gestational hypertension (GH), oxidative stress leads to inadequate placental perfusion thus resulting in a hypoxic placenta, which generally leads to the activation of maternal systemic inflammatory response. In PE, this causes inflammation in the kidneys and leads to proteinuria. A proteinuria marker known as urinary 8-oxoGuo excretion is expressed in preeclampsia. In GDM, oxidative stress plays a role in the pathogenesis of the disease, as a result of over secretion of insulin during pregnancy. This uncontrolled secretion of insulin results in the production of lipid peroxidation factors that also mask the secretion of antioxidants. Therefore, ROS becomes abundant at cellular level and prevents the cells from transporting glucose to body tissues. Summary. There is a need for more research investigating the role of oxidative stress, especially in obstetrics-related conditions. More studies are required in order to understand the difference between the pathogenesis and pathophysiology of PE versus GH since investigations on the differences in genetic aspects of each condition are lacking. Furthermore, research to improve diagnostic procedures for GDM in pregnancy is needed.

scholarly journals Fetal Outcome in Hypertensive Disorders of Pregnancy.

2013 ◽  
Vol 12 (1) ◽  
pp. 8-10 ◽  
Author(s):  
Arju Chand Singh ◽  
Sadikchya Singh Rana
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Antihypertensive Drugs ◽  
Gestational Hypertension ◽  
Fetal Outcome ◽  
Intrauterine Fetal Death ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Study Results ◽  
Low Birth Weight Babies

Introduction: Hypertensive disorders are the most common medical complications of pregnancy, affecting approximately 5-10% of pregnancies and the major cause of maternal and infant disease and death worldwide. Very few researches have been done in Nepal to analyze the effect of hypertension in fetus. The aim of this study was to determine the incidence and perinatal morbidity of hypertensive disorders of pregnancy. Methods: This was a hospital based prospective observational study conducted at Paropakar Maternity and Women’s hospital. The study was conducted from 18th October to 22nd December 2007. All primi and multigravid patient with BP ≥140/90 mmHg after 28 weeks of pregnancy were included in the study. Women with a blood pressure ≥140/90mmHg at or before 20 weeks of gestation, previous hypertension or women on antihypertensive drugs and Intrauterine fetal death (IUFD) were excluded from the study. Results: A total of 126 cases of hypertensive disorders of pregnancy were identifi ed among 3819 obstetric cases. The incidence of hypertensive disorders of pregnancy was 3.3%. Among 100 cases who were included in the study, 42 had pre eclampsia and 58 had gestational hypertension. Among 42 preeclamptic patients, 15(35.71%) had low birth weight babies, and 9(15.5%) babies had low birth weight among 58 gestational hypertensive mothers. Conclusions: Preeclampsia increases the risk of intrauterine growth restriction, low birth weight and stillbirth.Medical Journal of Shree Birendra Hospital; January-June 2013/vol.12/Issue1/8-10DOI:http://dx.doi.org/10.3126/mjsbh.v12i1.9083  

scholarly journals Morphological and morphometrical study of placenta in normal and hypertensive pregnancies.

2014 ◽  
Vol 03 (01) ◽  
pp. 24-28
Author(s):  
Pushpa Gowda ◽  
Jayanthi KS
Keyword(s):  
Surface Area ◽  
Fetal Outcome ◽  
Control Group ◽  
Chronic Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Group ◽  
Hypertensive Disorders ◽  
The Mean ◽  
Placental Volume ◽  
Morphometrical Study

Abstract Background and Aim: Placenta is the main channel in utero, through which the fetus receives its nutrition from the mother. Hypertensive disorders of pregnancy are fairly common and affect the growth and development of the placenta and fetus in many ways. Knowledge of these changes in placenta due to hypertension in pregnancy is essential as many of these changes can be diagnosed prenatally by available techniques to improve the fetal outcome and reduce perinatal morbidity and mortality. Materials and Methods: The present study was conducted to note the morphometrical and morphological parameters in the placenta of normal and hypertensive pregnancies and to correlate them with fetal outcome. The study was done on 30 placentae as control group, obtained after delivery of normotensive women and 30 placentae as study group, which were obtained after delivery of hypertensive mothers which included chronic hypertension, pre eclampsia and eclampsia. The placental specimens were collected from the department of obstetrics and gynecology, KIMS, Bangalore and new bom parameters were taken from their records. Results: The placental morphometrical parameters were significantly less in hypertensive group as compared to the control group. The mean placental weight was 458.33±70.47 gms; mean placental surface area was 215.82±27.83 sqcms, the mean placental volume was 583.67+66.21 cc and mean decidual thickness was 2.50 ±0.24 cms in hypertensive group while in the control group the values were 561.67±77.33 gms, 241.91±37.23 sqcms, 674.00±88.50 cc and 2.83±0.34 cms respectively. The mean birth weight (kg) of newborn was 2.92 ± 0.45 in control group and it was and 2.47 ±0.40 in hypertensive group. Conclusion: Thus hypertensive disorders of pregnancy affects the placenta in a major way by decreasing its weight, surface area, thickness and volume and by increasing pathological changes like placental infarcts and calcified areas which adversely affect fetal parameters like weight and APGAR score.

scholarly journals Study of the serum uric acid level as a prognostic indicator in hypertensive disorders of pregnancy

2021 ◽  
Vol 10 (9) ◽  
pp. 3441
Author(s):  
Smitha Krishnegowda ◽  
G. Nita
Keyword(s):  
Uric Acid ◽  
Disease Severity ◽  
Serum Uric Acid ◽  
Mode Of Delivery ◽  
Prognostic Indicator ◽  
Maternal Serum ◽  
P Value ◽  
Chronic Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Background: Abnormal uric acid levels in patients with preeclampsia and eclampsia affect both maternal and fetal outcome negatively. This study was done to know the alterations in these serum levels in comparison to normal pregnancy and also among various hypertensive disorders of pregnancies.Methods: Maternal serum uric acid levels were compared among cases and controls in relation to disease severity, mode of delivery, maternal outcome.Results: In group A (cases), 10 patients had raised uric acid levels, of which 5 were severe preeclampsia, 3 were eclampsia and 2 cases of chronic hypertension superimposed preeclampsia. P value is 0.001 (highly significant). Also serum uric acid is significantly elevated in hypertensive disorders of pregnancy compared with controls with a P value of 0.001.Conclusions: Significant correlation was observed between maternal serum uric acid, disease severity and maternal outcome. Our study concludes that uric acid can be considered as a sensitive prognostic indicator of severity in hypertensive disorders of pregnancy.

scholarly journals Effect of Acute Ingestion of Green Tea Extract and Lemon Juice on Oxidative Stress and Lipid Profile in Pigs Fed a High-Fat Diet

Antioxidants ◽  
2019 ◽  
Vol 8 (6) ◽  
pp. 195 ◽  
Author(s):  
Xi Fang ◽  
Michael Azain ◽  
Kristi Crowe-White ◽  
Jennifer Mumaw ◽  
Janet A. Grimes ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Single Dose ◽  
Lipid Profile ◽  
Green Tea ◽  
High Fat Diet ◽  
Lemon Juice ◽  
Green Tea Extract ◽  
High Fat ◽  
Tea Extract

Green tea and its catechins have been shown to ameliorate high fat diet-induced oxidative stress and hyperlipidemia. However, low bioavailability of catechins limits their therapeutic potential. Lemon juice (LJ) has been suggested to enhance the bioavailability of catechins in vitro. This study investigated the antioxidative and hypolipidemic efficacy of a single dose of green tea extract (GTE) or GTE plus LJ (GTE + LJ) in high-fat diet fed pigs. Sixteen pigs ingested a single dose of GTE (190 mg/kg/day) or GTE + LJ (0.75 mL/kg/day) mixed with low-fat (LF; 5% fat) or high-fat (HF; 22% fat) diets and blood samples were collected for 24 h. Plasma catechin level peaked at two hours, and gradually returned to baseline after six hours following the intake. The addition of LJ significantly increased plasma catechin level. The diet containing GTE did not lower plasma cholesterol and triacylglycerol (TG) concentrations, superoxide dismutase (SOD) and catalase activity, or malondialdehyde concentration in 24 h in HF-fed pigs. Addition of a single dose of LJ, however, significantly decreased plasma TG level in LF groups but did not cause further changes on any other markers compared to the GTE alone. Our findings indicate limited effect of a single meal containing GTE on plasma antioxidant enzymes, lipid profile, and lipid peroxidation in pigs and no significant synergistic/additive action of adding LJ to GTE within 24 h in pigs. A study with a longer treatment period is warranted to further understand the potential role of GTE in reducing HF diet-induced oxidative stress and the possible synergistic role of LJ.

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