Clinical Significance of Detection of Coagulation Indexes, Immune Factors and Inflammatory Factors in Patients with Pregnancy-Induced Hypertension Syndrome in China

Background: To investigate the clinical significance of monitoring the coagulation indexes, immune factors and inflammatory factors in pregnancy-induced hypertension syndrome (PIH). Methods: 90 pregnant women with PIH admitted in Weihaiwei People's Hospital of Shandong Province, China from 2016 to 2017 were collected, including 45 cases in mild-moderate group and 45 cases in severe group. Another 45 normal pregnant women at the same period were selected as control group. The immune indexes, four index signs of coagulation bloods and serum inflammatory factors in three groups of subjects were determined. Results: The levels of complement 3 (C3), complement 4 (C4), immunoglobulin A (IgA), immunoglobulin G (IgG) and immunoglobulin M (IgM) were successively increased in severe PIH group, mild-moderate PIH group and normal pregnancy group (P<0.05). Compared with those in normal pregnancy group, the levels of PT, APTT and TT were significantly decreased and Fib levels were significantly increased in PIH groups (P<0.05). Compared with those in normal pregnant women, the levels of TNF-α and IL-6 in pregnant women with PIH were significantly increased (P<0.05), and the changes in severe PIH group were more obvious than those in mild-moderate group. Conclusion: Pregnant women with PIH are in a hypercoagulable state and have a higher risk of thrombus and secondary hyperfibrinolysis. Immune factors and inflammatory factors are also associated with the occurrence and development of the disease. Monitoring the changes in coagulation indexes and levels of immune factors and inflammatory factors provide an important reference value for clinical treatment and prevention of complications.

Download Full-text

Enhancement of plasma corticotropin-releasing hormone in pregnancy-induced hypertension

Acta Endocrinologica ◽

10.1530/acta.0.1220711 ◽

1990 ◽

Vol 122 (6) ◽

pp. 711-714 ◽

Cited By ~ 20

Author(s):

W. Jeske ◽

P. Soszyński ◽

E. Lukaszewicz ◽

R. Dȩbski ◽

W. Latoszewska ◽

...

Keyword(s):

Pregnant Women ◽

Gestational Age ◽

Placental Tissue ◽

Normal Pregnancy ◽

Placental Lactogen ◽

Control Group ◽

Pregnancy Induced Hypertension ◽

Human Placental Lactogen ◽

Induced Hypertension ◽

In Pregnancy

Abstract. The role of a high CRH level in normal pregnancy remains unknown. Therefore we evaluated the concentrations of CRH and the related hormones in patients with pregnancy-induced hypertension. Fourteen women with pregnancy-induced hypertension, aged 20-39, at 30-39 gestational week, were investigated. The control group consisted of 20 healthy pregnant women matched according to gestational age. Plasma CRH, β-endorphin-like immunoreactivity, cortisol, and human placental lactogen were measured by radioimmunoassay, ACTH by an immunoradiometric method. It was found that in hypertensive patients the mean CRH concentration was significantly higher (4257±840 (sem) ng/l) than that in healthy pregnant women (1083±227 ng/l, p<0.001). The concentration of ACTH, however, was only slightly higher 65.0±6.0 vs 50.7±2.5 ng/l, p<0.025, whereas the differences in β-endorphin, cortisol and human placental lactogen were not significant. In both groups there was no correlation between the CRH level and those of the related hormones. In healthy pregnant women the CRH level closely correlated with gestational age (r=0.76, p<0.001), whereas in patients with hypertension no such correlation was present (r=0.29). We assume that the marked enhancement of plasma CRH in pregnancy-induced hypertension is probably caused by its decreased breakdown in ischemic placental tissue, but its increased synthesis in the placenta and its indirect counterregulatory hypotensive role must also be considered.

Download Full-text

Comparison of the Antioxidant Nutrient Profile among Normal Pregnant Women and Women having Pregnancy Induced Hypertension

Pakistan Journal of Public Health ◽

10.32413/pjph.v10i4.388 ◽

2021 ◽

Vol 10 (4) ◽

pp. 246-251

Author(s):

Kausar Aamir ◽

Arfa Azhar ◽

Fatima Abid ◽

Shamaila Khalid ◽

Fiza Ali Khan

Keyword(s):

Vitamin E ◽

Pregnant Women ◽

Cell Damage ◽

Alpha Tocopherol ◽

Control Group ◽

P Value ◽

Pregnancy Induced Hypertension ◽

Nutrient Profile ◽

Induced Hypertension ◽

Mild Hypertensive

Background: Preeclampsia is a multifactorial disorder comprising many organs. Oxidative stress (OS) has been intensely linked to its occurrence. Vitamin E, a lipophilic chain breaking antioxidant has been proved to suppress the OS. Present study was designed to investigate antioxidant nutrient profile in patients with different grades of pregnancy induced hypertension (PIH) and to compare them with normal pregnant controls. Methods: The study group comprised 110 patients divided in three groups as Group A (n=40) Normotensive patients, Group B (n=40) Mild hypertensive, Group C (n=30) Severe hypertensive. Vitamin A, B-Carotene, serum alpha tocopherol (vitamin E) and vitamin C levels were analysed. Results: Serum alpha tocopherol (vitamin E) was significantly low in severe and mild cases (0.32±0.00 mg/dl, 0.74±0.03 mg/dl respectively), when compared with normal pregnant women levels (0.78±0.040). All other nutrients were also found to be in reduced quantity for Group C when compared to control group (P value <0.001). Conclusion: It was therefore concluded that in patients with risk of preeclampsia (PE) adequate antioxidant nutrients may have a role in cessation of free radical-mediated cell disturbances, and thereby protecting against endothelial cell damage, which is the key factor in PE development.

Download Full-text

Adoption of Ultrasonic Imaging Diagnosis Under Machine Learning Algorithm in Treatment of Pregnancy-Induced Hypertension and Nursing

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2021.3426 ◽

2021 ◽

Vol 11 (1) ◽

pp. 268-275

Author(s):

Wei Gao ◽

Ani Zhou

Keyword(s):

Machine Learning ◽

Pregnant Women ◽

Learning Algorithm ◽

Resistance Index ◽

Nursing Intervention ◽

Control Group ◽

Pregnancy Induced Hypertension ◽

Induced Hypertension ◽

Omaha System ◽

Ultrasonic Images

In order to study the application of doppler ultrasound in monitoring the changes of important vascular hemodynamic indexes in pregnant women with Pregnancy-induced Hypertension (PIH) during pregnancy under the Omaha systematic nursing intervention (NI), in this study, 83 PIH pregnant women were taken as the study object. First, 60 normal pregnant women were taken as the control group (CG). Ultrasonic images of the uterine artery (UA) and middle cerebral artery (MCA) were collected. The machine learning (ML) algorithm was used to detect the edge of the target vessel in the UA image. The hemodynamic indexes of UA and MCA were compared between the two groups. Then, according to the routine NI and the NI method based on the Omaha system, 83 PIH pregnant women were divided into the routine group (RG) (n = 35) and the observation group (OG) (n = 48). The differences in UA hemodynamic parameters and quality of life (QOL) scores were compared between the two groups at 6 d after surgery. The results showed that pre-pregnancy BMI, mean artery pressure (MAP), and uric acid content in the CG were significantly lower than those in the PIH group (P < 0.05); the content of serum albumin in the CG was significantly higher than that in the PIH group (P < 0.05); compared with Sobel operator, edge detection (ED) based on ML algorithm was more coherent; in the CG, the systolic peak velocity (PSV), acceleration index (AI), pulse index (PI), and resistance index (RI) were significantly lower than those in the PIH group (P < 0.05); the values of PI and RI in MCA of CG were significantly higher than those in PIH group (P < 0.05); after NI, PSV, PI, RI, and AI values in the OG were significantly lower than those in the RG (P < 0.05); the health status, trunk pain, social function, emotional function, vitality, mental health, and total score of the OG were significantly higher than that of the RG (P < 0.05), which indicated that ultrasonic detection based on ML algorithm can be used in monitoring the changes of hemodynamic indexes of PIH pregnant women during NI, and the NI based on the Omaha system can effectively improve the QOL of PIH pregnant women.

Download Full-text

Hypo-magnesium and Hyperlipidemia Responsible for Hypertensive Status of Pregnant Women in Pakistani Population

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i3230934 ◽

2020 ◽

pp. 61-66

Author(s):

Asia Parveen ◽

Khan Farooq ◽

Fatima Arshad ◽

Modasrah Mazhar ◽

Nureen Zahra ◽

...

Keyword(s):

Pregnant Women ◽

Serum Magnesium ◽

Density Lipoprotein ◽

Serum Levels ◽

Lipoprotein Cholesterol ◽

Control Group ◽

Case Group ◽

Pregnancy Induced Hypertension ◽

Induced Hypertension ◽

Group A

Background/ Aim: Pregnancy induced hypertension (PIH) has been a leading cause of maternal mortality worldwide. It could be responsible for several complications like hemodilution, altered lipid metabolism and deficiencies of different minerals in body. Although the causes of Pregnancy induced hypertension (PIH) remains indistinct. The aim of our present study was to evaluate the changes in magnesium serum levels and lipid profile in hypertensive and normotensive pregnant women. Materials and Methods: An analytical case control study comprising 60 individuals was designed. From which 30 normotensive pregnant women served as control group (A) and 30 pregnancy induced hypertensive women served as case group (B). Patients with pre-existing hypertension were excluded. Results: The independent t-test was used for comparison of various parameters between group A and B. Triacylglycerol (TAG) and low density lipoprotein cholesterol (LDL-C) levels were significantly high in PIH (B) as compare to normotensive group (A). Mean serum values of TG were measured as (195.73 ± 70.28 vs 156.27 ± 55.60 mg dL-1) and LDL-C vs control (87.33 ± 37.74 vs 69.45 ± 28.58 mg dL-1) in PIH and normotensive groups respectively. HDL-C in PIH vs Control (47.40±1.12 vs 54.43 ±1.27 mg dL-1) and Mg+2 PIH vs control (1.36±0.07 vs 1.94±0.35 mg dL-1) were measured respectively. High density lipoprotein cholesterol (HDL-C) and magnesium Mg+2 levels were significantly reduced in PIH. Conclusion: The lower serum magnesium levels and abnormal lipids profile may indicate their possible role as risk factors in the development of PIH in pregnant women. Hence initial diagnosis of hypomagnesemia in PIH cases may help in minimizing the complications and development of new cure strategies.

Download Full-text

Stimulation of Active Renin Release in Normal and Hypertensive Pregnancy

Clinical Science ◽

10.1042/cs0790505 ◽

1990 ◽

Vol 79 (5) ◽

pp. 505-511 ◽

Cited By ~ 15

Author(s):

Mark A. Brown ◽

Vivienne C. Zammit ◽

Delma Adsett

Keyword(s):

Pregnant Women ◽

Plasma Renin ◽

Normal Pregnancy ◽

Active Plasma ◽

Pregnancy Induced Hypertension ◽

Third Trimester ◽

Renin Substrate ◽

Plasma Renin Concentration ◽

Active Renin ◽

Induced Hypertension

1. Active plasma renin concentration but not total renin concentration is reduced in women with pregnancy-induced hypertension compared with normotensive pregnant women. This study was conducted to determine whether women with pregnancy-induced hypertension are able to stimulate release of active renin. 2. Active plasma renin concentration was measured as the generation of angiotensin I at physiological pH in the presence of excess renin substrate, and total renin concentration was determined in the same way after trypsin activation. Inactive plasma renin concentration was calculated as the difference between total renin and active plasma renin concentrations. 3. Resting active plasma renin concentration was significantly greater in third-trimester primigravidae compared with normotensive non-pregnant women and active plasma renin and total renin concentrations rose significantly without a fall in inactive plasma renin concentration in both groups after 2 h ambulation, suggesting increased release of active plasma renin and not conversion of circulating inactive to active renin. These responses were blunted in women taking oral contraceptives. 4. Although the active plasma renin concentration was significantly reduced in third-trimester primigravidae with pregnancy-induced hypertension, total renin concentration was not significantly different compared with normotensive women of similar gestation and in both groups 30 min 60° head-up tilt increased active but not inactive plasma renin concentration. 5. These studies show that in normal pregnancy active plasma renin concentration can be stimulated to a similar extent as in non-pregnant women, despite a higher resting level. This appears to be due to increased secretion of active plasma renin rather than conversion of circulating inactive to active renin. Women with pregnancy-induced hypertension are also still able to stimulate secretion of active renin despite resting concentrations similar to those of non-pregnant women. These data suggest that in pregnancy-induced hypertension basal secretion of active renin is prematurely reset to that in the non-pregnant state but that secretion of active renin responds normally to posture.

Download Full-text

Soluble Fas and Fas Ligand in Pregnancy

Angiology ◽

10.1177/0003319711406901 ◽

2011 ◽

Vol 63 (1) ◽

pp. 35-38 ◽

Cited By ~ 5

Author(s):

Velore J. Karthikeyan ◽

Gregory Y. H. Lip ◽

Sabah Baghdadi ◽

Deirdre A. Lane ◽

D. Gareth Beevers ◽

...

Keyword(s):

Pregnant Women ◽

Fas Ligand ◽

Normal Pregnancy ◽

Enzyme Linked Immunosorbent Assay ◽

Pregnancy Induced Hypertension ◽

Control Groups ◽

Pregnancy Hypertension ◽

Soluble Fas ◽

Induced Hypertension ◽

In Pregnancy

The pathophysiology of pregnancy-induced hypertension and preeclampsia may involve abnormalities in placentation and the Fas/Fas ligand system. Hypothesizing abnormal plasma Fas and Fas ligand in pregnancy-induced hypertension, we recruited 20 hypertensive pregnant women at mean week 15 and 29 at week 30: 18 were studied at both time points. Control groups were 20 normotensive pregnant women at week 20, 29 women at week 27, and 50 nonpregnant women. sFas and sFas ligand (sFasL) were measured by enzyme-linked immunosorbent assay (ELISA). The hypertensive women had lower sFasL at both stages of their pregnancy ( P < .05). There were no differences in sFas. In 18 hypertensive pregnant women, sFasL fell from week 15 to week 29 ( P < .03). We conclude that sFas and sFasL is unchanged in normal pregnancy. Hypertension in pregnancy is characterized by low sFasL, and levels fall from weeks 15 to 29. This may reflect differences in placentation in the differing physiological and pathological states.

Download Full-text

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.

Download Full-text

A ouabain-displacing factor in normal pregnancy, pregnancy-induced hypertension and pre-eclampsia

Clinical Science ◽

10.1042/cs0740307 ◽

1988 ◽

Vol 74 (3) ◽

pp. 307-310 ◽

Cited By ~ 18

Author(s):

I. Gregoire ◽

D. Roth ◽

G. Siegenthaler ◽

P. Fievet ◽

N. El Esper ◽

...

Keyword(s):

Pregnant Women ◽

Receptor Binding ◽

Adenosine Triphosphatase ◽

Binding Assay ◽

Normal Pregnancy ◽

Pregnancy Induced Hypertension ◽

Sodium Potassium ◽

Receptor Binding Assay ◽

Induced Hypertension ◽

In Pregnancy

1. A ouabain-displacing factor (ODF) was measured in the urine of non-pregnant, normotensive pregnant and hypertensive pregnant women by a receptor-binding assay with sodium, potassium-dependent adenosine triphosphatase. 2. Urinary ODF was significantly increased in normal pregnancy. 3. Greater increases were seen in pregnancy-induced hypertension and pre-eclampsia.

Download Full-text

Effect of low dose aspirin on maternal outcome in women at risk for developing pregnancy induced hypertension

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201229 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1590

Author(s):

Madhusmita Pradhan ◽

Kishore S. V. ◽

Jyotiranjan Champatiray

Keyword(s):

Risk Factors ◽

High Risk ◽

Pregnant Women ◽

Low Dose ◽

Multiple Pregnancy ◽

Control Group ◽

Pregnancy Induced Hypertension ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Induced Hypertension

Background: Pre-eclampsia is not totally a preventable disease. It is found more related to chains of social ills such as poor maternal nutrition, limited or no antenatal care and poor reproductive education. However, some specific “high-risk” factors leading to pregnancy induced hypertension (PIH) may be identified in individuals which include and not limited to young and elderly primigravida, multiple pregnancy, diabetes, Rh incompatibility, new paternity, pre-existing vascular or renal disease, family history of hypertension, pre-eclampsia and eclampsia, obesity, thrombophilia. Low dose aspirin given in 2nd trimester in these high-risk women is anticipated to prevent the development of PIH.Methods: This prospective randomized controlled trial was conducted in the department of obstetrics and gynecology, SCB MC and Hospital, Cuttack during November 2018 to October 2019. Pregnant women between the gestational age of 13th to 28th weeks were screened for risk factors and included in this study. Low dose aspirin of 60 mg daily till delivery was given to pregnant women who consented to be a part of study randomly with the other group having placebo.Results: Protienuric hypertension was high in control group who did not receive aspirin. Low dose aspirin significantly reduces PIH in high-risk group (3.48% in case versus 23.52% in control). Low dose aspirin was not associated with significant increase in placental bleeding. Low dose aspirin was generally safe for the fetus and new born infant with no evidence of an increased likelihood of bleeding.Conclusions: Low dose aspirin has a definite role in the prevention of PIH in high risk pregnancy. Low dose aspirin reduces the incidence of PIH. Low dose aspirin can be considered a safe drug without any deleterious side effect for mother and the fetus. Benefits of prevention of PIH, justifies its administration in women at high risk.

Download Full-text