scholarly journals STUDY OF PLACENTAS OF HYPERTENSIVE MOTHERS ASSISTED IN TWO PUBLIC MATERNITIES OF RECIFE-PE

2021 ◽  
pp. 11
Author(s):  
Keyword(s):  
Middle Layer ◽  
Hypertensive Disorders Of Pregnancy ◽  
Fibrin Deposition ◽  
Endothelial Layer ◽  
Histomorphometric Study ◽  
Hypertensive Disorders ◽  
Significant Difference ◽  
Deposition Thickness ◽  
The Difference ◽  
Hematoxylin Eosin

Objective: Perform the histomorphometric study of the following regions: areas of perivillous fibrin deposition; thickness of the endothelial layer of the vessels; analysis of Tenney-Parker changes. Analyze the Placental Index (IP). Results: It was seen that the weight of the placentas increased according to the weight of the newborn, however, when the variable PI was analyzed as being decisive for the development of a risk-free pregnancy, it was found that this parameter was not significant between the groups studied. (p <0.05). It was found that there is a significant difference in relation to the areas of fibrin deposition (P <0.05) between the groups and that it possibly converges with the data found in the literature in which it could be established that in the GrH there is a different relationship in this pattern. The findings of the thickness of the middle layer were significant in the GrH when compared to the GrN (p <0.05), when this parameter is compared between the Hypertensive Disorders of Pregnancy (HDP) groups, microscopically the PE cases showed prominent changes. I n the present study, Tenney-Parker changes were prominent and discreet in 75% of the GrH placentas versus 20% in the GrN. However, there are contradictions in the literature regarding the consideration of this finding seen only in Hematoxylin-Eosin staining. Conclusion: Given the above, the presence of syncytial knots, the difference between vessel thickness and areas of fibrin deposition are possibly involved in the pathogenesis of Hypertensive Syndromes, regardless of age and established classifications. In order to evaluate syncytial knots, further studies are needed in this population.

scholarly journals STUDY OF PLACENTAS OF HYPERTENSIVE MOTHERS ASSISTED IN TWO PUBLIC MATERNITIES OF RECIFE-PE

2021 ◽  
pp. 39
Author(s):  
Keyword(s):  
Middle Layer ◽  
Hypertensive Disorders Of Pregnancy ◽  
Fibrin Deposition ◽  
Endothelial Layer ◽  
Histomorphometric Study ◽  
Hypertensive Disorders ◽  
Significant Difference ◽  
Deposition Thickness ◽  
The Difference ◽  
Hematoxylin Eosin

Objective: Perform the histomorphometric study of the following regions: areas of perivillous fibrin deposition; thickness of the endothelial layer of the vessels; analysis of Tenney-Parker changes. Analyze the Placental Index (IP). Results: It was seen that the weight of the placentas increased according to the weight of the newborn, however, when the variable PI was analyzed as being decisive for the development of a risk-free pregnancy, it was found that this parameter was not significant between the groups studied. (p <0.05). It was found that there is a significant difference in relation to the areas of fibrin deposition (P <0.05) between the groups and that it possibly converges with the data found in the literature in which it could be established that in the GrH there is a different relationship in this pattern. The findings of the thickness of the middle layer were significant in the GrH when compared to the GrN (p <0.05), when this parameter is compared between the Hypertensive Disorders of Pregnancy (HDP) groups, microscopically the PE cases showed prominent changes. I n the present study, Tenney-Parker changes were prominent and discreet in 75% of the GrH placentas versus 20% in the GrN. However, there are contradictions in the literature regarding the consideration of this finding seen only in Hematoxylin-Eosin staining. Conclusion: Given the above, the presence of syncytial knots, the difference between vessel thickness and areas of fibrin deposition are possibly involved in the pathogenesis of Hypertensive Syndromes, regardless of age and established classifications. In order to evaluate syncytial knots, further studies are needed in this population.

Activated Macrophages in Preeclampsia

Pteridines ◽  
1993 ◽  
Vol 4 (3) ◽  
pp. 144-148
Author(s):  
H. Schröcksnadel ◽  
D. Fuchs ◽  
M. Herold ◽  
H. Wachter ◽  
O. Dapunt
Keyword(s):  
Pregnant Women ◽  
Macrophage Activation ◽  
Tnf Alpha ◽  
Activated Macrophages ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Significant Difference

SummaryNeopterin (serum. urine) and other markers of macrophage activation (lL-1 IL-6, TNF alpha) were compared in preeclamptic patients and healthy pregnant controls. The prepartal urine neopterin median in preeclampsia (337 μmol/mol creat.) was 33% higher than that of healthy pregnant controls (253 μmol/mol creat.). There was no statistically significant difference between the groups (p = 0.08). In plasma there were no statistically significant differences in cytokine concentrations between healthy pregnant and nonpregnant controls with the exception of neopterin. that showed higher values in pregnant women (p = O.OO4). Elevated levels of IL-6. TNF-alpha and neopterin were observed in hypertensive women. Differences to healthy pregnant controls were statistically significant for IL-6 (p = 0.008). TNF-alpha (p = 0.009) and neopterin (p=0.04) and were more pronounced in severe forms of the disease. These three parameters of monocytic origin showed positive significant correlations amongst each other. A participation of macrophages in the pathomechanism of hypertensive disorders of pregnancy can thus be assumed.

scholarly journals Comparison between invasive and non-invasive assessment of blood pressure in hypertensive disorders of pregnancy

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ayman Khairy M. Hassan ◽  
Ayman H. Shaamash ◽  
Asmaa G. Mohamed ◽  
Salwa R. Demitry ◽  
Nady A. Razik
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Strong Positive Correlation ◽  
Hypertensive Disorders Of Pregnancy ◽  
University Hospitals ◽  
Cross Sectional ◽  
Non Invasive ◽  
Hypertensive Disorders ◽  
Significant Difference

Abstract Background The management of hypertensive disorders of pregnancy (HDP) during hospitalization requires an accurate blood pressure (BP) measurement, mainly by invasive intra-arterial reading. Nevertheless, little is known about the precision of non-invasive (NI) central BP measurements in HDP. We aimed to assess the accuracy of NI central BP assessment in comparison to invasive BP measurement in HDP. This cross-sectional study included all patients with HDP that were admitted to university hospitals for high BP control, from December 2018 till December 2019, and 10 healthy matched non-hypertensive controls. Patients were compared for demographic, anthropometric, and echocardiographic data. In all subjects, invasive BP assessment was done by radial arterial cannulation and NI assessment of BP was performed by an oscillometric automated device (Mobil-O-Graph); the comparison was done after initial control of BP. Results One hundred patients were included and divided into 3 groups (pre-existing hypertension (HTN), gestational HTN, and pre-eclampsia). There was no statistically significant difference between NI central and invasive methods in measuring both systolic BP (SBP) (126.39 ± 14.5 vs 127.43 ± 15.3, p = 0.5) and diastolic BP (82.41 ± 9.0 vs 83.78 ± 8.9, p = 0.14) among the total studied population. A strong positive correlation was found between NI central and invasive SBP (r = 0.96, p < 0.001). HDP was associated with an increase in arterial stiffness, left ventricular diastolic dysfunction, and complications. Conclusion Non-invasive measurement of BP using oscillometric automated devices is as accurate as the invasive method, and it is a practical safe method in pregnant women with hypertensive disorders (CTR no. = NCT04303871).

scholarly journals Endometriosis Does not Seem to Be an Influencing Factor of Hypertensive Disorders of Pregnancy in IVF / ICSI Cycles

2021 ◽  
Author(s):  
Pingyin Lee ◽  
Canquan Zhou ◽  
Yubin Li
Keyword(s):  
Influencing Factor ◽  
Protective Role ◽  
Reproductive Technology ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Significant Difference ◽  
Potential Damage ◽  
Frozen Thawed Embryo Transfer ◽  
Thawed Embryo Transfer

Abstract IntroductionTo evaluate whether the incidence of hypertensive disorders of pregnancy (HDP) in pregnant women was related to endometriosis (EM), ovulation and embryo vitrification technology. MethodsA retrospective cohort study was conducted on the clinical data of 3674 women who were treated with IVF / ICSI in the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-sen University and maintained clinical pregnancy for more than 20 weeks. All pregnancies were followed up until the end of pregnancy. The follow-up consisted of recording the course of pregnancy, pregnancy complications, and basic situation of newborns.ResultsCompared with NC-FET without EM, HRT-FET without EM was found to have a higher incidence of HDP during pregnancy (2.7% V.S. 6.1%, P<0.001); however, no significant difference was found in the incidence of HDP between NC-FET and HRT-FET combined with EM (4.0% V.S. 5.7%, P>0.05). In total frozen-thawed embryo transfer (total-FET), the incidence of HDP in the HRT cycle without ovulation (HRT-FET) was observed to be higher than that in the NC cycle with ovulation (NC-FET) (2.8% V.S. 6.1%, P<0.001). In patients with EM, no significant difference was found in the incidence of HDP between fresh ET and NC-FET (1.2% V.S. 4.0%, P>0.05). ConclusionEM does not seem to have an effect on the occurrence of HDP in assisted reproductive technology. During the FET cycle, the formation of the corpus luteum may play a protective role in the occurrence and development of HDP. Potential damage to the embryo caused by cryopreservation seems to have no effect on the occurrence of HDP.

scholarly journals Why Some Mothers Could Be Saved and Not Others? Evaluating Different Phases of Delay in Causing Maternal Near Misses and Maternal Deaths

2020 ◽  
Author(s):  
Banashree Nath ◽  
Kashika Nagpal ◽  
Nandini Rajamani ◽  
Harsha S Gaikwad
Keyword(s):  
Quantitative Data ◽  
Poor Prognosis ◽  
Qualitative Data ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Hypertensive Disorders Of Pregnancy ◽  
Maternal Deaths ◽  
Sequence Of Events ◽  
Hypertensive Disorders ◽  
Significant Difference

Introduction: The factors playing key role in determining death and survival among the Maternal Mortality (MM) and Maternal Near Miss (MNM) cases are multidetermined and interdependent. It ranges from initial illness to perception of patients to seek healthcare services and initiation of management at primary health care settings. Aim: To evaluate the factors responsible for causing delay at different phases and thereby assess the key determinants of survival and death of mothers. Materials and Methods: This cross-sectional observational study was undertaken at the tertiary care centre and teaching hospital in northern India from October 2015 to December 2016. Study population consisted of all women who were identified as MNM and MM which occurred at Centre. Attendants accompanying the patient, mostly nearest kin who were able to give details of her health were questioned. Details regarding the sequence of events that caused her severe morbidity were taken right from recognition of morbid status to landing up in the tertiary setup. Approximate duration of delay for each case of MNM and MM was assessed. Any delays in accessing or receiving medical care were recorded, if available. Data Entry was done on MicroSoft Excel spreadsheet. Proportions were calculated for qualitative data. Mean score with confidence interval was calculated for quantitative data. Qualitative data was analysed by Chi-Square test and t-test was applied for quantitative data. Results: Out of 31,111 live births during the study period, there were 249 maternal near miss cases and 131 maternal deaths. Delay in women seeking help was observed in a total of 92.36% of cases in MNM group and 97.70% of cases in MM group (p=0.034). The study discovered significant differences when referral status (p=0.4904) as well as when number of referrals (p=0.041) were considered. There was a significant difference between the women of the two groups who reported only first phase delay (p=0.033). The major pregnancy related morbidities were haemorrhage and hypertensive disorders of pregnancy. Patients with hypertensive disorders of pregnancy with delay more than 12 hours survived the acute insult but were unable to cope with dysfunction of multiple organs and passed on after prolonged intensive care whereas in cases of Postpartum Haemorrhage (PPH), delay >6 hours were observed with extremely poor prognosis. Conclusion: Delay in taking decisions to seek healthcare is a major cause of MM. There is a little difference in outcome in terms of survival and death of mothers with delay in any of three phases despite increased intervention taken in adequate referral facilities. Precious time lost in deferral and referral contributes immensely to poor prognosis of mothers as compared to direct referral to an adequate health facility.

scholarly journals Association between maternal serum beta human chorionic gonadotropin levels and hypertensive disorders of pregnancy

2020 ◽  
Vol 9 (8) ◽  
pp. 3157
Author(s):  
Archana Kumari ◽  
Vahini M.
Keyword(s):  
Pregnant Women ◽  
Late Onset ◽  
Maternal Serum ◽  
Severe Preeclampsia ◽  
Control Group ◽  
Study Group ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Significant Difference ◽  
Β Hcg

Background: A major challenge in obstetrics is early identification of hypertensive disorders of pregnancy (HDP). This study was performed to determine the association between elevated maternal serum β-hCG levels and HDP, the correlation between serum β-hCG level and severity of preeclampsia and to determine the value of serum β-hCG level as a diagnostic marker for early diagnosis of HDP.Methods: This was a hospital based observational study conducted in the department of obstetrics and gynecology, Rajendra Institute of Medical Sciences, Ranchi on 375 pregnant women with period of gestation more than 20 weeks, including 250 pregnant women with HDP as study group and 125 normotensive pregnant women as controls. Serum β-hCG concentration was measured and its level was compared between two groups.Results: The maternal mean serum β-hCG levels (51161.08±30038.21 IU/L) of study group of HDP were higher than the normotensive control group (17603.23±16748.21 IU/L). In non-severe preeclampsia, the mean serum levels were 36417.32±23876.74 IU/L while in severe preeclampsia, 60030.34±28771.31 IU/L. There was statistically significant difference (p<0.001) with higher levels in early onset preeclamptic mothers than late onset preeclampsia. The cut-off point of β-hCG for predicting HDP was 32077 IU/L with sensitivity of 65% and specificity of 86%.Conclusions: Serum β-hCG level is higher in HDP when compared to normotensive women. Higher levels of β-hCG are associated with increasing severity of hypertensive disorders of pregnancy. The utility of serum β-hCG as a diagnostic test is limited because of low sensitivity and difficulty in deciding the cut-off value.

scholarly journals Neuro-imaging in severe hypertensive disorders of pregnancy: a study from North Indian tertiary health care institution

2020 ◽  
Vol 9 (6) ◽  
pp. 2346
Author(s):  
Rohit Dogra ◽  
Rama Thakur ◽  
Vijay Thakur ◽  
Anita Pal ◽  
Shaina Chamotra ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Perinatal Outcomes ◽  
Occipital Lobe ◽  
Signs And Symptoms ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Significant Difference ◽  
Clinical Signs And Symptoms ◽  
Adverse Pregnancy ◽  
Neuro Imaging

Background: Hypertensive disorders of pregnancy comprising of pre-eclampsia and eclampsia are a major cause of adverse pregnancy outcomes. Neurological manifestations of pregnancy induced hypertension are the most common cause of maternal and foetal morbidity and mortality. Cranial neuro-imaging reveals focal regions of symmetric hemispheric oedema; with parietal and occipital regions getting most commonly affected.Methods: The study was conducted among 65 antenatal women diagnosed with pre-eclampsia and eclampsia at gestational age >20 weeks in the department of obstetrics and gynecology, Kamla Nehru State Hospital for Mother and Child IGMC Shimla. Clinical signs and symptoms, neuroimaging findings were recorded for study purpose.Results: About 17.6% of severe pre-eclampsia and 100% of eclampsia had findings observed on cranial MRI. Headache and visual complaints were most frequently recorded. PRES was the predominant neuroradiographic finding in present study and occipital lobe was commonly affected region. No significant difference was observed regarding blood pressure parameters between MRI positive and negative subjects.Conclusions: Neuroimaging in antenatal with severe hypertensive disorders might aid in better understanding of the poorly explained phenomenon. In addition, this would be helpful in better management of the disorders along with their much-dreaded complications. Patients with hypertensive disorders of pregnancy should be subjected routinely to cranial imaging for the better perinatal outcomes.

Basal Chronic Villitis and Disorders of the Placental Basal Plate: A Possible Immunological Link Between Hypertensive Disorders of Pregnancy and Morbidly Adherent Placenta

2019 ◽  
Vol 22 (4) ◽  
pp. 334-339 ◽  
Author(s):  
Philip J Katzman ◽  
Joseph Blitman ◽  
Leon A Metlay
Keyword(s):  
Clinical History ◽  
Basal Plate ◽  
Intrauterine Fetal Death ◽  
Hypertensive Disorders Of Pregnancy ◽  
Morbidly Adherent Placenta ◽  
Hypertensive Disorders ◽  
Adherent Placenta ◽  
Significant Difference ◽  
History Of ◽  
Chronic Villitis

Background Hypertensive disorders of pregnancy (HDP) are a common cause for preterm delivery. Prior studies showed that chronic villitis (CV) is associated with intrauterine growth restriction, preeclampsia, intrauterine fetal death, and morbidly adherent placenta (MAP). The authors hypothesize that disorders of the placental basal plate, especially basal chronic villitis (BCV), are associated with HDP. Methods The laboratory information system was queried over 12 years to identify placentas with or without the clinical history of HDP and with or without multifocal/focal CV or BCV. As a control for tissue sampling, a similar search was performed over 5 years for placentas evaluated for MAP. Results Of 19,683 placentas identified, 14.8% had CV which was in 18.5% and 14.2% of placentas associated with or without HDP, respectively, a significant difference ( P < .0001). BCV was present in 6.0% and 3.9% of placentas with or without HDP, respectively, also a significant difference ( P < .0001). BCV was more likely than multifocal/focal CV to occur in HDP (32.4% vs 27.4%) when all cases of CV were analyzed ( P = .025). Of 221 placentas with MAP, 64% had multifocal/focal CV and 36% had BCV. Conclusions BCV and CV are more common in placentas with HDP than in normotensive pregnancies. They are also seen in MAP, as supported by another recent study.

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.

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