Study of Gross Anatomy of Human Placenta in Pregnancy Induced Hypertension

Introduction: Pregnancy induced hypertension (PIH), also referred to as Gestational hypertension is a condition of high blood pressure during pregnancy. Progression the disease causes preeclampsia and eclampsia, which are the commonest causes of maternal and fetal morbidity and mortality.Objective: The objectives of the study were to observe and measure the macroscopic changes in the placenta in pregnancy induced hypertension and to compare the placental findings of the control group. .Method: This descriptive observational study was carried out in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU). Forty placentas were collected from Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) and Bangabandhu Sheikh Mujib Medical University. Out of forty placentas, twenty were from non-hypertensive mother considered as controls and twenty from PIH mothers. Mother who had Rh-negative blood group, positive for VDRL and HbsAg and mother delivered multiple babies or babies with any visible congenital malformation were excluded. All women included in the study gave birth to a live born baby after 35 weeks of gestation by caesarian section. The macroscopic features of placentas were recorded and after that specimen was fixed in 10% formol saline. After two week of fixation, a point counting method was used on placental slices for estimation of the volume of parenchyma and non-parenchyma.Results: The general features of the control and PIH mother were statistically matched. As compared with the control group, PIH group showed no statistically significant difference in values of placental weight, volume and diameter.Mean placental weight (gm), mean volume (ml) and the mean diameter (cm) of the placental, mean absolute volume of parenchyma, mean proportional and mean absolute volume of non-parenchyma were lower in PIH group than the control group. The mean number of cotyledon of the placenta and mean proportional volume of parenchyma were higher in PIH group than control group and. These differences did not reach statistically significant level.Conclusion: Several authors has concluded that the changes in the placenta in diabetic and toxaemic mother are the reflection of some compensatory mechanism, but the present study fails to identify any statistically significant changes in PIH group in favour of such statement.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014

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Neonatal and maternal platelet cytosolic calcium in normotensive and hypertensive pregnancies.

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/fn.71.1.f6 ◽

1994 ◽

Vol 71 (1) ◽

pp. F6-10 ◽

Cited By ~ 1

Author(s):

M D Kilby ◽

F Broughton Pipkin ◽

E M Symonds

Keyword(s):

Gestational Hypertension ◽

Venous Blood ◽

Cytosolic Calcium ◽

Significant Rise ◽

Specific Factor ◽

Pregnancy Induced Hypertension ◽

Significant Difference ◽

Induced Hypertension ◽

The Mean ◽

In Pregnancy

A prospective study investigated platelet cytosolic calcium in non-pregnant volunteers (n = 30) and samples from the umbilical veins of babies from both normotensive (n = 18) and hypertensive (n = 15) primigravidae, and their mothers. There was no significant difference between the neonatal umbilical venous platelet cytosolic calcium concentration (p[Ca2+]i) in babies born to normotensive primigravidae or to those whose pregnancies were complicated by gestational hypertension (88 x 9 (SE) 2 x 5) in normotensive primagravidae, 80 x 6 (2 x 8) in pregnancy induced hypertension without proteinuria, and 89 x 3 (3 x 2) nmol/l in pre-eclampsia. There was also no significant difference in the p[Ca2+]i from the umbilical veins of the pregnancies studied and those of non-pregnant female volunteers in the follicular phase of their menstrual cycle. This was despite a gradual and significant rise in p[Ca2+]i with increasing severity of disease in the mothers of the babies studied (119 x 9 (4 x 1) in normotensive primagravidae, 130 x 8 (7 x 3) in pregnancy induced hypertension without proteinuria, and 148 x 2 (4 x 5 ) nmol/l in pre-eclampsia). The mean maternal p[Ca2+]i in the three samples returned to concentrations comparable with those in non-pregnant subjects by 12 weeks after birth. These data demonstrate no significant difference between the mean p[Ca2+]i in non-pregnant women and those obtained from the umbilical venous blood of normotensive or hypertensive primigravidae. They suggest that the functional hypoactivity of neonatal platelets is probably not secondary to a decrease in basal p[Ca2+]i. They also suggest that the progressively raised p[Ca2+]i in normal and hypertensive pregnancies might be due to a pregnancy specific factor that does not cross the placenta,

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Doppler ultrasound of umbilical artery in prediction of fetal outcome in pregnancy induced hypertension Sudanese population

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195890 ◽

2019 ◽

Vol 8 (1) ◽

pp. 96

Author(s):

Rihab A. Yousif ◽

Awadia G. Suliman ◽

Raga A. Aburaida ◽

Ibrahim M. Daoud ◽

Naglaa E. Mohammed

Keyword(s):

Flow Velocity ◽

Umbilical Artery ◽

Fetal Outcome ◽

Fetal Mortality ◽

Pregnancy Induced Hypertension ◽

Diastolic Flow ◽

Induced Hypertension ◽

The Mean ◽

Doppler Indices ◽

In Pregnancy

The pregnancy induced hypertension increase the fetal mortality and morbidity and the using of Doppler umbilical artery indices decrease the fetal mortality and morbidity however, there is few complete data about the most frequently altered Doppler US parameters to predict fetal outcome in pregnancy induced hypertension . Methods This ia cohort prospective study done in two hundred and six women of second and third trimester presenting to antenatal clinic in Soba University Hospital at the department of Obstetrics & Gynecology, in the fetus unit and critical pregnancy in the period From June 2008 to April 2013 to assess the Doppler indices of umbilical artery in pregnancy induced hypertension for prediction of prenatal outcome; 105 pregnancy induced hypertension patients and 101 women with uneventful pregnancies as normal control group included in this study . Baseline investigations and color Doppler of umbilical artery were done. Statistical analysis of data were done using SPSS, Receiver Operating Characteristic (ROC) curve analysis was performed and the area under the curve (AUC) used to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of umbilical artery Doppler indices to predict fetal outcome.Results The study determine that there was significant difference in Doppler indices in PIH and control group ( p<0.01, the mean indices of umbilical artery is higher in PIH group compared with normal pregnancy group , the mean different of S/D ratio was 0.40, mean difference of RI was 0.06 and the mean different of PI index was 0.16, high percentage of adverse fetal outcome had been reported in in Pregnancy Induced Hypertension group than in control , which was more in absent and reversed flow velocity in umbilical artery in Pregnancy Induced Hypertension compared with group of Pregnancy Induced Hypertension with present end diastolic flow velocity. Systolic/Diastolic ratio was most accurate in predicting adverse outcome in pregnancy induced hypertension patients, followed by the Pulastility index then the Resistance index (75%, 66% and 57% respectively).ConclusionThis study concluded that pregnancy induced hypertension leads to worsen placental insufficiently, which appears on the higher Doppler indices of umbilical artery to PIH patients when compared with normal pregnancy. A low diastolic flow and higher indices characterized the pregnancies with abnormal outcomes. Doppler of the umbilical artery was useful to predict fetal well being in PIH patients, high percentage of adverse fetal outcome had been reported in absent and reversed end diastolic flow velocity in umbilical artery compared with group of present flow velocity.

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Hematological changes in pregnancy induced hypertension in their third trimester at Jhalawar Medical College, Jhalawar, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193632 ◽

2019 ◽

Vol 8 (9) ◽

pp. 3497

Author(s):

Neelam Jhajharia ◽

Madhureema Verma

Keyword(s):

Control Group ◽

Case Group ◽

Haematocrit Level ◽

Haematological Parameter ◽

Pregnancy Induced Hypertension ◽

Medical College ◽

Induced Hypertension ◽

Life Threatening ◽

The Mean ◽

And Control

Background: Pregnancy induced hypertension (PIH) is one of the most common and potential life-threatening complications of pregnancy. This study is aimed to investigate and correlate the hemoglobin, haematocrit, white blood cell count, lymphocytes and platelets in PIH patients in their third trimester.Method: Total 126 subjects were studied out of them 63 patients (case) and 63 healthy pregnant women (control) visiting the Obstetrics and Gynaecology department Jhalawar Medical College, Jhalawar were registered in the study and followed during their pregnancy. Two millilitre of blood sample was drawn aseptically using the 5ml syringe from the median ante cubital vein of all the cases and control participants into EDTA-anticoagulated tubes. Haematological parameter calculated by using Sysmex XN-9100™ Automated Haematology System.Results: The mean hemoglobin level of the case group (8.8206±2.53779) was significantly lower than that of the control group (9.7289±2.47033) (p<0.05). The mean platelet count of the case group (131.4937±62.05999) was significantly lower than that of the control group (324.9683±230.78764) (p<0.05). The mean lymphocytes level of case group (1.2510±0.56369) was significantly lower than that of the control group (1.9295±1.4150) (p<0.05). The mean WBC level of case group (36.3467±119.90635) was significantly high than control group (11.5260±4.83059) (p<0.05). The mean haematocrit level of case group (32.6851±7.29789) was significantly high than control group (30.0424±23.38116) (p<0.05).Conclusion: The mean hemoglobin, mean platelets and mean lymphocytes are lower in PIH patients. The mean WBC and haematocrit are higher in PIH patient.

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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.

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Study of Umbilical Cord in Pregnancy Induced Hypertension with and without Diabetes Mellitus

Bangladesh Journal of Anatomy ◽

10.3329/bja.v12i1.22609 ◽

2015 ◽

Vol 12 (1) ◽

pp. 03-06

Author(s):

Rita Rani Saha ◽

Nazma Farhat ◽

Mallika Karmaker

Keyword(s):

Diabetes Mellitus ◽

Umbilical Cord ◽

Diabetic Control ◽

Control Group ◽

Pregnancy Induced Hypertension ◽

Significant Difference ◽

Induced Hypertension ◽

Mode Of Attachment ◽

Post Hoc ◽

Umbilical Cords

Context : Two organs that can provide a good insight into pregnancy induced hypertension with and without diabetes mellitus are the placenta and the umbilical cord along with their vessels. In the present study the umbilical cord is taken from the placenta of hypertensive and diabetic mothers to measure its diameter, to observe contained vessels and its mode of attachment to the placenta. Materials and Methods: An observational and analytical type of study was conducted in the department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between November 2003 to May 2004 on umbilical cords. To study the umbilical cord, placentas were collected from fifty eight Bangladeshi women who gave birth to a single live baby through Caesarian section after 35 to 40 weeks of gestasion. Twenty of the mothers were non hypertensive, non diabetic control, twenty had pregnancy induced hypertension(PIH) and eighteen had pregnancy induced hypertension and gestesional diabetes mellitus(PIH+GDM). Results: No significant difference was found between any groups for diameter of the umbilical cord. All the umbilical cords had same number of vessels. There was variation among the mode of insertion of umbilical cord. Conclusion: Diameter of umbilical cords did not show significant difference in either of the two diseased groups with the control group in the Post Hoc option of analysis of variance (ANOVA) at 5% level. DOI: http://dx.doi.org/10.3329/bja.v12i1.22609 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 03-06

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The significance of uteroplacental ratio in the prediction of perinatal outcome in pregnancy-induced hypertension

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i3.1368 ◽

2019 ◽

Vol 10 (3) ◽

pp. 1756-1762

Author(s):

Iman Allami M

Keyword(s):

Confidence Interval ◽

Perinatal Outcome ◽

Umbilical Vein ◽

Reference Ranges ◽

Pregnancy Induced Hypertension ◽

Third Trimester ◽

Induced Hypertension ◽

Doppler Waveform ◽

The Mean ◽

In Pregnancy

Doppler investigations of placental and maternal flow have picked up a wide prominence as it could give significant data with respect to fetal prosperity and could be utilized to distinguish embryos in danger of bleakness and mortality, in this manner giving a chance to improve fetal results. In such manner, the accessible typical reference estimations of proportion () for example uterine corridor Doppler waveform parameters to those of umbilical course and impact of hypertension on Doppler waveform of the obstetric populace of various countries, were not unequivocally illustrated. The examination incorporates 60 pregnant ladies (in two periods 33-36 weeks and 37-40 weeks of incubation, 40 of them with pregnancy instigated hypertension and 20 as a control. The uterine courses and umbilical corridor files were determined just as proportions () for the RI and S/D, subsequent to gating the normal estimations of both uterine conduits files, the proportion between the uterine supply route and umbilical vein records was taken(normal uterine supply route/umbilical vein proportion, ). The mean ± SD of parameters expressed in the following manner:For PIH group At 33-36 weeks: RI =0.89 ± 0.26, PI = 0.94 ± 0.41and S/D =0.86 ± 0.31. The 95% confidence interval of the mean for four weeks were 0.77-1.0, 0.78-1.11, 0.74-0.99, respectively. At 37-40 weeks: RI= 1.00 ± 0.26, PI =1.05 ± 0.43 and S/D =1.03 ± 0.36. The 95% confidence interval of the mean for four weeks were 0..61, 0..31 and 0.81-1.25 respectively. For control group:At 33-36 weeks : RI =0.69 ± 0.08,PI= 0.73 ±0.13, and S/D=0.67 ± 0.09. The 95% confidence interval of the mean for four weeks were 0..80, 0..90 and0..78 respectively. At 37-40 weeks : RI= 0.99 ± 0.31, PI=0.95 ± 0.33, and S/D=0.92 ± 0.25. The 95% confidence interval of the mean for four weeks were 0..80, 0.76-1.13 and0.78-1.06respectively. A starter foundation of proportion ( of RI, PI and S/D) of Iraqi obstetric populace in and PIH at third trimester is most likely settled. The present investigation gave reference ranges in regards to uterine and umbilical supply routes , and S/ at 33-36 and 37-40 weeks of incubation in both.

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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.

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The association of pregnancy-induced hypertension and neonatal hypospadias.

10.22541/au.161248631.13273255/v1 ◽

2021 ◽

Author(s):

Yi Wang ◽

Lin Wang ◽

Zeyong Yang ◽

Fang Chen ◽

Zhiwei Liu

Keyword(s):

Regression Analysis ◽

Birth Weight ◽

Gestational Age ◽

Occurrence Rate ◽

Multiple Birth ◽

Control Group ◽

Hypertensive Disorder ◽

Pregnancy Induced Hypertension ◽

Induced Hypertension ◽

In Pregnancy

Background: The prevalence of hypertensive disorder in pregnancy has been well-documented worldwide. In Chinese newborns, the risk of hypospadias in women with hypertension during pregnancy remains ambiguous. This study aimed to evaluate the relationship between hypertension in pregnancy and neonatal hypospadias based on a large sample of Chinese people. Methods: A retrospective cohort study was conducted at our hospital from 2015 to 2019. Mothers who delivered male infants with hypospadias or those without any malformations were enrolled. Factors such as hypertension, placenta previa, thyroid diseases, hepatitis B, obesity, multiple birth, amniotic fluid, gestational age, birth weight, and in vitro fertilization were collected to establish a regression analysis to assess risk factors for hypospadias. Results: In total, 41,490 mothers and 42,244 male infants were enrolled. The overall incidence of hypospadias was 0.23%. The occurrence rate of hypospadias in pregnancy-induced hypertension (PIH) group was higher than control group (0.944% vs. 0.186%, RR 5.08), whereas the occurrence rate in chronic hypertension group was 0%. Potential exposure factors were screened for hypospadias, and PIH, multiple birth, hyperthyroidism, preterm delivery, low birth weight, and small for gestational age (SGA) were found to have higher proportion of hypospadias in offspring. After adjustment for potential confounders in the multivariate regression analysis, PIH (OR: 2.437, 95% CI: 1.478–4.016, P<0.01), birth weight (OR: 0.852, 95% CI: 0.795–0.912, P<0.01), and SGA (OR: 3.282, 95% CI: 1.644–6.549, P<0.01) showed a significant relationship with hypospadias. Conclusion: Women with PIH had higher risks of hypospadias in offspring. Lower birth weight, SGA and hyperthyroidism were also statistically associated with hypospadias.

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EFFECTIVENESS OF ANTENATAL CARE PACKAGE ON KNOWLEDGE OF PREGNANCY INDUCED HYPERTENSION FOR ANTENATAL MOTHERS IN SELECTED HOSPITALS OF MANGALORE

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703625 ◽

2013 ◽

Vol 03 (01) ◽

pp. 08-10

Author(s):

Sr. Jolly Joseph ◽

Sabitha Nayak ◽

Philomena Fernandes ◽

Vandana Suvarna

Keyword(s):

Antenatal Care ◽

Knowledge Score ◽

Educational Status ◽

Pregnancy Induced Hypertension ◽

Knowledge Questionnaire ◽

Significant Difference ◽

Induced Hypertension ◽

Post Test ◽

Care Package ◽

The Mean

AbstractThe study was conducted on effectiveness of antenatal care package on knowledge of pregnancy induced hypertension for antenatal mothers from 7/09/2009 to 10/10/2009. The research design was an evaluative approach using one group pretest post test the experimental design 40 antenatal mothers were selected by purposive sampling. Data was collected using structured knowledge questionnaire. Antenatal care package was developed.The pre test knowledge questionnaire was administered on the first day followed by an antenatal care package. The post test was conducted after five days using the same tool. The pretest knowledge data showed that maximum number of mothers 26(65.5%) scored between the range of 11-20% (average).The mean knowledge score was 14.88 where as the maximum possible score was 30.Among seven areas, the mean percentage knowledge in the area of basic factors of PIH was 43.75%, clinical features 41%, diagnosis 44%, management 57.5%, diet 50%, complication 50%, and prevention 58%.The 't” value showed the significant difference in the posttest, ('t' calculated value of pretest and post test knowledge scores = 14.22 p<0.05 which showed that antenatal care package was effective in improving the knowledge of antenatal mothers on pregnancy induced hypertension.There was significant association between pretest level of knowledge and age, educational status, occupation, monthly income, parity, gestational age, history of hypertension in previous pregnancy.

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