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 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.

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 COVID-19 OUTCOMES IN PREGNANCY: A REVIEW OF 275 SCREENED STUDIES

2021 ◽  
Author(s):  
Rupalakshmi Vijayan ◽  
Hanna Moon ◽  
Jasmine Joseph ◽  
Madiha Zaidi ◽  
Chhaya Kamwal ◽  
...  
Keyword(s):  
Literature Review ◽  
Pregnant Women ◽  
Direct Evidence ◽  
Case Series ◽  
Adverse Outcomes ◽  
Morbidity And Mortality ◽  
World Health ◽  
Increased Risk ◽  
Immunological Changes ◽  
In Pregnancy

In December 2019, a novel strain of severe acute respiratory syndrome (SARS-CoV-2), was declared as a cause of respiratory illness, called coronavirus 2019 (COVID-19), characterized by fever and cough. In diagnostic imaging, the afflicted population showed pathognomonic findings of pneumonia. What started out as an epidemic in China, rapidly spread across geographical locations with a significant daily increase in the number of affected cases. According to the World Health Organization (WHO) reports, the range of worldwide mortality is 3 to 4%. Maternal adaptations and immunological changes predispose pregnant women to a prolonged and severe form of pneumonia, which results in higher rates of maternal, fetal, and neonatal morbidity and mortality. There is limited data about the consequences of COVID-19 in pregnancy, thereby limiting the prevention, counseling, and management of these patients. The objective of this literature review is to explore pregnancy and perinatal outcomes of COVID-19, complications, morbidity, and mortality in this sub-population. We conducted a literature review pertaining to COVID-19 and pregnancy in databases such as: PubMed, Google Scholar, and Science Direct. The studies we chose to focus on were systematic reviews, meta-analysis, case series, and case reports. Twenty four articles were reviewed regarding COVID-19 and pregnancy, complications and their outcomes. Due to immunological changes during pregnancy as evidenced by the flaring of auto-immune diseases; pregnant women may be at an increased risk for infection. Women (19.7%) who had underlying comorbidities such as gestational DM, HTN, hypothyroidism, and autoimmune disease, COPD, or HBV infection were considered high risk. The most common maternal outcomes were premature rupture of membranes (PROM) and pre-eclampsia. Asthma was the most common comorbidity associated with maternal mortality. The most common neonatal complications were fetal distress leading to NICU admissions and preterm birth <37 weeks. The most common laboratory changes were elevated CRP and lymphocytopenia. Most patients underwent C-section due to their underlying comorbidities. Pregnant and lactating women did not shed viral particles through their vaginal mucus and milk, as evidenced by negative nucleic-acid tests of these secretions. Neonatal infections as demonstrated by positive RT-PCR were rare, but direct evidence supporting intrauterine transmission was not confirmed. Direct evidence indicating vertical transmission of COVID-19 is not available, but risk for transmission cannot be ruled out. Pregnant women should be closely monitored due to increased risk of adverse outcomes.

scholarly journals Evidence of a Role for One-Carbon Metabolism in Blood Pressure: Can B Vitamin Intervention Address the Genetic Risk of Hypertension Owing to a Common Folate Polymorphism?

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Helene McNulty ◽  
J J Strain ◽  
Catherine F Hughes ◽  
Kristina Pentieva ◽  
Mary Ward
Keyword(s):  
Blood Pressure ◽  
Carbon Metabolism ◽  
Genetic Risk ◽  
Methylenetetrahydrofolate Reductase ◽  
Association Studies ◽  
Genome Wide Association Studies ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
One Carbon Metabolism ◽  
In Pregnancy

ABSTRACT Hypertension in adulthood is recognized as the leading risk factor contributing to mortality worldwide, primarily from cardiovascular disease, whereas hypertension in pregnancy leads to serious adverse fetal and maternal outcomes. This article explores the under-recognized role of one-carbon metabolism in blood pressure (BP) and the potential for folate-related B vitamins to protect against hypertension. Genome-wide association studies and clinical studies provide evidence linking the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR) with BP and increased risk of hypertension and hypertension in pregnancy. A novel role for riboflavin (the MTHFR cofactor) has recently emerged, however, with evidence from randomized trials that supplemental riboflavin can lower BP specifically in adults with the variant MTHFR 677TT genotype. Further studies are required to elucidate the biological mechanisms linking one-carbon metabolism with BP and explore the effect of riboflavin in modulating the genetic risk of hypertension in early and later life.

scholarly journals Hypertensive Disorders in Pregnancy

2018 ◽  
Vol 03 (02/03) ◽  
pp. 068-078
Author(s):  
Lalita Nemani
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Stress Test ◽  
Later Life ◽  
Chronic Hypertension ◽  
Prevention Measures ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Abstract Hypertension in pregnancy is defined as systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg or both on two different occasions at least 6 hours apart. Severe hypertension is SBP ≥ 160 mm Hg or DBP ≥ 110 mm Hg. Hypertension is the most common medical problem in pregnancy and one of the major causes of maternal and perinatal mortality and morbidity. Hypertensive disorders in pregnancy (HDP) are classified as (1) chronic hypertension, (2) chronic hypertension with superimposed preeclampsia, (3) preeclampsia-eclampsia, and (4) gestational hypertension. HDP contributes to increased risk of hypertension, stroke, and maternal cardiovascular disease (CVD) in later life. HDP can be considered as a failed cardiovascular stress test identifying women susceptible to CVD in later life. Further research is required to identify the mechanisms in HDP that contribute to CVD in later life so as to initiate appropriate prevention measures.

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 Prognostic values of high blood pressure duringpregnancy

2008 ◽  
Vol 14 (1) ◽  
pp. 22-26 ◽  
Author(s):  
E. Baranova ◽  
O. Bolshakova
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Arterial Hypertension ◽  
High Blood Pressure ◽  
Young Women ◽  
Additional Risk ◽  
Hypertension In Pregnancy ◽  
In Pregnancy

Arterial hypertension in pregnancy is now believed to be a risk factor for future maternal cardiovascular diseases. Despite the low immediate cardiovascular risk in a population of young women, a pregnancy complicated with hypertension carries a significant additional risk of future disease.

Chronic hypertension in pregnancy: synthesis of influential guidelines

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ioannis Tsakiridis ◽  
Sonia Giouleka ◽  
Alexandra Arvanitaki ◽  
Apostolos Mamopoulos ◽  
George Giannakoulas ◽  
...  
Keyword(s):  
International Society ◽  
Perinatal Outcomes ◽  
Morbidity And Mortality ◽  
Chronic Hypertension ◽  
Optimal Dosage ◽  
Antenatal Corticosteroids ◽  
Hypertension In Pregnancy ◽  
Gynecology And Obstetrics ◽  
Obstetric Medicine ◽  
In Pregnancy

Abstract Chronic hypertension in pregnancy accounts for a substantial proportion of maternal morbidity and mortality and is associated with adverse perinatal outcomes, most of which can be mitigated by appropriate surveillance and management protocols. The aim of this study was to review and compare recommendations of published guidelines on this condition. Thus, a descriptive review of influential guidelines from the National Institute for Health and Care Excellence, the Society of Obstetric Medicine of Australia and New Zealand, the International Society of Hypertension, the International Society for the Study of Hypertension in Pregnancy, the European Society of Cardiology, the International Federation of Gynecology and Obstetrics, the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists on chronic hypertension in pregnancy was conducted. All guidelines agree on the definition and medical management, the need for more frequent antenatal care and fetal surveillance and the re-evaluation at 6–8 weeks postpartum. There is also a consensus that the administration of low-dose aspirin is required to prevent preeclampsia, although the optimal dosage remains controversial. No universal agreement has been spotted regarding optimal treatment blood pressure (BP) targets, need for treating mild-to-moderate hypertension and postnatal BP measurements. Additionally, while the necessity of antenatal corticosteroids and magnesium sulfate for preterm delivery is universally recommended, the appropriate timing of delivery is not clearly outlined. Hence, there is a need to adopt consistent practice protocols to optimally manage these pregnancies; i.e. timely detect and treat any potential complications and subsequently reduce the associated morbidity and mortality.

Managing high blood pressure in pregnancy

1993 ◽  
Vol 31 (14) ◽  
pp. 53-56
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
High Blood Pressure ◽  
Chronic Hypertension ◽  
Pregnancy Induced Hypertension ◽  
Hypertension In Pregnancy ◽  
Arterial Blood ◽  
Induced Hypertension ◽  
In Pregnancy

Raised arterial blood pressure is common in pregnancy. Usually it is due solely to the pregnancy and resolves within days or weeks of delivery (pregnancy-induced hypertension – PIH). Occasionally it is chronic hypertension which predates or begins during pregnancy; it persists after delivery. In some women it is a mixture of both, with pregnancy-induced hypertension superimposed on existing chronic hypertension. In this article we discuss the risks to mother and fetus of hypertension in pregnancy and review its prevention and management.

scholarly journals Population reference and healthy standard blood pressure range charts in pregnancy: findings from the Born in Bradford cohort study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Gillian Santorelli ◽  
Debbie A. Lawlor ◽  
Jane West ◽  
Derek Tuffnell ◽  
Diane Farrar
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Ethnic Group ◽  
Pressure Range ◽  
Adverse Outcome ◽  
Gestational Hypertension ◽  
Born In Bradford ◽  
Increased Risk ◽  
Blood Pressure Range ◽  
In Pregnancy

AbstractWomen who develop gestational hypertension are at increased risk of adverse perinatal and longer-term outcomes. Reference charts may aid early detection of raised blood pressure (BP) and in doing so reduce adverse outcome risk. We used repeated BP measurements to produce ‘reference’ (whole population) and ‘standard’ (healthy pregnancies only) gestational-age-specific BP charts for all pregnant women (irrespective of ethnicity) and for White British (WB) and Pakistani (P) women. We included 9218 women recruited to the Born in Bradford study with 74,770 BPs. 19% of the whole population, 11% and 25% of WB and P women respectively were defined as healthy pregnancies. For reference and standard charts, for all women and each ethnic group, SBP/DBP at 12 and 20 weeks gestation was similar before rising at 37 weeks. DBP/SBP of reference charts for all women and for each ethnic group were higher than those of the corresponding standard charts. Compared to WB, P women had lower SBP/DBP at 12, 20 and 37 weeks gestation. To conclude; maternal population BP reference charts are higher compared to standard charts (healthy pregnancies) and are influenced by ethnicity.

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