Hypertension in Pregnancy最新文献

{"title":"Administration of corticosteroid therapy for HELLP syndrome in pregnant women: evidences from seven randomized controlled trials.","authors":"Wei-Jing Sun, Jing Hu, Qing Zhang, Jin-Mei Shan","doi":"10.1080/10641955.2023.2276726","DOIUrl":"10.1080/10641955.2023.2276726","url":null,"abstract":"<p><strong>Background: </strong>HELLP syndrome, featuring hemolysis, elevated liver enzymes, and thrombocytopenia, is life-threatening disease of pregnancy that triggers comorbidities in both pregnant women and the fetus/newborn. This study provides an updated systematic review and meta-analysis of relevant studies to assess the therapeutic efficacy of corticosteroids in maternal and neonatal outcomes.</p><p><strong>Methods: </strong>Randomized control trials (RCTs) regarding the use of corticosteroids in the HELLP population from three electronic databases, including Ovid MEDLINE, Ovid EMBASE, andCochrane Central Register of Controlled Trials, were searched from database inception to 23 March 202323 March 2023.</p><p><strong>Results: </strong>A total of 485 patients treated with corticosteroids from 7 RCTs were included. Compared to placebo, corticosteroids therapy failed to significantly improve the maternal outcomes regard to maternal morbidity (RR = 1.36, 95%CI [0.45, 4.10]), eclampsia (RR = 1.16, 95%CI [0.76, 1.77]), acute renal failure (RR = 0.71, 95%CI [0.41, 1.22]), pulmonary edema (RR = 0.34, 95%CI [0.10, 1.15]) and oliguria (RR = 1.08, 95%CI [0.75, 1.54]). In addition, pooled data showed that it wasn't significant differences between corticosteroids therapy and placebo regarding neonatal outcomes.</p><p><strong>Conclusions: </strong>This study compared the efficacy of corticosteroids in patients with HELLP syndrome, revealing that corticosteroids did not provide any significant benefit in clinical outcomes for pregnant women and newborns with HELLP. The conclusions of this study must be verified by a larger sample of high-quality RCTs.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"42 1","pages":"2276726"},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71480990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between the hemodynamic profile and resistant hypertension in pregnant patients with hypertensive crisis.","authors":"María Andrea Zambrano, Jose A Rojas-Suarez, Evelyn E Peña-Zarate, Javier Andres Carvajal, Laura Sofia Gutierrez-Puerto, Felipe Aguilar-Cano, Jose Santacruz-Arias, Merida Rodríguez-Lopez, María Fernanda Escobar","doi":"10.1080/10641955.2023.2272176","DOIUrl":"10.1080/10641955.2023.2272176","url":null,"abstract":"<p><strong>Objective: </strong>Reducing maternal morbidity and mortality has been a challenge for low and middle-income countries, especially in the setting of hypertensive disorders of pregnancy. Improved strategies for treating obstetric patients with resistant hypertension are needed. We sought to explore whether hemodynamic parameters may be used to identify patients that develop resistant hypertension in pregnancy.</p><p><strong>Methods: </strong>Retrospective cohort study among pregnant patients with gestational hypertension or preeclampsia that experienced severe blood pressure elevations. Hemodynamic variables were evaluated, including cardiac output (CO), and total peripheral resistance (TPR). The primary endpoint was resistant hypertension. An exploratory logistic regression was performed to evaluate the association between the hemodynamic profile and the development of resistant hypertension. Adverse maternal and fetal outcomes were additionally described according to the presence of resistant hypertension.</p><p><strong>Results: </strong>Fifty-seven patients with severe pregnancy hypertension were included, of whom 34 developed resistant hypertension (59.7%). The resistant hypertension group, in comparison to those without resistant hypertension, presented with a hypodynamic profile characterized by reduced CO < 5 L/min (41.2% vs. 8.7%, p: 0.007), and increased TPR > 1400 dyn-s/cm5 (64.7% vs. 39.1%, p: 0.057). Logistic regression analysis revealed an association between a hypodynamic profile and resistant hypertension (OR 3.252, 95% CI 1.079-9.804; <i>p</i> = 0.035). Newborns of the resistant hypertension group had more frequent low birth weight (<2500 g), low Apgar scores, ICU admissions, and acute respiratory distress syndrome.</p><p><strong>Conclusion: </strong>Patients experiencing hypertensive crisis during pregnancy and exhibiting a hypodynamic profile (TPR ≥1400 dyn·s/cm5 and CO ≤ 5 L/min) developed higher rates of resistant hypertension.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"42 1","pages":"2272176"},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138498277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soluble endoglin versus sFlt-1/PlGF ratio: detection of preeclampsia, HELLP syndrome, and FGR in a high-risk cohort.","authors":"A Iannaccone,&nbsp;B Reisch,&nbsp;L Mavarani,&nbsp;M Darkwah Oppong,&nbsp;R Kimmig,&nbsp;P Mach,&nbsp;B Schmidt,&nbsp;A Köninger,&nbsp;A Gellhaus","doi":"10.1080/10641955.2022.2066119","DOIUrl":"https://doi.org/10.1080/10641955.2022.2066119","url":null,"abstract":"<p><p>The angiogenic factors sFlt-1 and PlGF play an established role in the detection of preeclampsia (PE). Recent data suggest that sEng might contribute to the pathogenesis of PE. However, only a few studies so far have addressed its role.This monocentric cross-sectional study of high-risk pregnancies aims to compare the levels of sFlt-1/PlGF ratio and sEng depending on different placental-related adverse pregnancy outcomes. The statistical analysis takes into account Pearson's correlation coefficient between angiogenic factors, the area under the curve estimates (AUCs) for detection, and adjusted odds ratios (aOR) with 95% confidence intervals (95%-CIs). The analysis included 206 patients: 60 controls, 90 PE (59 EOPE, 35 LOPE), 94 FGR, and 35 HELLP cases. Some outcomes overlapped because FGR commonly complicated PE and HELLP syndrome. Serum levels of sFlt-1/PlGF and sEng correlated with each other. Higher levels were observed in HELLP syndrome and EOPE cases. AUCs for sFlt-1/PlGF ratio and sEng were, respectively, 0.915 (95%-Cl 0.87-0.96) and 0.872 (95%-Cl 0.81-0.93) in PE, 0.895 (95%-Cl 0.83-0.96) and 0.878 (95%-Cl 0.81-0.95) in HELLP syndrome, 0.891 (95%-Cl 0.84-0.94), and 0.856 (95%-Cl 0.79-0.92) in FGR.aORsfor sFlt-1/PlGF ratio and sEng were, respectively: 2.69 (95%-Cl 1.86-3.9) and 2.33 (95%-Cl 1.59-3.48) in PE, 2.38 (95%-Cl 1.64-3.44) and 2.28 (95%-Cl 1.55-3.4) in FGR, and 2.10 (95%-Cl 1.45-3.05) and 1.88 (95%-Cl 1.31-2.69) in HELLP syndrome. In addition, the aORs between sFlt-1/PlGF and sEng were very similar but higher for PE and FGR than HELLP syndrome.In conclusion,sEng performed similarly to sFlt-1/PlGF to detect placental dysfunctions.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"41 3-4","pages":"159-172"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10382892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Maternal and fetal outcome in women with gestational hypertension in comparison to gestational proteinuria: A 3-year observational study.","authors":"","doi":"10.1080/10641955.2022.2107290","DOIUrl":"https://doi.org/10.1080/10641955.2022.2107290","url":null,"abstract":"After publication of this article, questions about the scientific integrity of the article content were brought to the Publisher and Editor’s attention. When approached for an explanation, the authors have not been able to provide responses or sufficient supporting information within the requested timeframe. Therefore, as we continue to work through the issues raised, we advise readers to interpret the information presented in the article with due caution.","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"41 3-4","pages":"204"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10643755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: Methyldopa versus labetalol or no medication for treatment of mild and moderate chronic hypertension during pregnancy: a randomized clinical trial.","authors":"","doi":"10.1080/10641955.2022.2107312","DOIUrl":"https://doi.org/10.1080/10641955.2022.2107312","url":null,"abstract":"","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"41 3-4","pages":"206"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10643758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soluble urinary somatic angiotensin converting enzyme is overexpressed in patients with preeclampsia: a potential new marker for the disease?","authors":"Fernando Sontag,&nbsp;Sonja Suvakov,&nbsp;Vesna D Garovic","doi":"10.1080/10641955.2022.2115060","DOIUrl":"https://doi.org/10.1080/10641955.2022.2115060","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to identify and quantify urinary Angiotensin-Converting-Enzyme (ACE) in hypertensive disorders of pregnancy.</p><p><strong>Methods: </strong>Urine samples were analyzed by Western blot. Patients were classified into: normotensive pregnancy (N); preeclampsia and superimposed preeclampsia (PE+SPE); and gestational hypertension (GH).</p><p><strong>Results: </strong>Somatic ACE protein expression was higher in PE+SPE compared to N and GH. There was a positive correlation between ACE and urinary protein to creatinine ratio, systolic and diastolic blood pressures.</p><p><strong>Conclusion: </strong>These results indicate ACE overexpression in the urine of preeclamptic patients and suggest that it may be a new marker for the disease.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"41 3-4","pages":"190-197"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9771896/pdf/nihms-1836340.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of preeclampsia based on maternal serum endoglin level in women with pregestational diabetes mellitus.","authors":"Roman V Kapustin,&nbsp;Ekaterina V Kopteeva,&nbsp;Elena N Alekseenkova,&nbsp;Andrey V Korenevsky,&nbsp;Ilya V Smirnov,&nbsp;Olga N Arzhanova","doi":"10.1080/10641955.2022.2068574","DOIUrl":"https://doi.org/10.1080/10641955.2022.2068574","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the level of soluble endoglin (sEng) in pregnant women with pregestational diabetes mellitus (DM) and to assess its predictive value for preeclampsia development.</p><p><strong>Methods: </strong>Ninety pregnant women were enrolled in the study forming five comparison groups: type 1 DM (not planned, n = 20; planned, n = 20), type 2 DM (diet, n = 15; insulin therapy, n = 20), and the control group (n = 15). The primary outcome was clinically confirmed preeclampsia. Maternal serum concentrations of sEng were measured at 11+0-13+6 and 30+0-33+6 weeks.</p><p><strong>Results: </strong>sEng level was elevated in all patients with pregestational DM compared to the control group. Its plasma concentration increased with gestational age and in case of preeclampsia development. In patients with type 1 DM, serum sEng level did not depend on the presence of preeclampsia. This is evidence of severe metabolic disorder and endothelial dysfunction in these patients. The addition of sEng level to logistic models considering established risk factors (body mass index + age + HbA1c level) in the first and third trimesters significantly improved their performance for preeclampsia prediction.</p><p><strong>Conclusions: </strong>Eng level may become an important marker for early prediction of preeclampsia in women with pregestational DM.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"41 3-4","pages":"173-180"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10382890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of Concern: First versus second trimester mean platelet volume and uric acid for prediction of preeclampsia in women at moderate and low risk.","authors":"","doi":"10.1080/10641955.2022.2107296","DOIUrl":"https://doi.org/10.1080/10641955.2022.2107296","url":null,"abstract":"","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"41 3-4","pages":"205"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10643757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between hypertensive disorders of pregnancy and risk of attention-deficit/hyperactivity disorder in the offspring: a systematic review and meta-analysis.","authors":"Jiejing Zhao,&nbsp;Lihua Xia","doi":"10.1080/10641955.2022.2079674","DOIUrl":"https://doi.org/10.1080/10641955.2022.2079674","url":null,"abstract":"<p><strong>Objective: </strong>We reviewed the association between hypertensive disorders of pregnancy (HDP) and the risk of attention-deficit/hyperactivity disorder (ADHD) in children.</p><p><strong>Methods: </strong>We searched the databases of PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar for studies.</p><p><strong>Results: </strong>Twelve studies were included. Meta-analysis demonstrated that history of HDP results in a statistically significant increased risk of ADHD. Subgroup analysis of cohort and case-control studies also yielded similar results. Pre-eclampsia and chronic hypertension were associated with a statistically significant increased risk of ADHD in the offspring but not pregnancy-induced hypertension.</p><p><strong>Conclusion: </strong>Exposure to HDP significantly increases the risk of ADHD in the offspring.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"41 3-4","pages":"149-158"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10372579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of regional vs general anesthesia on vital functions after cesarean section: a single center experience.","authors":"Danka Mostic Stanisic,&nbsp;Nevena Kalezic,&nbsp;Nina Rajovic,&nbsp;Tatjana Ilic Mostic,&nbsp;Jelena Cumic,&nbsp;Tamara Stanisavljevic,&nbsp;Aleksandra Beleslin,&nbsp;Jelena Stulic,&nbsp;Ivana Rudic,&nbsp;Nevena Divac,&nbsp;Natasa Milic,&nbsp;Radan Stojanovic","doi":"10.1080/10641955.2022.2124417","DOIUrl":"https://doi.org/10.1080/10641955.2022.2124417","url":null,"abstract":"<p><strong>Background: </strong>The aim was to determine the effect of regional anesthesia (RA) on postoperative vital functions in contrast to general endotracheal anesthesia (GEA) after the cesarean section.</p><p><strong>Methods: </strong>Prospective cohort study included consecutive term pregnant women delivered by cesarean section (GEA, n = 284; RA, n = 249).</p><p><strong>Results: </strong>Higher levels of blood pressure and heart rate, as well as lower levels of pulse oximetry were found for GEA in contrast to RA (p < 0.001). The application of RA presented less side-effects (p < 0.05).</p><p><strong>Conclusions: </strong>RA for cesarean section should be preferred when balancing the risks and benefits for the mother and fetus.</p>","PeriodicalId":13054,"journal":{"name":"Hypertension in Pregnancy","volume":"41 3-4","pages":"198-203"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10750353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}