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Fetal Development and Maternal Diet
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Hypertension during pregnancy consists of gestational hypertension, preeclampsia, eclampsia, and pre-gestational hypertension. Pregnancy-induced hypertension is a new-onset hypertension typically identified after the 20th week of gestation. Women with chronic hypertension present prior to pregnancy are at an increased risk for development of preeclampsia. Preeclampsia is defined as elevated blood pressure (20–30 mmHg systolic increase and/or 10–15 mmHg diastolic pressure increase) observed on two separate occasions at least 6 hours apart accompanied by proteinuria and/or edema. Other associated maternal morbidities include elevated liver function tests, blurred vision, severe headache, altered consciousness, and pulmonary edema. Eclampsia is the worsening of preeclampsia leading to seizures. The only cure for eclampsia is delivery of the fetus and placenta.
Gestational hypertension and pre-eclampsia
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
A spectrum of clinical signs and symptoms, presenting either alone or in combination, makes the diagnosis of pre-eclampsia a subject of great controversy. Historically, diagnosis included a relative increase in blood pressure as well as presence of edema. Neither of these criteria has proven to be reliable for diagnosis (2). A finding of abnormal blood pressure is subject to many errors; several variants may influence the readings: faulty equipment, cuff size, race, obesity, smoking, position, patient anxiety, or duration of the resting period (18).
DRCOG OSCE for Circuit C Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Associated symptoms and signs of pre-eclampsia include chest or epigastric pain, frontal and occipital headache, visual disturbances, fever, vomiting, a rapid rise in blood pressure or a rise of > 30/20 mmHg over the booking BP, hyper-reflexia and clonus.
Reduced left ventricular function and sustained hypertension in women seven years after severe preeclampsia
Published in Scandinavian Cardiovascular Journal, 2022
L. Gronningsaeter, H. Skulstad, A. Quattrone, E. Langesaeter, M. E. Estensen
Despite a significant subclinical reduction in LV function compared with controls, none of our patients had clinical signs of heart failure. Regardless, our findings are of concern especially as they were demonstrated in relatively young premenopausal women with hypertension persisting in one-third of women for 7 y after pre-eclampsia. Of note, none of the women had hypertension before their pre-eclamptic pregnancy. A significant number of our patients had poorly regulated hypertension despite treatment. Current European guidelines have already acknowledged hypertensive pregnancy disorder as a risk factor for future hypertension, stroke and ischaemic heart disease and recommend annual follow-up and lifestyle modifications to avoid future cardiovascular complications. In addition, the guidelines have recommended intense lifestyle modifications for patients in the prehypertensive category (SBP 130–140 mmHg and/or DBP 80–90 mmHg) [50]. However, existing guidelines differ on when to start screening and follow-up, and on which health-care professionals should have the responsibility to establish a follow-up. At present, only half of the most commonly used guidelines advise cardiovascular risk assessment after pregnancy [43].
Platelet parameters and risk of hypertension disorders of pregnancy: a propensity score adjusted analysis
Published in Platelets, 2022
Shanshan Lin, Lifang Zhang, Songying Shen, Dongmei Wei, Jinhua Lu, Xiaojuan Chen, Qiaozhu Chen, Xiaoyan Xia, Qiu Xiu
The presence of doctor-diagnosed preeclampsia (PE) or GH was retrieved from medical records. The diagnose of HDP was made based on American College of Obstetricians and Gynecologists’ guidelines [23]: GH was defined by a systolic blood pressure ≥ 140 mmHg or a diastolic blood pressure ≥ 90 mmHg after 20 weeks of gestation in previously normotensive women. PE was defined as de novo GH with concurrent new-onset proteinuria. In the absence of proteinuria, the diagnosis of PE was made based on hypertension plus any of the following: thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, or cerebral or visual disturbances. Eclampsia was diagnosed when PE patients with unexplained seizures. Early-onset HDP was defined by a diagnosis of HDP before 34 weeks of gestation and late-onset HDP by a diagnosis at or after 34 weeks of gestation [24].
Relevance of the assessment of natriuretic peptide plasma concentrations in hypertensive pregnant women
Published in Biomarkers, 2020
Agata Gondek, Aleksandra Jagodzińska, Bronisława Pietrzak, Artur Mamcarz, Agnieszka Cudnoch-Jędrzejewska
PE is one of the complications of pregnancy-induced arterial hypertension and pregestational hypertension. This syndrome is characterized by arterial hypertension, proteinuria or organ dysfunction due to microangiopathies in the brain, kidneys or liver. Its diagnostic criteria are listed in Table 1, whereas Table 2 presents the most common clinical symptoms preceding an episode of eclampsia (that consist in the onset of tonic-clonic seizures with the loss of consciousness in a woman during pregnancy, childbirth or puerperium). Potential maternal complications of PE include convulsions, pulmonary oedema, cerebral stroke, renal failure and death, whereas the complications in neonates, including hypotrophy and cardiovascular centralization, are associated with placental hypoperfusion and premature delivery (Lain and Roberts 2002).