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Pregnancy
Published in Michelle Tollefson, Nancy Eriksen, Neha Pathak, Improving Women's Health Across the Lifespan, 2021
Nancy L. Eriksen, Kristi R. VanWinden, Anne Bingham, John McHugh
Hypertensive disorders of pregnancy include the spectrum of gestational hypertension and preeclampsia. Pregnant women who do not exercise, regardless of BMI, are three times more likely to develop hypertension.136 In contrast, higher levels of prepconceptual or early pregnancy physical activity reduce the risk of developing preeclampsia by 20–35% and are inversely associated with preeclampsia in a dose-dependent manner.137
Gestational hypertension and pre-eclampsia
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
This practice was challenged by Matthews and associates (57), who found no differences in perinatal mortality in women with gestational hypertension between those who were hospitalized for the duration and those who were managed as outpatients. Further, Matthews and colleagues (58) studied 135 patients with gestational hypertension in a randomized trial. They showed that complete bed rest appeared to have no advantage over “ambulation as desired” in controlling the severity of maternal disease. Similarly, Crowther and coworkers (59) conducted a randomized controlled trial on 218 patients with gestational hypertension. They showed that bed rest in pregnancies complicated by gestational hypertension was not associated with an overall improvement in fetal growth or reduced neonatal morbidity. Instead, the recording of fetal kick count at home and continued outpatient antenatal care provided a safe alternative to hospital admission.
Paper 2
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Gestational hypertension by definition is detected after 30 weeks’ gestationis hypertension without proteinuriaresolves within 6 months of deliveryis hypertension with proteinuriais a blood pressure measurement of ≥130/85mmHg.
Short stature in small-for-gestational-age offspring born to mothers with hypertensive disorders of pregnancy
Published in Hypertension in Pregnancy, 2023
Sakurako Mishima, Takashi Mitsui, Kazumasa Tani, Jota Maki, Eriko Eto, Kei Hayata, Yosuke Washio, Junko Yoshimoto, Hirokazu Tsukahara, Hisashi Masuyama
We retrospectively examined 1918 women with HDP who gave birth between 2009 and 2015 at 13 perinatal medical centers in eight prefectures in Chugoku and Shikoku, Japan. HDP was diagnosed according to the definition of the Japan Society for the Study of Hypertension in Pregnancy (14). HDP is defined as hypertension (blood pressure≥140/90 mmHg) occurring during pregnancy and includes chronic hypertension, gestational hypertension, preeclampsia, and superimposed preeclampsia. Mothers included in this study had preeclampsia or superimposed preeclampsia. Preeclampsia is defined as gestational hypertension accompanied by one or more of the following new-onset conditions at or after 20 weeks gestation. These conditions could be proteinuria or other maternal organ dysfunctions, including liver involvement, progressive kidney injury, neurological complications, hematological complications, or uteroplacental dysfunction. However, all symptoms are normalized by 12 weeks postpartum. Superimposed preeclampsia is defined as hypertension that is diagnosed pre-pregnancy or before 20 weeks of gestation and followed by new onset conditions, as in preeclampsia at or after 20 weeks of gestation. A total of 226 SGA offspring (males, 115; females, 111) and their women with HDP were included in this study (Figure 1).
The impact of shared governance on the adverse mood of parturients with gestational hypertension and perinatal indicators of newborns
Published in Journal of Obstetrics and Gynaecology, 2022
Wenyan Li, Manxiang Jiang, Ruiying Lu
Gestational hypertension is the development of hypertension in pregnant women after 2 or 20 weeks of gestation, affecting approximately 5% of parturients. It is characterised by headache, dizziness, nausea and swelling of the lower legs (Fahmy et al. 2018). Patients with gestational hypertension experience mildly elevated blood pressure followed by proteinuria, hypertension and even eclampsia in severe cases (Németh and Molnár 2017; Sandall et al. 2018). Surveys have found that the incidence rate of gestational hypertension is approximately 5–10% outside China and 9.4–10.4% in China, and the prevalence is increasing with changes in lifestyle and dietary habits in the recent years (Woodd et al. 2019; Song et al. 2020). Hypertension during pregnancy not only causes symptoms such as proteinuria, but also increases the incidence of neonatal risk events such as asphyxia, preterm rupture of membranes, and growth restriction; making early intervention key to improving maternal and neonatal prognosis (Zimring and Hudson 2016; Nombela and Ortega-Villaizan 2018). High incidences of maternal anxiety and depression have been observed in women with gestational hypertension (Nombela and Ortega-Villaizan 2018). A study conducted on 100 patients with gestational hypertension (Belizaire et al. 2019) showed that 80% of mothers exhibited anxiety, 76% exhibited depression and more than 90% complained of doubts regarding the impact on the newborn.
Platelet response to aspirin in UK and Irish pregnancy cohorts: a genome-wide approach
Published in Platelets, 2022
Fionnuala Mone, Juhi K. Gupta, Marie M. Phelan, Shireen Meher, Lu Yung Lian, Ben Francis, Eunice Zhang, Cecilia Mulcahy, Ana Alfirevic, Fionnuala M. Mcauliffe, Kate Navaratnam
The program of work included two stages; first, a cross-sectional study to establish reference intervals and select a PFT which is acceptable to women and reflects aspirin’s platelet effects and develop an accurate low dose aspirin (LDA) adherence test (cohort phenotyping). Second, a meta-analysis of genome-wide association studies from two independent cohorts of pregnant women taking LDA to prevent preeclampsia. We included two cohorts of pregnant women, one with and one without risk factors for preeclampsia from University of Liverpool and cohort at low risk from a published randomized controlled trial (RCT) in University College Dublin, respectively. The data presented from the later cohort represent a secondary analysis from this RCT [ISRCTN 15191778] [18]. Gestational hypertension and preeclampsia were defined for both populations in with theInternational Society for the Study of Hypertension in Pregnancy criteria [1].