Effect Of Pregnancy Induced Hypertension Research Articles

The Effect of Pregnancy-induced Hypertension on Pregnancy Outcome and Its Prevention Measures

The Effect of Pregnancy-induced Hypertension on Pregnancy Outcome and Its Prevention Measures

The Effect of Pregnancy-Induced Hypertension on Uteroplacental Vasculature Hemodynamic Changes and Pregnancy Outcome

Background: Among the various complications of pregnancy, pregnancy-induced hypertension is found to be the most common which may affect maternal and fetal outcome. Pregnancy induced hypertension can cause growth retardation of fetus.
 Aim and Objective: This study aims to assess hemodynamic variations in uteroplacental circulation in pregnancy-induced hypertension and its effect on fetal outcome.
 Materials and Methods: The study was carried out at tertiary care hospital of nawab shah for the period of 06 months at Department of Radiology in association with Department of Gyne and Obs. Total 106 participants were selected for the study and all females were pregnant with 1st or 2nd trimester gestational record and medical history was taken from all participants and co-morbidities was also evaluated. Blood pressure was checked from all participants from their right arm in lying position and Ultrasound test was repeated as per requirement through color Doppler ultrasound machine and Data was analyzed by using statistical software SPSS. 24.00 version.
 Results: After collection of research data from all participants, the entire data was assembled for the analysis. Participants were divided into various age groups as 26 were in 18-21yeras, 34 in 22-25years, 21 in 26-29years and only 07 were from 34-37years. 26 participants were belongs to 1st trimester, 34 among 2nd trimester and 21 in third trimester. PI was also noted with three different readings 32 in Umbilical artery, 21 in middle cerebral artery and 37 in uterine artery. RI was also noted among different arteries 41 in umbilical, 36 in middle cerebral and 39 in uterine arteries. S/D was also noted, 33 in umbilical artery, 49 in middle cerebral artery and 30 in uterine arteries.
 Conclusion: Pregnancy-induced hypertension causes hemodynamic variations in uteroplacental vasculature which may be responsible for causing impaired fetal growth in some cases.

PREGNANCY INDUCED HYPERTENSION AND NEONATAL GROWTH

Pregnancy-induced hypertension (PIH), especially preeclampsia, is a major cause of maternal and perinatal morbidity and mortality worldwide. The impact of PIH on birth outcomes has not been extensively studied. PIH has been confirmed to increase significantly the risk of low birth weight by both increasing preterm birth as well as reducing fetal growth. Low birth weight or IUGR babies have been associated with the occurrence of several chronic diseases in later life. However, to date, there have been few studies on the effects of PIH on infant growth and neonatal wellbeing. The purpose of this study was to evaluate the fetal growth and wellbeing of newborns born of mothers with confirmed pregnancy induced hypertension.Material and methods: This was prospective opservational study during the period of the last year, 1st of July 2018 up to the end of June 2019 conducted at the University Clinic for Gynecology and Obstetrics in Skopje. As pregnancy induced hypertension is defined the condition of blood pressure equal to or greater than 130/90 mmHg on more than two occasions greater than six hours apart without proteinuria after 21 weeks of gestation. All other more severe conditions are defined as pre-eclampsia or eclampsia. As outcome was considered the birth weight, gestational age and white blood cells count. IUGR was defined as birth weight below the tenth percentile of expected weight for gestational age. Also maternal age and BMI were considered as conjoined risk factor for the birth weight. Results: In this study, 4726 newborns were born at the University Clinic for Gynecology and Obstetrics, and for analysis were considered 4273 newborns who were late preterm (35 and 36 gestational weeks) or term newborns. Two groups were evaluated: control group of 200 consecutively born newborns (late preterm and term) of healthy mothers and 100 newborns (late preterm and term) consecutively born of mothers with confirmed diagnosis of PIH, which constituted the study group. Within the control group, the proportion of Small for Gestational Age-SGA was 6,3%, and in the group of mothers with PIH was 9,5% (p<0,05). The maternal mean age of the hypertensive mothers was (32.8±5.0) years while that of normotensive mothers was (26.6±3.7) years, and there was not statistical significance (p>0.05). The Body Mass Index was higher in hypertensive mothers, compared to the healthy mothers (31,3±2.02 vs. 27.8±2.8). The mean gestational age of the study group was (35.8±1.8) weeks compared to that in control group (37.4±1.2) weeks. The number of White Blood Cells (WBC) count in newborns of hypertensive mothers was 21.4±5.3x109/L compared with the control group, 18.5±3.12x109/L (p=0.005). Neonatal thrombocytopenia was found in 32% of neonates of preeclamptic mothers while it's found only in 9.5% of neonates in control group p<0,002. Discussion: The limitation of this study was the lack of data about maternal smoking, life style, etc. There is limited number of studies examining the correlation between fetal growth and PIH, and every information is of great value. The fact is that this condition can progress in more severe degree of hypertension and deleterious effects on the mother itself and on her child, if not treated on time. Conclusion: A change in infant growth of the IUGR baby itself (e.g. catch-up growth) such as in the critical early infant period may also have long-term effects on health later in life, and this change of postpartum growth may be influenced by PIH. Therefore, it is important to study postpartum infant growth patterns of babies born to mothers with PIH, and to determine if there are differences in infant growth between babies with and those without IUGR. And, the most important action is to monitor and treat pregnancy induced hypertension and prevent more severe condition of pre-eclampsia.

Effects of pregnancy induced hypertension on lipid metabolism and bilirubin metabolism in term neonates

Objective To observe the effects of pregnancy induced hypertension on lipid metabolism and bilirubin metabolism in term neonates. Methods 200 term neonates were selected and divided into the two groups,100 cases whose mother were healthy were control group and another 100 cases whose mother had gestational hypertension were observation group. Birth weight, measured in cord blood triglyceride(TG),total cholesterol(TC)levels, high density lipoprotein(HDL-C),low density lipoprotein(LDL-C), adiponectin(APN)level were recorded. Results Birth weight of the observation group had significantly lower birth weight(2 927±492)g,than the weight of the control group(3 452±348)g.The incidence of lower birth weight was higher than in the observation group.TG,LDL-C levels of the observation group were(0.6±0.24)mmol/L,(1.95±0.25)mmol/L,were higher than those of the control group[(0.39±0.17)mmol/L,(1.95±0.25)mmol/L].There was a statistically significant difference between the groups(t=12.35,2.35,P<0.01 or P<0.05).HL-C and APN of the observation group were lower than those of the control group(t=1.79,7.00,all P<0.05).Bilirubin after borned 24 hours,48 hours,72 hours and bilirubin peak of the observation group were(8.64±2.17)mg/L,(11.06±3.12)mg/L,(10.32±2.47)mg/L,(12.04±2.13)mg/L and were higher than those of the control group[(3.06±0.94)mg/L,(6.98±1.56)mg/L,(7.26±1.89)mg/L,(9.64±1.98)mg/L](t=23.48,11.65,9.84,8.27,all P<0.01). Conclusion Maternal PIH may affect birth weight, lipid metabolism and bilirubin metabolism. Key words: Pregnancy induced hypertension; Infant, newborn; Blood, Lipid; Bilirubin

Abstract P101: Hypertension in Pregnancy and Risk of Hypertension in Later Life: The Bogalusa Heart Study

Background: Few studies have examined whether hypertension in pregnancy imposes long-term cardiovascular risk compared to a normal pregnancy. The objective of this study was to examine if previous history of hypertension in pregnancy is a risk for hypertension after pregnancy. Methods: A case-control analysis was performed using the Bogalusa Heart Study database. Cases were defined as women whose systolic blood pressure ≥140 mmHg or diastolic ≥ 90 mmHg, or having hypertension treatment. Controls were defined as women with normal blood pressure. After exclusions, 604 women (67% white and 33% black, aged 32-44 years) were included for analysis. Univariable and multivariable logistic regression were used to estimate the odds ratio (OR) and 95% confidence interval (CI). Results: The prevalence of hypertension in women was 12.1% (73/604). Hypertensive women had higher proportion of previous history of hypertension in pregnancy (25/73, 34%) than normotensive controls (83/531, 13.7%), with an OR of 2.81 (95% CI: 1.64-4.81). After adjustment for age, race, body mass index and smoking, adjusted OR (aOR) of having previous history of hypertension in pregnancy for developing hypertension later was 1.36 (1.00-3.75). In addition, age, black ethnicity and body mass index were associated with hypertension, with aORs of 1.16 (1.09-1.25), 3.73 (2.13-6.52), and 1.09 (1.05-1.13), respectively. Conclusions: Hypertension in pregnancy may be associated with an increased risk of hypertension in later life. Further studies are needed to separate the effect of pregnancy-induced hypertension and pre-exiting chronic hypertension on the subsequent risk of hypertension later in life.

Effects of pregnancy-induced hypertension on the essential fatty acid statuses of Ecuadorian and Dutch women

Objective: Among white Dutch women pregnancy-induced hypertension was shown to be associated with elevated levels of the long-chain polyenes of 18:2n-6 and 18:3n-3 in combination with reduced levels of those parent essential fatty acids. This observation suggested an enhanced desaturation and elongation of the parent fatty acids. This study was performed to investigate whether this phenomenon also occurs under completely different nutritional and geographic conditions. Study Design: Plasma fatty acids of primiparous Mestizo Ecuadorian women with uncomplicated pregnancies and with pregnancy-induced hypertension were assessed at delivery and compared with similar data from white Dutch women. Neonatal values, as determined in umbilical plasma and umbilical vessel walls, were also compared. Results: In contrast to the pattern seen among white mothers, pregnancy-induced hypertension did not increase the long-chain polyene status of Mestizo mothers. Despite the absence of this compensatory mechanism, long-chain polyene status was not compromised in Mestizo neonates born after pregnancy-induced hypertension. Conclusion: Additional mechanisms may be active in maintaining the long-chain polyene status of neonates born after pregnancy-induced hypertension. (Am J Obstet Gynecol 1999;180:1185-90.)

The effect of hypertension in pregnant women on fetal adrenal function and fetal plasma lipoprotein-cholesterol metabolism

In the present investigation, we evaluated the effect(s) of long-term hypertension and pregnancy-induced hypertension in women on the activity of the adrenals of their fetuses. We measured dehydroisoandrosterone sulfate, cortisol, and lipoprotein-cholesterol in umbilical cord plasma of newborn infants delivered (30 to 41 weeks' gestation) of 120 women whose pregnancies were uncomplicated and of 98 women with pregnancy-induced or long-term hypertension. Umbilical cord plasma levels of cortisol were similar in both groups of newborn infants at each gestational period. Fetal plasma levels of dehydroisoandrosterone sulfate also were similar in both groups at 30 to 33 weeks of gestation but were significantly reduced in newborn infants of hypertension women who were delivered between 34 and 41 weeks of gestation compared with those of newborn infants of normal women who were delivered at a similar gestational age. At term, umbilical cord plasma levels of total cholesterol and low-density lipoprotein-cholesterol were significantly higher in the newborn infants of hypertensive women compared with those levels in newborn infants of normotensive women; fetal plasma levels of high-density lipoprotein-cholesterol and very low-density lipoprotein-cholesterol were similar in both groups of newborn infants. The lowest plasma levels of dehydroisoandrosterone sulfate and the highest plasma levels of total cholesterol and low-density lipoprotein-cholesterol were found in newborn infants of women with the most severe pregnancy-induced hypertension. Based on these findings, we conclude that maternal hypertension effects a decrease in the rate of steroidogenesis of the fetal zone of the fetal adrenal cortex but does not act in a similar manner to effect steroidogenesis of the neocortical zone and leads to hypercholesterolemia in the fetus as a consequence of reduced adrenal utilization of low-density lipoprotein-cholesterol. In addition, the effects of pregnancy-induced hypertension appear to be manifest in the fetus late in pregnancy at a time when the fetal adrenal normally undergoes an accelerated rate of growth and steroid biosynthesis.

The Endocrinology of Pregnancy-Induced Hypertension

Discussed in this article are the effects of pregnancy-induced hypertension on the renin-angiotensin-aldosterone system; the possible role of prostanoids, deoxycorticosterone, and deoxycorticosterone sulfate in blood pressure control; and the effect of pregnancy-induced hypertension upon the endocrinology of the maternal-fetal-placental unit.

Effect of pregnancy-induced hypertension upon placental prostaglandin metabolism: Decreased prostaglandin F2α catabolism with normal prostaglandin E2 catabolism

Effect of pregnancy-induced hypertension upon placental prostaglandin metabolism: Decreased prostaglandin F2α catabolism with normal prostaglandin E2 catabolism