Pregnancy-induced Hypertension Women Research Articles

Thyroid status in pregnant women with pregnancy induced hypertension – A case control study

Introduction: Pregnancy induced hypertension (PIH) is an important cause of maternal and fetal morbidity and mortality affecting 5-10% of pregnancies. PIH is more frequently associated with elevated TSH (Thyroid-stimulating hormone). Thyroid dysfunction plays an important role in the development of gestational hypertension. However, this relationship remains unclear. The study was performed to evaluate the thyroid status in pregnant women with PIH and normal pregnant women. Methodology: This was a hospital based observational case control study done in Dr M K Shah Medical College, Ahmedabad. Total 100 pregnant women were included, out of them 50 PIH women were included in the case study group and 50 normotensive healthy pregnant women were included in the control group. After taking written consent, thyroid profile (TSH, free T3 and free T4) were measured in all 100 subjects. Results: Women with PIH had higher TSH levels and lower free T3 and free T4 as compared to normotensive pregnant women. There was a significant association between hypothyroidism and PIH cases. There was a significant positive correlation between TSH and systolic BP (r=0.42) and diastolic BP (r=0.52). Conclusion: PIH women are at greater risk of decreased thyroid function. Therefore, PIH women should be monitored for thyroid levels regularly.

A Cross-Sectional Study Investigating the Association of Serum Iron Concentration and Platelet Count as a Risk Biomarker among the Pregnancy-Induced Hypertensive Women in the Highlands Western Ghats of Nilgiris.

Background:The elevated serum iron levels and reduced platelet count at 20–24th week of gestation period cause oxidative stress that leads to the pregnancy-induced hypertension (PIH).Objectives:The objective is to determine the prevalence of serum iron concentration, decrease in platelet count, and its association with PIH.Methods:A cross-sectional study was conducted in the secondary care hospital of Udhagamandalam. A total of 150 study participants were enrolled. Descriptive analysis was performed for demographic characteristics. The Pearson Chi-square test was performed for categorical variables. To measure the strength of the association between the two variables, Pearson's correlation test and logistic regression analysis were performed.Results:The mean serum iron levels in both the groups were 99.01 ± 12.86 ug/dL and 82.76 ± 18.95 ug/dL, respectively, at a P value of 0.005. The platelet count (96.34 ± 9.77 vs. 116.68 ± 23.55) was significantly lower in PIH group. A moderate and weak correlation was seen between serum iron levels and systolic blood pressure (SBP) (r = 0.435; P = 0.01) and diastolic blood pressure (DBP) (r = 0.435; P = 0.01). Moderate negative correlation was observed between SBP, DBP, and platelet count. The risk of developing PIH is 6.76 times due to increased serum iron levels and 3.67 due to decreased platelet count.Conclusion:The serum iron levels were elevated, and the platelet indices were reduced in the PIH group. This should be considered a possible risk biomarker for PIH.

Umbilical Artery Flow Velocity in Pregnancy Induced Hypertension at Third Trimester

Background: Doppler ultrasound of umbilical vessels is a technique for evaluating fetoplacental blood flow which is very important in high risk pregnancies like hypertensive pregnancies and can predict both fetal and maternal morbidity and mortality. Since the traditional methods are not good enough to assess uteroplacental and fetoplacental circulation, blood flow studies are used to assess fetal well-being in normal and hypertensive pregnancies. Aim: To measure the blood flow indices of umbilical artery using Doppler ultrasound in patients with pregnancy induced hypertension (PIH) and healthy pregnant women. Methods: This is a case control study at which 60 participants, 40 with PIH and 20 with normal pregnancy at the third trimester were studied in Al Najaf Governorate. Doppler ultrasound of umbilical artery was performed for both, the patient and the control groups in which Resistive Index (RI), Pulsatility Index (PI) and Systolic to Diastolic ratio (S/D ratio) were calculated. Results: The mean ±SD of RI, PI and S/D of the umbilical artery were 0.63±0.11, 0.97± 0.33 and 2.9±1.38 respectively in the PIH group, they were higher than those of the control group (0.62±0.06, 0.91± 0.17 and 2.72 ± 0.41 respectively) at 33-36 weeks. However, differences were found to be insignificant as well as they were higher at 37-40 weeks. Conclusion: There are insignificant elevations of indices of the umbilical artery in PIH women with respect to those of normal pregnancy.

Incidence of Pregnancy Induced Hypertensive Women and its Associated Factors

Background: Pregnancy induced hypertension is a fetal disease resulting into morbidity and mortality of female as well as its neonate. Objective: To find the incidence of pregnancy induced hypertension in Pakistani women. Study Design: Cross sectional study Place and Duration of the Study: Department of Obstetrics & Gynaecology, Sandeman Provincial Hospital, Quetta from 1st March 2019 to 31st March 2021. Methodology: Seven hundred and twenty eight females were identified with pregnancy induced hypertension from all the pregnant women attending the outdoor were enrolled. Each female was checked for their protein urea as well as systolic and diastolic blood pressure according to standard operating protocol. Socio-demographic, clinical and family history were documented. Results: Among all pregnant women, 150 were identified as pregnancy induced hypertensive with a 20.6% incidence of pregnancy induced hypertension. The mean value systolic blood pressure value was 144.3±5.2 and of diastolic as 83.1±5.2 in pregnancy induced hypertension women. Conclusion: Family history, obesity and renal diseases are the main factors associated with pregnancy induced hypertension with an incidence of 20.6% among pregnant women. Keywords: Pregnancy induced hypertension, Body mass index, Pregnant women, Hypertension

PLACENTAL DIAMETER AND THICKNESS AND NUMBER OF COTYLEDONS IN MILD AND SEVERE PREGNANCY INDUCED HYPERTENSIVE WOMEN VERSUS NORMOTENSIVE WOMEN OF DISTRICT D.I.KHAN, PAKISTAN

Background: Pregnancy induced hypertension (PIH) adversely affects the development of placenta and growth of fetus. The objectives of this study were to compare the placental diameter, placental thickness and number of cotyledons in mild PIH and severe PIH women versus normotensive women of District D.I.Khan, Pakistan.Material Methods: This comparative cross-sectional study was conducted in Department of Anatomy, Gomal Medical College, D.I.Khan, Pakistan from January to October 2014. Three samples were selected; each of size 50, group 1 normotensive/ control, group 2 with mild PIH and group 3 with severe PIH. Three research variables; placental diameter (cm), thickness (mm) and number of cotyledons were measured on ratio scale for three groups. Descriptive analysis included mean± SD with 95% confidence intervals for each group separately. With three groups on ratio data, one way-ANOVA test was applied to see significance of difference between three groups. Post hoc Dunnett’s t test was applied at alpha 0.05 to see difference of mild PIH group 2 to normotensive/ control group 1 and of severe PIH group 3 to normotensive/ control group 1separately.Results: Mean placental diameter was 18.28±2.15, 16.57±1.94 and 16.18±1.75 cm and mean placental thickness was 19.33 ±3.70, 19.18±2.78 and 17.60±3.52 mm in group 1, 2 and 3 respectively. Mean number of cotyledons was 14.42±2.25, 14.08±2.30 and 13.16±2.15 in group 1, 2, and 3 respectively. Placental diameter was statistically significantly lower in group 2 (p=.00001) and 3 (p=.00001) than group 1. Placental thickness in group 2 (p=.957) was similar to group 1, while in group 3 (p=.019) it was lower than group 1. Number of cotyledons in group 2 (p=.666) was similar to group 1, while in group 3 (p=.011) it was lower than group 1.Conclusion: In mild pregnancy induced hypertension (PIH), placental diameter was lower than normotensives, while placental thickness and number of cotyledons were similar to normotensives. In severe PIH, placental diameter, placental thickness and number of cotyledons were all lower than normotensives. It is concluded that in mild PIH, the development of placenta is mildly affected, while in severe PIH, the development of placenta is severely affected.

Sympathovagal imbalance, cardiometabolic risks and hypertension status are linked to depression in women having risk factors for pregnancy-induced hypertension

Background and Aim: Pregnancy is a physiological state in which there are cardiovascular, autonomic, hemodynamic and psychological changes. Increase in incidence of stress and depression in antenatal period has been reported. Autonomic changes in pregnancy-induced hypertension (PIH) and its dysfunction in depression are well documented. However, there is no report of contribution of sympathovagal imbalance (SVI) and cardiometabolic alterations to stress and depression in PIH. Methods: In this case-control study, we assessed and analyzed cardiovascular autonomic functions including heart rate variability (HRV) and cardiometabolic risks (CMR) between pregnant women having risks of PIH (n=62) and normal healthy pregnant women (n=68). The perceived stress scale (PSS-10) and Quality of Life (QoL) were used to evaluate depressive symptoms and perceived stress. The HRV and CMR parameters were correlated with PSS. Multiple regression analysis was performed individually to study their association with PSS. Logistic regression was done to determine the prediction of hypertension/prehypertension status by PSS. Results: There was increase in heart rate and blood pressure, decreased HRV and increased markers of insulin resistance, atherogenic lipid profile, markers of inflammation, oxidative stress and vascular endothelial dysfunction in PIH risk subjects compared to control subjects. Parameters of SVI and decreased cardiovagal modulation and CMR were significantly correlated and associated with PSS. PSS had independent prediction of prehypertension/hypertension status in the study group. Conclusion: Findings of the present study indicate that there is considerable SVI and CMR in PIH. It appears that depression is the major cause of SVI and decreased cardiovagal modulation in PIH, and retrograde inflammation and vascular endothelial dysfunction could be the potential mechanisms of depression mediated SVI in PIH.

Sonographic Assessment of Renal Volume in Normotensive Pregnant Women and Women With Pregnancy-Induced Hypertension in Enugu Metropolis

Objective: Renal volume (RV) assessment during obstetric sonography is rarely considered in our locality. Understanding the changes in RV in both normotensive pregnant (NP) and pregnancy-induced hypertensive (PIH) women is important in making correct diagnosis regarding pregnancy outcome. This study is aimed at determining the RV in NP and PIH women and correlating RV with fetal gestational age (FGA), body mass index (BMI), and parity in NP women. Materials and Methods: This cross-sectional study involved 450 patients recruited at a Tertiary Hospital. A pilot study was done to determine the interobserver variability in RV measurement. RV was calculated using the following formula: L × W × AP × 0.523. Parity, BMI, and blood pressure were documented, while FGA was calculated as an average of FGAs obtained from the measurements of fetal biometric parameters. Results: Mean RV of PIH women was significantly higher than that of NP women ( P < .05). RV shows a positive significant relationship with BMI and FGA, while it shows a negative relationship with parity in NP ( P < .05). Conclusion: Reference range values of RV were generated for clinical use in our locality, while there is statistically significant difference between RV in NP and PIH women.

English

Pregnancy-induced hypertension has remained a significant cause of prenatal morbidity and mortality of mothers. So this study aims to assess renal function test, serum total protein, and lipid profile concentrations among pregnancy-induced hypertension women in Asrade Zewudie Memorable hospital (ASZMPH), Gojjam, Ethiopia. A case-control study was done on 200 pregnant women: 100 with pregnancy-induced hypertension (case group) and 100 normotensives (control group) at Asrade Zewudie Memorable Primary hospital Gojjam, Ethiopia from January 24, 2020 to April 30, 2020. 5 ml of venous blood was collected on the SST test tube and analyzed for serum lipid profile, renal function test, and serum total protein. The analysis was done by using SPPS software (version 20.0). The level significance was set at a 95% confidence interval (P-value less than 0.05 was considered clinically significant). In the present study, there was a significant increase in the serum TC, TGs, blood urea, serum creatinine, and LDL (p < 0.05) and a significant decrease in HDL cholesterol in case groups as compared to normal groups (p < 0.05). The elevation of serum total protein was not significant (p >0.05). The outcome of the final multiple logistic regression model indicate that factors like BMI, habits of doing scheduled exercise, habit of drinking alcohol, habit of fruit consumption, trimester and gravidity had significant association with lipid profile tests of the study participants. In the present study, the degree of association between different risk factors selected in multiple logistic regression and lipid profile tests was more significant in case group relative with control group. According to the result of this study, early detection of altered lipid profile and renal function test in preeclamptics showed the incidence of complications can be decreased, which in turn reduces the materno-fetal morbidity and mortality. Key words: Lipid profile, serum total protein, renal function test, PIH, and Ethiopia

Comparative sonographic evaluation of placental thickness in pregnancy-induced hypertension and normotensive pregnant women in the University of Calabar Teaching Hospital, Calabar, Nigeria

Objectives: The human placenta is the nourishing reservoir for the sustenance of the fetus and synthesizes a growth-stimulating hormone to enhance proper growth and maturation. The size or thickness of the placenta enlarges as the pregnancy progresses in age to attain a favorable state which can cope with the increasing fetal demands. Placental thickness (PT) is a reflector of fetal well-being, and it is related to fetal weight making it necessary to assess the influence of pregnancy-induced hypertension (PIH), a common pathology in pregnancy, on the placental size or thickness. The main objective of this research is to compare and evaluate the PT and fetal weight in PIH and normotensive pregnant women. Material and Methods: The study was a prospective cross-sectional case-controlled study done in the Radiology Department of the University of Calabar Teaching Hospital. During a 12 months study period, 200 singleton pregnant women (consisting of 100 pregnancy-induced hypertensives and 100 normotensive pregnant women) of between 20 and 40 weeks of gestation were enrolled in this study. The two groups were gestational age-matched. The PT was measured trans-abdominally using an ultrasound scan. Pearson’s correlation analysis was used to establish the degree of relationship between PT and other fetal anthropometric and maternal parameters. Results: PT was significantly lower in pregnancy-induced hypertensives than in the controls (28.95 ± 5.71 mm vs. 32.31 ± 5.47 mm, P = 0.000). There was a significant negative correlation between the PT and the degree of proteinuria (P = 0.011). Conversely, a significant positive correlation existed between PT and estimated gestational age (P = 0.000) and also estimated fetal weight (EFW) (P = 0.000), in both groups. This same relationship was observed between the body mass index and PT (P = 0.007) as well as the EFW (P = 0.002) in the control group. The mean EFW in pregnancy-induced hypertensives (2.23 ± 1.07 kg) was higher than in the controls (2.13 ± 1.03 kg), but the difference was not significant (P = 0.505). Conclusion: There was a reduction in the PT in PIH, which may be due to the appearance of proteinuria when the blood pressure was elevated. However, we did not observe the expected reduction in the EFW due to a reduction in PT, which usually results from proteinuria.

Serum Uric Acid Level in Primigravidae with Pre-Eclampsia:A Case Control Study from Karnataka

Introduction: Pregnancy inducedhypertension is an exclusive condition affecting 10% ofpregnant women. The study of uric acid in serum is an interesting problemespecially in normal pregnancy and pregnancy inducedhypertension (PIH). Objective: To compare the changes of serum uric acid level in healthy non pregnant, PIH and normotensive pregnant women. Methodology: Cross sectional observational study conducted in the Obstetrics and Gynecology department, hospital, Navodaya medical college , Raichur, Karnataka involving 30 each pregnant, PIH and non-pregnant women. Serum uric acid levels were measured and analysed the data using SPSS 23 version software. Results: Comparison ofmean serum uric acid level in pregnant normotensive (4.14±1.05) and in PIH women (6.03±1.61) was found significant. Comparison of mean serum uric acid level in pregnant normotensive women (4.14±1.05) and in non pregnant women ( 3.39±0.5) found significant. Mean serum uric acid level in PIH women was 6.03±1.61 whereas in non pregnant women was 3.39±0.5 (p<0.001). Conclusion:Serum uric acid level is at higher side in PIH women as compared to pregnant normotensives and non pregnant women in our study.

Lipoprotein (a) and Atherogenic Index of Plasma are Indicators for Endothelial Dysfunction in Pregnancy-induced Hypertensive Women

Lipoprotein (a) and Atherogenic Index of Plasma are Indicators for Endothelial Dysfunction in Pregnancy-induced Hypertensive Women

Risk of small for gestational age babies in preterm delivery due to pregnancy-induced hypertension

BACKGROUND Pregnancy-induced hypertension (PIH) causes high maternal morbidity and mortality worldwide. This study aims to assess the impact of PIH on fetal growth according to gestational age in preterm deliveries.METHODS A prospective cohort study using secondary data was undertaken in Ende District, East Nusa Tenggara, Indonesia from September 2014 to August 2015. The t-test was performed to compare mean birth weight based on gestational week between normotensive and PIH women, continued by linear regression. The chi-square or Fisher exact test was also conducted to determine the probability of birthing small for the gestational age (SGA) and large for gestational age (LGA) babies between normotensive and PIH women.RESULTS A total of 1,673 deliveries were recorded in Ende Hospital over the 1-year study period, among which 182 cases involved preterm births. The PIH group had lower birth weight than normotensive women at each gestational age starting from 32–35 weeks (p=0.004; 95% CI 150.84–771.36). Normotensive women at gestational ages of 32 (p=0.05; 95% CI 0.01–0.83), 34 (p=0.37; 95% CI 0.01–4.12), and 36 (p=0.31; 95% CI 0.02–2.95) weeks had a lower risk of birthing SGA babies than PIH women; LGA babies were recorded at gestational ages of 33 (p=1.00; 95% CI 0.07–37.73) and 35 (p=0.31; 95% CI 0.34–63.07) weeks.CONCLUSIONS Poor perfusion of the uteroplacental is one of the reasons behind intrauterine growth restriction, which results in SGA babies born to PIH women.

HYDROGEN PEROXIDE LEVELS CORRELATE WITH SUPEROXIDE DISMUTASE IN IRAQI WOMEN WITH PREGNANCY-INDUCED HYPERTENSION

Objective: Pregnancy-induced hypertension (PIH) is a major pregnancy complication that leads to maternal mortality. Here, we have scrutinized the correlation between serum levels of hydrogen peroxide (H2O2) and superoxide dismutase (SOD) in PIH.Methods: Serum samples were collected from 80 Iraqi women (40 women with PIH as patients group, 20 normotensive pregnant women as a positive control, and 20 normotensive non-pregnant women as a negative control) all groups were diagnosed clinically.Results: Serum of H2O2 and SOD levels was measured for all studied groups. Results showed that there were no significant variances in age and gestational age distribution between all studied groups. Furthermore, result showed that the serum level of SOD was a highly significant decrease in PIH in compared to control groups while H2O2 was a highly significant increase in PIH in compared with control groups. The obtained results also indicated that there was a negative correlation between SOD and H2O2 PIH women while no correlation in other control groups.Conclusion: Our study showed that there was a correlation between H2O2 levels and SOD in PIH. These imbalance lead to generate oxidative stress that could be responsible for starting and progression of pathological processes related to PIH and may be a critical determinant of diseases. Testing for SOD and H2O2 level can be a monitoring instrument for oxidative stress in early pregnancy, and they could help in the detection and consequently prevent future hypertension in pregnancy.

Macrophage M1/M2 polarization in patients with pregnancy-induced hypertension.

This study aimed to validate whether macrophage polarization imbalance and abnormal cytokines production occurred in pregnancy-induced hypertension (PIH) patients. PIH women (n = 26) were enrolled and the level of biochemical parameters were determined. The percentage of CD86- and CD163-positive cells, representing M1 and M2 macrophages, were determined by flow cytometry. The concentrations of cytokines (TNF-α, IL-1β, IL-4, IL-13, and IL-10) were determined using enzyme-linked immunosorbent assay kit. THP-1 cells were incubated with 10% serum from PIH and control groups, and then macrophage polarization and cytokines production were analyzed. The levels of high-density lipoprotein cholesterol and apolipoprotein A1 were significantly lower, and the levels of fasting blood glucose, total cholesterol, triacylglycerol, low-density lipoprotein cholesterol, apolipoprotein B, and lipoprotein a were significantly higher in the PIH group than that in the control group. The PIH group contained a significant higher percentage of CD86-positive cells (M1) and a significant lower percentage of CD163-positive cells (M2), representing higher M1/M2 ratio, than the control group. The PIH group expressed higher concentrations of TNF-α and IL-1β, and expressed lower concentrations of IL-4, IL-10, and IL-13 than the control group. The in vitro experiment also showed macrophage polarization imbalance and abnormal cytokines production in THP-1 cells treated with PIH serum as compared with that treated with control serum. Macrophage polarization imbalance and abnormal cytokines production occurred in PIH patients and in THP-1 cells treated with PIH serum.

Serum Levels of TNF-α and IL-6 Are Associated With Pregnancy-Induced Hypertension.

Tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) are proinflammatory cytokines and known to be involved in many pathological processes. However, the association between serum levels of TNF-α, IL-6, and pregnancy-induced hypertension (PIH) is unclear. The aim of the present study was to determine the serum levels of TNF-α and IL-6 and to investigate their potential correlation with PIH. In this study, the serum concentrations of TNF-α and IL-6 in pregnant women who developed PIH and normal pregnant women were measured. We found that the serum concentrations of TNF-α and IL-6 were significantly increased in the patients with PIH compared to the normal pregnant women. In addition, elevated TNF-α and IL-6 concentrations were associated with pathological complications. Moreover, in a hypoxia-induced PIH mice model, animals from the PIH group demonstrated higher TNF-α and IL-6 levels when compared to control, and serum TNF-α and IL-6 levels were positively correlated with right ventricular systolic blood pressure. Furthermore, TNF-α and IL-6 levels were decreased when the PIH mice were treated with remodulin compared to control group. In conclusion, our results suggested that high serum TNF-α and IL-6 levels are associated with PIH, and TNF-α and IL-6 might be potential predictors in the prognosis of PIH.

Impact of pregnancy-induced hypertension on fetal growth

Background: Pregnancy-induced hypertension (PIH) is still a major cause of maternal and infant morbidity and mortality worldwide. The aim of this study to investigate the impact of PIH on fetal growth.Methods: A longitudinal cross-sectional study was conducted by 2,076 obstetric patients registered in the book of delivery emergency room BLUD RSUD Ende/ Ende hospital from September 1st 2014 to August 31st 2015. Pregnancy-induced hypertension was classified into gestational hypertension, preeclampsia, and severe preeclampsia. Categorical comparative chi-square continued by logistic regression analysis were performed to examine the effect of PIH to infants’ growth outcome.Results: Women with preeclampsia had higher number of preterm delivery (26.7%). Infants born from preeclamptic women had lower birth weight (median 2,575 gram; p<0.001), birth length (median 49 cm; p<0.001), and also head circumference (median 32 cm; p<0.001). Severe preeclampsia contributed statistically significance to SGA (OR=1.90; 95% CI=1.20-3.01; adjusted OR=1.91; 95% CI=1.20-3.01) and LGA (OR=2.70; 95% CI=1.00-7.29; adjusted OR=2.92; 95% CI=1.07-8.00). Based on birth weight independent of gestational age, severe preeclampsia had an impact to VLBW (OR=11.45; 95% CI=2.77-47.38; adjusted OR=8.68; 95% CI=1.57-48.04) and LBW (OR=6.57; 95% CI=4.01-10.79; adjusted OR=5.71; 95% CI=3.33-9.78) where it showed statistical significance.Conclusion: PIH women who had SGA or VLBL or LBW infants were caused by the hypoperfusion model as the pathogenesis of preeclampsia. Meanwhile, LGA infants born by preeclamptic women were due to the compensation of the decrease from uteroplacental perfusion or other diseases such as obese mother or gestational.diabetes mellitus.

Perinatal outcome in relation with laboratory findings in pregnancy induced hypertension(PIH)

Background: Perinatal mortality is an important indicator of the status of maternal and child health, the conditions of obstetric care and the level of economic development of a community. The perinatal mortality rate (PMR) reflects both the characteristics of reproductive health and the quality of antenatal care, delivery, and newborn care. Objective: To find out the corelation between laboratory parameters with perinatal outcomes in PIH cases. Method: 320 patients having an average systolic blood pressure ≥ 140 mm hg and/or diastolic blood pressure ≥ 90 mm Hg were included in the study and biochemistry parameters like serum AST, ALT analysed by UV kinetic, LDH by UV kinetic IFCC, Uric acid by modified Trinder’s method and calcium by arsenazo III methods, were measured by Xl 300 autoanalyzer. Result: In our study overall incidence of PIH was 14.3 %. Maternal death occurred in 09 cases(2.8%). Perinatal mortality occurred in 86(23.3%) with 57(17.8%) Stillbirth and 29(9.0%) Neonatal deaths. Low birthweight160/110 and above (Table 2). Perinatal death increased significantly in PIH women with increased levels of serum AST, ALT, uric acid, LDH and with a significant decrease in serum calcium levels. Perinatal death occurred in 63(73%) cases with Uric acid >6.0 mg/dl, 48(55.8%) in cases with > 600U/l LDH and in 48(55.8%) cases with < 8.0 mg/dl Calcium. Conclusion: A positive correlation has been made out between serum AST, ALT, uric acid, LDH, calcium and perinatal deaths in relation to the severity of PIH and these may be useful markers and diagnostic tools for predicting the progression of PIH. Keywords: Preeclampsia, uric acid, LDH, calcium, Perinatal mortality

Evaluation of Lipid Profile, Calcium and Alkaline Phosphatase in Pregnancy Induced Hypertension Women

Pregnancy induced hypertension is a main cause of maternal mortality and morbidity . The aim of the present study was destined to evaluate the association of blood Rheology of complicated pre-eclampsia and its comparison with that in normal pregnancy and normal non-pregnant woman. The grouping was done as group I (normal, non-pregnant women) and group II (normal pregnant women) and group III (pregnancy with PIH) Mean age range was 20-35 years. Serum lipid profile, calcium and alkaline phosphatase were monitored in pre-eclampsia, normal pregnant and normal non-pregnant women. The normal pregnancy was associated with significant increase in HDL-cholesterol, VLDL-cholesterol, Triglyceride, Alkaline phosphatase, with no significant increase in T. cholesterol and significant decrease in LDL-cholesterol and serum calcium when compared to normal non pregnant woman. A significant rise of total cholesterol, triglyceride, LDL cholesterol, VLDL-cholesterol, Alkaline phosphatase and fall in HDL-cholesterol and serum calcium was observed with the pre-eclampsia when compared with normal and control groups. Decreased HDL cholesterol and delayed triglyceride clearance and high blood pressure are associated with development of pre-eclampsia and eclampsia, this association may be crucial for understanding the pathologic processes of pre-eclampsia and eclampsia and may helpful for prevention.

Risk factors for pregnancy-induced hypertension

Objective. The aim of the research was to investigate if the two groups of patients, women with pregnancy-induced hypertension (PIH) and women with normal pregnancy differed in some studied risk factors. Methods. The study has been carried out in Health Centre 'Sid' in Sid, Serbia, at Department for Women Primary Health Care. In order to collect data necessary for the research the survey questionnaire was used that was created by the study authors. The study sample consisted of 200 pregnant women divided in two groups. The first one included 100 pregnant women with hypertension. The second group included 100 pregnant women with normal pregnancy. The study subjects of two groups were selected randomly from the larger pool of pregnant women, which were followed regularly at the Department. Results. PIH occurred between 26-30 years of age in total of 34% of pregnant women. The average age of pregnancy when the disorder was firstly observed was 29.7 gestational weeks. In the group of women with PIH, 37% of them had the body mass index (BMI) between 25 and 29.99 kg/ m2, and 38% of women had BMI over 30 kg/m2. The total of 35% of pregnant women with PIH frequently consumed salty and spicy foods, while 42% of pregnant women such food consumed only occasionally. Conclusion. There were no significant differences in age between the patients with PIH and pregnant women with normal course of pregnancy. PIH was more common in primiparous mothers, pregnant women with elevated body mass index, among pregnant women with reduced physical activity, pregnant women who smoked and in pregnant women who consumed salty and spicy foods.

Systemic inflammation and alteration in vitamin D levels in pregnancy induced hypertension

Background: The increasing incidence of Pregnancy induced hypertension (PIH) or Pre-eclampsia in developed and developing countries are alarming. Systemic inflammation and disturbances in vitamin D and minerals (Sodium &amp; Calcium) metabolism are almost invariable consequences of PIH; and variation in their levels can adversely affect the pregnancy leading to the development of PIH. Aim: In this context, a study was carried out to assess the level of serum vitamin D, sodium, calcium and inflammatory marker C-reactive protein (CRP) in non-pregnant (NP), normotensive pregnant (NTP) and PIH women and to determine their role in the etio-pathogenesis of PIH. Material and method: Serum vitamin D, sodium, calcium and CRP levels were estimated in 20 NTP women (Group I) and 20 PIH women (Group II) by using standard methods and statistically compared it with that of age matched 20 healthy non pregnant women (Control group) by using student’s t-test. Result: Serum Ca++ level were found to be significantly low in both Group I (p&lt;0.05) and Group II (p&lt;0.01) as compared to healthy controls. However, plasma vitamin D levels were decreased insignificantly in Group I (p &lt; 0.1) and significantly (p &lt; 0.05) in Group II patients. Similarly, serum sodium and CRP levels were increased significantly only in Group II patients. Conclusion: Thus, regular assessment of serum CRP, vitamin D, sodium and calcium levels and recommendation of diet low in sodium, rich in calcium and appropriate vitamin D should be increased during pregnancy to prevent PIH and its related complications. DOI: http://dx.doi.org/10.3126/ajms.v5i4.9809 Asian Journal of Medical Sciences 2014 Vol.5(4); 11-15