Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, w...Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.展开更多
Background: Hypertensive disease in pregnancy is an important cause of morbidity, long-term disability, and maternal and neonatal mortality. The aim is to determine the socio-demographic characteristics and maternal p...Background: Hypertensive disease in pregnancy is an important cause of morbidity, long-term disability, and maternal and neonatal mortality. The aim is to determine the socio-demographic characteristics and maternal prognosis of these women with Hypertension during pregnancy. Material and Method: We conducted a cross-sectional study, we interview patients and after discussion we transcripts in a database in Excel software before analysis with SPSS version 20.0 and Stata 14.0 The qualitative variables have been summarised by the Percentage and the quantitative variables will be summarised by Means and Standard Deviation. The associations of the variables were calculated by Pearson’s chi-square test with a significance level set at a p-value Result: The average age of the patients was 30.33 ± 7.020 years, 92.1% were married, 79.8% lived in urban areas, most of the patients were overweight (43%), 92.1% of them had monofetal pregnancies, 36% were multiparous, 34.2% had a previous history of preeclampsia in pregnancy and 14% were known to have hypertension. Pre-eclampsia was the most frequent form of hypertension in pregnancy with 73.68% of cases and represents 84.8% of severe forms of hypertension in pregnancy, 53.4% of the patients delivered vaginally. Eclampsia was the most frequent complication in our patients with 31.7% frequency and among the socio-demographic parameters, age and body mass index were significantly associated with maternal complications. Conclusion: Maternal age and body mass index are important socio-demographic factors associated with the occurrence of maternal complications in women with hypertensive disorders in pregnancy.展开更多
Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of se...Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p < 0.05. Study of risk factors, Odds ratios and their confidence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is pathology is important to reduce maternal-fetal morbidity and mortality.展开更多
To study whether the development of hypertensive disorder complicating pregnancy is associated with -308G→A, -850C→T mutation at promoter of TNF-α gene, the -308G→A, -850C→T polymorphism was examined in patients ...To study whether the development of hypertensive disorder complicating pregnancy is associated with -308G→A, -850C→T mutation at promoter of TNF-α gene, the -308G→A, -850C→T polymorphism was examined in patients and healthy pregnant women by PCR-RFLP technique. The frequencies of genotype and allele were compared between the two groups. The re- sults showed that with -308G→A polymorphism distribution, the allele frequency of TNF2 and the frequency of the genotype TNF2/1 in the patient group was significantly higher in the patient group than in control group (P<0.05). A significant difference in genotype distribution of -850C→T poly- morphism was observed between the two groups. The allele frequencies of T in patient group was higher in the control group as compared with the patient group. The frequencies of CT and TT genotypes were lower in the patient group. It is concluded that the TNF2 allele of -308 is associated with the occurrence of hypertensive disorder complicating pregnancy, while T allele of -850 may be the protective factor against the development of the disease. TNF2/1 CC may be susceptibility genotype of hypertensive disorder complicating pregnancy.展开更多
This paper aims to explore the diagnostic value of noninvasive?cardiac function measurement for hypertension in pregnancy. One hundred and fifty-eight cases of gestational hypertension in our hospital were analyzed re...This paper aims to explore the diagnostic value of noninvasive?cardiac function measurement for hypertension in pregnancy. One hundred and fifty-eight cases of gestational hypertension in our hospital were analyzed retrospectively while 30 healthy pregnant women were served as normal controls. The heart function parameters in the two groups were measured with noninvasive cardiac function analyzer, such as myocardial contractive force indexes (JP, VP), impedance indexes (RTM, RS), volume load indexes (GCV, LVDP) and left heart output index (LCI). In all 158 cases of gestational hypertension, the myocardial contractive force indexes, impedance indexes and left heart output index increased unusually. The difference between the two groups was statistically significant (P < 0.05). The myocardial contractive force indexes and the impedance indexes increased significantly higher than left heart output index (P < 0.05). The noninvasive cardiac function measurement was much valuable in the early diagnosis of pregnancy-induced hypertension, especially the myocardial contractive force indexes, impedance indexes and left heart output index, it appeared to be simple and efficient, and it deserves to be clinically popularized and applied.展开更多
Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of h...Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects.90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology,including 30 cases in each of the hypertension group,the preeclampsia group,and the eclampsia group.Another 30 healthy pregnant women were selected as the control group.The serum cortisol levels of pregnant women in the above four groups were measured.Results:Compared with the control group,the serum cortisol levels in the other three groups were significantly increased.In perinatal outcome,compared with the control group,the three groups of patients had an increase in Apgar score,preterm birth,stillbirth rate,growth restriction rate and neonatal asphyxia rate.There were significant differences between groups(P<0.05),and showed as gestational hypertension<preeclampsia<eclampsia.Conclusion:With the exacerbation of hypertensive disorders during pregnancy,the serum cortisol level continues to increase,which has a serious adverse effect on the prognosis of the perinatal infants.展开更多
Objective:To study the correlation between central retinal artery hemodynamic characteristics in patients with hypertensive disorder complicating pregnancy and endothelial injury molecules as well as trophoblast cell ...Objective:To study the correlation between central retinal artery hemodynamic characteristics in patients with hypertensive disorder complicating pregnancy and endothelial injury molecules as well as trophoblast cell apoptosis molecules.Methods: 45 healthy pregnant women, 37 patients with gestational hypertension and 24 patients with preeclampsia who gave birth in Obstetrics Department of our hospital between May 2013 and December 2015 were selected and included in the control group, GH group and PE group respectively. Central retinal artery ultrasonography was done to determine peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI), serum was collected to determine interleukin-6 (IL-6), IL-17, IL-24, chemokine ligand 10 (CXCL10) and cartilage glycoprotein 40 (YKL40) content, and placenta tissue was collected to determine Fas, FasL, Bax, Caspase-3, Caspase-9, XIAP, Survivin and Livin expression.Results: Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of GH group and PE group were significantly lower than those of control group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of control group (P<0.05). Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of PE group were significantly lower than those of GH group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of GH group (P<0.05). Serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were negatively correlated with PSV and EDV, and positively correlated with RI;XIAP, Survivin and Livin expression in placenta were positively correlated with PSV and EDV, and negatively correlated with RI. Conclusions:Central retinal artery blood flow characteristics in patients with hypertensive disorder complicating pregnancy are the significantly increased blood flow resistance and the significantly decreased blood flow volume, and the above blood flow characteristics are associated with maternal endothelial injury and trophoblast cell apoptosis.展开更多
Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with i...Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with its synonyms or related words:"iron","supplement",“hypertensive disorders in pregnancy”through MEDLINE(OVID),CINAHL,PubMed,Cochrane Library,Scopus,Web of Science,ICTRP,and ClinicalTrials.gov,and manual search of references was used in seven potential resources.The inclusion criteria were randomized control trials(RCTs),published in English,full-text available,having healthy pregnant women without anaemia for study participants,and having hypertensive disorders in pregnancy at the end of pregnancy as the outcome.The risk of bias assessment tool was used for quality appraisal.Meta-analysis was conducted by calculating the fixed and random effects of the odds ratio(OR)for iron supplementation among non-anaemic pregnant women compared with the incidence of hypertensive disorders in pregnancy.The range of the study’s estimation accuracy was reflected by a 95%confidence interval(CI).Results:Four RCTs were included in the meta-analysis.The pooled results showed that iron supplementation possibly had no effect on the incidence of hypertensive disorders in pregnancy(OR 0.93,95%CI 0.81-1.07;P=0.30),gestational hypertension(OR 1.37,95%CI 0.69-2.73;P=0.36)as well as on the development of preeclampsia(OR 1.45,95%CI 0.71-2.97;P=0.31).Conclusions:Iron supplementation has no effect on the incidence of hypertension in non-anaemic pregnant women.In general,there is a lack of evidence for the association between iron supplementation and the incidence of hypertensive disorders in pregnancy among non-anaemic pregnant women,and further studies are needed.展开更多
Introduction: Hypertension is one of the common problems associated with pregnancy that may be followed by eclampsia, acute renal failure, maternal death, premature delivery, intra-uterine growth restriction and other...Introduction: Hypertension is one of the common problems associated with pregnancy that may be followed by eclampsia, acute renal failure, maternal death, premature delivery, intra-uterine growth restriction and other. This study was conducted to determine the results of pregnancies associated with hypertension in patients visiting in the Delivery Ward of Valiasr Hospital. Methods: A descriptive study was conducted on all the patients admitted to the aforementioned department and who possessed the inclusion criteria for hypertensive pregnancy. Results: Among the 1694 delivery cases examined, 173 cases had hypertension (9.8%). Among these, 75 (45%) had gesta-tional hypertension;24 (14.8%) had preeclampsia-eclampsia;30 (18%) had preeclampsia su-perimposed on chronic hypertension;21 (13.5%) cases had chronic hypertension;and 13 (8%) had pregnancy-aggravated chronic hypertension. Ninety-six point three percent (96.3%) had a systolic blood pressure (BP) of 140 - 190 mmHg, and 3.7% had a systolic BP greater than 190 mmHg. Whereas 61.1% of diastolic blood pressure 90 - 110 mmHg and 38.9% of the mothers had diastolic BP greater than 110 mmHg. The HELLP (Hemolysis, Elevated Liver enzymes & Low Platelet count) syndrome was present in 4.9% of cases;52.6% experienced premature delivery;7.4% had IUFD (intra uterine fetal death);9.9% had IUGR (intrauterine growth retardation);and 17.3% had LBW babies. Conclusions: Based on our results, hypertensive mothers who are younger and have lower weight babies at birth experience more perinatal complications. The unpleasant effects of hypertension in pregnancy warrant the need for training, routine prenatal care, the early detection and treatment of hypertension at younger ages of pregnancy, and follow-up after delivery.展开更多
<strong><em>Introduction</em></strong><span style="white-space:normal;"><b><span style="font-family:;" "="">: </span></b></sp...<strong><em>Introduction</em></strong><span style="white-space:normal;"><b><span style="font-family:;" "="">: </span></b></span><span style="white-space:normal;"><span style="font-family:;" "="">Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae. The objective of this study was to describe the prognosis in the postpartum period of patients with HDP in Departmental University Hospital of Borgou CHUD-B from Parakou in 2020. <b><i>Methods</i>: </b>The study was prospective with a descriptive and analytical design and was conducted from January 2020 to September 2020. Patients with HDP were recruited from the gynecology-obstetrics department and each followed for 3 months in the cardiology department. HDP was classified according to the International Society for the Study of Hypertension in Pregnancy, and blood pressure (BP) was taken according to WHO recommendations. Self-measurement of BP at home was performed to assess blood pressure control outside the hospital. Epidata 3.1 and SPSS 21 software were used for data processing and analysis. P values < 5% were considered statistically significant. <b><i>Results</i>: </b>During the study period, the hospital frequency of HDP was 15.6%. The frequency of maternal complications in the postpartum period was 28% (severe hypertension: 23.2%;eclampsia: 3.6%;puerperal psychosis: 1.2%). At the end of the three-month follow-up, blood pressure returned to normal in 73.2% of cases;it persisted in 26.8% of women. Factors associated with persistence of hypertension after multivariate analysis were, overweight/obesity RRa 8.664 [1.566 - 47.941], (p = 0.013);family history of hypertension RRa 6.499 [1.493 - 28.289], (p = 0.013);history of hypertension in previous pregnancies RRa 7.764 [1.561 - 38.601], (p < 0.012). <b><i>Conclusion</i>: </b>The frequency of HDP is not negligible at CHUD-B/A. The evolution of these HDP was marked in more than a quarter of cases by complications in the postpartum period followed by a persistence of hypertension 3 months after childbirth predicted by cardiovascular risk factors.</span></span>展开更多
The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: ...The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: It has been a descriptive cross-sectional study with a prospective collection of data using a questionnaire in prenatal consultation in the health center of Parakou’s commune for 4 months (May 1 to August 31, 2019). Result: A proportion of 8.2% (55/671) of the pregnancy had </span><span style="font-family:Verdana;">the hypertensive</span><span style="font-family:Verdana;"> disorders of pregnancy. </span><span style="font-family:Verdana;">The Gestational</span><span style="font-family:Verdana;"> HyperTension was the most common type of arterial hypertension (AHT) with a proportion of 49.1%. The factors associated with HDP were the age of 30 to 34 (OR: 11.9;95% CI: 1.54 - 92.29;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0346), the family history of Arterial HyperTension (AHT) (OR: 1.5;95% CI: 1.03 - 4.66;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0481), the BMI > 30 (OR:14.2;95% IC: 7.02 - 28.69;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0235), being married or in a common-law relationship (OR = 2.51;95% CI: 1.30 - 4.86;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0412), the stress (OR: 2.0;95% CI:1.09 - 3.32;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0209), the history of HDP (OR: 9.0;95% CI: 2.53 - 15.23;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> < 0.05). Conclusion: HDP </span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> common in Parakou. Some factors previously described in the literature are associated with them.展开更多
Objective: To discuss the ultrasonic evaluation of fetal ventricular systolic function in hypertensive disorder complicating pregnancy and its correlation with the expression of placental hypoxia-related genes. Method...Objective: To discuss the ultrasonic evaluation of fetal ventricular systolic function in hypertensive disorder complicating pregnancy and its correlation with the expression of placental hypoxia-related genes. Methods: A total of 98 late pregnant women with hypertensive disorder complicating pregnancy who were treated in the hospital between December 2014 and February 2017 were selected as hypertensive disorder complicating pregnancy group and 100 normal late pregnant women who received physical examination in the hospital during the same period were selected as normal control group. The ultrasonic parameters of fetal ventricular systolic function in two groups of pregnant women were detected before delivery, and the expression of hypoxia-related genes in placental tissue was detected by fluorescence quantitative PCR. Pearson test was used to assess the correlation between the parameters of fetal ventricular systolic function and placental hypoxia in hypertensive disorder complicating pregnancy. Results: The fetal left ventricular fractional shortening and right ventricular fractional shortening levels of hypertensive disorder complicating pregnancy group were lower than those of normal control group. Angiogenesis-related genes VEGF, netrin-1 and XIAP mRNA expression in placental tissue of hypertensive disorder complicating pregnancy group were lower than those in placental tissue of normal control group while HIF-1α mRNA expression was higher than that in placental tissue of normal control group;oxidative stress-related genes Nrf2, TAC3 and PrxⅡ mRNA expression in placental tissue were lower than those in placental tissue of normal control group;apoptosis genes Fas, p53 and caspase-9 mRNA expression in placental tissue were higher than those in placental tissue of normal control group while Bcl-2 and SFRP2 mRNA expression were lower than those in placental tissue of normal control group. Pearson test showed that the ultrasonic parameter levels of fetal ventricular systolic function in hypertensive disorder complicating pregnancy were directly correlated with the degree of placental hypoxia. Conclusion:Ultrasonic testing of fetal ventricular systolic function in hypertensive disorder complicating pregnancy can be used as a reliable method to measure the degree of placental hypoxia.展开更多
Objective: To study the effect of folic acid and vitamin supplement on endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy. Methods: A total of 62 patients wh...Objective: To study the effect of folic acid and vitamin supplement on endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy. Methods: A total of 62 patients who were diagnosed with preeclampsia in Wuhan Red Cross hospital between March 2015 and February 2017 were selected as the research subjects and randomly divided into two groups, the observation group received folic acid, vitamin and conventional symptomatic treatment, and control group accepted conventional symptomatic treatment. Serum contents of endothelial injury markers and oxidative stress indexes were detected before treatment and 2 weeks after treatment;the expression of apoptosis genes in the placenta were detected after delivery. Results: 2 weeks after treatment, serum ET-1, tTG, sFlt-1, sEng, MPO, IMA, MDA and AOPP levels of both groups of patients were significantly lower than those before treatment, and serum ET-1, tTG, sFlt-1, sEng, MPO, IMA, MDA and AOPP levels of observation group were significantly lower than those of control group;after delivery, Fas, Bax and Caspase-3 mRNA expression levels in placenta tissue of observation group were significantly lower than those of control group while Bcl-2, Survivin and Livin mRNA expression levels were significantly higher than those of control group. Conclusion:Folic acid and vitamin supplement can significantly improve the endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy.展开更多
Objective: To study the effect of low molecular weight heparin therapy on maternal endothelial injury and placental pathological injury after hypertensive disorder complicating pregnancy. Methods: A total of 70 patien...Objective: To study the effect of low molecular weight heparin therapy on maternal endothelial injury and placental pathological injury after hypertensive disorder complicating pregnancy. Methods: A total of 70 patients with hypertensive disorder complicating pregnancy who were treated in the hospital between September 2014 and May 2016 were divided into control group and observation group according to the random number table method, 35 cases in each group. Control group received conventional therapy, the observation group received low molecular weight heparin combined with conventional therapy, and both therapies lasted until delivery. The differences in the levels of endothelial injury indexes in serum as well as the expression of oxidative stress indexes and apoptosis molecules in the placental grinding fluid were compared between the two groups of patients. Results: After treatment, serum ET and VCAM-1 levels of both groups of patients were lower than those before treatment while NO and PGE levels were higher than those before treatment, and serum ET and VCAM-1 levels of observation group were lower than those of control group while NO and PGE levels were higher than those of control group;after delivery, AOPP and MDA levels in placental grinding fluid were significantly lower than those of control group while SOD and GSH-Px levels were higher than those of control group;Fas, p53 and caspase-3 mRNA expression in placental grinding fluid were lower than those of control group while Bcl-2 and bax mRNA expression were higher than those of control group. Conclusion: Adjuvant low molecular weight heparin therapy can help to reduce the maternal endothelial injury, reduce the systemic oxidative stress and suppress the placental cell apoptosis in patients with hypertensive disorder complicating pregnancy.展开更多
To examine the changes in number and function of endothelial progenitor cells (EPCs) from peripheral blood (PB) in hypertension disorder complicating pregnancy (HDCP), 20 women with HDCP and 20 normal pregnant women a...To examine the changes in number and function of endothelial progenitor cells (EPCs) from peripheral blood (PB) in hypertension disorder complicating pregnancy (HDCP), 20 women with HDCP and 20 normal pregnant women at the third trimester were studied. Mononuclear cells (MNCs) from PB were isolated by Ficoll density gradient centrifugation. EPCs were identified by positive expression of both CD34 and CD133 under fluorescence microscope and positive expression of factor Ⅷ as shown by immunocytochemistry. The number of EPCs was flow-cytometrically determined. Proliferation and migration of EPCs were measured by MTT assay and modified Boyden chamber assay, respectively. The adhesion activity of EPCs was detected by counting the number of the adherent cells. The results showed that, compared with normal pregnant women, the number of EPCs was significantly reduced in HDCP (4.29%±1.21% vs 15.32%±2.00%, P<0.01), the functional activity of EPCs in HDCP, such as proliferation (13.45%±1.68% vs 18.45%±1.67%), migration (37.25±7.28 cells/field vs 67.10±9.55 cells/field) and adhesion activity (20.65±5.19 cells/field vs 34.40±6.72 cells/filed) was impaired (P<0.01). It is concluded that the number and function of EPCs are significantly decreased in HDCP.展开更多
BACKGROUND Juxtaglomerular cell tumor(JGCT)of the kidney,also known as reninoma,is a rare renal tumor that typically clinically manifests as hypertension,hypokalemia,high renin,and high aldosterone.It is a cause of se...BACKGROUND Juxtaglomerular cell tumor(JGCT)of the kidney,also known as reninoma,is a rare renal tumor that typically clinically manifests as hypertension,hypokalemia,high renin,and high aldosterone.It is a cause of secondary hypertension.Pregnancy with JGCT is rarer and easily misdiagnosed as pregnancy-induced hypertension,thus affecting treatment.CASE SUMMARY A 28-year-old woman presented in early pregnancy with hypertension(blood pressure of 229/159 mmHg),nausea,and occasional dizziness and headache.The patient was diagnosed with pregnancy-induced hypertension,and no relief was found after symptomatic treatment;hence,the pregnancy was terminated by artificial abortion.Her blood pressure remained high following termination of pregnancy.Blood tests suggested hypokalemia(2.997 mmol/L),blood aldo-sterone measured 613 ng/L,and computed tomography urography showed a tumor in the right kidney.Therefore,laparoscopic partial nephrectomy was performed.After surgery,the patient’s blood pressure returned to normal,and blood potassium,aldosterone,and renin normalized.Postoperative pathological examination revealed JGCT.After long-term follow-up,the patient became pregnant again 6 mo after surgery.No hypertension occurred during pregnancy,and the patient delivered a healthy female neonate.CONCLUSION Patients with pregnancy complicated by JGCT are difficult to diagnose.Herein,we advise surgeons on proper handling of such situations.展开更多
The prevalence of hypertensive disorders in China was much higher than that in the United States. Considering the large population with wide geographic area of China, we aimed to add more information regarding the ris...The prevalence of hypertensive disorders in China was much higher than that in the United States. Considering the large population with wide geographic area of China, we aimed to add more information regarding the risk factors for hypertensive disorders of pregnancy. A case-control study was performed on 373 hypertensive cases and 507 normotensive controls. Participants were recruited from 2008 to 2014 in Yichang Maternal and Child Health Care Center in Hubei province and Anyang Maternal and Child Health Care Hospital in Henan province, China. Socio-demographic factors, family-related factors, pregnancy-associated factors, factors related to daily life behaviors and psychosocial factors were investigated with respect to hypertensive disorders in pregnancy through well-designed questionnaire. Chi-square test, t-test, univariate logistic regression analysis, and multivariate logistic regression analysis were used to find the possible risk factors behind hypertensive disorders in pregnancy. The results showed that family history of cardiovascular diseases(OR=6.18, 95% CI, 2.37 to 16.14), history of pregnancy-induced hypertension(OR=16.64, 95% CI, 5.74 to 48.22), low maternal educational level(OR=2.81, 95% CI, 1.30 to 6.04), and poor relationship with their parents-in-law(OR=3.44, 95% CI, 1.55 to 7.59) had statistically significant associations with hypertensive disorders in pregnancy through multivariate logistic regression analysis. Increased maternal age, increased pre-pregnancy body mass index, living in rural area, low paternal education level, family history of hypertension, passive smoking one year before and/or in pregnancy, and poor sleeping quality were significantly associated with hypertensive disorders in pregnancy from univariate logistic regression analysis while the associations became uncertain when they were entered for multivariate logistic regression analysis. It was concluded that family history of cardiovascular diseases, history of pregnancy-induced hypertension, low maternal educational level, and poor relationship with their parents-in-law were independent risk factors for hypertensive disorders among Chinese pregnant women.展开更多
Expression of endogenous ouabain in placenta and the concentrations of serum ET-1 and NO were examined in 30 patients with hypertensive disorder complicating pregnancy (HDCP) and 30 healthy pregnant women to investiga...Expression of endogenous ouabain in placenta and the concentrations of serum ET-1 and NO were examined in 30 patients with hypertensive disorder complicating pregnancy (HDCP) and 30 healthy pregnant women to investigate the effect of endogenous ouabain on HDCP. Compared with the healthy pregnant group, the expression of endogenous ouabain dramatically increased in the HDCP groups (P<0.01). There was a significantly positive correlation between the expression of en- dogenous ouabain with ET-1 (r= 0.5567, P<0.01), while the correlation of endogenous ouabain and NO was significantly negative (r=-0.6895, P<0.01). As expected, the correlation between ET-1 and NO was negative (r=-0.7796, P<0.01). ET-1 concentrations of maternal and cord sera in HDCP groups were significantly higher in comparison with healthy pregnant group (P<0.01). On the con- trast, NO concentrations were much lower in the maternal and cord sera of HDCP groups as com- pared with healthy pregnant group (P<0.01). Our data suggest that endogenous ouabain is directly involved in the nosogenesis of HDCP, with accompanying decreased NO and the elevated of ET-1.展开更多
Objective: To study the significance of Leptin and the activity of erythrocyte membrane Ca2+-ATPase(EMCA) in the development of hypertensive disorder complicating pregnancy. Methods: Radioimmunoassay was used to test ...Objective: To study the significance of Leptin and the activity of erythrocyte membrane Ca2+-ATPase(EMCA) in the development of hypertensive disorder complicating pregnancy. Methods: Radioimmunoassay was used to test the level of serum Leptin,and the activity of EMCA was determined chemically in 38 pregnant women with hypertensive disorder complicating pregnancy and 36 normotensive pregnant women. Results: The level of serum Leptin in hypertensive disorder complicating pregnancy(gestational hypertension: 13.76 ± 3.46 ng/ml; preeclampsia:15.76 ± 5.47 ng/ml; eclampsia: 18.32 ± 6.38 ng/ml)was significantly higher than that in normotensive pregnant women(11.33 ± 2.93 ng/ml),respectively. The average EMCA activity of patients with hypertensive disorder complicating pregnancy(gestational hypertension:1.65 ± 0.24 μmol·pi/mg·h ; preeclampsia:1.37 ± 0.19 μ mol·pi/mg·h; eclampsia:1.12 ± 0.14 μ mol·pi/mg·h) was significantly lower than that of normotensive pregnant women(1.83 ± 0.38 μ mol·pi/mg·h),respectively. There was a negative correlation between the level of serum Leptin and the activity of RMCA in hypertensive disorder complicating pregnancy(r = -0.63). Conclusion: Inhibition of EMCA activity of erythrocyte in hypertensive disorder complicating pregnancy may increase cytoplasmic free calcium, which contributes to the development of hypertensive disorder complicating pregnancy. The negative correlation between the level of serum Leptin and the activity of EMCA, also suggested that serum Leptin and the activity of EMCA may play a role in the development of hypertensive disorder complicating pregnancy.展开更多
基金The present study was supported by the National Natural Science Foundation of China(Grant No.82003415)the National Key Research&Development(R&D)Program of China(Grant No.2021YFC2700705).
文摘Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.
文摘Background: Hypertensive disease in pregnancy is an important cause of morbidity, long-term disability, and maternal and neonatal mortality. The aim is to determine the socio-demographic characteristics and maternal prognosis of these women with Hypertension during pregnancy. Material and Method: We conducted a cross-sectional study, we interview patients and after discussion we transcripts in a database in Excel software before analysis with SPSS version 20.0 and Stata 14.0 The qualitative variables have been summarised by the Percentage and the quantitative variables will be summarised by Means and Standard Deviation. The associations of the variables were calculated by Pearson’s chi-square test with a significance level set at a p-value Result: The average age of the patients was 30.33 ± 7.020 years, 92.1% were married, 79.8% lived in urban areas, most of the patients were overweight (43%), 92.1% of them had monofetal pregnancies, 36% were multiparous, 34.2% had a previous history of preeclampsia in pregnancy and 14% were known to have hypertension. Pre-eclampsia was the most frequent form of hypertension in pregnancy with 73.68% of cases and represents 84.8% of severe forms of hypertension in pregnancy, 53.4% of the patients delivered vaginally. Eclampsia was the most frequent complication in our patients with 31.7% frequency and among the socio-demographic parameters, age and body mass index were significantly associated with maternal complications. Conclusion: Maternal age and body mass index are important socio-demographic factors associated with the occurrence of maternal complications in women with hypertensive disorders in pregnancy.
文摘Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries. Hypertensive disorders of pregnancy are among the leading causes of severe maternal morbidity and mortality, particularly in developing countries, maternal hypocalcaemia being a factor favouring the onset of arterial hypertension during pregnancy. The aim was to determine the maternal and perinatal prognosis of patients with hypertensive disorders of pregnancy as a function of serum ionised calcium levels. Material and Methods: A cross-sectional analytical study of 114 patients with arterial hypertension during pregnancy or during pregnancy or in the postpartum period at the HGR/Panzi from 1 January 2021 to 30 June 2022, text was entered using Microsoft Office Word 2010 and the tables were analysed using Excel 2010. The data was analysed using SPSS version 20.0 and Stata 14.0. The associations of the variables were calculated using Pearson's chi-square test, with a significance threshold set at a value of p < 0.05. Study of risk factors, Odds ratios and their confidence intervals were estimated in a univariate analysis. The most determining factors were identified by multivariate analysis using the Forward conditional logistic regression model. Results: The mean gestational age was 34.43 ± 4.327 amenorheas weeks, 46.6% of patients had a vaginal delivery, 66.65% of which were indicated for maternal prognosis, maternal complications were associated with maternal hypocalcaemia in 81, 82% (P = 0.043) and an OR = 3.255 (P = 0.0158) threefold risk that the patient presenting with a complication is likely to be in a state of hypocalcaemia at 95% confidence index, and fetal prognosis was not significantly related to maternal calcaemia. Conclusion: Maternal hypocalcaemia is one of the factors that can influence maternal-foetal complications maternal-fetal complications, early management and prevention of this pathology is pathology is important to reduce maternal-fetal morbidity and mortality.
文摘To study whether the development of hypertensive disorder complicating pregnancy is associated with -308G→A, -850C→T mutation at promoter of TNF-α gene, the -308G→A, -850C→T polymorphism was examined in patients and healthy pregnant women by PCR-RFLP technique. The frequencies of genotype and allele were compared between the two groups. The re- sults showed that with -308G→A polymorphism distribution, the allele frequency of TNF2 and the frequency of the genotype TNF2/1 in the patient group was significantly higher in the patient group than in control group (P<0.05). A significant difference in genotype distribution of -850C→T poly- morphism was observed between the two groups. The allele frequencies of T in patient group was higher in the control group as compared with the patient group. The frequencies of CT and TT genotypes were lower in the patient group. It is concluded that the TNF2 allele of -308 is associated with the occurrence of hypertensive disorder complicating pregnancy, while T allele of -850 may be the protective factor against the development of the disease. TNF2/1 CC may be susceptibility genotype of hypertensive disorder complicating pregnancy.
文摘This paper aims to explore the diagnostic value of noninvasive?cardiac function measurement for hypertension in pregnancy. One hundred and fifty-eight cases of gestational hypertension in our hospital were analyzed retrospectively while 30 healthy pregnant women were served as normal controls. The heart function parameters in the two groups were measured with noninvasive cardiac function analyzer, such as myocardial contractive force indexes (JP, VP), impedance indexes (RTM, RS), volume load indexes (GCV, LVDP) and left heart output index (LCI). In all 158 cases of gestational hypertension, the myocardial contractive force indexes, impedance indexes and left heart output index increased unusually. The difference between the two groups was statistically significant (P < 0.05). The myocardial contractive force indexes and the impedance indexes increased significantly higher than left heart output index (P < 0.05). The noninvasive cardiac function measurement was much valuable in the early diagnosis of pregnancy-induced hypertension, especially the myocardial contractive force indexes, impedance indexes and left heart output index, it appeared to be simple and efficient, and it deserves to be clinically popularized and applied.
文摘Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects.90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology,including 30 cases in each of the hypertension group,the preeclampsia group,and the eclampsia group.Another 30 healthy pregnant women were selected as the control group.The serum cortisol levels of pregnant women in the above four groups were measured.Results:Compared with the control group,the serum cortisol levels in the other three groups were significantly increased.In perinatal outcome,compared with the control group,the three groups of patients had an increase in Apgar score,preterm birth,stillbirth rate,growth restriction rate and neonatal asphyxia rate.There were significant differences between groups(P<0.05),and showed as gestational hypertension<preeclampsia<eclampsia.Conclusion:With the exacerbation of hypertensive disorders during pregnancy,the serum cortisol level continues to increase,which has a serious adverse effect on the prognosis of the perinatal infants.
文摘Objective:To study the correlation between central retinal artery hemodynamic characteristics in patients with hypertensive disorder complicating pregnancy and endothelial injury molecules as well as trophoblast cell apoptosis molecules.Methods: 45 healthy pregnant women, 37 patients with gestational hypertension and 24 patients with preeclampsia who gave birth in Obstetrics Department of our hospital between May 2013 and December 2015 were selected and included in the control group, GH group and PE group respectively. Central retinal artery ultrasonography was done to determine peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI), serum was collected to determine interleukin-6 (IL-6), IL-17, IL-24, chemokine ligand 10 (CXCL10) and cartilage glycoprotein 40 (YKL40) content, and placenta tissue was collected to determine Fas, FasL, Bax, Caspase-3, Caspase-9, XIAP, Survivin and Livin expression.Results: Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of GH group and PE group were significantly lower than those of control group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of control group (P<0.05). Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of PE group were significantly lower than those of GH group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of GH group (P<0.05). Serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were negatively correlated with PSV and EDV, and positively correlated with RI;XIAP, Survivin and Livin expression in placenta were positively correlated with PSV and EDV, and negatively correlated with RI. Conclusions:Central retinal artery blood flow characteristics in patients with hypertensive disorder complicating pregnancy are the significantly increased blood flow resistance and the significantly decreased blood flow volume, and the above blood flow characteristics are associated with maternal endothelial injury and trophoblast cell apoptosis.
基金This study was funded by the Indonesia Endowment Fund for Education(LPDP)with Reference number S-422/LPDP.3/2018.
文摘Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with its synonyms or related words:"iron","supplement",“hypertensive disorders in pregnancy”through MEDLINE(OVID),CINAHL,PubMed,Cochrane Library,Scopus,Web of Science,ICTRP,and ClinicalTrials.gov,and manual search of references was used in seven potential resources.The inclusion criteria were randomized control trials(RCTs),published in English,full-text available,having healthy pregnant women without anaemia for study participants,and having hypertensive disorders in pregnancy at the end of pregnancy as the outcome.The risk of bias assessment tool was used for quality appraisal.Meta-analysis was conducted by calculating the fixed and random effects of the odds ratio(OR)for iron supplementation among non-anaemic pregnant women compared with the incidence of hypertensive disorders in pregnancy.The range of the study’s estimation accuracy was reflected by a 95%confidence interval(CI).Results:Four RCTs were included in the meta-analysis.The pooled results showed that iron supplementation possibly had no effect on the incidence of hypertensive disorders in pregnancy(OR 0.93,95%CI 0.81-1.07;P=0.30),gestational hypertension(OR 1.37,95%CI 0.69-2.73;P=0.36)as well as on the development of preeclampsia(OR 1.45,95%CI 0.71-2.97;P=0.31).Conclusions:Iron supplementation has no effect on the incidence of hypertension in non-anaemic pregnant women.In general,there is a lack of evidence for the association between iron supplementation and the incidence of hypertensive disorders in pregnancy among non-anaemic pregnant women,and further studies are needed.
文摘Introduction: Hypertension is one of the common problems associated with pregnancy that may be followed by eclampsia, acute renal failure, maternal death, premature delivery, intra-uterine growth restriction and other. This study was conducted to determine the results of pregnancies associated with hypertension in patients visiting in the Delivery Ward of Valiasr Hospital. Methods: A descriptive study was conducted on all the patients admitted to the aforementioned department and who possessed the inclusion criteria for hypertensive pregnancy. Results: Among the 1694 delivery cases examined, 173 cases had hypertension (9.8%). Among these, 75 (45%) had gesta-tional hypertension;24 (14.8%) had preeclampsia-eclampsia;30 (18%) had preeclampsia su-perimposed on chronic hypertension;21 (13.5%) cases had chronic hypertension;and 13 (8%) had pregnancy-aggravated chronic hypertension. Ninety-six point three percent (96.3%) had a systolic blood pressure (BP) of 140 - 190 mmHg, and 3.7% had a systolic BP greater than 190 mmHg. Whereas 61.1% of diastolic blood pressure 90 - 110 mmHg and 38.9% of the mothers had diastolic BP greater than 110 mmHg. The HELLP (Hemolysis, Elevated Liver enzymes & Low Platelet count) syndrome was present in 4.9% of cases;52.6% experienced premature delivery;7.4% had IUFD (intra uterine fetal death);9.9% had IUGR (intrauterine growth retardation);and 17.3% had LBW babies. Conclusions: Based on our results, hypertensive mothers who are younger and have lower weight babies at birth experience more perinatal complications. The unpleasant effects of hypertension in pregnancy warrant the need for training, routine prenatal care, the early detection and treatment of hypertension at younger ages of pregnancy, and follow-up after delivery.
文摘<strong><em>Introduction</em></strong><span style="white-space:normal;"><b><span style="font-family:;" "="">: </span></b></span><span style="white-space:normal;"><span style="font-family:;" "="">Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae. The objective of this study was to describe the prognosis in the postpartum period of patients with HDP in Departmental University Hospital of Borgou CHUD-B from Parakou in 2020. <b><i>Methods</i>: </b>The study was prospective with a descriptive and analytical design and was conducted from January 2020 to September 2020. Patients with HDP were recruited from the gynecology-obstetrics department and each followed for 3 months in the cardiology department. HDP was classified according to the International Society for the Study of Hypertension in Pregnancy, and blood pressure (BP) was taken according to WHO recommendations. Self-measurement of BP at home was performed to assess blood pressure control outside the hospital. Epidata 3.1 and SPSS 21 software were used for data processing and analysis. P values < 5% were considered statistically significant. <b><i>Results</i>: </b>During the study period, the hospital frequency of HDP was 15.6%. The frequency of maternal complications in the postpartum period was 28% (severe hypertension: 23.2%;eclampsia: 3.6%;puerperal psychosis: 1.2%). At the end of the three-month follow-up, blood pressure returned to normal in 73.2% of cases;it persisted in 26.8% of women. Factors associated with persistence of hypertension after multivariate analysis were, overweight/obesity RRa 8.664 [1.566 - 47.941], (p = 0.013);family history of hypertension RRa 6.499 [1.493 - 28.289], (p = 0.013);history of hypertension in previous pregnancies RRa 7.764 [1.561 - 38.601], (p < 0.012). <b><i>Conclusion</i>: </b>The frequency of HDP is not negligible at CHUD-B/A. The evolution of these HDP was marked in more than a quarter of cases by complications in the postpartum period followed by a persistence of hypertension 3 months after childbirth predicted by cardiovascular risk factors.</span></span>
文摘The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: It has been a descriptive cross-sectional study with a prospective collection of data using a questionnaire in prenatal consultation in the health center of Parakou’s commune for 4 months (May 1 to August 31, 2019). Result: A proportion of 8.2% (55/671) of the pregnancy had </span><span style="font-family:Verdana;">the hypertensive</span><span style="font-family:Verdana;"> disorders of pregnancy. </span><span style="font-family:Verdana;">The Gestational</span><span style="font-family:Verdana;"> HyperTension was the most common type of arterial hypertension (AHT) with a proportion of 49.1%. The factors associated with HDP were the age of 30 to 34 (OR: 11.9;95% CI: 1.54 - 92.29;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0346), the family history of Arterial HyperTension (AHT) (OR: 1.5;95% CI: 1.03 - 4.66;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0481), the BMI > 30 (OR:14.2;95% IC: 7.02 - 28.69;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0235), being married or in a common-law relationship (OR = 2.51;95% CI: 1.30 - 4.86;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0412), the stress (OR: 2.0;95% CI:1.09 - 3.32;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0209), the history of HDP (OR: 9.0;95% CI: 2.53 - 15.23;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> < 0.05). Conclusion: HDP </span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> common in Parakou. Some factors previously described in the literature are associated with them.
文摘Objective: To discuss the ultrasonic evaluation of fetal ventricular systolic function in hypertensive disorder complicating pregnancy and its correlation with the expression of placental hypoxia-related genes. Methods: A total of 98 late pregnant women with hypertensive disorder complicating pregnancy who were treated in the hospital between December 2014 and February 2017 were selected as hypertensive disorder complicating pregnancy group and 100 normal late pregnant women who received physical examination in the hospital during the same period were selected as normal control group. The ultrasonic parameters of fetal ventricular systolic function in two groups of pregnant women were detected before delivery, and the expression of hypoxia-related genes in placental tissue was detected by fluorescence quantitative PCR. Pearson test was used to assess the correlation between the parameters of fetal ventricular systolic function and placental hypoxia in hypertensive disorder complicating pregnancy. Results: The fetal left ventricular fractional shortening and right ventricular fractional shortening levels of hypertensive disorder complicating pregnancy group were lower than those of normal control group. Angiogenesis-related genes VEGF, netrin-1 and XIAP mRNA expression in placental tissue of hypertensive disorder complicating pregnancy group were lower than those in placental tissue of normal control group while HIF-1α mRNA expression was higher than that in placental tissue of normal control group;oxidative stress-related genes Nrf2, TAC3 and PrxⅡ mRNA expression in placental tissue were lower than those in placental tissue of normal control group;apoptosis genes Fas, p53 and caspase-9 mRNA expression in placental tissue were higher than those in placental tissue of normal control group while Bcl-2 and SFRP2 mRNA expression were lower than those in placental tissue of normal control group. Pearson test showed that the ultrasonic parameter levels of fetal ventricular systolic function in hypertensive disorder complicating pregnancy were directly correlated with the degree of placental hypoxia. Conclusion:Ultrasonic testing of fetal ventricular systolic function in hypertensive disorder complicating pregnancy can be used as a reliable method to measure the degree of placental hypoxia.
文摘Objective: To study the effect of folic acid and vitamin supplement on endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy. Methods: A total of 62 patients who were diagnosed with preeclampsia in Wuhan Red Cross hospital between March 2015 and February 2017 were selected as the research subjects and randomly divided into two groups, the observation group received folic acid, vitamin and conventional symptomatic treatment, and control group accepted conventional symptomatic treatment. Serum contents of endothelial injury markers and oxidative stress indexes were detected before treatment and 2 weeks after treatment;the expression of apoptosis genes in the placenta were detected after delivery. Results: 2 weeks after treatment, serum ET-1, tTG, sFlt-1, sEng, MPO, IMA, MDA and AOPP levels of both groups of patients were significantly lower than those before treatment, and serum ET-1, tTG, sFlt-1, sEng, MPO, IMA, MDA and AOPP levels of observation group were significantly lower than those of control group;after delivery, Fas, Bax and Caspase-3 mRNA expression levels in placenta tissue of observation group were significantly lower than those of control group while Bcl-2, Survivin and Livin mRNA expression levels were significantly higher than those of control group. Conclusion:Folic acid and vitamin supplement can significantly improve the endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy.
文摘Objective: To study the effect of low molecular weight heparin therapy on maternal endothelial injury and placental pathological injury after hypertensive disorder complicating pregnancy. Methods: A total of 70 patients with hypertensive disorder complicating pregnancy who were treated in the hospital between September 2014 and May 2016 were divided into control group and observation group according to the random number table method, 35 cases in each group. Control group received conventional therapy, the observation group received low molecular weight heparin combined with conventional therapy, and both therapies lasted until delivery. The differences in the levels of endothelial injury indexes in serum as well as the expression of oxidative stress indexes and apoptosis molecules in the placental grinding fluid were compared between the two groups of patients. Results: After treatment, serum ET and VCAM-1 levels of both groups of patients were lower than those before treatment while NO and PGE levels were higher than those before treatment, and serum ET and VCAM-1 levels of observation group were lower than those of control group while NO and PGE levels were higher than those of control group;after delivery, AOPP and MDA levels in placental grinding fluid were significantly lower than those of control group while SOD and GSH-Px levels were higher than those of control group;Fas, p53 and caspase-3 mRNA expression in placental grinding fluid were lower than those of control group while Bcl-2 and bax mRNA expression were higher than those of control group. Conclusion: Adjuvant low molecular weight heparin therapy can help to reduce the maternal endothelial injury, reduce the systemic oxidative stress and suppress the placental cell apoptosis in patients with hypertensive disorder complicating pregnancy.
基金supported by a grant from the National Nature Science Foundation of China (No. 30600679).
文摘To examine the changes in number and function of endothelial progenitor cells (EPCs) from peripheral blood (PB) in hypertension disorder complicating pregnancy (HDCP), 20 women with HDCP and 20 normal pregnant women at the third trimester were studied. Mononuclear cells (MNCs) from PB were isolated by Ficoll density gradient centrifugation. EPCs were identified by positive expression of both CD34 and CD133 under fluorescence microscope and positive expression of factor Ⅷ as shown by immunocytochemistry. The number of EPCs was flow-cytometrically determined. Proliferation and migration of EPCs were measured by MTT assay and modified Boyden chamber assay, respectively. The adhesion activity of EPCs was detected by counting the number of the adherent cells. The results showed that, compared with normal pregnant women, the number of EPCs was significantly reduced in HDCP (4.29%±1.21% vs 15.32%±2.00%, P<0.01), the functional activity of EPCs in HDCP, such as proliferation (13.45%±1.68% vs 18.45%±1.67%), migration (37.25±7.28 cells/field vs 67.10±9.55 cells/field) and adhesion activity (20.65±5.19 cells/field vs 34.40±6.72 cells/filed) was impaired (P<0.01). It is concluded that the number and function of EPCs are significantly decreased in HDCP.
基金Supported by Medical and Health Technology Project of Hangzhou,No.A20220540.
文摘BACKGROUND Juxtaglomerular cell tumor(JGCT)of the kidney,also known as reninoma,is a rare renal tumor that typically clinically manifests as hypertension,hypokalemia,high renin,and high aldosterone.It is a cause of secondary hypertension.Pregnancy with JGCT is rarer and easily misdiagnosed as pregnancy-induced hypertension,thus affecting treatment.CASE SUMMARY A 28-year-old woman presented in early pregnancy with hypertension(blood pressure of 229/159 mmHg),nausea,and occasional dizziness and headache.The patient was diagnosed with pregnancy-induced hypertension,and no relief was found after symptomatic treatment;hence,the pregnancy was terminated by artificial abortion.Her blood pressure remained high following termination of pregnancy.Blood tests suggested hypokalemia(2.997 mmol/L),blood aldo-sterone measured 613 ng/L,and computed tomography urography showed a tumor in the right kidney.Therefore,laparoscopic partial nephrectomy was performed.After surgery,the patient’s blood pressure returned to normal,and blood potassium,aldosterone,and renin normalized.Postoperative pathological examination revealed JGCT.After long-term follow-up,the patient became pregnant again 6 mo after surgery.No hypertension occurred during pregnancy,and the patient delivered a healthy female neonate.CONCLUSION Patients with pregnancy complicated by JGCT are difficult to diagnose.Herein,we advise surgeons on proper handling of such situations.
基金supported by National Natural Science Foundation of China(No.81172679/H2605)
文摘The prevalence of hypertensive disorders in China was much higher than that in the United States. Considering the large population with wide geographic area of China, we aimed to add more information regarding the risk factors for hypertensive disorders of pregnancy. A case-control study was performed on 373 hypertensive cases and 507 normotensive controls. Participants were recruited from 2008 to 2014 in Yichang Maternal and Child Health Care Center in Hubei province and Anyang Maternal and Child Health Care Hospital in Henan province, China. Socio-demographic factors, family-related factors, pregnancy-associated factors, factors related to daily life behaviors and psychosocial factors were investigated with respect to hypertensive disorders in pregnancy through well-designed questionnaire. Chi-square test, t-test, univariate logistic regression analysis, and multivariate logistic regression analysis were used to find the possible risk factors behind hypertensive disorders in pregnancy. The results showed that family history of cardiovascular diseases(OR=6.18, 95% CI, 2.37 to 16.14), history of pregnancy-induced hypertension(OR=16.64, 95% CI, 5.74 to 48.22), low maternal educational level(OR=2.81, 95% CI, 1.30 to 6.04), and poor relationship with their parents-in-law(OR=3.44, 95% CI, 1.55 to 7.59) had statistically significant associations with hypertensive disorders in pregnancy through multivariate logistic regression analysis. Increased maternal age, increased pre-pregnancy body mass index, living in rural area, low paternal education level, family history of hypertension, passive smoking one year before and/or in pregnancy, and poor sleeping quality were significantly associated with hypertensive disorders in pregnancy from univariate logistic regression analysis while the associations became uncertain when they were entered for multivariate logistic regression analysis. It was concluded that family history of cardiovascular diseases, history of pregnancy-induced hypertension, low maternal educational level, and poor relationship with their parents-in-law were independent risk factors for hypertensive disorders among Chinese pregnant women.
基金the Scientific Research Foundation for the Returned Overseas ChineseScholars, State Education Ministry (NO:200414519001).
文摘Expression of endogenous ouabain in placenta and the concentrations of serum ET-1 and NO were examined in 30 patients with hypertensive disorder complicating pregnancy (HDCP) and 30 healthy pregnant women to investigate the effect of endogenous ouabain on HDCP. Compared with the healthy pregnant group, the expression of endogenous ouabain dramatically increased in the HDCP groups (P<0.01). There was a significantly positive correlation between the expression of en- dogenous ouabain with ET-1 (r= 0.5567, P<0.01), while the correlation of endogenous ouabain and NO was significantly negative (r=-0.6895, P<0.01). As expected, the correlation between ET-1 and NO was negative (r=-0.7796, P<0.01). ET-1 concentrations of maternal and cord sera in HDCP groups were significantly higher in comparison with healthy pregnant group (P<0.01). On the con- trast, NO concentrations were much lower in the maternal and cord sera of HDCP groups as com- pared with healthy pregnant group (P<0.01). Our data suggest that endogenous ouabain is directly involved in the nosogenesis of HDCP, with accompanying decreased NO and the elevated of ET-1.
文摘Objective: To study the significance of Leptin and the activity of erythrocyte membrane Ca2+-ATPase(EMCA) in the development of hypertensive disorder complicating pregnancy. Methods: Radioimmunoassay was used to test the level of serum Leptin,and the activity of EMCA was determined chemically in 38 pregnant women with hypertensive disorder complicating pregnancy and 36 normotensive pregnant women. Results: The level of serum Leptin in hypertensive disorder complicating pregnancy(gestational hypertension: 13.76 ± 3.46 ng/ml; preeclampsia:15.76 ± 5.47 ng/ml; eclampsia: 18.32 ± 6.38 ng/ml)was significantly higher than that in normotensive pregnant women(11.33 ± 2.93 ng/ml),respectively. The average EMCA activity of patients with hypertensive disorder complicating pregnancy(gestational hypertension:1.65 ± 0.24 μmol·pi/mg·h ; preeclampsia:1.37 ± 0.19 μ mol·pi/mg·h; eclampsia:1.12 ± 0.14 μ mol·pi/mg·h) was significantly lower than that of normotensive pregnant women(1.83 ± 0.38 μ mol·pi/mg·h),respectively. There was a negative correlation between the level of serum Leptin and the activity of RMCA in hypertensive disorder complicating pregnancy(r = -0.63). Conclusion: Inhibition of EMCA activity of erythrocyte in hypertensive disorder complicating pregnancy may increase cytoplasmic free calcium, which contributes to the development of hypertensive disorder complicating pregnancy. The negative correlation between the level of serum Leptin and the activity of EMCA, also suggested that serum Leptin and the activity of EMCA may play a role in the development of hypertensive disorder complicating pregnancy.
