Female ; Humans ; Pre-Eclampsia ; etiology ; physiopathology ; Pregnancy

Preeclampsia is represented by hypertension and proteinuria in pregnancy. It usually occurs after 20 gestational weeks. There are few reports on preeclampsia before 20 gestational weeks. In this case, we report a patient with chronic hypertension superimposed with preeclampsia at 13 gestational weeks.
Adult ; Female ; Gestational Age ; Humans ; Hypertension ; physiopathology ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications

Antiphospholipid syndrome (APS) refers to a group of clinical symptoms and signs caused by antiphospholipid antibody (aPLA). We reported a rare case of poor outcome of a pregnant woman with APS. The pregnant woman had APS, hemolytic anemia, elevated liver function and low platelet count (HELLP) syndrome, and eclampsia and had a poor outcome from a second pregnancy. She was treated with antispasmodics, sedatives, and anti-hypertensive agents, along with anticoagulant therapy and infusion of immunoglobulin. APS during pregnancy often makes pregnancy even more complex and risky. Obstetricians should carry out anticoagulation treatment throughout the perinatal period.
Abortion, Induced ; adverse effects ; Adult ; Antiphospholipid Syndrome ; complications ; Eclampsia ; etiology ; Female ; HELLP Syndrome ; etiology ; Humans ; Pre-Eclampsia ; physiopathology ; Pregnancy

Aortic dissection accompanying with preeclampsia during pregnancy can be lethal to both the mother and the fetus and carries a high mortality. Of the 2 preeclampsia patients with aortic dissection, one was Type B aortic dissection, occurring in postpartum period. The patient was treated medically and underwent catheter-based stent-graft treatment with fenestration technique. Another patient was Type A acute dissection, occurring in the third trimester. This patient was undiagnosed and both died. Although extremely rare, aortic dissection might be a possibility in preeclampsia pregnant women, the differential diagnosis of chest and/or epigastric pain in preeclampia patient should be thoroughly investigated and treated.
Adult ; Aneurysm, Dissecting ; diagnosis ; etiology ; Female ; Humans ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications, Cardiovascular

OBJECTIVETo study the relationship between preeclampsia umbilical blood flow changes and the pregnancy outcomes.

METHODThe umbilical arterial blood flow parameters including the S/D, pulsatility index (PI), resistance index (RI) and the average birth weight, Apgar score and placental weight changes were analyzed in 106 preeclampsia patients (including 43 mild and 63 severe cases), with 89 women with normal pregnancy as the control. The relation between the blood flow parameters and the perinatal outcomes were analyzed.

RESULTSS/D, PI, and RI all tended to increase with the severity of preeclampsia, and these indices were significantly higher in patients with severe preeclampsia than in the control group (P<0.01) but showed no significant differences between mild preeclampsia group and the control group (P>0.05). The average birth weight of the newborns, Apgar scores, and placental weight were significantly lower (P<0.01), and the incidence of fetal growth restriction (FGR) and perinatal mortality significantly higher in severe preeclampsia group than in the control group (P<0.01). No significant differences were found in these parameters between the mild preeclampsia and the control groups (P>0.05).

CONCLUSIONSUmbilical artery blood flow parameters as indicators for determining the fetal status can be used to predict the pregnancy outcomes.

Adult ; Case-Control Studies ; Female ; Humans ; Perinatal Mortality ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Outcome ; Umbilical Cord ; blood supply ; Young Adult

Research on the association between maternal periodontal disease and the risk of preeclampsia has generated inconsistent results. This meta-analysis was conducted to evaluate the association between maternal periodontal disease and the risk of preeclampsia. A literature search of PubMed and Embase was performed to identify relevant papers published before March 2013. Only observational studies that assessed maternal periodontal disease and the risk of preeclampsia were selected. Patients' periodontal status was examined at different time points during pregnancy or after delivery (at 14-32 weeks of gestation, within 48 h prior to or within 5 days after delivery). Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated for cases and controls. Cases were defined as women with concurrent hypertension and proteinuria after 20 weeks of gestation. Eleven studies involving 1118 women with preeclampsia and 2798 women without preeclampsia were identified and analyzed. Women with periodontal disease before 32 weeks of gestation had a 3.69-fold higher risk of developing preeclampsia than their counterparts without periodontal disease (OR=3.69; 95% CI=2.58-5.27). Periodontal disease within 48 h prior to delivery was associated with a 2.68-fold higher risk of preeclampsia (OR=2.68; 95% CI=1.39-5.18). Pregnant women with periodontal disease within 5 days after delivery had a 2.22-fold higher risk of preeclampsia than women without periodontal disease (OR=2.22; 95% CI=1.16-4.27). In conclusion, this meta-analysis suggests that maternal periodontal disease is an independent predictor of preeclampsia.
Adult ; Female ; Humans ; Observational Studies as Topic ; Odds Ratio ; Periodontal Diseases ; physiopathology ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications ; physiopathology ; Risk Assessment ; statistics & numerical data ; Risk Factors

BACKGROUNDWomen with a history of preeclampsia have twice the risk of cardiovascular diseases, and there is a graded relationship between the severity of preeclampsia and the risk of cardiac disease. Moreover, metabolic scores are associated with developing preeclampsia. However, since there are no diagnostic criteria for metabolic syndrome during pregnancy and pregnant women undergo metabolic changes, it is difficult to elucidate the relationship between preeclampsia and metabolic syndrome. We carried out a cross-sectional study to investigate the relationship between metabolic syndrome and preeclampsia among women with a history of severe preeclampsia shortly after an indexed pregnancy.

METHODSWe recruited 62 women with a history of severe preeclampsia 1 to 3 years after an indexed pregnancy. Blood pressure and body compositional indices were recorded. Fasting blood samples were tested for glucose, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, triglycerides, and insulin. A questionnaire was used to collect demographic data including pre-pregnancy weight and family history of diseases associated with cardiovascular diseases. Criteria for metabolic syndrome were defined by the National Cholesterol Education Program, Adult Treatment Panel III 2001 (NCEP III) and International Diabetes Federation 2005 (IDF). Data were analyzed by the a2 test and multivariate Logistic regression.

RESULTSAccording to NCEP III and IDF standards, 17 (27%) and 24 (39%) women, respectively, were identified as having metabolic syndrome. Being overweight pre-pregnancy and currently overweight were risk factors, and currently overweight was an independent risk factor. A combination of blood pressure and waist circumference was predictive of metabolic syndrome with a sensitivity of 91.67% and specificity of 94.74%.

CONCLUSIONSAn unfavorable metabolic constitution in women may lead to metabolic syndrome, preeclampsia, and long-term cardiovascular disease. In women with severe preeclampsia, therapeutic interventions should include weight-control shortly after pregnancy, especially among women who were previously overweight.

Adult ; Cardiovascular Diseases ; epidemiology ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Metabolic Syndrome ; epidemiology ; physiopathology ; Middle Aged ; Pre-Eclampsia ; epidemiology ; etiology ; Pregnancy ; Risk Factors

OBJECTIVE: It is uncertain whether preeclampsia (PE) is caused by pre-existing factors or by pregnancy itself. We want to answer this important question in public health by conducting a large pre-conception cohort in China. METHODS: A prospective and pre-conception cohort study with a target recruitment of 5000 couples who plan to have a baby within 6 months was performed and their conception, delivery, and postpartum were followed up in Liuyang county, Hunan Province of P. R. China. RESULTS: A total of 1915 young couples have been recruited into this unique pre-conception cohort till now. In general, both systolic blood pressure and diastolic blood pressure decreased in early second trimester from pre-conception level but increased in third trimester and at delivery. CONCLUSION The proposed pre-conception cohort study will have important theoretical and practical implications on the prevention of PE and its associated cardiovascular disease risks.
Adult ; Blood Pressure ; physiology ; China ; Female ; Humans ; Pre-Eclampsia ; etiology ; physiopathology ; prevention & control ; Pregnancy ; Pregnancy Complications, Cardiovascular ; physiopathology ; prevention & control ; Prospective Studies ; Young Adult

This study examined in vitro effect of lipoxin A(4) (LXA(4)) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE). Peripheral venous blood was drawn from 15 patients with severe preeclampsia (PE group) and 20 normal pregnant women (control group) to prepare monocytes which were then treated with LXA(4) at different concentrations of 0, 10, 100 nmol/L respectively. IL-1β level in the supernatant of monocytes was detected by enzyme linked immunoassay. The [Ca(2+)](i) of monocytes was measured by laser scanning confocal microscopy. The results showed that the IL-1β level and the [Ca(2+)](i) of monocytes in the PE group were significantly higher than those in the control group. LXA(4) significantly decreased the generation of IL-1β in a dose-dependent manner in the PE group. After treatment with 100-nmol/L LXA(4), in the PE group, the [Ca(2+)](i) concentration of monocytes was significantly reduced. It was concluded that LXA(4) may inhibit the IL-1β production of monocytes from severe preeclampsia women by inhibiting extracellular calcium influx.
Adult ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; Calcium ; metabolism ; Cells, Cultured ; Female ; Humans ; Interleukin-1beta ; biosynthesis ; Lipoxins ; pharmacology ; Monocytes ; cytology ; metabolism ; Pre-Eclampsia ; blood ; physiopathology ; Pregnancy

BACKGROUNDPregnant women with heart disease are at high risk. Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes. In this paper, we try to discuss the main risk factors of cardiac events in pregnant women with heart disease and to establish a risk assessment system.

METHODSA retrospective analysis was carried out for pregnancies in 1741 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and September 2010. A Logistic regression model was used to identify independent risk factors of cardiac events and calculate the risk index in pregnant women with heart disease.

RESULTSThe composition of heart disease in pregnant women was arrhythmia (n = 662, 38.00%), congenital heart disease (CHD; n = 529, 30.40%), cardiomyopathy (n = 327, 18.80%), rheumatic heart disease (RHD; n = 151, 8.70%), and cardiopathy induced by pre-eclampsia (n = 53, 3.00%). Main cardiac events were heart failure (n = 110, 6.32%), symptomatic arrhythmia needing medication (n = 43, 2.47%), cardiac arrest (n = 2, 0.11%), syncope (n = 3, 0.17%), and maternal death (n = 10, 0.57%). Six independent risk factors to predict cardiac events in pregnant women with heart disease were cardiac events before pregnancy (heart failure, severe arrhythmia, cardiac shock, etc., P = 0.000), New York Heart Association (NYHA) class > II (P = 0.000), oxygen saturation < 90% (P = 0.018), pulmonary artery hypertention (PAH) > 50 mmHg (P = 0.025), cyanotic heart disease without surgical correction (P = 0.015), and reduced left ventricular systolic function (ejection fraction < 40%, P = 0.003). Every risk factor was calculated as 1 score. The incidence of cardiac events in patients with scores 0, 1, 2, 3, and ≥ 4 was 2.10%, 31.61%, 61.25%, 68.97%, and 100.00% respectively.

CONCLUSIONSPregnancy with heart disease could lead to undesirable pregnancy outcomes. The risk of cardiac events in pregnant women with heart disease could be assessed by risk index.

Arrhythmias, Cardiac ; epidemiology ; Cardiomyopathies ; epidemiology ; Female ; Heart Defects, Congenital ; epidemiology ; Heart Diseases ; epidemiology ; Heart Failure ; epidemiology ; Humans ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Retrospective Studies ; Risk Factors