No abstract

Gestational hypertension (GH) is associated with adverse cardiometabolic and pregnancy outcomes. Though yoga is known to be beneficial in pregnancy, the effects of yoga rendered for twenty weeks starting from 16th week of gestation in pregnant women having risk of GH on the incidence of hypertension, cardiometabolic risks and fetomaternal outcomes have not been studied. A randomized control trial was conducted on 234 pregnant women having risk of GH receiving standard antenatal care (Control group, n = 113), and receiving standard care + yoga (Study group, n = 121). Interventions were given for twenty weeks starting at 16th week of gestation. Baroreflex sensitivity (BRS), heart rate variability (HRV), insulin resistance, lipid-risk factors, and markers of inflammation, oxidative stress and vascular endothelial dysfunction (VED) were assessed before and after intervention. Incidence of new-onset hypertension, level of cardiometabolic risks at 36th week, and fetomaternal-neonatal outcomes in the perinatal period, were noted. The link of hypertension, pregnancy outcomes and cardiometabolic risks with nitric oxide (NO), the marker of VED was assessed by analysis of covariance, Pearson’s correlations, and multilinear and logistic regressions. In study group, 6.61% women developed hypertension compared to 38.1% in the control group following 20-week intervention and there was significant decrease in risk of developing GH (RR, 2.65; CI 1.42–4.95). There was less-painful delivery, decreased duration of labor, increased neonatal birthweight and Apgar score in study group. Increase in total power of HRV (β = 0.187, p = 0.024), BRS (β = 0.305, p < 0.001), and decrease in interleukin-6 (β =  − 0.194, p = 0.022) had significant association with increased NO. Twenty weeks of practice of yoga during pregnancy decreases the incidence of hypertension, improves fetomaternal outcomes, and reduces cardiometabolic risks in pregnant women having risk of GH. Decreased blood pressure, increased HRV, BRS and birth weight and decreased inflammation were associated with improved endothelial function. Trial registration: Clinical Trials Registry of India (CTRI), registration number: CTRI/2017/11/010608, on 23.11.2017.

From this, we conclude that S. grandiflora protects the kidney against alcohol and PUFA-induced oxidative stress, which can be attributed to the phenolic compounds and anthocyanins present in the plant.

Background and Aim: Though the mechanisms responsible for the pathogenesis of Gestational Hypertension (GHT) are unclear, it has been reported that the disease is characterized by low circulating volume and high vascular resistance. The increased peripheral vascular resistance is caused due to sympathetic overactivity which in turn causes the increase in blood pressure and Cardiovascular risk (CV). Therefore, in the present study, we aimed to study the sympathovagal imbalance, Baroreflex Sensitivity (BRS) and Rate Pressured Product (RPP) in pregnant women with risk of developing GHT during their first and third trimesters of gestation. Methods: Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP) were measured. Rate-pressure product was calculated using SBP and HR. Spectral analysis of Heart Rate Variability (HRV), Blood Pressure Variability (BPV) including BRS were assessed in a group of pregnant women (n=18) with risk factors for GHT at 16 th week and 36th week of their gestation. Parameters were compared after 36 th week with 16th weeks and analyzed. Results: It was observed that the ratio of low-frequency to high-frequency power (LF-HF ratio) of HRV was significantly increased at 36 th week of pregnancy compared with 16 th week. There was decreased BRS at 36 th week of pregnancy in risk of GHT. Significant increase in RPP was seen at 36 th week of pregnant women with risk of developing GHT when compared with 16 th of gestation. Conclusion: In the present study we conclude that there is sympathovagal imbalance in pregnant women with risk of developing GHT. Also reduced BRS and increased RPP were seen in these subjects indicating that there was increased CV risk in these patients.

Hypertension is one of the most common medical problem encountered in about 15% of pregnancies and it contributes to 12% of maternal morbidity and mortality especially in developing countries of southeast Asia. The Autonomic Nervous System (ANS) has a prominent role in the cardiovascular system adaptation to pregnancy. However, in gestational hypertension, sympathetic overactivity leads to intense vasoconstriction that results in hypertension. Current evidence suggests that sympathovagal imbalance is highly prevalent in women with Gestational Hypertension (GHT). The sympathovagal imbalance is a major cardiovascular risk in hypertensive disorders including the hypertensive disorders of pregnancy. Thus, sympathovagal imbalance is not only the physiological mechanism for genesis of hypertension in GHT, but also a major contributor to cardiovascular risk in GHT.

Background: The incidence of low birth weight babies continues to be high in India at about 30% in contrast to 5-7% in developed countries. Perinatal, neonatal and infant mortality as well as morbidity is associated with low birth weight (LBW) neonates of which, it is the Small for Gestational Age (SGA) neonates that are at increased risk. Henceforth, it becomes important to study the prevalence of SGA babies and to compare various anthropometric measurements among term neonates for assessing as to which of these could be taken as surrogate markers of small for gestational age babies.Methods: It was a cross sectional study conducted over a period of 2 years among 100 term neonates delivered in a private medical college in Puducherry, India.Results: The prevalence of low birth weight babies and small for gestational age was found to be 40% and 30% respectively. Using mid arm circumference as a predictor, the sensitivity, specificity, positive predictive value and negative predictive value of SGA was found to be 100%, 57.14%, 50% and 100% respectively. Using MAC/HC ratio as a predictor, the sensitivity, specificity, positive predictive value and negative predictive value was found to be 46.67%, 100%, 100% and 81.4% respectively.Conclusions: In predicting SGA babies, mid arm circumference has the highest sensitivity whereas MAC/HC ratio has the highest specificity followed by mid arm circumference. Present study concluded that mid arm circumference and ratio of MAC/HC are very helpful in identifying SGA neonates among term neonates.