Effects of intra-abdominal hypertension on maternal-fetal outcomes in term pregnant women: A systematic review

Correia, Maria Luísa Arruda; Filho, Fernando Maia Peixoto; Júnior, Saint Clair Gomes; Peixoto, Maria Virgínia Marques

doi:10.1371/journal.pone.0280869

Cited by 3 publications

(3 citation statements)

References 34 publications

(97 reference statements)

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“…According to the latest systematic review, the antepartum IAP in singleton normotensive pregnancies ranged from 7.3 to 14.1 mmHg. The postpartum IAP ranged from 3.7 to 10.8 mmHg [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

The association between maternal intra-abdominal pressure and hypertension in pregnancy

Jayasundara,

Goonewardene,

Dassanayake

2023

PLoS ONE

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Introduction Pregnancy leads to a state of chronically increased intra‐abdominal pressure (IAP) caused by a growing fetus, fluid, and tissue. Increased intra-abdominal pressure is leading to state of Intra-Abdominal Hypertension (IAH) and Abdominal Compartment Syndrome. Clinical features and risk factors of preeclampsia is comparable to abdominal compartment syndrome. IAP may be associated with the hypertension in pregnancy (HIP). Objectives The study aimed to determine the antepartum and postpartum IAP levels in women undergoing caesarean delivery (CD) and association between hypertension in pregnancy, and antepartum and postpartum IAP levels in women undergoing CD. Method Seventy pregnant women (55 normotensive, 15 HIP) undergoing antepartum, non-emergency CD, had their intravesical pressure measured before and after the CD, the intravesical pressure measurements obtained with the patient in the supine position were considered to correspond to the IAP. Multivariable linear regression models were used to study associations between intraabdominal pressure and baseline characteristics in normotensive pregnancies and hypertensive pregnancies. Results In normotensive pregnancies at mean gestation age of 38.2 weeks (95%CI 37.9 to 38.6), mean antepartum IAP was 12.7 mmHg(95%CI 11.6 to 13.8) and the mean postpartum IAP was 7.3 mmHg (95% CI 11.6 to 13.8). Multivariable linear regression models showed HIP group antepartum IAP positively associated with coefficient value of 1.617 (p = 0.268) comparing with normotensive pregnancy group. Postpartum IAP in HIP group positively associated with coefficient value of 2.519 (p = 0.018) comparing with normotensive pregnancy group. IAP difference is negatively associated with HIP (coefficient -1.013, p = 0.179). Conclusion In normotensive pregnancies at term, the IAP was in the IAH range of the non-pregnant population. Higher Antepartum IAP and Postpartum IAP are associated with HIP. Reduction of IAP from antepartum period to postpartum period was less with HIP.

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“…According to the latest systematic review, the antepartum IAP in singleton normotensive pregnancies ranged from 7.3 to 14.1 mmHg. The postpartum IAP ranged from 3.7 to 10.8 mmHg [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

The association between maternal intra-abdominal pressure and hypertension in pregnancy

Jayasundara,

Goonewardene,

Dassanayake

2023

PLoS ONE

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“…Even in uncomplicated pregnancies, the bigger is the maternal BMI, the higher the resistance in UA [39]. Obesity is also related to increased intra-abdominal hypertension, which represents a risk of venous congestion and abdominal compartment syndrome [40].…”

Section: Plos Onementioning

confidence: 99%

“…In addition, uterine development would alter IAP, which would generate patterns of abdominal hypertension (AIH), accommodated by a significant portion of pregnant women. Adaptation to increased IAP would be correlated with the ability to adapt abdominal compliance to increased pregnancy content [40,[48][49][50][51][52].…”

Section: Plos Onementioning

confidence: 99%

Effects of osteopathic manipulative treatment on maternal-fetal hemodynamics in third trimester pregnant women: A prospective study

Arruda Correia,

Peixoto Filho,

Gomes Júnior

et al. 2024

PLoS ONE

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Objective To evaluate the maternal-fetal hemodynamic effects after osteopathic manipulative treatment by measuring vital signs and Doppler velocimetry in third-trimester pregnant women. Materials and methods This is a prospective study with pregnant women undergoing outpatient follow-up and hospitalized in a ward at Instituto Fernandes Figueira/Fiocruz, between August 2021 to August 2022, during the SARS-CoV-2 pandemic. This study was registered in REBEC under Register Number RBR-9q7kvg and approved by the ethics committee under number 32216620.0.0000.5269. The study population was composed of 51 pregnant women between 28 and 40 weeks of gestation, over 18 years of age, allocated in a single group. Pregnancies with multiple fetuses, malformations, premature rupture of the membrane, and active labor were excluded. The procedures evaluated maternal-fetal hemodynamics using three consecutive measures of ultrasound examination with Doppler velocimetry, and three maternal vital signs measured by an electronic blood pressure monitor. Results Most vital signs changed after osteopathic treatment. However, only the systolic blood pressure (109.92 ±14.42 to 110.71±12.8, p = 0.033), diastolic blood pressure (79.8±11.54 to 77.57±9.44, p = 0.018) and heart rate (87.59±11.93 to 81.12±10.26, p = 0.000) in the sitting position, systolic blood pressure (110.75±13.26 to 108.59±13.07; p = 0.034) in the supine, and heart rate (83.22±11.29 to 80.39±11.0; p = 0.013) in left lateral decubitus reached statistical significance. The oximetry measures (98.55±0.64 to 98.67±0.68; p = 0.098) stayed stable during all three positions. All artery values remained stable after treatment, and no statistically significant difference was recorded in the artery results. Conclusion Responses to osteopathic treatment in women in the third trimester of pregnancy did not affect uteroplacental and fetoplacental circulation. However, some maternal vital signs had statistically significant results, with a decrease in diastolic blood pressure and heart rate, and an increase in systolic blood pressure in the sitting position, a decrease of heart rate in the left lateral decubitus position, and systolic blood pressure in the supine position. All the results observed were maintained in the normal parameters. The study responses attest to the safety of using the osteopathic manipulative treatment for the fetus and for pregnant women with comorbidities.

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Bioinformatics study and experimental validation of METTL3 regulation of immune-related genes affecting placental vascular development

Zhao,

Du,

Yang

et al. 2023

Preprint

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The proper development of the placental vascular system is a crucial factor in ensuring fetal health. m6A modification is a key pathophysiological mechanism in placental vascular development. However, the specific mechanism by which m6A influences placental vascular development remains unclear. Here, we explored the role of 21 m6A regulators in placental development based on the Gene Expression Omnibus (GEO) database. Following a series of machine learning techniques, METTL3 was recognized as the pivotal m6A regulator. We subsequently employed consensus clustering analysis to delineate two distinct m6A isoforms, and investigated their correlation with immune cells. Further, through weighted gene co-expression network analysis (WGCNA) coupled with correlation analysis, we pinpointed METTL3-associated placental development genes. These genes were notably enriched in immune-related categories. Furthermore, we uncovered immune-related differentially expressed genes that were associated with differentially expressed m6A regulators. Additionally, we performed an immune infiltration analysis to gain a deeper understanding of how these genes interact with immune cells. Ultimately, to validate our findings, we carried out animal experiments. In conclusion, our study found that targeting METTL3 could affect placental vascular development, which may provide guidance for the clinical treatment of placental-like diseases.

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Effects of intra-abdominal hypertension on maternal-fetal outcomes in term pregnant women: A systematic review

Cited by 3 publications

References 34 publications

The association between maternal intra-abdominal pressure and hypertension in pregnancy

The association between maternal intra-abdominal pressure and hypertension in pregnancy

Effects of osteopathic manipulative treatment on maternal-fetal hemodynamics in third trimester pregnant women: A prospective study

Bioinformatics study and experimental validation of METTL3 regulation of immune-related genes affecting placental vascular development

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