Hypertensive complications of pregnancy: A clinical overview

Antza, Christina; Cífková, Renata; Kotsis, Vasilios

doi:10.1016/j.metabol.2017.11.011

Cited by 63 publications

(37 citation statements)

References 82 publications

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“…A systolic/diastolic blood pressure (SBP/DBP) of 140/90 mm Hg is defined as gestational hypertension (HT). The etiology of HT is multifactorial, but nulliparity, obesity, stress, heredity, high maternal age, multiple pregnancy, diabetes, thrombophilia, kidney disease, chronic HT, and nutritional deficiency are all risk factors [ 2 ]. When HT is accompanied by proteinuria of at least 0.3g/day, it is defined as PE.…”

Section: Introductionmentioning

confidence: 99%

Magnesium Supplementation and Blood Pressure in Pregnancy: A Double-Blind Randomized Multicenter Study

Bullarbo

Mattson

Broman

et al. 2018

Journal of Pregnancy

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Objective To investigate the effect of magnesium (Mg) supplementation in healthy pregnant women for prevention of blood pressure increase. Secondary outcomes were comparison of biomarkers for hypertensive disorders and labour and fetal outcomes between the groups. Methods Two hundred nulliparous healthy pregnant women were double-blind randomized to receive Mg daily or placebo. Results There were no differences in blood pressure increase. However, among the Mg-treated women, there was a significant negative correlation between increase in blood levels of magnesium and increase in systolic blood pressure (p = 0.042). Magnesium supplementation seems to be safe for both mother and infant. Conclusion Magnesium supplementation in healthy first-time pregnant women is not to be recommended for prevention of blood pressure increase. Supplementation in risk pregnancies needs to be further investigated. The study is listed on the ISRCTN registry with study ID 13890849.

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Section: Introductionmentioning

confidence: 99%

Magnesium Supplementation and Blood Pressure in Pregnancy: A Double-Blind Randomized Multicenter Study

Bullarbo

Mattson

Broman

et al. 2018

Journal of Pregnancy

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“…Chemicals: Nanocurcumin (Gifted by Dr. B.P. Mohanty, CIFRI, ICAR, India), 18 β Glychrrhetinic Acid (MP Biochemicals, India), N G -nitro-Larginine methyl ester (L-NAME), 1H- [1,2,4] oxadiazolo [4, 3-a] quinoxaline-1one (Cayman Chemical, USA) and Carbenoxolone (Sigma, USA) were employed in this study. All the solutions were prepared fresh in triple-distilled water except for 18βGA, ODQ which were dissolved in dimethyl sulfoxide (DMSO) and indomethacin, which was dissolved in ethanol.…”

Section: Methodsmentioning

confidence: 99%

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2020

IJPSR

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The present study is designed to investigate vasorelaxation mechanisms of Nanocurcumin in the middle uterine artery (MUA) of both non-pregnant (NP) and pregnant (P) Capra hircus (Ch). Methods: MUA rings were mounted in an automatic organ bath and the contractile response was recorded isometrically by highly sensitive force transducer connected to a power lab data acquisition system. Nanocurcumin (1 pM-100 µM) vasorelaxation response (NCVR) was elicited in PEprecontracted rings either in the absence or presence of different blockers. Results: The maximal vasorelaxation (R max) to Nanocurcumin in phenylephrine-precontracted endothelium intact MUA rings of NP (40.36 ± 2.38%) and of P (44.09 ± 3.41%) was reduced to 22.93 ± 0.80% and 25.37 ± 2.2% in endothelium-denuded MUA rings of NP and P Ch. L-NAME, Indomethacin and L-NAME + Indomethacin inhibited NCVR by significantly decreasing the R max to 17.65%, 28.42%, 17.95% in NP and to 27.34%, 39.06%, 24.50% in P Ch. The ODQ and carbenoxolone/18β Glycyrrhetinic acid did not inhibit the R max of NCVR. Conclusion: Nanocurcumin potentially dilates the MUA of both NP and PCh. The endothelial L-NAME sensitive eNOS is activated by Nanocurcumin and it has the potential to increase blood flow to the uterus and fetus. Additionally, it could also be useful in the effective treatment of hypertensive disorders such as pre-eclampsia. INTRODUCTION: Hypertension is the most common health disorder of pregnancy and is reported to complicate up to 10% of pregnancies and is associated with increased maternal and neonatal morbidity and mortality 1. NO maintains vascular tone by relaxing vascular smooth muscle cells 2 .

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“…These complications may be difficult to distinguish from pregnancy-related hypertension (or preeclampsia) and gestational diabetes. 53,54 Pharmacokinetics in the Infant Tac can enter the fetal circulation through the placenta, 47,55,56 resulting in the possibility of fetotoxic and teratogenic effects. Tac was found in infants' blood at concentrations of 50%-70% lower than that of the mother, measured within 3 days after birth (median = 1.15 ng/mL versus 0.4 ng/mL 47 and median = 6.6 ng/mL versus 1.1 ng/mL 57 ).…”

Section: Pharmacokinetics Of Tac Pharmacokinetics In the Mothermentioning

confidence: 99%

Usage of Tacrolimus and Mycophenolic Acid During Conception, Pregnancy, and Lactation, and Its Implications for Therapeutic Drug Monitoring: A Systematic Critical Review

Le¹,

Francke

Andrews

et al. 2020

Therapeutic Drug Monitoring

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Background: Conception, pregnancy, and lactation following solid organ transplantation require appropriate management. The most frequently used immunosuppressive drug combination after solid organ transplantation consists of tacrolimus (Tac) plus mycophenolic acid (MPA). Here, the effects of Tac and MPA on fertility, pregnancy, and lactation are systematically reviewed, and their implications for therapeutic drug monitoring (TDM) are discussed. Methods: A systematic literature search was performed (August 19, 2019) using Ovid MEDLINE, EMBASE, the Cochrane Central Register of controlled trials, Google Scholar, and Web of Science, and 102 studies were included. Another 60 were included from the reference list of the published articles. Results: As MPA is teratogenic, women who are trying to conceive are strongly recommended to switch from MPA to azathioprine. MPA treatment in men during conception seems to have no adverse effect on pregnancy outcomes. Nevertheless, in 2015, the drug label was updated with additional risk minimization measures in a pregnancy prevention program. Data on MPA pharmacokinetics during pregnancy and lactation are limited. Tac treatment during conception, pregnancy, and lactation seems to be safe in terms of the health of the mother, (unborn) child, and allograft. However, Tac may increase the risk of hypertension, preeclampsia, preterm birth, and low birth weight. Infants will ingest very small amounts of Tac via breast milk from mothers treated with Tac. However, no adverse outcomes have been reported in children exposed to Tac during lactation. During pregnancy, changes in Tac pharmacokinetics result in increased unbound to whole-blood Tac concentration ratio. To maintain Tac concentrations within the target range, increased Tac dose and intensified TDM may be required. However, it is unclear if dose adjustments during pregnancy are necessary, considering the higher concentration of (active) unbound Tac. Conclusions: Tac treatment during conception, pregnancy and lactation seems to be relatively safe. Due to pharmacokinetic changes during pregnancy, a higher Tac dose might be indicated to maintain target concentrations. However, more evidence is needed to make recommendations on both Tac dose adjustments and alternative matrices than whole-blood for TDM of Tac during pregnancy. MPA treatment in men during conception seems to have no adverse effect on pregnancy outcomes, whereas MPA use in women during conception and pregnancy is strongly discouraged.

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Hypertensive complications of pregnancy: A clinical overview

Cited by 63 publications

References 82 publications

Magnesium Supplementation and Blood Pressure in Pregnancy: A Double-Blind Randomized Multicenter Study

Magnesium Supplementation and Blood Pressure in Pregnancy: A Double-Blind Randomized Multicenter Study

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Usage of Tacrolimus and Mycophenolic Acid During Conception, Pregnancy, and Lactation, and Its Implications for Therapeutic Drug Monitoring: A Systematic Critical Review

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