Outline of Definition and Classification of “Pregnancy induced Hypertension (PIH)”

Watanabe, Kazushi; Naruse, Katsuhiko; Tanaka, Kanji; Metoki, Hirohito; Suzuki, Yukiko

doi:10.14390/jsshp.1.3

Cited by 114 publications

(75 citation statements)

References 9 publications

(6 reference statements)

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“…In addition, 49 healthy preg-hypertension (PIH) was defined as patients with persistent blood pressure elevation to a systolic level of 140 mmHg or a diastolic level of 90 mmHg on two occasions, several hours apart, with or without proteinuria of > 300 mg in a 24-h urine collection according to the definition of PIH by the Japan Society of Obstetrics and Gynecology [13]. Fetal growth restriction (FGR) was a fetal estimated weight that is below the -1.5SD for the standard deviation of estimated weight from Japanese standard fetal weight [14].…”

Section: Methodsmentioning

confidence: 99%

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

et al. 2015

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POLYCYSTIC OVARY SYNDROME (PCOS) is a common endocrine and metabolic disorder present in 5-15% of women of reproductive age depending on the diagnostic criteria used [1,2]. The common features of PCOS are hyperandrogenism, irregular menstruation and polycystic ovaries by ultrasonography [3,4]. In addition, insulin resistance, hyperandrogenism and obesity might play important roles in the pathophysiologic process of PCOS, and the interaction of these factors might result in an increased risk of not only type 2 diabetes mellitus, metabolic syndrome and cardiovascular disease [5][6][7] Abstract. Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by insulin resistance and hyperandrogenism. The interaction of these factors might result in increased risks of miscarriage and pregnancy complications such as gestational diabetes mellitus (GDM). To examine the pregnancy risks in women with PCOS, we compared obstetrical outcomes between patients with and without PCOS. We also studied the differences in maternal characteristics, glucose intolerance and pregnancy complications between PCOS patients with and without GDM, with and without obesity, and between successful pregnancies and miscarriages. We observed a high incidence of GDM and prevalence of GDM diagnosis in the first trimester in PCOS. Patients with GDM had higher body mass index (BMI) and lower homeostasis model assessment of β-cell function (HOMA-β) at preconception than those without GDM. Obese pregnant women with PCOS demonstrated a high incidence of GDM with severe insulin resistance, including high fasting insulin, HOMA of insulin resistance (HOMA-IR), and HOMA-β at preconception compared with normal-weight patients. BMI was significantly correlated with HOMA-IR or HOMA-β, and both indices were lower in PCOS patients with than without GDM for the same BMI. There were no significant differences in maternal characteristics (excluding maternal age) between PCOS patients with successful pregnancy and PCOS patients with miscarriages. Our data suggest that pregnant women with PCOS have an increased risk of GDM, especially if they have obesity and/or poorer insulin secretion. Measure of β-cell function, such as HOMA-β, at preconception might be a useful predictor of the risk of GDM in pregnant PCOS patients.Key words: Polycystic ovary syndrome, Insulin resistance, Pregnancy complication, Gestational diabetes mellitus gestational diabetes mellitus (GDM) [8].Because insulin resistance and obesity might affect the course of pregnancy in women with PCOS, we compared the obstetrical outcomes between the patients with PCOS and without PCOS. We also examined the differences in maternal characteristics and perinatal outcomes between PCOS patients with and without GDM and with and without obesity. Furthermore, we examined the differences in maternal characteristics between successful pregnancies and miscarriages to determine the risks of pregnancy loss in women with PCOS. Materials and MethodsA total of 64 Japanese pregnant women with PCOS (includ...

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Section: Methodsmentioning

confidence: 99%

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

et al. 2015

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“…Preeclampsia was defined as hypertension (systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg on two separate occasions) and proteinuria ( > 300 mg/24 h) arising de novo after the 20th week of pregnancy. 7) Fetal loss was defined as fetal death after 22 weeks of gestation and premature birth (preterm) as live birth before 37 weeks of gestation. Diagnosis of antiphospholipid syndrome was established according to the updated Sapporo classification.…”

Section: Methodsmentioning

confidence: 99%

Disease flare-ups and obstetric outcomes in pregnant women with systemic lupus erythematosus

Takahashi

Mimura

Kanagawa

et al. 2013

Hypertens Res Pregnancy

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Aim:The purpose of this study was to review the maternal and fetal outcomes in pregnant women with systemic lupus erythematosus (SLE), and to evaluate the prognostic risk factors that may contribute to obstetric outcomes or SLE flareups. Methods: We evaluated 100 births in 97 SLE patients who were seen at Osaka University from 1995 to 2013. Main outcome measures included obstetric outcomes and SLE flare-ups. Results: The mean patient age was 30.7 ± 4.6 years, and the nulliparity rate was 62.8%. Corticosteroids were taken by 75.3% of the patients, and 48.5% were on a dosage of ≥ 7.5 mg /day. Disease flare-up and preeclampsia occurred in 17.5% and 11.3% of the patients, respectively. Seven SLE flare-ups (41.2%) occurred after delivery. Fourteen of the patients with a flare-up were taking high dose corticosteroids ( ≥ 7.5 mg /day) and showed significantly poorer obstetric outcomes compared to patients taking low dose corticosteroids ( < 7.5 mg /day) (P = 0.0021). Conclusions: A multidisciplinary approach in the care of pregnant women with SLE is important for good maternal and fetal outcomes. Furthermore, a high daily dosage of corticosteroids may be a prognostic risk factor for adverse SLE flare-ups.

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“…1 According to the Canadian Hypertension Society, PIH refers to one of four conditions: a) pre-existing hypertension, b) gestational hypertension and pre-eclampsia, c) pre-existing hypertension plus superimposed gestational hypertension with proteinuria and d) unclassifiable hypertension. 2 Leading cause of maternal deaths due to hypertensive disorders ranges from 6 to 10% for which the leading risk factor is intra cerebral hemarrohage.…”

Section: Introductionmentioning

confidence: 99%

A prospective, parallel group, open label, observational study to compare efficacy and feto-maternal outcomes in treatment of pregnancy induced hypertensive patients

Afreen¹,

Rishtha²,

Swathi³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Pregnancy induced hypertension (PIH) is defined as elevation in blood pressure 140/90 mmHg or greater after 20 weeks of gestation on two occasions more than 4 hours apart in a newly diagnosed patients. Complications of pregnancy are the major health problems leading to maternal and perinatal mortality and morbidity. Some anti-hypertensive drugs are commonly used to control hypertension.Methods: A prospective, parallel group, open label observation study was carried out at SVS Medical Hospital, Mahabubnagar. Patients were divided into three groups based on severity of hypertension and the drug used for treatment.Results: Of 120 patients diagnosed with PIH majority (50%) of women were in the age group of 21-24 years with 33-37 gestational age. In the present study there was a significant reduction in BP after the treatment with Labetalol when compare to Nifedepine and Methyldopa. Although, all the three groups have shown significant reduction in BP during 24 hrs treatments and the mean time to achieve target BP was shown less in Labetalol group when compare to Methyldopa and Nifedepine and the maximum doses required to achieve target BP was in between 4-6 doses/day. 40% of complication observed was HELLP syndrome.Conclusions: Our study coincides with the previous findings that labetolol is an efficacious and safer drug for use in control of PIH and mean time required to achieve target BP is low when compared to nifedipne and methyldopa.

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Outline of Definition and Classification of “Pregnancy induced Hypertension (PIH)”

Cited by 114 publications

References 9 publications

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

Disease flare-ups and obstetric outcomes in pregnant women with systemic lupus erythematosus

A prospective, parallel group, open label, observational study to compare efficacy and feto-maternal outcomes in treatment of pregnancy induced hypertensive patients

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