Pregnancy and Severe Chronic Hypertension: Maternal Outcome

Gracia, Paulino Vigil-De; Montúfar-Rueda, Carlos; Smith, Alejandro

doi:10.1081/prg-200030315

Cited by 25 publications

(15 citation statements)

References 13 publications

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“…Vigil-De Gracia et al stated that eclampsia was not detected in women with superimposed preeclampsia suggesting different pathophysiological abnormalities leading to development of eclampsia in women with or without chronic hypertension. 9 The results of this study reinforced the hypothesis of Vigil-De Gracia et al Similar to our results; Vigil-De Gracia et al did not find any difference in preterm delivery at 37 weeks of gestation between the groups. They also suggested that perinatal outcomes after expectant management were not different in women with superimposed preeclampsia compared to severe preeclampsia.…”

Section: Discussionsupporting

confidence: 82%

The Obstetric Outcomes in Women with Preeclampsia and Superimposed Preeclampsia

Şimşek¹,

Uludağ²,

Tüten³

et al. 2017

Turkiye Klinikleri J Gynecol Obst

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here is an increasing tendency towards delayed childbearing. The risk of hypertensive disorders in pregnancy increases gradually with age. 1 The hypothesis that superimposed preeclampsia results in worseThe Obstetric Outcomes in Women with Preeclampsia and Superimposed Preeclampsia A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: This study was performed to compare the obstetric outcomes between preeclampsia and superimposed preeclampsia cases. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This retrospective study included 500 women with preeclampsia and 101 women with superimposed preeclampsia who delivered in a tertiary care center. Clinical findings, maternal and perinatal outcomes were compared between the two groups. R Re es su ul lt ts s: : In cases of preeclampsia, antenatal, perinatal, neonatal mortality rates were 13.4%, 17.9%, 5.1% respectively. The rate of cases which mother's life at risk was 30.2%. The antenatal, perinatal and neonatal mortality rates were 12.9%, 19.8%, and 8.9%, respectively, in cases of superimposed preeclampsia and the rate of cases where mother's life was at risk was 25.7%. There was no significant difference between the two groups in terms of time of onset of the symptoms (p = 0.669), mean birth week (p = 0.410) and birth weight (p= 0.340). Rates of intrauterine growth retardation (p = 0.434), early and late neonatal loss (p = 0.111, p = 0.848) and stillbirth (p = 0.887) did not differ between the groups. Although maternal deaths and maternal near miss cases were not significantly different between the two groups (p=0.370), the rate of complication with eclampsia in preeclampsia cases was higher than that of superimposed preeclampsia cases (p=0.001). C Co on nc cl lu us si io on n: : Preeclampsia and superimposed preeclampsia have similar obstetric outcomes. Further research is needed to elucidate the mechanisms underlying eclampsia in preeclampsia cases.K Ke ey yw wo or rd ds s: : Pre-eclampsia; perinatal mortality; maternal mortality; pregnancy outcome Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışma preeklampsi ve süperimpoze preeklampsi olgularının obstetrik sonuçlarını karşılaştırmak amacıyla gerçekleştirilmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : B Bu u ç ça al lı ış şm ma ay ya a ü üç çü ün nc cü ü b ba as sa am ma ak k bir sağlık biriminde doğumları gerçekleştirilen 500 preeklampsili ve 101 süperimpoze preeklampsili gebe dahil edildi. Hasta dosyaları geriye dönük olarak incelendi. İki grup arasında klinik bulgular, maternal ve perinatal sonuçlar karşılaştırıldı. B Bu ul lg gu ul la ar r: : Preeklampsi olgularında antenatal, perinatal ve neonatal mortalite oranları sırasıyla %13.4, %17.9, %5.1, anne hayatının risk altında olduğu olguların oranı %30.2 idi. Süperimpoze preeklampsi olgularında antenatal, perinatal ve neonatal mortalite oranları sırasıyla %12.9, %19.8, %8.9, anne hayatının risk altında olduğu olguların oranı %25.7 idi. Semptomların ortaya çıkış zamanı (p: 0.669), ortalama doğum haftası (p: 0.410) ve doğum kilosu (p: 0.340) açıs...

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Section: Discussionsupporting

confidence: 82%

The Obstetric Outcomes in Women with Preeclampsia and Superimposed Preeclampsia

Şimşek¹,

Uludağ²,

Tüten³

et al. 2017

Turkiye Klinikleri J Gynecol Obst

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“…5 The main recommendation is to prevent BP increase during pregnancy through an improvement in dietary and lifestyle habits (also aimed at body weight control), while pharmacologic treatment is considered to prevent progression towards more severe disease and to improve maternal and fetal outcomes. 6 Indeed, while there are consistent data regarding the effect of severe hypertension on maternal and fetal morbidity and mortality as well as the effects of antihypertensive treatment in these hypertensive patients, [7][8][9] less is known about the risk predictors and the effect of pharmacologic treatment in patients with mild to moderate hypertension and the relative effect of antihypertensive treatment. 10 In this context, the main aim of our study was to evaluate the independent prognostic factors of maternal and fetal negative outcomes in a relatively large sample of normotensive pregnant women affected by chronic hypertension, gestational hypertension, or preeclampsia.…”

mentioning

confidence: 99%

Independent Determinants of Maternal and Fetal Outcomes in a Sample of Pregnant Outpatients With Normal Blood Pressure, Chronic Hypertension, Gestational Hypertension, and Preeclampsia

Cicero

Esposti

Immordino

et al. 2015

J of Clinical Hypertension

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The aim of this retrospective study was to evaluate the main independent prognostic factors of negative maternal and fetal outcomes in a relatively large sample of pregnant outpatients (N=906) who were normotensive or affected by chronic hypertension, gestational hypertension, or preeclampsia. Among the studied parameters, the ones significantly associated with negative maternal outcomes were a diagnosis of preeclampsia (vs other forms of hypertension or normotension) and higher serum uric acid level, while antihypertensive treatment, number of previous deliveries, and blood pressure (BP) control at deliveries seemed to be protective. Regarding negative fetal outcomes, the parameters significantly associated with a negative maternal outcome were a diagnosis of preeclampsia (vs other forms of hypertension or normotension) and mother pre‐pregnancy body mass index, while antihypertensive treatment and BP control at delivery seemed to be protective. Specific patient characteristics should help to predict the risk of negative maternal and fetal outcomes.

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“…14,15 Labetalol and nifedipine have similar hemodynamic effects and are also widely used. 16,17 Although some reports have indicated that sodium nitroprusside is also effective and safe when infused for short periods and at low doses, 18 obstetricians rarely prescribe nitroprusside and the experience of its use during pregnancy is very limited.…”

Section: Discussionmentioning

confidence: 99%