جستجوی مقالات مرتبط با کلیدواژه « پره اکلامپسی » در نشریات گروه « پزشکی »

Preeclampsia (PE) is a pregnancy-specific syndrome recognized as a major risk factor for preterm delivery. Preeclampsia (PE) is characterized by high blood pressure, significant proteinuria, and an excessive maternal systemic inflammatory response. The aim of this study was to investigate the role and function of regulatory T cells (Tregs) in pregnancy and preeclampsia.

This study is a narrative review that utilized the PubMed-Medline and Embase databases to search for the role of regulatory T cells (Tregs) in pregnancy and preeclampsia. Data were obtained from searching and extracting relevant articles.

The results of various studies indicated that paternal antigens and female sex hormones are responsible for the increased number of Tregs during pregnancy. The expansion of Tregs and the regulation of the immune system are essential for maternal tolerance towards the fetus. Indeed, the number and function of Tregs play a crucial role in pregnancy; a reduction in the number and function of these cells is observed in unsuccessful pregnancies such as those complicated by preeclampsia.

Regulatory T cells play vital roles in maintaining immune tolerance towards the fetus during pregnancy. A decrease in the number or function of these cells can lead to pregnancy complications, including preeclampsia. Health professionals should be aware of the importance of immune balance during pregnancy and consider immune system-related factors when assessing the risk of preeclampsia. Additionally, a better understanding of the role of Tregs could contribute to the development of new diagnostic and therapeutic methods for preeclampsia.

Preeclampsia (PE) is the most common hypertensive disorder after 20 weeks of gestation, and its complications are the leading cause of maternal and fetal mortalities. Changes in the innate and adaptive immune systems play a crucial role in the pathogenesis of PE. Natural Killer Cells (NKTs) are the most abundant leukocytes during pregnancy, recruited and activated by ovarian hormones in the decidua. Recent evidence supports the idea that NKT cells exist in various environmental tissues and the decidua with their unique transcriptional profiles and cytokines, and bridge between innate and adaptive immune systems. Therefore, this study aimed to review the number, phenotype, changes, and functional function of NKT cells in normal pregnancy and preeclampsia.

This study was a narrative review that utilized the PubMed-Medline and Embase databases to search for the role of NKT cells in pregnancy and preeclampsia. Data were obtained from searching and extracting relevant articles.

The results of various studies showed that the number of NKT cells increases in preeclampsia compared to normal pregnancy. However, there isn't any significant difference in the quantity and characteristics of iNKT cells between normal pregnancy and preeclampsia. Nonetheless, normal pregnant women exhibit a slight but meaningful reduction in the secretion of IFN-γ from iNKT cells compared to women with preeclampsia.

NKT cells regulate the balance of Th1 and Th2 responses by secreting interleukin-4 and interferon-γ. During pregnancy, maternal immunity is biased towards the production of type 2 cytokines to inhibit the function of type 1 cytokines, which can be harmful to the developing fetus. This shift to type 2 cytokines occurs in normal pregnancy.

This study aimed to evaluate the effect of furosemide administration on controlling high blood pressure after Cesarean section (CS) in women with mild preeclampsia. 

This double-blind, placebo-controlled randomized clinical trial was conducted on 120 women with mild preeclampsia after CS in Khalij Fars Hospital, Bandar Abbas, south of Iran, in 2017. They were randomly allocated to two groups of oral furosemide (20 mg daily for five days) and placebo. Systolic and diastolic blood pressures, mean arterial pressure, and heart rate were measured in all patients on days 0 (before treatment), 1, 3, 5, and 7 after delivery. Data were analyzed in SPSS software, version 19, using independent t-test and chi-square test. 

Before treatment, there was no significant difference between the two groups regarding systolic and diastolic blood pressures, mean arterial pressure, and heart rate. However, systolic blood pressure was significantly lower in the furosemide groups on the 1st, 3rd, 5th, and 7th days after delivery compared to the placebo group (P<0.05). Diastolic blood pressure was significantly lower in the furosemide group only on the first day after delivery. Also, mean arterial pressure was significantly lower in the furosemide group on days 1 (P<0.001) and 3 (P=0.021). At the end of the treatment, blood pressure was controlled in 70% of patients in the furosemide group and 50% of patients in the placebo group (P=0.025). 

It seems that 20 mg oral furosemide taken daily for five days after CS can significantly reduce systolic blood pressure on the 1st, 3rd, 5th, and 7th days after delivery in women with mild preeclampsia.

Acute kidney injury after childbirth is a rare disorder. However, it can have long-term consequences for the mother and the baby. Among the risk factors causing acute kidney injury are placental abruption and preeclampsia. The purpose of this article is to describe a case of postpartum acute renal failure that occurred in connection with placental abruption and preeclampsia.

Case report: 

The patient was referred at 33 weeks and five days of gestation based on ultrasound with complaints of labor pain and vaginal treatment. Our report is an interesting case for several reasons: a patient underwent a cesarean section with suspicion of placental abruption and was then treated for suspicion of preeclampsia and finally diagnosed with acute renal failure. Also, differential diagnosis was difficult due to the increase in liver function tests and the outflow of serous fluid.

Paying attention to the risk factors of Acute kidney failure plays a significant role in better management of midwifery services. Therefore, placental abruption and its risk factors should be carefully evaluated as an independent risk factor for perinatal mortality.

The medical and surgical condition of mother during pregnancy can be affected on prenatal morbidity and mortality. Physician must have knowledge about the effects of pregnancy on the course of disease as well as the effects of disease on outcome of pregnancy and treatment of disease during pregnancy.Hypertension is one of the common difficulties and complications during pregnancy, which leads to hospitalization. Blood pressure disorders occur in approximately 10% of pregnancies in the United States, and it accounts for 12.3% of maternal deaths. Hypertension in pregnancy is an important alarm that carries risks for both the mother and the fetus. In some cases, these complications can be life-threatening risks for both. For example, preeclampsia ranks among the top four leading causes of maternal mortality, when it is diagnosed and treated correctly it is possible to prevent adverse consequences. There are different types of high blood pressure in pregnancy that can be related to pregnancy or not related to pregnancy, and the diagnosis and management of each of them are different from each other. The purpose of this study was to provide a brief overview of definitions, diagnostic methods, risk factors, symptoms, side effects, drug and non-drug treatments, and prevention of various types of hypertension during pregnancy based on the latest American Obstetrics and Gynecology Guidelines and the latest edition of Beckman and Ling's Obstetrics and Gynecology.

Preeclampsia is a disorder of pregnancy characterized by high blood pressure. Regarding vascular and red blood cell (RBC) damages in preeclampsia patients, the present study was performed with aim to investigate the relationship between the level of RBC indicators with the incidence and severity of preeclampsia.

This case-control study was conducted within one year (July 2021 to July 2022) on 22 pregnant women with mild preeclampsia, 38 pregnant women with severe preeclampsia, and 38 healthy pregnant women who referred to Amiral Momenin Hospital in Zabol city. Evaluation of the number of red blood cells and the amount of hemoglobin, hematocrit, MCV, MCH, and MCHC was obtained by analyzing 2 ml of blood containing anticoagulant. Data analysis was done using SPSS statistical software (version 26) and independent t-test, chi-square, Pearson, and logistic regression analysis. P<0.05 was considered statistically significant.

Among the basic variables, having a history of preeclampsia (P=0.005), body mass index (P=0.030), systolic blood pressure (P<0.001) and diastolic blood pressure (P<0.001) had significant differences between the three studied groups. Among the RBC indices, MCV was significantly different between the studied groups (P=0.043). Hemoglobin (r= -0.248, P=0.034), MCV (r= -0.335, P=0.004), and MCH (r= -0.315, P=0.007) had a significant correlation with systolic blood pressure. Hemoglobin [OR (95% CI)= 0.545 (0.335, 0.912), P=0.021], hematocrit [OR (95% CI)= 0.789, (0.644, 0.967), P=0.022], and MCV [OR (95% CI)= 0.891 (0.808, 0.983), P=0.022] were related to the severity of preeclampsia.

Considering the significant reduction of MCV index in the preeclampsia group and the correlation of this decrease with the increase of systolic blood pressure and the severity of preeclampsia, it is suggested that this non-invasive index be measured during pregnancy for screening of preeclampsia.

 Mirror syndrome is a rare disorder in which fetal hydrops is associated with maternal edema, proteinuria and hypertension. Its pathogenesis is unclear and it is frequently mistaken for preeclampsia, even though distinguishing features can be identified and placentomegaly is consistently observed. It is associated with an increase in fetal mortality and maternal morbidity.

 we report an uncommon case of mirror syndrome, which appeared in 22 weeks and 4 days in multi parous pregnant women that characterized by complaints of headache, swollen limbs and hemorrhoids. And According to ultrasound, hydrops fetalis was confirmed and the decision was made to terminate the pregnancy. Our report is an interesting example of an unusual form of Mirror syndrome for several reasons which ultimately leads to hysterectomy. First due to mirror syndrome in a patient suffering from hemorrhoids and lack of hypertension. Then Due to the association of mirror syndrome with uncontrollable bleeding, following medical treatment to terminate the pregnancy and finally curettage and hysterectomy. and then concurrent multiple ovarian cysts in the right ovary with a size of 10 cm and left ovarian edema and presence of ascites, serosis uterine, and bladder, uterine and ovarian edema at the time of hysterectomy.

 mirror syndrome is associated with an increase in perinatal mortality and maternal morbidity. SO in order to improve midwifery management in cases of mirror syndrome, reduce fetal mortality and maternal morbidity and recognize concurrent unknown disorders, we must carefully examine all the symptoms of the mother and take treatment as soon as possible and, if necessary, consider delivery.

Preeclampsia is a common complication of the second half of pregnancy. Sleep disorders can cause high blood pressure by causing oxidative stress and endothelial dysfunction. Therefore, the present study was performed to determine the relationship between sleep disorders and preeclampsia.

This is a case-control study that was performed on 240 women referred to the affiliated university hospitals in Mashhad. Sampling was performed in the case group of hospitalized women with a definite diagnosis of preeclampsia (n=90) and in the control group (n=150) among pregnant women without preeclampsia referred to the obstetrics clinic. Data collection tools included demographic information questionnaire and gynecological/obstetric records, Pittsburgh Sleep Quality Questionnaire and clinical evaluation form to determine the symptoms and severity of preeclampsia. Data analysis was performed using SPSS statistical software (version 22) and Mann-Whitney, Chi-square and Fisher tests. A P value of less than 0.05 was considered significant.

The present paper is the result of a research project approved by the Vice-Chancellor for Research of Mashhad University of Medical Sciences (Code: IR.MUMS.NURSE.REC.1397.042).

The mean amount of real sleep at night in the group of healthy individuals (8.4±2.3) was significantly higher than patients (8.0± 2.2) (P = 0.028). In terms of loud snoring, waking up in the middle of the night was most frequent in the affected group (P <0.001). There was a statistically significant difference between the two groups in terms of sleep quality score level (P <0.001) based on logistic regression test in women with severe sleep problems at risk of preeclampsia (P <0.001, 95% CI 2.9-42.2, OR : 11 / 11) (11/11) was equal compared to healthy women.

The present study showed that sleep disorders in pregnancy are associated with an increased risk of preeclampsia.

Maternal diseases such as diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy in pregnancy are associated with fetal and neonatal complications. The aim of this study was to compare the prognosis of neonates in maternal diseases.

This study was a cross-sectional study. The present study was performed on 600 preterm infants with mothers with diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy. This study was done in Ghaem Hospital of Mashhad from March 2015 to April 2021 with available sampling. The data collection tool was a researcher-made checklist including infant (gestational age, Apgar score of the first minute, Apgar score of the fifth minute) and maternal (mode of delivery, prenatal care, premature rupture of the membranes) characteristics. Neonatal prognosis was compared at birth. All clinical and diagnostic examinations of newborns were performed by a neonatologist. Neonatal and maternal data in the group of newborns with normal mothers and newborns with maternal diseases were analyzed by Kolmogorov-Smirnov and Chi-square tests. The significance level was considered p≤0.05 in all cases.

The results show that 161 newborns (28.90%) had normal mothers, 89 newborns (15.98%) had diabetic mothers, 117 newborns (21.01%) had hypertensive mothers, and 50 newborns (8.98%) had hypothyroid mothers. One hundred tweny newborns (21.72%) had mothers with preeclampsia, 19 newborns (3.41%) had mothers with epilepsy. Newborns with mothers with epilepsy had the lowest Apgar score of the first minute and the lowest gestational age and newborns with mothers with diabetes had the lowest Apgar score of the fifth minute. Mothers with hypothyroidism had the highest rate of premature rupture of the membranes and mothers with hypertension and preeclampsia had the highest incidence of cesarean section.

Maternal diseases including diabetes, hypertension, preeclampsia, hypothyroidism and epilepsy affect the prognosis of neonates in terms of the severity of prematurity, premature rupture of the membranes, type of delivery, Apgar scores of the first and fifth minutes. Therefore, proper control and treatment of these diseases may improve neonatal prognosis.

Given the high prevalence of severe preeclampsia and its complications and the conflicting reports on the role of antiphospholipid antibodies, especially anti-cardiolipin, this study was performed aimed to compare the anti-cardiolipin antibody titer in pregnant women with preeclampsia and control group.

In this case-control study, 220 pregnant women in the third trimester of pregnancy who referred to Ali ibn-e Abitaleb Hospital in Zahedan in 2012 were evaluated in two groups of pregnant women with preeclampsia and control group.  4 cc of blood samples were taken from all the women under study and sent to the laboratory for   tests under standard conditions. Anticardiolipin IgG and IgM levels were determined by ELISA method. Data were analyzed by SPSS (version 19) and Mann-Whitney test. P<0.05 was considered statistically significant.

In the present study, the mean IgM antibody titers in pregnant women with severe preeclampsia were 1.0±856.842 mg/L and in the control group 2.1±215.610 mg/L which was not significantly different between the two groups (P=0.531). Mean IgG antibody titers were also 2.1±468.163 mg/L in pregnant women with severe preeclampsia and 2.139±0.545 mg/L in the control group which was not significantly different between the two groups (P=0.345).

In this study, no correlation was found between the levels of anti-cardiolipin antibody titers in pregnant women with preeclampsia compared with normal pregnant women.

There is a strong association between ABO blood groups and increased susceptibility to certain diseases including cardiovascular events, viral and bacterial infections, colorectal cancer, intracranial aneurysms and thromboembolic diseases. The present study was performed aimed to investigate the relationship between maternal blood groups and adverse pregnancy complications.

In this cross-sectional (descriptive-analytical) and retrospective study, the file of 400 pregnant women referred to the maternity hospital of Ali Ebn Abi Taleb Hospital of Zahedan from 2017 to 2019 were included. The variables of this study were ABO blood groups, preeclampsia, eclampsia, placental abruption, gestational diabetes mellitus, preterm labor and intrauterine growth restriction. The data collection tool included an information form in which the required information was entered. Data were analyzed by SPSS (version 22) and chi-square test. P<0.05 was considered statistically significant.

Out of a total of 400 pregnant women with a mean age of 33.09±7.53 years, 153 (38.3%) had blood type O, 116 (29%) B, 97 (24.3%) A and 34 (8.5%) AB. The relationship between ABO blood groups and preeclampsia (p = 0.848), placental abruption (p = 0.833), preterm birth (p = 0.705) and intrauterine growth restriction (p = 0.214) was not statistically significant, but gestational diabetes (p=0.049) and eclampsia (p=0.039) had a significant relationship with blood groups.

There was no significant difference between preeclampsia, placental abruption, preterm labor and intrauterine growth restriction with ABO blood groups, but there was a significant difference between eclampsia and gestational diabetes with ABO blood groups.

Preeclampsia and eclampsia are pregnancy specific syndromes. Vitamin D is one of the pathological factors of this syndrome. The aim of this study was to compare the serum levels of vitamin D in pregnant women with preeclampsia or eclampsia with healthy pregnant women.

In a cross-sectional, descriptive and analytical study, 50 pregnant women with preeclampsia or eclampsia and 50 healthy individuals were selected based on inclusion and exclusion criteria, and after taking blood sampling, serum vitamin D levels were measured using a commercial kit and ELISA. Statistical analysis was done by SPSS: 20. P <0.05 was considered as significant difference.

The mean serum vitamin D in pregnant women with preeclampsia or eclampsia was lower than the healthy group (P = 0.002). Also, 38% and 2% of pregnant women with preeclampsia or eclampsia and healthy had severe vitamin D deficiency. Vitamin D deficiency was more common in pregnant women over 30 years of age and BMI over 25, education less than a diploma, a housewife, and a gestational age of less than 34 weeks.

The results indicate that most pregnant women with preeclampsia and eclampsia syndrome are deficient in vitamin D, which affect in the development of preeclampsia or eclampsia. Therefore, timely screening and treatment of vitamin D deficiency can probably prevent preeclampsia or eclampsia and promote the quality of pregnancy.

Postpartum pelvic hematomas are classified as vulvovaginal, paravaginal and retroperitoneal hematomas. Retroperitoneal hematoma is the most uncommon condition after normal vaginal delivery. In the present study, a rare case of large retroperitoneal hematoma after uncomplicated vaginal delivery is reported.

The patient was a 25-year-old woman P1L1 who was admitted to a university hospital of Mashhad in July 2021 for pregnancy termination due to preeclampsia. She developed dizziness while walking 24 hours after uncomplicated normal vaginal delivery. CT-scan showed large retroperitoneal hematoma.

In the case of any abnormal findings in vital signs after delivery, the diagnosis of pelvic hematomas, especially large retroperitoneal hematoma, should be considered. Prompt diagnosis and treatment of this complication can reduce the risk of maternal morbidity and mortality.

Preeclampsia is one of the most serious cases of high-risk pregnancies that endanger women’s health worldwide, especially in developing countries. Preeclampsia is a specific pregnancy syndrome with a prevalence of about 7-14%, which is one of the three leading causes of death in pregnant women. Preeclampsia is the second most common cause of maternal mortality in Iran and accounts for 14% of maternal mortality. The present study was conducted to design, create and evaluate mobile-based preeclampsia self-care application.

This study was conducted in four stages to assess the needs of information elements, design, create and evaluate preeclampsia self-care application. In needs assessment step, 42 specialists, assistants and personnel related to the subject working in the Amir Al-Momenin (AS) Educational, Research and Treatment Center affiliated to Semnan University of Medical Sciences participated. The program was then initially evaluated by 7 physicians, and finally the suggestions provided by users in the design of the program were applied and the final version of the program was completed. The application was designed in the Android Studio environment and then its usability was evaluated using the opinions of 20 mothers and the QUIS tool.

The information elements and functional capabilities required by the program were determined. In addition, the program established communication between the patient and the provider, also created the possibility of care management and control of the disease process. The performance of the program was evaluated by physicians and experts and then evaluated by pregnant mothers in terms of usability. The findings showed that users were satisfied with the application.

The use of mobile-based applications is a useful way to increase knowledge and promote the health of pregnant mothers and facilitate their access to medical information and acquire the necessary skills in their disease. This program helps pregnant mothers with preeclampsia to control their disease by observing proper nutrition and treatment principles to minimize the complications of their disease.

Preeclampsia refers to high blood pressure and protein in the urine after the 20th weeks of pregnancy. Some studies show that the location of the placenta in pregnancies can predict the occurrence of preeclampsia, preterm delivery and fetal growth restriction. The present study was performed aimed to investigate the relationship between placental site and occurrence of preeclampsia.

This cross-sectional and prospective study was performed in 2019 on 325 pregnant women with 18 to 22 weeks gestational age in Kosar Hospital in Qazvin. Questionnaire information included placenta location, gestational age, neonatal sex, fetal growth restriction, and preterm delivery. Then, the location of the placenta was determined by ultrasound and the placenta with anterior, posterior, and fundus positions was included in the central group and the right and left lateral placenta in the lateral placenta group. Data were analyzed using SPSS software (version 22) and chi-square and logistic regression tests. P<0.05 was considered statistically significant.

The fundal placenta compared to the anterior placenta reduced the incidence of fetal growth restriction (P=0.044). The posterior placenta compared to the anterior placenta increased the incidence of preterm labor (P=0.041). In the present study, there was no significant relationship between placental location and the occurrence of preeclampsia (P= 0.680).

Ultrasound to determine the location of the placenta in the first months of pregnancy can predict the occurrence of pregnancies prone to preterm labor and fetal growth retardation, but placental location cannot be predictive of preeclampsia.

Preeclampsia is a condition of placental pathogenesis, which divided into mild and severe forms, based on the severity of hypertension and proteinuria. Severe type of the disease with HELLP syndrome and neurological symptoms such as seizures play a very important role in maternal complications. Cerebral Venous Thrombosis with incidence of 11.6 per 100,000 deliveries per year,  as a rare cerebrovascular disease, can occur as a result of pregnancy-related changes in coagulation state and vascular endothelial damage and be the cause of the life-threatening risks of the preeclamptic mother.

The patient is a 22-year-old, gravida 1 (33 weeks) woman, with no history of underlying disease, who following the initial seizure and without consciousness, was transferred by the 115th Emergency Department to the triage unit of Valiasr Hospital in Kazerun. Due to repeated recurrent seizures during the 20-minute transmission and the results of test based on HELLP Syndrome, she immediately undergoing a cesarean section.  Subsequently, the results of the CAT-SCAN request confirmed the occurrence of cerebral venous thrombosis in the mother. The infant was discharged because of the absence of respiratory disorder and regularity of heart rate. Six-week postpartum follow-up showed maternal recovery.