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

Pre-eclampsia (PE) can cause brain damage before birth. However, its mechanism is not clear. The present study evaluated the effect of cinnamic acid (CIN) on the expression of inflammatory cytokines of the forebrain and neuronal damage in the hippocampus of PE model fetuses induced with l-NAME.

25 pregnant female rats were randomly divided into 5 groups: control group (no treatment), PE+NS group (daily injection of 250 mg l-NAME from embryonic day (ED) 15 to 20 to induce PE and then one hour later normal saline gavage), PE+CIN25, PE+CIN50 and PE+CIN100 groups (CIN gavage with doses of 25, 50 and 100 mg, respectively, one hour after l-NAME injection). On the ED21, after cesarean section, the fetal brain was dissected. The content of tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6) and interleukin-1 beta (IL-1β) in the forebrain and cell density in the CA1 and CA3 regions of the fetal hippocampus were measured.

A significant increase in TNF-α, IL-6 and IL-1β in the forebrain along with a decrease in neuronal density in the CA1/CA3 regions was seen in the PE+NS group compared to the control group (p<0.05). While in the groups receiving CIN, they showed a significant decrease in TNF-α, IL-6 and IL-1β in the forebrain and an increase in CA1/CA3 neuronal density compared to the PE+NS group (p<0.05).

CIN improved the inflammation and reduced cell damage in the hippocampus of PE model fetuses through modulating the level of anti-inflammatory cytokines in the fetal forebrain.

Increased Doppler indices of uterine artery correlate with adverse pregnancy outcomes. The present study was conducted with aim to investigate the relationship between elevated resistance in the pulsatility index (PI) of the uterine artery at 18-20 weeks of pregnancy and adverse pregnancy outcomes.

In this prospective cohort study, colour Doppler ultrasonography was performed on 173 patients referred to the perinatology office at Sabzevar University of Medical Sciences during 18-20 weeks of pregnancy. The 95th percentile of the average uterine PI was recorded. After delivery, adverse pregnancy and childbirth outcomes were evaluated. Data were analysed using SPSS (version 26) and Fisher's exact test and Mann-Whitney U test.

In terms of maternal and fetal outcomes, one case (2.3%) experienced intrauterine fetal death (IUFD), two (4.5%) had premature births, eight infants (18.2%) were hospitalized in the neonatal intensive care unit (NICU), and four (9.1%) had low birth weight (LBW). No cases of infant deaths or intrauterine growth restriction (IUGR) were reported. A significant relationship was found between mean PI exceeding 1.5 and high blood pressure during pregnancy (p=0.003). Additionally, significant relationship was found between an elevation in resistance beyond the 95th percentile of the PI and increased blood pressure (p=0.005) and premature delivery (p=0.04). However, no significant relationships were noted between mean and the 95th percentile of the PI and other maternal and fetal outcomes.

No cases of infant deaths and IUGR were reported. The elevated uterine artery PI is associated with increased risk of gestational hypertension and preterm delivery.

Preeclampsia is a multisystemic disorder with unknown cause in pregnant women that has dangerous complications for mother and fetus. Contradictory studies have been reported about increasing carotid artery intimal media thickness in the preeclamptic pregnant women. The present study was conducted with aim to compare carotid artery intima-media thickness of pregnant women with preeclampsia and healthy pregnant and non-pregnant women.

 This cross-sectional analytical study was performed in 2019 and 2020 on 21 preeclamptic pregnant women, 21 healthy pregnant with normal blood pressure and 21 non-pregnant women with normal blood pressure. The intima-media thickness of the carotid artery of the subjects was measured in 3 areas of the common carotid artery on both sides and its mean was recorded. Data were analyzed by SPSS software (version 16) and Kolmogorov-Smirnov, ANOVA, independent t, and Kruskal-Wallis tests. P<0.05 was considered significant.

 Based on the results of Kruskal-Wallis test, the minimum, maximum and mean thickness of carotid artery intima media in preeclamptic pregnant women was (0.4, 0.8, 0.600),  in healthy pregnant (0.3, 0.4, 0.300), and in non-pregnant women was (0.2, 0.5, 0.300) (P <0.001).

The thickness of intima media of carotid artery was significantly different among the three groups.

Preeclampsia occurs as a result of poor perfusion of the placental vessels, which in turn, arises from insufficient regeneration of the spiral arteries of the maternal uterus. Early diagnosis and prediction of preeclampsia (PE) may prevent fetal and maternal complications. The present study was conducted with aim to determine the diagnostic value of screening tests in the second trimester of pregnancy regarding the incidence of preeclampsia in late pregnancy.

This cross-sectional study was conducted during 2021-2022 in the Perinatology Clinic of Sabzevar. In this study, 150 patients with high risk of preeclampsia in the screening of the second trimester of pregnancy were included. Preeclampsia was diagnosed using hospitalization documents. Data were analyzed using descriptive tests, ROC curve, and the Area under the Curve (AUC). P<0.05 was considered statistically significant.

Of 150 high-risk individuals in terms of preeclampsia, only 12 (8%) were diagnosed with preeclampsia. The accuracy of different factors to predict preeclampsia was obtained: 0.45 for AFP, 0.43 for inhibin a, 0.27 for beta HCG, and 0.57 for UE3. With 95% confidence, UE3 level between 0.42 and 0.73 had the best diagnostic value for preeclampsia. The highest sensitivity and specificity of UE3 for predicting preeclampsia was 66% and 49%, respectively for 0.74 MOM.

The reduction of unconjugated estriol can be used as a biomarker in predicting preeclampsia. The high risk of screening in the second trimester of pregnancy cannot merely predict the risk of 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.

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.

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.