scholarly journals Pheochromocytoma in pregnancy: a case report and review of literature

2010 ◽  
Vol 3 (2) ◽  
pp. 83-85 ◽  
Author(s):  
J George ◽  
J Y L Tan
Keyword(s):  
Gestational Hypertension ◽  
Beta Blockers ◽  
Cardiovascular Complications ◽  
Definitive Treatment ◽  
Fetal Mortality ◽  
Optimal Timing ◽  
Tumour Resection ◽  
Urinary Catecholamines ◽  
Operative Control ◽  
In Pregnancy

Hypertension is a common problem in pregnancy that can result in significant maternal and fetal morbidity and mortality. The common causes include pre-eclampsia, gestational hypertension and essential hypertension. Although phaeochromocytoma is a rare cause of hypertension in pregnancy, it can lead to potentially life-threatening cardiovascular complications for the mother and increased fetal mortality if left undiagnosed and untreated. The diagnosis can be confirmed by measurement of plasma and urinary catecholamines and their metabolities followed by radiological localization of the tumour. Surgical resection of the tumour after adequate pre-operative control of hypertension using sequential alpha- followed by beta-blockers is the definitive treatment. In pregnancy, depending on the gestation at which diagnosis is made, the optimal timing for surgery is during the late first or early second trimester. When the pregnancy is more advanced, medical management followed by combined caesarean section and tumour resection closer to term is preferred.

scholarly journals Pheochromocytoma during pregnancy - a rare diagnose with a complex multidisciplinary approach

2021 ◽  
Vol 10 (9) ◽  
pp. 3587
Author(s):  
Rita Silva ◽  
Catarina R. Carvalho ◽  
Madalena Andrade Tavares ◽  
Celia Pedroso ◽  
Paula Tapadinhas
Keyword(s):  
Multidisciplinary Approach ◽  
Gestational Hypertension ◽  
Cardiovascular Complications ◽  
Fetal Mortality ◽  
Common Causes ◽  
Threatening Condition ◽  
Fetal Complications ◽  
Life Threatening ◽  
The Common ◽  
In Pregnancy

Hypertension is a common problem in pregnancy that can result in significant maternal and fetal morbidity and mortality. The common causes include pre-eclampsia, gestational hypertension and essential hypertension. Although pheochromocytoma is a rare of hypertension in pregnancy, it can lead to potentially life-threatening cardiovascular complications for the mother and increased fetal mortality if left undiagnosed and untreated. Early diagnosis and timely, appropriate management reduce possible maternal and fetal complications. We report a case of a 32-week pregnant woman diagnosed with hypertension secondary to pheochromocytoma. An elective caesarian section was performed at 37 weeks of gestational age and underwent a laparoscopic left adrenalectomy with success. A multidisciplinary approach is of utmost importance and essential during the management of this life-threatening condition during pregnancy.

BMI: new aspects of a classical risk factor for hypertensive disorders in pregnancy

2006 ◽  
Vol 111 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Brigitte Leeners ◽  
Werner Rath ◽  
Sabine Kuse ◽  
Claudia Irawan ◽  
Bruno Imthurn ◽  
...  
Keyword(s):  
Risk Factor ◽  
Hellp Syndrome ◽  
Gestational Hypertension ◽  
Continuous Variable ◽  
Normal Weight ◽  
World Health ◽  
Fetal Mortality ◽  
Obese Women ◽  
Hypertensive Diseases ◽  
In Pregnancy

HDP (hypertensive diseases in pregnancy) are one of the leading causes of maternal and fetal mortality and morbidity. BMI (body mass index) is an established risk factor for pre-eclampsia, but its role in HELLP syndrome is unknown. We therefore investigated BMI as a risk factor in the development of HELLP syndrome. At the beginning of pregnancy, BMI was measured in 1067 women with a history of HDP and 1063 controls. Diagnoses of HDP were classified according to ISSHP (International Society for the Study of Hypertension in Pregnancy) and BMI according to WHO (World Health Organization) criteria. After verification of exclusion criteria and matching for confounders, 687 women with hypertensive diseases in pregnancy and 601 controls remained for statistical evaluation by χ2 test and multiple logistic regressions. As a continuous variable, the increase in BMI was associated with an increase in the development of gestational hypertension {OR (odds ratio), 1.1 [95% CI (confidence interval) 1.062–1.197]} and pre-eclampsia [OR, 1.1 (95% CI, 1.055–1.144)]}, but not for HELLP syndrome. According to WHO definitions, overweight women (BMI ≥25 and <30 kg/m2) had a 2-fold (95% CI, 1.365–2.983) risk and obese women (BMI ≥30 kg/m2) had a 3.2-fold (95% CI, 1.7–5.909) risk of developing pre-eclampsia when compared with women of normal weight (BMI ≥15.5 and <25 kg/m2). Being overweight or having obesity had no effect on the risk of HELLP syndrome. As an increased BMI is correlated with the risk of developing pre-eclampsia but not HELLP syndrome, both diseases have a different risk profile. This finding supports that underlying physiological mechanisms in pre-eclampsia vary from those in HELLP syndrome.

scholarly journals Maternal and perinatal outcome in women with hypertensive disorders in pregnancy

2021 ◽  
Vol 10 (2) ◽  
pp. 46-49
Author(s):  
Lakshmi A ◽  
Akshatha DS ◽  
Pooja P ◽  
Prashanth FG ◽  
Veena MV ◽  
...  
Keyword(s):  
Gestational Hypertension ◽  
Adverse Outcomes ◽  
Fetal Mortality ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Mortality And Morbidity ◽  
Hypertensive Disorders ◽  
Study Results ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Aims and objectives To determine the effect of hypertension in pregnancy To determine the maternal and fetal outcome in patients with hypertensive disorders of pregnancy. Materials and methods This is a retrospective study conducted in ESIC MC and PGIMSR, Bangalore from January 2020 to December 2020. All pregnant women who presented with Hypertensive disorder in pregnancy were included in the study. Results A total of 1503 patients who delivered during the study period were included in the study of which 172 patients had hypertensive disorder (11.44 %). Gestational hypertension occurred in 113 cases, preeclampsia in 45 cases, chronic hypertension in 8 cases, chronic hypertension with superimposed preeclampsia in 2 cases and eclampsia in 4 cases. Of these 85(49.41%) cases were primigravida and 87(50.58%) were multigravida. 38 deliveries occurred preterm and 134 were term. 4 patients had intrauterine fetal demise. Gestational diabetes occurred in 30(17.44%) cases, hypothyroidism in 45 cases(26.16%), IUGR in 11 cases(6.39%), oligohydramnios in 10 cases(5.81%). Discussion Hypertensive disorders in pregnancy is a spectrum of disease. It is one of the non communicable diseases occurring in pregnancy. It is the third most common cause of maternal mortality. By timely detection and proper management, it is possible to decrease the complications and adverse outcomes associated with this condition. Conclusion Hypertensive disorders in pregnancy is an important cause for maternal and fetal mortality and morbidity. Hence it is important to identify the risk factors and prevent it for better outcome.

scholarly journals Midgut Volvulus: A Rare but Fatal Cause of Abdominal Pain in Pregnancy—How Can We Diagnose and Prevent Mortality?

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Eelyn Chong ◽  
David S Liu ◽  
Neil Strugnell ◽  
Vishnupriya Rajagopal ◽  
Krinal K Mori
Keyword(s):  
Abdominal Pain ◽  
Rare Condition ◽  
Definitive Treatment ◽  
Fetal Mortality ◽  
Midgut Volvulus ◽  
Loss Of Life ◽  
Delay In Diagnosis ◽  
Life Threatening ◽  
Low Incidence ◽  
In Pregnancy

Midgut volvulus in pregnancy is rare but life-threatening, resulting in high maternal and fetal mortality. This surgical emergency commonly masquerades as symptoms of pregnancy, which together with its low incidence often leads to delay in diagnosis and definitive treatment. Here, we review the last three decades of the literature, discuss the challenges in managing this rare condition, and raise awareness among clinicians to minimise loss of life.

DESIGN AN “IN HOUSE” SOFTWARE FOR SCREENING PREECLAMPSIA BY MATERNAL FACTORS AND MEAN ARTERIAL PRESSURE AT 11 – 13 WEEKS IN COMMUNE HEALTH CENTERS.

2015 ◽  
pp. 115-126
Author(s):  
Viet Nhan Nguyen ◽  
Ngoc Thanh Cao ◽  
Thi Minh Thi Ha ◽  
Van Duc Vo ◽  
Quang Vinh Truong ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Gestational Hypertension ◽  
Area Under The Curve ◽  
Health Centers ◽  
Maternal Factors ◽  
Good Tool ◽  
Uterine Artery Doppler ◽  
Study Results ◽  
In Pregnancy

Objective: Design an “in house” software for screening preeclampsia by maternal factors and mean arterial pressure at 11 – 13 gestational weeks in commune health centers. Methods: Based on the algorithms for calculating the risk of preeclampsia (PE) by maternal factors and mean artirial pressure at 11 - 13 gestational weeks in the study results of the authors, an “in house” software was deigned in Excel. The results of prediction preeclampsia by The Fetal Medicine Foundation (FMF)(version 2.3) were compared with the results by “in house” software in 1110 singleton pregnant women. Results: The “in house” software met the requirements for calculating the risks of PE and save data. FMF risk for gestational hypertension disorder in pregnancy by maternal factors, mean arterial pressure,uterine artery Doppler and PAPP-A has an area under the curve of 0.68 (95%CI: 0.59 – 0.78). The “in house” software risk for gestational hypertension in pregnancy by maternal factors, mean arterial pressure has an area under the curve of 0.643 (0.55 – 0.73) There was no statistically significant different between two programs (p:0.52). The risk cut-off 1:50 in the prediction of gestational hypertension of the “in house” software was used to identify the group of high risk with detetion rate (DR) 28.6% (95%CI: 14.9-42.2) comparing to 40.5% (95%CI:25.6-55.3) of FMF. Conclusion: The FMF version 2.3 is better but in the absence of Doppler ultrasound and PAPP-A test in the commune health cares, the “in house” software for screening PE is a good tool for councelling, following up and early intervention for PE.

Does physical activity in leisure time early in pregnancy reduce the incidence of preeclampsia or gestational hypertension?

2010 ◽  
Vol 89 (2) ◽  
pp. 261-267 ◽  
Author(s):  
KARLIJN C. VOLLEBREGT ◽  
HANS WOLF ◽  
KEES BOER ◽  
MARCEL F. VAN DER WAL ◽  
TANJA G.M. VRIJKOTTE ◽  
...  
Keyword(s):  
Physical Activity ◽  
Leisure Time ◽  
Gestational Hypertension ◽  
In Pregnancy

scholarly journals Quantifying Fetal Reprogramming for Biomarker Development in the Era of High-Throughput Sequencing

Genes ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 329
Author(s):  
Fu-Sheng Chou ◽  
Krystel Newton ◽  
Pei-Shan Wang
Keyword(s):  
High Throughput ◽  
High Throughput Sequencing ◽  
Well Being ◽  
Placental Insufficiency ◽  
Definitive Treatment ◽  
Optimal Timing ◽  
Hypertensive Disorders ◽  
Clinical Tools ◽  
Fetal Reprogramming ◽  
Offspring Health

Gestational hypertensive disorders continue to threaten the well-being of pregnant women and their offspring. The only current definitive treatment for gestational hypertensive disorders is delivery of the fetus. The optimal timing of delivery remains controversial. Currently, the available clinical tools do not allow for assessment of fetal stress in its early stages. Placental insufficiency and fetal growth restriction secondary to gestational hypertensive disorders have been shown to have long-term impacts on offspring health even into their adulthood, becoming one of the major focuses of research in the field of developmental origins of health and disease. Fetal reprogramming was introduced to describe the long-lasting effects of the toxic intrauterine environment on the growing fetus. With the advent of high-throughput sequencing, there have been major advances in research attempting to quantify fetal reprogramming. Moreover, genes that are found to be differentially expressed as a result of fetal reprogramming show promise in the development of transcriptional biomarkers for clinical use in detecting fetal response to placental insufficiency. In this review, we will review key pathophysiology in the development of placental insufficiency, existing literature on high-throughput sequencing in the study of fetal reprogramming, and considerations regarding research design from our own experience.

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

scholarly journals Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 667
Author(s):  
Kjerstine Breintoft ◽  
Regitze Pinnerup ◽  
Tine Brink Henriksen ◽  
Dorte Rytter ◽  
Niels Uldbjerg ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Cesarean Section ◽  
Placental Abruption ◽  
Gestational Hypertension ◽  
Adverse Pregnancy Outcome ◽  
Placenta Previa ◽  
Meta Analysis ◽  
Increased Risk ◽  
Spontaneous Hemoperitoneum ◽  
In Pregnancy

Background: This systematic review and meta-analysis summarizes the evidence for the association between endometriosis and adverse pregnancy outcome, including gestational hypertension, pre-eclampsia, low birth weight, and small for gestational age, preterm birth, placenta previa, placental abruption, cesarean section, stillbirth, postpartum hemorrhage, spontaneous hemoperitoneum in pregnancy, and spontaneous bowel perforation in pregnancy. Methods: We performed the literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), by searches in PubMed and EMBASE, until 1 November 2020 (PROSPERO ID CRD42020213999). We included peer-reviewed observational cohort studies and case-control studies and scored them according to the Newcastle–Ottawa Scale, to assess the risk of bias and confounding. Results: 39 studies were included. Women with endometriosis had an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth, compared to women without endometriosis. These results remained unchanged in sub-analyses, including studies on spontaneous pregnancies only. Spontaneous hemoperitoneum in pregnancy and bowel perforation seemed to be associated with endometriosis; however, the studies were few and did not meet the inclusion criteria. Conclusions: The literature shows that endometriosis is associated with an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth.

scholarly journals Prevalence and determinants of chronic kidney disease in women with hypertensive disorders in pregnancy in Nigeria: a cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Salisu M. Ishaku ◽  
Timothy Olusegun Olanrewaju ◽  
Joyce L. Browne ◽  
Kerstin Klipstein-Grobusch ◽  
Gbenga A. Kayode ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gestational Hypertension ◽  
Monitoring Program ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Sub Saharan ◽  
In Pregnancy

Abstract Background Worldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5 and 10% of pregnancies. Sub-Saharan Africa (SSA) is disproportionately affected by a high burden of HDPs and chronic kidney disease (CKD). Despite mounting evidence associating HDPs with the development of CKD, data from SSA are scarce. Methods Women with HDPs (n = 410) and normotensive women (n = 78) were recruited at delivery and prospectively followed-up at 9 weeks, 6 months and 1 year postpartum. Serum creatinine was measured at all time points and the estimated glomerular filtration rates (eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR< 60 mL/min/1.73m2 lasting for ≥ 3 months. Prevalence of CKD at 6 months and 1 year after delivery was estimated. Logistic regression analyses were conducted to evaluate risk factors for CKD at 6 months and 1 year postpartum. Results Within 24 h of delivery, 9 weeks, and 6 months postpartum, women with HDPs were more likely to have a decreased eGFR compared to normotensive women (12, 5.7, 4.3% versus 0, 2 and 2.4%, respectively). The prevalence of CKD in HDPs at 6 months and 1 year postpartum was 6.1 and 7.6%, respectively, as opposed to zero prevalence in the normotensive women for the corresponding periods. Proportions of decreased eGFR varied with HDP sub-types and intervening postpartum time since delivery, with pre-eclampsia/eclampsia showing higher prevalence than chronic and gestational hypertension. Only maternal age was independently shown to be a risk factor for decreased eGFR at 6 months postpartum (aOR = 1.18/year; 95%CI 1.04–1.34). Conclusion Prior HDP was associated with risk of future CKD, with prior HDPs being more likely to experience evidence of CKD over periods of postpartum follow-up. Routine screening of women following HDP-complicated pregnancies should be part of a postpartum monitoring program to identify women at higher risk. Future research should report on both the eGFR and total urinary albumin excretion to enable detection of women at risk of future deterioration of renal function.

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