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Latest & greatest articles for preeclampsia
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An automated method for the determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia 19850276 2010 02 01 2010 02 19 2010 02 01 1097-6868 202 2 2010 Feb American journal of obstetrics and gynecology Am. J. Obstet. Gynecol. An automated method for the determination of the sFlt-1/PIGF ratio in the assessment of preeclampsia. 161.e1-161.e11 10.1016/j.ajog.2009.09.016 The angiogenic and antiangiogenic factors soluble fms-like tyrosine kinase (sFlt)-1 and placental growth factor (PIGF (...) ) have been implicated in the mechanisms of disease responsible for preeclampsia (PE). Moreover, it has been proposed that the concentrations of these markers in maternal serum/plasma may have predictive value. This study evaluates a newly developed Elecsys (Roche, Penzberg, Germany) assay for sFlt-1 and PIGF and tests the value of the sFlt-1/PIGF ratio in the assessment of PE. This multicenter case-control study included 351 patients: 71 patients with PE and 280 gestational age-matched control
Preeclampsia-eclampsia and the risk of stroke among peripartum in Taiwan 19228854 2009 03 31 2009 04 24 2016 11 22 1524-4628 40 4 2009 Apr Stroke Stroke Preeclampsia-eclampsia and the risk of stroke among peripartum in Taiwan. 1162-8 10.1161/STROKEAHA.108.540880 The occurrence of preeclampsia-eclampsia during pregnancy has been reported to increase the risk of stroke in mainly Western populations. However, few studies have evaluated stroke risk in Asian populations and followed women beyond (...) of stroke. Sociodemographic factors and obstetric complications were used in multivariate logistic regression models to determine the adjusted odds ratios of preeclampsia-eclampsia on the risk of hemorrhagic and ischemic stroke during pregnancy and within the first postpartum year. The incidence of stroke was 21.47 cases per 100,000 deliveries. There were 139 cases of hemorrhagic stroke and 107 cases of ischemic stroke. The respective adjusted relative risk of preeclampsia-eclampsia for hemorrhagic
Prediction, prevention, and prognosis of preeclampsia. In: Diagnosis, evaluation and management of the hypertensive disorders of pregnancy. Prediction, prevention, and prognosis of preeclampsia. In: Diagnosis, evaluation and management of the hypertensive disorders of pregnancy. | National Guideline Clearinghouse Search Sign In Username or Email * Password * Remember Me Don't have an account? Guideline Summary NGC:006811 This guideline summary has been replaced by an updated version. Please
Maternal smoking, preeclampsia, and infant health outcomes in New York City, 1995-2003 19001134 2008 12 30 2009 01 23 2017 02 20 1476-6256 169 1 2009 Jan 01 American journal of epidemiology Am. J. Epidemiol. Maternal smoking, preeclampsia, and infant health outcomes in New York City, 1995-2003. 33-40 10.1093/aje/kwn293 A number of previous studies have reported an inverse association between maternal smoking and preeclampsia. Additionally, some have suggested that smokers who develop (...) preeclampsia have worse maternal and fetal outcomes than nonsmokers who develop preeclampsia. The authors examined the relation of smoking to preeclampsia among 674,250 singleton pregnancies in New York City between 1995 and 2003. Although smoking was associated with a reduced risk of preeclampsia overall (adjusted odds ratio = 0.88, 95% confidence interval: 0.82, 0.94), no association was found for preeclampsia superimposed on chronic hypertension (adjusted odds ratio = 1.04, 95% confidence interval: 0.90
Expectant management of severe preeclampsia remote from term: a structured systematic review Expectant management of severe preeclampsia remote from term: a structured systematic review Expectant management of severe preeclampsia remote from term: a structured systematic review Magee LA, Yong PJ, Espinosa V, Cote AM, Chen I, von Dadelszen P CRD summary This review concluded that observational evidence suggested that expectant management of early severe pre-eclampsia prolonged pregnancy by one (...) to two weeks, had low maternal risk and improved neonatal outcomes compared with interventionist management. The findings supported the limited randomised data available. Due to the authors’ limited search and biases associated with observational evidence these conclusions require some caution in interpretation. Authors' objectives To evaluate observational evidence on clinical outcomes associated with expectant versus interventionist care of severe pre-eclampsia remote from term. Searching MEDLINE
Acetylsalicylic acid for the prevention of preeclampsia and intra-uterine growth restriction in women with abnormal uterine artery Doppler: a systematic review and meta-analysis Acetylsalicylic acid for the prevention of preeclampsia and intra-uterine growth restriction in women with abnormal uterine artery Doppler: a systematic review and meta-analysis Acetylsalicylic acid for the prevention of preeclampsia and intra-uterine growth restriction in women with abnormal uterine artery Doppler (...) : a systematic review and meta-analysis Bujold E, Morency AM, Roberge S, Lacasse Y, Forest JC, Giguere Y CRD summary The authors concluded that low-dose acetylsalicylic acid treatment initiated early in pregnancy reduced the incidence of pre-eclampsia and its consequences in women with ultrasonographic evidence of abnormal placentation. The findings reflected the evidence, but as acknowledged by the authors they were limited by a lack of studies and the small numbers of women recruited at less than 20 weeks
Correlation of catheterized and clean catch urine protein/creatinine ratios in preeclampsia evaluation 18757659 2008 09 01 2008 11 13 2013 11 21 0029-7844 112 3 2008 Sep Obstetrics and gynecology Obstet Gynecol Correlation of catheterized and clean catch urine protein/creatinine ratios in preeclampsia evaluation. 606-10 10.1097/AOG.0b013e3181827c89 To examine whether clean catch urine specimens correlate with catheterized specimens for determination of protein/creatinine ratios in pregnant (...) women being evaluated for preeclampsia. Sixty pregnant women who were at least at 20 weeks of gestation were enrolled. Patients with ruptured membranes, vaginal bleeding, or urinary tract infections were excluded. Midstream clean catch urine specimens were collected. Catheterized specimens were then collected and used for clinical management. The specimens were analyzed for protein, creatinine, urinalysis, and culture. Based on sample size calculations, 60 participants were needed to detect
Interactions between smoking and weight in pregnancies complicated by preeclampsia and small-for-gestational-age birth 18558661 2008 08 11 2008 08 21 2016 11 22 1476-6256 168 4 2008 Aug 15 American journal of epidemiology Am. J. Epidemiol. Interactions between smoking and weight in pregnancies complicated by preeclampsia and small-for-gestational-age birth. 427-33 10.1093/aje/kwn140 Cigarette smoking protects against preeclampsia but increases the risk of small-for-gestational-age birth (SGA (...) ). Regarding body weight, the converse is true: obesity elevates rates of preeclampsia but reduces rates of SGA. The authors assessed the combined effects of smoking and weight among US women developing preeclampsia or SGA, studying 7,757 healthy, primigravid women with singleton pregnancies in 1959-1965. Smoking (never, light, heavy), stratified by prepregnancy body mass index (BMI (weight (kg)/height (m)(2)); underweight, overweight, obese), was examined in relation to preeclampsia and SGA. Among
Preeclampsia and the Risk of End-Stage Renal Disease. BACKGROUND: It is unknown whether preeclampsia is a risk marker for subsequent end-stage renal disease (ESRD). METHODS: We linked data from the Medical Birth Registry of Norway, which contains data on all births in Norway since 1967, with data from the Norwegian Renal Registry, which contains data on all patients receiving a diagnosis of end-stage renal disease (ESRD) since 1980, to assess the association between preeclampsia in one or more (...) pregnancies and the subsequent development of ESRD. The study population consisted of women who had had a first singleton birth between 1967 and 1991; we included data from up to three pregnancies. RESULTS: ESRD developed in 477 of 570,433 women a mean (+/-SD) of 17+/-9 years after the first pregnancy (overall rate, 3.7 per 100,000 women per year). Among women who had been pregnant one or more times, preeclampsia during the first pregnancy was associated with a relative risk of ESRD of 4.7 (95% confidence
Protein/Creatinine ratio in preeclampsia: a systematic review 18591319 2008 07 01 2008 08 05 2015 11 19 0029-7844 112 1 2008 Jul Obstetrics and gynecology Obstet Gynecol Protein/creatinine ratio in preeclampsia: a systematic review. 135-44 10.1097/AOG.0b013e3181778cfc To estimate the accuracy of the protein/creatinine ratio in predicting 300 mg of protein in 24-hour urine collection in pregnant patients with suspected preeclampsia. Articles were identified through electronic databases (MEDLINE (...) , CINHAL, and Cochrane) using the terms "preeclampsia," "protein/creatinine ratio," and "diagnosis," during the period January 1966 to October 2007. The relevant citations were hand searched. Included studies evaluated patients for suspected preeclampsia with a 24-hour urine sample and a protein/creatinine ratio. Only English-language articles were included. Studies including patients with only chronic illness such as chronic hypertension, diabetes mellitus, or renal impairment were excluded. Using
Maternal infection and risk of preeclampsia: systematic review and metaanalysis. 18166297 2008 01 01 2008 01 28 2008 07 09 1097-6868 198 1 2008 Jan American journal of obstetrics and gynecology Am. J. Obstet. Gynecol. Maternal infection and risk of preeclampsia: systematic review and metaanalysis. 7-22 10.1016/j.ajog.2007.07.040 There are lingering questions regarding the association between maternal infection and preeclampsia. Systematic review and metaanalysis was conducted of observational (...) studies that examined the relationship between maternal infection and preeclampsia. Forty-nine studies met the inclusion criteria. The risk of preeclampsia was increased in pregnant women with urinary tract infection (pooled odds ratio, 1.57; 95% CI, 1.45-1.70) and periodontal disease (pooled odds ratio, 1.76; 95% CI, 1.43-2.18). There were no associations between preeclampsia and presence of antibodies to Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus, treated and nontreated HIV
Alternative complement pathway activation fragment Bb in early pregnancy as a predictor of preeclampsia 18221926 2008 04 08 2008 05 27 2016 11 22 1097-6868 198 4 2008 Apr American journal of obstetrics and gynecology Am. J. Obstet. Gynecol. Alternative complement pathway activation fragment Bb in early pregnancy as a predictor of preeclampsia. 385.e1-9 10.1016/j.ajog.2007.10.793 Preeclampsia is a multisystem disease classically defined on the basis of hypertension and proteinuria. As shown (...) in animal studies, complement activation is associated with inflammation in the placenta and adverse pregnancy outcomes. The association between complement activation in humans and adverse pregnancy outcomes is unclear. The purpose of this study was to determine whether elevated levels of the activation fragment Bb in early pregnancy are predictive of preeclampsia. This prospective study of 701 women was conducted in Denver, CO. A single plasma sample was obtained from each woman before 20 weeks
Antioxidant Therapy to Prevent Preeclampsia: A Randomized Controlled Trial. OBJECTIVE: To study whether antioxidant supplementation will reduce the incidence of preeclampsia among patients at increased risk. METHODS: A randomized, placebo-controlled, double-blind clinical trial was conducted at four Brazilian sites. Women between 12 0/7 weeks and 19 6/7 weeks of gestation and diagnosed to have chronic hypertension or a prior history of preeclampsia were randomly assigned to daily treatment (...) with both vitamin C (1,000 mg) and vitamin E (400 International Units) or placebo. Analyses were adjusted for clinical site and risk group (prior preeclampsia, chronic hypertension, or both). A sample size of 734 would provide 80% power to detect a 40% reduction in the risk of preeclampsia, assuming a placebo group rate of 21% and alpha=.05. The alpha level for the final analysis, adjusted for interim looks, was 0.0458. RESULTS: Outcome data for 707 of 739 randomly assigned patients revealed
Combined vitamin C and E supplementation during pregnancy for preeclampsia prevention: a systematic review Combined vitamin C and E supplementation during pregnancy for preeclampsia prevention: a systematic review Combined vitamin C and E supplementation during pregnancy for preeclampsia prevention: a systematic review Polyzos N P, Mauri D, Tsappi M, Tzioras S, Kamposioras K, Cortinovis I, Casazza G CRD summary This review assessed the effects of combined vitamin C and E supplementation during (...) pregnancy on pre-eclampsia and major adverse infant outcomes. No significant effects were found. The authors concluded that vitamin C and E supplementation during pregnancy should be discouraged. The authors' conclusions are likely to be reliable, however, their applicability is uncertain as the trials included were mainly of high-risk populations. Authors' objectives To evaluate the effect of combined vitamin C and E supplementation during pregnancy on the prevention of pre-eclampsia and major adverse
Trends in fetal and infant survival following preeclampsia. CONTEXT: Management of preeclampsia often culminates in induced delivery of a very preterm infant. While early termination protects the fetus from an intrauterine death, the newborn then faces increased risks associated with preterm delivery. This practice has increased in recent decades, but its net effect on fetal and infant survival has not been assessed. OBJECTIVE: To assess the effect on fetal and infant survival of increased (...) rates of early delivery of preeclamptic pregnancies. DESIGN, SETTING, AND PARTICIPANTS: Population-based observational longitudinal study using registry data from 804 448 singleton first-born infants with Norwegian-born mothers and registered in the Medical Birth Registry of Norway between 1967 and 2003. MAIN OUTCOME MEASURES: Odds ratio (OR) of fetal and early childhood death in relation to preeclampsia. RESULTS: Among preeclamptic pregnancies, inductions before 37 weeks increased from 8% in 1967
Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. BACKGROUND: Alterations in circulating soluble fms-like tyrosine kinase 1 (sFlt1), an antiangiogenic protein, and placental growth factor (PlGF), a proangiogenic protein, appear to be involved in the pathogenesis of preeclampsia. Since soluble endoglin, another antiangiogenic protein, acts together with sFlt1 to induce a severe preeclampsia-like syndrome in pregnant rats, we examined whether it is associated (...) with preeclampsia in women. METHODS: We performed a nested case-control study of healthy nulliparous women within the Calcium for Preeclampsia Prevention trial. The study included all 72 women who had preterm preeclampsia (<37 weeks), as well as 480 randomly selected women--120 women with preeclampsia at term (at > or =37 weeks), 120 women with gestational hypertension, 120 normotensive women who delivered infants who were small for gestational age, and 120 normotensive controls who delivered infants who
Vitamins C and E and the risks of preeclampsia and perinatal complications. 16641396 2006 04 27 2006 05 03 2013 11 21 1533-4406 354 17 2006 Apr 27 The New England journal of medicine N. Engl. J. Med. Vitamins C and E and the risks of preeclampsia and perinatal complications. 1796-806 Supplementation with antioxidant vitamins has been proposed to reduce the risk of preeclampsia and perinatal complications, but the effects of this intervention are uncertain. We conducted a multicenter, randomized (...) trial of nulliparous women between 14 and 22 weeks of gestation. Women were assigned to daily supplementation with 1000 mg of vitamin C and 400 IU of vitamin E or placebo (microcrystalline cellulose) until delivery. Primary outcomes were the risks of maternal preeclampsia, death or serious outcomes in the infants (on the basis of definitions used by the Australian and New Zealand Neonatal Network), and delivering an infant whose birth weight was below the 10th percentile for gestational age
Urinary placental growth factor and risk of preeclampsia. CONTEXT: Preeclampsia may be caused by an imbalance of angiogenic factors. We previously demonstrated that high serum levels of soluble fms-like tyrosine kinase 1 (sFlt1), an antiangiogenic protein, and low levels of placental growth factor (PlGF), a proangiogenic protein, predict subsequent development of preeclampsia. In the absence of glomerular disease leading to proteinuria, sFlt1 is too large a molecule to be filtered (...) into the urine, while PlGF is readily filtered. OBJECTIVE: To test the hypothesis that urinary PlGF is reduced prior to onset of hypertension and proteinuria and that this reduction predicts preeclampsia. DESIGN, SETTING, AND PATIENTS: Nested case-control study within the Calcium for Preeclampsia Prevention trial of healthy nulliparous women enrolled at 5 US university medical centers during 1992-1995. Each woman with preeclampsia was matched to 1 normotensive control by enrollment site, gestational age
Prevention of preeclampsia with low-dose aspirin: a systematic review and meta-analysis of the main randomized controlled trials Prevention of preeclampsia with low-dose aspirin: a systematic review and meta-analysis of the main randomized controlled trials Prevention of preeclampsia with low-dose aspirin: a systematic review and meta-analysis of the main randomized controlled trials Ruano R, Fontes R S, Zugaib M CRD summary The review investigated the effect of low-dose aspirin in women at low (...) risk and high risk of pre-eclampsia. It concluded that aspirin is associated with a small reduction in the incidence of pre-eclampsia in women at high risk. The conclusion appears to follow from the evidence presented, although relevant studies might have been missed and the lack of detail about the methods makes it difficult to verify the findings. Authors' objectives To determine the effectiveness of low-dose aspirin in the prevention of pre-eclampsia in women at low risk and high risk
Circulating angiogenic factors and the risk of preeclampsia. BACKGROUND: The cause of preeclampsia remains unclear. Limited data suggest that excess circulating soluble fms-like tyrosine kinase 1 (sFlt-1), which binds placental growth factor (PlGF) and vascular endothelial growth factor (VEGF), may have a pathogenic role. METHODS: We performed a nested case-control study within the Calcium for Preeclampsia Prevention trial, which involved healthy nulliparous women. Each woman with preeclampsia (...) was matched to one normotensive control. A total of 120 pairs of women were randomly chosen. Serum concentrations of angiogenic factors (total sFlt-1, free PlGF, and free VEGF) were measured throughout pregnancy; there were a total of 655 serum specimens. The data were analyzed cross-sectionally within intervals of gestational age and according to the time before the onset of preeclampsia. RESULTS: During the last two months of pregnancy in the normotensive controls, the level of sFlt-1 increased