Objectives: Assess the usefulness of the sFlt-1/PlGF ratio for the differential diagnosis of uncontrolled chronic hypertension vs. superimposed preeclampsia.
Study Design: We performed a cross-sectional study from 2015 to 2017 and 42 women with initial diagnosis of superimposed preeclampsia were enrolled in the emergency room. After a 12 week follow up patients were grouped as superimposed preeclampsia (Group A) and uncontrolled chronic hypertension (Group B) according to the American College of Obstetricians and Gynecologist criteria. A group of 33 healthy women paired by gestational age were included as controls (Group C). Maternal serum levels of sFlt-1 and PlGF were measured at enrollment, and the ratios of the groups were compared.
Main Outcome Measures: Superimposed preeclampsia vs. uncontrolled chronic hypertension.
Results: After follow-up, group distribution was 30 women in Group A, 12 women in Group B, and 25 women in Group C. The sFlt-1/PlGF ratio was higher in women with superimposed preeclampsia than in women with uncontrolled chronic hypertension (215.5 vs. 9.65, p < 0.001). The control group displayed lower ratio values (3.66, p < 0.001). The sFlt-1 concentration was higher in Group A than in Group B (7564 vs. 1281 pg/mL, p < 0.001) and the PlGF level was lower in Group A (34.39 vs. 169 pg/mL, p < 0.001).
Conclusions: The sFlt-1/PlGF ratio exhibits good performance for the differential diagnosis of superimposed preeclampsia vs. uncontrolled chronic hypertension.
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http://dx.doi.org/10.1016/j.preghy.2020.04.014 | DOI Listing |
Pregnancy Hypertens
January 2025
Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, University of Chicago Medical Center, Chicago, IL, USA. Electronic address:
Background: Oral furosemide postpartum improves the time to hypertension resolution in randomized control trials. Further investigation is needed to determine the impact of furosemide in routine clinical practice.
Objective: Real world study to assess impact of furosemide on rates of postpartum hypertension and readmissions for patients with hypertensive disorders of pregnancy.
Pregnancy Hypertens
January 2025
Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Objectives: To evaluate blood pressure control during the immediate postpartum period in hypertensive women who had used methyldopa during pregnancy, comparing continuation of that drug with switching it for captopril.
Study Design: A single-blind, randomized clinical trial involving 172 postpartum women with hypertension who had previously used methyldopa during pregnancy at a minimum dose of 750 mg/day for at least one week prior to delivery. The subtypes of hypertension included were gestational hypertension, chronic hypertension, preeclampsia, superimposed preeclampsia, HELLP syndrome and eclampsia.
Novel Insights In presence of cardiotocographic features suspected for hypoxic insult, intrapartum ultrasound in the hands of experienced operators can demonstrate cerebral edema as an indirect sign of fetal hypoxia affecting the fetal CNS and exclude non-hypoxic conditions potentially leading to abnormalities of the fetal heart rate. Introduction Hypoxic-ischemic encephalopathy is a syndrome involving the fetal central nervous system as the result of a perinatal hypoxic-ischemic injury. To date, transfontanellar ultrasound represents the first line exam in neonates with clinical suspicion of HIE as it allows to show features indicating acute hypoxic injury and exclude potential non-hypoxic determinants of HIE, however there is no report concerning the sonographic assessment of the brain during labor.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, Epidemiology and Clinical and Translational Research, University of Pittsburgh, Pittsburgh, Pennsylvania.
Importance: Chronic hypertension and preeclampsia are leading risk enhancers for maternal-neonatal morbidity and mortality. Severe maternal morbidity (SMM) indicators include heart, kidney, and liver disease, but studies have not excluded patients with preexisting diseases that define SMM. Thus, SMM risks for uncomplicated chronic hypertension specific to preeclampsia remain unclear.
View Article and Find Full Text PDFIntroduction And Objective: As thresholds for the diagnosis of gestational diabetes mellitus (GDM) become lower, and the prevalence of obesity in society rises, more pregnant women will be diagnosed with GDM and hypertension. Both conditions hold dangers for mother and baby. Our objective was to properly describe this association.
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