Acute renal failure in hypertensive disorders of pregnancy

Article Abstract:

Kidney failure is a rare complication of preeclampsia and eclampsia, disorders of pregnancy marked by high blood pressure, swelling and protein in the urine and, in the case of eclampsia, convulsions. During acute renal failure, the kidneys are unable to filter wastes from the blood, concentrate urine and maintain balanced electrolytes. The mechanism involved in damaging the kidney structures is unclear. The relationship between the presence of kidney disease and complications of pregnancy in causing acute kidney failure was studied in 18 patients with preeclampsia and 12 patients with chronic high blood pressure, kidney disease, or both, present at the onset of pregnancy. Two mothers with preeclampsia and one mother with severe high blood pressure died six to eight weeks after delivery. All 18 patients had tissue damage in the kidney tubules. Dialysis, a method of mechanically filtering the blood of waste products, was required in nine patients (50 percent) with preeclampsia and five patients (42 percent) with severe high blood pressure. Abruptio placenta, the premature separation of the placenta from the uterine wall, was experienced by nine mothers with preeclampsia (50 percent) and seven (54 percent) of the mothers with chronic hypertension and kidney disease. Eleven of the 16 cases (52 percent) resulted in the death of the fetus. Kidney damage was reversed in all patients with preeclampsia, with normal kidney functioning returning within four years. Long-term dialysis was required in nine out of 11 patients surviving chronic hypertension and kidney disease. End-stage kidney disease developed in four patients diagnosed with chronic hypertension and kidney disease, all of whom eventually died. Acute renal failure is uncommon in patients with preeclampsia and eclampsia, and it is not associated with long-term complications in the well-managed patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Acute renal failure, Acute kidney failure

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A comparison of no medication versus methyldopa or labetalol in chronic hypertension during pregnancy

Article Abstract:

The poor fetal outcome that is associated with high blood pressure during pregnancy can be improved if measures are taken to reduce the blood pressure. Blood pressure-lowering agents (antihypertensives) have proved useful in treating pregnancy-induced high blood pressure, chronic high blood pressure and preeclampsia. To see if treatment for mild to moderate chronic high blood pressure, which is present before pregnancy begins, can improve pregnancy outcome, 263 women were given either methyldopa (87 women), labetalol (86 women) or no medication (90 women). Blood pressure was significantly lower in the patients receiving medication. The incidence of superimposed preeclampsia (a disorder of pregnancy marked by high blood pressure, protein in the urine and swelling), abruptio placenta (premature detachment of the placenta), spontaneous fetal loss, and stillbirth or premature delivery was similar in all three groups. There was no difference in fetal birth weight, growth retardation, head size and age of the fetus at delivery. Early treatment of pregnant women with mild chronic high blood pressure did not improve the outcome of the pregnancy or reduce fetal complications. (Consumer Summary produced by Reliance Medical Information, Inc.)

Hypertension, Labetalol, Methyldopa

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Magnesium supplementation during pregnancy: A double-blind randomized controlled clinical trial

Article Abstract:

It has been suggested that magnesium deficiencies in pregnancy result in preeclampsia, a potentially life-threatening condition in pregnancy causing high blood pressure, excessive urine protein and swelling. Oral doses of supplemental magnesium were given to 185 pregnant women with normal blood pressures, while a placebo was given to 189 patients during the 13-24 weeks of pregnancy. There were no significant differences between these two groups in any of the parameters studied. Magnesium supplements therefore did not reduce the incidence of preeclampsia or growth retardation in this group of patients.

Health aspects, Care and treatment, Pregnancy, Blood pressure, Magnesium, Magnesium (Metal), Toxemia of pregnancy, Pregnancy toxemias

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