Hypocalciuria of preeclampsia is independent of parathyroid hormone level

Article Abstract:

Preeclampsia is a complication of pregnancy characterized by increasing hypertension, or abnormally high blood pressure; headaches; albuminuria, or the presence of the blood protein albumin in the urine; and tissue fluid accumulation in the lower extremities. Preeclampsia and other hypertensive disorders have been shown to be associated with abnormalities in calcium metabolism. Studies suggest that the development of hypocalciuria, or low urinary calcium levels, can help to distinguish preeclampsia from other hypertensive disorders. Reduced calcium intake in the diet, increased intake of calcium by the fetus, or impaired kidney function may contribute to the development of hypocalciuria. Parathyroid hormone (PTH) increases blood calcium levels by causing the release of calcium from bone and absorption of calcium in the kidney tubules. This hormone also increases the production of 1,25-dihydroxycholecalciferol, which increases calcium absorption from the intestine. The actions of PTH on the bones and kidneys involve the activation of the enzyme adenylate cyclase and the production of cyclic adenosine monophosphate (cAMP). The role of PTH in the development of hypocalciuria associated with hypertensive complications of pregnancy was assessed in 14 women with preeclampsia, 12 women with chronic hypertension, and 11 pregnant women with normal blood pressure, in the last three months of pregnancy. The urinary calcium excretion rate was lowest in patients with preeclampsia, higher in patients with chronic hypertension, and highest in normotensive women. The blood levels of PTH and urinary excretion of cAMP were lower in patients with preeclampsia than in hypertensive or normotensive women. These findings suggest that PTH does not contribute to the development of hypocalciuria associated with preeclampsia, which may result from impaired kidney function. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Parathyroid hormone, Parathyroid hormones, Preeclampsia, Calcium metabolism disorders

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High-order multifetal gestation - management and outcome

Article Abstract:

There is a high risk of fetal and neonatal complications and death associated with multifetal gestations, especially those with preterm birth. With an increased number of fetuses there is often a decrease in the duration of gestation and birth weight. Although the incidence of quadruplets, quintuplets, and sextuplets is still rare, the use of ovulation-stimulating drugs has increased the occurrence of multifetal pregnancies. There may be increased risk of obstetric problems with multifetal pregnancies. One obstetrical team's experience with 11 high-order (quadruplet or greater) multifetal pregnancies is described and management guidelines are outlined. During a 13-year period, there were eight quadruplet, two quintuplet, and one sextuplet pregnancies resulting from ovulation induction therapy. Malpresentation of the fetuses was common; 17 were in the breech position (buttocks first). A total of 39 infants were born alive and the total fetal loss was 23 percent. Two of the 39 liveborn infants died because of medical complications. The 37 surviving infants have been followed, 30 of them for at least two years. Each case presented specific and complex obstetrical problems and it is not possible to develop general management guidelines. The basic goal is to prolong the period of gestation. Bed rest was prescribed and the mothers were hospitalized at the beginning of their third trimester. Premature contractions occurred in all patients and tocolytic therapy was used to control preterm labor. Cesarean delivery was performed for all multifetal pregnancies. Although multifetal pregnancy reduction to selectively choose fetuses that have a better chance of survival was an option, the patients to whom this procedure was offered refused because of their religious beliefs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Prognosis, Pregnancy, Complications of, Pregnancy complications, Multiple birth

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Pregnancy after myocardial infarction: are we playing safe?

Article Abstract:

Coronary artery disease is the most common cause of death in the western world. Smoking and the use of oral contraceptives increase the risk of developing this disease. However, coronary artery disease is rare in young women of child-bearing years. It is estimated that under 4 percent of the women who become pregnant have heart disease. However, more older women are having babies, and this may lead to an increase in heart disease among pregnant women. During pregnancy, the heart has to work harder and this can cause problems in women who have heart disease. A recent study reported that approximately 8 out of every 100,000 women experience heart attack during pregnancy. Twenty cases of pregnancy in women who previously had a heart attack have been previously reported. Of the 20 women, four had heart failure and four had an increase in the severity of angina (chest pain caused by reduced oxygen supply to the heart) during pregnancy. The cases are reported of four women who became pregnant between nine months and nine years after experiencing a heart attack. In all four cases, the pregnancies were uncomplicated and the women did not experience any heart problems related to the attack. It is concluded that women who have had a heart attack can have normal pregnancies. It is recommended that women who have had a heart attack have a heart examination before becoming pregnant, to ensure a safe and uncomplicated pregnancy. Smoking, eating saturated fat, and intense physical activity should be restricted in these patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Cardiovascular diseases, Heart attack, Pregnancy, Labor, Complicated, Labor complications, Cardiovascular diseases in pregnancy

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