Longitudinal study of the renin-angiotensin-aldosterone system in hypertensive pregnant women: deviations related to the development of superimposed preeclampsia

Article Abstract:

Preeclampsia, a condition of pregnancy characterized by high blood pressure, headaches, abnormal amounts of protein in the urine, and swelling of the legs, can progress to eclampsia, which is life-threatening. The women most susceptible to preeclampsia are those with chronic hypertension (high blood pressure); however, identification of which hypertensive pregnant women will develop the complication is not easy at early stages of pregnancy. To learn more concerning the relationship between events in early pregnancy and preeclampsia later on, 25 chronically hypertensive women (blood pressure higher than 140/90 millimeters of mercury on two or more occasions) were studied during 30 pregnancies. Fifty-eight women with normal blood pressure constituted the control group. Of particular interest was the renin-angiotensin-aldosterone system, a system that affects blood pressure in response to physiological changes in the body. Results showed that 13 of the 30 pregnancies were associated with preeclampsia called ''superimposed'' preeclampsia, usually developing during the third trimester. These women gave birth earlier than the women who did not develop preeclampsia, and their infants were smaller than those born to hypertensive women who did not develop preeclampsia or to controls. Preeclamptic women had an incidence of serious fetal morbidity and mortality of almost 30 percent. Data concerning blood pressure changes and renal function throughout pregnancy for all subjects are provided. Longitudinal studies of the renin-angiotensin-aldosterone system revealed that the women who developed preeclampsia had decreased renin activity and urinary aldosterone as the complication progressed; in addition, their levels of estradiol (a female hormone) did not increase normally late in pregnancy. Atrial natriuretic factor (another hormone that affects blood pressure) also increased in these women. These changes were not noted for the chronically hypertensive women who did not develop preeclampsia. The results provide information of potential value in understanding the physiological basis for superimposed preeclampsia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Renin-angiotensin system

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The effect of vibroacoustic stimulation on the nonstress test at gestational ages of thirty-two weeks or less

Article Abstract:

The presence of accelerated fetal heart rates is known to indicate fetal well-being. Nonstress tests are noninvasive tests which are used to assess fetal status by monitoring the fetus for heart rate accelerations after vibratory or acoustic stimulation. Sound vibrations applied during a nonstress test are helpful in reducing the number of false test results (nonreactive, no heart rate acceleration after vibratory stimulation). To determine the effects of sound vibrations on 20 to 32-week-old fetuses, 15 pregnancies were studied during 316 nonstress tests. Auditory stimulation was used in 168 nonreactive stress tests. A nonstress test is considered normal (reactive) if the fetal heart rate accelerates more than 15 beats per minute for 15 seconds. Nonstress tests are considered abnormal if there is no reaction to vibration or sound within 20 minutes. The incidence of reactive stress tests increased after 26 weeks of pregnancy. It is thought that increased response to sound is related to the maturation of fetal hearing. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Testing, Fetus, Vibration, Vibration (Physics), Prenatal influences, Sound, Acceleration (Physiology)

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A prediction model for superimposed preeclampsia in women with chronic hypertension during pregnancy

Article Abstract:

Women with chronic hypertension are at increased risk for superimposed preeclampsia. A prediction algorithm for superimposed preeclampsia is developed using comprehensive clinical and laboratory information that was measured during early pregnancy in women with chronic hypertension.

United States, Science & research, Risk factors

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