Renal vascular hypertension during pregnancy
Article Abstract:
If an artery supplying the kidney with blood becomes narrowed or blocked (stenosis), the resulting lack of oxygen in the kidney causes the release by the kidney of renin, a substance involved in the control of blood pressure. Renal vascular hypertension is high blood pressure caused in this way. It can be treated with a surgical procedure called transluminal angioplasty, in which a balloon-tipped catheter opens the blocked blood vessels. The restored blood flow to the kidney stops the release of renin, and thereby lowers blood pressure. Fourteen cases of renal vascular hypertension during pregnancy have been reported in the medical literature. In 73 percent of the cases, high blood pressure developed in the first trimester of pregnancy, and in most cases it continued through the second and third trimesters. In three of the cases the blood pressure became dangerously high, and decisions to end the pregnancies were made. There were one spontaneous abortion, two stillbirths, and two emergency cesarean sections for fetal distress. Nine of the women continued to have high blood pressure following delivery. In one case, transluminal angioplasty was performed during pregnancy. The procedure cured the high blood pressure and the rest of the pregnancy was normal with a normal delivery. The cases are reported of two pregnant women with high blood pressure caused by renal artery stenosis. In the first case, the woman underwent transluminal angioplasty during pregnancy. Following the procedure, her blood pressure returned to normal and the rest of the pregnancy, including delivery, was normal. In the second case, the woman developed high blood pressure 12 weeks after delivery. She was diagnosed as having renal vascular stenosis and transluminal angioplasty was performed successfully. It is concluded that transluminal angioplasty can be performed successfully during pregnancy when other methods of controlling blood pressure fail. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1991
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Erythropoietin in preeclampsia
Article Abstract:
Preeclampsia is a complication of pregnancy that can develop after the 20th week. It is characterized by high blood pressure, edema (accumulation of fluid in body tissues) and proteinuria (protein in the urine). In some cases, red blood cells are destroyed (hemolysis) and anemia (low red blood cell count) results. Ordinarily, when anemia is present, the kidneys make more erythropoietin (a protein that increases the production of red blood cells) in an attempt to correct the anemia. However, with preeclampsia the kidneys do not function properly and it is not clear whether they continue to produce erythropoietin when anemia occurs. Therefore, a study was performed to determine if the kidneys make erythropoietin when anemia is the result of preeclampsia. The study included 28 pregnant women: 14 with mild preeclampsia; five with severe preeclampsia; and nine without preeclampsia. All of the women were in their third trimester of pregnancy and none had kidney failure. The women with preeclampsia had high blood pressure and proteinuria. The amount of hemoglobin (the protein that carries oxygen in red blood cells) and the number of red blood cells (hematocrit) were similar in women with and without preeclampsia. As anemia developed in the women with preeclampsia, the amount of erythropoietin in the blood increased. The women who had preeclampsia had four times the amount of erythropoietin in their blood as the women who did not have preeclampsia. These findings indicate that the erythropoietin response to anemia appears to be normal during preeclampsia that does not cause kidney failure. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1991
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