The effect of maternal hemodynamics on fetal growth in hypertensive pregnancies

Article Abstract:

While maternal hypertension is a known risk factor for impaired fetal growth and intrauterine death, many pregnancies in hypertensive women yield normal infants without complications. Fetal growth impairment may result from a specific type of maternal hypertension called high-resistance hypertension, and low-resistance hypertension may be associated with normal fetal growth. This was studied in 76 pregnancies, 36 of which were low-resistance; 32, high-resistance; and 8, crossover (patients with patterns ranging from low- to high-resistance). High-resistance hypertension, associated with constriction of the blood vessels, was determined by measuring total peripheral resistance. The subjects with low-resistance hypertension were, on average, 19 kilograms heavier than those with high-resistance hypertension. Both the high-resistance and crossover groups had higher arterial blood pressures than the low-resistance group; the heart rates of the low-resistance and crossover groups were higher than of the high-resistance group. Mothers with high-resistance hypertension delivered their infants an average of four weeks earlier than mothers with low-resistance hypertension. The average birth weight of infants born to women in the high-resistance group was the 19th percentile compared with the 39th percentile for infants born to the low-resistance mothers. Infants from the crossover group had growth retardation similar to that of infants in the high-resistance group, and a high proportion (38 percent) died; in fact, this group suffered the most complications in the study. A discussion is presented of hypertension in pregnancy, which is no longer thought to be a simple effect of increased vasoconstriction. The results show that hypertensive mothers with vasoconstriction (the high-resistance group) often deliver prematurely and often have babies with impaired growth. Such women should be monitored carefully during pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Fetus, Physiological aspects, Fetal growth retardation, Hypertension in pregnancy, Gestational hypertension

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Preeclampsia: A hyperdynamic disease model

Article Abstract:

Preeclampsia is an abnormal condition found in about six percent of pregnant women after the 24th week of pregnancy. The characteristic high blood pressure, swelling (edema) and urine protein (proteinuria) adversely affect maternal and infant well- being. Bed rest and early delivery of the infant is the usual treatment. The underlying mechanism is not understood. One theory speculates the high blood pressure is caused by vasospasm, blood vessel constriction, which increases resistance within the vessel while heart output remains normal. This study proposes a model of the mechanics affecting the force and flow of blood (hemodynamics) and their relationship to preeclampsia. A review of support studies is presented. The model proposed takes note of the fact that when kidneys have increased load (renal hyperprofusion), this results in high blood pressure and protein output. Low-protein diets have also been associated with decreased occurrence of preeclampsia. The use of a beta-Blockade drugs supports the model proposed. The hemodynamic model should be used when making hypotheses on this disease.

Health aspects, Research, Hemodynamics, Preeclampsia, Adrenergic beta blockers, Adrenergic beta-antagonists, Pregnancy, Complications of, Pregnancy complications

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Management and outcome of pregnant women with interstitial and restrictive lung disease

Article Abstract:

Careful prenatal management of pregnant women with restrictive lung disease may result in good outcomes for both mother and fetus. Restrictive lung disease may involve lung fibrosis, connective tissue disease, or be drug induced. Researchers cared for nine pregnant women with lung inflammation and diminished respiratory function. Five patients with immune diseases were treated with prednisone during pregnancy. Supplemental oxygen was provided for women whose lungs could not adequately eliminate carbon monoxide. Lung function should be tested at the beginning of pregnancy in patients with restrictive lung disease. Epidural anesthesia during labor and delivery may be useful in decreasing the need for oxygen. Drugs, pets, and other allergens should be removed from the patient during pregnancy.

Care and treatment, Pregnant women, Lung diseases, Interstitial, Interstitial lung diseases, Hypersensitivity pneumonitis, Extrinsic allergic alveolitis

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