preeclampsia e primigravid
Resultado de pesquisa
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MDL98
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fotocópia
Ui: 98363326
Au: Knuist M; Bonsel GJ; Zondervan HA; Treffers PE.
Ad: Academic Medical Center, University of Amsterdam, Department of
Obstetrics and Gynaecology, The Netherlands.
Ti: Risk factors for preeclampsia in nulliparous women in distinct ethnic
groups: a prospective cohort study.
So: Obstet Gynecol. 92(2):174-8, 1998 Aug.
IS: 0029-7844
Cp: UNITED STATES
Ab: OBJECTIVE: To determine whether baseline characteristics during early
pregnancy, proposed as potential risk factors for preeclampsia, show
differences in prevalence and effects within distinct ethnic groups.
METHODS: In a prospective cohort study of 2413 healthy nulliparous
women from eight midwives' practices, we analyzed risk factors for
preeclampsia (maternal age, body mass index, blood pressure at
booking, smoking habit, and abortion history) in white, Mediterranean,
Asian, and black women. In a univariate analysis, we estimated the
relative risk of preeclampsia for the baseline variables and for
ethnicity. In a multivariate analysis, we evaluated the simultaneous
effect of the baseline variables in white (n = 1641) and black (n =
317) women. RESULTS: Significant differences were found in the
prevalence of the risk factors in different ethnic groups. In the
univariate analysis, the relative risk (RR) of preeclampsia in black
women was 2.4 (95% confidence interval [CI] 1.1, 5.6) compared with
white women. In the multivariate analysis in white women, the adjusted
RR of preeclampsia for a diastolic blood pressure at booking above 70
mmHg was 4.4 (CI 0.9, 20.8). Among black women, the adjusted RR of
preeclampsia was increased for high maternal age (RR 1.2; CI 1.0,
1.4), but not for a diastolic blood pressure at booking above 70 mmHg
(RR 0.8; CI 0.2, 3.9). CONCLUSION: In studies of risk factors for
preeclampsia, black women should be analyzed separately from white
women (Au).
Mh: ADULTO; ESTUDOS DE COORTES; ESTUDO COMPARATIVO; FEMININO; HUMANO;
PARIDADE; PRE-ECLAMPSIA/*EP; GRAVIDEZ; PREVALENCIA; ESTUDOS
PROSPECTIVOS; RACAS/*; FATORES DE RISCO; SUPPORT, NON-U.S. GOV'T;
Pt: JOURNAL ARTICLE
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Resultado de pesquisa
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MDL9288
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fotocópia
Ui: 91278237
Au: Eskenazi B; Fenster L; Sidney S.
Ad: Program of Maternal and Child Health, School of Public Health,
University of California, Berkeley 94720.
Ti: A multivariate analysis of risk factors for preeclampsia.
So: JAMA. 266(2):237-41, 1991 Jul 10.
IS: 0098-7484
Cp: UNITED STATES
Ab: OBJECTIVE.--To determine, in a multivariate analysis, risk factors for
preeclampsia that could be observed early in pregnancy and to
establish whether these risk factors are different for nulliparas and
multiparas. DESIGN.--A case-control study of preeclampsia.
SETTING.--Women who gave birth at Northern California Kaiser
Permanente Medical Centers in 1984 and 1985.
PARTICIPANTS.--Preeclamptic cases (n = 139) were determined from
discharge diagnosis of severe preeclampsia and by confirmation of
blood pressures and proteinuria from medical records. Controls (n =
132) were randomly selected women who had no discharge diagnosis of
any hypertensive disorder of pregnancy and who had no evidence of
hypertension or proteinuria from medical record review. MAIN VARIABLES
EXAMINED.--Medical records were abstracted for information regarding
maternal age, race, previous pregnancy history, family medical
history, socioeconomic status, employment during pregnancy, body mass,
and smoking and alcohol consumption. RESULTS.--Multiple logistic
regression analyses confirmed that case patients were more likely than
control patients to be nulliparous (adjusted odds ratio [OR], 5.4; 95%
confidence interval [Cl], 2.8 to 10.3) and that preeclampsia in a
previous pregnancy greatly increased the risk in a subsequent one
(adjusted OR, 10.8; 95% Cl, 1.2 to 29.1). However, regardless of
parity, preeclamptic women were also more likely to be of high body
mass (adjusted OR, 1.7; 95% Cl, 1.2 to 6.2), to work during pregnancy
(adjusted OR, 2.1; 95% Cl, 1.1 to 4.4), and to have a family history
of hypertension (adjusted OR, 1.7; 95% Cl, 0.92 to 3.2). Having a
previous history of a spontaneous abortion was protective but only in
multiparous women (adjusted OR for multiparas, 0.09; 95% Cl, 0.02 to
0.48). In contrast, being black was a significant risk for
preeclampsia but only in nulliparous women (adjusted OR for
nulliparas, 12.3; 95% Cl, 1.6 to 100.8). CONCLUSIONS.--There are a
number of risk factors for preeclampsia that may be determined early
in a woman's pregnancy. Multiparas and nulliparas share certain risk
factors but not others. A cohort investigation is needed to determine
the ability of these risk factors to predict who develops preeclampsia
(Au).
Mh: ADULTO; CALIFORNIA/EP; ESTUDOS DE CASOS E CONTROLES; FEMININO; HUMANO;
ANALISE MULTIVARIADA; PARIDADE; PRE-ECLAMPSIA/*EP/ET; GRAVIDEZ;
DISTRIBUICAO ALEATORIA; FATORES DE RISCO; FATORES SOCIO-ECONOMICOS;
SUPPORT, NON-U.S. GOV'T;
Pt: JOURNAL ARTICLE
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Identificador único: 97054094
Autor: Anate M; Akeredolu O
Endereço: University of Ilorin Teaching Hospital, Nigeria
Título: Pregnancy outcome in elderly primigravidae at University of Ilorin Teaching Hospital, Nigeria
Fonte: East Afr Med J; 73(8):548-51, 1996 Aug.
ISSN: 0012-835X
País de publicação: KENYA
Idioma: Eng
Resumo: The outcome of pregnancy in 120 elderly primigravid patients (35 years and above) managed at the University of Ilorin Teaching Hospital (UITH), Ilorin over a 5 year period has been studied and compared with 140 randomly selected group of young primigravid patients (20-25 years) managed during the same period in the same centre. All the patients were Nigerians. There was no significant difference in the incidence of abortion, mean gestational age, preeclampsia/pregnancy related hypertension, instrumental delivery and mode of onset of labour in the two groups. There was a statistically significant difference between the two groups in the incidence of foetal malpresentational (elderly 5%, young 1.4% P < 0.001), postpartum haemorrhage (elderly 1.7%, young 0.7%, P < 0.001), caesarean section (elderly 36.7%, young 6.9% P < 0.001), foetal abnormality (elderly 1.7%, young 5.7% P < 0.001), perinatal morbidity (elderly 26.7%, young 12.9% P < 0.05) and perinatal mortality (elderly 4.2%, young 1.4% P < 0.05). The implications of these findings are discussed (Au)
Termos MeSH: ADULTO; ESTUDO COMPARATIVO; PARTO; FEMININO; HOSPITAIS UNIVERSITARIOS; HUMANO; INCIDENCIA; IDADE MATERNA ACIMA DE 35/*; NIGERIA; PARIDADE/*; GRAVIDEZ; COMPLICACOES NA GRAVIDEZ/*ET/PC; RESULTADO DA GRAVIDEZ/*; ESTUDOS RETROSPECTIVOS
Tipo de publicação: JOURNAL ARTICLE
Identificador único: 94234192
Autor: Quinn M
Endereço: Department of Obstetrics and Gynaecology, University Hospital of Wales, Heath Park, Cardiff, United Kingdom
Título: Automated blood pressure measurement devices: a potential source of morbidity in preeclampsia? [see comments]
Comentários: Comment in:/Am J Obstet Gynecol/1995 Apr;172(4 Pt 1):1325-6
Fonte: Am J Obstet Gynecol; 170(5 Pt 1):1303-7, 1994 May.
ISSN: 0002-9378
País de publicação: UNITED STATES
Idioma: Eng
Resumo: OBJECTIVE: The purpose was to compare auscultatory and oscillometric techniques in the determination of maternal blood pressure in normotensive primigravid patients and primigravid patients with proteinuric preeclampsia (blood pressure > 140/90 on two occasions and proteinuria > 0.5 gm/L). STUDY DESIGN: A prospective comparison of systolic and diastolic blood pressure was made with an automated device using oscillometric principles and two observers using a double-headed stethoscope to determine auscultatory observations (phase I and phase IV of the vascular sounds) in normotensive primigravid patients (N = 40) and primigravid patients with proteinuric hypertension (N = 17). RESULTS: In patients with proteinuric preeclampsia the mean differences between auscultatory (phase I and phase IV) and oscillometric observations were 5.4 mm Hg (SEM 1.4 mm, p < 0.05) and 14.8 mm Hg (SEM 2.9 mm, p < 0.01) for systolic and diastolic observations, respectively. In normotensive patients the mean differences between auscultatory (phase I and phase IV) and oscillometric observations were 2.4 mm Hg (SEM 0.9 mm, p not significant) and 7.5 mm Hg (SEM 1.9 mm, p < 0.01) for systolic and diastolic observations, respectively. CONCLUSION: Automated devices using oscillometric principles "underrecord" systolic and diastolic blood pressure compared with auscultatory observations (phase I and phase IV) in patients with proteinuric preeclampsia. In some cases the difference between observations exceeds 30 mm Hg (Au)
Termos MeSH: ADULTO; AUSCULTACAO; PRESSAO ARTERIAL; DETERMINACAO DA PRESSAO ARTERIAL/*MT; MONITORES DE PRESSAO ARTERIAL/*; ESTUDO COMPARATIVO; FEMININO; HUMANO; OSCILOMETRIA; PRE-ECLAMPSIA/*DI; GRAVIDEZ/PH; ESTUDOS PROSPECTIVOS
Tipo de publicação: JOURNAL ARTICLE
Identificador único: 91076231
Autor: Taylor RN; Heilbron DC; Roberts JM
Endereço: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
Título: Growth factor activity in the blood of women in whom preeclampsia develops is elevated from early pregnancy
Fonte: Am J Obstet Gynecol; 163(6 Pt 1):1839-44, 1990 Dec.
ISSN: 0002-9378
País de publicação: UNITED STATES
Idioma: Eng
Resumo: Preeclampsia is a pregnancy-specific disorder of uncertain cause and pathophysiology that appears to be associated with endothelial cell injury. Our current studies demonstrate that a pregnancy growth factor activity is elevated compared with postpartum values in the blood of women with preeclampsia months before the onset of clinical manifestations of toxemia. A cohort of primigravid women was followed throughout pregnancy and multiple serial plasma samples from six women with preeclampsia and six matched normal women were assayed for mitogenic activity. The data indicated that the ratio of predelivery/postdelivery plasma mitogenic activity was greater in women predestined to meet strict criteria for the diagnosis of preeclampsia compared with matched normal primigravid women. Growth factor activity could distinguish women in whom preeclampsia would develop from their normal peers throughout pregnancy, and as early as the first trimester of gestation (p less than 0.05). Similar studies performed with plasma obtained greater than 6 weeks post partum, when the two groups of patients were clinically indistinguishable, revealed no differences in this index of mitogenic activity. Our results indicate that elevated mitogenic activity ratios of prepartum versus postpartum plasma antedate the clinical recognition of preeclampsia, and return to normal with the resolution of the syndrome (Au)
Termos MeSH: ADULTO; PRESSAO ARTERIAL; FEMININO; SUBSTANCIAS DE CRESCIMENTO/*BL; HUMANO; ESTUDOS LONGITUDINAIS; PRE-ECLAMPSIA/*BL/PP; GRAVIDEZ; PRIMEIRO TRIMESTRE DA GRAVIDEZ; PUERPERIO/BL; SUPPORT, U.S. GOV'T, P.H.S.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância: 0 (Growth Substances)
Identificador único: 89132691
Autor: Villar MA; Sibai BM
Endereço: Division of Maternal/Fetal Medicine, University of Tennessee, Memphis 38103
Título: Clinical significance of elevated mean arterial blood pressure in second trimester and threshold increase in systolic or diastolic blood pressure during third trimester [see comments]
Comentários: Comment in:/Am J Obstet Gynecol/1990 Mar;162(3):876-7
Fonte: Am J Obstet Gynecol; 160(2):419-23, 1989 Feb.
ISSN: 0002-9378
País de publicação: UNITED STATES
Idioma: Eng
Resumo: The purpose of this investigation was to determine the diagnostic value of an average mean arterial blood pressure in the second trimester of greater than or equal to 90 mm Hg and a threshold increase in diastolic blood pressure of greater than or equal to 15 mm Hg or in systolic blood pressure of greater than or equal to 30 mm Hg, on two occasions, 6 hours apart, in predicting preeclampsia. The study population consisted of 700 young normotensive primigravid women who were evaluated prospectively during pregnancy. Systolic and diastolic blood pressures were carefully measured at each prenatal visit, and the mean arterial blood pressure in the second trimester was calculated for each measurement. An average greater than 90 mm Hg was considered abnormal. One hundred thirty-seven patients had preeclampsia, for an overall incidence of 19.6%. An average greater than 90 mm Hg had a sensitivity of 8% and a positive predictive value of 23%. The respective values for a threshold increase of greater than 15 mm Hg in diastolic pressure were 39% and 32%. For a threshold increase of greater than 30 mm Hg in systolic pressure, values were 22% and 33%. The negative predictive values for all tests studied ranged between 81% and 85%. Neither a mean arterial blood pressure in the second trimester of greater than 90 mm Hg nor a threshold increase in systolic or diastolic blood pressure during the third trimester was significantly predictive of the development of preeclampsia (Au)
Termos MeSH: PRESSAO ARTERIAL/*; DIASTOLE; FEMININO; IDADE GESTACIONAL; HUMANO; PRE-ECLAMPSIA/*DI; VALOR PREDITIVO DOS TESTES; GRAVIDEZ; SEGUNDO TRIMESTRE DA GRAVIDEZ; TERCEIRO TRIMESTRE DA GRAVIDEZ; SENSIBILIDADE E ESPECIFICIDADE; SISTOLE
Tipo de publicação: JOURNAL ARTICLE
Identificador único: 88127264
Autor: Morgan MA; Thurnau GR
Endereço: Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City
Título: Pregnancy-induced hypertension without proteinuria: is it true preeclampsia?
Fonte: South Med J; 81(2):210-3, 1988 Feb.
ISSN: 0038-4348
País de publicação: UNITED STATES
Idioma: Eng
Resumo: A profile scoring system has recently been developed as a standardized method of early identification and severity assessment of pregnancy-induced hypertension (PIH). The purpose of this study is twofold: (1) to compare the PIH profile scores of patients demonstrating mild PIH without proteinuria with those of patients demonstrating mild PIH with proteinuria, and (2) to introduce the PIH profile graph as a standardized clinical assessment tool. Serial PIH profile data after 24 weeks' gestation from 46 term primigravid patients with mild PIH (group 1 = 19 patients without proteinuria; group 2 = 27 patients with proteinuria) were plotted on PIH profile graphs and compared. Profile scores from ten normotensive primigravidas at term served as controls. Serial profile scores for groups 1 and 2 showed similar patterns on the profile graph. Based on these data, we believe that PIH without proteinuria is clinically and biochemically a manifestation of true preeclampsia before the onset of proteinuria. Furthermore, the PIH profile graph allows one to identify subtle changes in the disorder and to anticipate the development of severe preeclampsia (Au)
Termos MeSH: ADULTO; ESTUDO COMPARATIVO; FEMININO; HUMANO; HIPERTENSAO/DI/UR; PRE-ECLAMPSIA/*DI/UR; GRAVIDEZ; COMPLICACOES CARDIOVASCULARES NA GRAVIDEZ/DI/UR; PROTEINURIA/*
Tipo de publicação: JOURNAL ARTICLE
Identificador único: 87046179
Autor: Sibai BM; el-Nazer A; Gonzalez-Ruiz A
Título: Severe preeclampsia-eclampsia in young primigravid women: subsequent pregnancy outcome and remote prognosis
Fonte: Am J Obstet Gynecol; 155(5):1011-6, 1986 Nov.
ISSN: 0002-9378
País de publicação: UNITED STATES
Idioma: Eng
Resumo: The purpose of this report is to compare subsequent pregnancy outcome and incidence of chronic hypertension and diabetes on follow-up in two groups of patients. Group 1 included 406 young women who had severe preeclampsia-eclampsia in their first pregnancies. Group 2 consisted of 409 young, well-matched women who remained normotensive during their first pregnancies. All patients were followed up for a minimum of 2 years (range 2 to 24). The preeclamptic-eclamptic group had a higher incidence of preeclampsia in their second pregnancies (46.8% versus 7.6%, p less than 0.0001) and in subsequent pregnancies (20.7% versus 7.7%, p less than 0.001) when compared with the normotensive group. The overall incidence of chronic hypertension was significantly higher in the preeclamptic-eclamptic group (14.8% versus 5.6%, p less than 0.001). Most of the difference occurred in patients followed up greater than or equal to 10 years. Within the preeclamptic-eclamptic group, patients having preeclampsia-eclampsia at less than or equal to 30 weeks' gestation and those having recurrent preeclampsia in their second pregnancies had a significantly higher incidence of subsequent chronic hypertension (p less than 0.001) than was found in the other patients. Within the normotensive group, patients remaining normotensive in subsequent pregnancies had the lowest incidence of chronic hypertension (Au)
Termos MeSH: ADOLESCENCIA; ADULTO; CRIANCA; ECLAMPSIA/CO/*PP; FEMININO; SEGUIMENTOS; HUMANO; HIPERTENSAO/PP; COMPLICACOES DO TRABALHO DE PARTO/ET; PARIDADE; PRE-ECLAMPSIA/*PP; GRAVIDEZ; GRAVIDEZ NO DIABETES/ET; PROGNOSTICO; RECIDIVA
Tipo de publicação: JOURNAL ARTICLE
Identificador único: 85119405
Autor: Moutquin JM; Rainville C; Giroux L; Raynauld P; Amyot G; Bilodeau R; Pelland N
Título: A prospective study of blood pressure in pregnancy: prediction of preeclampsia
Fonte: Am J Obstet Gynecol; 151(2):191-6, 1985 Jan 15.
ISSN: 0002-9378
País de publicação: UNITED STATES
Idioma: Eng
Resumo: A prospective study of blood pressure recording was conducted in 1000 patients, at each antenatal visit, with the use of an automatic random-zero sphygmomanometer. In 46 patients, among 808 primigravid women, who developed preeclampsia, the diastolic and mean blood pressures were significantly elevated compared to values at the first antenatal visit (p less than 0.01, 9 to 12 weeks). This difference was sustained throughout pregnancy until delivery by at least 10 mm Hg as compared to pressures in the normotensive group. Sensitivity for predicting preeclampsia early in pregnancy with an elevated blood pressure measurement (130 to 135/80 to 85 mm Hg) ranged from 16% to 57% while specificity ranged from 75% to 98%. The results substantiate an early vasospasm (9 to 12 weeks) in those women destined to develop preeclampsia (Au)
Termos MeSH: ADULTO; PRESSAO ARTERIAL/*; FEMININO; HUMANO; HIPERTENSAO/*CO/PP; RECEM-NASCIDO; PRE-ECLAMPSIA/*ET/PP; GRAVIDEZ; COMPLICACOES CARDIOVASCULARES NA GRAVIDEZ/*PP; PROGNOSTICO; ESTUDOS PROSPECTIVOS; RISCO; SUPPORT, NON-U.S. GOV'T
Tipo de publicação: JOURNAL ARTICLE
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