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Background: Complications of pregnancy are reflected in placenta. Placenta is the mirror of maternal and foetal status. So a study of placenta and new born will help to identify the disease by which mother is affected in pregnancies of pregnancy induced hypertension. Aim: Our study aimed in study of morphology, morphometry and histology of placenta in normal pregnancy and in pregnancy induced hypertensive (PIH) mothers. This study also correlates the birth weight and height of the new born babies of both the mothers of normal pregnancy and PIH. Materials and Methods: 50 booked cases (25-normal pregnancy and 25 PIH) have been studied in an institution in eastern India. Antenatal check up of these cases were made routinely. After delivery, placentas were examined for morphological, morphometric, histological and histopathological parameters and features. Birth height and weight of the newborn babies were documented in each case. Finally, parameters were analyzed in between both the groups. Results: Placental weight and volume reduced significantly in P.I.H. mothers and the reduction of placental area was suggestive of pregnancy induced hypertension. Incidence of gross calcification in placenta, retro placental blood clots and infarction increased markedly in pregnancy induced hypertensive mothers. There has been increased incidence of syncitial knots and syncytio-trophoblast in PIH. Thickening of basement membrane, increased intervillous space and fibrinoid necrosis were associated with PIH. Conclusion: Structural changes in the placenta, macroscopic ad well as microscopic, during pregnancy induced hypertension has been detrimental to the foetus, which is the main focus of our study.

Abstract Objectivies Pregnancy induced hypertension (PIH) syndrome is a disease that unique to pregnant women and is associated with elevated risk of offspring cardiovascular diseases (CVDs) and neurodevelopmental disorders in their kids. Previous research on cord blood utilizing the Human Methylation BeadChip or EPIC array revealed that PIH is associated with specific DNA methylation site. Here, we investigate the whole genome DNA methylation landscape of cord blood from newborns of PIH mother. Methods Whole-genome bisulfite sequencing (WGBS) was used to examine the changes in whole genome DNA methylation in the umbilical cord blood of three healthy (NC) and four PIH individuals. Using methylKit, we discovered Hypo- and hyper- differentially methylated probes (DMPs) or methylated regions (DMRs) in the PIH patients’ cord blood DNA. Pathway enrichments were assessed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment assays. DMPs or DMRs relevant to the immunological, neurological, and circulatory systems were also employed for enrichment assay, Metascape analysis and PPI network analysis. Results 520 hyper- and 224 hypo-DMPs, and 374 hyper- and 186 hypo-DMRs between NC and PIH group, respectively. Both DMPs and DMRs have enhanced pathways for cardiovascular, neurological system, and immune system development. Further investigation of DMPs or DMRs related to immunological, neurological, and circulatory system development revealed that TBK1 served as a hub gene for all three developmental pathways. Conclusion PIH-associated DMPs or DMRs in umbilical cord blood DNA may play a role in immunological, neurological, and circulatory system development. Abnormal DNA methylation in the immune system may also contribute to the development of CVDs and neurodevelopment disorders.

Background: Uric acid is frequently linked to cardiovascular disease. The elevated serum uric acid levels have been studied as one of the criteria for the detection of pre-eclampsia. Therefore, knowledge of the normal physiology of serum uric acid during pregnancy is essential for the appropriate interpretation of uric acid readings. Methodology:100 patients 50 diagnosed with pre-eclampsia & 50 controls between the ages of 20 and 35 were studied at a tertiary teaching hospital & Research Centre in central India. The Uricase Peroxidase Method was used to estimate uric acid. Results: The data was statistically analysed by using an online student t-test calculator. A p-value of less than 0.05 was seen as significant. Conclusion: Serum uric acid levels were considerably greater in individuals with preeclampsia and PIH, and in hypertensive patients, they may serve as a helpful predictor of maternal and fetal complications. [ABSTRACT FROM AUTHOR]

Objectivies: Pregnancy induced hypertension (PIH) syndrome is a disease that unique to pregnant women and is associated with elevated risk of offspring cardiovascular diseases (CVDs) and neurodevelopmental disorders in their kids. Previous research on cord blood utilizing the Human Methylation BeadChip or EPIC array revealed that PIH is associated with specific DNA methylation site. Here, we investigate the whole genome DNA methylation landscape of cord blood from newborns of PIH mother. Methods: Whole-genome bisulfite sequencing (WGBS) was used to examine the changes in whole genome DNA methylation in the umbilical cord blood of three healthy (NC) and four PIH individuals. Using methylKit, we discovered Hypo- and hyper- differentially methylated probes (DMPs) or methylated regions (DMRs) in the PIH patients' cord blood DNA. Pathway enrichments were assessed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment assays. DMPs or DMRs relevant to the immunological, neurological, and circulatory systems were also employed for enrichment assay, Metascape analysis and PPI network analysis. Results: 520 hyper- and 224 hypo-DMPs, and 374 hyper- and 186 hypo-DMRs between NC and PIH group, respectively. Both DMPs and DMRs have enhanced pathways for cardiovascular, neurological system, and immune system development. Further investigation of DMPs or DMRs related to immunological, neurological, and circulatory system development revealed that TBK1 served as a hub gene for all three developmental pathways. Conclusion: PIH-associated DMPs or DMRs in umbilical cord blood DNA may play a role in immunological, neurological, and circulatory system development. Abnormal DNA methylation in the immune system may also contribute to the development of CVDs and neurodevelopment disorders. [ABSTRACT FROM AUTHOR]

BackgroundMaternal near miss (MNM) is one of the newly adopted assessment parameters to gauge the quality of maternity care. In Ethiopia, several studies have been conducted to investigate the incidence, underlying causes, and determinants of MNM. However, the findings from those studies vary greatly and are largely inconsistent. Thus, this review aims to more robustly estimate the pooled prevalence, identify underlying causes, and single out determinants of MNM in Ethiopia.MethodsStudies were searched from international databases (PubMed/ Medline, Cochrane Library, and Embase databases) and other potential sites. All observational studies were included. Heterogeneity between studies was checked using Cochrane Q test statistics and I2 test statistics and small study effects were checked using Egger’s statistical test at a 5% significance level. Outcome measures were overall and specific underlying causes (obstetrics hemorrhage, hypertensive disorder pregnancy, pregnancy-related infection) rates of MNMs per 10,000 live births.ResultThe meta-analysis included 43 studies consisting of 77240 MNM cases. The pooled prevalence MNM per 1000 live births in Ethiopia was 54.33 (95% CI: 33.93 to 85.89). Between-study heterogeneity was high (I2 = 100%, P < 0.0001), with the highest rate observed in Amhara region (384.54 per 1000). The prevalence of obstetrics hemorrhage (14.56 per 1000) was higher than that of hypertensive disorder pregnancy (12.67 per 1000) and pregnancy-related infections (3.55 per 1000) were identified as underlying causes. Various factors, including socio demographic characteristics, previous medical and obstetrics history as well as access to and quality of care obtained, were associated with MNM.ConclusionAlmost six women encounter near miss among a hundred live births in Ethiopia. Obstetric hemorrhage and hypertensive disorder pregnancy were the most common underlying causes of MNM. Both individual and facility level determinants were found to be associated with MNM. Considering the magnitude and identified factors, tailored measures should be taken at every stage of the continuum of care.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023395259.

Background: Pregnancy induced hypertension are multi-system disorders of the mother that affect the fetus because of utero-placental insufficiency. These neonates may also have a spectrum of hematological changes which may add to the existing morbidity in them. objectives: To correlate cord Nucleated red blood cells and neonatal outcome in Pregnancy induced hypertension. Materials and method: The study was conducted in the Mata Chanan Devi Hospital, Janakpuri, New Delhi. A total of 55 cases and 55 controls of newborns fulfilling the inclusion criteria. The mother’s antenatal records were examined to rule out the Pre-Existing maternal medical illness. History of drug intake and compliance of treatment was recorded. Results: Cord blood nucleated red blood cells was significantly raised in neonates born to PIH mothers (>13 NRBC/100 WBC) compared to normotensive mothers and also had significantly higher incidence of Low birth weight, Hypoglycemia, Respiratory distress and Asphyxia. Conclusion: NRBC count can be used as a simple tool where expertise not available and accordingly can plan the interventions. It is a special boon in a rural care center, where advanced diagnostic modalities are unaffordable or inaccessible. Umbilical cord NRBC count it correlates well with neonatal outcome. [ABSTRACT FROM AUTHOR]

Background: Pregnancy‑Induced hypertension (PIH) is a common health problem that occurs during pregnancy and may lead to limited fetal growth and other major health problems. Being a serious public health issue, PIH is responsible for a significant number of deaths across the globe. Hyrtl’s anastomosis of the umbilical arteries and placenta is a blood vessel system that can affect the growth and development of the fetus. The studies conducted earlier have suggested that the abnormalities in Hyrtl’s anastomosis may be associated with the development of PIH and other adverse pregnancy outcomes. Aim: The aim of the current systematic literature review is to investigate the potential advantages and restrictions of Hyrtl’s anastomosis as a medical diagnosis and treatment tool for PIH by reviewing the available evidence. Materials and Methods: The current study is a systematic literature review that involves the selection of 10 articles published in or after 2019 from reputed journals that evaluated the effectiveness of Hyrtl’s anastomosis in PIH. The inclusion criteria for this review are as follows: studies that involved human subjects, were published in English, were randomized controlled trials, case‑control studies, observational studies, or systematic reviews, and evaluated the effectiveness of Hyrtl’s anastomosis. The exclusion criteria are as follows: studies published in other languages did not involve human subjects and did not measure the effectiveness of Hyrtl’s anastomosis in PIH. The search strategy includes a comprehensive search of the relevant databases using keywords related to Hyrtl’s anastomosis, umbilical artery, placenta, and PIH. Both data collection and analysis were conducted when the authenticity and validity of the articles used in this study were maintained. Data extraction was carried out by identifying the key findings of the articles selected for review in this particular study. The quality of the studies included in this review was assessed based on the JADAD scale. Findings and Conclusion: The aim of the systematic literature review is to evaluate the effectiveness of Hyrtl’s anastomosis in the detection and management of PIH. The current study design involved the selection of 10 articles published in or after 2019, with inclusion and exclusion criteria defined for the selection process. The search strategy included a comprehensive search of relevant databases. Both data collection and analysis were conducted when the authenticity and validity of the chosen articles were maintained. The quality of the studies included in the review was assessed based on the JADAD scale. [ABSTRACT FROM AUTHOR]

AIM: Incidence of ocular manifestations and demographic changes in women with pregnancy induced hypertension. SETTING AND DESIGN: Cross-sectional study. STATISTICAL ANALYSIS USED: Chi-square test and fisher exact test MATERIALS AND METHODS: We conducted a study on 203 womens with PIH over a period of 2.5 years in awadh region of Uttar Pradesh. We recorded the baseline data from the patient files and conducted a fundoscopic examination of all patients included in the study and findings classified on the basis of Keith Wegner and Barker classification. RESULT: Out of 203 patients 60% were primigravidas of average age 36 years. 57% patients had no fundus changes. Most common grade-1 retinopathy changes (29.60%) are seen followed by grade-2 (9.9%), grade -3(2.5%) and grade-4(1%). Most common fundus finding is arterial attenuation and most common symptom was headache. CONCLUSION: The examination of ocular fundus proved to be a valuable and necessary diagnostic procedure in determining the cause and appropriate treatment for mothers with pre-eclampsia. [ABSTRACT FROM AUTHOR]

Background: Hypertensive disorders are present in 3-10% of all pregnancies. They are among the main causes of maternal and perinatal morbidity and mortality. The present study was conducted to assess prevalence of pregnancy induced hypertension and to assess neonatal outcomes. Materials & Methods: The present retrospective study was done using data from the patient record of pregnant women with hypertension and neonates admitted to the Neonatal Intensive Care Unit of the Hospital. An analysis was performed on 1200 birth records. Of the women, 120 were diagnosed with hypertension in their pregnancies. The data was collected from the medical record and statistical analysis was done using statistical software SPSS version 22. P-value less than 0.05 was considered statically significant. Results: The prevalence of hypertension among the pregnant women hospitalized was 10% (120/1200). Maximum women of age group 20-36 years had diastolic blood pressure ≥110mmHg (32.5%) and diastolic blood pressure ≤110mmHg (33.33%). Maximum women had cesarean had diastolic blood pressure ≥110mmHg (30.83%) and diastolic blood pressure ≤110mmHg (31.66%). Maximum women had term pregnancy had diastolic blood pressure ≥110mmHg (39.16%) and diastolic blood pressure ≤110mmHg (49.16%).95.83% newborns were live born. Maximum newborns had weight ≥2500grams (73.33%). APGAR at the Ist minute was ≥7 in 83.47% newborns. APGAR at the 5th minute ≥7 in 98.26% newborns. There was a statistical association between DBP and newborn weight. The group of women with DBP ≥110 mmHg presented a smaller mean newborn weight compared to the group with DBP ≤110 mmHg. Conclusion: The study concluded that the prevalence of hypertension among the pregnant women hospitalized was 10% (120/1200). Maximum newborns were live born with weight ≥2500grams. There was a statistical association between DBP and newborn weight. The group of women with DBP ≥110 mmHg presented a smaller mean newborn weight compared to the group with DBP ≤110 mmHg. [ABSTRACT FROM AUTHOR]

Objectives: Pregnancy-induced hypertension (PIH) is a serious pregnancy complication that contributes significantly to both maternal and neonatal morbidity and mortality. The study aimed to evaluate various hematological and biochemical parameters predictive the severity of PIH and preeclampsia. Methods: This was a cross sectional observational study included the study group (120 preeclampsia patients) and the control group consisted of 120 healthy pregnant women. Venous blood samples were collected to study hematological profile, including coagulation and biochemical analysis. Results: out of total subjects, 40 were categorized as mild preeclampsia, 80 as severe preeclampsia, and 120 as healthy pregnant women. The mean hemoglobin level and mean platelet count was decreased significantly in Preeclampsia patients as the disease progressed (p<0.05). The mean Prothrombin time and activated partial thromboplastin time were increased significantly in PIH with disease progression (p<0.05). Liver enzymes, creatinine, and uric acid levels increased significantly in preeclampsia as the disease progressed (p<0.05). Conclusion:. Most of the hematological and biochemical parameters altered as PIH progressed in severity; these indices combined with other parameters can be used in the prediction of preeclampsia. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of Gestational Weight gain and Prepregnancy weight as risk factors for Pregnancy Induced Hypertension. Methods: The study was a prospective open cohort study at antenatal clinic of Lagos University Teaching Hospital, Nigeria. Ninety pregnant women who were previously not hypertensive prior to conception and booking were recruited for the study. The blood pressure and weight were done at booking and they were followed up till delivery. The pregnant women had no chronic medical condition. The P value of < 0.05 was considered significant. Results: The frequency of pregnancy induced hypertension was 43 (47.8%). The overall gestational weight gain and prepregnancy weight in pregnant women who developed pregnancy induced hypertension were compared to those without pregnancy induced hypertension. The mean overall weight gain in pregnancy was 11.75 ±4.53kg while mean prepregnancy weight was 65.78±11.52kg. About 37 (41.1%) of the pregnant women had gestational weight gain in the obese and overweight category using the Institute of Medicine classification. The pregnant women who were in the obese and overweight category using the Institute of Medicine classification system were 60.5%. These women had pregnancy induced hypertension while using gestational weight gain greater than 12kg, about 69.8% of woman had pregnancy induced hypertension. Meanwhile 67.4% of pregnant women with prepregnancy, Body Mass Index in the obese and overweight category had pregnancy induced hypertension (Risk ratio (95% confidence interval) 3.66 (1.53-8.75). Conclusion: Gestational weight gain can be used as a screening tool to predict those at risk for pregnancy induced hypertension especially in pregnant women with prepregnant body mass index in the obese and overweight category in resource poor settings. [ABSTRACT FROM AUTHOR]

Background: Pregnancy-Induced hypertension (PIH) is a common health problem that occurs during pregnancy and may lead to limited fetal growth and other major health problems. Being a serious public health issue, PIH is responsible for a significant number of deaths across the globe. Hyrtl’s anastomosis of the umbilical arteries and placenta is a blood vessel system that can affect the growth and development of the fetus. The studies conducted earlier have suggested that the abnormalities in Hyrtl’s anastomosis may be associated with the development of PIH and other adverse pregnancy outcomes. Aim: The aim of the current systematic literature review is to investigate the potential advantages and restrictions of Hyrtl’s anastomosis as a medical diagnosis and treatment tool for PIH by reviewing the available evidence. Materials and Methods: The current study is a systematic literature review that involves the selection of 10 articles published in or after 2019 from reputed journals that evaluated the effectiveness of Hyrtl’s anastomosis in PIH. The inclusion criteria for this review are as follows: studies that involved human subjects, were published in English, were randomized controlled trials, case-control studies, observational studies, or systematic reviews, and evaluated the effectiveness of Hyrtl’s anastomosis. The exclusion criteria are as follows: studies published in other languages did not involve human subjects and did not measure the effectiveness of Hyrtl’s anastomosis in PIH. The search strategy includes a comprehensive search of the relevant databases using keywords related to Hyrtl’s anastomosis, umbilical artery, placenta, and PIH. Both data collection and analysis were conducted when the authenticity and validity of the articles used in this study were maintained. Data extraction was carried out by identifying the key findings of the articles selected for review in this particular study. The quality of the studies included in this review was assessed based on the JADAD scale. Findings and Conclusion: The aim of the systematic literature review is to evaluate the effectiveness of Hyrtl’s anastomosis in the detection and management of PIH. The current study design involved the selection of 10 articles published in or after 2019, with inclusion and exclusion criteria defined for the selection process. The search strategy included a comprehensive search of relevant databases. Both data collection and analysis were conducted when the authenticity and validity of the chosen articles were maintained. The quality of the studies included in the review was assessed based on the JADAD scale.

Aim: This study aims to illustrate that the speed of blood flow can be determined using Doppler ultrasound which can be useful in obstetrics for determining the blood flow in pregnant women having hypertension. Methods: The present research was a prospective multicenter investigation including a cohort of 50 pregnant women diagnosed with pregnancy-induced hypertension (PIH). These individuals were subjected to sonographic evaluation using Doppler color imaging techniques. The research was carried out in the Department of Obstetrics and Gynaecology. The duration of the research spanned 16 months. Results: The cases of PIH were categorized into age groups of > 20, 20-24, 25-29, and 30-34 years. The bulk of the cases fell within the age category of 20-24, accounting for approximately 40% of the total cases. The average age of the participants was 25.5 years. A total of 34% of the reported cases were observed within the age group of 25-29. Within this study, it was observed that among the group of pregnant individuals with hypertension, 20 individuals (40%) were nulliparous, whereas 22 individuals (44%) were primiparous. The remaining 14% of cases were classified as multipara. Among the instances of Pregnancy-Induced Hypertension (PIH) that were examined, it was observed that out of a total of 50 cases, 32 cases exhibited aberrant uterine artery Doppler indices, representing 64% of the sample. Conclusion: Doppler ultrasound can detect cases of pregnancy-induced hypertension at an early stage of pregnancy through a reliable and non-invasive assessment of hemodynamic function. The utilization of Doppler indices obtained from fetal circulation has demonstrated a consistent ability to accurately forecast bad perinatal outcomes in obstetric patients, particularly those belonging to high-risk populations. Recommendation: Low-dose aspirin is recommended in patients with chronic hypertension in pregnancy from between 12- and 28 weeks gestation to delivery.

Background- Pregnancy induced hypertension (PIH) includes Pre-eclampsia and eclampsia. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) have been associated with pre-eclampsia. Nitroso-redox imbalance could be considered the causative element in pregnancy induced hypertension. Aim- To study the role of nitroso redox imbalance and antioxidants in Pregnancy induced hypertension. Methods- Pregnant females with and without hypertension were evaluated for Serum Nitric oxide(NOx), Serum Nitrothiol, Serum Total Thiol, Serum Superoxide dismutase(SOD), Serum uric acid and were compared. Results- Nitric oxide(NOx- Nitrite and nitrate), thiol, superoxide dismutase levels were decreased while nitrothiol and uric acid levels were increased in cases as compared to control. Discussion- Superoxide dismutase(SOD) seems to be the initiating factor for oxidative stress in PIH. Due to upregulation of xanthine oxidase, there is increased generation of uric acid and also superoxides. So more and more SOD is used up for the dismutation of superoxide radicals. Superoxides scavenge more and more Nitric oxide towards formation of peroxynitrite radicals, thus decreasing NO flux towards NOx. These peroxynitrite radicals react with thiol to form nitrothiol, thus decreasing thiol levels and increasing nitrothiol levels in PIH. Conclusion- Nitroso redox balance plays pivotal role as causative agent in PIH. [ABSTRACT FROM AUTHOR]

Background and purpose: Placental thickness measured at the level of the umbilical cord insertion can be used as a new parameter to estimate gestational age. The present study was undertaken to evaluate the relationship between placental thickness and gestational age and to assess the growth pattern of placenta with advancing gestational age in pregnancy induced hypertension and gestational diabetes mellitus. Objectives: 1. To assess the placental thickness in normal pregnancy, Pregnancy induced hypertension and gestational diabetes mellitus 2. To compare the placental thickness in normal pregnancy with placental thickness in gestational diabetes mellitus and in pregnancy induced hypertension. Methods: The study included 120 antenatal cases of gestational age between 24-28 weeks of gestation based on each 40 cases of normal pregnancy, gestational diabetes mellitus and pregnancy induced hypertension women aged between 18-40 years, who attending Adichunchanagiri Institute of Medical Sciences and referred to the Radiodiagnosis department for antenatal Ultrasound from the period of November 2019 to May 2020 The study mainly aimed at detailed assessment of placental thickness in normal pregnancy, pregnancy induced hypertension and gestational diabetes mellitus to assess the spectrum of placental changes and to correlate these findings with severity and duration of maternal disease and with the fetal outcome. A study of 120 pregnant patients were done with the collaboration of Department of Obstetrics and Gynecology, to find out the thickness of placenta in pregnancy induced hypertension, gestational diabetes mellitus and normal pregnancy. Mean placental thickness found to be much lower in the study group of pregnancy induced hypertension and increased in gestational diabetes mellitus in comparison to placental thickness of normal pregnancy. Placental thickness of normal pregnancy corresponds to the gestational age with normal fetal outcome. Multiparous women with increasing age groups were more likely to have gestational diabetes mellitus than primi-gravida women. Conclusion: To conclude on the outcome received in our study signifies placental thickness can be used as an accurate indicator for estimating the fetal and maternal well-being. The variations in placental thickness decide whether a fetus is considered to be at risk. Also in our study the thickness of placenta did not show any variation with the location of placenta. Abnormal placental thickness in the early stages helps to detect intrauterine growth restriction (IUGR) and gestational diabetes mellitus(GDM). In normal pregnancy the placental thickness almost corresponds to the gestational age and results in healthy fetus and mother. In GDM the placenta thickness appears thickened and undergoes alterations in its formation, structure, and function. According to the review, these alterations are related to an oxygenation deficiency in the fetus, changes in the transplacental transport of nutrients and other alterations that cause fetal overgrowth by increasing their availability, and other consequences to the developing fetus. Placental thickness is reduced in pregnancy induced hypertension due to increased blood pressure. Pregnancy induced hypertension, produces accelerated maturation and rapid aging of the chorionic villi with the risk of inducing a placental abruption. In addition, placental circulation is reduced causing decrease in oxygen saturation of the fetus. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to analyse the Doppler indices in umbilical artery, middle cerebral artery and uterine artery using Doppler ultrasound in a group of patients with pregnancy induced hypertension, assess the value of Doppler ultrasound in predicting the perinatal outcome in patients with pregnancy induced hypertension and evaluate the role of Doppler ultrasound in the management of pregnancy induced hypertension. Methods: This was a hospital based prospective study conducted among 150 patients who presented with pregnancy induced hypertension to the Department of Radiodiagnosis, Mysore Medical College and Research Institute, Mysore, over a period of 18 months from November 2017 to April 2019 after obtaining clearance from institutional ethics committee and written informed consent from the study participants. Results: The perinatal mortality was highest in the elevated RI (31%) group when compared to elevated S/D (25%) and elevated PI(28.5%) group. Amongst the umbilical artery waveforms highest LSCS for fetal distress was done in those with an elevated RI. Umbilical RI also had a 100% sensitivity in predicting APGAR<7 at 5 min. MCA Doppler studies revealed that when there was an increase in the Umbilical artery resistance there was a decrease in the values of MCA indices showing a brain sparing effect. In all the fetuses with a brain sparing effect the CPR was <1.08. Perinatal outcome as follows was - 48 delivered babies weighing <10th percentile and those with normal CPR had 26 babies weighing <10th percentile. 29 babies delivered by LSCS. 25 babies have APGAR values <7 at 5min. Statistical correlation was drawn and found to be significant (p<.05) in all the parameters in predicting poor perinatal outcome. Conclusion: Doppler ultrasound study is very useful in predicting pregnancy induced hypertension with adverse perinatal outcome when the Doppler velocimetry is abnormal. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major health problem among pregnant women all over the world due to high perinatal morbidity and mortality. Maternal mortality is mostly related to eclampsia, antepartum haemorrhage (placental abruption), HELLP syndrome, pulmonary oedema, acute renal failure, and disseminated intravascular coagulation (DIC). Though treating hypertension would not alter the progression of the disease, however, it has been shown that with proper antenatal care, early recognition of preeclampsia and timely intervention, decreases the frequency of hypertensive crisis and feto-maternal complications. So current study was design to find out the the incidence of hypertensive disorders of pregnancy and associated maternal and fetal mortality and morbidity rates, and to shed some light on factors influencing it. Material and methods: This was a retrospective, cross-sectional, hospital-based study conducted at SGT Medical College in Haryana from January 2019 to April 2021. All pregnant women beyond 20 weeks of gestation complicated by hypertensive disorders of pregnancy, and admitted in our institution for delivery were included in the study. Pregnancies with associated medical complications like diabetes with nephropathy, vascular or renal disease, epilepsy and convulsion disorders secondary to medical causes were excluded from the study. A total 2049 participants were included in the study. Results: In this study, 2049 deliveries were conducted in the study period; of which, 115(5.5%) cases had Hypertensive disorder of pregnancy. Incidence of gestational hypertension was 57(2.7%) Preeclampsia 49 (2.3%) eclampsia 6 (0.2%) and chronic hypertension was found in 0.1% of total pregnancies. Conclusion: This study shows that nearly one in 18 pregnant women in rural areas of Haryana suffer from a hypertensive disorder of pregnancy. The knowledge of risk factors for hypertensive disorders in pregnancy may give tracks for prevention in this population. Early diagnosis and treatment through regular antenatal check-up is a key factor to prevent hypertensive complications of pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: A major obstetric complication, that leads to severe maternal and foetal morbidity is Pre-eclampsia (PE). Studies evaluating the autonomic nervous activity in pregnant women with PE shows conflicting results. Previous studies are inadequate for the identification of the most useful tools to detect and monitor autonomic dysfunction prior to PE. The cold pressor test is a simple and validated test, in which the afferent sensory pathways are stimulated by the cold stimulus, resulting in an increase in Blood Pressure (BP). Aim: To evaluate the response to cold pressor test and Heart Rate Variability (HRV) to detect increased vascular reactivity and sympathetic activity prior to the clinical manifestation of PE in pregnant women. Materials and Methods: A longitudinal study was conducted in in the Department of Physiology at Hamdard Institute of Medical Sciences, HAHC Hospital, Jamia Hamdard, New Delhi, India. The duration of the study was 11 months, from December 2018 to November 2019. Subjects were 50 pregnant women, between age 18-40 years and of 12-14 weeks of gestation. Cold pressor test and HRV were parameters measured for the assessment of the autonomic functions during 12 and 21 weeks of gestational period. The Statistical Package for Social Sciences (SPSS) version 26.0 was used for analysis of the quantitative data. Paired t-test was done for comparison of all values. Results: The mean age of the study participants was 29±2.7 years. There was no hyper-reaction to cold pressor test at 12 weeks of gestation, nor the subjects showed any signs of PE. At 14 weeks of gestation, 2 (4%) showed hyper-reaction to cold pressor test. At 21 weeks of gestation, 3 (6%) subjects showed hyper-reactions to cold pressor test and out of them, 2 developed PE. Root Mean Square Standard Deviation (RMSSD) and difference between adjacent Standard Deviation of N-N intervals (SDNN) of HRV analysis were significantly higher in the first trimester as compared to 21 weeks of pregnancy. Conclusion: Response to cold pressor test showed increased vascular reactivity, as a sign before the development of PE. HRV analysis could not detect any significant features of increased sympathetic activity prior to the clinical manifestation of PE in pregnant women. [ABSTRACT FROM AUTHOR]

Introduction: Pre-eclampsia (PE), a pregnancy induced hypertensive disorder affects approximately 8-10% of all pregnancies in developing countries. A highly sensitive and specific marker for diagnosis of PE is the need of the hour as diagnostic criteria are still based on non-specific clinical symptoms, ultrasound, and laboratory findings. Imbalance in the placental release of various angiogenesis regulatory factors to the maternal circulation is one of the significant contributors to its clinical manifestations. Low levels of pro-angiogenic biomarker Placental Growth Factor (PLGF) are detectable several weeks before clinical presentation of PE. Aim: To determine the association of serum levels of PLGF with PE in second and third trimester of pregnancy. Materials and Methods: A prospective cohort study was performed in a tertiary care hospital from December 2018 to November 2021, on 130 patients by dividing study participants into two groups: Pre-eclamptic cases, Normotensive controls. At enrollment in second trimester (24-28 weeks) and during third trimester (beyond 28 weeks) serum PLGF concentration was measured by using the Enzyme-linked Immunosorbent Assay (ELISA) kit method. Data was statistically analysed. Student's t-test was used for comparing differences between study groups. The chi-square test was used to compare qualitative categorical data. Evaluation of the Area Under the Curve (AUC), diagnostic accuracy, sensitivity and specificity was done by Receiver Operating Characteristics (ROC) curve analysis done using software defined cut-off values. Results: Total of 115 patients were analysed in the present study with 55 patients in group 1(mean age: 25.83±3.27 years) and 60 patients in group 2 (mean age: 30.52±5.63 years) When compared with normotensive group PLGF levels were significantly lower in pre-eclamptic group with median 16.27 ng/mL versus 12.20 ng/mL (p <0.001) in second and 14.05 ng/mL versus 10.50 ng/mL (p <0.001) in third trimesters respectively. ROC curve analysis using cut-off point of 14.91 ng/mL showed sensitivity 80%, specificity 96.7%, AUC 0.896, 95%CI:(0.832-.959) in second trimester and in third trimester at cut-off point of 13 ng/mL sensitivity 73%, specificity 96.7%, AUC 0.882 95% CI:(0.816-.948) was found. Conclusion: PLGF may be used as a biomarker for early prediction, diagnosis, and management of PE. It might serve as ideal discriminating biochemical markers of PE. In the near future, the clinical utility of disease specific angiogenic biomarker in early detection of PE might improve health outcomes by preventing adverse maternal and neonatal outcomes and serious complications. [ABSTRACT FROM AUTHOR]

Background & Objectives: The incidence of gestational hypertension is increasing in India which accounts for various maternal morbidity & mortality. As gestational hypertension is hypercogulability state we wanted to assess platelet volume indices in gestational hypertension. Materials and Methods: This is a cross-sectional, case-control study conducted in the Department of Physiology, in collaboration with OBG and Pathology after obtaining institutional ethical clearance. Study includes 60 (n=60) hypertensive as cases and 60 (n=60) normotensive as controls who were in third trimester of pregnancy. Blood pressure was measured using mercury sphygmomanometer and those who had BP values more than 140/90 mmHg without proteinuria were taken as cases and those with normal values were taken as controls. Platelet volume indices were measured using sysmex automated flow meter. Statistically analyzed using t test and pearson’s correlation by SPSS 20 software. Results: Mean platelet volume, platelet distribution width and large cell platelet ratio were higher in hypertensive pregnant female when compared to normotensives which is not statistically significant. (10.72± 1.08 Vs 10.61±1.08 p= 0.56, 12.69± 2.79 Vs 12.57±2.85 p= 0.80, 30.75± 8.50 Vs 29.75±8.70 p= 0.52) plateletcrit was lower in hypertensive when compared to normotensive. (0.23± 0.08 Vs 0.24±0.04 p=0.48) there was no statistical significant correlation exists between BP and platelet volume indices. Conclusion: Our study concludes no strong association of platelet volume indices with severity of hypertension amongst gestational hypertension.

Background: Oneof the common medical complications of pregnancy are hypertensive disorders which contribute significantly to maternal and perinatal morbidity and mortality. Hypertensive disorders in pregnancy are responsible for 76,000 maternal and 50,0000 infants death each year worldwide. There is growing evidence indicating that the risk of preeclampsia is increased in women with elevated levels of triglycerides and oxidized low-density lipoproteins. So, this study is designed to evaluate the changes in lipid profile that develops during normal pregnancy and pregnancy induced hypertensions. Objective: To estimate and compare the levels of lipid profile in pregnancy induced hypertension cases and controls. Method: The present study was a case-control study. It was conducted in Department of Biochemistry in collaboration with Department of Obstetrics and Gynecology, SHKM, Government Medical College, Nuh, Haryana. A total of 180 pregnant females were enrolled for this study of age 18 to 45 years (reproductive age group). We collected 5 ml of fasting venous blood sample and analyzed it for lipid profile. Mean and standard deviation of lipid profile and its severity in pregnancy induced hypertension patients Results: Total Cholesterol was highest in Eclampsia Group (294.57±23.74 mg/dL), followed by severe preeclampsia Group (252.03±9.63 mg/dL), and then in mild preeclampsia Group (214.37±12.63 mg/dL) and was least in control Group (159.12±15.28 mg/dl). Triglyceride was highest in Eclampsia Group (235.10±37.61 mg/dL), followed by Severe preeclampsia Group (190.23±10.67 mg/dL) then in mild preeclampsia Group (170.10±9.07 mg/dL) and was least in control Group (138.24±10.10 mg/dl). LDL-C was highest in Eclampsia Group (208.78±20.67 mg/dL), followed by Severe preeclampsia Group (175.59±9.16 mg/dL), then in mild preeclampsia Group (139.38±11.20 mg/dL) and was least in control Group (82.10±9.89 mg/dl). HDL-C was lowest in Eclampsia Group (38.77±3.92 mg/dL), followed by Severe preeclampsia Group (38.40±2.65 mg/dL), then in mild preeclampsia Group (42.30±2.90 mg/dL) and was highest in control Group (49.38±6.21 mg/dl). Conclusion: Lipid profile is deranged in pregnancy induced hypertension and is correlated with severity. [ABSTRACT FROM AUTHOR]

Introduction: A major obstetric complication, that leads to severe maternal and foetal morbidity is Pre-eclampsia (PE). Studies evaluating the autonomic nervous activity in pregnant women with PE shows conflicting results. Previous studies are inadequate for the identification of the most useful tools to detect and monitor autonomic dysfunction prior to PE. The cold pressor test is a simple and validated test, in which the afferent sensory pathways are stimulated by the cold stimulus, resulting in an increase in Blood Pressure (BP). Aim: To evaluate the response to cold pressor test and Heart Rate Variability (HRV) to detect increased vascular reactivity and sympathetic activity prior to the clinical manifestation of PE in pregnant women. Materials and Methods: A longitudinal study was conducted in in the Department of Physiology at Hamdard Institute of Medical Sciences, HAHC Hospital, Jamia Hamdard, New Delhi, India. The duration of the study was 11 months, from December 2018 to November 2019. Subjects were 50 pregnant women, between age 18-40 years and of 12-14 weeks of gestation. Cold pressor test and HRV were parameters measured for the assessment of the autonomic functions during 12 and 21 weeks of gestational period. The Statistical Package for Social Sciences (SPSS) version 26.0 was used for analysis of the quantitative data. Paired t-test was done for comparison of all values. Results: The mean age of the study participants was 29±2.7 years. There was no hyper-reaction to cold pressor test at 12 weeks of gestation, nor the subjects showed any signs of PE. At 14 weeks of gestation, 2 (4%) showed hyper-reaction to cold pressor test. At 21 weeks of gestation, 3 (6%) subjects showed hyper-reactions to cold pressor test and out of them, 2 developed PE. Root Mean Square Standard Deviation (RMSSD) and difference between adjacent Standard Deviation of N-N intervals (SDNN) of HRV analysis were significantly higher in the first trimester as compared to 21 weeks of pregnancy. Conclusion: Response to cold pressor test showed increased vascular reactivity, as a sign before the development of PE. HRV analysis could not detect any significant features of increased sympathetic activity prior to the clinical manifestation of PE in pregnant women.

Introduction: Pre-eclampsia (PE), a pregnancy induced hypertensive disorder affects approximately 8-10% of all pregnancies in developing countries. A highly sensitive and specific marker for diagnosis of PE is the need of the hour as diagnostic criteria are still based on non-specific clinical symptoms, ultrasound, and laboratory findings. Imbalance in the placental release of various angiogenesis regulatory factors to the maternal circulation is one of the significant contributors to its clinical manifestations. Low levels of pro-angiogenic biomarker Placental Growth Factor (PLGF) are detectable several weeks before clinical presentation of PE. Aim: To determine the association of serum levels of PLGF with PE in second and third trimester of pregnancy. Materials and Methods: A prospective cohort study was performed in a tertiary care hospital from December 2018 to November 2021, on 130 patients by dividing study participants into two groups: Pre-eclamptic cases, Normotensive controls. At enrollment in second trimester (24-28 weeks) and during third trimester (beyond 28 weeks) serum PLGF concentration was measured by using the Enzyme-linked Immunosorbent Assay (ELISA) kit method. Data was statistically analysed. Student’s t-test was used for comparing differences between study groups. The chi-square test was used to compare qualitative categorical data. Evaluation of the Area Under the Curve (AUC), diagnostic accuracy, sensitivity and specificity was done by Receiver Operating Characteristics (ROC) curve analysis done using software defined cut-off values. Results: Total of 115 patients were analysed in the present study with 55 patients in group 1(mean age: 25.83±3.27 years) and 60 patients in group 2 (mean age: 30.52±5.63 years) When compared with normotensive group PLGF levels were significantly lower in pre-eclamptic group with median 16.27 ng/mL versus 12.20 ng/mL (p

ObjectiveHepatitis B virus (HBV) infection is a major health threat worldwide, especially in developing countries. We aimed to investigate the impact of hepatitis B carrier on pregnancy complications in pregnant women, in China.MethodsThis retrospective cohort study was conducted by using data from the EHR system of Longhua District People’s Hospital in Shenzhen, China, from January 2018 to June 2022. Binary logistic regression was used to evaluate the relationship between HBsAg carrier status and pregnancy complications and pregnancy outcomes.ResultsThe study included 2095 HBsAg carriers (exposed group) and 23,019 normal pregnant women (unexposed group). Pregnant women in the exposed group were older than the pregnant women in the unexposed group (29 (27,32) vs. 29 (26,32), p

Background: India contributes 15% of the total global maternal mortality burden. An increasing proportion of these deaths are due to Pregnancy Induced Hypertension (PIH), Gestational Diabetes Mellitus (GDM), and anaemia. This study aims to evaluate the effectiveness of a tablet-based electronic decision-support system (EDSS) to enhance routine antenatal care (ANC) and improve the screening and management of PIH, GDM, and anaemia in pregnancy in primary healthcare facilities of Telangana, India. The EDSS will work at two levels of primary health facilities and is customized for three cadres of healthcare providers – Auxiliary Nurse Midwifes (ANMs), staff nurses, and physicians (Medical Officers). Methods: This will be a cluster randomized controlled trial involving 66 clusters with a total of 1320 women in both the intervention and control arms. Each cluster will include three health facilities—one Primary Health Centre (PHC) and two linked sub-centers (SC). In the facilities under the intervention arm, ANMs, staff nurses, and Medical Officers will use the EDSS while providing ANC for all pregnant women. Facilities in the control arm will continue to provide ANC services using the existing standard of care in Telangana. The primary outcome is ANC quality, measured as provision of a composite of four selected ANC components (measurement of blood pressure, blood glucose, hemoglobin levels, and conducting a urinary dipstick test) by the healthcare providers per visit, observed over two visits. Trained field research staff will collect outcome data via an observation checklist. Discussion: To our knowledge, this is the first trial in India to evaluate an EDSS, targeted to enhance the quality of ANC and improve the screening and management of PIH, GDM, and anaemia, for multiple levels of health facilities and several cadres of healthcare providers. If effective, insights from the trial on the feasibility and cost of implementing the EDSS can inform potential national scale-up. Lessons learned from this trial will also inform recommendations for designing and upscaling similar mHealth interventions in other low and middle-income countries. Trial Registration. ClinicalTrials.gov, NCT03700034, registered 9 Oct 2018, https://www.clinicaltrials.gov/ct2/show/NCT03700034 CTRI, CTRI/2019/01/016857, registered on 3 Mar 2019, http://www.ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=28627&EncHid=&modid=&compid=%27,%2728627det%27 [ABSTRACT FROM AUTHOR]

Background and aim: One of the most frequent pregnancy problems and a leading global cause of maternal and fetal death and morbidity is pregnancy-induced hypertension. In order to provide effective educational interventions, this research was conducted to assess and enhance the level of awareness and adherence about pregnancy-induced hypertension (PIH) among pregnant women in Ismailia city. Method: An interventional study (pre-test/post-test) conducted at family centers and antenatal out-patient clinic of Ismailia public hospital. It was carried out on 80 hypertensive pregnant women on treatment for at least one month. Interview closed-ended questionnaire were used to collect data which included; socio-demographic data, pregnant women's knowledge about PIH, Morisky eight-item Medication Adherence Scale for measuring adherence to PIH drugs, tool for measuring adherence to PIH health related behaviors and health system factors which may affect adherence to PIH. Results: Significant improvement was reported after the education to be; 35%, 30% and 35% high, medium and low adherence to PIH drugs respectively. The level of adherence to PIH health related behaviors before health education was; 18.8% high, 36.2% medium and 45% low adherence, improved significantly after the education to; 57.5% high, 38.7% medium and 3.5% low adherence. Conclusion The results clearly demonstrated the effectiveness of educational intervention program in promoting knowledge and adherence towards PIH. [ABSTRACT FROM AUTHOR]

This GESTOSIS scale is a validated tool which aids in predicting high risk women for Pregnancy-Induced Hypertension (PIH). This study aimed to use machine learning algorithms to determine the efficacy of the GESTOSIS score in predicting PIH. A prospective observational study was conducted on 70 pregnant women. The features in GESTOSIS scale classified as mild, moderate, or severe. The results showed that the Adaptive Boosting (AB) model precisely predicts the PIH with an accuracy range between 97% to 99% based on the results of regression and classification prediction models respectively with a true -positive rate (TPR) of 90%. The GESTOSIS score is concluded to be a simple scale that can be administered by all front-line health workers in the community without intrusive procedures. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the association of fundus changes in pregnancy induced hypertension. Methods: We recruited a total of 100 patients based on the following inclusion and exclusion criteria. The research included all individuals who met the diagnostic criteria for PIH. Patients with pregnancy-induced hypertension who fall into any of the aforementioned criteria were chosen for the research. Labour records were kept in accordance with the proforma, and maternal and perinatal outcomes were tracked. Blood pressure was tested at least three times while sitting, and the lowest value was recorded. Keith Wagener classification was used to classify the retinal abnormalities. Results: In our study fundus changes were more among patients ≤ 25 years old and there is no significant correlation between age and fundus changes in PIH patients in our study. In our study there is no significant correlation between gravidity and fundus changes (p>0.05).In our study, there is no significant correlation between fundus changes and period of gestation (P>0.05). There is significant correlation between SBP and fundus changes in our study. In our study there is significant correlation between DBP and fundus changes. (p<0.05). Conclusion: Regular fundus examination in all instances of PIH, with a specific focus on younger, primigravida women and patients with early beginning of PIH, leads in an accurate evaluation of the patient's clinical condition. As a result, by doing repeated fundus checks at regular intervals, one may analyse the severity of the condition as well as the response to therapy, so improving the feto-maternal outcome by managing the pregnancy wisely. [ABSTRACT FROM AUTHOR]

Aim: To determine the fundus changes and fetomaternal Outcomes in Pregnancy Induced Hypertension. Methods: This prospective studywas carried out in the department of Obstetrics and Gynaecology, Bebe Nanki Mother and Child Care Centre, Govt. Medical College, Amritsar. We enrolled a total of 100 patients considering inclusion and exclusion criteria which were as follows. All patients who fulfilled the diagnostic criteria of PIH was included in the study. Labour records were maintained according to the proforma and follow up was done for maternal and perinatal outcome. Results: In our study most of patients had eclampsia 33 (33%), 28 (28%) had gestational hypertension, 24 (24%) had pre eclampsia and 15 (15%) had severe preeclampsia. Out of 22 patients with complications of PIH were in the form of PPH in 4 (18.2%), Recurrent fits in 4 (18.2%), Coagulation Disorder in 2 (9.1%), Pulmonary Odema in 1 (4.5%), Renal Failure in 1 (4.5%), HELLP Syndrome in 2 (9.1%), ARDS in1 (4.5%), Aspiration Pneumonia in 2 (9.1%), Abruption in 5 (22.8%). In our study out of 28 patients of gestational hypertension only 1 patient was suffered from PPH. Out of 24 patients of preeclampsia, only 1 patient was suffered from pulmonary oedema. Out of 15 patients of severe preeclampsia, 6 patients were having maternal morbidity. 2 had PPH, 1 had renal failure, 1 had HELLP syndrome, 1 had coagulation disorder and 1 patient suffered from abruption. Out of 33 patients diagnosed as eclampsia, 14 patients had complications in the form of PPH (1 patient), recurrent fits (4 patients), coagulation disorders (1 patient), ARDS (1 patient), aspiration pneumonia (2 patients) and abruption (4 patients). In our study total maternal morbidity was to the extent of 22%. In our study male neonate constituted a significant larger population in total births, in live births, in IUD and in perinatal deaths. In our study still birth rate was found to be 198.01/1000 births and perinatal mortality was found to be 395.06/1000 live births. Conclusion: fundus evaluation in PIH is an important procedure to predict adverse maternal and fetal outcome. [ABSTRACT FROM AUTHOR]

Background and objectives: Pregnancy-induced hypertension (PIH) is a serious pregnancy complication that contributes significantly to both maternal and neonatal morbidity and mortality. The study aimed to evaluate various hematological parameters associated with PIH and to identify early hematological parameters predictive of eclampsia and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. Methods: A total of 114 subjects were studied. Venous blood samples were collected to study hematological profile, including coagulation and biochemical analysis. Results: Of 114 subjects, 35 were categorized as gestational hypertension, 33 as mild preeclampsia, 40 as severe preeclampsia, and six as eclampsia. Eight cases progressed to HELLP syndrome. The mean hemoglobin level was 10.6+2.1 g/dl, which decreased significantly in PIH patients as the disease progressed (p=0.045). The mean platelet count was 191 + 84 x 109cells/L. The mean platelet count in PIH patients decreased significantly with disease progression (p=0.008). The mean prothrombin time and activated partial thromboplastin time were 13.12 + 1.33 and 33.62 + 6.34 seconds, respectively. These parameters also increased significantly with disease progression (p

Introduction: Pregnancy Induced Hypertension (PIH) can lead to intrauterine growth restriction resulting in Low Birth Weight (LBW) neonates. LBW remains a significant cause of under-five mortality in India and Asia. Aim: To calculate the prevalence of PIH and to study the correlation between Birth Weight (BW) of neonates and severity of maternal hypertension; and compare the incidence of neonatal morbidities across varying severity of maternal hypertension. Materials and Methods: A longitudinal study was conducted among 153 pregnant mothers, diagnosed with PIH. They were classified into mild {Systolic Blood Pressure (SBP) ≥140- 149 mmHg or Diastolic Blood Pressure (DBP) ≥90-99 mmHg}, moderate (SBP ≥150-159 mmHg or DBP ≥100-109 mmHg) and severe (SBP ≥160 mmHg or DBP ≥110 mmHg) hypertension. A total of 142 neonates, born to PIH mothers, were included. The neonates were followed-up for seven days to check for early neonatal outcomes and deaths. Correlation between maternal blood pressure (systolic and diastolic) and BW of the neonates was assessed using Pearson’s correlation coefficient (r). Binary Logistic Regression (BLR) was performed to analyse the impact of confounders on BW. Results: The prevalence of PIH was 7.76% (153/1972). The mean BW of neonates born to mothers with moderate (2.435 kg) and severe hypertension (2.342 kg) was significantly lower than that of neonates born to mothers with mild hypertension (2.828 kg) (p

To evaluate total Th1/Th2 cytokines in CD3+ cells (immunocompetent T-lymphocytes) and peripheral blood lymphocytes, mostly CD4+ (T helper cells) and CD8+ (T-cytotoxic cells) subpopulations in preeclampsia. Total blood leukocytes and lymphocytes counts, percent cells: CD3+, INF-g+/CD3+, IL-4+/CD3+, and IL-10+/CD3+, CD4+/CD8+ were determined by flow-cytometry. Preeclampsia (n= 26) and normal pregnancy (n= 25) participants were age and gestational age matched. CD4+ lymphocytes count was higher in preeclampsia, compared with normal pregnancy (43.6 ± 5.8 vs 37.6 ± 5.6%; P

Pregnancy induced hypertension (PIH) is the most common complication during pregnancy and it affects up to 12% of pregnancies. It is the leading cause of maternal and fetal morbidity and mortality (1). Sildenafil is a potent and selective inhibitor of cGMP .which results in increased levels of cGMP, leading to smooth muscle relaxation thus mediating improved uteroplacental perfusion and increased fetal growth (12). Objectives:This study is to evaluate effect of sildenafil citrate on fetal growth and Doppler indices in treatment of pregnancy induced hypertension Setting:Department of Obstetrics &Gynecology, Beni-Suef University Hospital. Methods:Patients were divided into two groups: Group A (sildenafil group) were offered Sildenafil 20 mg t.i.d. with a plenty of fluids until delivery in addition to traditional treatment. Group B (Placebo group) received placebo drug with the same shape and texture as sildenafil citrate in addition to traditional treatment.Main outcome measures: Utero placental perfusion, fetal growth and maternal and fetal safety. Results: Sildenafil treatment was associated with a significant decrease of SBP between the two time points (P-value

Introduction: Hypertensive disorder of pregnancy is among the leading causes of maternal and perinatal mortality in developing countries. There are only few studies regarding this topic so this study helps us to improve our management protocol thereby reducing maternal and foetal morbidity and mortality. The aim of this study was to find out the prevalence of pregnancy induced hypertensive disorder among patient admitted to the Department of Obstertric and Gynecology in a tertiary care centre. Methods: A descriptive cross sectional study was conducted in the Department of Obstetrics and Gynaecology of tertiary care centre from 30 July 2020 to 30 July 2021 after obtaining ethical approval from the Institutional Review Committee (Reference number: 2007211399). Convenience sampling method was used among patients who met the eligibility criteria. Point estimate and 95% Confidence Interval were calculated. Results: Among 4,303 deliveries, hypertensive disorder in pregnancy was seen in 110 (2.55%) (2.08-3.03, 95% Confidence Interval) Among 110 (2.55%) patients, preeclampsia was seen in the majority of the patients 69 (62.72%). Conclusions: The prevalence of hypertensive disorder among pregnancies was similar to the other studies done in similar settings. Hypertensive disorder poses a major issue in pregnant women so should be taken into a serious matter as it causes major problems in maternal and foetal outcomes.

Background: One of the main causes of maternal and perinatal death is pregnancyinduced hypertension (PIH), a stigmatising condition in the field of obstetrics that requires challenging stigma removal. In order to evaluate ocular symptoms in individuals with pregnancyinduced hypertension, the current investigation was carried out. Materials & Methods: 200 patients with pregnancy-related hypertension in total were enrolled. Patients with persistent hypertension, underlying renal diseases, diabetes, haematological problems, infectious infections, and any past ocular diseases were disqualified. Torch light was used to examine the anterior portion. With the help of tropicamide, the eyes were dilated, and an indirect ophthalmoscope was used to examine the fundus. SPSS software was used to record and analyse each outcome. Results: 19% of the patients experienced eyesight problems. 11 percent of the patients had macular oedema. In 2% and 3% of the patients, respectively, lid oedema and choroidal infarcts were found. 14 percent of the patients had a narrowing of the arteries. Conclusion: Of the cases of preeclampsia, 32% involved ocular symptoms. In PIH patients, routine retinal screening is recommended. [ABSTRACT FROM AUTHOR]

Background: Pregnancy-induced Hypertension (PIH) is a disease that causes serious maternal and fetal morbidity and mortality. Alisma Orientale (AO) has a long history of use as traditional Chinese medicine therapy for PIH. This study explores its potential mechanism and biosafety based on network pharmacology, network toxicology, molecular docking and molecular dynamics simulation. Methods: Compounds of AO were screened in TCMSP, TCM-ID, TCM@Taiwan, BATMAN, TOXNET and CTD database; PharmMapper and SwissTargetPrediction, GeneCards, DisGeNET and OMIM databases were used to predict the targets of AO anti-PIH. The protein-protein interaction analysis and the KEGG/GO enrichment analysis were applied by STRING and Metascape databases, respectively. Then, we constructed the "herbcompound-target-pathway-disease" map in Cytoscape software to show the core regulatory network. Finally, molecular docking and molecular dynamics simulation were applied to analyze binding affinity and reliability. The same procedure was conducted for network toxicology to illustrate the mechanisms of AO hepatotoxicity and nephrotoxicity. Results: 29 compounds with 78 potential targets associated with the therapeutic effect of AO on PIH, 10 compounds with 117 and 111 targets associated with AO induced hepatotoxicity and nephrotoxicity were obtained, respectively. The PPI network analysis showed that core therapeutic targets were IGF, MAPK1, AKT1 and EGFR, while PPARG and TNF were toxicity-related targets. Besides, GO/KEGG enrichment analysis showed that AO might modulate the PI3K-AKT and MAPK pathways in treating PIH and mainly interfere with the lipid and atherosclerosis pathways to induce liver and kidney injury. The "herb-compound-target-pathway-disease" network showed that triterpenoids were the main therapeutic compounds, such as Alisol B 23-Acetate and Alisol C, while emodin was the main toxic compounds. The results of molecular docking and molecular dynamics simulation also showed good binding affinity between core compounds and targets. Conclusion: This research illustrated the mechanism underlying the therapeutic effects of AO against PIH and AO induced hepatonephrotoxicity. However, further experimental verification is warranted for optimal use of AO during clinical practice. [ABSTRACT FROM AUTHOR]

Background: Hypertension in pregnancy is a systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or both. Both systolic and diastolic blood pressure raises are important in the identification of Pregnancy induced hypertension. Pregnancy induced hypertension (PIH) is hypertension that occurs after 20 weeks of gestation in women with previously normal blood pressure. The broad classification of pregnancy-induced hypertension during pregnancy is gestational hypertension (GE), pre-eclampsia and eclampsia. Serum uric acid and creatinine levels are a part of work up for the pregnant women with hypertension. The elevated levels of these parameters were due to decreased urinary clearance secondary to reduced Glomerular filtration Rate (GFR) and increased reabsorption. Materials and methods: The present study was carried out in the Department of Biochemistry, Dr VRK Womens Medical College, Teaching hospital and Research center. Total 70 patients of pregnancy were selected out of which 30 patients were of normal pregnancy and 40 patients were of pregnancy induced hypertension. Serum uric acid levels were estimated before delivery and after delivery in cases of pregnancy. Pregnant women with recurrent abortions, bad obstetric history, twins, preexisting medical disorders - such as diabetes mellitus, essential hypertension, renal disorders, cardiovascular, thyroid disorders, and liver disease - were excluded from the study. Results: In our study, we observed a significantly elevated serum uric acid PIH (9.51 ± 1.33 mg/dl) and Normal pregnant women (5.29 ±0.8 mg/dl). Blood Urea was 5.29 ±0.8 mg/dl among Normal pregnant women and 9.51 ±1.33 mg/dl among PIH. Moreover, Serum Creatinine level was1.25±0.53 mg/dl among PIH and 0.97±0.23 mg/dl among Normal pregnant women. Conclusion: On the basis of study findings we, concluded that the increased levels of serum uric acid, serum creatinine and serum urea are better diagnostic and predictive marker for PIH and immediate medical attention required for PIH. With the help of these parameters most cases are detected early in the pregnancy before they can progress to eclampsia. [ABSTRACT FROM AUTHOR]

Objective: To find out prevalence, risk factors, severity and outcome of neonatal thrombocytopenia (TCP). Study Design: Prospective Observational study. Setting: Neonatal Intensive Care Unit (NICU) of Children Hospital Complex Multan. Period: January 2020 to January 2021. Material & Methods: A total of 191 neonates admitted to NICU during the study period were enrolled. A special proforma was designed to record all study information while SPSS version 26.0 was utilized for data analysis. Prevalence of TCP was noted among neonates admitted in NICU during the study period. Maternal risk factors, neonatal risk factors, severity of TCP and outcome were recorded. Results: In a total of 191 neonates, 110 (57.6%) were male while overall mean age was recorded to be 2.98+2.46 days. The prevalence of TCP was recorded to be 47.1% (90/191). Pregnancy induced hypertension (p=0.0003), premature rupture of membrane (p=0.0105) and eclampsia (0.0215) were found to have significant association with the presence of TCP. Preterm neonates (p<0.0001), small for gestational age (p<0.0001), sepsis (p<0.0001) and nectrozing enterocolitis (p=0.0014) were found to have significant association with TCP. A total of 13 (6.8%) neonates died, out of which, 5 (38.5%) were having severe TCP. Conclusion: Prevalence of neonatal thrombocytopenia at neonatal intensive care unit was found to be high (47.1%). Pregnancy induced hypertension, premature rupture of membrane and eclampsia were found to have significant association with neonatal thrombocytopenia. Preterm, small for gestational age, sepsis and necrotizing enterocolitis were noted to be significantly associated with neonatal thrombocytopenia. Severe thrombocytopenia was noted to be a significant predictor of poor outcomes. [ABSTRACT FROM AUTHOR]

Background: Hypertension during pregnancy is one of major causes in our country (Iraq), and at AL - Ramadi city (PHCCs) for morbidity in pregnant women. Several risk factors have been studied to show the impact on induced hypertension during pregnancy. Objectives: TO find out associations between certain risk factors and their effects on pregnancy induced hypertension in PHCCs. Materials and Methods: A cross-sectional study in two main PHCCs was conducted In First sector in AL-Ramadi city. (AL-ANDULUS), and (AL-TASH) PHCCs which represent urban and rural area respectively. the data was collected from March through September-2022 in PHCCs. Questionnaire was designed for purpose of study. Both cases and controls were examined for hypertension. The cases (170) hypertension women, were diagnosed by examination and information of pregnant women and repeated measurement of blood pressure, and (210) healthy pregnant women. Analysis by chi - square test, p-value less than (0.05) were significant association. Results: The present study shows that significant association between risk factors and hypertension during pregnancy a include maternal age, level of education parity, BMI, family history, smoking during pregnancy, previous type of delivery, previous history of PIH, spacing, Contraception more association in use pills, Conclusion: The study shows that there was significant association between the following risk factors and PIH. Age of pregnant hypertensive women, education level more in low education level. Parity more =5, BMI, positive Family history, Smoking, Elective C/S, Previous history PIH. Spacing 2-3 years interval. Use of contraception more in pills users. [ABSTRACT FROM AUTHOR]

Background: Pregnancy-induced hypertension (PIH) is associated with significant maternal as well as fetal morbidity and untreated cases may be associated with poor pregnancy outcomes. It brings about various histological and morphological changes in the placenta such as infarcts, fibrosis, and calcification thereby affecting the well-being of fetus. Detection of it at an early stage is important from the point of view of management as early intervention is associated with improved maternal and fetal outcome. Shear wave elastography (SWE) of placenta is a non-invasive investigation that can detect changes in placental elasticity during the pregnancy. Aims and Objectives: The aim of the study was to assess and compare the difference in values of placental elasticity in normal pregnancy and in clinically diagnosed cases of PIH and to study its association with uterine artery-pulsatility index (UtA-PI) and fetal outcome. Materials and Methods: This was a prospective and observational study in which pregnant females with gestational age of 20–34 weeks who were referred to radiology department for routine sonography including the clinically diagnosed pregnancies with PIH were included on the basis of a predefined inclusion and exclusion criteria. A total of 106 individuals were included in the study, B-mode sonography, uterine artery Doppler, and placental SWE were performed in all these patients. All these pregnancies were followed up for the fetal outcome. Results: The mean gestational age of the studied cases was found to be 26.51±4.415 weeks. Higher SWE values were found, as compared to the normal pregnancies, in pregnancies complicated by PIH and the difference was found to be statistically highly significant (P<0.001). Placental SWE showed a strong association with UtA-PI and fetal outcome. Incidence of adverse fetal outcome such as preterm deliveries, intrauterine death, stillbirths, and small for gestational age babies was more commonly seen in PIH group and the difference was statistically significant (P<0.005). Incidence of birth asphyxia (as determined by low APGAR score) and neonatal intensive care unit admissions was more in neonates born to patients with PIH as compared to those in healthy women and the difference was statistically significant (P<0.005). Conclusion: SWE has the potency to detect the changes in placental morphology and can help with diagnosis of pregnancies complicated with PIH. It does have a synergistic role to play alongside the uterine artery Doppler and clinical parameters to predict the pregnancies with PIH. [ABSTRACT FROM AUTHOR]

Introduction: First trimester vaginal bleeding, a serious obstetric challenge to developing embryo, occurs in 15-25% of all pregnant women. It is a matter of great concern to both mother and obstetrician for its increased association of adverse maternal and foetal outcome. Aim: To measure the prevalence of patients with first trimester vaginal bleeding, to evaluate factors associated with it and to assess foeto-maternal outcome in those pregnant women. Materials and Methods: This was a prospective, hospital-based, longitudinal study carried out among 120 women with first trimester vaginal bleeding having normal bodyweight, and regular cycles and agreeing to follow-up, at Department of Obstetrics and Gynaecology in a tertiary teaching hospital, Kolkata, West Bengal, India, from January 2019 to June 2020. The incidence of vaginal bleeding in first trimester, its risk factors, foeto-maternal outcome in terms of Pregnancy Induced Hypertension (PIH), abortions, preterm deliveries, Antepartum Haemorrhages (APH), birth weight of baby, low APGAR (Appearance or colour of the baby, Pulse, Grimace, Activity, and Respiration) score at birth were assessed. The descriptive statistics to calculate percentage and mean and Chi-square-test with significance value considered at p-value <0.05. Results: Out of 4716 pregnant women attending in Obstetric clinic at their first trimester, 332 had vaginal bleeding, incidence being 7.04%. Out of 332 women, 120 study participants met inclusion criteria. Of 120 cases, 79 (65.8%) were from age group of 21-30 years. Highest incidence was 74 (61.7%) in primigravida. Incidence was high in poor socio-economic status (upper lower and lower) ie., 57 and unplanned cases, 87 (72.5%). On follow-up of 120 participants, 66 (55%) had threatened abortion, of them 51.5% (34/66) led to term pregnancy followed by preterm labour 39.39% (26/66) and only few, 9.09% (6/66) ended up with incomplete miscarriage. Spotting was most common nature of bleeding per vagina 41.66%, (50/120). On follow-up of 60 (90.9%) viable pregnancies, PIH was in 12 (20%) cases and abruption was seen in one (1.6%). Majority of preterm babies 65.4%, (17/26) Needed Neonatal Intensive Care Unit (NICU) admission. Conclusion: Vaginal bleeding in first trimester is an indicator of the maternal and foetal adverse consequences and results of this study can enrich our knowledge to plan and manage these pregnant women adequately. [ABSTRACT FROM AUTHOR]

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Background: Maternal near miss (MNM) is one of the newly adopted assessment parameters to gauge the quality of maternity care. In Ethiopia, several studies have been conducted to investigate the incidence, underlying causes, and determinants of MNM. However, the findings from those studies vary greatly and are largely inconsistent. Thus, this review aims to more robustly estimate the pooled prevalence, identify underlying causes, and single out determinants of MNM in Ethiopia., Methods: Studies were searched from international databases (PubMed/ Medline, Cochrane Library, and Embase databases) and other potential sites. All observational studies were included. Heterogeneity between studies was checked using Cochrane Q test statistics and I 2 test statistics and small study effects were checked using Egger's statistical test at a 5% significance level. Outcome measures were overall and specific underlying causes (obstetrics hemorrhage, hypertensive disorder pregnancy, pregnancy-related infection) rates of MNMs per 10,000 live births., Result: The meta-analysis included 43 studies consisting of 77240 MNM cases. The pooled prevalence MNM per 1000 live births in Ethiopia was 54.33 (95% CI: 33.93 to 85.89). Between-study heterogeneity was high (I 2 = 100%, P < 0.0001), with the highest rate observed in Amhara region (384.54 per 1000). The prevalence of obstetrics hemorrhage (14.56 per 1000) was higher than that of hypertensive disorder pregnancy (12.67 per 1000) and pregnancy-related infections (3.55 per 1000) were identified as underlying causes. Various factors, including socio demographic characteristics, previous medical and obstetrics history as well as access to and quality of care obtained, were associated with MNM., Conclusion: Almost six women encounter near miss among a hundred live births in Ethiopia. Obstetric hemorrhage and hypertensive disorder pregnancy were the most common underlying causes of MNM. Both individual and facility level determinants were found to be associated with MNM. Considering the magnitude and identified factors, tailored measures should be taken at every stage of the continuum of care., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023395259., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tesfay, Hailu, Begna, Habtetsion, Taye, Woldeyohannes and Jina.)

Objective: This systematic review evaluated the available evidence on the effects of proton pump inhibitors during pregnancy on preeclampsia and related maternal, fetal, and neonatal outcomes., Data Sources: Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and Global Medicus Index) were searched on November 17, 2023., Study Eligibility Criteria: Randomized controlled trials of pregnant women who used any class or dose of proton pump inhibitor were eligible., Methods: A meta-analysis was conducted for all outcomes of interest using random-effects models. Results were presented as risk ratios or mean difference. Quality assessment was performed using the Risk of Bias 2 tool, and Grading of Recommendations, Assessment, Development, and Evaluations assessment was completed to evaluate the certainty of the evidence. The study was registered in the International Prospective Register of Systematic Reviews under identifier CRD42023423673., Results: Our search identified 3879 records that were screened independently by 2 authors. Nine reports (describing 8 trials) met our eligibility criteria, however, 6 trials were ultimately excluded from our analysis because women were only given proton pump inhibitors immediately before cesarean delivery for acid aspiration prevention. The 2 trials that were included in the meta-analysis evaluated the treatment of 177 women with diagnosed preeclampsia. For the primary outcomes, moderate-certainty evidence showed that the use of proton pump inhibitors likely has no effect on the risk for hemolysis, elevated liver enzymes, and low platelet count syndrome (risk ratio, 1.21; 95% confidence interval, 0.37-3.99; I²=0%) or perinatal mortality (risk ratio, 0.81; 95% confidence interval, 0.36-1.79; I²=0%), and there were insufficient data to conduct a meta-analysis on all other primary outcomes, including eclampsia and neonatal mortality. No trials investigated the use of proton pump inhibitors for the prevention of preeclampsia., Conclusion: Given the limited outcome data, we are uncertain about the effect of proton pump inhibitors on women with preeclampsia. Further trials are required to determine what (if any) effects proton pump inhibitors might have for preeclampsia prevention or treatment., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Pregnancy induced hypertension (PIH)is a significant public health threat. It increases the risk of cardiac failure, renal failure and cerebrovascular accidents. Objectives: To study the socio-demographic profile among the study population and to study the factors associated with pregnancy induced hypertension among the study population.Method: A Case control study was done among 100 pregnant women attending the tertiary centre. Cases and controls were selected in the ratio of 1:1 with 50 cases and 50 controls.The study participants were selected randomly and interviewed using a pretested questionnaire. Data was be entered in MS excel and analysis was done using Epi info 7.2.2.16. Results: Out of the total study participants 64% of the cases and 54% of the controls were Hindu by religion. Majority (72%) of the cases and 54% of the controls were multigravida. Majority (36%) of the cases belong to class II socio-economic status and majority of the controls (36%) belong to class III socio-economic status according to modified B.G Prasad classification.Majority(63%) of the subjects were multi-gravida and 71.2% have parity greater than two.LowerSocio-economic status,Physical Inactivity and History of PIH were found to be significant factors for Pregnancy induced hypertension among the cases. Conclusion: Lower socio-economic status, lack of exercise and past history of PIH were found to be significant among the study population.Anemia as a predictor of PIH needs further research as only few studies showed significant association between PIH and anemia. Although association between diet and PIH was present, it was not significant and needs further research.