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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]

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]

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: 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]

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: 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]

Objectives: the aim is to determine the prevalence of hypertensive disorders and to describe the sociodemographic aspects and risk factors for preeclampsia, gestational hypertension and intrauterine growth restriction. Methods: a descriptive cross-sectional study. Maternal characteristics, history from the first prenatal visit and outcomes were obtained. The prevalence and percentages were calculated and described. Results: the prevalence of hypertensive disorders was 12.7%, preeclampsia was 8.0%, followed by gestational hypertension at 4.7%. Of the preeclampsia, 54.8% were severe and 11.9% were of early onset. Moreover, 56.5% of the severe preeclampsia had preterm deliveries. IUGR had a prevalence of 5.3%. Based on maternal history, the most relevant risk factors were a family and personal history of preeclampsia and IUGR. Conclusions: we found a considerable prevalence of preeclampsia with a high percentage of preterm deliveries, associated with varying severity. This data helps health professionals to be aware of the risk factors that can be followed up for preventing complications. The determination of the risk of developing a hypertensive disorder during pregnancy is fundamental to encouraging proper counseling and care for these women through gestation. [ABSTRACT FROM AUTHOR]

Introduction: Intrauterine growth restriction (IUGR) has been demonstrated to have serious consequences for health in adult age. Pregnancy induced hypertension is closely related with placental dysfunction that result in fetal growth restriction. The study was to determine the frequency and outcome of intrauterine growth restriction (IUGR) in pregnancy induced hypertension. Material and Methods: This cross-sectional study was conducted from 1st June 2021 to 31st December 2021, involving 160 pregnant women presenting at the Jinnah Medical College Hospital, Karachi. All the pregnant ladies of 15-45 years of age either nulliparous or multiparous had pregnancy induced hypertension after 20 weeks of gestation were recruited for the study. All the subjects with PIH were observed for IUGR and outcome according to the parameters mentioned in operational definition. The clinical maneuvers (history and clinical examination) were performed by researcher while the ultrasound was performed by sonologist. The data was collected on pre-designed proforma. The data was analyzed in SPSS version 16.00. Results:During 6-months study period total 160 pregnancy induced hypertension were observed for intrauterine growth restriction (IUGR). The mean ±SD for maternal age (years), gestational age (weeks), duration of disease (weeks), baby weight (grams) and apgar score for overall population was 38.95±8.92, 33.73±6.92, 3.00±2.0, 4.91±1.52, 1811±3.32 and 4.21±1.21. The IUGR was detected in 104(65%) babies while the outcome identified as low apgar score 28(26.9%), abortion 13 (12.5%), low birth weight 28 (26.9%), pre-term birth 20(19.2%) and still birth 15(14.4%). Conclusion: Intra-uterine growth restriction is frequently a sequel of hypertensive disorders of pregnancy and the frequency of IUGR in patients with PIH was found to be 65%. [ABSTRACT FROM AUTHOR]

Background: Oocyte donation has facilitated couples to achieve pregnancy in conditions like diminished ovarian reserve, premature ovarian failure, and inheritable disorders. However, it is unclear whether pregnancy complications are due to oocyte donation per se or due to confounding factors such as maternal age or the allogenic fetus. In this retrospective comparative cohort, an attempt was made to evaluate and compare multiple obstetric and perinatal outcomes. Methods: The present study comprised all women in the age range of 20-45 years who conceived from oocyte donation (n=102) between 1/12/2011 to 30/09/2017. Control group consisted of spontaneous conception cases (n=306) in ratio of 1:3 with no previous medical or surgery comorbidity. Obstetric and perinatal outcomes were compared between two groups. Results: Mean maternal age was significantly higher in the donor oocyte IVF group (group 1; 35.13 years) as compared to spontaneous conception group (group 2; 31.75 years). Parity between the two groups was comparable. Pregnancy induced hypertension (PIH) was seen in 33.33% of cases in group 1 as compared to 7.18% in group 2. Moreover, gestational diabetes mellitus was seen in 34.31% of cases in group 1 as compared to 9.47% in group 2 (p=0.001). By the same token, there was significant difference in perinatal outcomes between the two groups. Conclusion: Oocyte donation should be treated as an independent risk factor for miscarriage, hypertensive disorder, and gestational diabetes mellitus in pregnancy. [ABSTRACT FROM AUTHOR]

Background: Pregnancy Induced Hypertension (PIH) is a major contributor to maternal and perinatal mortality. It is associated with proteinuria and generalized oedema. When PIH is associated with significant proteinuria (protein in urine > 0.3g/in 24 h) it is termed as a pre-eclamptic condition. When preeclampsia is associated with seizures, it is defined as eclampsia. The Pregnancy induced hypertension is a multi-system disorder that can lead to retinal changes which correlate with progression of PIH and foetal mortality, due to similar vascular ischemic changes in the placenta. Material and Methods: Being a cross sectional study the main aim was to determine the prevalence of retinal changes in patients of pregnancy induced hypertension observed in the hilly terrain of Garhwal belt. It was further aimed to correlate retinal changes, disease severity and stage of hypertension. A total 75 antenatal cases detected with PIH and referred for fundus evaluation at a tertiary hospital of Garhwal region were included. Age, gestation period, gravid status, extent of proteinuria and blood pressure were noted from the case records. Detailed ocular history and ocular examination with direct and indirect ophthalmoscopy were performed to assess the level of retinopathy. Statistical analysis of the observations were done employing Fisher's exact test on a SPSS software. Results: Of the 75 patients evaluated, gestation period ranged from 28 to 40 weeks. 48 (64%) of examined subjects showed retinal changes. The distribution of severity, revealed, 32% with Grade I, 24% Grade II, 6% Grade III and 2 % as Grade IV. 71% patients had mild preeclampsia, 23.8% had severe preeclampsia and 5.2% had frank eclampsia. Statistically significant positive correlation was noted for Retinal changes with blood pressure, and severity of PIH. Conclusion: Retinopathy in PIH is an important cause of ocular morbidity in the pregnant women of the hilly district of Garhwal. Not only does it correlate with severity of blood pressure, it provides a useful tool of monitoring to the clinicians to predict the foetal outcome and ocular morbidity. [ABSTRACT FROM AUTHOR]

Introduction: Hypertensive disorders in pregnancy are a relevant medical and social problem that can have consequences for both, the mother and the fetus. According to the World Health Organization (WHO), preeclampsia is one of the most serious complications, affecting approximately 2-8% of pregnancies worldwide. Case Report: Patient X., 26 years old, second ongoing pregnancy, 37-38 weeks of gestational (w.g.), presented herself at the Emergency Unit of Tertiary Perinatal Center, Chisinau, Republic of Moldova (RM) with the complains: fatigue, persisting occipital headache for 2-3 days, along with high blood pressure (BP) 165/100 mmHg. Information gathered via clinical case monitoring, through diligent examination of the medical record, and by a comprehensive review of the literature. Discussions : Patient X., 26 years old, admitted with complaints: fatigue, persisting occipital headache for 2-3 days, along with high BP 165/100 mmHg. Obstetric history revealed the history of cesarian section (C-section), due to preeclampsia, associated with premature rupture of the amniotic sac at 39 w.g. Ultrasound exam revealed a placentomegaly at 36 w.g. in the current pregnancy. The patient, hemodynamically stable, with a respiratory rate of 17 breaths per minute, a pulse rate of 88 beats per minute, and BP initially measured at 170/110 mmHg, which subsequently decreased to 150/100 mmHg over 2 hours, without changes in the pulse rate. Palpation of the uterus revealed an ovoid shape and normal tone. The fetus was in the cephalic presentation. Fetal heart rate was ~146 beats/min, clear, rhythmic. The pelvic exam revealed the biologically unprepared birth canal. Traces of protein in urine. The diagnosis was established: Pregnancy 37-38 w.g. Rh negative without isoimmunization. History of C-section. Pregnancy induced hypertension. Antihypertensive treatment was administered according to the guidelines (methyldopa, nifedipine, metoprolol). Despite the treatment, BP values remain elevated (165-150 /100-90 mmHg) for the next 2 days with periodic occipital headaches. Ultrasound of the fetus showed blood flow centralization, also cardiotocographic changes were determined. In support of the preeclampsia diagnosis update, the C-section was recommended along with magnesium therapy. A female fetus was delivered, 3000 grams, Apgar score 7/8. The post-operative period was uncomplicated. Conclusions: Comprehensive understanding and management of hypertensive disorders in pregnancy is crucial for preventive measures to minimize maternal and/or fetal risks. Therefore, handling the appropriate medication, deciding a delivery method, and timing, along with optimal postpartum management are essential. [ABSTRACT FROM AUTHOR]

Objective: To assess the frequency of IUDs and their possible causes since the Covid-19 pandemic. Material and Methods:. Study design: Cross-sectional study. Setting: Department of Obstetrics and Gynaecology, Shalamar Hospital, Medical and Dental College, Lahore, Pakistan. Duration of study: 15/03/2020 to 15/06/2020 This is a cross-sectional single-center study. The relevant details about IUDs like age, parity, social status, booked status, comorbidities, and social status were entered into a Performa and the data analyzed. Results: The Intrauterine death rate from the study was 41.99 fetal deaths per 1000 live births (Total births: 643, IUDs: 27) while the mean age of the mothers was 29.67 with a minimum age of 22 years and a maximum of 37 years. According to the risk factors associated with the IUD, 11.1% had Pregnancy Induced hypertension, 11.1% had Pre-Eclampsia, 22.2% had Gestational Diabetes Mellitus and 22.2% Pregnancy Induced Hypertension and Gestational Diabetes Mellitus and 33.3% had no comorbidities. Amongst all the patients 33.3% of cases were unbooked. Conclusion: We conclude that in the last one year the fetal deaths per 1000 at Shalamar Hospital were around 28.57 per 1000 live births, during the last 3 months they gone up to 41.99 fetal deaths per 1000 live births. The leading cause(s) for IUDs in Pregnancy during the Covid-19 were pandemic Induced Hypertension and Gestational Diabetes Mellitus, which cumulatively account for 44.4% cases but 33.3% cases had no co-morbidities and still ended up in an Intra-Uterine death, which may or may not have been influenced by a Covid-19 infection. From the looks of it, Non-clinical reasons seem to have a higher probability of increasing the IUD rate but clinical effects of the Covid-19 infection can also not be ruled out completely, further studies are required into the pathogenesis and the effect of Covid-19 on pregnancy. [ABSTRACT FROM AUTHOR]

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Pregnancy induced hypertension is a common obstetric disorder. It is among the leading causes of maternal and fetal mortality and morbidity. This research aims to assess pregnant women’s knowledge regarding pregnancy induced hypertension, and to find out the relationship between pregnant women’s knowledge and their demographic and clinical data . A quasi-experimental design is used to investigate the effectiveness of instructional program upon women’s knowledge suffering from pregnancy induced hypertension, from the 8th of January to 3th September2020, included 80 pregnant (40 women as study group), and (40 women as a control group). The current study found that the knowledge of the majority of women about pregnancy induced hypertension is poor in complication domain specialty before the implementation of instructional program. However, 100% of them have had good knowledge after two weeks of implementation of the instructional program. The women have developed and improved in their knowledge about pregnancy induced hypertension. The study revealed that there were high significant in the study group knowledge regarding the pregnancy induced hypertension in the pre-test and post-test measurements. The study has concluded that the instructional program has a positive effect on the study sample blood pressure. The instructional program has a positive effect on the study sample knowledge regarding the PIH. Levels of education, monthly income, residential area, occupational status, and the type of family are affect the pregnant’s knowledge regarding the PIH. [ABSTRACT FROM AUTHOR]

Background: Preeclampsia is a multifactorial disorder comprising many organs. Oxidative stress (OS) has been intensely linked to its occurrence. Vitamin E, a lipophilic chain breaking antioxidant has been proved to suppress the OS. Present study was designed to investigate antioxidant nutrient profile in patients with different grades of pregnancy induced hypertension (PIH) and to compare them with normal pregnant controls. Methods: The study group comprised 110 patients divided in three groups as Group A (n=40) Normotensive patients, Group B (n=40) Mild hypertensive, Group C (n=30) Severe hypertensive. Vitamin A, B-Carotene, serum alpha tocopherol (vitamin E) and vitamin C levels were analysed. Results: Serum alpha tocopherol (vitamin E) was significantly low in severe and mild cases (0.32±0.00 mg/dl, 0.74±0.03 mg/dl respectively), when compared with normal pregnant women levels (0.78±0.040). All other nutrients were also found to be in reduced quantity for Group C when compared to control group (P value <0.001). Conclusion: It was therefore concluded that in patients with risk of preeclampsia (PE) adequate antioxidant nutrients may have a role in cessation of free radical-mediated cell disturbances, and thereby protecting against endothelial cell damage, which is the key factor in PE development. [ABSTRACT FROM AUTHOR]

Objective: To determine the positive predictive value of beta Human Chorionic Gonadotrophin in early second trimester for predicting pregnancy induced hypertension. Study Design: Cross-sectional study. Place and Duration of Study: Department of Obstetrics and Gynaecology Combined Military Hospital, Lahore, from Jun 2017 to Nov 2017. Methodology: A total of 214 female pregnant patients met the criteria for inclusion in this study. Patients with beta human chorionic gonadotrophin (βHcg) levels ≥2 MoM were followed at 22, 26, 30 and 34 weeks of gestation. Blood pressure was monitored. Pregnancy induced hypertension (PIH) was labelled after 20 weeks (as per dating scan) of gestation in patients who did not have proteinuria (≥300 mg 24 hour urine sample) and had a systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg (blood pressure readings taken at two separate points in time four hours apart). Results: Patients ranged between 18-35 years of age, with the mean age being 27.3 ± 4.3 years. Mean gestational age was observed to be 15.6 ± 1.8 weeks. Mean BMI was 23.8 ± 3.2 kg/m² . Out of 214 patients, 30 patients (14%) had beta human chorionic gonadotrophin level >2 MoM. Out of these 30 patients, 25 patients (83.3%) developed PIH. There were 100 primigravida (46.7%) and 114 multigravidas (53.3%). Beta human chorionic gonadotrophin in predicting pregnancy induced hypertension showed sensitivity of 96.1%, a specificity of 97.3%, with a PPV 83.3%, a NPV 99.4% and diagnostic accuracy of 97.2%. Conclusion: Pregnant women with beta human chorionic gonadotrophin levels >2 MoM at 13-18 weeks gestation were at an increased risk of developing pregnancy induced hypertension. [ABSTRACT FROM AUTHOR]

Background: Pregnancy induced hypertension, is common throughout the world but more frequent in developing countries and cause of maternal and infant mortality and morbidity. Objectives: To the effectiveness of educational program about PIH on nurse-midwives’ knowledge Subjects and Method: A quasi-experimental design, non- probability (purposive) sample of (50) nurse-midwives’ who are working in Bint Al-Huda hospital in Al-Nasiriyah City during February 13th through April 2nd 2019. Results: The results of the study show that more than a one third of the study sample are within age group (20-25) years, and had more than a half were married, one third were nursing school graduates and had experiences for 10 years or more. In pretest the nurse’s knowledge show poor and fair level, after intervention of the program and through two posttest in different timing the score show a progress in result to very good level. (84.9%) for knowledge during posttest I and to (100%) for posttest II to knowledge. Conclusion: The study concludes there were significant of educational program on nurse-midwives’ knowledge. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of PIH is about 8-10% of pregnancies. Hypertensive disorder of pregnancy if unchecked will result in eclampsia with generalized convulsions, HELLP syndrome etc. It is usually managed with medicines. There are various non-pharmacological treatment like muscle relaxation, meditation, breathing etc. which are used to control of hypertension. Present study was aimed to assess the effectiveness of audio assisted relaxation therapy on level of blood pressure among mother with pregnancy induced hypertension. Method: Experimental approach with one group pretest- posttest design was used for the study. Study was conducted among 30 antenatal mothers diagnosed with PIH admitted in Kamla Nehru Hospital, Shimla H.P, selected by using convenience sampling technique. Semi structured interview schedule is used to collect background information and sphygmomanometer was used to measure the level of blood pressure. The blood pressure (BP) was monitored three times a day for two days to obtain a baseline data and average of it was considered as pre-test. Audio assisted relaxation therapy was then administered for 20 minutes per sessions, two times a day for three days. The blood pressure (BP) was monitored before and after each session of relaxation therapy Results: The mean posttest systolic is BP, 139.81 mm of Hg was significantly lower than the mean pretest systolic BP, 146.45 mm of Hg. The mean posttest diastolic BP, 87.63 mm of Hg was also lower than the mean pretest diastolic BP, 92.06 mm. Both differences were significant at the level of <0.001. Discussion: The result of present study shows there is a significant difference in BP before and after intervention. So audio assisted relaxation therapy can be used as an effective add on intervention for the management of with women hypertension during pregnancy. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus is a leading medical condition woman encounter during pregnancy with serious short- and long-term consequences for maternal morbidity. However, limited evidence was available on potential impacts of gestational diabetes mellitus using updated international diagnostic criteria on adverse maternal outcomes. Therefore, this study aimed to assess the effects of gestational diabetes mellitus on the risk of adverse maternal outcomes in Northwest Ethiopia.Methods: A prospective cohort study was conducted among pregnant women followed from pregnancy to delivery. Gestational diabetes mellitus status was determined by using a two-hour 75 g oral glucose tolerance test and based on updated international diagnostic criteria. Multivariable log-binomial model was used to examine the effects of gestational diabetes mellitus on the risk of adverse maternal outcomes.Results: A total of 694 women completed the follow-up and included in the analysis. Women with gestational diabetes mellitus had a higher risk of composite adverse maternal outcome (ARR=1.58, 95% CI: 1.22, 2.04), caesarean delivery (ARR=1.67; 95%: 1.15, 2.44), pregnancy induced hypertension (ARR= 3.32; 95%: 1.55, 7.11), premature rupture of membranes (ARR= 1.83; 95%: 1.02, 3.27), antepartum hemorrhage (ARR= 2.10; 95%: 1.11, 3.98) and postpartum hemorrhage (ARR= 4.85; 95%:2.28, 10.30) compared to women without gestational diabetes mellitus.Conclusions: Gestational diabetes mellitus increased the risk of adverse maternal outcomes. This implies that maternal care and intervention strategies relating to women with gestational diabetes mellitus should be strengthened. [ABSTRACT FROM AUTHOR]

Background of the Study: Hypertension, complicating 5-10% of all pregnancies worldwide, is a leading cause of maternal and fetal morbidity. The control of pregnancy-induced hypertension (PIH) appears difficult to achieve. Part of the reason for poor control of hypertension in these women might be limited PIH self-care knowledge. Objective: to assess the knowledge and risk factors of PIH among antenatal mothers and to find out the association between knowledge and risk factors with selected demographic variables. Materials and Method: Study was conducted on 110 antenatal mothers attending in Gynecologic OPD, AIMS, Kochi, Kerala. The research design used was non experimental descriptive design. Result: The present study reveals that more than half of the mothers (63.6%) had average knowledge regarding PIH. Half of the mothers had the risk factors of family history of hypertension (50%) and followed by 32.7% had the habit of high non vegetarian food intake. A statistically significant association was observed for education and knowledge and comorbidities and knowledge of antenatal mothers. Significant association was found in risk factors and comorbidities of antenatal mothers. Conclusion: The finding of the study shows that antenatal mothers had average knowledge related to PIH. Health care providers should implement the focused health education programme during antenatal visit [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy induced hypertension (PIH) is a pregnancy specific, multisystem disorder characterized by development of edema, hypertension and proteinuria after 20 weeks of gestation. The group of diseases includes preeclampsia and eclampsia, which are peculiar to pregnancy. Antihypertensive treatment should be commenced in all women with a systolic blood pressure ≥170 mm Hg or a diastolic blood pressure ≥110 mm Hg because of the risk of intracerebral hemorrhage and eclampsia. Aim: To evaluate the safety and efficacy of nifedipine in gestational hypertension. Methodology: A Prospective observational study was conducted in outpatient and inpatient department of obstetrics and gynaecology of Government hospital for a period of one year (November 2017 - November 2018). Inclusion criterion of the study was to collect and analyse the case sheets of patients having Gestational hypertension and Gestational age of >20 weeks admitted in the hospital and visited outpatient department during one year duration. Exclusion criterion of this study was patients having chronic hypertension, Gestational age of <20 weeks, Patients who were diagnosed with other causes of convulsions in pregnancy like cerebral malaria and epilepsy and Patients not willing to participate in the study. Results and Discussion: In the present study, 70(68.62%) patients were treated with nifedipine and rest 32(31.37%) patients were treated with other antihypertensive. Nifedipine showed significantly better clinical outcomes in comparison to other anti hypertensive. Nifedipine safety profile in terms of adverse effects was significantly better than other anti hypertensive. IUGR had greater relative risk compared to other fetal outcomes while relative risk was significantly less for maternal outcomes in patients treated with nifedipine. Conclusion: Our study results implicated the efficacy of nifedipine in pregnancy induced hypertension in terms of clinical outcomes, type of delivery, maternal outcomes and fetal outcomes and incidence of adverse effects. [ABSTRACT FROM AUTHOR]

Objective: To study the Impact and Comparison of Pregnancy Induced Hypertension and Obesity on Fetal and Maternal Outcome in our set up. Study Design: Comparative cross sectional study. Place and Duration of Study: Combined Military Hospital Kharian, from May 2017 to May 2018. Methodology: A total of 210 pregnant women were divided into healthy, overweight and obese groups according to WHO classification and normal, mild to moderate and severe hypertensive groups on blood pressure basis. The maternal and neonatal morbidity including Disseminated Intravascular Coagulation, post prandial hemorrhage, eclampsia, acute renal failure, birth weight, small for gestation, admission to Neonatal Intensive Care Unit or neonatal death were recorded. Results: The mean age was 26.15 ± 3.22 years, mean blood pressure 128.57 ± 10.09/86.91 ± 5.89 mmHg, and mean BMI 21.33 ± 2.52. Most female were between 25-30 years age, were house wife, and delivered by spontaneous vaginal delivery. Among severe pregnancy induced hypertension and obese women, eclampsia (16.7% vs. 13%), Disseminated Intravascular Coagulation (25% vs. 13%), and maternal mortality (5.6% vs. 8.6%) was seen respectively, while neonatal morbidity including Neonatal Intensive Care Unit admissions (38.9% vs. 52.2%), small for gestation (25% vs. 30.4%), low birth weight (13.9% vs. 13%), and death (11.1% vs. 13%) respectively. Conclusion: The obese women showed a higher fetal (small for gestation, neonatal intensive care unit admission and neonatal death) and maternal risk (acute renal failure, post-partum hemorrhage, Critical Care Unit admission, and maternal mortality) than women with severe pregnancy induced hypertension. [ABSTRACT FROM AUTHOR]

Pregnancy-induced hypertension (PIH), especially preeclampsia, is a major cause of maternal and perinatal morbidity and mortality worldwide. The impact of PIH on birth outcomes has not been extensively studied. PIH has been confirmed to increase significantly the risk of low birth weight by both increasing preterm birth as well as reducing fetal growth. Low birth weight or IUGR babies have been associated with the occurrence of several chronic diseases in later life. However, to date, there have been few studies on the effects of PIH on infant growth and neonatal wellbeing. The purpose of this study was to evaluate the fetal growth and wellbeing of newborns born of mothers with confirmed pregnancy induced hypertension. Material and methods: This was prospective opservational study during the period of the last year, 1st of July 2018 up to the end of June 2019 conducted at the University Clinic for Gynecology and Obstetrics in Skopje. As pregnancy induced hypertension is defined the condition of blood pressure equal to or greater than 130/90 mmHg on more than two occasions greater than six hours apart without proteinuria after 21 weeks of gestation. All other more severe conditions are defined as pre-eclampsia or eclampsia. As outcome was considered the birth weight, gestational age and white blood cells count. IUGR was defined as birth weight below the tenth percentile of expected weight for gestational age. Also maternal age and BMI were considered as conjoined risk factor for the birth weight. Results: In this study, 4726 newborns were born at the University Clinic for Gynecology and Obstetrics, and for analysis were considered 4273 newborns who were late preterm (35 and 36 gestational weeks) or term newborns. Two groups were evaluated: control group of 200 consecutively born newborns (late preterm and term) of healthy mothers and 100 newborns (late preterm and term) consecutively born of mothers with confirmed diagnosis of PIH, which constituted the study group. Within the control group, the proportion of Small for Gestational Age-SGA was 6,3%, and in the group of mothers with PIH was 9,5% (p<0,05). The maternal mean age of the hypertensive mothers was (32.8±5.0) years while that of normotensive mothers was (26.6±3.7) years, and there was not statistical significance (p>0.05). The Body Mass Index was higher in hypertensive mothers, compared to the healthy mothers (31,3±2.02 vs. 27.8±2.8). The mean gestational age of the study group was (35.8±1.8) weeks compared to that in control group (37.4±1.2) weeks. The number of White Blood Cells (WBC) count in newborns of hypertensive mothers was 21.4±5.3x109/L compared with the control group, 18.5±3.12x109/L (p=0.005). Neonatal thrombocytopenia was found in 32% of neonates of preeclamptic mothers while it's found only in 9.5% of neonates in control group p<0,002. Discussion: The limitation of this study was the lack of data about maternal smoking, life style, etc. There is limited number of studies examining the correlation between fetal growth and PIH, and every information is of great value. The fact is that this condition can progress in more severe degree of hypertension and deleterious effects on the mother itself and on her child, if not treated on time. Conclusion: A change in infant growth of the IUGR baby itself (e.g. catch-up growth) such as in the critical early infant period may also have long-term effects on health later in life, and this change of postpartum growth may be influenced by PIH. Therefore, it is important to study postpartum infant growth patterns of babies born to mothers with PIH, and to determine if there are differences in infant growth between babies with and those without IUGR. And, the most important action is to monitor and treat pregnancy induced hypertension and prevent more severe condition of pre-eclampsia. [ABSTRACT FROM AUTHOR]

Objective: To find out the effectiveness of musical therapy and physiotherapy in pregnancy induced hypertension. Materials and Method: Ethical clearance was obtained from the Institutional Ethical Committee. 40 women attending the antenatal therapy at physiotherapy outpatient department, Krishna Hospital, Karad, Maharashtra, India, were women with 3rd trimester of pregnancy with mild pregnancy induced hypertension participated in this study; 20 women in the GROUP A i.e. music group and 20 women in the GROUP B i.e. music and physiotherapy group by convenient sampling with random allocation of the subject. Result: Inter group statistical analysis for systolic blood pressure revealed extremely significant in post intervention for group B (p<0.0001). Diastolic blood pressure was extremely significant for group B (P value<0.0001). Pulse rate was extremely significant for group B (p<0.0001). While Post intervention analysis showed extremely significant difference between Group A and Group B (p<0.0001). Group B treated with musical therapy and physiotherapy was extremely significant. Conclusion: An integrated approach to combination of musical therapy and physiotherapy is safe and effective. It decreases the systolic blood pressure, diastolic blood pressure and pulse rate with less complication in delivery. [ABSTRACT FROM AUTHOR]

Introduction: Magnesium Sulphate (MgSO4) is the most effective drug used for seizure prevention in preeclampsia; however, the dosage of MgSO4 is still in controversy. Maternal weight is an important factor for the serum MgSO4 level; however, there has not been any weight-adjusted regimen of MgSO4 reported. Aim: To compare the effectiveness of weight-adjusted versus standard two grams per hour (g/hr) protocols of intravenous MgSO4 for preventing convulsion in preeclampsia. Materials and Methods: A randomised controlled trial was conducted with 86 preeclamptic women from January 2018 to September 2018. The study group (43 cases) received MgSO4 4 g loading followed by a weight-adjusted protocol starting with 1.2-1.5 g/hr depending on maternal weight. The control group (43 cases) received MgSO4 4 g loading followed by 2 g/hr. The serum Mg level was monitored at two and four hours after MgSO4 injection. The MgSO4 dosage was adjusted and continued until 24 hours after delivery. The percentages of those who achieved a therapeutic level of MgSO4 (4.8-8.4 mg/dL) in the first four hours were compared between the two groups. Clinical signs of Mg toxicity were monitored. Maternal and neonatal outcomes were evaluated. Results: At four hours after treatment, the proportion of participants who achieved a therapeutic level were 11.6% in the study group and 41.9% in the control group (RR 0.28, 95% CI 0.11 to 0.68, p-value <0.01). The 2 g/hr protocol for those participants whose maternal weight was <80 kg had a higher proportion who achieved a therapeutic level (p-values >0.001). However, both protocols had similar low proportions who achieved a therapeutic level for those whose maternal weight was >80 kg (8% in maternal weight 80-99.9 kg, 0% in maternal weight >100 kg). No clinical MgSO4 toxicity was observed. Maternal and neonatal outcome were not statistically significant. Conclusion: Maternal bodyweight is important for MgSO4 dosage adjustment. In those patients whose maternal bodyweight is <80 kg, a 2 g/hr maintenance dose is more effective than a lower dose; however, in patients whose maternal bodyweight is >80 kg, higher dose is required for achieving therapeutic level. A low dose is not sufficient for any weight range. At least 2 g/hr is minimum required for preventing convulsion in preeclampsia. [ABSTRACT FROM AUTHOR]

BACKGROUND: Disorders of pregnancy induced hypertensive are a major health problem in the obstetric population as they are one of the leading causes of maternal and perinatal morbidity and mortality. The World Health Organization estimates that at least one woman dies every seven minutes from complications of hypertensive disorders of pregnancy. The objective of this study is to assess pregnancy induced hypertension and its associated factors among women attending delivery service at Mizan-Tepi University Teaching Hospital, Gebretsadikshawo Hospital and Tepi General Hospital. METHODS: A health facility based cross-sectional study was carried out from October 01 to November 30/2016. The total sample size (422) was proportionally allocated to the three hospitals. Systematic sampling technique was used to select study participants. Variables with p-value of less than 0.25 in binary logistic regression were entered into the multivariable logistic regression to control cofounding. Odds ratio with 95% confidence interval was used. P-value less than 0.05 was considered as statistically significant. RESULTS: The prevalence of pregnancy induced hypertension was 33(7.9%); of which 5(15.2%) were gestational hypertension, 12 (36.4%) were mild preeclampsia, 15(45.5%) were severe preeclampsia and 1 (3%) eclampsia. Positive family history of pregnancy induced hypertension [AOR5.25 (1.39-19.86)], kidney diseases (AOR 3.32(1.04-10.58)), having asthma [AOR 37.95(1.41-1021)] and gestational age (AOR 0.096(0.04-.23)) were predictors of pregnancy induced hypertension. CONCLUSION: The prevalence of pregnancy induced hypertension among women attending delivery service was 7.9%. Having family history of pregnancy induced hypertension, chronic kidney diseases and gestational age were predictors of pregnancy induced hypertension. [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy induced hypertension is considered as the major cause of maternal morbidity and mortality in developing as well as developed countries complicating 7 – 10% of all pregnancies. Since fundus changes are very good gauge for severity of hypertension for differentiating chronic hypertension in pregnancy induced hypertension, the current study was conducted to assess the visual impairment in relation to the fundus changes in antenatal women with pregnancy induced hypertension. Materials and methods: 56 Pregnant females admitted with pregnancy induced hypertension in Meenakshi Medical College and Research Institute were evaluated thoroughly for eye signs and fundus examination with direct and indirect ophthalmoscope. Results: The most common fundus changes observed were grade 1 and grade 2 hypertensive retinopathy with grade 3 and grade 4 hypertensive retinopathy the least found. Conclusion: The current study concludes that retinal changes leads to poor visual and systemic prognosis and a premature delivery of fetus gives a better prognosis. [ABSTRACT FROM AUTHOR]

Objective: To identify the effect of pregnancy induced hypertension on neonatal outcomes in early and moderate preterm infants of gestational age less than 34 weeks.Study Design: Prospectively collected data in 773 premature deliveries less than 34 weeks from 10 centers in China between July 2014 and July 2016 were analyzed in this cohort study. Univariate and Multivariate regression analyses were conducted to exam the effect of pregnancy induced hypertension on neonatal outcomes, including mortality to discharge, intrauterine growth restriction, severe brain injury, neonatal respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, early onset of sepsis and retinopathy of prematurity.Results: The incidence of PIH in this cohort was 18.4%. Women with PIH tended to have a higher cesarean delivery rate (78.2% vs 40.9%, P < 0.001). More tocolytics and magnesium sulfate were used in PIH women (72.5% vs 48.7%, P < 0.001; 59.2% vs 34.7%, P < 0.001). Mean birth weight was lower in infants of PIH mothers than infants of non-PIH mothers (1522.1 ± 348.8 g vs 1683.4 ± 345.3, P < 0.001). In multivariate regression models, PIH was associated with increased risk of IUGR (OR 8.402; 95% CI 4.350-16.227) and lower odds of NRDS (OR 0.526; 95% CI 0.332-0.853).Conclusion: Preterm infants less than 34 weeks born to PIH women had a higher risk of intrauterine growth restriction and lower birth weight. PIH warrants more intensive interventions to prevent relevant infant morbidities. [ABSTRACT FROM AUTHOR]

Objective: To determine the incidence of preeclampsia with severe features among pregnant women and evaluate the characteristics, maternal complications, and perinatal outcomes between nonsevere preeclampsia versus preeclampsia with severe features and hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome. Materials and methods: A retrospective descriptive study was conducted at Khon Kaen University’s Srinagarind Hospital, a tertiary care facility in northeast Thailand. The pregnant women who had been diagnosed with preeclampsia according to American College of Obstetricians and Gynecologists guidelines from January 1, 2012 to December 31, 2016 were identified and their medical records were reviewed. Various characteristics were examined to compare maternal complications and perinatal outcomes. Results: There was a total of 11,199 deliveries during the study period, out of which 213 preeclamptic women were identified. One hundred and seven women (9.6 per 1,000 deliveries) were diagnosed with nonsevere preeclampsia, 90 (8 per 1,000 deliveries) had preeclampsia with severe features, and 16 (1.4 per 1,000 deliveries) had HELLP syndrome. Twenty-one women (9.9%) experienced postpartum hemorrhage; 11 (10.3%) in the nonsevere features preeclampsia group and 10 (9.4%) in the preeclampsia with severe features and HELLP syndrome group. Placental abruption (3 women; 1.4%) and heart failure (1 women; 0.4%) only occurred among women in the preeclampsia with severe features group. Neonatal complications were significantly higher in the preeclampsia with severe features and HELLP syndrome group (low birth weight =35.1% versus 74.3%, p,0.001; birth asphyxia =4.4% versus 18.2%, p=0.001; neonatal intensive care unit admission =7.0% versus 30.9%, p,0.001; neonatal resuscitation =15.8% versus 42.7%, p,0.001). Stillbirths only occurred in cases of preeclampsia with severe features and HELLP syndrome (3 cases, 1.4%). Intrapartum death was higher in cases of preeclampsia with severe features and HELLP syndrome, but without statistical significance (2.6% versus 6.4%, p=0.190). Conclusion: The incidence of preeclampsia with severe features and HELLP syndrome was 9.5 per 1,000 deliveries. Severe maternal and perinatal outcomes were more commonly observed. [ABSTRACT FROM AUTHOR]

Introduction: The trend towards delayed motherhood has accelerated in developed countries over the last few decades. Advanced maternal age (AMA) is defined as age 35 years and older at the estimated date of delivery. Objective: The aim of this large retrospective cohort study is to assess for the association between AMA and adverse maternal outcomes after adjustment for confounding factors in maternal characteristics and in the obstetric history. Study Design: Mothers of 20 years and older, who delivered singleton babies in Malta and Gozo between 1st January 2000 and 31st December 2014 were studied. All data was derived from the National Obstetric Information System. Results: The study population included 55,943 singleton births. 12.2% (6,838) of mothers were between 35 - 39 years and 2.4% (1,325) were 40 years and older. Significant difference was found between maternal age and BMI (p<0.0001), maternal smoking status (p<0.0001), noninsulin dependent diabetes mellitus (p=0.004), history of stillbirth (p<0.0001), gestational diabetes (p<0.0001), pregnancy - induced - hypertension (p=0.008) and preeclampsia (p=0.008). Significant difference was also found between maternal age and mode of delivery (p<0.0001). Regression analysis revealed persistent significant differences between maternal age and different maternal outcomes. Conclusion: This study demonstrates that AMA in Malta significantly increases the risk for hypertension in pregnancy, gestational diabetes and caesarean delivery. Care providers need to be aware of these increased risks and adjust their obstetric management according to the individual to ensure optimal maternal outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association of polymorphisms and haplotypes of angiotensin receptor 2 (AT2R) gene with pregnancy induced hypertension (PIH) in Chinese Han women.Methods: A case-control study was designed with 446 cases (gestational hypertension, GH: 124; pre-eclampsia, PE + eclampsia, E: 322) and 650 controls. rs5193, rs1403543 and rs12710567 of AT2R gene were genotyped. A logistic regression approach was applied to estimate the relationship between the polymorphisms and haplotypes of AT2Rgene with PIH risk.Results: No relationship between AT2R gene polymorphisms and PIH was detected. The haplotype analysis also showed a negative result.Conclusions: rs5193, rs1403543 and rs12710567 of AT2R gene might have no effect on PIH risk among Chinese Han women. [ABSTRACT FROM AUTHOR]

Introduction: Retinal changes are a frequent observation in pregnancy-induced hypertension. Early detection and monitoring of these changes can help to determine the further course of pregnancy. The study is intended to determine the prevalence of retinal changes in pregnancy-induced hypertension (PIH) and the association of these changes with the blood pressure, proteinuria, and disease severity. Methods: All patients admitted with the diagnosis of PIH were observed in this study. Age, gravida, gestational period, blood pressure, and proteinuria were noted. A proper history of any ophthalmological symptoms and Fundoscopic examination was done after dilation of the pupils with a direct ophthalmoscope in, the ward itself. All findings were noted and then analyzed. Results: A total of 75 patients of PIH were examined. The mean age of patients was 24.88 years (range 18-39 years). The gestation period ranged from 27 weeks to 42 weeks; 40 (53.33%) were primigravida. 35(46.66%) were multigravida. 44 (58.66%) patients had mild preeclampsia, 26 (34.66%) had severe preeclampsia and 5 (6.66%) had eclampsia. Retinal changes (hypertensive retinopathy) were noted in 25 (33.33%) patients -- grade I in 19 (25.33%) and grade II in 4 (5.33%). Haemorrhages or exudates were seen in 1 (1.33%) patient and retinal detachment was seen in 1(1.33%) patient. There was a statistically significant positive association between retinal changes and blood pressure (p<0.0001), proteinuria (p=0.0000036) and severity of the PIH (p=0.0001). Conclusion: Ophthalmic fundus examination is an important procedure to be performed in all pregnant hypertensive women. It helps to determine the further course of pregnancy. In our study, Retinal changes were seen with PIH and they were significantly associated with blood pressure, proteinuria, and severity of the disease. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the molecular mechanisms of microRNA (miR)-181b in heart disease due to hypertensive disorders complicating pregnancy (HDCP) through regulating the expression of metallopeptidase inhibitor 3 (TIMP3). miR-181b expression was detected by reverse transcription-quantitative polymerase chain reaction in peripheral blood samples from patients with HDCP. These samples were analyzed for clinical pathological characteristics. The primary cardiomyocytes of rats were cultured in hypoxic conditions for 24 h, in which miR-181b expression was detected at different time points. The expression of TIMP3 was assessed in normal rat cardiomyocytes following transfection with miR-181b mimics by western blot analysis. The TIMP3 protein was also detected in cardiomyocytes following transfection with TIMP3 short interfering-RNA. The apoptosis rate of transfected cardiomyocytes was detected by flow cytometry following 24 h of culture in a hypoxic environment. Luciferase assay was applied to validate whether miR-181b binds to the 3' untranslated region of TIMP3 mRNA. miR-181b expression was significantly downregulated in the peripheral blood of patients with HDCP and the miR-181b expression was negatively associated with the grades of hypertension (P<0.05). The results of luciferase assay indicated that miR-181b directly targets TIMP3. The apoptosis rates of rat cardiomyocytes in the group transfected with miR-181b or TIMP3 siRNA was significantly lower than the normal control group (P<0.05). miR-181b may inhibit apoptosis of cardiomyocytes to protect myocardial cells through directly targeting TIMP3 genes, which serve important roles in HDCP. [ABSTRACT FROM AUTHOR]

Background: Changes in the microvasculature associated with pre-eclampsia and gestational hypertension have been proposed as a potential pathway in the development of cardiovascular disease. We examined whether gestational hypertensive disorders, such as pre-eclampsia and gestational hypertension, are related to the maternal retinal microvasculature status after pregnancy.Methods: This study is part of an ongoing population-based prospective cohort study. During pregnancy and 6.2 years after the index pregnancy (90% range 5.7-7.4 years), we examined 3391 women with available information on pre-eclampsia, gestational hypertension, and retinal vascular calibers. Retinal arteriolar and venular calibers were measured in the left eye from digitized retinal photographs.Results: Women with pre-eclampsia had smaller retinal arteriolar calibers 6 years after pregnancy than women with a normotensive pregnancy (adjusted difference: -0.40 standard deviation score [SDS]; 95% confidence interval [CI]: -0.62, -0.19). For women with previous gestational hypertension, similar trends were observed (-0.20 SDS; 95% CI: -0.34, -0.05). With respect to retinal venular calibers, we did not observe consistent trends for women with previous pre-eclampsia. However, in women with previous gestational hypertension, we observed larger venular calibers (0.22 SDS; 95% CI: 0.07-0.36) than in women with a previous normotensive pregnancy. The association of gestational hypertensive disorders with retinal vessel calibers was mediated through mean arterial pressure at the time of retinal imaging.Conclusions: Compared to women with a previous normotensive pregnancy, women with pre-eclampsia and gestational hypertension show an altered status of the microvasculature 6 years after the index pregnancy. This is reflected by smaller retinal arteriolar calibers and wider retinal venular calibers. These microvascular changes may possibly contribute to the development of cardiovascular disease in later life. [ABSTRACT FROM AUTHOR]