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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]

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.

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: 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.

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) 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]

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: 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]

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.

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: 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: 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]

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: 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 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: 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.

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: 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]