Abstract:
BACKGROUND:In routine antenatal care, blood pressure is used as a screening tool for preeclampsia and its associated adverse outcomes. As such women with a blood pressure greater than 140/90 mm Hg undergo further investigation and closer follow-up, whereas those with lower blood pressures receive no additional care. In the nonpregnant setting, the American College of Cardiology now endorses lower hypertensive thresholds and it remains unclear whether these lower thresholds should also be considered in pregnancy. OBJECTIVE:(1) To examine the association between lower blood pressure thresholds (as per the American College of Cardiology guidelines) and pregnancy outcomes and (2) to determine whether there is a continuous relationship between blood pressure and pregnancy outcomes and identify the point of a change at which blood pressure is associated with an increased risk of such outcomes. STUDY DESIGN:This was a retrospective study of singleton pregnancies at Monash Health, Australia. Data were obtained with regards to maternal characteristics and blood pressure measurements at varying gestational ages. Blood pressures were then categorized as (1) mean arterial pressure and (2) normal, elevated, stage 1 and stage 2 hypertension, as per the American College of Cardiology guidelines. Multivariable regression analysis was performed to identify associations between blood pressure categories and pregnancy outcomes. RESULTS:This study included 18,243 singleton pregnancies. We demonstrated a positive dose-response relationship between mean arterial pressure and the development of preeclampsia in later pregnancy. Across all gestational ages, the risk of preeclampsia was greater in those with "elevated blood pressure" and "stage 1 hypertension" in comparison with the normotensive group (adjusted risk ratio; 2.45, 95% confidence interval, 1.74-3.44 and adjusted risk ratio, 6.60; 95% confidence interval, 4.98-8.73 respectively, at 34-36 weeks' gestation). There was also an association between stage 1 hypertension, preterm birth, and adverse perinatal outcomes. CONCLUSION:This study demonstrated that preeclampsia and the associated adverse outcomes are not exclusive to those with blood pressures greater than 140/90 mm Hg. As such, those with prehypertensive blood pressures may also benefit from closer monitoring. Further research is essential to determine whether lowering the blood pressure threshold in pregnancy would improve detection and outcomes.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Reddy M,Rolnik DL,Harris K,Li W,Mol BW,Da Silva Costa F,Wallace EM,Palmer Kdoi
10.1016/j.ajog.2019.12.272subject
Has Abstractpub_date
2020-06-01 00:00:00pages
606.e1-606.e21issue
6eissn
0002-9378issn
1097-6868pii
S0002-9378(20)30018-1journal_volume
222pub_type
杂志文章abstract::Previous studies in our laboratory have suggested that measurement of methylumbelliferylguanidinobenzoate (MUGB) reactive proteases in midtrimester amniotic fluid is potentially of value for the intrauterine detection of cystic fibrosis. Thirty-nine pregnancies of obligate heterozygotes of cystic fibrosis and 12 cases...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32679-5
更新日期:1981-12-15 00:00:00
abstract:OBJECTIVE:The objective of the study was to characterize reports to the Vaccine Adverse Event Reporting System (VAERS) in pregnant women who received seasonal influenza vaccines to assess for potential vaccine safety concerns. STUDY DESIGN:We searched VAERS for reports of adverse events (AEs) in pregnant women who rec...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.08.050
更新日期:2011-02-01 00:00:00
abstract::A transvaginal duplex Doppler ultrasonography system was used to measure blood flow characteristics in the ascending uterine artery before and during pregnancy. The system uses a 5 MHz Doppler transducer coupled to a 6.5 MHz imaging probe. There was a steady increase in volume flow rate in the left ascending uterine a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90834-t
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to determine whether estrogen increases the expression of the inducible nitric oxide synthase gene. STUDY DESIGN:An inducible nitric oxide synthase fusion gene was created with its promoter and the reporter gene, luciferase. COS cells were transfected transiently with the fusion ge...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2003.350
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:Cervical inflammation has been proposed as a cofactor in the development of cervical cancer. The purpose of this study was to document the prevalence of cervical (pre)neoplastic changes in asymptomatic women with a cytologically diagnosed Gardnerella vaginalis infection. STUDY DESIGN:Data were collected from...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.04.036
更新日期:2008-11-01 00:00:00
abstract::Sacral neuromodulation with an implanted device is used in patients who experience urinary retention and malfunctioning overactive bladder where conservative treatment is not sufficient. The knowledge of its effect on pregnancy is not known. This article presents the case of a 34-year-old pregnant woman with an implan...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2014.04.015
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:Our objective was to determine whether the use of preoperative antibiotics prevents serious infections associated with total abdominal hysterectomy. STUDY DESIGN:We identified 25 randomized controlled trials of antibiotic prophylaxis that used rigorous protocols. We performed meta-analysis and cumulative met...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/0002-9378(93)90266-l
更新日期:1993-11-01 00:00:00
abstract::Although the importance of zinc nutrition during pregnancy has been well recognized, there have been few studies of zinc transport in maternal or fetal sera. We examined total serum zinc levels as well as zinc associated with its major transport proteins, albumin and alpha 2-macroglobulin, prospectively in 46 women du...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90029-2
更新日期:1984-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to describe the outcome of peripartum cardiomyopathy in patients cared for in a community hospital. STUDY DESIGN:The cases of peripartum cardiomyopathy treated at Central Baptist Hospital in Lexington, Kentucky, from January 1, 1992, to December 31, 1998, were reviewed. RESULTS...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.105402
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:We performed a retrospective review of the literature on the complications that could be associated potentially with water birth. STUDY DESIGN:We performed an extensive review of the medical literature using the Pub Med search engine, which is available through the National Library of Medicine. We also exami...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2003.12.007
更新日期:2004-05-01 00:00:00
abstract::Human ovarian tissue and bovine ovarian stroma and follicles bound tritiated oxytocin and tritiated arginine vasopressin with similar affinity, whereas bovine corpora lutea bound tritiated oxytocin only. Competition for the binding of tritiated oxytocin by various agonists and antagonists was suggestive of receptor fu...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90781-2
更新日期:1990-12-01 00:00:00
abstract::Survival data on 36 patients with clear-cell adenocarcinomas are reported: seven with vaginal lesions and 29 with cervical lesions. Although the tumor responds to present treatment modalities, it tends to be associated with early lymph node involvement, thus making early diagnosis essential. Radiation as a primary the...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90158-7
更新日期:1976-02-01 00:00:00
abstract::In Finland an organized mass screening program covers the total female population. Based on the material (429,832) from a nationwide mass screening registry it was estimated that the female population not subjected to electrocoagulation of the uterine cervix (362,511) had a sixfold risk of frankly invasive carcinoma, ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90115-1
更新日期:1978-07-01 00:00:00
abstract:OBJECTIVE:Our purpose was to immunolocalize urokinase-type plasminogen activator and the plasminogen activator inhibitors 1 and 2 in human implantation sites, with emphasis on the types of trophoblast expressing the plasminogen activator and the inhibitors. STUDY DESIGN:Urokinase and the plasminogen activator inhibito...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70246-2
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Pelvic organ prolapse is common, but the underlying etiologies are poorly understood, which limits our current prevention and treatment options. OBJECTIVE:Our primary objective was to compare the uterosacral ligament histologic features in women with and without prolapse using the novel pelvic organ prolaps...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2020.10.040
更新日期:2021-01-01 00:00:00
abstract::Pregnancy-specific beta 1-glycoprotein (SP-1) was measured by radioimmunoassay in patients admitted to the hospital with a clinical diagnosis of hemorrhage in early pregnancy. The results were compared with a normal range and were analyzed for their predictive value in determining prognosis. Six of the total study gou...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)90243-4
更新日期:1980-10-01 00:00:00
abstract:OBJECTIVE:We compared the diagnostic performances of fetal fibronectin assay of cervical and vaginal secretions and of transvaginal ultrasonographic evaluation of the uterine cervix in the prediction of preterm delivery of patients presenting with preterm labor and intact membranes. STUDY DESIGN:One hundred eight pati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70020-0
更新日期:1996-11-01 00:00:00
abstract::In 1970 Morgan described an operation designed to meet the problem created by scarring and fibrosis resulting from previous operative procedures to the urethra and bladder neck. In the method, a 2 cm wide polypropylene (Marlex) mesh is placed as a broad hammock to elevate and support the urethrovesical junction with l...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90681-1
更新日期:1979-02-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to determine (1) the methadone serum trough level adequate to prevent withdrawal symptoms in heroin-addicted pregnant women and (2) whether the methadone serum trough level in symptomatic women with withdrawal symptoms differs from that of asymptomatic women. STUDY DESIGN:Pregnant w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.127132
更新日期:2002-11-01 00:00:00
abstract::A rapid and accurate technique for assessment of spermatozoa motility has been developed. With the use of tricolor photography with sequential exposures in green, red, and blue light, spermatozoa were photographed in Makler chambers with a depth of 10 mu. Exposure in green light had a 1-second duration and was immedia...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)90497-0
更新日期:1983-01-15 00:00:00
abstract:OBJECTIVE:The study was conducted to systematically investigate previous anecdotal reports of memory decline during pregnancy. STUDY DESIGN:We used a longitudinal design to investigate memory in women throughout pregnancy and in the postpartum period. Closely matched, nonpregnant women were similarly studied at equiva...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70073-0
更新日期:1998-09-01 00:00:00
abstract::Histidyl proline diketopiperazine values have been established in human amniotic fluid (n = 81) and maternal serum (n = 36) throughout gestation (10 to 42 weeks). Newborn cord serum (n = 10) and first-voided fetal urine (n = 10) levels were also documented. These measurements reveal increasing amniotic fluid levels wi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90998-m
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:Placental passage of the angiotensin-converting enzyme inhibitors temocapril and enalapril was investigated in a placental perfusion model. STUDY DESIGN:In an open system a placental lobe was perfused on both the maternal and the fetal side with a blood-free medium containing the test substances plus a refer...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70587-2
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:Our purpose was to examine the hypothesis that corticosteroids, when administered extraamniotically, can enhance the labor process and reduce the induction-to-delivery interval. STUDY DESIGN:A double-blind, randomized study was conducted on 98 women with a gestational age of 36 to 42 weeks, an unfavorable ce...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-11-01 00:00:00
abstract::A subset of women with a high rate of fetal wastage is identifiable among those with serologic but not necessarily clinical evidence of connective tissue disease. The presence of lupus anticoagulant in the plasma of a pregnant woman serves as a marker for a high rate of fetal wastage and risk of thrombosis. Lupus anti...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
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更新日期:1985-10-01 00:00:00
abstract:OBJECTIVE:We undertook this study to systematically assess prevailing pain management regimes used at our hospital in women after cesarean delivery. STUDY DESIGN:Between August 1999 and July 2000, all women delivered by cesarean section at Parkland Hospital were assigned to 1 of 4 different pain management strategies:...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.10.707
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:Oxidative stress plays a causative role in diabetic embryopathy. We tested whether mitigating oxidative stress, using superoxide dismutase 1 (SOD1) transgenic (Tg) mice, would block hyperglycemia-induced specific protein kinase C (PKC) isoform activation and its downstream cascade. STUDY DESIGN:Day 8.5 embry...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2011.02.071
更新日期:2011-07-01 00:00:00
abstract::A study of fetal activity was undertaken as the first step in a series of physiologic fetal movement studies. A simple, safe, noninvasive, clinically applicable method for studying fetal movement with a tocodynamometer is described. Four basic types of fetal movement have been seen and defined in terms of their durati...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90467-1
更新日期:1976-09-01 00:00:00
abstract::Immunoreactive endorphin peptides (ir EP) and prolactin (PRL) were measured by radioimmunoassay in venous blood from the umbilical cord of 86 neonates, 23 postpartum mothers, and 40 randomly selected blood bank donor control subjects. We also assayed these hormones in serosanguineous placental tissue fluid following d...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(81)90103-4
更新日期:1981-05-15 00:00:00
abstract:OBJECTIVE:We sought to determine the fetal injury rate associated with shoulder dystocia and to determine whether there is a higher rate of brachial plexus injury or bone fracture when fetal manipulation techniques are required for delivery. STUDY DESIGN:A retrospective review of 285 cases of shoulder dystocia that oc...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70312-6
更新日期:1998-06-01 00:00:00