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Abstract Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.
Resumo Objetivo Determinar o perfil dos óbitos maternos ocorridos no período de 2000 a 2019 no Hospital de Clínicas de Porto Alegre (HCPA) e comparar com os óbitos maternos entre 1980 e 1999 na mesma instituição. Métodos Estudo retrospectivo que analisou 2.400 prontuários de mulheres entre 10 e 49 anos que morreram entre 2000 e 2019. O presente estudo foi aprovado pelo Comitê de Ética (CAAE 78021417600005327). Resultados Após revisão de 2.481 prontuários de mulheres que morreram em idade reprodutiva, 43 mortes ocorreram durante a gravidez ou no período pós-parto. Destas, 28 foram considerados óbitos maternos. A taxa de mortalidade materna foi de 37.6 por 100.000 nascidos vivos. Em relação às causas, 16 óbitos (57.1%) estiveram diretamente associados à gravidez, 10 (35.1%) estiveram indiretamente associados e 2 (7.1%) não estiveram relacionados. A principal causa de morte foi hipertensão na gravidez (31.2%) seguida de esteatose hepática aguda da gravidez (25%). No estudo anterior, publicado em 2003 na mesma instituição4, a taxa de mortalidade foi de 129 por 100.000 nascidos vivos, e a maioria dos óbitos estava relacionada a causas obstétricas diretas (62%). As principais causas de óbito neste período foram por complicações hipertensivas (17.2%), seguidas de infecção pós-cesárea (16%). Conclusão Em comparação com os dados anteriores à década de 2000, houve uma redução importante das mortes maternas por causas infecciosas.
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Humans , Female , Pregnancy , Child , Adolescent , Adult , Young Adult , Pregnancy Complications/epidemiology , Maternal Death/etiology , Maternal Mortality , Retrospective Studies , Cause of Death , Postpartum Period , Live Birth , Middle AgedABSTRACT
Background: Pre-eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality in India. Objective of this study was to establish whether a spot urinary albumin/creatinine ratio (ACR) measured between 18-28 weeks of gestation can predict subsequent pre-eclampsia in asymptomatic pregnant women.Methods: A prospective observational study involving 50 registered antenatal cases visiting the obstetrics outpatient department between 18-28 weeks of singleton pregnancy with nil proteinuria upon dipstick measurement were included. ACR was determined from random single midstream urine sample. Statistical analysis was performed using Chi square test and Student’s t-test.Results: Of the study group, 10 patients had high ACR value, with 8(80%) developed pre-eclampsia and 2(20%) remained normotensive. ACR had a sensitivity of 80%, specificity 97.56%, positive predictive value of 88.89%, diagnostic accuracy of the test being 94.12%.Conclusions: The spot urinary protein creatinine ratio is a reliable predictor for pre-eclampsia in pregnancy.
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This study aimed to explore the optimal indications and mechanism of Uncariae Ramulus cum Uncis(UR)-Eucommiae Cortex(EC) in lowering blood pressure based on network pharmacology and molecular docking. Chemical constituents were collected and screened by TCMSP database. Swiss Target Prediction platform was used to predict the related targets of the drug. OMIM, TCMIP and GeneCards databases were used to collect hypertension-related genes, and the intersections were taken to obtain potential targets for anti-hypertensive treatment of UR-EC. FunRich software was used to enrich the clinical phenotype and expression site of potential target of lowering blood pressure to analyze and predict the optimal indications of UR-EC. STRING database was used for KEGG pathway enrichment analysis, and Cytoscape 3.7.2 was used to construct the network of "composition-target-pathway". The key targets and their corresponding components in the network were analyzed and obtained, and then molecular docking was applied for preliminary verification. Twenty potential active components of UR and 24 potential active components of EC were respectively collected, and 92 anti-hypertensive potential targets of UR-EC were obtained. According to FunRich enrichment results, the optimal indication of UR-EC was pregnancy hypertension, which involved calcium signaling pathway, HIF-1 signaling pathway, neuroactive ligand receptor interaction, renin vascular tightening, VEGF signaling pathway, etc. In addition, AKT1, NOS2, ADRB2, F2, NOS3, SCN5 A, HTR2 A and JAK2 were considered as the key targets in the network. The molecular docking results showed that the screened potential active components had high binding activity with the key targets. This study preliminarily revealed that UR-EC may have therapeutic effects on pregnancy hypertension in terms of sedation, anti-hypertension, anti-inflammatory, anti-oxidation, improvement of vascular endothelial function and so on.
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Humans , Pregnancy , Drugs, Chinese Herbal/pharmacology , Hypertension/genetics , Medicine, Chinese Traditional , Molecular Docking SimulationABSTRACT
Objective To evaluate the clinical efficacy of dexamethasone in the treatment of severe pregnancy induced hypertension with thrombocytopenia syndrome .Methods 50 cases of severe pregnancy induced hypertension with thrombocytopenia syndrome were selected .The patients were randomly divided into the magnesium sulfate group and dexamethasone group according to the digital table ,25 cases in each group.The magnesium sulfate group was given magnesium sulfate treatment,the dexamethasone group was treated with dexamethasone .The treatment effect,the neonatal mortality rate,premature delivery rate,neonatal asphyxia rate,cesarean section rate,incidence of symptoms and prognosis were compared between the two groups .Results The effective rate of the dexamethasone group (92%) was higher than that of the magnesium sulfate group (68%,χ2 =5.164,P <0.05).The incidence rate of concurrent symptoms in the dexamethasone group (4%) was significantly lower than that in the magnesium sulfate group (20%,χ2 =4.287,P <0.05).The liver function recovery time,ALT recovery time,platelet recovery time in the dexametha-sone group were (3.12 ±1.23)d,(2.09 ±0.26)d,(2.45 ±0.25)d,respectively,which were obviously shorter than those in the magnesium sulfate group (t =3.011,3.872,3.456,all P <0.05).Conclusion Dexamethasone in the treatment of severe pregnancy induced hypertension with thrombocytopenia syndrome has prominent treatment effect , the neonatal mortality,premature birth,neonatal asphyxia rate,cesarean section rate and incidence rate of complica-tions are low,the prognosis is good,it is worthy of further study.
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Objective: To explore clinical observation of magnesium sulfate and nifedipine treatment of pregnancy-induced hypertension. Methods:Retrospective analysis from December 2009 to November 2011 in our hospital was conducted. Sixty cases of pregnant women with severe pregnancy-induced hypertension divided into two groups. The clinical efficacy and incidence of adverse reactions were observed in patients. Results: The overall response rate(90.0%)was significantly higher overall response rate (73.3%) in observation group. The observation group patients(13.3%) was significantly lower than the control group, the totalefficiency (23.3%),the result is significant(t=2.240, P<0.05). Conclusion: Magnesium sulfate and nifedipine treatment of pregnancy-induced hypertension has significant efficacy and good safety.
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INTRODUCCIÓN: los trastornos hipertensivos de la gestación constituyen una de las complicaciones más frecuentes que causan morbimortalidad materno-fetal, por lo que la reducción de su prevalencia e incidencia es una prioridad. Para enfrentar este reto se debe tener un enfoque médico integral en la atención preconcepcional y concepcional a la mujer, que condicione una mejor calidad de vida. OBJETIVO: describir la tendencia que han tenido estos trastornos en los últimos 4 años (2004-2007), y los factores de riesgo que con más frecuencia se presentaron. MÉTODOS: se diseñó un estudio observacional analítico transversal utilizando un universo de estudio de 25 gestantes con trastornos hipertensivos de la gestación del área de salud Dr Antonio Pulido Humarán. RESULTADOS: la hipertensión gestacional y la hipertensión arterial crónica tuvieron una tendencia ascendente en su prevalencia en el período 2004-2007. La obesidad, el tabaquismo, las inadecuadas condiciones socioeconómicas, la no suplementación de folatos, entre otras, constituyeron los factores de riesgo más frecuentes.
INTRODUCTION: pregnancy hypertensive disorders are one of the more frequent complications causing morbidity and mortality in mother-fetus, where decrease of its prevalence and incidence is a priority. To confront this challenge we must to have a integral medical approach on woman pre-conception and conception care to achieve a better quality of life.] OBJECTIVE: to describe trend of these disorders during past 4 years (2004-2007), and the more frequent risk factors. METHODS: authors designed a cross-sectional, analytical and descriptive study using a cohort of 25 pregnant with hypertensive disorders related to this condition from Dr Antonio Pulido Humarán health area. RESULTS: pregnancy hypertension and chronic high blood pressure had a rising trend in its prevalence during 2004-2007. Obesity, smoking, and the inappropriate socioeconomic conditions, the non folate-fortification among others, were the more frequent risk factors.
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Humans , Female , Pregnancy , Pregnancy Complications, Cardiovascular/epidemiology , Hypertension, Pregnancy-Induced/epidemiology , Risk FactorsABSTRACT
Serum levels of testosterone (T), free testosterone (T_f), dehydroepiandrosterone sulfate, estradiol and sex hormone binding globulin were measured in patients with pregnancy-induced hypertension syndrome (PIH). Results showed that the levels of T and T_f and mean arterial pressure were significantly higher in the PIH group than those in the control group (all P