Gestational Hypertension and Preeclampsia: An Overview of National and International Guidelines

Tsakiridis, Ioannis; Giouleka, Sonia; Arvanitaki, Alexandra; Giannakoulas, George; Papazisis, Georgios; Mamopoulos, Apostolos; Athanasiadis, Apostolos; Dagklis, Themistoklis

doi:10.1097/ogx.0000000000000942

Cited by 35 publications

(47 citation statements)

References 101 publications

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“…Pre-eclampsia (PE) is a complication in 2-5% of pregnancies and is one of the leading causes of perinatal morbidity and mortality in women, especially when it has an early onset. It is more common in developing countries due to older maternal age and obesity [1,2]. There is still no agreement on the definition of pre-eclampsia amongst many guidelines [2].…”

Section: Introductionmentioning

confidence: 99%

“…It is more common in developing countries due to older maternal age and obesity [1,2]. There is still no agreement on the definition of pre-eclampsia amongst many guidelines [2]. PE is defined by the International Society for the Study of Hypertension in Pregnancy (ISSHP) by hypertension (blood pressure ≥ 140/90 mmHg) developing after 20 weeks' gestation coexisting with newly occurring proteinuria and/or maternal kidney damage [2].…”

Section: Introductionmentioning

confidence: 99%

“…There is still no agreement on the definition of pre-eclampsia amongst many guidelines [2]. PE is defined by the International Society for the Study of Hypertension in Pregnancy (ISSHP) by hypertension (blood pressure ≥ 140/90 mmHg) developing after 20 weeks' gestation coexisting with newly occurring proteinuria and/or maternal kidney damage [2]. Modern definitions acknowledge other manifestations including maternal liver dysfunction, neurological symptoms, hemolysis, thrombocytopenia, and uteroplacental dysfunction, such as an abnormal umbilical artery Doppler [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…PE is defined by the International Society for the Study of Hypertension in Pregnancy (ISSHP) by hypertension (blood pressure ≥ 140/90 mmHg) developing after 20 weeks' gestation coexisting with newly occurring proteinuria and/or maternal kidney damage [2]. Modern definitions acknowledge other manifestations including maternal liver dysfunction, neurological symptoms, hemolysis, thrombocytopenia, and uteroplacental dysfunction, such as an abnormal umbilical artery Doppler [2][3][4][5][6]. Some guidelines recommend a combined screening strategy including maternal blood pressure, maternal factors, uterine artery doppler, and placenta growth factor levels [2].…”

Section: Introductionmentioning

confidence: 99%

“…Modern definitions acknowledge other manifestations including maternal liver dysfunction, neurological symptoms, hemolysis, thrombocytopenia, and uteroplacental dysfunction, such as an abnormal umbilical artery Doppler [2][3][4][5][6]. Some guidelines recommend a combined screening strategy including maternal blood pressure, maternal factors, uterine artery doppler, and placenta growth factor levels [2]. Treatment recommendations vary on whether non-severe hypertension should even be treated, although there is an overall agreement on the drugs of choice (methyldopa, labetalol, and nifedipine), and the timing of delivery in uncomplicated gestational hypertension cases, which should be on or after 37 weeks of gestation [2].…”

Section: Introductionmentioning

confidence: 99%

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Loss of E-Cadherin Staining Continuity in the Trophoblastic Basal Membrane Correlates with Increased Resistance in Uterine Arteries and Proteinuria in Patients with Pregnancy-Induced Hypertension

Pęksa

Kamieniecki

Gabrych

et al. 2022

JCM

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Pregnancy-induced hypertension (PIH), especially when complicated with pre-eclampsia (PE), could be a life-threatening complication of pregnancy. Pre-eclampsia is one of the leading causes of perinatal morbidity and mortality in women. Pre-eclampsia is mainly characterized by hypertension and kidney damage with proteinuria. Abnormal placentation and altered structure of the placental barrier are believed to participate in the pathogenesis of pregnancy-induced hypertension, leading to PE. In the current study, we aimed to analyze the immunohistochemical expression pattern of E-cadherin and p120, two markers of epithelial–mesenchymal transition, in placental samples derived from a group of 55 patients with pregnancy-induced hypertension, including pre-eclampsia and 37 healthy pregnant controls. The results were correlated with the presence of an obtained early uterine artery flow notching during diastole on Doppler ultrasound. We observed a higher frequency of discontinuous E-cadherin staining in the basement membrane of syncytiotrophoblast in patients with PIH/PE compared to controls (p < 0.001, Fisher’s exact test). Moreover, the loss of continuity of E-cadherin expression correlated with the presence of a bilateral early diastolic notch on Doppler ultrasound (p < 0.001, Fisher’s exact test) and the presence of proteinuria (p = 0.013, Fisher’s exact test). These findings suggest that E-cadherin contributes to the integrity of the placental barrier, and its loss could be an immunohistochemical marker of PE.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Loss of E-Cadherin Staining Continuity in the Trophoblastic Basal Membrane Correlates with Increased Resistance in Uterine Arteries and Proteinuria in Patients with Pregnancy-Induced Hypertension

Pęksa

Kamieniecki

Gabrych

et al. 2022

JCM

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Evaluation of Fetal Cardiac Functions in Preeclampsia: Does the Severity or Proteinuria Affect Fetal Cardiac Functions?

Hendem

Oluklu

Beşer

et al. 2023

J of Ultrasound Medicine

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ObjectiveTo compare the fetal cardiac functions in preeclampsia and control group, and determine whether the severity or amount of proteinuria affects fetal cardiac functions.MethodsThis prospective case–control study involves 48 pregnant women with preeclampsia and 48 healthy women. Pulsed wave Doppler, M‐mode, and tissue Doppler imaging were used to measure the cardiac function between the 32 and 34 gestational weeks in each group. All Doppler indices and cardiac function parameters were also compared in subgroups with mild and severe preeclampsia and between subgroups with proteinuria >3 g/24 hours and <3 g/24 hours.ResultsDecreased diastolic function (decreased E, A, E′, and A′ values in mitral/tricuspid valves and increased isovolumetric relaxation time) and decreased systolic functions (decreased mitral and tricuspid annular plane systolic excursion and S′ value in mitral/tricuspid valves) were detected in the preeclampsia group. Decreased tricuspid E value in severe preeclampsia compared with mild preeclampsia was shown in the present study.ConclusionPreeclampsia may cause changes in systolic and diastolic functions in the fetal heart. Subclinical functional changes of these fetuses can be detected earlier and more sensitively with the help of tissue Doppler imaging. Biventricular diastolic functional changes are more prominent in preeclamptic cases with proteinuria >3 g/24 hours.

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Diagnostic value of sFlt‐1/PlGF‐1 ratio and plasma PROK1 for adverse pregnancy outcomes in women with hypertensive disease of pregnancy

Lv,

2024

The Kaohsiung J of Med Scie

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Hypertensive disease of pregnancy (HDP) is one of the most important causes of increased maternal mortality and perinatal complications during pregnancy. We investigated the pregnancy outcomes of 156 HDP patients (65 gestational hypertension [GH], 13 chronic hypertension [CH], 74 preeclampsia‐eclampsia [PE‐EC], and 4 superimposed on PE [CH with PE]). In patients with different types of HDP, levels of soluble fms like tyrosine kinase‐1 (sFlt‐1), placental growth factor (PlGF)‐1, and prokinin‐1 (PROK1) were measured and compared. The predictive efficacy of these indicators was evaluated using receiving operating characteristics curves and area under the curve. Results showed that the PE cohort had a higher sFlt‐1/PlGF ratio (46.12 [39.24, 68.85]) and PROK1 (498.84 [213.67, 678.30] pg/mL) level than the GH (sFlt‐1/PlGF, 32.3 [21.98, 58.00], PROK1 300.77[250.0, 345.29]pg/mL) and CH cohort (sFlt‐1/PlGF, 37.49 [32.68, 39.68], PROK1, 281.48 [229.25, 453.94]pg/mL). In the HDP cohort, 54 patients experienced adverse pregnancy events, and the sFlt‐1/PlGF ratio, PROK1, and the combined indicators (sFlt‐1/PlGF ratio and PROK1) were excellent predictors of adverse pregnancy events, especially for PE patients.

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Gestational Hypertension and Preeclampsia: An Overview of National and International Guidelines

Cited by 35 publications

References 101 publications

Loss of E-Cadherin Staining Continuity in the Trophoblastic Basal Membrane Correlates with Increased Resistance in Uterine Arteries and Proteinuria in Patients with Pregnancy-Induced Hypertension

Loss of E-Cadherin Staining Continuity in the Trophoblastic Basal Membrane Correlates with Increased Resistance in Uterine Arteries and Proteinuria in Patients with Pregnancy-Induced Hypertension

Evaluation of Fetal Cardiac Functions in Preeclampsia: Does the Severity or Proteinuria Affect Fetal Cardiac Functions?

Diagnostic value of sFlt‐1/PlGF‐1 ratio and plasma PROK1 for adverse pregnancy outcomes in women with hypertensive disease of pregnancy

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