Risk factors for postpartum hypertension in women with twin pregnancies

Morikawa, Mamoru; Cho, Kazutoshi; Yamada, Takashi; Yamada, Takahiro; Akaishi, Rina; Koyama, Takahiro; Takeda, Mahito; Nishida, Ryutaro; Minakami, Hisanori

doi:10.1515/jpm.2011.113

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…Our results clearly demonstrated that 67% of the cases with a diagnosis of GH or PE were recognized to have the disease during the intrapartum or postpartum period. Another study in Japan demonstrated that 40% of women without antenatal hypertension in twin pregnancy developed postpartum hypertension . A limitation of that report was a relatively small patient sampling and selection bias due to a heterogeneous population that contained more women with high risk referred at an advanced stage of gestation.…”

Section: Discussionmentioning

confidence: 97%

Clinical features and prenatal risk factors for hypertensive disorders in twin pregnancies

Taguchi

Ishii

Hayashi

et al. 2014

J of Obstet and Gynaecol

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One-fifth of the twin pregnancies developed GH or PE. Furthermore, more than half of the patients were diagnosed with the disease during the intrapartum or postpartum period. Significant risk factors for GH or PE in twin pregnancies were primiparity, pregestational body mass index, family history of hypertension, and history of a hypertensive disorder during a previous pregnancy. The significance of monitoring blood pressure after delivery for a twin pregnancy is stressed.

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Section: Discussionmentioning

confidence: 97%

Clinical features and prenatal risk factors for hypertensive disorders in twin pregnancies

Taguchi

Ishii

Hayashi

et al. 2014

J of Obstet and Gynaecol

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“…Women with twin pregnancies are more likely to develop hypertensive disorders, such as gestational hypertension, preeclampsia, and eclampsia, than women with singleton pregnancies [9,13]. Although the present 14 women with twin pregnancies did not develop hypertension during pregnancy, seven (50.0%) of the 14 women developed hypertension postpartum, consistent with the results of a recent study in which 60 (40%) of 150 women with twin pregnancies developed postpartum hypertension [13]. Thus, women with twin pregnancies are prone to the development of hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…Twin pregnancy differs considerably from singleton pregnancy in many aspects, such as the duration of pregnancy [11], the degree of enhancement of coagulation-fibrinolysis [14], the prevalence of pregnancy-induced hypertension [13,9], and the degree of blood volume expansion [15]. All these data suggest that pregnancy-induced changes in various biological and physiological parameters may be greater in women with twin pregnancies than in women with singleton pregnancies.…”

Section: Introductionmentioning

confidence: 99%

“…As blood parameters such as the platelet count and antithrombin activity are likely to decrease [12,17] and creatinine, urate and aspartate aminotransferases are likely to increase before the development of hypertension in women with twin pregnancies [13], the changes in PAC and PRA may differ between women with twin and singleton pregnancies. Accordingly, we conducted this prospective study.…”

Section: Introductionmentioning

confidence: 99%

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Plasma Aldosterone Concentration and Plasma Renin Activity Decrease during the Third Trimester in Women with Twin Pregnancies

Koyama

Yamada

Furuta

et al. 2012

Hypertension in Pregnancy

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OBJECTIVE: Changes in the plasma aldosterone concentration (PAC) and the plasma renin activity (PRA) have not been extensively studied in women with twin pregnancies. METHODS:The PAC and PRA levels were determined during the second and third trimesters and on postpartum day 3 in 14 normotensive women with twin pregnancies and 80 normotensive and 7 preeclamptic women with singleton pregnancies. RESULTS:In women with twin pregnancies, elevated PAC and PRA levels (598 ± 248 pg/mL and 10.0 ± 4.7 ng/mL/hour, respectively) in the second trimester decreased significantly during the third trimester (to 396 ± 210 pg/mL and 3.5 ± 2.9 ng/mL/hour, respectively), while the corresponding PAC increased significantly from 421 ± 207 pg/mL to 667 ± 371 pg/mL and the PRA did not change significantly (from 7.3 ± 3.4 ng/mL/hour to 6.9 ± 4.2 ng/mL/hour) in women with normal singleton pregnancies.These changes in the PAC and PRA levels in women with twin pregnancies resembled those in hypertensive women with singleton pregnancies. CONCLUSIONS:In women with twin pregnancies, both the PAC and PRA levels were significantly enhanced during the second trimester, while those in the third trimester were significantly reduced compared with those in women with normal singleton pregnancies.

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“…Twin pregnancy differs considerably from singleton pregnancy in many aspects, such as the duration of pregnancy [1], the degree of enhancement of coagulation-fibrinolysis [2], the prevalence of pregnancy-induced hypertension [3,4], changes in plasma aldosterone and renin activity [5], and the degree of blood volume expansion [6]. These data suggest that pregnancy-induced changes in various biological and physiological parameters may be higher in women with twin pregnancies than in those with singleton pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Serum levels of N-terminal fragment of precursor protein brain-type natriuretic peptide (NT-proBNP) in twin pregnancy

Yamada¹,

Koyama²,

Furuta³

et al. 2013

Clinica Chimica Acta

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Twin pregnancy differs considerably from singleton pregnancy in many aspects and it is unknown how serum NT-proBNP level behaves in women with twin pregnancies. Serum NT-proBNP levels were determined longitudinally at gestational weeks (GW) 24 and 35 in normotensive women with 13 twin and 99 singleton pregnancies. The effects of maternal demographic characteristics on NT-proBNP levels were also analyzed. The serum NT-proBNP levels (pg/mL) in twin pregnancies, which were not different from those in singleton pregnancies at 24 GW (26 ± 15 vs. 40±27, respectively, P = 0.0718), increased significantly (P = 0.0038) and were significantly higher than those in singleton pregnancies at 35 GW (72 ± 49 vs. 34 ± 24, P < 0.0001). In the analysis including women with singleton pregnancies, the serum levels of NT-proBNP at 35 GW were significantly inversely correlated with pre-pregnancy body mass index (BMI, kg/m 2 ) and were significantly higher in nulliparous than multiparous women. Thus, women with twin pregnancy were likely to exhibit an increase in serum NT-proBNP levels in the late stage of pregnancy, especially in lean and nulliparous women. The relative greater blood volume expansion occurring in twin than in singleton pregnancies was considered to be responsible for this phenomenon.

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Risk factors for postpartum hypertension in women with twin pregnancies

Abstract: Antenatal blood pressure measurements and a laboratory work-up may be useful clinically for predicting postpartum hypertension in women with twin pregnancies.

Cited by 5 publications

References 16 publications

Clinical features and prenatal risk factors for hypertensive disorders in twin pregnancies

Clinical features and prenatal risk factors for hypertensive disorders in twin pregnancies

Plasma Aldosterone Concentration and Plasma Renin Activity Decrease during the Third Trimester in Women with Twin Pregnancies

Serum levels of N-terminal fragment of precursor protein brain-type natriuretic peptide (NT-proBNP) in twin pregnancy

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