Academic literature on the topic 'Preeclampsia (PE)'

This study was carried out on 105 pregnant women with preeclampsia in addition to 105 pregnant women without preeclampsia as a control at Al-Najaf province from September ,2017-May 2018. All the included patients were examined by Doppler study to assess the resistive index of umbilical artery RI in preeclamptic pregnant patients with PE and pregnant women without PE. The results reveals that there was significant difference of umbilical artery RI 0.658±0.304, concerning preeclamptic pregnant patients in comparison to pregnant women without PE(0.571±0.215) , ( PV lesser than0.05) . In addition to that the umbilical artery RI was (0.577±0.301) in preeclamptic pregnant patient with mild PE while it was (0.813±0.247) in preeclamptic pregnant patient with severe PE which displayed a statistically significant difference( PV less than0.05).Also this study showed that the umbilical artery RI in preeclamptic pregnant patients with H. pylori was(1.11±0.319) which was greater than that for preeclamptic pregnant patients without H. pylori (0.919±0.25) with a statistically significant difference ( PV less than 0.5). It was concluded that Umbilical artery resistive index is a useful parameter in detection of preeclampsia and its severity and the umbilical artery resistive index might be useful parameter in prediction of infection of positive H. pylori infection associated with preeclampsia.

Maternal serum activin A levels are elevated in women with preeclampsia. To explore whether this could be due, at least in part, to increased production by the gestational tissues, we have measured activin A in the serum of women with (n=23) or without preeclampsia (n=62) at 29-40 weeks of gestation and in placenta and fetal membranes from preterm preeclamptic (PT-PE, n=8), term preeclamptic (T-PE, n=10) and healthy term controls (T-C, n=10). We have also explored if there are associated changes in activin receptor Alk2, ActRII and ActRIIB in these tissues. The relative amounts of receptor proteins were measured by densitometry on Western blots and receptors and activin beta(A) subunit localised by immunohistochemistry in PT-PE, T-PE and T-C gestational tissues (n=8-10/group). Maternal serum activin A levels were significantly elevated in women with preeclampsia (multiples of the normal median (MoM)=3.5, P<0.0001, Mann-Whitney U test) compared with healthy women (median MoM=1.0). Compared with control tissues, the activin A content was significantly higher in preeclamptic placentae (P=0.001 and P=0.0005 for PT-PE and T-PE respectively, Mann-Whitney U test), but significantly lower in the amnion (P=0.005 and P=0.014 for PT-PE and T-PE respectively) and choriodecidua (P=0.009 for T-PE). The maternal serum activin A level in women with preeclampsia was significantly correlated with elevated placental production (P=0.01, Pearson's correlation). Receptor Alk2 protein levels were significantly elevated in T-PE placentae (P=0.0006, Mann-Whitney U test), ActRIIB levels were significantly lower in PT-PE placentae (P=0.01) and ActRII levels were significantly lower in PT-PE choriodecidua (P=0.0002) compared with controls. There were no apparent differences in the distribution of the beta(A) subunit and receptors Alk2, ActRII and ActRIIB between control and preeclamptic tissues. These findings suggest that elevated levels of activin A in the maternal circulation in association with preeclampsia are due, at least in part, to increased placental production, and that the regulation of activin synthesis in placenta and fetal membranes is differentially regulated. Further, the differences in activin receptor protein levels between preeclamptic and control placenta and choriodecidua suggest that activin A-induced regulation may be altered in preeclampsia.

Placental, immune and genetic factors are thought to play an important role in preeclampia (PE)’s pathophysiology. Angiotensin-Converting Enzyme (ACE) plays a vital role in the renin-angiotensin-system (RAS) which regulates blood pressure by converting angiotensin I into a powerfull vasoconstrictor angiotensin II. A deletion polymorphism (D allele) has been reported to be associated with elevated ACE activity. The aim of the this study was to investigate whether there is an association between angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism and PE. In this study, 120 preeclamptic and 116 normotensive Turkish pregnant women were genotyped for ACE I/D polymorphism and the distribution of genotype and allele frequencies of this polymorphism in preeclampsia and controls were evaluated. Codominant, dominant and recessive models were appplied in ACE gene I/D polymorphism. In the codominant model, DD genotype was found significantly more frequent in preeclampsia than controls (P=0.016). Moreover, in dominant model (DD frequency versus DI+II frequency) there was a significant relation between DD genotype and preeclampsia (P=0.006). D allele frequency was 64.6% in preeclampsia while it was 56.1% in controls (P=0.062). In conclusion, there was significant difference in genotype distribution between preeclampsia and controls.

Background and Objectives: obesity and blood pressure disorders are one of the main risk factors for antenatal, intra, postpartum, and neonatal complications. In preeclampsia (PE), the placental hypoxia leads to vascular endothelium dysfunction, cell necrosis, and apoptosis. This condition is associated with the release of free fetal DNA (cffDNA) circulating in plasma. The disturbance of the efficiency of vasodilatation and blood pressure regulation in PE can be confirmed by analyzing the apelin, salusin, and prosalusin. This study aimed to assess the influence of obesity on cffDNA, and the effectiveness of maintaining normal blood pressure in patients with preeclampsia and gestational hypertension. Material and Methods: the research material was blood serum and oral mucosa swabs, obtained from 168 patients. Pregnant women were divided into the following: a control group (C)—67 women; a gestational hypertension group (GH)—35 patients; a preeclampsia with obesity group (PE + O) (pre-gravid BMI > 30)—23 patients. The rest were lean preeclamptic women (PE)—66 patients—(pre-gravid BMI < 25 in 43 women). Results: the cffDNA was observed in 1.50% of women in the C group, in 2.45% in the GH group, but in 18.18% of lean patients with preeclampsia. The cffDNA was detected in 58% of obese pregnant women with PE. The greater the placental hypoxia was in preeclampsia, the less efficient the hypotensive mechanisms, according to an analysis of the studied adipokines. The prosalusin concentration was significantly lower in the PE group with cffDNA than in the PE group without it (p = 0.008). Apelin was higher in the PE group with cffDNA (p = 0.006) compared to other groups. The same results were also observed in the subgroup with obesity. Conclusion: in preeclamptic women, obesity seems to act as an additive factor of placental damage by means of the dysregulation of hypotensive mechanisms.

Although preeclampsia (PE) is a major cause of maternal and fetal mortality, its pathogenesis is not fully understood. Endogenous digitalis-like cardiotonic steroids (CTS) are implicated in the pathophysiology of PE, as illustrated by clinical observations that Digibind, a digoxin antibody which binds CTS, lowers blood pressure in patients with PE. Recently we reported that plasma levels of marinobufagenin (MBG), a bufadienolide vasoconstrictor CTS, are increased four-fold in patients with severe PE. In the present study, we compared levels of MBG in normal and preeclamptic placentae, and tested whether antibodies against MBG, and against ouabain for their interaction with the material purified from preeclamptic placentae via high-performance liquid chromatography (HPLC). Levels of MBG, but not that of endogenous ouabain, exhibited a four-fold elevation in preeclamptic placentae. The elution time of endogenous placental MBG-like immunoreactive material from reverse-phase HPLC column was identical to that of authentic MBG. Immunoassay based on Digibind did not detect cross-reactivity with HPLC containing ouabain-like immunoreactive material, but cross-reacted with HPLC fractions having retention time similar to that of MBG and other bufadienolides. Our results demonstrate that levels of MBG are significantly elevated in preeclamptic placentae, and suggest that MBG is a potential target for immunoneutralization in patients with preeclampsia.

Preeclampsia (PE) is a devastating adverse outcome of pregnancy. Characterized by maternal hypertension, PE, when left untreated, can result in death of both mother and baby. The cause of PE remains unknown, and there is no way to predict which women will develop PE during pregnancy. The only known treatment is delivery of both the fetus and placenta; therefore, an abnormal placenta is thought to play a causal role. Women with obesity before pregnancy have an increased chance of developing PE. Increased adiposity results in a heightened state of systemic inflammation that can influence placental development. Adipose tissue is a rich source of proinflammatory cytokines and complement proteins, which have been implicated in the pathogenesis of PE by promoting the expression of antiangiogenic factors in the mother. Because an aggravated inflammatory response, angiogenic imbalance, and abnormal placentation are observed in PE, we hypothesize that maternal obesity and complement proteins derived from adipose tissue play an important role in the development of PE.

Background: Preeclampsia (PE) is a significant cause of remarkable fetomaternal morbidity and mortality worldwide. Visfatin is 52 KDa novel adipokine, pre B cell colony enhancing factor (PBEF) which could be used as a biochemical marker predictor or a diagnostic tool for preeclampsia. Trans abdominal pulsed Doppler ultrasound (US) monitor the impedance to blood flow in the uterine arteries in pregnant females and those with preeclampsia. Visfatin has been implicated in the pathogenesis of preeclampsia with a limited contradictory. The aim of our study is to monitor the risky pregnant females through Visfatin level and transabdominal pulsed Doppler of the uterine artery.Methods: Assessment of the serum Visfatin levels in the maternal circulation of preeclamptic pregnant females wether mild or severe, and compared to those in the normal pregnant subjects as control through recruitment of cases of mild PE (n=40), severe PE (n=40), normal pregnant subjects (n=60) in a cross sectional study where the cases were of the patients hospitalized at El Shatby Hospital of Obstetrics and Gynecology, and the control subjects were of referrals to the outpatient departments. Fasting blood samples were drawn, kept at -20 degree centigrades , enzyme linked immune sorbant assay (ELISA) Test was performed on them to determine the Visfatin level and recorded the uterine arteries pulsatility index through transabdominal doppler ultrasound. Lastly, the data were analysed using (F test) ANOVA statistical method.Results: Amongst the groups, Serum visfatin level was significantly higher in the severe preeclamptic group rather than the normal pregnant group and those with mild preeclampsia (p<0.001). Uterine artery pulsatility index was significantly higher in the severe preeclamptic group rather than the normal pregnant group and those with mild preeclampsia (p<0.001).Conclusions: Severe preeclamptic pregnant females were shown to represent higher circulating visfatin levels as one of the most recent biochemical markers of preeclampsia, higher uterine artery pulsatility index compared to normal pregnant and those with mild preeclamptic groups of women.

Background. Preeclampsia is a major cause of maternal and neonatal morbidity and mortality in sub-Saharan Africa. Evidence indicates that endothelial dysfunction is central to the pathogenesis of preeclampsia. This study assessed the level of the components of the arginine-nitric oxide pathway to evaluate endothelial dysfunction in normotensive pregnancies and pregnancies complicated with preeclampsia. Methods. This case-control study was conducted among pregnant women who visited Comboni Hospital from January 2017 to May 2018. A total of 180 pregnant women comprising 88 preeclamptic women (PE) and 92 healthy normotensive pregnant women (NP) were recruited. Sociodemographic, clinical, and obstetric data were obtained using validated questionnaires. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of nitric oxide (NO∙), L-arginine, asymmetric dimethylarginine (ADMA), and 3-nitrotyrosine using an enzyme-linked immunosorbent assay technique. Results. The mean NO∙ ( p = 0.010 ) and L-arginine/ADMA ratio ( p < 0.0001 ) was significantly lower in PE compared to NP while mean L-arginine ( p = 0.034 ), ADMA ( p < 0.0001 ), and 3-nitrotyrosine ( p < 0.0001 ) were significantly higher in PE than NP. ADMA showed a significant positive association with systolic blood pressure ( β = 0.454 , p = 0.036 ) in severe PE. Women with PE had significant intrauterine growth restriction ( p < 0.0001 ) and low birth weight infants ( p < 0.0001 ) when compared to NP. Conclusion. Preeclampsia is associated with reduced NO∙ bioavailability, L-arginine/ADMA ratio, and elevated levels of ADMA and 3-nitrotyrosine. Measurements of the levels of these parameters can help in the early prediction of endothelial dysfunction in preeclampsia. Exogenous therapeutic supplementation with L-arginine during pregnancy to increase the L-arginine/ADMA ratio should be considered to improve endothelial function in preeclampsia and pregnant women at risk of developing preeclampsia.

Preeclampsia (PE) is a multisystem disorder of human pregnancy, affecting about 6% of all pregnancies worldwide, and is one of the leading causes of maternal and infant morbidity and mortality. Despite decades of research into the pathogenesis of this complex disease, the underlying mechanisms remain unclear. As a result, the options for prevention and management of PE are limited. In recent years, there has been a growing body of evidence suggesting that folate deficiency is associated with PE, and folic acid supplementation may reduce the risk of developing PE in certain populations. Folate contributes to cell division and growth, and folate metabolism is involved in a large number of physiological and pathophysiological processes in human development. Sufficient supply of folate is therefore particularly important during pregnancy. Nevertheless, the exact mechanisms of folic acid deficiency increasing the risk of developing PE are still unclear. This article reviews what is understood about the aetiology of PE and the relationship between folate metabolism and PE so as to enhance further discussions on the subject.

Preeclampsia (PE) is a major reason for maternal morbidity and mortality globally. Studies showed that body mass index (BMI) is one of the risk factors of PE. In this study, the BMI and physiological and hematological profile were associated with predicting the severity of preeclampsia, so that proper counseling and antenatal care could be given for good pregnancy outcome. The study was carried out on 100 healthy normotensive pregnant and 100 diagnosed preeclamptic women. Healthy pregnant and PE were categorized into three groups based on BMI, on WHO criteria. BMI group 1 (<25 Kg/m2) considered as normal, group 2 (25 – 30 Kg/m2) as over-weight and group 3 (>30 Kg/m2) obese. Systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), white blood corpuscles (WBC), red blood corpuscles (RBC) and platelets were compared in control and PE groups. Then the respective control groups were compared with PE groups. The prevalence of overweight was more in PE groups when compared to normotensive pregnancy (P=0.004). Statistically, a significant difference was not observed in BMI group1, group 2 and group 3 of control and PE in relation to SBP, DBP, Hb, WBC, RBC and platelets. But a statistically significant difference was made when respective control groups were compared with PE (P<0.005). BMI does not have any statistically significant association with SBP, DBP, Hb, WBC, RBC and platelets. BMI could not be considered as a predictor or severity of preeclampsia.

Präeklampsie (PE) ist eine Komplikation, die während der Schwangerschaft auftritt, fast 2-8% aller Schwangerschaften betrifft und human spezifisch ist. PE ist eine der Hauptursachen für den Tod von Mutter und Kind. Eine abnormale Plazentaentwicklung aufgrund einer verminderten Trophoblasteninvasion und einem gestörten Umbau der Spiralarterien trägt zur Pathogenese der PE bei. Klinisch wird die PE durch Bluthochdruck und Proteinurie, auftretendnach der 20. Schwangerschaftswoche, diagnostiziert und kann durch eine Funktionsstörung von Organen begleitet werden. Bei besonders schweren Verläufen ist die frühzeitige Endbindung die letzte Möglichkeit das Überleben der Mutter zu gewährleisten. Das Ziel dieser Studie ist es, weitere Gene zu identifizieren, die durch ERVs in der menschlichen Plazenta spezifisch reguliert werden und in PE dysreguliert sind. Um dieses Ziel zu erreichen, wurde das Transkriptom von primären menschlichen Trophoblastenzellen von 5 gesunden und 5 früh einsetzenden PE-Plazenten mittels RNA-Sequenzierung analysiert. Es wurden 335 Gene identifiziert, welche eine höhere Expression in den Trophoblastenzellen im Vergleich zu anderen Geweben aufwiesen. Zusätzlich zeigten einige der Gene (n=88) eine Co-Regulation der Expression durch retrovirale LTRs (10-kb 5‘ des transcription start side (TSS) des Gens). Hauptinteresse lag hierbei auf den Genen, welche ebenfalls eine Dysregulation in der PE aufwiesen (n = 16). Diese Studie identifizierte EPS8L1, das durch primaten-spezifisches ERV-LTR (MLT1G1) in Trophoblastenzellen reguliert wird, als einen wichtigen Faktor in der Entwicklung der menschlichen Plazenta. EPS8L1 ist in der PE Plazenta dysreguliert und involviert in mehrere Signalwege und die Funktionalität von Trophoblasten wie Invasion, Angiogenese und Redoxhomöostase. Hierdurch führt diese Arbeit zu einem besseren Verständnis der PE und deren human-spezifischer Natur.
Preeclampsia (PE) is a complication that occurs during pregnancy and affects almost 2-8% of all pregnancies and is often regarded as a human-specific disorder.1,2 PE is one of the major causes of maternal and fetal death.1 Failure of the trophoblast cells to invade into the maternal decidua results in the improper remodeling of spiral arteries leading to PE pathogenesis. Clinically, it is diagnosed as a maternal syndrome, diagnosed by the new-onset of hypertension and proteinuria or other end-organ dysfunction after the 20th week of pregnancy. So far, the only effective treatment of the disorder is the removal of the placenta tissue and delivery of the infant. The aim of this study is to identify additional genes that are regulated by the human ERV-LTRs in the human placenta specifically, and are dysregulated in PE. To achieve this aim, the transcriptome of primary human trophoblast cells of 5 healthy and 5 early-onset PE placentas were analyzed by RNA sequencing (RNA-seq). RNA-seq analysis identified genes (n=335) with stronger expression in the trophoblast cells as compared to other human body tissues. Additionally, some of the genes (n=88) showed co-regulation of expression by the human ERV-LTRs in their vicinity (10-kb upstream of transcription start side (TSS) of the gene). Since my interest was to identify the new targets of PE pathogenesis, so I focused on genes (n=16) with dysregulated expression in women presented with PE. This study identified a new gene EPS8L1, regulated by primate-specific ERV-LTR in trophoblast cells that has a predominant role in the human placenta development and demonstrated that its dysregulation affected multiple pathways involved in trophoblast function like invasion, angiogenesis and maintenance of cell redox homeostasis. Furthermore, this study leads to the better understanding of the disease by explaining certain aspects of human-specific nature of PE.

Publicación a texto completo no autorizada por el autor
Determina los factores nutricionales asociados a la preeclampsia en las gestantes que acuden al Instituto Nacional Materno Perinatal durante el periodo enero - marzo 2016. Se selecciona a 47 pacientes con diagnóstico de preeclampsia y 48 pacientes sin dicho diagnóstico. La selección de los controles se realiza considerando el apareamiento por edad de las gestantes. Los resultados revelan que la edad promedio de las gestantes con preeclampsia es de 29.7 ±7 años y de las gestantes sin preeclampsia es 29.3±6.5 años, muchas (46.8%) procedentes de Lima Este y amas de casa (72.3%). En el análisis de los factores nutricionales dietarios se observa que el consumo de omega 3<3.7 g/d (p=0.007; OR= 3.273; IC=1.4-7.9), calcio<800 mg/d (p<0.001; OR=6.3; IC=2.4-16.2), Zinc< 9.5 mg/d (p<0,001; OR=4.8; IC=1.9-11.7), magnesio< 290 mg/d (p=0.033; OR= 4.05; IC= 1.0-15.8) y potasio<4700 mg/d (p=0,003; OR=4.1; IC=1.6-10.7) son factores de riesgo asociados al diagnóstico de preeclampsia. Sin embargo, no se encuentra asociación significativa entre el consumo de carbohidratos mayor a 312 g/d (p=0.864) ni a mayor a 451 g/d (p=0.210) con la preeclampsia.
Tesis

OBJETIVO: Determinar la relación entre el nivel de conocimientos y las fuentes de información sobre preeclampsia en gestantes con este trastorno atendidas en el Instituto Nacional Materno Perinatal durante Mayo - Julio 2015. METODOLOGÍA: Estudio de tipo observacional, correlacional, prospectivo y de corte transversal, en el que se tomó a 184 gestantes con preeclampsia que hayan recibido información sobre este trastorno y que cumplían con los criterios de inclusión y exclusión. El grado de relación entre el nivel de conocimientos y las fuentes de información se estimó a través de la prueba Chi-cuadrado, con un nivel de confianza (IC) del 95%, el cual se consideró significativo cuando tenía un valor p<0.05. RESULTADOS: Las fuentes de información que recibieron las gestantes con preeclampsia fueron a través de medios de información como el Obstetra en el 39.1% y el Médico ginecólogo en el 29.3%; el lugar de información fue el Hospital en el 47.8% y el momento de información fue durante el control prenatal en el 53.8%. El nivel de conocimientos que presentan las gestantes con preeclampsia es “Medio” en el 60.3% y “Alto” en el 22.3%. El nivel de conocimientos sobre preeclampsia se relaciona con el medio de información (p=0.000), el lugar de información (p=0.000) y el momento de información (p=0.025) en las gestantes con este trastorno. CONCLUSIÓN: El nivel de conocimiento se relaciona con el medio, el lugar y el momento de información sobre preeclampsia en las gestantes con este trastorno atendidas en el Instituto Nacional Materno Perinatal durante Mayo - Julio 2015. PALABRAS CLAVES: Preeclampsia, conocimientos, fuentes de información.
OBJECTIVE: To determine the relationship between the level of knowledge and the sources of information about preeclampsia in pregnant women with this disorder attended in the National Institute Maternal Perinatal during May-July 2015. METHODOLOGY: Observational study, correlational, prospective and cross-sectional in which was taken in 184 pregnant women with preeclampsia who have received information about this disorder and who met the inclusion and exclusion criteria. The degree of relationship between the level of knowledge and the sources of information is estimated using the Chi-square test, with a confidence interval (CI) of 95%, which is considered significant when p value was <0.05. RESULTS: The sources of information they received pregnant women with preeclampsia were through the mass media such as the 39.1% Obstetrician and gynecologist at 29.3%; the place of information was the Hospital in 47.8% and the moment information during antenatal care was at 53.8%. The present level of knowledge that pregnant women with preeclampsia are "Medium" at 60.3% and "High" at 22.3%. The level of knowledge about the information medium preeclampsia (p = 0.000), the location information (p = 0.000) and the time information (p = 0.025) in pregnant women are associated with this disorder. CONCLUSIONS: The level of knowledge is related to the medium, location and timing information about preeclampsia in pregnant women with this disorder attended in the National Institute Maternal Perinatal during May to July 2015. KEYWORDS: Preeclampsia, knowledge, information sources.
Tesis

Objetivo: El objetivo del estudio fue determinar los resultados del manejo expectante de la preeclampsia severa en embarazos menores de 34 semanas. Material y métodos: Se realizó un estudio descriptivo, observacional, retrospectivo de corte transversal con 79 gestantes preeclámpticas severas entre las 23 – 34 semanas que recibieron manejo expectante durante el período comprendido entre el 01 de enero del 2002 y el 31 de diciembre de 2006,llevado a cabo en el Hospital Nacional Docente Madre Niño “San Bartolomé”,el análisis estadístico se realizó con el programa 14.0. Resultados: El antecedente personal más frecuente fue la preeclampsia (22,8%), mientras que el antecedente familiar más importante fue la hipertensión arterial (58,2%). Las complicaciones maternas más frecuentes en fueron la falla renal aguda (16,5%) y el síndrome HELLP (13,9%). La restricción de crecimiento intrauterino (81%) y la muerte intraparto (6,3%) fueron las principales complicaciones fetales, mientras que la asfixia neonatal (7,6%) fue la complicación neonatal más frecuente. Las indicación más frecuente para terminar el embarazo fue la preeclampsia refractaria al tratamiento (26,6%). En el 57% de casos el tiempo de prolongación del embarazo con el manejo expectante fue de 1 – 3 días. La vía del parto en el 89,9% fue por cesárea y el peso promedio de los recién nacidos estuvo comprendido entre los 1000 – 1499 gramos en el 31,6% de casos y en el 30,4% entre los 1500 – 1999 gramos.Resultados: Se concluyó que el manejo expectante de la preeclampsia severa entre las 23 – 34 semanas de gestación fue factible, debiendo realizarse en forma selectiva y en instituciones que garanticen una estricta vigilancia materno – fetal. Palabras Clave: Preeclampsia severa, manejo expectante, embarazo pretérmino.
Tesis de segunda especialidad

Se trata de un estudio caso control, el cual tuvo como objetivo el determinar la relación que pudiera existir entre la infección urinaria ,el broncoespasmo y el intervalo intergenésico con el desarrollo de preeclampsia .Este estudio se realizó en el Instituto Especializado Materno Perinatal, entre los meses de agosto y noviembre del 2003, en donde se comparó 75 puérperas que tuvieron preeclampsia con 75 puérperas que no tuvieron la enfermedad, pareadas con respecto a la edad materna. Se analizó los factores potenciales asociados a preeclampsia usando la prueba de asociación Odd Ratio (OR), pruebas de diferencias de proporciones Chi cuadrada y pruebas de diferencia de medias “t student”. Resultados: La preeclampsia estuvo asociada a infección urinaria durante el embarazo con un OR : 5.4 (IC 95% 1.7 – 17.4) , constituyendo el principal factor asociado. La infección vaginal mostró también asociación a preeclampsia : OR: 4.6 (IC 95 % 1.3-14.0) . El intergenésico largo (>48 meses) estuvo asociado a preeclampsia con un OR: 4.6 (IC 95 % 1.4-15.3). Conclusiones: El intervalo intergenésico largo y las infecciones (urinaria y vaginal) constituyen factores de riesgo para el desarrollo de preeclampsia. Las mujeres que tienen alguno de estos factores poseen un riesgo incrementado para que su embarazo sea complicado con preeclampsia.
Tesis

Introducción: La preeclampsia es uno de los trastornos hipertensivos del embarazo que origina más complicaciones y figura entre las primeras causas de muerte materna y perinatal. Para su prevención y tratamiento las modificaciones dietéticas son mínimas ya que su etiología se atribuye a otros factores, sin embargo en los últimos años se ha descubierto el importante papel de algunos nutrientes en el desarrollo de esta patología. Objetivo: Determinar la influencia de los hábitos alimentarios sobre la preeclampsia en gestantes que asisten al Instituto Nacional Materno Perinatal 2015 Diseño: Estudio cuantitativo, observacional, analítico de casos y controles. Lugar: Instituto Nacional Materno Perinatal. Lima – Perú. Participantes: El estudio incluyó 120 gestantes (60 del grupo casos y 60 del grupo control) entre 20 y 34 años con una edad gestacional mayor a 20 semanas. Intervenciones: Se aplicó un cuestionario para medir los hábitos alimentarios cuyas dimensiones fueron: criterios para la selección de alimentos, formas de consumo y frecuencia de consumo de alimentos. El diagnóstico de preeclampsia se obtuvo directamente de las historias clínicas. Para verificar la asociación entre ambas variables se utilizó la prueba chi cuadrado. Resultados: La preeclampsia y los hábitos alimentarios no presentaron asociación (p valor = 0.315). Sin embargo analizando la relación de la preeclampsia con cada indicador que componía las tres dimensiones se encontró asociación con: el número de comidas al día, la forma en la que se consume los productos cárnicos, la omisión del desayuno, la omisión de la cena, el tiempo post cena que se deja pasar para dormir y el lugar de consumo de alimentos, así también se encontró asociación entre la preeclampsia y la frecuencia de consumo de alimentos hipotensores tales como la cebolla, el limón, el plátano de seda y el pescado. Conclusiones: Los hábitos alimentarios no ejercieron influencia sobre la preeclampsia en gestantes que asisten al Instituto Nacional Materno Perinatal 2015. Palabras clave: Hábitos alimentarios, preeclampsia, gestantes.
--- Introduction: Preeclampsia is a hypertensive disorders of pregnancy that causes more complications and is among the leading causes of maternal and perinatal death. Dietary modifications are minimal for prevention and treatment because their etiology is attributed to other factors, however in recent years it has been discovered the important role of some nutrients in the development of this pathology. Objective: To determine the influence of dietary habits on preeclampsia in pregnant women attending the Maternal Perinatal Institute 2015 National Design: Quantitative Study, an observational, analytical cases and controls. Location: National Maternal Perinatal Institute. Lima Peru. Participants: The study included 120 pregnant women (60 group and 60 cases in the control group) between 20 and 34 years with a gestational age greater than 20 weeks. Interventions: A questionnaire was used to measure eating habits, dimensions were: criteria for selecting foods, forms of consumption, frequency of food consumption. The diagnosis of preeclampsia was obtained from medical records. Chi-square test was used to verify the association between the two variables. Results: Preeclampsia and eating habits are not associated (p value = 0.315). However analyzing the relationship preeclampsia with each item composing the three dimensional was found association with: the number of meals per day, the way in which meat products is consumed, the omission of breakfast, omission of dinner, time post dinner that let sleeping and the place of food consumption, and also found association between preeclampsia and frequency of consumption of onions, lemon, banana silk and fish. Conclusions: Eating habits did not exert influence on preeclampsia in pregnant women attending the National Maternal Perinatal Institute 2015. Keywords: Eating Habits, preeclampsia, pregnant.
Tesis

La preeclampsia es una complicación seria de la gestación y es una de las principales causas de mortalidad materna y perinatal en el Perú y en el mundo. Por largo tiempo se ha intentado uniformizar criterios diagnósticos, lo cual haga factible comparar estudios de investigación con respecto a los trastornos hipertensivos en el embarazo. Se realizó un estudio observacional, descriptivo, retrospectivo. Se revisaron las historias clínicas de las pacientes quienes tuvieron su parto entre los meses de octubre a diciembre del 2004 en el Instituto Nacional Materno Perinatal de Lima, quienes presentaban algún diagnóstico de trastorno hipertensivo durante su ingreso al ser hospitalizadas o al momento del alta. Se obtuvo una incidencia de trastornos hipertensivos del embarazo del 5.13%, y de preeclampsia de 3.25%, en el INMP en este periodo. Se observó que del total de pacientes evaluadas 56.7% eran nulíparas. Del total de casos de trastornos hipertensivos del embarazo el diagnóstico más frecuente fue el de Preeclampsia con un 56.7%. La proteinuria se determinó principalmente por prueba cualitativa, y cuando se realizó la prueba cuantitativa los valores detectados fueron bajos, no relacionándose con la gravedad del caso. Al comparar preeclampsia con hipertensión gestacional se encontró asociación estadísticamente significativa entre preeclampsia y parto por cesárea, prematuridad, plaquetopenia previa y post parto, transfusión de hemoderivados y con ingreso a la UCI materna. Las complicaciones maternas más frecuentemente encontradas fueron anemia y plaquetopenia, y la complicación perinatal más frecuente fue la prematuridad. Concluye que la hipertensión arterial durante el embarazo es un factor de riesgo importante para presentar mayor morbilidad materna y perinatal. Se debe uniformizar criterios diagnósticos de los trastornos hipertensivos del embarazo, lo cual, permitirá tener estadísticas más confiables y permitir las comparaciones con estudios realizados en otras instituciones. Los trastornos hipertensivos del embarazo deben ser cuidadosamente evaluados y manejados en hospitales que tengan la infraestructura necesaria para poder resolver complicaciones maternas y perinatales.
Trabajo académico

Objetivo: Determinar la relación entre la violencia doméstica de la pareja y la preeclampsia en gestantes atendidas en el Hospital San Juan de Lurigancho enero – julio, 2015. Material y métodos: Estudio retrospectivo, analítico de casos y controles en 80 gestantes (40 gestantes con preeclampsia y 40 gestantes normotensas) atendidas en el Hospital San Juan de Lurigancho durante el periodo enero – julio, 2015. Con la finalidad de evaluar la presencia o ausencia de violencia doméstica de la pareja durante el embarazo. Los datos se recopilaron a través de la revisión de historias clínicas y un cuestionario válido para la violencia intrafamiliar durante el embarazo. En el análisis se aplicó estadísticas descriptivas, distribución de frecuencias y proporciones en las variables cualitativas. Para las variables cuantitativas se aplicó medidas de tendencia central, promedios y desviaciones estándar. Para las inferencias estadísticas se aplicó la prueba de Chi-Cuadrado en las variables cualitativas. Para la determinación de las relaciones se aplicó la razón de productos cruzados (OR) con sus intervalos de confianza al 95%, regresión logística binaria, regresión de Cox y Snell y se aplicó la prueba de Hosmer y Lemeshow para la validación del modelo, considerándose adecuado cuando el p > 0.05. Resultados: El promedio de edad de las gestantes preeclampticas (casos) fue 27.83 y 27.35 para las gestantes normotensas (controles). En ambos grupos, la educación secundaria completa fue mayoritaria, 72.5% en los casos y 57.5% en los controles. El 85% de los casos manifestaron ser amas de casa al igual que los controles, 72.5%. El 62.5% de los casos tienen una procedencia de nacimiento de la costa y el 40% de los controles procede de la sierra. En ambos grupos el estado civil conviviente fue mayoritario, 72.5% en los casos y el 80% en los controles. Asimismo el tiempo de cohabitación sexual con la pareja representó el 57.5% y el 92.5% para los casos y controles, respectivamente. La probabilidad de tener Preeclampsia cuando se presenta violencia física (OR: 2.1; IC95% 0.706-6.253) es más de dos veces y casi tres veces más cuando se presenta la violencia sexual (OR: 2.97; IC95% 0.966-9.155), p<0.05. Para la violencia psicológica, la probabilidad de sufrir preeclampsia en presencia de este factor es 1.11 veces más, p>0.05. En general, existe una probabilidad de 2.5 veces más en desarrollar Preeclampsia cuando se presenta la violencia (OR: 2.54; IC95% 0.895-7.202), p>0.05. Conclusiones: La violencia doméstica física y sexual de la pareja incrementa el riesgo de sufrir preeclampsia. No se obtuvieron datos estadísticamente significativos para la violencia psicológica y su relación con esta patología. En general, la violencia doméstica de la pareja constituye un factor de riesgo para desarrollar preeclampsia en las gestantes atendidas en el Hospital San Juan de Lurigancho en el periodo enero – julio 2015, aunque estos resultados no fueron estadísticamente significativos. PALABRAS CLAVES: Violencia infligida por la pareja, violencia durante el embarazo, preeclampsia.
--- Objective: To determine the relationship between domestic partner violence and preeclampsia in pregnant women treated at the Hospital San Juan de Lurigancho January to July 2015. Materials and methods: Retrospective, analytical case-control study of 80 pregnant women (40 pregnant women with preeclampsia and 40 normotensive pregnant) at the Hospital San Juan de Lurigancho for the period January-July 2015. In order to assess the presence or absence of domestic partner violence during pregnancy. Data were collected through review of medical records and valid for domestic violence during pregnancy questionnaire. In the analysis descriptive statistics, frequency distributions and proportions for qualitative variables applies. For quantitative variables measures of central tendency, means and standard deviations was applied. For the statistical inferences Chi-Square test is applied in the qualitative variables. To determine the relationship was applied the odds ratio (OR) with confidence intervals of 95%, binary logistic regression, Cox and Snell products and the HosmerLemeshow test was used to validate the model, considering suitable when the p> 0.05. Results: The mean age of preeclamptic pregnant women (cases) was 27.83 and 27.35 for normotensive pregnant women (controls). In both groups, the majority was completed secondary education, 72.5% in cases and 57.5% in controls. 85% of cases being housewives expressed as the controls, 72.5%. 62.5% of cases have a source of birth of the coast and 40% of controls comes from the mountains. In both groups the majority law marriage was 72.5% in cases and 80% in controls. Also the time of sexual cohabitation with the couple represented 57.5% and 92.5% for cases and controls, respectively. The chance of having preeclampsia when physical violence (OR: 2.1; 95% CI 0.706- 6.253) presented is more than twice and almost three times as sexual violence (OR: 2.97; 95% CI 0.966–9.155) is presented, p <0.05. For psychological violence, the likelihood of preeclampsia in the presence of this factor is 1.11 times, p> 0.05. In general, there is a probability of 2.5 times in preeclampsia when violence (OR: 2.54; 95% CI 0.895-7.202) is presented p> 0.05. Conclusions: Domestic physical and sexual partner violence increases the risk of preeclampsia. No statistically significant data for psychological violence and their relationship with this pathology were obtained. Usually, Domestic partner violence is a risk factor for preeclampsia in pregnant women treated at the Hospital San Juan de Lurigancho in the period January to July 2015, although these results were not statistically significant. KEYWORDS: Intimate partner violence, violence during pregnancy, preeclampsia.
Tesis

Objetivos: Determinar la asociación entre el antecedente de preeclampsia en el embarazo y endometritis puerperal en pacientes que tuvieron un parto en el servicio de Gineco - Obstetricia del Hospital Nacional María Auxiliadora durante el periodo de enero a diciembre del 2014. Material y métodos: Se realizó un estudio observacional, descriptivo, retrospectivo de casos y controles. Se revisaron 589 casos (Pacientes que desarrollaron endometritis durante el puerperio) y 589 controles (Pacientes que no desarrollaron endometritis durante el puerperio) en el periodo de enero a diciembre del 2014. Resul tados: El 60% de las gestantes tenían entre 25 y 34 años. Hubo una mayor frecuencia de gestantes casadas en un 93.2%.La mayoría de las gestantes eran nulípara en un 65.2%.Hubo una mayor frecuencia de gestantes con más de cinco controles prenatales en un 61%.El 63.5% de gestantes tenían grado de instrucción secundaria. El 74.5% de las gestantes tuvo parto cesárea. El 49% de gestantes desarrollo preeclampsia. Conclusiones: Existe una asociación estadísticamente significativa entre la preeclampsia severa durante el embarazo y su relación con endometritis puerperal en pacientes que tuvieron un parto en el servicio de Gineco- Obstetricia del Hospital Nacional María Auxiliadora (P<0.05).La mayoría de pacientes con preeclampsia y endometritis tenían entre 25 y 34 años, eran casadas, nulíparas, con más de cinco controles prenatales, con grado de instrucción secundaria, y la mayoría tuvo parto cesárea.
Tesis

Preeclampsia (PE) is a multi-organ system disorder defined as hypertension with blood pressures greater than 140/90 on two occasions and proteinuria of more than 300 mg/24 hours. Eclampsia is defined as when seizures occur in a woman with preeclampsia. The pathophysiology of preeclampsia/eclampsia is felt to be related to incomplete penetration of the cytotrophoblasts of the placenta into the myometrium, leading to local ischemia, propagation of ischemic factors causing hypertension, resulting in endothelial dysfunction. The clinical features are related to which end organ is involved: in the kidney, proteinuria; in the liver, coagulopathy; and in the brain, posterior white matter dysfunction. The involvement of the parietal and occipital lobes explains the associated neurological features of confusion and visual changes. MRI reflects the white matter changes associated with eclampsia in posterior reversible encephalopathy syndrome (PRES). Eclampsia is treated with blood pressure control and magnesium to treat the seizures.