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Dosagem seriada dos fatores reguladores de angiogênese soluble fms-like tyrosine kinase-1 (sFlt-1) e placental growth factor (PIGF) para predição de pré-eclâmpsia e pré-eclâmpsia superajuntada; Serial assessment of the angiogenic factors soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) levels for predicting preeclampsia and superimposed preeclampsia

Costa, Rafaela Alkmin da
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 22/10/2014 Português
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Apesar de sua importância clínica e epidemiológica, a fisiopatologia da préeclâmpsia ainda não foi completamente compreendida. Sabe-se que a doença constitui-se de uma fase pré-clínica e um estágio clínico. Durante a última década muito esforço tem se concentrado na identificação precoce da doença, ainda em sua fase pré-clínica. A literatura científica tem demonstrado claramente um desequilíbrio na regulação da angiogênese das gestantes com pré-eclâmpsia, marcado por níveis elevados do fator antiangiogênico soluble fms-like tyrosine kinase-1 (sFlt-1) e níveis diminuídos do fator pró-angiogênico placental growth fator (PlGF). Embora um número crescente de estudos em populações de alto risco tenha avaliado o papel desses biomarcadores no diagnóstico de pré-eclâmpsia, dados sobre sua utilização para a predição de pré-eclâmpsia superajuntada, cujo diagnóstico pode ser particularmente difícil, permanecem relativamente escassos e controversos. Com o presente estudo pretendemos avaliar o desempenho de medidas seriadas dos níveis maternos circulantes dos fatores sFlt-1 e PlGF, bem como da razão sFlt-1/PlGF, para predição de pré-eclâmpsia superajuntada e compará-lo ao seu desempenho na predição de pré-eclâmpsia em sua forma "pura"...

The impact of prior preeclampsia on the risk of superimposed preeclampsia and other adverse pregnancy outcomes in patients with chronic hypertension

Sibai, Baha M.; Koch, Matthew A.; Freire, Salvio; Pinto e Silva, Joao Luiz; Rudge, Marilza Vieira Cunha; Martins-Costa, Sergio; Moore, Janet; Santos, Cleide de Barros; Cecatti, Jose Guilherme; Costa, Roberto; Ramos, Jose Geraldo; Moss, Nancy; Spinnato, Jo
Fonte: Mosby-elsevier Publicador: Mosby-elsevier
Tipo: Artigo de Revista Científica Formato: 6
Português
Relevância na Pesquisa
37.34%
OBJECTIVE: We sought to compare the rates of superimposed preeclampsia and adverse outcomes in women with chronic hypertension with or without prior preeclampsia.STUDY DESIGN: We conducted secondary analysis of 369 women with chronic hypertension (104 with prior preeclampsia) enrolled at 12-19 weeks as part of a multisite trial of antioxidants to prevent preeclampsia (no reduction was found). Outcome measures were rates of superimposed preeclampsia and other adverse perinatal outcomes.RESULTS: Prepregnancy body mass index, blood pressure, and smoking status at enrollment were similar between groups. The rates of superimposed preeclampsia (17.3% vs 17.7%), abruptio placentae (1.0% vs 3.1%), perinatal death (6.7% vs 8.7%), and small for gestational age (18.4% vs 14.3%) were similar between groups, but preterm delivery <37 weeks was higher in the prior preeclampsia group (36.9% vs 27.1%; adjusted risk ratio, 1.46; 95% confidence interval, 1.05-2.03; P = .032).CONCLUSION: In women with chronic hypertension, a history of preeclampsia does not increase the rate of superimposed preeclampsia, but is associated with an increased rate of delivery at <37 weeks.

Implicações fisiopatológicas das descompartimentalização da hemoglobina para a biologia do óxido nítrico em pacientes com pré-eclâmpsia; Physiopathological implications of hemoglobin decompartmentalization to the nitric oxide biology in patients with preeclampsia

Jonas Tadeu Cau Sertorio
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 26/11/2012 Português
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O óxido nítrico (NO) exerce um importante papel durante as alterações hemodinâmicas que normalmente acompanham uma gravidez sadia (GS). Entretanto, em mulheres com pré-eclâmpsia (PE), uma síndrome caracterizada por hipertensão e proteinúria, a vasodilatação da circulação sistêmica materna está comprometida. Isso possivelmente ocorre devido a uma menor biodisponibilidade de NO, a qual resulta de uma menor produção e uma maior degradação do NO. Como a hemoglobina livre no plasma sequestra o NO pela rápida reação de dioxigenação, o que pode comprometer a eficiência do processo de vasodilatação mediado pela via do NO/guanilato ciclase, formulamos a hipótese de que pacientes com PE, quando comparadas com grávidas sadias, apresentariam concentrações aumentadas de hemoglobina livre no plasma, o que resultaria em maior degradação (consumo) do NO e menor biodisponibilidade de NO. Além disso, também formulamos a hipótese de que os diferentes fenótipos da haptoglobina (Hp) podem modular a biodisponibilidade de NO ao influenciar o consumo de NO na PE. A haptoglobina é uma proteína polimórfica (Hp1-1, Hp2-1 e Hp2-2) que se liga à hemoglobina para formar um complexo (Hb-Hp) que é removido da circulação...

Preeclampsia: from epidemiological observations to molecular mechanisms

López-Jaramillo,P.; Casas,J.P.; Serrano,N.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2001 Português
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Preeclampsia is the main cause of maternal mortality and is associated with a five-fold increase in perinatal mortality in developing countries. In spite of this, the etiology of preeclampsia is unknown. The present article analyzes the contradictory results of the use of calcium supplementation in the prevention of preeclampsia, and tries to give an explanation of these results. The proposal of an integrative model to explain the clinical manifestations of preeclampsia is discussed. In this proposal we suggest that preeclampsia is caused by nutritional, environmental and genetic factors that lead to the creation of an imbalance between the free radicals nitric oxide, superoxide and peroxynitrate in the vascular endothelium. The adequate interpretation of this model would allow us to understand that the best way of preventing preeclampsia is the establishment of an adequate prenatal control system involving adequate antioxidant vitamin and mineral supplementation, adequate diagnosis and early treatment of asymptomatic urinary and vaginal infections. The role of infection in the genesis of preeclampsia needs to be studied in depth because it may involve a fundamental change in the prevention and treatment of preeclampsia.

Markers of insulin resistance and sedentary lifestyle are predictors of preeclampsia in women with adverse obstetric results

Hoirisch-Clapauch,S.; Benchimol-Barbosa,P.R.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2011 Português
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37.27%
Some thrombophilias and severe preeclampsia may increase the risk for preterm deliveries and fetal death due to placental insufficiency. Our objective was to evaluate clinical and laboratory data as predictors of preeclampsia in a population of mothers with 3rd trimester fetal losses or preterm deliveries. In a longitudinal retrospective study, 54 consecutive women (age range: 16 to 39 years) with normotensive pregnancies were compared to 79 consecutive women with preeclampsia (age range: 16 to 43 years). Weight accrual rate (WAR) was arbitrarily defined as weight gain from age 18 years to the beginning of pregnancy divided by elapsed years. Independent predictors of preeclampsia were past history of oligomenorrhea, WAR >0.8 kg/years, pre-pregnancy or 1st trimester triglyceridemia >150 mg/dL, and elevated acanthosis nigricans in the neck. In a multivariate logistic regression model, two or more predictors conferred an odds ratio of 15 (95%CI [5.9-37]; P < 0.001) to develop preeclampsia (85% specificity, 73% sensitivity, c-statistic of 81 ± 4%; P < 0.0001). Clinical markers related to insulin resistance and sedentary lifestyles are strong independent predictors of preeclampsia in mothers with 3rd trimester fetal losses or preterm deliveries due to placental insufficiency. Women at risk for preeclampsia in this particular population might benefit from measures focused on overcoming insulin resistance.

Prevention of preeclampsia with low-dose aspirin: a systematic review and meta-analysis of the main randomized controlled trials

Ruano,Rodrigo; Fontes,Rosana S.; Zugaib,Marcelo
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2005 Português
Relevância na Pesquisa
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The purpose of this paper is to evaluate the effectiveness of low-dose aspirin in the prevention of preeclampsia in low-risk and high-risk women. We identified randomized clinical trials of the use of low-dose aspirin to prevent preeclampsia through the PUBMED search engine, and through the Cochran Library database. Twenty-two studies met our inclusion criteria, and were divided according to the studied population into 2 groups: trials with women at low risk for preeclampsia and trials with women at high risk. Effects were measured through the incidence of preeclampsia in women taking either placebo or aspirin, in studies where the relative risks and the 95% confidence intervals were calculated for both groups. A total of 33,598 women were studied, comprising 5 trials with 16,700 women at low-risk and 17 trials including 16,898 women at high risk. The incidence of preeclampsia was 3.75% (626/17,700), in the low-risk group, 9.01% (1,524/16,898) in the high-risk group, and 6.40% (2,150/33,598) overall. Low-dose aspirin had no statistically significantly effect on the incidence of preeclampsia in the low-risk group (RR = 0.95, 95% CI = 0.81-1.11), but had a small beneficial effect in the high-risk group (RR = 0.87, 95% CI = 0.79-0.96). Therefore...

TNF-receptor levels in preeclampsia - results of a longitudinal study in high-risk women

Schipper, E.J.; Bolte, A.; Schalkwijk, C.; van Geijn, G.; Dekker, G.
Fonte: Taylor & Francis Ltd Publicador: Taylor & Francis Ltd
Tipo: Artigo de Revista Científica
Publicado em //2005 Português
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37.27%
Objective. Tumor necrosis factor-alpha (TNF-) is thought to play a role in immune activation in preeclampsia. The objective of this study was to establish if soluble TNF-receptor I (sTNF-rI) levels relate to the onset and severity of preeclampsia. Methods. Maternal plasma sTNF-rI levels were studied throughout pregnancy in 68 women with a history of severe preeclampsia or intra-uterine growth restriction (IUGR), and primigravidas with chronic hypertension. Data are presented as mean (SD) in ng/ml. Results. In the second trimester there was a significant difference in sTNF-rI levels between preeclamptic pregnancies with and without IUGR (means 1.33 (0.20) and 1.11 (0.15) respectively, p < 0.005). In severe preeclampsia with delivery before 34 weeks of gestation, sTNF-rI levels were higher than in mild preeclampsia in the second and third trimesters (means 1.40 (0.16) vs. 1.16 (0.19), p < 0.02 and 1.82 (0.47) vs. 1.42 (0.22), p < 0.05, respectively). Conclusion. sTNF-rI levels were higher in preeclampsia with fetal involvement, suggesting that increased TNF- production in preeclampsia is related to impaired placentation rather than to the maternal syndrome.; http://www.informaworld.com/smpp/content?content=10.1080/14767050500246466; Elbert-Jaap I. Schipper...

Fibrinogen concentration and factor VIII activity in women with preeclampsia

Williams, V.; Griffiths, A.; Carbone, S.; Hague, W.
Fonte: Marcel Dekker Inc Publicador: Marcel Dekker Inc
Tipo: Artigo de Revista Científica
Publicado em //2007 Português
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37.36%
Objective: To compare fibrinogen concentration and factor VIII activity obtained from pregnant women with preeclampsia with those obtained from women with either normal pregnancies or with complications unrelated to preeclampsia. Materials and Methods: Fibrinogen concentration and factor VIII activity were measured in the following groups: normal pregnancy, consisting of women at routine 16- to 28-week antenatal visits or after admission at term for elective cesarean section; women with non-preeclampsia (non-PE) related conditions, including women with threatened abortion, cholestasis, systemic lupus erythematosus (SLE), and previous deep venous thrombosis (DVT); and women with preeclampsia as defined by the Australasion Society for the Study of Hypertension in Pregnancy (ASSHP) criteria. Blood was collected from 44 women in each group. Fibrinogen concentration and factor VIII activity were measured. Results: Fibrinogen concentrations and factor VIII activities were higher in women with preeclampsia compared with those from women with either normal or complicated pregnancies (p < 0.05). It was twice as likely that a woman with preeclampsia would have a raised fibrinogen and factor VIII levels. The ranges for each analyte did, however...

Urinary proteomics for prediction of preeclampsia

Carty, D.; Siwy, J.; Brennand, J.; Zurbig, P.; Mullen, W.; Franke, J.; McCulloch, J.; Roberts, C.; North, R.; Chappell, L.; Mischak, H.; Poston, L.; Dominiczak, A.; Delles, C.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2011 Português
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Preeclampsia is a major determinant of fetal and maternal morbidity and mortality. We used a proteomic strategy to identify urinary biomarkers that predict preeclampsia before the onset of disease. We prospectively collected urine samples from women throughout pregnancy. Samples from gestational weeks 12 to 16 (n=45), 20 (n=50), and 28 (n=18) from women who subsequently had preeclampsia develop were matched to controls (n=86, n=49, and n=17, respectively). We performed capillary electrophoresis online coupled to micro-time-of-flight mass spectrometry. Disease-specific peptide patterns were generated using support vector machine-based software. Candidate biomarkers were sequenced by liquid chromatography-tandem mass spectrometry. From comparison with nonpregnant controls, we defined a panel of 284 pregnancy-specific proteomic biomarkers. Subsequently, we developed a model of 50 biomarkers from specimens obtained at week 28 that was associated with future preeclampsia (classification factor in cases, 1.032±0.411 vs controls, −1.038±0.432; P<0.001). Classification factor increased markedly from week 12 to 16 to 28 in women who subsequently had preeclampsia develop (n=16; from −0.392±0.383 to 1.070±0.383; P<0.001) and decreased slightly in controls (n=16; from −0.647±0.437 to −1.024±0.433; P=0.043). Among the biomarkers are fibrinogen alpha chain...

Integrated proteomics pipeline yields novel biomarkers for predicting preeclampsia

Myers, J.; Tuytten, R.; Thomas, G.; Laroy, W.; Kas, K.; Vanpoucke, G.; Roberts, C.; Kenny, L.; Simpson, N.; Baker, P.; North, R.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2013 Português
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Preeclampsia, a hypertensive pregnancy complication, is largely unpredictable in healthy nulliparous pregnant women. Accurate preeclampsia prediction in this population would transform antenatal care. To identify novel protein markers relevant to the prediction of preeclampsia, a 3-step mass spectrometric work flow was applied. On selection of candidate biomarkers, mostly from an unbiased discovery experiment (19 women), targeted quantitation was used to verify and validate candidate biomarkers in 2 independent cohorts from the SCOPE (SCreening fOr Pregnancy Endpoints) study. Candidate proteins were measured in plasma specimens collected at 19 to 21 weeks’ gestation from 100 women who later developed preeclampsia and 200 women without preeclampsia recruited from Australia and New Zealand. Protein levels (n=25), age, and blood pressure were then analyzed using logistic regression to identify multimarker models (maximum 6 markers) that met predefined criteria: sensitivity ≥50% at 20% positive predictive value. These 44 algorithms were then tested in an independent European cohort (n=300) yielding 8 validated models. These 8 models detected 50% to 56% of preeclampsia cases in the training and validation sets; the detection rate for preterm preeclampsia cases was 80%. Validated models combine insulin-like growth factor acid labile subunit and soluble endoglin...

Untersuchungen zur Bedeutung von oxidativem Stress bei Präeklampsie; Investigations about the importance of oxidative stress in preeclampsia

Amraei Davijani, Felor
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
Relevância na Pesquisa
37.3%
Präeklampsie ist eine der häufigsten schwerwiegenden Schwangerschafts-Komplikationen, die durch Hypertonie, Proteinurie und Ödeme charakterisiert ist. Die Pathogenese ist weitgehend unklar. Viele Untersuchungen legen nahe, dass Präeklampsie mit oxidativem Stress im mütterlichen Organismus verbunden ist. In der vorliegenden Arbeit wurden zunächst Indikatoren des oxidativen Stresses durch in-vitro-Versuche charakterisiert. Dabei wurde mit H2O2, t-BHP, KO2 und Xanthin/XOD künstlicher oxidativer Stress im Plasma gesunder Probandinnen induziert. Zur Erfassung der Parameter für oxidativen Stress diente die gesamte antioxidative Kapazität (TRAP) sowie die Peakhöhe der Chemilumineszenz der AAPH-Reaktion (2,2’-Azobis (2-amidiniopropan)-hydrochlorid). Diese wurde durch die verwendeten Oxidantien vermindert. Zusätzlich wurden die Konzentrationen der Thiole im Plasma untersucht. Unter der Einwirkung der Oxidantien wurde eine Abnahme der freien Thiolgruppen, vor allem der an Proteine gebundenen, im Plasma festgestellt. Auf die Malondialdehyd-Konzentration hatte die Inkubation mit H2O2 keinen Effekt, t-BHP verursachte eine Zunahme. Auch bei der Wirkung auf die ATP-Konzentration in Erythrozyten wurde eine viel stärkere Abnahme des ATP durch t-BHP im Vergleich zu H2O2 gefunden. Danach wurde durch klinisch-chemische Blutanalyse der Frage nachgegangen...

Aspectos inmunológicos implicados en la etiopatogenia de la preeclampsia

Paz Fajardo, Lucía
Fonte: Universidade de Cantabria Publicador: Universidade de Cantabria
Tipo: Trabalho de Conclusão de Curso
Português
Relevância na Pesquisa
37.32%
RESUMEN: La patología preeclámptica es de suma importancia en lo que a la atención a la gestante se refiere, por la elevada morbimortalidad que puede suponer si no se previene o trata correctamente, y es importante tenerla presente ya que aparece en el 5% de todos los embarazos. He tratado de enfocar esta revisión sobre la preeclampsia como una forma de rechazo agudo, analizando las interacciones inmunológicas que se producen entre madre y embrión. Además, se ha revisado el papel de las distintas células inmunológicas implicadas así como los factores solubles producidos por estas y otras moléculas envueltas en la etiopatogenia y fisiopatología de esta enfermedad. Se ha intentado analizar la preeclampsia desde el punto de vista de una perdida de mecanismos responsables del mantenimiento de tolerancia inmunológica desencadenándose así una respuesta inmune. Por otra parte he revisado los eventos adversos endoteliales implicados en la preeclampsia así como las consecuencias de los mismos. Aunque son muchos los estudios que se han hecho sobre esta enfermedad, son aún numerosos los interrogantes acerca de muchos de los mecanismos implicados, por lo que el estudio de esta patología está aún lejos de ser concluido.; ABSTRACT: Preeclampsia is a very frequent condition during pregnancy...

Effects of Pregnancy and Physical Activity on Angiogenesis and Endothelial Function: Implications for the Development of Preeclampsia

WEISSGERBER, TRACEY
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado Formato: 2336434 bytes; application/pdf
Português
Relevância na Pesquisa
37.3%
Prospective epidemiological studies indicate that regular exercise during the year prior to conception reduces preeclampsia risk, whereas exercise during affects pregnancy reduces preeclampsia risk only at specific dosages, or in specific subpopulations. The risk of severe preeclampsia is increased among women who exercise for more than 270 minutes/week in early pregnancy. Physiology studies are needed to identify mechanisms through which regular exercise may influence preeclampsia risk. This dissertation examined the effects of pregnancy (30-36 weeks gestation), and regular exercise participation, on two important pathophysiological features of preeclampsia; circulating anti-angiogenic markers, represented by soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng), and endothelial dysfunction. The results demonstrate that regularly exercising, pregnant non-smoking women have higher levels of serum placental growth factor (PlGF), lower levels of serum sFlt-1 and sFlt-1:PlGF, and are less likely to experience high serum sEng levels, than sedentary women. The effects of exercise on PlGF and sFlt-1:PlGF are more pronounced among women exercising less than 270 minutes/week in pregnancy. Anti-angiogenic changes that could contribute to preeclampsia were not observed immediately after short-duration...

Complicaciones de la preeclampsia severa y su relación con variables demográficas y obstétricas

Pérez Pachón, Karen Johanna
Fonte: Facultad de Medicina Publicador: Facultad de Medicina
Tipo: info:eu-repo/semantics/bachelorThesis; info:eu-repo/semantics/acceptedVersion Formato: application/pdf
Português
Relevância na Pesquisa
37.37%
Introducción: La preeclampsia severa es una de las principales patologías que afectan a las mujeres embarazadas, sus complicaciones tienen un alto impacto en la salud del binomio madre-hijo. Materiales y métodos: Se realizo una serie de casos, durante un periodo de 1 año se revisaron las historias clínicas de las pacientes que ingresaron a la unidad de cuidado intensivo obstétrico de la Clínica Orquídeas, con diagnóstico de preeclampsia severa. Se describieron los datos demográficos y las complicaciones. Se realizó análisis univariado con las variables de interés y se calcularon diferencias significativas por medio del test exacto de Fisher. Resultados: Se registraron 196 pacientes con preeclampsia severa en el periodo de estudio. Las complicaciones mas frecuentes fueron síndrome HELLP (30,6%), insuficiencia renal aguda (16,3%) y edema pulmonar (10,2%); el ingreso de las pacientes con preeclampsia severa a la UCIO en embarazo aumenta el riesgo de sufrir complicaciones. El síndrome de HELLP se presento con mayor frecuencia en pacientes que realizaron 6 o mas controles prenatales (p=0.066). Discusión: Los resultados evidencian una prevalencia de preeclampsia severa mayor que la observada por otros autores, probablemente por ser una UCI exclusivamente obstétrica. Las complicaciones mas frecuentes son concordantes con otros estudios publicados. El mayor riesgo de complicaciones asociadas en pacientes que ingresan embarazadas a la UCIO podría estar en relación a la severidad de la patología. Se requieren estudios analíticos para establecer asociaciones entre cada una de las complicaciones y sus factores condicionantes.; Introduction: Severe preeclampsia is one of the major diseases affecting pregnant women...

Desenlaces maternos y fetales en el manejo expectante de la preeclampsia lejos del término

Franco Chuaire, María Liliana; Calderón Díaz, Ivonne
Fonte: Facultad de Medicina Publicador: Facultad de Medicina
Tipo: info:eu-repo/semantics/bachelorThesis; info:eu-repo/semantics/submittedVersion Formato: application/pdf
Português
Relevância na Pesquisa
37.39%
Introducción La preeclampsia hace parte del espectro de los trastornos hipertensivos asociados al embarazo y es causa de alta morbimortalidad materna. La edad gestacional ha sido relacionada con la presentación más severa de esta cuando ocurren lejanas al término. Hoy en día existe la posibilidad de proporcionar manejo expectante en estos casos en unidades de cuidado obstétrico especializadas, con el fin de disminuir el riesgo de morbimortalidad asociada a la prematurez extrema. Metodología Se realizó un estudio de corte transversal que incluyó pacientes con preeclampsia lejos del término entre las 24 y 34 semanas que recibieron manejo expectante entre 2009 y 2012 en la Unidad de Cuidado Intensivo Obstétrico de la Clínica Colsubsidio Orquídeas. Resultados Se incluyeron 121 pacientes con preeclampsia lejos del término, quienes recibieron manejo expectante. La edad promedio fue 29.8, el promedio de días de manejo expectante fue 4 días, con una mediana de tres días. La edad gestacional de ingreso fue 30 1/7 semanas y la edad promedio de terminación 30 5/7 semanas. El 88.4% recibieron esquema de maduración completo. El 81.6% presentaron preeclampsia severa. El desenlace materno más frecuente fue Síndrome Hellp (37%) y el desenlace fetal fue restricción de crecimiento intrauterino (29%). Discusión Se debe considerar el manejo expectante en toda paciente con preeclampsia previa a la semana 34 para manejo antenatal con corticoesteroides...

PAPP-A y β-hCG libre como predictores de preeclampsia y bajo peso al nacer en una población latina

Buitrago Leal, Marcela; Martinez Castañeda, Lorena; Rizo Bekerman, Jessica
Fonte: Facultad de medicina Publicador: Facultad de medicina
Tipo: info:eu-repo/semantics/bachelorThesis; info:eu-repo/semantics/acceptedVersion Formato: application/pdf
Publicado em 07/11/2012 Português
Relevância na Pesquisa
37.3%
Introducción: La Preeclampsia ocurre entre el 2-7% de los embarazos. Previos estudios han sugerido la asociación entre los niveles alterados de PAPP-A y la β-hCG libre con el desarrollo de Preeclampsia (PE) y/o Bajo Peso al Nacer (BPN). Metodología: El diseño del estudio es de Prueba Diagnóstica con enfoque de casos y controles. Las mediciones séricas de PAPP-A y la β-hCG libre, fueron realizadas entre la semana 11-13.6 días durante 2 años. Resultados: La cohorte incluyó 399 pacientes, la incidencia de PE fue de 2,26% y de BPN fue de 14.54%. El punto de corte del percentil 10 fue MoM PAPP-A: 0,368293 y MoM β-hCG libre: 0,412268; la especificidad en PE leve fue de 90,5 y para BPN de 90. Los MoM de la β-hCG libre, la edad y el peso materno se comportan como factores de riesgo, mientras que mayores valores de MoM de la PAPP-A y mayor número de partos factores de protección. Para el BPEG severo la edad materna y la paridad se comportan como factores de riesgo, mientras que un aumento promedio de los valores de los MoM de la PAPP-A y la β-hCG libre, como factores de protección en el desarrollo de BPEG Severo. Conclusiones: Existe una relación significativa entre los valores alterados de PAPP-A y de β-hCG libre...

Lipidomic Assessment of Plasma and Placenta of Women with Early-Onset Preeclampsia

Korkes, Henri Augusto; Sass, Nelson; Moron, Antonio F.; Câmara, Niels Olsen S.; Bonetti, Tatiana; Cerdeira, Ana Sofia; Da Silva, Ismael Dale Cotrim Guerreiro; De Oliveira, Leandro
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
37.3%
Introduction: Adipose tissue is responsible for triggering chronic systemic inflammatory response and these changes may be involved in the pathophysiology of preeclampsia. Objective: To characterize the lipid profile in the placenta and plasma of patients with preeclampsia. Methodology Samples were collected from placenta and plasma of 10 pregnant women with preeclampsia and 10 controls. Lipids were extracted using the Bligh–Dyer protocol and were analysed by MALDI TOF-TOF mass spectrometry. Results: Approximately 200 lipid signals were quantified. The most prevalent lipid present in plasma of patients with preeclampsia was the main class Glycerophosphoserines-GP03 (PS) representing 52.30% of the total lipid composition, followed by the main classes Glycerophosphoethanolamines-GP02 (PEt), Glycerophosphocholines-GP01 (PC) and Flavanoids-PK12 (FLV), with 24.03%, 9.47% and 8.39% respectively. When compared to the control group, plasma samples of patients with preeclampsia showed an increase of PS (p<0.0001), PC (p<0.0001) and FLV (p<0.0001). Placental analysis of patients with preeclampsia, revealed the PS as the most prevalent lipid representing 56.28%, followed by the main class Macrolides/polyketides-PK04 with 32.77%, both with increased levels when compared with patients control group...

Revisando a prevenção da pré-eclâmpsia com aspirina em baixa dose: uma revisão sistemática dos principais estudos randomizados controlados; Prevention of preeclampsia with low-dose aspirin: a systematic review and meta-analysis of the main randomized controlled trials

Ruano, Rodrigo; Fontes, Rosana S.; Zugaib, Marcelo
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; Formato: application/pdf
Publicado em 01/10/2005 Português
Relevância na Pesquisa
37.3%
Esta revisão busca reúne estudos sobre a eficácia da aspirina em baixas doses na prevenção da pré-eclâmpsia em pacientes de alto e baixo risco. Identificamos estudos clínicos randomizados controlados usando baixas doses de aspirina para prevenir a pré-eclâmpsia, publicados no MEDLINE. Vinte e dois estudos preencheram nossos critérios de inclusão. Dividimos os estudos de acordo com a população estudada em dois grupos: estudos com mulheres de baixo risco para pré-eclâmpsia e estudos com pacientes de alto risco. A principal medida de efeito foi a incidência de pré-eclâmpsia em pacientes que usaram placebo ou aspirina, na qual os riscos relativos e os intervalos de confiança de 95% foram calculados para os grupos de pacientes de baixo e de alto risco para pré-eclâmpsia. Um total de 33.598 pacientes foram estudadas, dentre as quais cinco estudos com 16.700 pacientes de baixo risco e 17 estudos incluindo 16.898 pacientes de alto risco. As incidências de pré-eclâmpsia no geral, no grupo de baixo e no de alto risco foram de 6,40% (2.150/33.598), 3,75% (626/17.700), e 9,01% (1.524/16.898), respectivamente. Baixas doses de aspirina não tiveram efeito estatístico significante na redução da incidência de pré-eclâmpsia em pacientes de baixo risco (RR=0.95...

Perfil epidemiológico y perinatal de pacientes con preeclampsia

Sáez Cantero,Viviana de la Caridad; Pérez Hernández,María Teresa
Fonte: Revista Cubana de Obstetricia y Ginecología Publicador: Revista Cubana de Obstetricia y Ginecología
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2014 Português
Relevância na Pesquisa
37.4%
Introducción: la preeclampsia es un problema obstétrico mayor que acarrea importante morbilidad y mortalidad materna y perinatal por los trastornos sistémicos asociados. Objetivo: comparar los resultados maternos y perinatales en gestantes que cursaron con preeclampsia en sus diferentes presentaciones clínicas. Métodos: estudio prospectivo, descriptivo, transversal, realizado en el hospital "Enrique Cabrera", desde el 1ro. de enero de 2010 al 31 diciembre de 2011. De las gestantes con trastornos hipertensivos (n = 293), se eligieron aquellas con preeclampsia (n = 89) y se dividieron en tres grupos: preeclampsia leve (n = 30), preeclampsia grave (n = 48) y preeclampsia sobreañadida (n = 11). Variables epidemiológicas, obstétricas y perinatales se procesaron por el sistema estadístico SPSS-11,5, utilizando estadística descriptiva, comparación de proporciones mediante la prueba de Chicuadrado y estimado de medias de variables cuantitativas con ANOVA-Eta, considerando la diferencia estadísticamente significativa p £ 0,05. Resultados: predominaron las adolescentes en la preeclampsia grave (25 %) y las ³ 35 años en la preeclampsia sobreañadida (p = 0,002), la obesidad también prevaleció en la preeclampsia sobreañadida (54...

Enzyme activity of superoxide dismutase and zincemia in women with preeclampsia

Araùjo Brito,José; Nascimento Marreiro,Dilina do; Machado Moita Neto,José; Michelle Costa e Silva,Danilla; Gonçalves de Sousa Almondes,Kaluce; Valadares Neto,João de Deus; Nascimento Nogueira,Nadir do
Fonte: Nutrición Hospitalaria Publicador: Nutrición Hospitalaria
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/04/2013 Português
Relevância na Pesquisa
37.32%
Introduction: Preeclampsia is a complex syndrome of unknown aetiologic origin. It is characterized by the clinical triad of hypertension, edema and protenuria. Current concepts of the genesis of preeclampsia include endothelial dysfunction and oxidative stress. Objective: This study assessed the relationship between the activity of superoxide dismutase, the zincemia and the preeclampsia. Methods: A case-control study was carried out with 94 women, age between 17 and 44 years, which were divided in two groups: women with preeclampsia (n = 44) and control group women with normal pregnancy (n = 50). The activity of superoxide dismutase enzyme was determined according to Ransod kit. Zinc concentrations in plasma and erythrocytes were determined using the flame atomic absorption spectrophotometry technique, both determined before delivery and during puerperium. Student's t-test and the paired t-test were used for statistical analysis, and significance was established at p < 0.05. Results: The study revealed plasma hypozincemia more pronounced in women with severe preeclampsia (p < 0.05). This behavior was not observed in eryth-rocytes, whose concentrations remained stable, before delivery and puerperium in women with preeclampsia and normal pregnancy. The antioxidant activity of the enzyme superoxide dismutase was found elevated in women with and without preeclampsia (p>0.05)...