Skip to main content

Can We Predict Preeclampsia? | Chapter 12 | Current Trends in Medicine and Medical Research Vol. 4

Hypertensive  disorders  in  pregnancy  are  a  leading  cause  of  peripartum  morbidity  and  mortality. Preeclampsia is a heterogeneous maternal syndrome. Large  studies  have  pointed  out  the  association  of  impaired  spiral  artery  remodeling  at  the fetomaternal interphase in preeclampsia, but how exactly is the fetomaternal dialogue mediated and what are the biomarkers to detect the subclinical disease in various subsets of high-risk pregnancies is  still  a  challenge.  These  biomarkers  can  finally  be  used  to  diagnose  renal  function  (Kallikrein-creatinine ratio), vascular resistance (uterine artery Doppler), coagulation disorders (platelet volume, fibronectin,  prostacyclin,  thromboxane,  oxidant  stress  (lipid  peroxidase,  8-isoprostane,  antioxidants, anticardiolipin  antibodies,  homocysteine,  serum  uric  acid),  vascular  adaptation  (Placental  growth factor, Vascular endothelial growth factor, s-flt, s-eng) and markers ofplacental function and ischemia (placental  CRH,  CRH  bp,  activin,  inhibin, hCG).Post  partum  preeclampsia  can  be  predicted  by identifying the factors preventing the excretion of sodium, puerperal diuresis  and shift of intravascular fluid into the extra vascular compartment compartment(atrial natriuretic peptide in the first week after delivery,  natriuresis  and  inhibition  of  aldosterone,  angiotensin  II,  vasopressin).  Preeclampsia  is  a heterogeneous  disease.  The  late  onset  preeclampsia  at  or  near  term  has  low fetal  and  maternal morbidity. But the early onset preeclampsia (1%) of all preeclampsia has significant risks. Prediction of  risks  and  identification  of  subclinical  disease  is  mandatory.  The  majority  of  at  risk  groups  in multigravida  are  chronic  hypertension,  pregestational  and  gestational  diabetes,  age  and  multiple fetuses. Whereas, in primi only 14% have these risks. This suggests that there are multiple underlying etiologies  of  different  clinical  presentations.  A  clinical  algorithm  based  on  clinical,  biochemical  and ultrasound markers is outlined. Post partum eclampsia can be predicted and monitored with central venous  pressure  and  pulmonary  capillary  wedge  pressure.  The  maternal  syndrome  (proteinuria, edema  and  hypertension)  also  has  differences  in  time of  onset,  severity  and  organ  system involvement as highlighted in several studies. These clinical subpopulations need to be identified and preeclampsia predicted with rigorous definition of different biomarkers of different clinical phenotypes. The  future endeavors  should  be  to  identify  subclinical  disease  in  various  clinical  phenotypes  with these potential biomarkers in prospective longidunal studies.

Author(s) Details

Dr. Jayavelan Ramkumar
Department of Cardiothoracic Surgery, Sri Ramachandra Medical College and University, Chennai-600116, India.

Dr. Nidhi Sharma
Department of Obstetrics and Gynaecology, Saveetha Medical College, Saveetha University, Chennai-602105, India.

View Volume: https://doi.org/10.9734/bpi/ctmmr/v4

Comments

Popular posts from this blog

Consensus Summit: Lipids and Cardiovascular Health in the Nigerian Population | Chapter 09 | Current Trends in Food Science Vol. 1

Aims: To issue a consensus statement on Lipids and Cardiovascular Health and the impact of their interrelationship in Nigerian Population. Study Design: Experts from a range of relevant disciplines, deliberated on different aspects of Lipids and Cardiovascular Health in the Nigerian Population at a Summit. Place and Duration of Study: The Summit was held in April 2016 at the Nigerian Institute of Medical Research. Methodology: Presentations were made on central themes after which expert participants split into four different groups to consider the questions relevant to different sub themes of the title. Consensus was arrived at, from presentations of groups at plenary. Conclusion: With the increase in the prevalence of NCDs, especially Cardiovascular Disease in Nigeria, and the documented evidence of deleterious effects of lipids, the expert panel called for an urgent need to advocate for the general public and health professionals to make heart-friendly

A Review on Gongronema latifolium, an Extremely Useful Plant with Great Prospects | Chapter 11 | Recent Advances in Biological Research Vol. 3

Gongronema latifolium is a plant that has a wide range of nutritional and ethnomedical uses in different tropical African communities. Scientific reports on the chemical composition and bioactivity (anti-inflammatory, antimicrobial, antidiabetic, antioxidant, anticancer and allelopathic properties) of the plant material by different authors are discussed in this review. Future prospects of the plant extracts in the areas of herbal formulations, food preservation, alcoholic fermentation and beer production, drug discovery and allelopathy are also highlighted. Author   Details: Olugbenga Morebise Faculty of Basic Medical Sciences, All Saints University School of Medicine, Roseau, Commonwealth of Dominica. Read full article: http://bp.bookpi.org/index.php/bpi/catalog/view/50/403/433-1 View Volume: https://doi.org/10.9734/bpi/rabr/v3

Dictionary of Medicinal Plants - Scientific Names, Family and Selected Vernacular (English, Sinhala, Sanskrit and Tamil) Names | Book Publisher International

Medicinal plants have been known for centuries and are highly valued all over the world as a rich source of therapeutic agents of medicinal plants for public health care in developing nations [65]. Even today, the WHO estimates that up to 80 percent of the world population still relies mainly on traditional remedies such as herbs for their primary health care [13]. Ahmed et al. mentioned that according to a survey conducted by W.H.O., traditional healers treat 65% patients in Sri Lanka and 80% in India [3]. According to the WHO, around 21,000 plant species have the potential for being used as medicinal plants. Different ethnic and different language speaking peoples are living in Asian countries. Plants are commonly known by their local names in every part of the world. These local names play a very important role in ethno-botanical study of a specific tribe or region. Local names given to plants by indigenous people in their local dialects often reflect a broad spectrum of inf