Abnormal Development - Hypertension

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Introduction

Hypertensive disorders of pregnancy (maternal hypertension) can be environmental, genetic or of unknown causes, occurs in 2-3% (some say higher) of all pregnancies and has an increasing incidence associated with obesity. This page mainly focusses on the effects of hypertension on development, rather than the maternal health condition.

Hypertension has previously been grouped into 4 classes:[1]

  1. chronic hypertension
  2. preeclampsia-eclampsia
  3. preeclampsia superimposed on chronic hypertension
  4. gestational hypertension (transient hypertension of pregnancy , chronic hypertension after GA 20 weeks)


Draft Page - Notice removed when completed.


Environmental Links: Introduction | low folic acid | iodine deficiency | Nutrition | Drugs | Australian Drug Categories | USA Drug Categories | thalidomide | herbal drugs | Illegal Drugs | smoking | Fetal Alcohol Syndrome | TORCH | viral infection | bacterial infection | fungal infection | Zoonotic Infection | Toxoplasmosis | Malaria | Maternal Diabetes | Maternal Hypertension | maternal hyperthermia | Maternal Inflammation | Maternal Obesity | Hypoxia | Biological Toxins | Chemicals | heavy metals | radiation | Prenatal Diagnosis | Neonatal Diagnosis | International Classification of Diseases | Fetal Origins Hypothesis

Some Recent Findings

  • Pharmacogenomics of Hypertension and Preeclampsia: Focus on Gene-Gene Interactions[2] "Hypertension is a leading cause of cardiovascular mortality, but only about half of patients on antihypertensive therapy achieve blood pressure control. Preeclampsia is defined as pregnancy-induced hypertension and proteinuria, and is associated with increased maternal and perinatal mortality and morbidity. Similarly, a large number of patients with preeclampsia are non-responsive to antihypertensive therapy. Pharmacogenomics may help to guide the personalized treatment for non-responsive hypertensive patients."
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Search term: Maternal Hypertension

<pubmed limit=5>Maternal Hypertension</pubmed>

Search term: Gestational Hypertension

<pubmed limit=5>Gestational Hypertension</pubmed>

Search term: Preeclampsia

<pubmed limit=5>Preeclampsia</pubmed>

Gestational Hypertension

Gestational hypertension was previously called pregnancy-induced hypertension (PIH) and is the new onset of hypertension after 20 weeks of gestation.


Pre-Eclampsia

This condition is also known as gestational proteinuric hypertension and occurs in occurs in approximately 2 to 4% of all pregnancies. The pathogenesis of eclamptic convulsions remains unknown and women with a history of eclampsia are at increased risk of eclampsia (1-2%) and preeclampsia (22-35%) in subsequent pregnancies. "Magnesium sulfate is the drug of choice for reducing the rate of eclampsia developing intrapartum and immediately postpartum."(see Sibai BM. 2005).

Recent research using a large population study in Norway has shown a strong generational association such that daughters of women who had pre-eclampsia during pregnancy had more than twice the risk of pre-eclampsia themselves. The paper concludes "Maternal genes and fetal genes from either the mother or father may trigger pre-eclampsia. The maternal association is stronger than the fetal association. The familial association predicts more severe pre-eclampsia."[3]

References

  1. Mammaro A, Carrara S, Cavaliere A, Ermito S, Dinatale A, Pappalardo EM, Militello M & Pedata R. (2009). Hypertensive disorders of pregnancy. J Prenat Med , 3, 1-5. PMID: 22439030
  2. Luizon MR, Pereira DA & Sandrim VC. (2018). Pharmacogenomics of Hypertension and Preeclampsia: Focus on Gene-Gene Interactions. Front Pharmacol , 9, 168. PMID: 29541029 DOI.
  3. Skjaerven R, Vatten LJ, Wilcox AJ, Rønning T, Irgens LM & Lie RT. (2005). Recurrence of pre-eclampsia across generations: exploring fetal and maternal genetic components in a population based cohort. BMJ , 331, 877. PMID: 16169871 DOI.

Reviews

Hutcheon JA, Lisonkova S & Joseph KS. (2011). Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol , 25, 391-403. PMID: 21333604 DOI.

Leeman L & Fontaine P. (2008). Hypertensive disorders of pregnancy. Am Fam Physician , 78, 93-100. PMID: 18649616

Articles

Ahmad AS & Samuelsen SO. (2012). Hypertensive disorders in pregnancy and fetal death at different gestational lengths: a population study of 2 121 371 pregnancies. BJOG , 119, 1521-8. PMID: 22925135 DOI.

Mammaro A, Carrara S, Cavaliere A, Ermito S, Dinatale A, Pappalardo EM, Militello M & Pedata R. (2009). Hypertensive disorders of pregnancy. J Prenat Med , 3, 1-5. PMID: 22439030


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Environmental Links: Introduction | low folic acid | iodine deficiency | Nutrition | Drugs | Australian Drug Categories | USA Drug Categories | thalidomide | herbal drugs | Illegal Drugs | smoking | Fetal Alcohol Syndrome | TORCH | viral infection | bacterial infection | fungal infection | Zoonotic Infection | Toxoplasmosis | Malaria | Maternal Diabetes | Maternal Hypertension | maternal hyperthermia | Maternal Inflammation | Maternal Obesity | Hypoxia | Biological Toxins | Chemicals | heavy metals | radiation | Prenatal Diagnosis | Neonatal Diagnosis | International Classification of Diseases | Fetal Origins Hypothesis


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Cite this page: Hill, M.A. (2018, December 17) Embryology Abnormal Development - Hypertension. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_Hypertension

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© Dr Mark Hill 2018, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G