Antiplatelet agents for preventing pre-eclampsia and its complications

Cochrane library, Journal Year: 2019, Volume and Issue: 2019(10)

Published: Oct. 30, 2019

Language: Английский

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Antioxidant Properties of Albumin and Diseases Related to Obstetrics and Gynecology

Antioxidants, Journal Year: 2025, Volume and Issue: 14(1), P. 55 - 55

Published: Jan. 6, 2025

Albumin, the most abundant protein, contributes significantly to various physiological processes, indicating its multifunctional properties. It has drawn attention of scientists and physicians because primary role in maintaining osmotic pressure involvement transporting numerous small molecules, including hormones, fatty acids, drugs. A growing body evidence recently illustrated an additional aspect albumin’s antioxidant Therefore, based on recent research findings, this review article delves into molecular biochemical aspects antioxidative capabilities. We highlight multifaceted significance proteins oxidative stress their relation pathologies obstetrics gynecology. In particular, we focused preeclampsia, which is closely involved pathogenesis, renal dysfunction leads increased albumin excretion urine, resulting hypoalbuminemia. addition, discussed preeclampsia diagnosis, patient prognosis. Understanding properties opens new avenues for therapeutic intervention sheds light novel strategies combating associated with damage. study, employed PubMed database search articles that assessed albumin, a specific focus obstetric diseases, particularly preeclampsia. The last update was conducted November 2024.

Language: Английский

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Preeclampsia screening and prevention—A Nordic perspective

Acta Obstetricia Et Gynecologica Scandinavica, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 14, 2025

Preeclampsia, particularly if onset is early, possess a significant challenge for obstetricians. Despite advances in maternal healthcare, the global incidence of preeclampsia remains at 2%–8%, with Nordic countries reporting rates around 3%–4%. Delivery only effective treatment, resulting high perinatal mortality and morbidity due to preterm birth. Furthermore, currently one leading causes severe worldwide. Over time, various preventive strategies have been explored, while ongoing pharmaceutical studies aim identify alternative options, low-dose acetylsalicylic acid (aspirin) has, so far, proven be most effective. Meta-analyses indicate that aspirin dose 100 mg/day, administered high-risk women before 16 weeks gestation, can reduce risk (preeclampsia delivery 37 gestation).1 However, exact possible benefit treatment started after gestation still being explored. The definition 'high-risk' eligibility prophylaxis varies across national obstetric guidelines. In (Denmark, Finland, Iceland, Norway Sweden), guidelines recommend based on or factors. This either single factor, such as pregestational diabetes, history preeclampsia. some multiple moderate-risk factors like body mass index nulliparity are also eligible prophylaxis. this screening approach, solely maternal/obstetric factors, has limited predictive accuracy. A Danish study found by alone detects less than 30% cases,2 similar evaluating current Swedish showed 20%–30% eventually developing detected.3 Recently, novel method using multi-marker algorithm proposed Fetal Medicine Foundation attracted attention. first-trimester combines measurement mean arterial pressure, uterine artery Doppler pulsatility index, biochemical markers, placental growth factor (PlGF) pregnancy-associated plasma protein-A (PAPP-A). Studies up 70%–75% screen-positive rate 10%,4 surpassing accuracy alone. Additionally, ASPRE (Combined Multimarker Screening Randomized Patient Treatment Aspirin Evidence-Based Preeclampsia Prevention) trial demonstrated women, identified treated 150 mg daily, experienced reduction over 60% incidence.5 Denmark, PRESIDE (PREeclampsia DEnmark) compared approach algorithm, finding latter significantly more population.6 Sweden, IMPACT (Improving Maternal Pregnancy And Child ouTcomes) performance an model tailored population, expected results during 2025.7 Some centers already implemented Sweden now effect retrospectively. conducting prospective local different concepts, Iceland planning biomarker data collection research. Finland exploring evaluations locally. While literature increasingly supports shifting followed group, widespread implementation requires impact large clinical cohorts. Single center evaluated reported their following implementation. show decrease, others do not find change.8, 9 No published far. Denmark plans initiate initiative (PREPRED, PREeclampsia PREvention Denmark) 2025 (results 2027), baseline interrupted time series design assess uptake compliance, preeclampsia, evaluate neonatal complications Denmark. Establishing ultrasound quality control standards part plan, continuous monitoring maintenance program considered essential when running programs. Compliance another important but often overlooked which prenatal programs, adherence prescribed needs attention preparing cost-effectiveness analyses. Evaluation cost crucial prerequisite National Health Board willing new program. These economic reports assumptions strongly influenced existing pregnancy care provided change, making them specific each country. worldwide cost-effective. Norway, health analysis shows savings,10 analyses Sweden. countries, robust healthcare infrastructure commitment public health, well-positioned lead paradigm shift care. challenges remain, including limitations, resource constraints, attitudes motivations regarding engagement screening, well those professionals. Ethical, political, must considered. country faces unique hurdles, collaborative efforts within region invaluable, given shared characteristics populations systems. We hope plan sharing research ideas, will beneficial establish improved evidence-based policies prevention countries.

Language: Английский

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Hypertension in Pregnancy and Postpartum: Current Standards and Opportunities to Improve Care

Circulation, Journal Year: 2025, Volume and Issue: 151(7), P. 490 - 507

Published: Feb. 17, 2025

Hypertension in pregnancy contributes substantially to maternal morbidity and mortality, persistent hypertension, rehospitalization. Hypertensive disorders of are also associated with a heightened risk cardiovascular disease, timely recognition modification factors is crucial optimizing long-term health. During pregnancy, there expected physiologic alterations blood pressure (BP); however, pathophysiologic may occur, leading preeclampsia gestational hypertension. The diagnosis effective management hypertension during essential mitigate risks, such as acute kidney injury, stroke, heart failure, while balancing potential fetal growth restriction preterm birth due altered uteroplacental perfusion. In the postpartum period, innovative multidisciplinary care solutions that include health clinics can help optimize short- through enhanced BP management, screening factors, discussion lifestyle modifications for disease prevention. As an adjunct or distinct from clinics, home monitoring programs have been shown improve ascertainment across diverse populations lower months after delivery. Because concerns about pregnant patients being vulnerable population research, little evidence trials examining treatment individuals. result, national international guidelines differ their recommendations, more studies needed bolster future establish best practices achieve optimal pregnancy. Future research should focus on refining thresholds range peripartum evaluating interventions outcomes would advance evidence-based worldwide people hypertensive

Language: Английский

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Prevention of Pregnancy Complications Using a Multimodal Lifestyle, Screening, and Medical Model

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(15), P. 4344 - 4344

Published: July 25, 2024

Prevention of pregnancy complications related to the “great obstetrical syndromes” (preeclampsia, fetal growth restriction, spontaneous preterm labor, and stillbirth) is a global research clinical management priority. These syndromes share many common pathophysiological mechanisms that may contribute altered placental development function. The resulting adverse outcomes are associated with increased maternal perinatal morbidity mortality post-partum risk cardiometabolic disease. Maternal nutritional environmental factors known play significant role in altering bidirectional communication between fetal-derived trophoblast cells decidual abnormal placentation. As result, lifestyle-based interventions have increasingly been recommended before, during, after pregnancy, order reduce decrease long-term risk. Antenatal screening strategies developed following extensive studies diverse populations. Multivariate preeclampsia using combination maternal, biophysical, serum biochemical markers at 11–14 weeks’ gestation can be performed same time as first-trimester ultrasound blood tests. Women identified high-risk offered prophylactic low dose aspirin monitored angiogenic factor assessment from 22 gestation, assessment, biochemistry, ultrasound. Lifestyle reassessed during counseling antenatal interventions. integration lifestyle interventions, screening, medical represents conceptual advance care has potential significantly later life outcomes.

Language: Английский

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Effect of aspirin on biomarker profile in women at high-risk for preeclampsia

American Journal of Obstetrics and Gynecology, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 1, 2024

Language: Английский

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