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They take care of pregnant women who have chronic conditions (e.g. heart or kidney disease, hypertension, diabetes, and thrombophilia), pregnant women who are at risk for pregnancy-related complications (e.g. preterm labor, pre-eclampsia, and twin or triplet pregnancies), and pregnant women with fetuses at risk.
Pre-eclampsia affects 2–8% of pregnancies worldwide. [4] [17] [12] Hypertensive disorders of pregnancy (which include pre-eclampsia) are one of the most common causes of death due to pregnancy. [6] They resulted in 46,900 deaths in 2015. [7] Pre-eclampsia usually occurs after 32 weeks; however, if it occurs earlier it is associated with worse ...
Nicolaides has developed methods of (i) screening for premature birth (which is the main cause of perinatal morbidity and mortality) by measurement of cervical length and prevention through the use of vaginal progesterone, [9] (ii) screening for pre-eclampsia (which is one of the main causes of maternal mortality) by measurement of blood flow ...
Eclampsia, like pre-eclampsia, tends to occur more commonly in first pregnancies than subsequent pregnancies. [38] [39] [40] Women who have long term high blood pressure before becoming pregnant have a greater risk of pre-eclampsia. [38] [39] Patients who have gestational hypertension and pre-eclampsia have an increased risk of eclampsia. [41]
Severe pre-eclampsia involves a BP over 160/110 (with additional signs). It affects 5–8% of pregnancies. [20] Eclampsia – seizures in a pre-eclamptic patient, affect around 1.4% of pregnancies. [21] Gestational hypertension can develop after 20 weeks but has no other symptoms, and later rights itself, but it can develop into pre-eclampsia. [22]
Preeclampsia is a pregnancy-specific condition characterized by maternal hypertension and proteinuria after the 20th week of gestation. [5] Normally, during early formation of the placenta, extravillous cytotrophoblasts, a type of specialized fetal cell, enter the spiral arteries of the uterus.
Gestational age at birth is on average shortened by various pregnancy aspects: twin pregnancy, prelabor rupture of (fetal) membranes, pre-eclampsia, eclampsia, intrauterine growth restriction. [29] The ratio between fetal growth rate and uterine size (reflecting uterine distension) is suspected to partially determine the pregnancy length. [30]
Progesterone causes many changes to the genitourinary system. A pregnant woman may experience an increase in the size of the kidneys and ureter due to the increase blood volume and vasculature. Later in pregnancy, the woman might develop physiological hydronephrosis and hydroureter, which are normal. [33]
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