Objective: The mechanisms underlying increased cardio vascular risk among women with a history of pre-eclampsia remain unclear. Imp aired endothelial function has been observed in both pre-eclampsia and atherosc leros...Objective: The mechanisms underlying increased cardio vascular risk among women with a history of pre-eclampsia remain unclear. Imp aired endothelial function has been observed in both pre-eclampsia and atherosc lerosis, and provides a plausible link between the two conditions. We studied en dothelial function and arterial compliance in non-pregnant, previously pre-ecl amptic women. Design: A study of 30 women with a history of pre-eclampsia and 2 1 women with a previous normotensive, uncomplicated pregnancy was carried out. M ethods: Changes in brachial artery blood flow, induced by intra-arterial infusi ons of an endothelium-independent(sodium nitroprusside) and an endothelium-dep endent(acetylcholine) vasodilator,were measured by venous occlusion plethysmogra phy. Arterial stiffness was assessed by pulse wave analysis. Results: Vasodilata tion was impaired in women with previous pre-eclampsia; at low and high concent rations of endothelium-independent(P=0.004 and P=0.057, respectively) and endot helium-dependent(P=0.045 and P=0.02) vasodilators, respectively. There was no d ifference in arterial stiffness between the groups(P=0.45). In multiple regressi on analyses both endothelium-independent and endothelium-dependent vasodilatat ions were independently associated with a history of pre-eclampsia and parity. There was no correlation with blood pressure, body mass index(BMI), smoking or a ge. Conclusions: The finding of impaired vascular dilatation several years after a pre-eclam-ptic pregnancy could contribute to the higher risk of cardiovascu lar disease in these women.展开更多
Objective: Our aim was to study whether universal screening of all pregnant women by Oral Glucose Challenge Test (OGCT) would identify a higher number of women with Gestational Diabetes (GDM) than risk factor based sc...Objective: Our aim was to study whether universal screening of all pregnant women by Oral Glucose Challenge Test (OGCT) would identify a higher number of women with Gestational Diabetes (GDM) than risk factor based screening. Study design: A 50 g OGCT test was performed prospectively in 532 unselected women at 26- 28 weeks of gestation. The 1h venous plasma glucose concentration of >7.3 mmol/l was considered as a positive screening result. Patients with a positive OGCT underwent a 75 g 2- h OGTT, which was used as the actual diagnostic test for GDM. When two or all three of the glucose concentrations in OGTT (measured at fasting state and1and 2h afterthe 75g glucose load) were above the 97.5th percentile the patient was considered as having GDM. In addition, women with risk factors for GDM also underwent a 75 g OGTT regardless of the result of the OGCT. Results: A positive 50 g OGCT was obtained in 123 (23% ) of the women. In 15 (12% ) of these, a diagnosis of GDM was established by the subsequent OGTT. Out of the 409 remaining women with a normal OGCT, 148 (36% ) had risk factors for GDM. An OGTT performed in these patients identified 4 additional women with a GDM. Seventy-nine percent of GDM was thus found with 50 g OGCT without regarding risk factors. Forty-seven percent of the women with GDM would have been missed in screening by risk factors only. Conclusions: In our population 50 g OGCT appears to identify a higher number of GDM than risk factor based screening. Combined with risk factor screening a few more cases of GDM would be found.展开更多
文摘Objective: The mechanisms underlying increased cardio vascular risk among women with a history of pre-eclampsia remain unclear. Imp aired endothelial function has been observed in both pre-eclampsia and atherosc lerosis, and provides a plausible link between the two conditions. We studied en dothelial function and arterial compliance in non-pregnant, previously pre-ecl amptic women. Design: A study of 30 women with a history of pre-eclampsia and 2 1 women with a previous normotensive, uncomplicated pregnancy was carried out. M ethods: Changes in brachial artery blood flow, induced by intra-arterial infusi ons of an endothelium-independent(sodium nitroprusside) and an endothelium-dep endent(acetylcholine) vasodilator,were measured by venous occlusion plethysmogra phy. Arterial stiffness was assessed by pulse wave analysis. Results: Vasodilata tion was impaired in women with previous pre-eclampsia; at low and high concent rations of endothelium-independent(P=0.004 and P=0.057, respectively) and endot helium-dependent(P=0.045 and P=0.02) vasodilators, respectively. There was no d ifference in arterial stiffness between the groups(P=0.45). In multiple regressi on analyses both endothelium-independent and endothelium-dependent vasodilatat ions were independently associated with a history of pre-eclampsia and parity. There was no correlation with blood pressure, body mass index(BMI), smoking or a ge. Conclusions: The finding of impaired vascular dilatation several years after a pre-eclam-ptic pregnancy could contribute to the higher risk of cardiovascu lar disease in these women.
文摘Objective: Our aim was to study whether universal screening of all pregnant women by Oral Glucose Challenge Test (OGCT) would identify a higher number of women with Gestational Diabetes (GDM) than risk factor based screening. Study design: A 50 g OGCT test was performed prospectively in 532 unselected women at 26- 28 weeks of gestation. The 1h venous plasma glucose concentration of >7.3 mmol/l was considered as a positive screening result. Patients with a positive OGCT underwent a 75 g 2- h OGTT, which was used as the actual diagnostic test for GDM. When two or all three of the glucose concentrations in OGTT (measured at fasting state and1and 2h afterthe 75g glucose load) were above the 97.5th percentile the patient was considered as having GDM. In addition, women with risk factors for GDM also underwent a 75 g OGTT regardless of the result of the OGCT. Results: A positive 50 g OGCT was obtained in 123 (23% ) of the women. In 15 (12% ) of these, a diagnosis of GDM was established by the subsequent OGTT. Out of the 409 remaining women with a normal OGCT, 148 (36% ) had risk factors for GDM. An OGTT performed in these patients identified 4 additional women with a GDM. Seventy-nine percent of GDM was thus found with 50 g OGCT without regarding risk factors. Forty-seven percent of the women with GDM would have been missed in screening by risk factors only. Conclusions: In our population 50 g OGCT appears to identify a higher number of GDM than risk factor based screening. Combined with risk factor screening a few more cases of GDM would be found.
