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  • 1
    In: Acta Obstetricia et Gynecologica Scandinavica, Wiley, Vol. 95, No. 9 ( 2016-09), p. 1048-1054
    Abstract: Some pregnant women develop significant proteinuria in the absence of hypertension. However, clinical significance of isolated gestational proteinuria ( IGP ) is not well understood. This study aimed to determine the prevalence of IGP in singleton pregnancies and the proportion of women with IGP who subsequently developed preeclampsia ( IGP ‐ PE ) among all PE cases. Material and methods This was an observational study of 6819 women with singleton pregnancies at 12 centers, including 938 women with at least once determination of protein‐to‐creatinine ratio (P/Cr). Significant proteinuria in pregnancy ( SPIP ) was defined as P/Cr (mg/mg) level 〉 0.27. IGP was defined as SPIP in the absence of hypertension. Gestational hypertension ( GH ) preceding preeclampsia ( GH ‐ PE ) was defined as preeclampsia ( PE ) in which GH preceded SPIP . Simultaneous PE (S‐ PE ) was defined as PE in which both SPIP and hypertension occurred simultaneously. Results IGP and PE were diagnosed in 130 (1.9%) and 158 (2.3%) of 6819 women, respectively. Of 130 women with IGP , 32 (25%) progressed to PE and accounted for 20% of all women with PE . Hence, women with IGP had a relative risk of 13.1 (95% CI ; 9.2–18.5) for developing PE compared with those without IGP [25% (32/130) vs. 1.9% (126/6689)]. At diagnosis of SPIP , P/Cr levels already exceeded 1.0 more often in women with S‐ PE than in those with IGP ‐ PE [67% (33/49) vs. 44% (14/32), respectively, p = 0.031]. Conclusions IGP is a risk factor for PE , and IGP ‐ PE accounts for a considerable proportion (20%) of all PE .
    Type of Medium: Online Resource
    ISSN: 0001-6349 , 1600-0412
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2024554-3
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  • 2
    In: Journal of Obstetrics and Gynaecology Research, Wiley, Vol. 43, No. 2 ( 2017-02), p. 291-297
    Abstract: The aim of this retrospective study was to assess tadalafil treatment in pregnant women with fetal growth restriction (FGR) in terms of maternal and perinatal outcomes. Methods We retrospectively analyzed 11 Japanese singleton pregnant women with FGR who received tadalafil along with conventional management for FGR at Mie University Hospital from July 2015 to February 2016 (tadalafil group). These women were matched for maternal age, parity, gestational age, and estimated fetal weight at enrollment with 14 singleton pregnant women who received only the conventional management for FGR in 2014 (conventional management group). The conventional management for FGR was performed according to guidelines for obstetric practice in Japan. Results Both birthweight and fetal growth velocity from enrollment to birth were significantly higher in the tadalafil group than in the conventional management group. The cesarean delivery rate was approximately twofold higher in the conventional management group than in the tadalafil group. Importantly, cesarean section due to non‐reassuring fetal status was performed in seven pregnant women in the conventional management group (58.3%) but in none in the tadalafil group ( P 〈 0.05, chi‐squared test). Conclusions Tadalafil may improve perinatal outcome in FGR by modulating fetal growth through maintenance or improvement of fetal well‐being.
    Type of Medium: Online Resource
    ISSN: 1341-8076 , 1447-0756
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2079101-X
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  • 3
    In: Journal of Obstetrics and Gynaecology Research, Wiley, Vol. 43, No. 7 ( 2017-07), p. 1159-1168
    Abstract: We designed a safety and dose‐finding trial of tadalafil administered for fetal growth restriction (FGR). Methods Three cases were initially commenced on 10 mg/day and monitored for major adverse events. Should a major adverse event be observed in one or more of the three cases, an examination into its relation with tadalafil would be conducted by a safety evaluation committee. If one or more of these new cases exhibited the same adverse event, the trial would be stopped completely. If there were no harmful side‐effects, the trial would be extended to three cases at 20 mg/day, and the protocol would continue as in the 10‐mg/day dose. The 40‐mg/day dosage was tried in six cases as the dosage was considered to be high. Results The study population consisted of pregnant women with FGR. Maternal adverse events in all doses were recorded as least one grade 1 adverse events, as tadalafil was considered acceptable from the viewpoint of the mothers. However, a dose of 40 mg/day increased the number of grade 1 adverse events. The only fetal adverse event was a case of intrauterine fetal death related to the velamentous insertion of the umbilical cord. Neonatal adverse events showed no correlation to tadalafil dose, but were found more frequently in preterm births and, therefore, were correlated to infant prematurity. Conclusion This safety and dose‐finding trial showed that tadalafil had a favorable safety profile for pregnant women and fetuses with FGR.
    Type of Medium: Online Resource
    ISSN: 1341-8076 , 1447-0756
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2017
    detail.hit.zdb_id: 2079101-X
    Location Call Number Limitation Availability
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