Preeclampsia: Prevention, Prediction and Possibilities, 1st Edition (Paperback) book cover

Preeclampsia

Prevention, Prediction and Possibilities, 1st Edition

By Pankaj Desai

CRC Press

168 pages | 28 Color Illus.

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Description

Preeclampsia is a high blood pressure condition affecting countless pregnant women. This rise in blood pressure can have profound and far-reaching effects on the mother as well as the fetus. This book discusses the causes, prediction and prevention. It examines the role played by a defective second wave of trophoblastic invasion, immunology guided oxidative stress, endothelial cell dysfunction, lipid denaturation and reperfusion, in the causation of preeclampsia. Complexities in the etiopathology is followed by prediction through prediction tools and further preventive measures. This book will be an updated resource for obstetricians, gynecologists, professionals and trainees.

Key Features

  • Presents the etiopathology of preeclampsia with recent research updates
  • Establishes links between preeclampsia and other obstetric vasculopathies
  • Explores a unique approach by covering clinical management with prevention and prediction of Preeclampsia
  • Provides key take-home messages at the end of each chapter

Table of Contents

Part 1: General Aspects of Preeclampsia

CHAPTER 01. INTRODUCTION

  • General Aspects Of Preeclampsia
  • What Is Preeclampsia?
  • What Is Obstetric Vasculopathy?

Part 2: Possibilities in Etiology of Preeclampsia

CHAPTER 02. IMMUNOLOGY OF PREECLAMPSIA

  • Immune Tolerance And Preeclampsia
  • Types Of Preeclampsia Based On Immunology
    • Preeclampsia Of Onset After 32 Weeks
    • Early Onset Preeclampsia

  • First Few Days Of Placentation And Preeclampsia
  • The Autonomous Tight Unit
  • Uterine Glands And Placentation
    • Uterine Milk
    • UGKO Cells
    • The Crosstalk

  • References

CHAPTER 03. ENDOTHELIAL CELL DYSFUNCTION & PREECLAMPSIA

    • Introduction
    • The Phenomenon Of Endothelial Cell Activation
    • Circulating Markers Of Endothelial Activation
    • Plasminogen And Allied Procoagulant Activity - A Manifestation Of Endothelial Cell Activation
    • Antiphospholipid Antibodies Act Through Procoagulant Mechanism
    • Endothelial Cell Adhesion Molecule Disturbances
    • VEGF
      • Clinical Bearings

    • Endothelin
    • Other Molecules Contributing To Endothelial Cell Activation
      • Immunological Antibodies
      • Cytokines
      • "Toxins"

    • References

CHAPTER 04. OXIDATIVE STRESS & PREECLAMPSIA

    • Introduction
    • What Is Oxidative Stress?
    • What Is A Free Radical?
    • Oxygen - A Double Edged Sword
    • The Mischief Of Free Radicals In Vascular Walls
    • Lipid Peroxides - The Agents Of Oxidative Stress
    • Our Basic Study
    • Lipid Metabolism In Normal Pregnancy And In Preeclampsia
    • Hypertriglyceridemia And Preeclampsia
    • Small Dense LDL Phenotype In Preeclampsia
    • Placental Lipid Peroxidation
    • Clinical Manifestations
    • Reperfusion
    • Innate Maternal Reducing Systems
    • The Family Of Free Radicals
    • Vascular Endothelium & Oxidative Stress
    • Inefficient Second Wave Of Trophoblastic Invasion
    • Production Of VEGF
    • Nitric Oxide In Preeclampsia
    • Nitric Oxide And Endothelial Cells
    • Placental Atherosis In Preeclampsia
    • Uric Acid: The Powerhouse Reductant
      • Riots And Policemen Model To Understand Uric Acid

    • Limitations Of Reducing Systems
    • Inconsistency Of Reducing Systems
    • The Ideal Reducing System
    • Exercise & Prevention Of Preeclampsia
    • The Beauty Of Lysophosphotidyl Choline
    • References

CHAPTER 05. METABOLIC SYNDROME AND PREECLAMPSIA

    • What Is Metabolic Syndrome?
    • Metabolic Syndrome And Hypertension
    • Metabolic Changes In Normal Pregnancy
      • Basal Metabolic Rate (BMR)
      • Proteins And Amino Acids
      • Carbohydrates
      • Lipids

    • Diagnosis Of Metabolic Syndrome
    • Metabolic Syndrome And Preeclampsia

CHAPTER 06. THE GENETICS OF PREECLAMPSIA

    • Basis For Reviewing The Role Of Genetics In Preeclampsia
    • Challenges To The Genetic Studies In Preeclampsia
    • Mammalian Studies
    • Application Of Genetic Models
    • Examining Associations
    • Fetal Contributions: Any?
    • Immunology And Genetics
    • Epigenetics And Preeclampsia
    • References

Part 3: Prediction

CHAPTER 07. PREDICTION OF PREECLAMPSIA

    • Introduction
    • Challenges To Tests For Prediction In Preeclampsia
    • Need For Multiple Tests
    • Assessing The Quality Of Tests In Prediction Of Preeclampsia
    • Overview Of Types Of Tests
    • Clinical Bearings Of Negative And Positive Tests
    • An Ideal Test
    • Clinical Tests
      • Mid-Trimester BP
      • The Roll-Over Test
      • Hand-Grip Test

    • Urinary Tests
      • Microalbuminuria
      • Urinary Calcium
      • Calcium: Creatinine Ratio
      • Kallikrein

    • Hematological Indices
      • Cellular Components In Prediction Of Preeclampsia
        • Leucocytes
        • Platelets And Platelet Activation

      • Uric Acid
      • Fibronectin
      • Β-HCG

    • Epidemiological Indices
    • Colour Doppler
      • Review Of Indices
      • Doppler Indices With Biomarkers
      • What Is Diastolic Notch?
      • Practical Problem With Using Colour Doppler And Biomarker In Combination
      • Notch Depth Index
      • Doppler Indices For Discontinuation Of Preventive Measures
      • Identifying Low-Risk Subjects In I-Trimester

    • The Future- Nanoparticles Including Exosomes
    • References

Part 4: Prevention

CHAPTER 08. PREVENTION OF PREECLAMPSIA

    • Introduction
    • What Is The Difference Between Disease And Derangement
    • Which Subjects May Benefit
    • Salt Restriction
    • Diuretics
    • Antihypertensives
    • Calcium Supplementation
    • Other Trace Elements And Micro-Nutrients
    • Aspirin For Prevention Of Preeclampsia
      • Possible Mechanism Of Action Of Aspirin
      • Aspirin: Review Of Literature
      • What Dose Aspirin 75 Mg Or 150 Mg?
      • Aspirin Timing

Part 5: Systemic Manifestations

CHAPTER 09. CENTRAL NERVOUS SYSTEM

    • Changes In The CNS
    • Pathological Lesions In Preeclampsia
      • Brain

    • Posterior Leukoencephalopathy Syndrome
    • Psychiatric Complications Following Obstetric Vasculopathies: Any Correlation?
    • References

CHAPTER 10. CARDIOVASCULAR SYSTEM

    • Changes In Cardiac Functions
    • Stroke Volume And Heart Rate
    • How Does The Heart Increase Its Cardiac Output?
    • Vascular Response To Increase Cardiac Output
    • Oscillatory Pressure And Propulsive Pressure
    • Peripheral Vascular Resistance
    • Changes In Venous System
    • References

CHAPTER 11: HEMATOLOGICAL SYSTEM

  • Introduction
  • Alteration In Coagulation Factors (Other Than Platelets) And Procoagulants
  • Alteration In Other Cellular Components Of Blood
  • Review Of Coagulation Alterations In Preeclampsia
  • Platelets In Normal And Preeclamptic Pregnancies
  • Concept Of Competence Alteration (Efficiency) Of Platelets
  • Platelet Activation And Thromboxane A2 Production
  • References

CHAPTER 12: HEPATOBILIARY SYSTEM

  • Introduction
  • Pathological Changes In The Liver
  • Liver In HELLP Syndrome
  • References

CHAPTER 13: OPHTHALMIC SYSTEM

  • Introduction
  • The Peripheral Pathogenesis Of Ophthalmic Changes In Preeclampsia
  • The Central Pathogenesis Of Ophthalmic Changes In Preeclampsia
  • Visual Alterations Of Special Mention – Recurrent And Unilateral
  • References

CHAPTER 14: RENAL SYSTEM

  • Introduction
  • Brief Outline Of Renal Changes In Pregnancy
  • Vulnerability Of Renal System
  • Special Features Of Renal Failure Complicating Preeclampsia
  • Renal Lesions
  • Are Kidney Changes In Preeclampsia – Pathognomonic?
  • Gross Changes In The Kidneys
  • On Microscopy
  • Renal Function Alterations In Preeclampsia

  • Renal Handing Of Proteins In Preeclampsia
    • Handling Of Urinary Excretion Of Proteins In Preeclampsia

  • Renin-Angiotensin System In Preeclampsia
  • References

Part 6: Clinical features of preeclampsia

CHAPTER 15: CLINICAL FEATURES

  • Introduction
  • Classification
  • Proteinuria
  • Edema
  • Grades Of Severity Of Preeclampsia

Part 7: Treatment of Preeclampsia

CHAPTER 16: TREATMENT

  • Introduction
  • Management Goals In Preeclampsia
  • Early Diagnosis And Alert Surveillance
  • Do Subjects of Preeclampsia Need Admission?
  • Management On Hospitalization
  • Antihypertensives
    • Does Mild Preeclampsia Need Antihypertensives?
    • Challenges Before Any Antihypertensive In Preeclampsia
    • Which Antihypertensive
    • Mono Therapy V/S Multidrug Therapy
    • Drugs And Their Dosage Schedules
    • When To Stop Antihypertensives

  • Induction Of Labour In Eclampsia
    • 37 Weeks
    • Induction Of Labour In Eclampsia
    • Induction Of Labour In Severe Preeclampsia
    • Induction Of Labour In Pregnancy For Fetal Reasons
    • Case Study In CPR
      • Analysis Of The Case Study

  • The Need For Involving A Neonatologist
  • Readiness Of The Maternal System For Labour Induction In PIH
  • Methods Of Induction Of Labour Methods Of Induction Of Labour
    • Trachleodynamics In Induction Of Labour
    • Prostaglandins
      • Dose

    • Foley’s Catheter In Induction Of Labour
    • Other Methods Of Labour Induction

  • Cesarean Section In PIH
  • Post Delivery Care
    • Post-Partum Hemorrhage (PPH)
    • The BP
    • Coagulation Failure
    • Renal Failure
    • Pulmonary Edema

About the Author

Dr. Pankaj Desai is one of the best known academicians and teachers in obstetrics and gynecology in India. All his twelve books have proved to be best-sellers, one of which was awarded the best book award in the subject. A prolific writer, he has contributed 43 chapters to different text books internationally and nationally. His outstanding academic contributions in the subject have been acknowledged and honored with 7 gold medals and 60 orations. An extremely popular teacher that he is, he has delivered 717 guest lectures in different parts of India and the world at the time of this book going for print. He has published 107 research papers till date, 9 of which have been awarded best research paper prizes. His website www.drpankajdesai.com has become an extremely popular portal for students and practitioners of the subject seeking references and up-to-date knowledge of the subject. It has invited nearly 200000 hits by the time of this publication. His blogs on different academic and non-academic aspects being published on the net as Dr. Pankaj Desai's blogs have also become very popular inviting more than 30,000 reads as of now. He was recently felicitated by his large number of students and was called The Best Teacher of The century!

Subject Categories

BISAC Subject Codes/Headings:
MED000000
MEDICAL / General
MED014000
MEDICAL / Clinical Medicine
MED029000
MEDICAL / Family & General Practice
MED033000
MEDICAL / Gynecology & Obstetrics
MED082000
MEDICAL / Reproductive Medicine & Technology