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Obstetric Vasculopathies Pankaj Desai

CHAPTER 1:General Aspects of Obstetric Vasculopathies
- INTRODUCTION
- WHAT ARE OBSTETRIC VASCULOPATHIES
CHAPTER 2:Cardiovascular Changes in Normal Pregnancy
- INTRODUCTION
- BLOOD PRESSURE
  - Animal Studies
  - Diurnal Variations in BP
- LONGITUDINAL CHANGES IN CARDIAC FUNCTIONS
- PERIPHERAL VASCULAR RESISTANCE
- CHANGES IN VENOUS SYSTEM: ANY?
CHAPTER 3:Immunology of Obstetric Vasculopathy
- INTRODUCTION
- LEADS THROUGH RECURRENT SPONTANEOUS ABORTION (RSA)
- FETUS AS AN ALLOGRAFT
- WHAT PROTECTS THE FETUS?
- FETUS AS A UNIQUE ALLOGRAFT
- SUPPRESSOR MECHANISMS IN PROTECTION
- PARTNER SPECIFICITY IN MISCARRIAGES
- AUTOIMMUNITY IN RECURRENT PREGNANCY LOSS
  - Antiphospholipid Antibodies
- EMBRYO DECIDUA CROSSTALK IN IMMUNOLOGY OF OBSTETRICS VASCULOPATHY
- IMPLANTATION NOT A RIGHT OF EMBRYO
- RESULTS OF THE CROSSTALK
- OTHER CONTRIBUTORY MECHANISMS
- WHAT IS SPONTANEOUS RESOLUTION?
- THE MIRACLE OF PARADOX
  - Leads to Transplant Scientists
  - Concept of Artificial Syncitiotrophoblasts and Organ Transplants
CHAPTER 4:Endothelial Cell Dysfunction and Obstetric Vasculopathy
- INTRODUCTION
- THE PHENOMENON OF ENDOTHELIAL CELL ACTIVATION
- ENDOTHELIAL ACTIVATION AND PROSTAGLANDINS
- PLASMINOGEN AND ALLIED PROCOAGULANT ACTIVITY—A MANIFESTATION OF ENDOTHELIAL CELL ACTIVATION
- ANTIPHOSPHOLIPID ANTIBODIES ACT THROUGH PROCOAGULANT MECHANISM
- ENDOTHELIAL CELL ADHESION MOLECULE DISTURBANCES
- COMPONENTS OF FIBRONECTIN
- VASCULAR ENDOTHELIAL GROWTH FACTOR (VEGF)
  - Clinical Bearing
- ENDOTHELIN
- OTHER MOLECULES CONTRIBUTING TO ENDOTHELIAL CELL ACTIVATION
CHAPTER 5:Oxidative Stress and Obstetric Vasculopathies
- INTRODUCTION
- WHAT IS OXIDATIVE STRESS?
- OUR BASIC STUDY1
- WHAT IS A FREE RADICAL?
- OXIDATIVE STRESS AND HEALTH
- THE MISCHIEF OF FREE RADICALS IN VASCULAR WALLS
- LIPID PEROXIDES: THE AGENTS OF OXIDATIVE STRESS
- LIPID METABOLISM IN NORMAL PREGNANCY AND ITS BEARINGS IN ABNORMAL PREGNANCY
  - Hypertriglyceridemia and Obstetric Vasculopathies
  - Small Dense LDL Phenotype in Obstetric Vasculopathy
- PLACENTAL LIPID PEROXIDATION
  - Transition Metals in Lipid Peroxidation
- CLINICAL MANIFESTATIONS
- REPERFUSION
- INNATE MATERNAL REDUCING SYSTEMS
- THE FAMILY OF FREE RADICALS
- VASCULAR ENDOTHELIUM AND OXIDATIVE STRESS
- INEFFICIENT SECOND WAVE OF TROPHOBLASTIC INVASION
  - Generation of VEGF
- NITRIC OXIDE IN OBSTETRIC VASCULOPATHY
  - Problems with Assessment of NO
  - Nitric Oxide and Endothelial Cells
- PLACENTAL ATHEROSIS IN OBSTETRIC VASCULOPATHY
- EXTRACELLULAR REDUCING SYSTEMS
  - Uric Acid: One of the Most Power House Reductant
    - Riots—Policemen Model to Understand Uric Acid
  - Limitations of Reducing Systems
  - Inconsistency of Reducing Systems
  - The Ideal Reducing System
- EXERCISE AND PREVENTION OF OBSTETRIC VASCULOPATHIES
- TREATMENT BEARINGS
  - The Beauty of Lysophosphotidyl Choline
CHAPTER 6:The Placenta, Trophoblasts and Obstetric Vasculopathies
- BASIC PROCESS OF NORMAL PLACENTA AND PLACENTATION
  - Role of Oxygen Tension in Trophoblastic Invasion
- OXYGENATION AND TROPHOBLASTIC DIFFERENTIATION
- FAULTS IN FETOMATERNAL LINKAGE AT PLACENTA AND OBSTETRIC VASCULOPATHY
- MATERNAL ENVIRONMENT PREVENTING TROPHOBLASTIC INVASION
CHAPTER 7:The Genetics of Obstetrics Vasculopathies
- BASIS FOR REVIEWING THE ROLE OF GENETICS IN OBSTETRIC VASCULOPATHIES
- CHALLENGES TO THE GENETIC STUDIES IN OBSTETRIC VASCULOPATHIES
- MAMMALIAN STUDIES
- APPLICATION OF GENETIC MODELS
- EXAMINING ASSOCIATIONS
- FETAL CONTRIBUTIONS: ANY?
- REVERSE ASSOCIATIONS
- IMMUNOLOGY AND GENETICS
- INPUTS FROM ANIMAL MODELS
- EPIGENETIC FEATURES IN PREECLAMPSIA
  - Renal System
CHAPTER 8:Obstetric Vasculopathies and their Effects on Heart
- INTRODUCTION
- HEMODYNAMICS IN NORMAL PREGNANCY AND DURING OBSTETRIC VASCULOPATHIES
- EFFECT OF PREECLAMPSIA ON THE OFFSPRING—ANY?
CHAPTER 9:Obstetric Vasculopathies and their Effects on the Renal System
- VULNERABILITY OF RENAL SYSTEM
- SPECIAL FEATURES OF RENAL FAILURE IN OBSTETRIC VASCULOPATHIES
- KIDNEY LESIONS
- RENAL FUNCTION ALTERATIONS IN PREECLAMPSIA
  - Renal Handling of Proteins in Preeclampsia
    - Handling of Urinary Excretion of Proteins in Preeclampsia
  - Renin-Angiotensin System in Preeclampsia
CHAPTER 10:Obstetric Vasculopathies and their Effects on the Central Nervous System
- THE PRIVILEGED STATUS OF CENTRAL NERVOUS SYSTEM (CNS)
- PATHOLOGICAL LESIONS IN PREECLAMPSIA
  - Brain
- PSYCHIATRIC COMPLICATIONS FOLLOWING OBSTETRIC VASCULOPATHIES: ANY CORRELATION?
CHAPTER 11:Obstetric Vasculopathies and their Effects on Hematological System
- INTRODUCTION
- ALTERATION IN COAGULATION FACTORS (OTHER THAN PLATELETS) AND PROCOAGULANTS
- ALTERATION IN OTHER CELLULAR COMPONENTS OF BLOOD
- REVIEW OF COAGULATION ALTERATIONS IN OBSTETRIC VASCULOPATHIES
  - Platelets in Normal and Preeclamptic Pregnancies
    - Concept of Competence Alteration (Efficiency) of Platelets
    - Platelet Activation and Thromboxane A2 Production
CHAPTER 12:Obstetric Vasculopathies and their Effects on the Liver
- INTRODUCTION
- PATHOLOGICAL CHANGES IN THE LIVER
- LIVER IN HEMOLYSIS ELEVATED LIVER ENZYMES LOW PLATELETS (HELLP) SYNDROME
CHAPTER 13:Ophthalmic Features in Obstetric Vasculopathy
- INTRODUCTION
- RETINAL EDEMA
- CENTRAL AND PERIPHERAL CAUSE OF VISUAL ALTERATIONS
  - Visual Alterations of Special Mention—Recurrent and Unilateral
CHAPTER 14:Vascular Responses in Obstetric Vasculopathy
- BLUNTED VASCULAR RESPONSE
- PLACENTAL ISCHEMIA
- ANIMAL EXPERIMENTS
- HARD FACTS EMERGING FROM ANIMAL EXPERIMENTS
CHAPTER 15:Clinical Profile of Obstetric Vasculopathies
- INTRODUCTION
- HYPERTENSION
  - What BP is Hypertension?
  - Concept of Competence of Reducing Systems
- PROTEINURIA
- EDEMA
- OTHER LABORATORY PARAMETERS
  - Plasma Urea
CHAPTER 16:Differential Diagnosis of Obstetric Vasculopathies
- INTRODUCTION
- PREECLAMPSIA AND CHRONIC HYPERTENSION
  - Is it Terribly Important to Differentiate the Two?
- TRANSIENT HYPERTENSION
- RENAL DISEASES
- HEPATO-HEMATOLOGICAL INVOLVEMENTS
CHAPTER 17:Predicting Obstetric Vasculopathies
- INTRODUCTION
- OVERVIEW OF AVAILABLE PREDICTING MEASURES
- APPLICATION OF PREDICTING SYSTEMS FOR OTHER USES
- THE AMORPHOUS CHARACTERIZATIONS OF PATHOGENESIS AND CLINICAL FEATURES
- OVERVIEW OF THE TYPES OF TESTS
- NEGATIVE TO POSITIVE PREDICTIVE VALUE
- CONDITIONS BASED TESTS
- AN IDEAL TEST
- CLINICAL TESTS
- URINARY TESTS
- HEMATOLOGICAL CELLULAR AND NON-CELLULAR INDICES
- EPIDEMIOLOGICAL INDICES
- COLOR DOPPLER IN OBSTETRIC VASCULOPATHIES: THE GAME CHANGER
  - The Diastolic Notch
    - What is the Diastolic Notch?
  - Review of Indices
CHAPTER 18:Prevention of Preeclampsia and other Obstetric Vasculopathies
- INTRODUCTION
- WHAT IS THE DIFFERENCE BETWEEN DISEASE AND DERANGEMENT?
- PREVENTING OBSTETRIC VASCULOPATHY IS A CHALLENGE
- WHICH SUBJECTS MAY BENEFIT OUT OF PREVENTIVE MEASURES
  - Nullipara
  - Abnormal Uterine Artery Doppler
    - Inconsistent Presence of Diastolic Notch: Any Significance?
    - Subjects with Obstetric Challenges
- MEASURES PREVENT OCCURRENCE OR PREVENT WORSENING
- PREVENTIVE MEASURES OF OBSTETRIC VASCULOPATHIES
- PREVENTION OF ECLAMPSIA
CHAPTER 19:Color Doppler in Obstetric Vasculopathies
- INTRODUCTION
- COLOR DOPPLER IN EARLY PREGNANCY
  - What is Diastolic Notch?
- THIRD TRIMESTER COLOR DOPPLER IN OBSTETRIC VASCULOPATHIES
- COLOR DOPPLER FOR DISCONTINUATION OF ANTITHROMBOTIC AGENTS
  - Cardiac Doppler in Obstetric Vasculopathies
- FETAL AORTIC DOPPLER STUDIES
CHAPTER 20:Cardiotocography in Obstetric Vasculopathies
- INTRODUCTION
- PHYSIOLOGY AND CARDIOTOCOGRAPHY
- HYPOXIA AND FETAL HEART RATE
- CARDIOTOCOGRAPHIES IN SUBJECTS WITH APA SYNDROME
- COLOR DOPPLER AND CARDIOTOCOGRAPHY CORRELATION
  - The Two together in Preeclampsia
  - The Two together in IUGR
CHAPTER 21:Treatment of Obstetric Vasculopathy: Recurrent Miscarriages
- INTRODUCTION
- CORTICOSTEROIDS: NOT USED ANY MORE
- FOLIC ACID
- LOW DOSE ASPIRIN
  - FAQs on Aspirin
- HEPARIN
- PROGESTERONE IS TREATMENT OF IMMUNOLOGICAL MISCARRIAGES
  - Difficulties in Interpreting Scientific Data
- TREATMENT OF A SUBJECT OF MISCARRIAGE ALWAYS FOR PREVENTION
CHAPTER 22:Treatment of Obstetric Vasculopathy—Preeclampsia
- INTRODUCTION
- LIMITATIONS OF BLOOD PRESSURES AS AN INDICATOR OF SEVERITY
- EARLY DIAGNOSIS AND ALERT SURVEILLANCE
- DO SUBJECTS OF PREECLAMPSIA NEED ADMISSION
- MANAGEMENT ON HOSPITALIZATION
- ANTIHYPERTENSIVES
- INDUCTION OF LABOR IN PREGNANCY INDUCED HYPERTENSION (PIH)
  - When to Induce Labor in Pregnancy Induced Hypertension (PIH)
  - The Need for Involving a Neonatologist
- METHODS OF INDUCTION OF LABOR
- CESAREAN SECTION IN PREGNANCY INDUCED HYPERTENSION (PIH)
- POST DELIVERY CARE
CHAPTER 23:Treatment of Obstetric Vasculopathy: Accidental Hemorrhage
- INTRODUCTION
- THE ETIOPATHOLOGY OF ACCIDENTAL HEMORRHAGE
- THE CLINICAL EFFECTS OF ACCIDENTAL HEMORRHAGE
- CARDIOTOCOGRAPHY CHANGES IN ACCIDENTAL HEMORRHAGE
- ULTRASONOGRAPHY IN ACCIDENTAL HEMORRHAGE
- OBSTETRIC MANAGEMENT OF ACCIDENTAL HEMORRHAGE
  - Why Labor in Accidental Hemorrhage does not Follow the Partogram
- CESAREAN SECTION IN ACCIDENTAL HEMORRHAGE
- MEDICAL MANAGEMENT

INDEX

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Chapter Notes