摘要:

ABSTRACT: During the past 20 years it has become apparent that successful pregnancy is possible in many women with chronic renal disease. The single most important prognostic factor appears to be the GFR at the time of conception. Women with normal or near normal GFR may experience a higher incidence of gestational hypertension and proteinuria than normals, but the overall fetal and maternal morbidity is similar to the general poulation. The same is true for women with SLE whose disease has been inactive for at least 6 months preceding pregnancy. Active SLE is associated with a high rate of maternal and fetal morbidity. Pregnancy among women with moderate to severe renal insufficiency is unusual and associated with a high rate of maternal complications and fetal death. Nephrosis and hypertension are common features of pregnancy in those with renal disease. In both cases, conservative management with bed rest and early delivery appear to produce the most satisfactory results. Antihypertensive medications may be necessary in a few cases, but almost all such agents are associated with undsirable side-effects to the fetus, the mother, or both. Renal allograft recipients with stable renal function and good general health often experience uncomplicated pregnancies. Immunosuppressive medications apparently do no increase the incidence of congenital malformation but may be associated with significant neonatal problems.

ISSN:0002-9629    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

ABSTRACT: To determine whether pulmonary and systemic vascular responses to arginine vasopressin (AVP) ar altered by hypoxic adaptation, AVP, and, as a control, phenylephrine were administered intravenously in graded doses to pentobarbital anesthetized rats that had been exposed to 10% O2at ambient pressure or room air for 28 days. After a 30-minute interval, d(CH2)5Tyr(Me) AVP (130 μg/kg), a specific V1receptor antagonist of AVP, was injected, and AVP (160 ng/kg) was administered again 5 minutes after injection of d(CH2)5Tyr(Me) AVP. Mean systemic arterial pressure (MSAP) and mean pulmonary artery pressure (MPAP) were monitored before and after injection of AVP and d(CH2)5Tyr(Me) AVP. AVP had a significant depressor effect (maximal response = −6.3 ± 0.5 mm Hg following adminstration of 160 ng/kg AVP) in the pulmonary vascular bed of animals with hypoxic pulmonary hypertension, but no significant effect in normoxic rats. Rats exposed to chronic hypoxia exhibited a blunted systemic pressor response to AVP compared to normoxic rats. In contrast, there were no significant differences in pulmonary and systemic pressor responses to phenylephrine between the hypoxic and normoxic groups. The effects of AVP on MSAP and MPAP were abolished by the specific AVP V1receptor antagonist, indicating that these effects are V1receptor mediated. Further study is needed to determine whether AVP is useful in the pharmacologic treatment of hypoxic pulmonary vasoconstriction.

ISSN:0002-9629    

出版商:OVID    

年代:1987

数据来源: OVID