Improving Blood Pressure Control and Pregnancy Outcomes: The Impact of Evidence-Based Care and Aerobic Exercise in Patients with Hypertensive Disorders During Pregnancy.

Objective: To explore the effect of evidence-based care plus aerobic exercise on blood pressure control and pregnancy outcome in patients with hypertensive disorders during pregnancy. Methods: A total of 100 patients diagnosed with hypertensive disorder in pregnancy treated in our hospital between February 2020 and November 2021 were recruited, analyzed and assigned at a ratio of 1:1 to receive routine nursing (control group) or evidence-based care plus aerobic exercise (experimental group) via random number table method. Outcome measures included blood pressure, negative emotions, sleep duration, and pregnancy outcome. Results: The blood pressure of both groups decreased after nursing, and the diastolic and systolic blood pressure of patients in the experimental group (79.84±5.18 mmHg, 111.62±7.96 mmHg) were lower than those in the control group (88.65±5.69 mmHg, 132.15±8.14 mmHg) (P < .05). After the completion of the nursing period, assessments using the Self-Rating Anxiety Scale and Hamilton Depression Scale were conducted. The results revealed significantly lower scores in the experimental group, which received evidence-based care along with aerobic exercise, compared to the control patients who received routine care. The sleep duration was prolonged in both groups after nursing, and patients in the experimental group got longer sleep duration than those in the control group (P < .05). The experimental group showed a significantly lower incidence of adverse pregnancy outcomes than the control group (P < .05). Limitations: While our study demonstrates the positive impact of evidence-based care combined with moderate aerobic exercise on patients with hypertensive disorders during pregnancy, it is essential to acknowledge some notable limitations. First, the sample size was relatively small, which may limit the generalizability of our findings to a larger population. Furthermore, our study primarily focused on short-term outcomes, and future research could explore the sustained benefits of this approach. Finally, individual variations in exercise tolerance and compliance may also affect the effectiveness of the intervention. Despite these limitations, our findings hold promise and provide a foundation for further research in this area. Conclusion: Evidence-based care combined with moderate aerobic exercise has proven to be an effective approach in enhancing the overall management of patients with hypertensive disorders during pregnancy. This combined intervention not only effectively regulates blood pressure levels but also mitigates adverse emotional states, enhances sleep quality, and ultimately leads to improved pregnancy outcomes. These findings hold significant promise for clinical application. Healthcare providers may consider implementing this approach to improve the well-being of pregnant individuals with hypertensive disorders, potentially reducing the risk of complications and enhancing the overall quality of care. Pregnant individuals, on the other hand, can benefit from a more comprehensive and holistic approach to their care, which may result in better health and pregnancy outcomes. Future research in this area could explore the long-term sustainability and cost-effectiveness of this intervention, as well as its potential applicability to diverse patient populations and healthcare settings.

Efficacy of Quality Care on Maternal and Infant Outcomes in Patients with Hypertensive Disorders Complicating Pregnancy Complicated with Cerebral Hemorrhage.

Objective: This study aimed to evaluate the impact of quality care on maternal and infant outcomes in patients with hypertensive disorders complicating pregnancy (HDCP) complicated by cerebral hemorrhage. Methods: From February 2020 to September 2021, 68 women with HDCP complicated by cerebral hemorrhage hospitalized at our hospital were included and divided into a routine group (standard care) and a quality group (quality care). Outcome measures included National Institutes of Health Stroke Scale (NIHSS) scores, blood pressure, self-rating anxiety scale (SAS) scores, self-rating depression scale (SDS) scores, and maternal and infant outcomes. Results: Patients in the quality group (3.22±1.89) had significantly lower NIHSS scores aftercare than those in the routine group (6.15±3.24) (P < .05). Quality care resulted in lower diastolic blood pressure (Quality group:81.23±6.15; Routine: 90.58±7.98), systolic blood pressure (Quality group:125.49±13.37; Routine: 139.74±16.67), SAS scores (Quality group: 48.42±2.65; Routine: 58.15±2.43), and SDS scores versus routine care (Quality group:48.42±2.65; Routine: 58.15±2.43)(P < .05). The quality group showed a lower incidence of adverse maternal and infant pregnancy outcomes than the routine group (P < .05). Conclusion: The findings underscore the positive impact of quality care in reducing adverse maternal and newborn pregnancy outcomes. This reduction is particularly significant for clinical practice, as it is achieved through the amelioration of various factors, such as neurological impairments, blood pressure regulation, and the alleviation of negative emotions, including anxiety and depression, in patients with HDCP complicated by cerebral hemorrhage. The practical implications of these findings for healthcare providers and patients are substantial. They highlight the potential to improve patient outcomes, enhance the overall quality of care, and reduce the burden on healthcare systems. By addressing these factors, healthcare providers can enhance the well-being of both mothers and newborns, leading to improved clinical outcomes and increased patient satisfaction.

Cardiac Remodeling During Pregnancy With Metabolic Syndrome: Prologue of Pathological Remodeling.

BACKGROUND: The heart undergoes physiological hypertrophy during pregnancy in healthy individuals. Metabolic syndrome (MetS) is now prevalent in women of child-bearing age and might add risks of adverse cardiovascular events during pregnancy. The present study asks if cardiac remodeling during pregnancy in obese individuals with MetS is abnormal and whether this predisposes them to a higher risk for cardiovascular disorders. METHODS: The idea that MetS induces pathological cardiac remodeling during pregnancy was studied in a long-term (15 weeks) Western diet-feeding animal model that recapitulated features of human MetS. Pregnant female mice with Western diet (45% kcal fat)-induced MetS were compared with pregnant and nonpregnant females fed a control diet (10% kcal fat). RESULTS: Pregnant mice fed a Western diet had increased heart mass and exhibited key features of pathological hypertrophy, including fibrosis and upregulation of fetal genes associated with pathological hypertrophy. Hearts from pregnant animals with WD-induced MetS had a distinct gene expression profile that could underlie their pathological remodeling. Concurrently, pregnant female mice with MetS showed more severe cardiac hypertrophy and exacerbated cardiac dysfunction when challenged with angiotensin II/phenylephrine infusion after delivery. CONCLUSIONS: These results suggest that preexisting MetS could disrupt physiological hypertrophy during pregnancy to produce pathological cardiac remodeling that could predispose the heart to chronic disorders.

Ultrasound of Fetal Cardiac Function Changes in Pregnancy-Induced Hypertension Syndrome.

Pregnancy-induced hypertension syndrome (PIH) is a common pregnancy syndrome that could cause varying degrees of maternal and fetal organic damage and even endanger their lives. This study aimed to investigate ultrasound of fetal cardiac function changes in PIH. Totally 40 cases of gestational hypertension admitted to Cangzhou Central Hospital between October 2018 and September 2019 were enrolled in the hypertension group, and 40 women with healthy pregnancies during the same period were assigned to the normal group. Ultrasound results showed that PIH was associated with a significantly higher fetal cardiac septal thickness, fetal left ventricular end-diastolic area and end-systolic area, fetal right ventricular end-diastolic area and end-systolic area, fetal left ventricular systolic fraction 1 (VSF1), fetal left ventricular systolic fraction 2 (VSF2), fetal right VSF1, and fetal right VSF2 versus healthy pregnancy. The PIH fetuses had significantly lower neonatal weights versus healthy fetuses. Newborns of hypertensive pregnancies have larger hearts, faster heart rates, increased cardiac contractility, and lower weights versus newborns of healthy pregnancies.

Ultrasound Multiparametric Assessment of the Impact of Hypertensive Disorders of Pregnancy on Fetal Cardiac Function and Growth and Development.

Objective: To evaluate the ultrasound multiparametric assessment of the impact of hypertensive disorders of pregnancy (HDP) on fetal cardiac function and growth and development. Methods: In this prospective study, 98 cases of HDP treated in our institution were recruited into a study group, and 100 pregnant women with healthy singleton pregnancies were included in a control group. All eligible patients were also assigned to either study group A (HDP fetuses with growth restriction) or study group B (HDP fetuses with normal growth). Fetal echocardiography was performed on all eligible participants to obtain hemodynamic and cardiac function parameters for the evaluation of fetal growth and development, and the impact of HDP on fetal heart function and growth and development was analyzed. Results: HDP fetuses were associated with smaller head circumference, biparietal diameter, femoral length, and abdominal circumference versus healthy fetuses. The study group had a higher resistance index (RI) and pulsatility index (PI) of umbilical artery (UA), ductus venous (DV), pulmonary vein (PV), and lower RI and PI of aortic isthmus (AoI) than the control group. The study group showed higher left and right ventricular isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT), and myocardial performance index (MPI) values and lower mitral and tricuspid E wave and E/A values than the control group. The systolic blood pressure was positively correlated with PI, RI of UA, DV, and PV, and left and right ventricular IVCT, IVRT, and MPI and negatively correlated with PI and RI of AoI and mitral and tricuspid E wave and E/A values of HDP fetuses. The peak systolic/diastolic flow rate (S/D), PI, and RI of umbilical blood flow in study group A were higher than those in study group B. Umbilical blood flow S/D showed the highest AUC and specificity for predicting fetal growth restriction, and PI had the highest sensitivity for predicting fetal growth restriction. Conclusion: HDP compromises fetal cardiac function and growth, and ultrasound multiparametric assessment provides accurate detection of fetal cardiac function and hemodynamics changes. The patient's condition can be monitored through the assessment of ultrasound parameters of fetal growth and development.

Diagnostic Value of Echocardiography Combined with Serum h-FABP and cTnI in Myocardial Infarction and Its Evaluation Value in Left Ventricular Function.

Objective: To explore the value of color Doppler echocardiography (CDE) combined with serum heart-type fatty acid-binding protein (h-FABP) and cardiac troponin I (cTnI) in the diagnosis of myocardial infarction and its evaluation value in left ventricular function. Methods: A total of 44 patients with myocardial infarction who were treated in Cangzhou Central Hospital from October 2018 to February 2020 were included in the observation group, and 45 healthy subjects were included in the control group. The serum h-FABP and cTnI levels of the two groups were compared and analyzed. The coincidence rate of echocardiography plus serum h-FABP and cTnI for single diagnosis and combined diagnosis was analyzed. The left ventricular function indexes of patients with myocardial infarction in different cardiac function grades were compared, including left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), stroke volume (SV), cardiac index (CI), and the ratio of peak velocity blood flow from left ventricular relaxation in early diastole to peak velocity flow in late diastole (E/A). The value of echocardiography combined with serum h-FABP and cTnI in the left ventricular function in patients with myocardial infarction was analyzed. Results: The levels of serum h-FABP and cTnI in the observation group were significantly higher than those in the control group (P < 0.05). CDE plus serum h-FABP and cTnI was associated with significantly higher sensitivity, specificity, and accuracy in diagnosing myocardial infarction versus single detection (P < 0.05). The LVEDV, SV, and CI parameters were similar in patients with different cardiac function grades (P > 0.05). Compared with cardiac function grades I and II, the level of LVEF in patients with myocardial infarction in grades III and IV of cardiac function decreased, while the levels of LVEDD, LVESD, LVESV, and E/A increased (P < 0.05). The levels of serum h-FABP and cTnI in patients with myocardial infarction increased with the increase of cardiac function grades (P < 0.05). Conclusion: Patients with myocardial infarction show high levels of h-FABP and cTnI, and CDE plus the detection of serum h-FABP and cTnI levels can significantly improve the detection accuracy and effectively evaluate the left ventricular function of patients with myocardial infarction, with a certain predictive value for cardiac function grading in myocardial infarction.