Prevalence of hypertensive disorders in women after preeclamptic pregnancy associated with decidual vasculopathy.

OBJECTIVE: A subgroup of preeclamptic women has spiral artery lesions termed decidual vasculopathy (DV) which relate to worse clinical outcome. We aimed to determine whether a history of preeclampsia (PE) with DV is associated with adverse overall and future pregnancy outcome, including increased recurrence risk of hypertensive diseases of pregnancy. METHODS: Via posted survey women with PE and DV (DV positive) in the index pregnancy were compared to those without the lesions (DV negative) on overall and future pregnancy outcome. RESULTS: DV positive cases showed a higher incidence of chronic hypertension both preconceptionally and at time of survey, adjusted odds ratio 4.8 (2.0-11.9). The DV positive group had a higher overall incidence of pregnancies with gestational hypertension (22% vs 13%, p = 0.04), preterm birth (59% vs 45%, p = 0.02) and a lower birth weight centile (30 vs 39, p = 0.02). There was no difference in outcome of future pregnancies, irrespective of the use of prophylactic aspirin. CONCLUSION: Women with DV-associated PE have a higher overall incidence of adverse obstetric outcome and of chronic hypertension, indicating an underlying vascular pathology, putting them at risk for pregnancy and cardiovascular complications. These women constitute a target group for counseling, monitoring and possibly lifestyle or pharmacological interventions.

Myoelectric activity during voluntary elbow movements in above-elbow amputees.

This study is concerned with the analysis of myoelectric activity in the biceps and triceps muscles of unilateral above-elbow (AE) amputees during voluntary fast elbow movements. The signal patterns obtained from each subject's remnant limb were analysed and compared with similar acquired muscle patterns from the sound arm. Our findings, in agreement with suggestions from the literature, show that a significant portion of the so-called triphasic muscle patterns still occur in the remnant limbs of amputees, and therefore, are generated without the use of proprioceptive and sensory feedback. Although the patterns show some unexplained inconsistencies in timing and duration, the results indicate that for traumatic amputees the loss of an arm does not mean that remnant muscle contractions lose their relation to previous movements. In addition, congenital amputees did not show phasic patterns during voluntary fast elbow movements.