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Gerda G Zeeman

Publications and source records attributed to Gerda G Zeeman.

4 recordsLinked to original sources
PubMed2003

Inhibin-A and superimposed preeclampsia in women with chronic hypertension.

OBJECTIVE: To determine if maternal serum inhibin-A can be used as a marker for subsequent development of superimposed preeclampsia in women with chronic hypertension. METHODS: Serum for measurement of inhibin-A was obtained at monthly intervals in women with chronic hypertension requiring antihypertensive medications. Superimposed preeclampsia, the primary outcome of interest, was diagnosed when hypertensive women developed proteinuria (at least 300 mg per 24-hour urine specimen). Serum inhibin-A was considered abnormally elevated when the value exceeded the mean plus two standard deviations of the log for chronically hypertensive women who did not develop preeclampsia. RESULTS: A total of 61 women were enrolled in this study, and 21 (34%) developed superimposed preeclampsia. Inhibin-A levels increased with advancing gestational age. Ten women had abnormally increased inhibin-A levels; eight (80%) developed superimposed preeclampsia, compared with 13 of 51 (26%) women with normal inhibin-A levels (P <.001). Sensitivity and specificity were 38% and 95%, respectively, whereas the positive and negative predictive values were 80% and 75%, respectively. CONCLUSION: Although inhibin-A was abnormally increased an average of 3 weeks before the clinical onset of superimposed preeclampsia, the sensitivity of the test as a screen was too limited to be clinically useful.

Adult↗
PubMed2003

A blueprint for obstetric critical care.

OBJECTIVE: The purpose of this study was to describe our 2-year experience with 483 critically ill peripartum women and to propose a blueprint for obstetric critical care. STUDY DESIGN: This was a prospective study to evaluate all admissions to the Obstetric Intermediate Care Unit and obstetric admissions to medical/surgical intensive care units. Our findings are followed by general recommendations for the organization of obstetric critical care. RESULTS: Almost two thirds of the women had obstetric complications that included pregnancy-associated hypertension and obstetric hemorrhage. Medical disorders were most common in the other one third of the women. CONCLUSION: An Obstetric Intermediate Care Unit allows for the continuation of care by obstetricians and results in fewer transfers to medical/surgical intensive care units. Patient treatment depends on hospital size and available resources. In most tertiary centers, the critically ill pregnant woman is best cared for by obstetricians in an Obstetric Intermediate Care Unit. In smaller hospitals, transfer to a medical or surgical intensive care unit may be preferable.

Critical Care↗
PubMed2002

Inhibin-A levels and severity of hypertensive disorders due to pregnancy.

OBJECTIVE: To evaluate the use of 3rd trimester inhibin-A levels as an adjunct to assess severity of hypertensive disorders due to pregnancy in women evaluated for preeclampsia. METHODS: Serum inhibin-A concentration was measured in a consecutive series of women evaluated for preeclampsia in the third trimester of pregnancy. RESULTS: Inhibin-A levels were significantly associated with the severity of proteinuric hypertensive disease due to pregnancy. Women with gestational hypertension or those with chronic hypertension without superimposed preeclampsia had levels comparable with normotensive women. The sensitivity to detect proteinuric hypertension was 16%. CONCLUSION: Although inhibin-A levels rise with increasing severity of disease, due to considerable overlap of normal and abnormal serum levels in women with and without preeclampsia, inhibin-A is not a useful adjunct for the classification of hypertensive disorders due to pregnancy.

Adult↗