Chesley's Hypertensive Disorders in Pregnancy,

Edition 4

Editors: Edited by Robert N. Taylor, James M. Roberts, Gary F. Cunningham and Marshall D. Lindheimer, MD, FACP

Publication Date: 02 Sep 2014

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Chesley’s Hypertensive Disorders in Pregnancy continues its tradition as one of the beacons to guide the field of preeclampsia research, recognized for its uniqueness and utility. Hypertensive disorders remain one the major causes of maternal and fetal morbidity and death. It is also a leading cause of preterm birth now known to be a risk factor in remote cardiovascular disease. Despite this the hypertensive disorders remain marginally studied and management is often controversial.The fourth edition of Chesley’s Hypertensive Disorders in Pregnancy focuses on prediction, prevention, and management for clinicians, and is an essential reference text for clinical and basic investigators alike. Differing from other texts devoted to preeclampsia, it covers the whole gamut of high blood pressure, and not just preeclampsia.

Key Features

Features new chapters focusing on recent discoveries in areas such as fetal programming, genomics/proteomics, and angiogenesis
Includes extensive updates to chapters on epidemiology, etiological considerations, pathophysiology, prediction, prevention, and management
Discusses the emerging roles of metabolic syndrome and obesity and the increasing incidence of preeclampsia
Each section overseen by one of the editors; each chapter co-authored by one of the editors, ensuring coherence throughout book

About the author

Edited by Robert N. Taylor, Professor of Obstetrics and Gynecology and Assistant Dean for Student and Academic Affairs, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA; James M. Roberts, Senior Scientist, Magee Women’s Research Institute, Professor, Obstetrics, Gynecology, Reproductive Sciences, Epidemiology, and Clinical and Translational ResearchUniversity of Pittsburgh, Pittsburgh, PA, USA; Gary F. Cunningham, Professor and Beatrice and Miguel Elias Distinguished Chair in Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, USA and Marshall D. Lindheimer, MD, FACP, Professor Emeritus, Department of Obstetrics and Gynecology and Medicine, and the Committee on Clinical Pharmacology, The University of Chicago, IL, USA

List of Contributors
Preface
- Preface to the Second Edition
- Comments Added to the Preface by Editors in 2008
- Preface to the Fourth Edition
Chapter 1. Introduction, History, Controversies, and Definitions
- History (Fig. 1.1)
- Signs
- Hypotheses and Rational Management
- Prophylaxis
- Classification of the Hypertensive Disorders in Pregnancy
- Editors’ Update
- Denouement
- References
Chapter 2. The Clinical Spectrum of Preeclampsia
- Introduction
- Clinical Manifestations of Preeclampsia Syndrome
- Differential Diagnosis
- References
Chapter 3. Epidemiology of Pregnancy-Related Hypertension
- Introduction
- Definitions of the Hypertensive Disorders of Pregnancy
- Prevalence of Hypertensive Disorders of Pregnancy
- Risk Factors for Preeclampsia
- First Birth and Other Placental Factors
- Clinical Predictors
- Natural History
- Impact on Children
- Critique of Studies
- Conclusion
- Acknowledgment
- References
Chapter 4. Genetic Factors in the Etiology of Preeclampsia/Eclampsia
- Dedication
- Introduction
- Biological Pathways of Preeclampsia
- Types of Genetic Studies Conducted
- A Genomics Approach to Preeclampsia
- Essential Variables to Consider
- High-Dimensional Biology
- A Predictive Genetic Test
- Pharmacogenomics
- The Future of Preeclampsia Genetic Research
- Conclusions
- References
Chapter 5. The Placenta in Normal Pregnancy and Preeclampsia
- Introduction
- The Microanatomy of Normal Human Placentation
- The Microanatomy of Abnormal Human Placentation in Preeclampsia
- The Road to Preeclampsia
- Oxygen Tension Regulates Human Cytotrophoblast Proliferation and Differentiation In Vitro
- During Normal Pregnancy, Invasive Cytotrophoblasts Modulate their Adhesion Molecule Repertoire to Mimic That of Vascular Cells
- In Preeclampsia, Invasive Cytotrophoblasts Fail to Switch their Adhesion Molecule Repertoire to Mimic That of Vascular Cells
- The Pathological Consequences of Abnormal Cytotrophoblast Invasion and Failed Spiral Artery Remodeling
- Novel Unbiased Approaches for Addressing the Complexities of the Preeclampsia Syndrome
- Summary and Future Directions
- Appendix Trophoblast Gene Expression in Normal Pregnancy and Preeclampsia
- References
Chapter 6. Angiogenesis and Preeclampsia
- Introduction
- Placental Vascular Development in Health
- Angiogenic Imbalance in Preeclampsia
- Perspectives
- References
Chapter 7. Metabolic Syndrome and Preeclampsia
- Introduction
- Metabolic Syndrome
- Metabolic Syndrome and Cardiovascular Disease
- Pregnancy-Induced Metabolic Changes
- Preeclampsia and Metabolic Syndrome
- Metabolic Syndrome: A Cause of Placental Dysfunction?
- Summary and Perspectives
- References
Chapter 8. Immunology of Normal Pregnancy and Preeclampsia
- Introduction
- Maternal Adaptation to a Foreign Fetus
- Innate and Adaptive Immunity
- Nature’s Transplant
- Classical Two-Stage Model of Preeclampsia
- Stage 1 Preeclampsia, Interface 1 and Maternal Immune Responses to Trophoblast
- Stage 2 Preeclampsia and Interface 2
- Endothelial Cells are Inflammatory Cells
- Inflammation and the Integrated Stress Response
- Widespread Implications of Vascular Inflammation
- Cytokines, Chemokines, Growth Factors, Adipokines and Angiogenic Factors
- Metabolism and Vascular Inflammation
- Acute-Phase Response
- Vascular Inflammation in Normal Pregnancy and Preeclampsia
- The Continuum between Normal Pregnancy and Preeclampsia
- Immunoregulation
- T Regulatory Cells, Th17 and T-Cell Memory
- Angiotensin II (Ang II), the Immune System and Preeclampsia
- Systemic Immunoregulation in Normal Pregnancy and Preeclampsia
- Acute Atherosis: A Second Inflammatory Lesion of Preeclampsia
- The Role of the Placenta and Non-Placental Factors
- Trophoblast Extracellular Vesicles
- Maternal Predisposing Factors
- Conclusions
- References
Chapter 9. Endothelial Cell Dysfunction
- Introduction
- Part I: Endothelial Cell Function and Preeclampsia
- Part II: Circulating Factors Induce Endothelial Cell Dysfunction
- Part III: Oxidative Stress: A Point of Convergence for Endothelial Cell Dysfunction
- Part IV: Clinical Trials
- Part V: Speculations and Directions of Future Investigations
- References
Chapter 10. Animal Models for Investigating Pathophysiological Mechanisms of Preeclampsia
- Introduction
- Models Used to Investigate Links between Placental Ischemia and Endothelial and Cardiovascular Dysfunction
- Animal Models Used to Study Role of Angiogenic Factors (See also Chapter 6)
- Models Used to Investigate the Role of Immune Mechanisms in Preeclampsia
- Genetic Models
- Summary
- References
Chapter 11. Tests to Predict Preeclampsia
- Introduction
- Assessing the Quality of Tests to Predict Disease
- Placental Perfusion and Vascular Resistance Dysfunction-Related Tests
- Fetal and Placental Unit Endocrinology Dysfunction-Related Tests
- Renal Dysfunction-Related Tests
- Endothelial Dysfunction and Oxidant Stress-Related Tests
- Other Tests
- The Use of Combined Tests
- Multivariable Prediction Models Derived from Combinations of Maternal Characteristics and Tests
- Perspectives and Conclusions
- Acknowledgement
- References
Chapter 12. Prevention of Preeclampsia and Eclampsia
- Introduction
- Dietary Manipulations
- Physical Activity
- Diuretics and Antihypertensive Drugs
- Antioxidant Vitamins
- Antithrombotic Agents
- Prevention of Eclampsia
- Treatment for Eclampsia (See Chapter 20)
- References
Chapter 13. Cerebrovascular Pathophysiology in Preeclampsia and Eclampsia
- Introduction
- Neuroanatomical Findings with Eclampsia
- Neuroimaging in Eclampsia
- Pathogenesis of Cerebral Manifestations in (PRE)Eclampsia
- Eclampsia as Posterior Reversible Encephalopathy Syndrome (PRES)
- Cerebral Blood Flow Autoregulation
- Cerebral Blood Flow Autoregulation and Hemodynamics in Pregnancy
- Mechanisms of Seizure During Pregnancy and Preeclampsia
- Role of Circulating Factors in Eclampsia
- Remote Cerebrovascular Health Following Preeclampsia and Eclampsia
- References
Chapter 14. Cardiovascular Alterations in Normal and Preeclamptic Pregnancy
- Introduction
- Hemodynamics and Cardiac Function in Normal Pregnancy
- Hemodynamics and Cardiac Function in Preeclampsia
- Factors that May Explain Vascular Changes in pregnancy
- Pregnancy-Associated Responses and the Assessment of Cardiovacular Disease Risk Later in Life
- Summary
- References
Chapter 15. The Renin-Angiotensin System, its Autoantibodies, and Body Fluid Volume in Preeclampsia
- Introduction
- Body Fluid Volumes
- Plasma Volume in Normal Pregnancy and Preeclampsia
- Concluding Perspectives
- References
Chapter 16. The Kidney in Normal Pregnancy and Preeclampsia
- Introduction
- Renal Hemodynamics and Glomerular Filtration Rate During Normal Pregnancy
- Osmoregulation in Normal Pregnancy
- Renal Hemodynamics and Glomerular Filtration Rate in Preeclampsia
- Renal Handling of Uric Acid
- Renal Handling of Proteins
- Renal Morphology in Pregnancy and Preeclampsia
- References
Chapter 17. Platelets, Coagulation, and the Liver
- Introduction
- Platelets
- Coagulation
- The Liver in Preeclampsia
- References
Chapter 18. Chronic Hypertension and Pregnancy
- Introduction
- Background
- Specific Hypertensive Disorders
- Management Principles
- References
Chapter 19. Antihypertensive Treatment
- Introduction
- Goals of Antihypertensive Drug Therapy
- General Principles in the Choice of Antihypertensive Agents
- Fetal Safety and Drug Use in Pregnant Women
- Choice of an Antihypertensive Drug for Use in Pregnancy
- Drug Use While Breastfeeding
- Evidence from Randomized Trials
- Conclusion
- References
Chapter 20. Clinical Management
- Introduction
- Preeclampsia
- Eclampsia
- Management of Severe Hypertension
- Neuroprophylaxis – Prevention of Eclampsia
- Delivery
- Persistent Severe Postpartum Hypertension
- References
Index
Color Plates

Title Reviews

Praise for the Fourth Edition:

"This book constitutes an indispensable update on preeclampsia, one of the most important and intriguing diseases of pregnancy. It covers the genetic, mechanistic, immunological and medical aspects of hypertension in pregnancy in a very comprehensive way. It is written clearly by world specialists in the subject, making it accessible to students, scientists and physicians as well."—Daniel Vaiman, PhD, HDR, Head Team "Genetics, Epigenetics, Physiopathology of Reproduction,"Co-Head, Department "Development, Reproduction, Cancer,"Cochin Institute, INSERM, Cochin Hospital, Paris, France

"Once again the editors of Chesley’s Hypertensive Disorders of Pregnancy have put together an outstanding team of contributors, combining investigators and clinicians, with expertise in preeclampsia to help elucidate our current understanding of this complex disorder. These contributors have put together an exemplary text that highlights recent basic science and clinical research as well as their implications for clinical care and future investigation. I suspect Dr. Chesley would be proud to see that his name continues to lead such an impressive tome."—Ira M. Bernstein, MD, John van Sicklen Maeck Professor and Chair, Department of Obstetrics, Gynecology and Reproductive Science, College of Medicine, University of Vermont, Burlington, VT, USA

"This 4th edition of Chesley’s classic textbook provides a superb analysis of the multiple topics that relate to hypertension in pregnancy, especially of preeclampsia, its most delicate condition. These range from the epidemiology to the molecular aspects, all analyzed from the background of normal pregnancy. Each chapter has been written by leaders in their respective areas, who discuss pioneering studies to still latent questions, simple interventions to sophisticated future tools, preconceptional management to the risks that mothers and offspring may face in later life. Clinical observations are conciliated with animal models and opposing hypotheses are united into continua (e.g., from an "underfilled"state in early pregnancy to an "overfill"in late pregnancy, from salt as a pressor element to an activator of the immune system). Putting into perspective the advancements made in the 47 years that separate this from the 1st edition illuminates the multiple achievements as well as the bridges that remain to be crossed. This text is a great way to honor the memory of Dr. Leon Chesley, the leader of this still open path, and should be obligatory reading for obstetricians, nephrologists, cardiologists and endocrinologists alike."—Gloria Valdes, MD, Professor, School of Medicine, Pontifi cia Universidad Católica, Santiago, Chile

ISBN: 9780124078666

Page Count: 484

Retail Price (USD) :

Goldman et.al., Women and Health, 2e, 9780123849786, 2012, $159.95; 1e published in 2000
Gabbe, Normal and Problem Pregnancies, 6e, 9781437719352, 2012, $169.00, Saunders; 5e published in 2007
Gupta, Reproductive and Developmental Toxicology, 9780123820327, 02/2011, $250.00
Alpern et.al., Seldin & Giebisch’s The Kidney, 5e, Two-Volume Set, 9780123814623, 2012, $400.00; 4e published in 2007
Black, Hypertension, 2e: A Companion to Braunwald’s Heart Disease, 9781455737352, Saunders, 2012, $169.00, 466 pp.