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VISION BLURRED Symptoms and Causes

What is high blood pressure in pregnancy?

Blood pressure is the force of your blood pushing against the walls of your arteries as your heart pumps blood. High blood pressure, or hypertension, is when this force against your artery walls is too high. There are different types of high blood pressure in pregnancy:

  • Gestational hypertension is high blood pressure that you develop while you are pregnant. It starts after you are 20 weeks pregnant. You usually don't have any other symptoms. In many cases, it does not harm you or your baby, and it goes away within 12 weeks after childbirth. But it does raise your risk of high blood pressure in the future. It sometimes can be severe, which may lead to low birth weight or preterm birth. Some women with gestational hypertension do go on to develop preeclampsia.
  • Chronic hypertension is high blood pressure that started before the 20th week of pregnancy or before you became pregnant. Some women may have had it long before becoming pregnant, but didn't know it until they got their blood pressure checked at their prenatal visit. Sometimes chronic hypertension can also lead to preeclampsia.
  • Preeclampsia is a sudden increase in blood pressure after the 20th week of pregnancy. It usually happens in the last trimester. In rare cases, symptoms may not start until after delivery. This is called postpartum preeclampsia. Preeclampsia also includes signs of damage to some of your organs, such as your liver or kidney. The signs may include protein in the urine and very high blood pressure. Preeclampsia can be serious or even life-threatening for both you and your baby.
What causes preeclampsia?

The cause of preeclampsia is not known.

Who is at risk for preeclampsia?

You are at higher risk of preeclampsia if you

  • Had chronic high blood pressure or chronic kidney disease before pregnancy
  • Had high blood pressure or preeclampsia in a previous pregnancy
  • Have obesity
  • Are over age 40
  • Are pregnant with more than one baby
  • Are African American
  • Have a family history of preeclampsia
  • Have certain health conditions, such as diabetes, lupus, or thrombophilia (a disorder which raises your risk of blood clots)
  • Used in vitro fertilization, egg donation, or donor insemination
What problems can preeclampsia cause?

Preeclampsia can cause

  • Placental abruption, where the placenta separates from the uterus
  • Poor fetal growth, caused by a lack of nutrients and oxygen
  • Preterm birth
  • A low birth weight baby
  • Stillbirth
  • Damage to your kidneys, liver, brain, and other organ and blood systems
  • A higher risk of heart disease for you
  • Eclampsia, which happens when preeclampsia is severe enough to affect brain function, causing seizures or coma
  • HELLP syndrome, which happens when a woman with preeclampsia or eclampsia has damage to the liver and blood cells. It is rare, but very serious.
What are the symptoms of preeclampsia?

Possible symptoms of preeclampsia include

  • High blood pressure
  • Too much protein in your urine (called proteinuria)
  • Swelling in your face and hands. Your feet may also swell, but many women have swollen feet during pregnancy. So swollen feet by themselves may not be a sign of a problem.
  • Headache that does not go away
  • Vision problems, including blurred vision or seeing spots
  • Pain in your upper right abdomen
  • Trouble breathing
  • Eclampsia can also cause seizures, nausea and/or vomiting, and low urine output. If you go on to develop HELLP syndrome, you may also have bleeding or bruising easily, extreme fatigue, and liver failure.

    How is preeclampsia diagnosed?

    Your health care provider will check your blood pressure and urine at each prenatal visit. If your blood pressure reading is high (140/90 or higher), especially after the 20th week of pregnancy, your provider will likely want to run some tests. They may include blood tests other lab tests to look for extra protein in the urine as well as other symptoms.

    How is preeclampsia treated?

    Delivering the baby can often cure preeclampsia. When making a decision about treatment, your provider take into account several factors. They include how severe it is, how many weeks pregnant you are, and what the potential risks to you and your baby are:

    • If you are more than 37 weeks pregnant, your provider will likely want to deliver the baby.
    • If you are less than 37 weeks pregnant, your health care provider will closely monitor you and your baby. This includes blood and urine tests for you. Monitoring for the baby often involves ultrasound, heart rate monitoring, and checking on the baby's growth. You may need to take medicines, to control your blood pressure and to prevent seizures. Some women also get steroid injections, to help the baby's lungs mature faster. If the preeclampsia is severe, you provider may want you to deliver the baby early.

    The symptoms usually go away within 6 weeks of delivery. In rare cases, symptoms may not go away, or they may not start until after delivery (postpartum preeclampsia). This can be very serious, and it needs to be treated right away.

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1 Unknown  Analgesic Effect of Paracetamol, Paracetamol + Codeine, Ibuprofen and Their Combination
Condition: Pain, Postoperative
Interventions: Drug: Ibuprofen + Paracetamol;   Drug: Ibuprofen + Paracetamol + Codeine;   Drug: Paracetamol + Codeine;   Drug: Placebo
Outcome Measures: Sum pain intensity SPI (0-10 Numerical Rating Scale);   Sum pain intensity difference score (PID);   Overall assessment of efficacy (4-point Verbal Rating Scale);   Adverse effects AE (Specific reporting of AE - type, duration and severity)
2 Not yet recruiting Equality Study of Ofirmev vs Oral Acetaminophen
Condition: Pain, Postoperative
Interventions: Drug: IV acetaminophen;   Drug: oral acetaminophen
Outcome Measures: Primary outcome will measure total opioid consumption while the patient is in the PACU;   time from PACU admission to request for first opioid dose
3 Unknown  Acetaminophen for Cancer Pain
Conditions: Cancer;   Pain
Interventions: Drug: Acetaminophen;   Drug: acetaminophen;   Drug: placebo, sugar pill
Outcome Measures: Patient preference for the acetaminophen or the placebo arm as assessed by asking the patient whether he/she preferred treatment period 1 or treatment period 2;   Differences in the mean pain intensity score as assessed by the daily average Numeric Rating Scale (NRS) pain score during the week given acetaminophen compared with the daily average NRS pain score during the week given placebo;   Symptoms possibly associated with acetaminophen use for each period using an NRS: feeling sick (nausea and vomiting);   drowsiness;   constipation;   cold sweats;   overall sense of well being;   Total analgesic consumption in each treatment period;   Best and worst pain scores for each treatment period;   Pain relief obtained in each treatment period;   Effect of pain on functional ability;   Strength of preference for acetaminophen versus placebo on a 5-point scale;   Proportion of patients who had a preference for acetaminophen who perceived the improvement warranted taking the additional tablets;   Proportion of patients having a clinically significant improvement in pain (defined as an improvement in mean NRS of at least 33% during the week taking acetaminophen)
4 Recruiting Intraoperative and Post-operative Analgesic Effect of IV Acetaminophen for Sinus Surgery
Condition: Chronic Sinusitis
Interventions: Drug: IV Acetaminophen;   Drug: Placebo
Outcome Measures: Assess the efficacy of IV acetaminophen in controlling postoperative pain;   Investigate the effect of IV acetaminophen on the use of postoperative opioid analgesics;   Analyze effects of IV acetaminophen on intraoperative analgesic use;   Identify potential correlation between vital signs and postoperative pain intensity;   Examine the effect of IV acetaminophen on post-operative quality of recovery
5 Recruiting Paracetamol (Acetaminophen) for Closure of PDA in Preterm Infants
Condition: PDA
Interventions: Drug: Paracetamol;   Drug: Ibuprofen;   Procedure: Closure of PDA
Outcome Measures: Closure of arterial duct - yes / No;   Need for surgical closure of arterial duct
6 Recruiting Paracetamol Effect on Oxidative Stress and Renal Function in Severe Malaria
Condition: Malaria
Interventions: Drug: Paracetamol;   Drug: No Paracetamol
Outcome Measures: Effect of paracetamol concentrations;   Compare treatment arm with control arm with respect to duration of Acute Kidney Injury (AKI) and development of AKI.;   Oxidative stress assessed by measuring F2-isoprostanes (F2-IsoPs);   Assessment of Blackwater fever;   Mortality trends;   Intravascular Haemolysis;   Fever clearance time;   Parasite clearance time;   Parasite sequestration;   Assessment of Acute Kidney Injury;   Creatinine clearance;   Safety assessment
7 Recruiting Slow Initial β-lactam Infusion With High-dose Paracetamol to Improve the Outcomes of Childhood Bacterial Meningitis
Condition: Bacterial Meningitis
Interventions: Drug: Infusion with paracetamol;   Drug: Bolus without paracetamol
Outcome Measures: Mortality;   Status on the modified Glasgow Outcome Scale;   Death or any sequelae;   A change in hearing threshold compared to the first test result;   Death or severe neurological sequelae;   Deafness
8 Unknown  Paracetamol for Cancer Pain
Conditions: Advanced Cancer;   Opioid Use, Unspecified
Interventions: Drug: paracetamol;   Drug: placebo tablets
Outcome Measures: Pain reduction caused by paracetamol 4g/d;   Overall satisfaction with the pain treatment
9 Recruiting Clinical Study Comparing the Efficacy of Transbuccal Paracetamol 125 mg Versus Paracetamol Injection 1g in Slow Infusion IV in Patients With Acute Pain
Condition: Acute Pain
Interventions: Drug: paracetamol;   Drug: Placebo
Outcome Measure: Pain score measured by visual analogue scale
10 Unknown  The Effect of Single Dose Paracetamol on the Lower Airways of Asthmatic and Healthy Children
Condition: Asthma
Intervention: Drug: paracetamol
Outcome Measure: A measurable change in lung functions in response to paracetamol exposure.
11 Recruiting Prospective, Randomized, Double Blind Study Comparing IV vs PO Acetaminophen in Patients Undergoing Lumbar Discectomy
Condition: Pain
Interventions: Drug: oral acetaminophen;   Drug: intravenous acetaminophen
Outcome Measures: Postoperative pain scores;   Quantity of intraoperative and postoperative opioids administered.
12 Recruiting Can Acetaminophen Given 1-2 Hours to Children Before Ear Tube Surgery Reduce Agitation After Anesthesia?
Conditions: Emergence Agitation;   Pain
Intervention: Drug: Acetaminophen
Outcome Measures: Emergence Agitation;   Pain
13 Recruiting Analgesic Efficacy of Intravenous Acetaminophen After Video-assisted Thoracic Surgery
Condition: Video-assisted Thoracic Surgery
Interventions: Drug: IV Acetaminophen;   Drug: Saline Placebo
Outcome Measures: Total morphine consumption;   Number of PCA morphine bolus requests;   Pain Scores;   Vital signs
14 Recruiting A Prospective, Randomized, Double Blind, Comparative-effectiveness Study Comparing Perioperative Administration of Oral Versus Intravenous Acetaminophen for Laparoscopic Cholecystectomy
Condition: Laparoscopic Cholecystectomy
Interventions: Drug: 2 capsules Oral Tylenol 2000 mg and IV "salt water";   Drug: IV Tylenol 1000mg and 2 oral capsule "sugar pills"
Outcome Measures: Pain;   Opioid Use
15 Not yet recruiting Adding Paracetamol to Ibuprofen for Treatment of Patent Ductus Arteriosus in Preterm Infants
Condition: Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants
Interventions: Drug: Paracetamol;   Drug: Placebo
Outcome Measures: The incidence of patent ductus arteriosus closure;   The need for surgical ligation for PDA;   Adverse effects
16 Recruiting Intravenous Acetaminophen for Non-Narcotic Postoperative Pain Management Following Knee Arthroscopy
Condition: Pain, Postoperative
Intervention: Drug: Intravenous Acetaminophen
Outcome Measures: Postoperative pain levels;   Postoperative opioid consumption
17 Recruiting Intravenous Acetaminophen in Craniotomy
Condition: Postoperative Pain
Interventions: Drug: Acetaminophen;   Drug: Placebo
Outcome Measures: Post-Operative Opioid Requirement;   Intra-Operative Opioid Requirement;   Post-Operative Pain;   Post-Operative Side Effects
18 Recruiting Efficacy of IV Acetaminophen for Pain Management
Condition: Post-operative Pain
Interventions: Drug: Placebo (normal saline);   Drug: IV acetaminophen
Outcome Measures: Amount of opioid rescue needed;   Time to return of bowel function (passage of flatus);   Patient Satisfaction;   Cost Effectiveness
19 Recruiting Acetaminophen Versus Ibuprofen in Children With Asthma
Conditions: Asthma;   Wheezing
Interventions: Drug: Acetaminophen;   Drug: Ibuprofen
Outcome Measure: exacerbation frequency
20 Recruiting The Efficacy of Intravenous Acetaminophen During The Perioperative Period Of Neurosurgical Patients Undergoing Craniotomies
Conditions: Craniotomy;   Brain Surgery
Interventions: Drug: Acetaminophen;   Drug: Placebo
Outcome Measures: Opioid requirement after surgery;   Time to rescue medication in both groups;   Amount of rescue medication in PACU in both groups;   Median difference in ICU length of stay/hospital length of stay between both groups;   Number of successful neurologic exams between intervention and placebo group as determined by a neurosurgical provider by answering either Yes or No;   Median difference in temperature between intervention and placebo groups;   Sedation scores measured by RASS every 8 hours for 24 hours in both groups;   Pain VAS scores (1-10) every 8 hours for 24 hours in both groups;   Delirium measured by CAM-ICU every 8 hours for 24 hours in both groups