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Hyperhomocysteinemia in pregnancy dr vivek patkar

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Indian Health Journal
Indian Health Journal

The document discusses the role of hyperhomocysteinemia in pregnancy complications like pregnancy-induced hypertension and intrauterine growth restriction. Elevated homocysteine levels can cause endothelial dysfunction and oxidative stress, leading to impaired placental perfusion. Supplementation with methyl donors like folate, vitamin B12, and vitamin B6 during pregnancy can help lower homocysteine levels and reduce the risk of complications.

Health & Medicine
1 of 54
Dr. Vivek D. Patkar [email_address]
Emerging Understandings about Nutrition in Pregnancy ,[object Object],[object Object],[object Object]
Top Three “Best Practices” to Improve Birth Outcomes & Reduce High Risk Births (NGA, June 2004) ,[object Object],[object Object],[object Object],[object Object],[object Object]
2 MAJOR PREGNANCY COMPLICATIONS PIH IUGR
PREGNANCY INDUCED HYPERTENSION ,[object Object],[object Object]
PATHOPHYSIOLOGY OF PIH ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
RISK FACTORS FOR PIH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],VDP
VASOSPASM DHP /Na retention Maternal changes Placental changes Spiral artery Constriction (defective perfusion of Fetoplacental unit) ,[object Object],[object Object],[object Object],[object Object],Progesterone Hypertension DIC Atherodamage Glomeruler endotheliosis EAF Poly Degran TFN Alpha VCA m1 VCA m2 Release IL CD 11 B CD 18 Tissue Damage IUGR Oligohyd Alt BPP IUFD Premature Labour Kidney Liver Lung Toxaemia Eclampsia CVA HE Fetal Maternal VDP
Hyperhomocystenemia as a risk factor____ ,[object Object],[object Object],[object Object]
Hyperhomocystenemia as a risk factor____ ,[object Object],[object Object]
Hyperhomocystenemia as a risk factor____ ,[object Object]
Hyperhomocystenemia as a risk factor____ ,[object Object],[object Object]
Homocysteine ,[object Object],[object Object]
Homocysteine metabolism ,[object Object],[object Object]
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Historical Perspective ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hyperhomocysteinemia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology of Hyperhomocysteinemia ,[object Object],[object Object],[object Object],[object Object]
Etiology of Hyperhomocysteinemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevalance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HOMOCYSTEINE & PREGNANCY ,[object Object],[object Object],[object Object],[object Object],[object Object]
NORMAL UTEROPLACENTAL CIRCULATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HEMODYNAMICS IN NORMAL PREGNANCY ,[object Object],[object Object],[object Object]
How does hyperhomocysteinemia leads to PIH ? ,[object Object],[object Object]
How does hyperhomocysteinemia leads to PIH? ,[object Object],[object Object],[object Object],[object Object],[object Object]
IUGR Pre-eclampsia VTE ENDOTHELIAL FUNCTION IUGR PIH - Pre-eclampsia VTE ENDOTHELIAL FUNCTION
Also …..….. ,[object Object],[object Object]
Also …..….. ,[object Object],[object Object]
Hyperhomocysteinemia in pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INTRA UTERINE GROWTH RESTRICTION ,[object Object],[object Object]
Placental Abruption ,[object Object],[object Object],[object Object],[object Object],[object Object]
Recurrent Pregnancy Loss ,[object Object],[object Object]
Congenital Anomaly ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
When to screen? ,[object Object],[object Object],[object Object],[object Object]
Sample Collection ,[object Object],[object Object],[object Object],[object Object],[object Object]
Methods ,[object Object],[object Object],[object Object]
Why to treat ? ,[object Object],[object Object]
Why to treat ? ,[object Object]
METHYLATON ENHANCEMENT ,[object Object],[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FOLIC ACID ,[object Object],[object Object],[object Object],[object Object],[object Object],Important cofactor in the Remethylation of Homocysteine
FOLIC ACID ,[object Object],[object Object],[object Object],Clin Chem. 2005 Mar;51(3):629-34. Epub 2004 Dec 22.
FOLIC ACID ,[object Object],[object Object],[object Object],Clin Chem. 2005 Mar;51(3):629-34. Epub 2004 Dec 22.
VITAMIN B 12 ,[object Object],[object Object],[object Object],[object Object],A cofactor, Methionine Synthetase (MS) in methylation
VITAMIN B 6 ,[object Object],[object Object],[object Object],A cofactor, Pyridoxal Phosphate in methylation
FOLIC ACID & Vit B6 ,[object Object],[object Object],[object Object],[object Object],Clin Chem. 2005 Mar;51(3):629-34. Epub 2004 Dec 22.
L – METHIONINE Methyl donor, antioxidant L-methionine is a precursor to L-cysteine Important factor for the normal fetal growth Essential amino acid which predicts the birth weight and length Increased concentrations of methionine in extraembryonic and amniotic fluid are directly related to low levels of homocysteine (BJOG. 2005; 104(1): 20-24)
CHOLINE ,[object Object],[object Object],[object Object],Important for the formation of Betaine
ANTIOXIDANTS ,[object Object],[object Object],[object Object],[object Object]
ANTIOXIDANTS ,[object Object],[object Object],[object Object]
THANK YOU

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Hyperhomocysteinemia in pregnancy dr vivek patkar

  • 1. Dr. Vivek D. Patkar [email_address]
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  • 4. 2 MAJOR PREGNANCY COMPLICATIONS PIH IUGR
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  • 29. IUGR Pre-eclampsia VTE ENDOTHELIAL FUNCTION IUGR PIH - Pre-eclampsia VTE ENDOTHELIAL FUNCTION
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  • 50. L – METHIONINE Methyl donor, antioxidant L-methionine is a precursor to L-cysteine Important factor for the normal fetal growth Essential amino acid which predicts the birth weight and length Increased concentrations of methionine in extraembryonic and amniotic fluid are directly related to low levels of homocysteine (BJOG. 2005; 104(1): 20-24)
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