Aim: To investigate the prevalence of chronic hypertension (CH), white coat hypertension (WCH), and masked hypertension (MHT) in women with suspected hypertension at <20 weeks of gestation.

Methods: If we suspected hypertension, defined as at least one hypertension level on two to three consecutive measurements in a clinical setting at <20 weeks of gestation, we lent the patient a home blood pressure (HBP) device. Ultimately, they were diagnosed with CH, WCH, or masked hypertension (MHT).

Results: Four institutes participated in this prospective cohort study. We evaluated 44 patients with suspected hypertension at <20 weeks of gestation. The prevalences of CH, WCH, and MHT were 11, 30, and 2%, respectively. Incidence of preeclampsia (PE) in women with CH was 20% (1/5); incidences of gestational hypertension (GH) and PE in women with WCH were 0% (0/12) and 17% (2/12), respectively. Incidences of GH and PE in women without hypertension were 17% (4/24) and 8% (2/24), respectively.

Conclusions: If pregnant women presented with suspected hypertension at <20 weeks of gestation, HBP monitoring should be recommended for a differential diagnosis of hypertension, and close observation should be planned to detect onset of PE/GH.

Aim: To clarify the relationship between the incidence of gestational diabetes mellitus (GDM) with or without hypertensive disorders of pregnancy (HDP) and the incidence of small-for-gestational-age (SGA) infants.

Methods: We conducted a 75-g oral glucose tolerance test between 24 and 28 weeks of gestation in 455 pregnant women who were classified into four groups according to their GDM and HDP status retrospectively.

Results: The number of SGA infants born to women with GDM+HDP was similar to that born to women with HDP alone. In the GDM group, the SGA rate in women with GDM+HDP was similar to that in women with GDM alone. However, in the non-GDM group, significantly more SGA infants were born to women with HDP alone than to women with no pathology. The mean birthweight SD in women with GDM+HDP was comparable to that in women with GDM alone. However, the birthweight SD in women with HDP alone was significantly lower than that in women with no pathology. By multivariate analysis, birthweight SD<−0.564 was a predictor of HDP in the non-GDM group, but not in the GDM group.

Conclusions: This study showed that GDM might offset the number of SGA infants induced by HDP.

We experienced three cases of intracranial hemorrhage in pregnant women with hypertensive disorders of pregnancy (HDP). Case 1 showed progression of chronic hypertension to superimposed preeclampsia, Case 2 was diagnosed with preeclampsia, and Case 3 was diagnosed with gestational hypertension. Intracranial hemorrhage developed at home in Cases 1 and 2, and during cesarean section in Case 3. Cases 1 and 2 were treated by hematoma removal and aneurysm clipping after cesarean section, while Case 3 elected conservative treatment. Case 1 had hypertension from the first trimester but was not diagnosed with chronic hypertension. She later developed severe hypertension but was managed as a normal pregnancy. Case 2, despite having preeclampsia, was not placed under stringent blood pressure control. Case 3, despite persistent high blood pressure during anesthesia, did not receive appropriate blood pressure control with antihypertensives. Appropriate management, including antihypertensive therapy for HDP, may reduce the risk of intracranial hemorrhage.

Background Neurofibromatosis type 1 is a disorder characterized by café-au-lait spots and neurofibromas. Recent studies have suggested that neurofibromatosis type 1 may induce vascular fragility. Limited information is currently available on vascular fragility in pregnancies complicated by neurofibromatosis type 1.

Case The patient was a 40-year-old woman (gravida 3, para 1) with neurofibromatosis type 1. In her second pregnancy, blood pressure began to rise at 30 weeks of gestation. At 34 weeks of gestation, left intercostal artery rupture and massive hemothorax occurred, resulting in neonatal death. In her third pregnancy, caesarean section was performed at 30 weeks of gestation prior to the expected increase in blood pressure, resulting in a livebirth. However, the patient died three months later due to left intercostal artery rupture.

Conclusion Pregnancy complicated by neurofibromatosis type 1 is associated with vascular fragility, leading to fatal events. Thus, obstetricians should be aware of this condition. A management strategy needs to be established for vascular fragility in complicated pregnancy.

This study aimed to present the diagnosis and management of adnexal masses of <6 cm in full-term pregnancy at a primary-level hospital. We present two cases of adnexal torsion. Cases 1 and 2 were conservatively managed for masses measuring 44.4×30.5 mm and 49.4×34.3 mm in the first trimester, and the patients experienced acute-onset serious abdominal pain at 39 and 37 weeks of gestation, respectively. Emergency cesarean section and unilateral salpingo-oophorectomy were performed. Histopathology confirmed serous cystadenoma with ischemic changes in both cases. Our findings suggest that clinical information regarding adnexal masses in the first trimester and their clinical symptoms can inform management decisions in the third trimester.