Changes in plasma endothelin-1 after elective cesarean section in women with preeclampsia and the relationship to thrombocytopenia.

Abstract

The aim of this study was to clarify the time course of plasma endothelin-1 levels and platelet counts after elective cesarean section in women with preeclampsia, and to investigate the relationship between them postoperatively. We studied 20 patients with preeclampsia and 25 healthy pregnant women without preeclampsia who underwent cesarean section and 20 women without preeclampsia who had vaginal deliveries. The plasma endothelin-1 and platelet counts were measured serially after cesarean section. 1) In patients with preeclampsia, plasma endothelin-1 levels peaked on postoperative day 0 (p<0.05), and remained high, then fell to the preoperative level from day 5. The concentration was lower in healthy pregnant women undergoing cesarean section than in patients with preeclampsia before surgery, but showed a gradual significant increase from postoperative day 0 to postoperative day 3 (p<0.05) before falling. The women who underwent vaginal delivery showed a peak level of endothelin-1 on the day of delivery but this fell rapidly between day 3. 2) Women with preeclampsia showed a negative correlation between plasma endothelin-1 levels and platelet counts after cesarean section (r=0.46, p<0.01), while women without preeclampsia undergoing cesarean and vaginal deliveries did not. Endothelin-1 production is stimulated after cesarean section, which is paralleled with postpartal thrombocytopenia only in patients with preeclampsia.