Abstract
Introduction and Aim: In preeclampsia(PE) due to abnormal trophoblastic invasion of the maternal spiral arteries leads to decreased uteroplacental circulation. Nitric oxide (NO) is involved in regulation offeto-placental vascular permeability and resistance. It also affects maturation, development of the placenta and foetal survival. Maternal serum NO levels are controversial in PEandonly few studies have focused on birth outcomes. Hence, the current study was undertaken to estimate and compare the maternal serum NOlevels in normal pregnant and PE womenandalso see the correlation betweenmaternal serum NO level with severity of PEand to study its association with birth outcome.
 Materials and Methods:The study was conductedat a tertiary care hospital in North Karnataka, India.Forty singleton primigravida PE patients diagnosed and classified as mild/severePE, as per ACOG guidelines and 40 healthy pregnant were selected for the study. NO was estimated by ELISA method.
 Results: NO was high in PE cases than controls but it was not statistically significant. But NO was significantly (p=0.03) higher in mild PE than severe PE patients. The NO level negatively correlated significantly (p=0.031) with case severity. Maternal serum NO did not show any significant correlation with birth weight and APGAR score of the new born baby.
 Conclusion:In mild PE rise in maternal serum NO, may be to due compensatory mechanism to normalise persistently elevated blood pressure and decreased level of serum NO in severe PE may be due to down-regulation of the nitric oxide synthase.
Highlights
Introduction and AimIn preeclampsia (PE) due to abnormal trophoblastic invasion of the maternal spiral arteries leads to decreased uteroplacental circulation
In mild PE rise in maternal serum Nitric oxide (NO), may be to due compensatory mechanism to normalise persistently elevated blood pressure and decreased level of serum NO in severe PE may be due to down-regulation of the nitric oxide synthase
Systolic blood pressure, diastolic blood pressure and body mass index were significantly higher in preeclampsia women than normal pregnant women
Summary
In preeclampsia (PE) due to abnormal trophoblastic invasion of the maternal spiral arteries leads to decreased uteroplacental circulation. Nitric oxide (NO) is involved in regulation of feto-placental vascular permeability and resistance. Primary disturbance appears to result from reduced uteroplacental circulation due to abnormal trophoblastic invasion of the maternal spiral arteries resulting in poor placentation. These spiral arteries retain their endothelial lining and the underlying smooth muscles, which make them reactive to vasoactive agents expressed by the endothelial cells. Endothelial cell dysfunction can cause hypertension with its increased production of vasoconstrictor agents such as plasma endothelin or reduced release of vasodilator agents such as Nitric oxide (NO) and prostacyclin [5,6,7]
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