Abstract
BackgroundMaternal circulating levels of anti-angiogenic factors such as soluble fms-like tyrosine kinase-1 (sFlt-1), endoglin (sEng) and placental proteins like activin A and inhibin A are increased before the onset of pre-eclampsia. There is evidence for oxidative stress in pre eclampsia. Recently it was shown that placental oxygen concentration is related to sFlt-1 and inhibin A. In addition it is reported that oxidative stress markers are increased in placental tissue delivered after labour. Therefore, the objective of this study is to investigate if these proteins are altered in maternal circulation of labouring pre-eclampsia and normal pregnancies.MethodologyTo assess the effects of labour, samples were taken from 10 normal pregnant (NP) and 10 pre-eclamptic (PE) women pre-labour, full dilation, placental delivery and 24 h. To assess the effects of placental delivery, plasma samples were taken from 10NP and 10PE women undergoing elective Caesarean section, pre-delivery, placental delivery and 10 min, 60 min and 24 h post delivery. SFlt-1 and sEng and activin A and inhibin A were measured using commercial and in house ELISA's respectively.ResultsThe levels of sFlt-1 and sEng were significantly higher in PE compared to NP women in both groups. In labour, sFlt-1 levels increased significantly at full dilatation in PE women, before declining by 24 hr. However there was no significant rise in sEng levels in labour. Activin A and inhibin A levels declined rapidly with placental delivery in NP and PE pregnancies. There was a significant rise in activin A levels during labour in PE compared to pre labour, but inhibin levels did not increase.ConclusionLabour in pre-eclamptic women increases the levels of sFlt-1 and activin A. This pilot data suggests that increase in the maternal levels of these factors in labour could predict and/or contribute to the maternal syndrome postpartum.
Highlights
Pre-eclampsia is a pregnancy specific complication and a major cause of maternal and fetal morbidity and mortality
The levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and Soluble Endoglin (sEng) were significantly higher in PE compared to normal pregnant (NP) women in both groups
Labour in pre-eclamptic women increases the levels of sFlt-1 and activin A
Summary
Pre-eclampsia is a pregnancy specific complication and a major cause of maternal and fetal morbidity and mortality. The transformation of the spiral arteries is completed around mid gestation in order to optimise the distribution of maternal blood into low resistance uterine vascular network and inside the placental intervillous chamber [3]. In pre-eclampsia, there is defective early trophoblastic invasion of the decidua due to failure of conversion of the spiral arteries into low-resistance channels. This results in retention of vasoreactivity within the placental vascular bed which causes diminished and variable perfusion to the intervillous space [4,5,6]. The objective of this study is to investigate if these proteins are altered in maternal circulation of labouring preeclampsia and normal pregnancies
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
