Abstract

Aberrant production of hydrogen sulfide (H2S) has been linked to preeclampsia. We hypothesized that sodium thiosulfate (STS), a H2S donor, reduces hypertension and proteinuria, and diminishes fetal growth restriction in the Dahl salt-sensitive (S) rat, a spontaneous model of superimposed preeclampsia. In addition to a control group (n = 13), two groups received STS via drinking water at a dose of 2 g (n = 9) or 3 g per kg body weight per day (n = 8) from gestational day (GD) 10 to 20. Uterine artery resistance index was measured (GD18), urinary protein excretion rate was determined (GD19), and blood pressure and fetal outcomes were evaluated (GD20). At 2 g, STS had no effect on preeclamptic symptoms or fetal outcome. At 3 g, STS reduced maternal hypertension (121.8 ± 3.0 vs. 136.3 ± 2.9), but increased proteinuria (89 ± 15 vs. 56 ± 5 mg/24 h), and relative kidney weight (0.86 ± 0.04 vs. 0.73 ± 0.02%). Fetal/placental weight ratio was reduced (3.83 ± 0.07 vs. 4.31 ± 0.08) without affecting litter size. No differences in uterine artery flow or renal histological damage were noted across treatment groups. While these data suggest a promising antihypertensive effect that could imply prolongation of preeclamptic pregnancies, the unfavorable effects on proteinuria, kidney weight, and fetal/placental weight ratio implies that clinical implementation of STS is contra-indicated until safety for mother and child can be verified.

Highlights

  • Preeclampsia (PE) complicates 3% to 5% of all pregnancies and is a leading cause of maternal and perinatal mortality [1,2]

  • PE presents after 20 weeks of gestation and is characterized by hypertension accompanied by maternal organ disturbances, as well as fetal growth restriction (FGR) [3]

  • Our lab previously showed that proteinuria in healthy Sprague-Dawley rat is 12 ± 3 mg/24 h during late pregnancy [20]

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Summary

Introduction

Preeclampsia (PE) complicates 3% to 5% of all pregnancies and is a leading cause of maternal and perinatal mortality [1,2]. The resulting systemic endothelial dysfunction eventually leads to the cardinal symptoms of PE [2,5]

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