Eclamptic Groups Research Articles

Role of prostaglandin E 2 in alterations of the β-adrenergic system from rat eclamptic uterus

The inotropic effect of isoproterenol, as well as the β-adrenoceptor population, was measured in pregnant uterine tissue from female spontaneous hypertensive rats (SHR) (control group: C) and female SHR that were grafted with skin from Holtzman male rats (eclamptic group: E). The K d value of the concentration response curve of isoproterenol was higher for uteri from E rats than C rats. This phenomenon was not accompanied by a modification in the expression of β-adrenoceptors. Inhibition of the synthesis of prostaglandins prevented the hyporeactivity to isoproterenol during eclampsia. Moreover, uteri from E rats generated and released greater amounts of prostaglandin E 2 (PGE 2) than uteri from C rats, even in the presence or absence of isoproterenol. In addition, whereas isoproterenol administered alone increased basal cyclic AMP (cAMP) production from C uteri, PGE 2 administered alone enhanced cAMP production in E uterine tissue. These results suggest that the decrease in β-adrenergic response to the agonist in E rats is ascribed to PGE 2 production. The abnormal reactivity to the β-agonist could be associated with a heterologous desensitization of uterine β-adrenoceptors exerted by PGE 2 overload in uteri from E rats. These results bear directly on the regulation of uterine motility during pregnancy, since an impaired response to β-adrenergic innervation could lead to increased uterine motility, impairing the maintenance of pregnancy.

Antiphospholipid Antibodies in Eclampsia

Objective: To establish the association of raised levels of antiphospho-lipid antibodies and eclampsia.Methods: Thirty-four patients with eclampsia and 34 normotensive controls matched for maternal age, gestational age, and parity were included in the study. All had anticardiolipin antibodies and lupus anticoagulant performed by established techniques.Results: Seven patients (21%) in the eclamptic group and 8 (24%) in the control group had raised anticardiolipin antibodies.Conclusion: No association was found between raised antiphospholipid antibodies and eclampsia. Of interest is the association between antiphospholipid antibodies and the HELLP syndrome, which needs further investigation.

Effect of Magnesium Sulfate On Electroencephalographic Findings in Preeclampsia-Eclampsia

Electroencephalograms (EEGs) were recorded in 36 eclamptic, 14 preeclamptic, and 13 normotensive control patients. In the eclamptic group, EEGs were recorded while patients were receiving intravenous magnesium sulfate (MgSO4) with serum magnesium (Mg) levels of 4.5 to 11 mg/dL, and recorded again after MgSO4 was discontinued (serum Mg levels 1.8 to 2.5 mg/dL). In preeclamptic patients, EEGs were recorded before starting MgSO4, during administration of the loading dose (serum Mg levels 6 to 10 mg/dL), and eight hours through the maintenance dose (serum Mg levels 3.6 to 6.2 mg/dL). Twenty-seven (75%) eclamptic patients had abnormal EEGs, four patients showed paroxysmal spike activity, and the others showed focal or diffuse slowing (delta waves). Seven (50%) preeclamptic women had abnormal EEGs (all had generalized slowing). In preeclamptic-eclamptic patients who had serial EEG recordings, the gross EEG findings obtained during MgSO4 infusion and in the absence of MgSO4 were similar. In addition, the abnormal EEG findings were frequent despite the serum Mg levels considered therapeutic in the clinical management of these patients. Two eclamptic patients had seizure activity at serum Mg levels of 9.6 and 11 mg/dL. These findings suggested that abnormal EEGs are frequent in preeclamptic-eclamptic patients. Abnormal EEG findings in such patients are not altered by serum Mg levels achieved in the clinical management of these patients.

Studies on toxemia of pregnancy with special reference to blood pressure. I. Incidence and some characteristic features of the mothers and infants.

An investigation was made of 150 women who were diagnosed at the Department of Obstetrics and Gynaecology, University Hospital, Uppsala in 1964-68 as having toxaemia of pregnancy. Eleven had eclampsia and the remainder pre-eclampsia. Toxaemia occurred in 0.88% (average) of all parturients during the study period. Some characteristics of the mothers and their infants are reported. Thus, there were more instrumental deliveries in the toxaemia group than in the non-toxaemic patients delivered in the clinic. The maternal weight at delivery was also greater in the toxaemia group. The frequency of complications among the infants was higher in the group with toxaemia. There were more stillbirths, lower birth weights and more congenital malformations. With regard to blood pressure, almost identical pressures were noted in the eclamptic and pre-eclamptic groups, with one exception. The maximum blood pressure recorded during delivery was higher in the eclamptic than in the pre-eclamptic group (198/127 and 175/117).

Physiochemical responses to heparin in non-pregnant, normal pregnant, and eclamptic patients.

SummaryHeparin 50 mg. was injected intravenously into four groups of patients: non‐pregnant women who were not taking oral contraceptives, non‐pregnant women taking oral contraceptives, normal pregnant women, and eclamptic patients. Blood was collected before and ten minutes after the injection, and the following determinations were carried out: Lee‐White clotting time, serum free fatty acid concentration, in vitro lipoprotein lipase assay, in vitro post‐heparin phospholipase assay, and in vitro post‐heparin esterase assay.After the heparin injection, non‐pregnant patients showed a significantly greater prolongation of clotting time than pregnant patients. No significant differences were noted in increments of serum free fatty acid concentrations. The lipoprotein lipase and post‐heparin esterase assays in the post‐heparin serum showed greatest activity in the non‐pregnant women who were not taking oral contraceptives, least activity in the pregnant women, with the non‐pregnant women who were taking oral contraceptives intermediate between the others. The post‐heparin phospholipase activity in the post‐heparin serum from the women who were not pregnant or taking oral contraceptives was significantly greater than the activity from the non‐pregnant women who were taking oral contraceptives and from the pregnant women. No significant difference was found by any determination between the normal pregnant and the eclamptic groups. On the fifth postpartum day the responses of the normal pregnant and eclamptic groups resembled more closely those of the non‐pregnant women who were not taking oral contraceptives, but in general were not quite as large.

Excretion of Estrogen and Gonadotropin in Late Pregnancy: With Especial Reference to the Toxemias of Pregnancy and to Quantitative Methods

<h2>Summary</h2> The excretion of estrogen and gonadotropin has been determined in 74 cases during pregnancy; 70 cases were studied during late pregnancy (thirty-five weeks) and 4 cases in early pregnancy. Of the 70 cases studied in late pregnancy, 57 cases were used for a statistical study of the relation of these hormones to the toxemias of pregnancy. Of these, 43 cases (11 normal, 14 hypertensive and renal disease, 13 pre-eclamptic, and 5 eclamptic patients) had parallel quantitative assays of both estrogens and gonadotropins and 14 estrogen only. The other 13 cases represented various other conditions complicating pregnancy. In the group (43 cases) in which both the estrogens and gonadotropins were determined, there was a decrease in the estrogen excretion and an increase in the excretion of gonadotropin in the pre-eclamptic and eclamptic groups, but the excretion of estrogen was normal and the excretion of gonadotropin increased in the hypertensive and renal disease group. Because of the extreme variability of individual values the relationship of the estrogen and gonadotropin excretions (E :G ratio) is believed to be a better index of hormone values than the twenty-four-hour excretion value for either hormone. The values found for this group were <ul><li>1.The excretion of estrogen (Mean ± S. E., LU, per 24 hours) for the various groups was: normal, 38,260 ± 5,240; hypertensive and renal disease, 37,540 ± 5,770; pre-eclamptic, 17,620 ± 3,030; eclamptic, 11,800 ± 3,670.</li><li>2.The excretion of gonadotropin (Mean ± S. E., R.U. per 24 hours) for the same groups was: normal, 12,340 ± 2,760; hypertensive and renal disease, 20,690 ± 2,660; pre-eclamptic, 24,470 ± 3,960; eclamptic, 76,860 ± 31,210.</li><li>3.The ratios of the excretion of estrogen to gonadotropin expressed as the Mean ± S. E., for the above groups were: normal, 6.38 ± 2.13; hypertensive and renal disease, 2.63 ± 0.77; pre-eclamptic, 0.97 ± 0.23; eclamptic, 0.28 ± 0.08.</li></ul> Comparisons of these means by the Fisher method gave the following probabilities, P,* for significant differences between the various groups: <ul><li>1.For the excretion of estrogen per twenty-four hours, these values for the different groups were: normal and pre-eclamptic, P=<0.01; normal and hypertensive and renal disease, P=> 0.9; pre-eclamptic and hypertensive and renal disease, P=<0.01.</li><li>2.For the excretion of gonadotropin per twenty-four hours in the same groups, the values were: normal and pre-eclamptic, P=0.03; normal and hypertensive and renal disease, P=0.04; pre-eclamptic and hypertensive and renal disease, P=0.43.</li><li>3.For the estrogen:gonadotropin ratios the values were: normal and pre-eclamptic, P=0.01, including the eclamptic group, P=<0.01; normal and hypertensive and renal disease, P=0.07; pre-eclamptic and hypertensive and renal disease, P=0.06; hypertensive and renal disease and pre-eclamptic and including the eclamptic group, P=<0.01.</li></ul> The total group of estrogen studies (43 cases above and 14 with estrogen determinations only) gave the following values (Mean ± S. E., I.U. per 24 hours) for the various groups: normal, 36,550 ± 4,780; hypertensive and renal disease, 35,580 ± 4,490; pre-eclamptic, 18,490 ± 2,600. Comparison of these means shows a significant difference between the normal and the pre-eclamptic groups (P =<0.01) and the pre-eclamptic and the hypertensive and renal disease groups (P =<0.01) but not between the normal and the hypertensive and renal disease groups (P = 0.87). Methods for the quantitative assay of estrogens and gona'dotropins employing dose-effect standardization curves and methods of extraction are described and discussed. Excretion of estrogen and gonadotropin has been studied in 17 additional cases representing the following conditions: early pregnancy, hyperemesis gravidarum, abruptio placentae, hysteria with polyhydramnios and partial separation of the placenta, epilepsy, death of fetus, diabetes insipidus, diabetes mellitus, edema, achondroplastic dwarfism, and pseudomucinous cystadenoma of the ovary.