Group Of Healthy Pregnant Women Research Articles

Pregnancy Outcomes in Pregnant Women with Subchorionic Hematoma

Background: The role of subchorionic hematoma (SCH) in the first trimester of pregnancy remains open for discussion. Some authors claim that SCH does not affect the pregnancy; others have found that it is a serious risk factor for adverse pregnancy outcome. The objective of the present study was to explore the outcomes of pregnancy in patients with SCH diagnosed in the first trimester. Methods and Results: The study involved 194 pregnant women who were in terms of 6 to 12 weeks: 115 women with SCH (Group 1) and 79 apparently healthy pregnant women (Group 2). A missed miscarriage was observed in 27/23% women of Group 1 and in 4/5% of Group 2 (P<0.001), recurrent threat of miscarriage in 27/23% and in 4/5% (P<0.001), recurrent bleeding in 14/12% and 2/3% (P<0.02), and the short cervix syndrome in 22/19% and 5/6% (P<0.03) women, respectively. Conclusion: The results of our study show that the presence of SCH adversely affects the first half of pregnancy, leading to recurrent threatened abortion, recurrent threat of miscarriage, missed miscarriage until 12 weeks of gestation, and the short cervix syndrome. (Int I Biomed. 2015;5(3):137-140.)

O19. Decreased plasma hemopexin activity in preeclampsia is associated with decreased plasma AT-1 receptor levels and increased placental and monocyte AT-1 receptor expression

Introduction Hemopexin (Hx), apart from being a free heme scavenger, also has protease activity. While during healthy pregnancy, Hx activity was increased as compared with non-pregnant individuals, in preeclampsia, Hx activity was decreased as compared with healthy pregnant women. Since we have previously shown that active Hx was able to shed the angiotensin II type 1 receptor (AT-1R) from various cell types in vitro , we now hypothesized that the increased Hx activity in pregnancy leads to increased shedding of the AT-1R from the vascular wall and subsequently decreased angiotensin II sensitivity. In preeclampsia the decreased Hx activity may lead to decreased shedding of the AT-1R and therefore increased angiotensin II activity. Objective We aimed to evaluate whether decreased Hx activity in preeclampsia was associated with increased AT-1R expression (on placental tissue and monocytes) and reduced presence of the AT-1R in the circulation. Methods We obtained peripheral blood samples from non pregnant ( n =21), healthy pregnant ( n =25) and (early onset) preeclamptic ( n =26) women. We measured plasma Hx activity (colorimetric assay) and plasma AT-1R levels (Western blotting) and monocyte AT-1R expression (flow cytometry). From another group of healthy pregnant ( n =15) and (early onset) preeclamptic women ( n =24), we collected placental biopsies, in which we measured placental AT-1R expression using immunohistochemistry and qPCR. Results The increase in plasma Hx activity in healthy pregnant women vs non-pregnant women ( p p p p p p p Conclusions Our data suggest that also in vivo active Hx sheds the AT-1R from tissues, such as monocytes and placenta. Therefore active Hx may play a role in the development of the decreased responsiveness to angiotensin II in healthy pregnancy, while the decreased Hx activity in preeclampsia may contribute to increased angiotensin II sensitivity in this disease.

Development of Late-Onset Preeclampsia in Association with Road Densities as a Proxy for Traffic-Related Air Pollution

Introduction: Previous epidemiological studies indicate an association between maternal exposure to air pollution and an increased risk of hypertensive disorders in pregnancy. We analyzed the association between the occurrence of mild/severe and early-/late-onset preeclampsia (PE) and traffic-related air pollution (TRAP). Materials and Methods: Based on retrospective data, 50 pregnant women with PE were selected and matched with a control group of healthy pregnant women according to their age, parity, and number of fetuses. The total length of major roads around the women's home within a radius of 100, 200, 300, and 500 m and the distances from the domicile to the nearest ‘first class' main road and freeway were used as a proxy indicator of TRAP. We compared a PE subgroup and control group in terms of their exposure to TRAP. Results: Late-onset PE cases showed a significantly higher occurrence with density of major roads within a radius of 100-300 m compared to early onset cases (p = 0.006; 0.02; 0.04). In addition, a significantly shorter distance to the nearest ‘first class' main road was observed in late-onset PE cases (p = 0.0078). Conclusions: Exposure to TRAP during pregnancy was associated with an increased risk for the development of late-onset PE.

Effect of S100 calcium binding protein A12 on the pathogenesis of preeclampsia

To investigate the role of S100 calcium binding protein A12 (S100A12) in the pathogenesis of preeclampsia. Sixty patients with preeclampsia were recruited from March 2013 to December 2013 in the First Affiliated Hospital of Zhengzhou University. Among them, thirty cases were defined as the mild preeclampsia group and thirty cases were defined as the severe preeclampsia group. The other thirty healthy pregnant women were recruited in the healthy pregnant women group. The levels of S100A12 protein in maternal peripheral blood were detected by enzyme-linked immunosorbent assay (ELISA). Immunohistochemistry of streptavidin peroxidase biotin (SP) method was used to measure the protein expression of S100A12. The trophoblast cells were cultured in vitro with plasma from the three groups, and a blank control group was set up as well. Transwell was used to detect the cytotrophoblast invasion ability. Western blot was used to measure the protein expression level of receptor for advanced glycation end products (RAGE). (1) The levels of S100A12 in maternal peripheral blood of patients with preeclampisa [mild group: (30.8±2.7) µg/L, severe group: (49.3±4.1) µg/L] were significantly higher than that of the control group [(15.8±1.4) µg/L]. In addition, compared with the mild preeclampsia group, the level of S100A12 in the severe preeclampsia group was significantly higher (P < 0.05). (2) Positive immunostaining of S100A12 was observed in the cytoplasm of cytotrophoblast, decidual cells and the placentas from the three groups. The positive rate in the mild preeclampisa group was 77% (23/30); in the severe preeclampsia group it was 93% (28/30); and in the healthy pregnant women group it was 23% (7/30). The positive rates of placenta in the mild and severe preeclampsia groups were significantly higher than that in the healthy pregnant women group (P < 0.05). In addition, compared with the mild preeclampsia group, the positive rate of immunostaining of S100A12 in the severe group was significantly higher (P < 0.05). (3) Cytotrophoblast invasion ability and the expression of RAGE in the mild preeclampsia group were 29.1±3.2 and 0.479±0.038, respectively; in the severe preeclampsia group they were 16.8±2.5 and 0.652±0.059; in the healthy pregnant women group they were 38.6±24.3 and 0.327±0.024; and in the blank control group they were 42.6±5.6 and 0.194±0.011. Cytotrophoblast invasion ability and the expression of RAGE protein in the mild and severe preeclampsia groups were significantly higher than those in the healthy pregnant women group and the control group(P < 0.05). The expression of S100A12 increased in materal peripheral blood and placenta, and the receptor protein of S100A12 RAGE also had high expression. It suggested that the S100A12 may have some effect on the pathogenesis of preeclampsia.

Maternal soluble vascular cytoplasmic adhesion molecule-1 and fibronectin levels in early- and late-onset preeclamptic pregnancies

Objective: The purpose of this study was to investigate maternal plasma soluble vascular cytoplasmic adhesion molecule-1 (sVCAM- 1) and fibronectin levels in the patients with early-onset preeclampsia (EOP) and late-onset preeclampsia (LOP) and also to determine whether different mechanisms are involved in these two forms of disorders. Material and Methods: The authors performed a case control study consisting of randomly selected 80 healthy pregnant women (group 1= control group) and 80 preeclamptic women (group 2= defined study group). Study group consisted of 43 patients with EOP and 37 patients with LOP. sVCAM-1 and fibronectin concentrations were measured by enzyme-linked immunosorbent assay (ELISA) and the findings were compared between the groups. Results: The mean levels of sVCAM-1 and fibronectin were significantly higher in the LOP group than those in the normotensive group (p = 0.043 and 0.010 respectively). Markers were significantly different between the two hypertensive groups of pregnancy. The EOP group had a higher level of sVCAM-1 and fibronectin concentration than the LOP group (p = 0.01, for both markers). There was a positive correlation both between the values of plasma fibronectin and the systolic- diastolic blood pressure measurements (r:0.43 and 0.44, respectively), and between sVCAM-1 and the systolic/diastolic blood pressure measurements (r = 0.54 and 0.64, respectively). Conclusion: Increased plasma levels of fibronectin and sVCAM-1 were found in the preeclamptic patients, especially in those with early-onset preeclampsia. These markers might be related to the pathogenesis of different types of preeclampsia.

Neutrophil Expression of HNA-2 and mPR3 As Biomarkers for the Development of Preeclampsia

Introduction: The human neutrophil antigen-2 (HNA-2) is clinically important for being involved in immune neutropenias, febrile transfusion reactions and transfusion related acute lung injury (TRALI). HNA-2 is located on the glycoprotein CD177 (NB1) and is expressed on subpopulations of neutrophils, ranging from 0 to 100%. It has been suggested that the HNA-2 is the receptor to the membrane fraction of Proteinase 3 (mPR3), as they are co-expressed in the same subpopulation of neutrophils. Furthermore, HNA-2 binds to PECAM-1 on endothelial cells, facilitating the transendothelial migration of neutrophils. The preeclampsia (PE) is characterized by a neutrophil activation and production of pro-inflammatory cytokines, migration of neutrophils to human umbilical vein, and metabolic and phenotypic changes of neutrophils leading to endothelial dysfunction. The aim of this study was to determine the expression of HNA-2 and mPR3 into three different groups of individuals: nonpregnant women, healthy pregnant women and women with PE in order to investigate the role of these molecules in the pathogenesis of PE.Methods: A cross-sectional study included samples from 81 nonpregnant women, 75 healthy pregnant women, and 45 women with PE. Blood samples from nonpregnant women were collected at the Blood Center, while blood samples from pregnant women during the 2nd trimester of gestation were collected at 2 obstetric hospitals. The HNA-2 and mPR3 expression was determined by flow cytometry (FACSCalibur, Becton Dickinson) using the monoclonal antibodies MEM166 conjugated to PE and WGM2 conjugated to FITC, respectively (Abcam, Cambridge, UK). Mouse IgG1 was used as isotype control (Abcam, Cambridge, UK). The data acquisition and analysis was performed by CellQuest® software (Becton Dickinson). The fluorescence intensity was classified as low (≤ 60%), medium (61-80%) and high (> 80%). Subjects were considered HNA-2 or PR3-negative if less than 5% of their neutrophils reacted with the monoclonal antibodies.Results: The median percentage of neutrophils expressing HNA-2 and mPR3 was significantly higher in women with PE (88%), compared with the expression in healthy pregnant (70%) and nonpregnant women (72%) (p<0.0001; ANOVA). Analyzing the results according to the degree of HNA-2 and mPR3 expression, a higher expression (> 80%) was observed in 64% (29/45) of woman with PE compared to 33% (25/75) of healthy pregnant and 26% (21/81) of nonpregnant women (p=0.0009 and p<0.0001; respectively). Interestingly, we observed that two healthy pregnant women who initially presented increased antigens coexpression (median of 96%), developed PE at the 35th week of gestation. In addition, historical obstetric analysis of the healthy pregnant women group revealed three other women who had a previous clinical and laboratory diagnosis of PE showed in this study a high expression of antigens HNA-2 and mPR3 (median of 98%).Conclusion: The present study indicates that the expression of HNA-2 and mPR3 in neutrophils is significantly increased in women with PE. Such antigens overexpression may be associated to the increased migration of activated neutrophils to human umbilical vein endothelium in addition to the local inflammation and tissue destruction, factors already described to be involved in the etiology of PE. In conclusion, the present data suggest that high expressions of HNA-2 and mPR3 measured early in the 2nd trimester of the pregnancy may be possible biomarkers for the development of PE. DisclosuresNo relevant conflicts of interest to declare.

Differential expression of collectins in human placenta and role in inflammation during spontaneous labor.

Collectins, collagen-containing Ca2+ dependent C-type lectins and a class of secretory proteins including SP-A, SP-D and MBL, are integral to immunomodulation and innate immune defense. In the present study, we aimed to investigate their placental transcript synthesis, labor associated differential expression and localization at feto-maternal interface, and their functional implication in spontaneous labor. The study involved using feto-maternal interface (placental/decidual tissues) from two groups of healthy pregnant women at term (≥37 weeks of gestation), undergoing either elective C-section with no labor (‘NLc’ group, n = 5), or normal vaginal delivery with spontaneous labor (‘SLv’ group, n = 5). The immune function of SP-D, on term placental explants, was analyzed for cytokine profile using multiplexed cytokine array. SP-A, SP-D and MBL transcripts were observed in the term placenta. The ‘SLv’ group showed significant up-regulation of SP-D (p = 0.001), and down-regulation of SP-A (p = 0.005), transcripts and protein compared to the ‘NLc’ group. Significant increase in 43 kDa and 50 kDa SP-D forms in placental and decidual tissues was associated with the spontaneous labor (p<0.05). In addition, the MMP-9-cleaved form of SP-D (25 kDa) was significantly higher in the placentae of ‘SLv’ group compared to the ‘NLc’ group (p = 0.002). Labor associated cytokines IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α and MCP-1 showed significant increase (p<0.05) in a dose dependent manner in the placental explants treated with nSP-D and rhSP-D. In conclusion, the study emphasizes that SP-A and SP-D proteins associate with the spontaneous labor and SP-D plausibly contributes to the pro-inflammatory immune milieu of feto-maternal tissues.

Umbilical cord blood acid-base status in pregnancy with congenital heart disease.

The risk of fetal and neonatal complications is higher in pregnant women with congenital heart disease (CHD). It remains unknown whether umbilical cord blood gas values are different between pregnant women with CHD and healthy women undergoing elective cesarean section during combined spinal-epidural anesthesia. The purpose of the present study was to compare umbilical cord blood acid-base status and gas values in pregnant women with CHD vs. healthy pregnant women undergoing elective cesarean section during combined spinal-epidural (CSE) anesthesia. Patients with singleton pregnancy undergoing elective cesarean delivery under CSE anesthesia were enrolled. Patients were divided into two groups: healthy pregnant women (group H) and pregnant with congenital heart disease (group CHD). Immediately after delivery, umbilical cord arterial blood sample and venous blood sample were collected and measured. The comparison between two groups was performed using grouped t-test. Forty-four women in group H and 33 women in group CHD were analyzed finally. Umbilical arterial blood pH, base excess (BE) and HCO3 (-) (pH 7.29 ± 0.05, BE -1.4 ± 1.9 mmol/L, HCO3 (-) 21.5 ± 1.4 mmol/L) were significantly lower in pregnant women with CHD than in healthy pregnant women (pH 7.33 ± 0.03, BE -0.1 ± 2.1 mmol/L, HCO3 (-) 22.5 ± 1.4 mmol/L). The lower values of umbilical arterial blood pH, BE and HCO3 (-) were observed in pregnant women with CHD than in healthy women undergoing elective cesarean section during CSE anesthesia.

Prohepcidin in maternal circulation: is it related to spontaneous preterm labor?

To investigate whether spontaneous preterm labor (PTL) with intact membranes is associated with changes in maternal serum prohepcidin concentrations. The study consisted of patients with spontaneous PTL with intact membranes (n = 25), a control group of healthy pregnant women between the 24th and 37th gestational weeks (n = 22), and uncomplicated term pregnancies in spontaneous labor (n = 19). Blood samples were collected from patients at the time of clinical diagnosis. Levels of prohepcidin, hemoglobin, serum ferritin, serum iron, unsaturated iron binding capacity, total iron binding capacity, transferrin and transferrin saturation, C reactive protein, and interleukin-6 were measured. Patients with spontaneous PTL had significantly lower maternal serum prohepcidin concentrations than term delivery and control subjects. Maternal serum prohepcidin concentration is lower in patients with spontaneous PTL compared to term delivery and control subjects. This suggests that measuring maternal serum prohepcidin concentrations in PTL may be a feasible method for understanding etiologic causes of spontaneous preterm delivery, but, before suggesting this as a course of action, low levels of prohepcidin in patients with PTL need to be more fully investigated.

Immune mechanisms and the role of oxidative stress in intrahepatic cholestasis of pregnancy.

IntroductionThe purpose of this study was to investigate levels of inflammatory cytokines such as interleukin 6 (IL-6), tumor necrosis factor α (TNF-α) and neopterin and oxidative stress status in patients with intrahepatic cholestasis of pregnancy (ICP) as well as their potential role in the pathophysiology.Material and methodsThirty patients with ICP (Group 1) and 30 healthy pregnant women (Group 2) were included in this prospective case-control study. Levels of IL-6, TNF-α and neopterin were determined in both of the groups. Total anti-oxidant status (TAS) and total oxidative stress (TOS) levels were determined by means of a fully automated Erel method. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS.ResultsThere was no significant difference between the groups in IL-6 and TNF-α levels (p = 0.105 and p = 0.722, respectively). The mean neopterin level was significantly higher in Group 1 compared to Group 2 (2.34 ±0.77 and 1.57 ±0.38, respectively, p = 0.001). In addition, TAS, TOS and OSI levels were significantly higher in Group 1 (p = 0.004, p = 0.001 and p = 0.001, respectively) compared to Group 2.DiscussionIntrahepatic cholestasis of pregnancy is an inflammatory disorder in which maternal immune reaction may play a role. Interleukin 6 and TNF-α, which are some of the markers of humoral reaction, act as an indicator of abnormal reaction rather than acute-phase reaction in ICP. Further clinical trials and supportive placental findings are needed on the role of cytokines in cellular and humoral immune reactions during the symptomatic period and delivery to better understand the role of immune mechanisms in the aetiology of ICP.

158: Genome wide maternal leukocyte DNA methylation analysis performed longitudinally throughout normal pregnancy

Pregnancy is associated with significant change in leukocyte composition/function in the establishment/adaptation to pregnancy and parturition. We characterized methylation profiles longitudinally in a group of healthy pregnant women.

Examination of Intrarenal Resistance Indices Indicate the Involvement of Renal Pathology as a Significant Diagnostic Classifier of Preeclampsia

Preeclampsia (PE) is a hypertensive disorder during pregnancy with endotheliosis leading to occlusion of renal perfusion with an impact on the glomerular filtration barrier. We therefore analyzed the role of intrarenal resistance indices in the renal interlobular arteries measured by Doppler ultrasound as a diagnosis of PE. Women with preeclampsia (n = 24; mean blood pressure/24 h = 145 ± 11/ 93 ± 7 mm Hg; mean proteinuria = 5.63 ± 1.0 g/24 h) were compared against a group of healthy pregnant women (n = 24). All patients underwent a Doppler ultrasound of the intrarenal arteries between the 24th week of gestation and the 5th week postpartum. Several risk factors for PE, as well as the arterial resistive indices of the Arteriae uterinae and the Arteria umbilicalis, were monitored in parallel. The intrarenal resistive index (mean ± SD = 0.63 ± 0.05 in women with preeclampsia vs. 0.59 ± 0.056 in healthy pregnant women; P < 0.003), the pulsatile index (mean ± SD = 1.15 ± 0.19 in women with preeclampsia vs. 0.92 ± 0.13 in healthy pregnant women; P < 0.0001), and the end diastolic flow velocity (mean ± SD = 14.16 ± 4.75 cm/s in women with preeclampsia vs. 10.67 ± 2.68 cm/s in healthy pregnant women, P < 0.006) were elevated in patients with PE, as were the arterial resistive indices of the Aa. uterinae and A. umbilicalis. The intrarenal resistive indices correctly classified 84.2% of the women as having PE. Intrarenal resistive indices are a significant classifier of PE, providing the possibility to predict nephropathy. They could be a prognostic tool for cardiovascular comorbidity in PE patients even after delivery.

Factor de crecimiento de hepatocitos plasmático en preeclampsia y eclampsia

ObjectiveTo compare plasma hepatocyte growth factor concentrations in eclamptic, preeclamptic and normotensive pregnant women. Materials and methodWe included 30 patients with mild preeclampsia (group A), 30 patients with severe preeclampsia (group B) and 30 patients with eclampsia (group C). A control group of 30 healthy pregnant women (group D) was selected with a similar age and body mass index to participants in the study groups. Only nulliparous patients were included. Blood samples were collected for plasma hepatocyte growth factor determination in all patients before delivery and in the study groups immediately after diagnosis. ResultsPlasma hepatocyte growth factor values were highest in eclamptic patients and in severe preeclamptic patients and were lowest in mild preeclamptic patients. Hepatocyte growth factor values were significantly higher in the study groups than in controls (P<.05). Linear regression analysis revealed that 24-hour proteinuria significantly affected plasma hepatocyte growth factor concentrations (P<.05). ConclusionThe findings of this research showed that plasma hepatocyte growth factor concentrations were higher in eclamptic and preeclamptic patients than in normotensive pregnant women.

Diet and Carbohydrate Food Knowledge of Multi-Ethnic Women: A Comparative Analysis of Pregnant Women with and without Gestational Diabetes Mellitus

BackgroundDiet therapy is the cornerstone for the management of gestational diabetes mellitus (GDM). Carbohydrate is the primary nutrient affecting postprandial blood glucose levels. Hence, knowledge of food containing carbohydrates can assist women with GDM optimize glycemic control. Despite that, there is a paucity of research on carbohydrate-related knowledge of women with GDM. The United Arab Emirates (UAE) has one of the highest prevalence of diabetes (19.2%) in the world. This study compared diet and knowledge of carbohydrate-containing foods among pregnant women with and without GDM in the UAE.MethodsThe sample consisted of multi-ethnic women with GDM (n = 94) and a control group of healthy pregnant women (n = 90) attending prenatal clinics in three hospitals in Al Ain, UAE. Data were collected using a questionnaire and a 24-hour recall. Knowledge of food sources of carbohydrate, dietary patterns, and nutrient intakes of the two groups were compared.ResultsThere were no significant differences in the mean knowledge score of food sources of carbohydrate between women with GDM and that of pregnant women without GDM. Similarly, there were no significant differences in energy and nutrient intakes between the two groups with the exception of percent energy from protein. Women with GDM reported significantly lower intake of fruits and fruit juices (P = 0.012) and higher consumption of milk and yogurt (P = 0.004) compared to that of women without GDM. Twenty-two percent of women with GDM indicated they never visited a dietitian for counseling while 65% reported they visited a dietitian only once or twice during the pregnancy. Predictors of carbohydrate knowledge score were perceived knowledge of diet and GDM and parity among women with GDM and parity and educational level among those without GDM.ConclusionThe results of the study highlight the urgent need to provide nutrition education for women with GDM in the UAE.

VEGF, PIGF and HIF-1α in placentas of early- and late-onset pre-eclamptic patients

Purpose: The aim of this study was to compare the VEGF, PIGF, and HIF-1α levels in the placentas of early- and late-onset pre-eclamptic patients, which are thought to be important in pathophysiology of pre-eclampsia.Material and method: Pre-eclamptic early-onset (n = 22) and late-onset (n = 24) pregnant women and a control group of healthy pregnant women (n = 22) were recruited for this case–control study. A semi-quantitative immunohistochemical analysis of VEGF, PIGF and HIF-1α was performed in cross-sections of the placentas of the subjects, after which results were compared.Results: Levels of VEGF and PIGF in the placentas of pre-eclamptic patients were found to be lower than the levels in the placentas of healthy pregnant women (p < 0.001 and p = 0.025, respectively), whereas the levels of HIF-1α were found significantly higher (p < 0.001). No difference was observed in terms of VEGF, PIGF and HIF-1α in a comparison of the early- and late-onset pre-eclampsia groups (p > 0.05).Conclusion: The results of the study indicated that there is no relationship between the time of onset of pre-eclampsia and the placental changes that occur in these factors.

Thyroid autoimmunity and obstetric outcomes in women with recurrent miscarriage: a case–control study

ObjectivesThyroid antibody positivity during pregnancy has been associated with adverse outcomes including miscarriage and preterm delivery. The aim of the study is to evaluate the obstetric outcome in pregnant women with recurrent miscarriage and their response to levothyroxine (l-T4) therapy.Study design and methodsAll pregnant and non-pregnant women between 21 and 35 years of age with a history of two or more consecutive miscarriages were included in the study. A third group comprising 100 pregnant women without a history of miscarriage were taken as healthy controls. Thyroid autoimmunity, prevalence of subclinical hypothyroidism and maternal and foetal complications were analysed in all the groups with appropriate statistical methods.ResultsThe mean age of the patients included in the study was 27.0±3.1 years. Of 100 pregnant patients with previous recurrent miscarriage, thyroid autoimmunity (thyroid peroxidase antibody (TPOAb+) >34 U/ml) was found in 31% of the cases. The incidence of subclinical hypothyroidism was higher in TPOAb+ group than in TPOAb− group (52 vs 16%; P=0.0002). There was no difference in the prevalence of miscarriage or obstetric outcomes between recurrent miscarriage and healthy pregnant women group irrespective of TPO status.ConclusionsThe prevalence of thyroid autoimmunity was higher in pregnant women with a history of recurrent abortion compared with healthy pregnant control population. Following l-T4 treatment, there was no difference in prevalence of miscarriage between hypothyroid and euthyroid individuals in TPOAb+ women.

Cholesterol and Triglycerides May Reached the Undesirable Level in Gestational Diabetes Mellitus

4 Abstract: Lipid profile including cholesterol, triglycerides, High Density Lipoprotein-cholesterol (HDL-C) and Low Density Lipoprotein-cholesterol (LDL-C) level was determined in patients with Gestational Diabetes Mellitus (GDM) and compared to Healthy Pregnant Women (HPW). 103 GDM women and 97 HPW were registered in the Khyber Teaching Hospital, Peshawar in the time period of May to December 2012. Total cholesterol, triglycerides, HDL-C and LDL-C was determined by standard kit procedures. Mean Total Cholesterol (TC) and mean Triglyceride (TG) were significantly higher at P<0.05 in GDM group as compared to HPW group. The mean value of total cholesterol in GDM group was 205.81±19.09 mg/dL while in HPW (control group) it was 194.86±23.70 mg/dL. The mean TG level of GDM women was 189.62±20.01 mg/dL while of HPW was 169±22.26 mg/dL. The mean HDL cholesterol (HDL-C) and the mean LDL cholesterol (LDL-C) of GDM women were non significantly higher than HPW. The percentage of GDM in undesirable level of cholesterol (P = 0.03) and triglycerides (P = 0.003) was significantly higher as compared to HPW, however the percentage of GDM in undesirable level of HDL-C and LDL-C was non significantly different from HPW.

PP015. Plasma levels and placental expression of BNP/NT-proBNP in early and late onset preeclampsia

Women with preeclampsia (PE) have elevated plasma levels of NT-proBNP. We hypothesized that the placenta may be a source to these elevated levels. Our objectives were to study the plasma levels of NT-proBNP and the protein and mRNA expression of placental BNP in women with early and late onset PE and controls. Plasma levels of NT-proBNP were measured in women with early (n=18) and late (n=20) onset PE, in two groups of healthy pregnant women in gestational week 24-32 (n=22) and 36-42 (n=14), and in non-pregnant women (n=20). Placental BNP protein and mRNA was studied with immunohistochemistry and qPCR. Placental release of NT-proBNP was studied with tissue culturing. Women with early (365 (14-9815) pg/ml) and late (176 (33-2547) pg/ml) onset PE had higher levels of NT-proBNP in plasma than their respective controls (p<0.001). A tendency towards higher plasma levels in early compared to late onset PE was observed (p=0.057). 20 out of 25 placental tissue samples had proBNP mRNA, no differences between the study groups were found. BNP protein was found in maternal spiral arteries and syncytiotrophoblasts. NT-proBNP peptide (6-7pg/ml) was present in medium used for placenta cultures. Our results suggest that there may be a placental source of NT-proBNP. If this source is responsible for the elevated plasma levels of NT-proBNP in preeclamptic women and what role, if any, BNP/NT-proBNP play in PE pathophysiology remains to be elucidated.

Assessment of hemostatic function in pregnant women undergoing surgery using a Platelet Function Analyzer-100

Assessment of hemostatic function in pregnant women undergoing surgery using a Platelet Function Analyzer-100

Following Healthy Pregnancy by Nuclear Magnetic Resonance (NMR) Metabolic Profiling of Human Urine

In this work, untargeted NMR metabonomics was employed to evaluate the effects of pregnancy on the metabolite composition of maternal urine, thus establishing a control excretory trajectory for healthy pregnancies. Urine was collected for independent groups of healthy nonpregnant and pregnant women (in first, second, third trimesters) and multivariate analysis performed on the corresponding NMR spectra. Models were validated through Monte Carlo Cross Validation and permutation tests and metabolite correlations measured through Statistical Total Correlation Spectroscopy. The levels of 21 metabolites were found to change significantly throughout pregnancy, with variations observed for the first time to our knowledge for choline, creatinine, 4-deoxyerythronic acid, 4-deoxythreonic acid, furoylglycine, guanidoacetate, 3-hydroxybutyrate, and lactate. Results confirmed increased aminoaciduria across pregnancy and suggested (a) a particular involvement of isoleucine and threonine in lipid oxidation/ketone body synthesis, (b) a relation of excreted choline, taurine, and guanidoacetate to methionine metabolism and urea cycle regulation, and (c) a possible relationship of furoylglycine and creatinine to pregnancy, based on a tandem study of nonfasting confounding effects. Results demonstrate the usefulness of untargeted metabonomics in finding biomarker metabolic signatures for healthy pregnancies, against which disease-related deviations may be confronted in future studies, as a base for improved diagnostics and prediction.