Mild Preeclampsia Group Research Articles

Significance of the platelet distribution width as a severity marker for the development of preeclampsia

ObjectiveTo evaluate the platelet distribution width (PDW) and other platelet indices as potential severity markers of preeclampsia (PE). Study designA total of 935 pregnant women who had received continuous prenatal care and had undergone delivery were included. The participants were classified into 3 groups: healthy pregnant women (n=816), pregnant women with mild PE (n=59), and pregnant women with severe PE (n=60). Blood samples were collected during antenatal care or at the time of admission, and the platelet indices were compared among the three groups. ResultsAmong the three groups, the platelet count and plateletcrit decreased as the disease progressed. The mean platelet volume and the PDW, however, increased as the disease progressed. When compared to the levels of other platelet indices, the PDW showed significant elevation in the severe PE group. In the mild and severe PE groups, the PDW was statistically correlated with the mean arterial pressure (MAP) (r=0.231, p<0.05), whereas other platelet indices were not. In the receiver operating characteristics curve analysis, the area under the curve of the PDW to predict severe PE was 0.74. ConclusionsAmong platelet indices, the PDW is significantly higher in women with severe PE than in women with mild PE, and is positively correlated with the MAP. Therefore, the PDW can serve as a candidate marker for predicting the severity of PE.

Serum parathyroid hormone and total serum calcium levels in mild &amp; severe preeclampsia versus normal pregnancy

Background: Preeclampsia (PE) is a major cause of maternal morbidity and mortality, complicating 3-14% of all pregnancies. Although the etiology remains unknown, placental hypoperfusion and diffuse endothelial cell injury are considered to be the central pathological process; many endocrinological changes have been linked to the etiology of preeclampsia including parathyroid hormone and calcium level.&#x0D; Objective: to compare serum parathyroid hormone and total serum calcium levels in mild and severe preeclampsia versus normal pregnancy.&#x0D; Patients and methods: Serum parathyroid hormone (PTH) level and total serum calcium level were measured in thirty normotensive pregnant women and thirty women with mild preeclampsia and thirty women with severe preeclampsia using Enzyme Linked Immuno- Sorbent Assay (ELISA) test for parathyroid hormone &amp; colorimetric test for total serum calcium. All pregnant women enrolled in the study had similar demographic background. Patient and control groups were matched for age, and gestational age.&#x0D; Results: Total serum calcium level was decreased and parathyroid hormone level was elevated in preeclamptic women compared to normotensive women with significantly lower total serum calcium (7.43 ± 0.68) and higher level of parathyroid hormone (93.84 ±10.63) in severe preeclampsia compared to mild preeclampsia group where total serum calcium was(8.02±1.02) and parathyroid hormone was (79.34 ±6.04).With p value &lt;0.005 between mild &amp; severe preeclampsia groups.&#x0D; Conclusion: Total serum calcium is significantly decreased &amp; parathyroid hormone is significantly increased in severe preeclampsia in comparison to normal pregnancy.

Variants -250G/A and -514C/T in the LIPC gene are associated with hypertensive disorders of pregnancy in Chinese women.

We examined the influence of the promoter polymorphisms -250G/A (rs2070895) and -514C/T (rs1800588) in the human hepatic lipase (LIPC) gene on dyslipidemia and hypertensive disorders complicating pregnancy (HDCP) in a Chinese population. Clinically defined HDCP patients (N = 321) and healthy pregnant women (N = 331) were recruited and genotyped using polymerase chain reaction-restriction fragment length polymorphism for the two LIPC single nucleotide polymorphisms (SNPs). The results showed significant relationships between HDCP and triglycerides, apolipoprotein A1, and high-density lipoprotein cholesterol (P < 0.05), which confirmed that HDCP was accompanied by dyslipidemia. The results also demonstrated that in gestational hypertension (GH) patients, both total cholesterol (TC) and systolic blood pressure (SBP) levels were related to the two SNPs (P ≤ 0.004), although no significant association was found between HDCP and LIPC genotypes or alleles. Significant linkage disequilibrium of the two SNPs was found in both HDCP patients (R(2) = 0.867) and controls (R(2) = 0.91). Body mass index (BMI) was associated with -250G/A in women with mild preeclampsia (MPE) (P = 0.01). Carriers of the mutant homozygote -250AA genotype presented higher BMI in the MPE group. In conclusion, the LIPC -250G/A and -514C/T variants influenced TC and SBP levels in GH patients and the BMI level in the MPE group, although there was no evidence to validate an association between HDCP and LIPC allele, genotype, or haplotype frequencies.

G1691A MUTATION OF&amp;NBSP; F5 GENE AND PREECLAMPSIA

Background:G1691A mutation of F5 gene is a risk factor of thrombosis and endothelial dysfunction causing preeclampsia (PE). This study aimed to (1) determine the rate of 1691GG, 1691GA and 1691AA genotypes of F5 gene in preeclamptic and normotensive pregnant women, and (2) survey the association between G1691A mutation of F5 gene and preeclampsia. Patients and methods: 73 preeclamptic pregnant women and 292 normotensive pregnant women were determined G1691A genotypes of F5 gene by PCR-RFLP in with DNA samples extracted from peripheral blood lymphocytes. Results:100% normotensive pregnant women were 1691GG genotype. In the group of preeclamptic pregnant women, the rate of 1691GA genotype and 1691GG were 4.1% and 95.9%, respectively. G1691A mutation was a risk factor of preeclampsia, with OR = 29.04, 95%CI = 1.48-558.72. The rate of G1691A mutation carriers in mild PE group was 0%, in severe PE was 7.7% and in eclampsia was 100%. Conclusion:There was the association between G1691A mutation and the development and severity of preeclampsia. Keywords: Preeclampsia, G1691A mutation, factor V Leiden, F5 gene.

Procalcitonin: A Severity Marker for Pre-Eclampsia?

Introduction: Pre-eclampsia is a common and potentially dangerous disorder of human pregnancy. The maternal syndrome of hypertension and proteinuria is part of a severe systemic inflammatory response that includes leukocyte and endothelial cell activation. PCT is a polypeptide consisting of 116 aminoacids and is the precursor of calcitonin. Over the last decade, PCT has become increasingly popular as a novel marker of infection in the intensive care unit setting. The aim of our study was to evaluate changes in serum levels of PCT in pregnancies complicated with mild pre-eclampsia or severe pre-eclampsia and further investigate the correlation with CRP. Methods: Throughout the study period, 80 pregnant women complicated with mild preeclampsia, 80 pregnant women complicated with severe preeclampsia and 80 healthy pregnant women as a control group, giving a total of 240 pregnant women were enrolled into study. Results: Both severe pre-eclampsia and mild pre-eclampsia groups showed significantly higher PCT values when compared with control healthy group (p<0.05). Also, severe pre-eclampsia group showed significantly higher PCT values when compared with mild pre-eclampsia group (p<0.05). A statistically significant correlation was observed in between presence of pre-eclampsia and procalcitonin positivity (p<0.05). And also severity of pre-eclampsia has shown a statistically significant correlation with high values of procalcitonin (p<0.05). Conclusion: Procalcitonin might be a diagnostic marker for investigating women especially with suspected severe preeclampsia. Keywords: Procalcitonin, Pre-eclampsia, inflammation, marker. Read more →

Evaluation of plasma fibrinogen and plasma fibrin degradation product (FDP) in Preeclampsia

Background: Preeclampsia is one of the commonest complications of pregnancy. It is associated with a state of hypercoagulability. The present study aimed to estimate the plasma fibrinogen and plasma FDP levels in preeclampsia compared to normal pregnancies. Materials and Methods: This is a case-control hospital based study carried in the Department of Biochemistry M.G.M. Medical College and associated M.Y. Hospital, Indore (M.P., India). Normal pregnant women (n=36) and women with preeclampsia (n=64) in their third trimester were included in the study. Preeclamptic group was classified in to mild (n=42) and severe (n=22) preeclampsia. Plasma fibrinogen and FDP levels were analysed, and compared between the groups. Results: Preeclampsia and normal pregnancy groups were comparable for age and body mass index but preeclampsia group had higher blood pressures and less period of gestation (p<0.0001). The levels of plasma fibrinogen (654.5±131.74 vs. 491.52±81.7 mg/dL) and plasma FDP (10.96±2.32 vs. 5.54±0.8 µg/L) were higher in the preeclampsia group as compared to normal pregnancy (p<0.0001). Elevations in fibrinogen and FDP levels were more marked for severe preeclampsia group than mild preeclampsia group. Conclusion: Preeclampsia is associated with high fibrinogen and FDP levels as compared to normal pregnancies. Severe preeclampsia patients have greater elevations as compared to mild preeclampsia patients. Key words: Fibrin degradation products, Fibrinogen, pre-eclampsia.

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.

Maternal serum CA-125 level is elevated in severe preeclampsia.

The aim of this study was to determine the relationship between serum concentrations of cancer antigen-125 (CA-125) and pre-eclampsia severity. We evaluated 91 females with a singleton pregnancy. Serum CA-125 levels were measured in subjects with severe pre-eclampsia (n=34) and those with mild pre-eclampsia (n=24). Females with healthy pregnancies (n=31) served as the control group. The three study groups were statistically similar in terms of maternal age, gestational age, and body mass index. The CA-125 level was significantly higher in the severe pre-eclampsia group than that in the mild pre-eclampsia and control groups (p<0.05). No significant difference in CA-125 levels between the mild pre-eclampsia and control groups was observed. CA-125 level was positively correlated with proteinuria (r=0.489, p=0.000), systolic blood pressure (r=0.503, p=0.018), and diastolic blood pressure (r=0.532, p=0.000). In contrast, CA-125 was negatively correlated with birth weight (r=0.266, p=0.012) and gestational age at birth (r=0.250, p=0.018). CA-125 level increased in severe pre-eclampsia, which reflected abnormal trophoblastic invasion and chronic inflammation. Elevated levels of CA-125 in pre-eclamptic patients may be a marker of the disease severity.

Association between High Serum Homocystine and Preeclampsia

Background: Hyperhomocysteinemia is an important biological marker for adverse outcome of pregnancy. Objective: The aim of the present study was to see the association of high serum homocysteine with preeclampsia (PE). Methodology: This cross sectional study was carried out in the Department of Obstetrics and Gynaecology at Sir Salimullah Medical College &amp; Mitford Hospital, Dhaka. All pregnant women with or without eclampsia admitted at the hospital were included in this study. Pregnant women with diabetes mellitus, chronic hypertension, multiple pregnancies, chronic renal disease and patients taking anti-folate drugs were excluded from this study. Fasting serum total homocysteine (tHomocysteine) concentration was estimated by Fluorescence Polarization Immunoassay (FPIA) method. Result: A total number of 50 PE patient [Severe PE (23) &amp; Mild PE (27)] and 50 pregnant women without PE were selected purposively. Fasting serum total homocysteine (tHomocysteine) concentration was estimated by fluorescence polarization immunoassay (FPIA) method. Mean serum homocysteine concentration in severe PE, mild PE and pregnant women without PE were 11.5 4.58 mol/L, 10.43 5.12 and 5.70 1.30 respectively. Serum homocysteine was significantly increased in severe PE and mild PE in comparison to without PE group . Howere severe PE and mild PE group cases did not differ with respect to serum homocysteine. Conclusion: Significant positive correlation was found between serum homocysteine concentration and urinary total protein, uric acid level, systolic blood pressure and diastolic blood pressure. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16200 J Shaheed Suhrawardy Med Coll, 2013;5(1):21-25

Expression and clinical significance of serum levels of TGF-β1 and TNF-α in patients with hypertensive disorder complicating pregnancy

Objective To study the expression and clinical significance of serum levels of transforming growth factor-31 (TGF-β1) and tumor necrosis factor-alpha(TNF-α) in patients with hypertensive disorder complicating pregnancy(HDCP).Methods The serum levels of TGF-β1 and TNF-αin 50 cases with HDCP and 30 cases of normal third trimester pregnant women(control group) were detected by ELISA.50 cases with HDCP were divided into gestational hypertension group,mild preeclampsia group and severe preeclampsia group according to the severity of HDCP.Results The serum levels of TGF-β1 and TNF-α in HDCP patients were significantly higher than the control group (t =13.283,13.607,all P ＜ 0.05).The serum levels of TGF-β1 and TNF-α gradually increased with the aggravating of HDCP disease,the serum levels of TGF-β1 and TNF-αwere significantly different among the three subgroups of HDCP(P ＜ 0.05).The correlation analysis showed that the serum levels of TGF-β1,TNF-α were positively correlated with the severity of HDCP (r =0.575,0.512,all P ＜ 0.05),there was significantly positive correlation between the serum TGF-β1 and TNF-α(r =0.515,P ＜0.05).Conclusion The serum levels of TGF-β1 and TNF-α were high in the HDCP patients,the high levels of TGF-β1 and TNF-α can reflect the changes and development of HDCP disease.The abnormal levels of TGF-β1 and TNF-α may be associate with dysfunction of trophoblast cell. Key words: Hypertension, pregnancy-induced; Transforming growth factor-β1 ; Tumor necrosis factor-alpha

Relationship between pigment epithelium-derived factor expressed in placentas and the pathogenesis of preeclampsia disease

To investigate the effect of pigment epithelium-derived factor (PEDF) on the pathogenesis of preeclampsia disease, by detecting the expression of PEDF in the placentas, as well as the relationship between PEDF and the production of placental vessels. A study was performed in 60 cases of pregnant women with preeclampsia in the obstetrical department of Nanfang Hospital affiliated to southern medical university from October 2011 to January 2013, in which 30 cases were patients with mild preeclampsia(mPE) and other 30 cases were those with severe preeclampsia (sPE).40 normal pregnant women who also been hospitalized and delivered were selected as control group. The expression of PEDF and micro-vessel density (MVD) in placentas were assayed by using western blot and SP immunohistochemical method, then the relationship between PEDF and MVD was analyzed. (1) The pathological changes of placentas:the placental weight were lightened obviously in the mild preeclampsia and severe preeclampsia groups, the reduced blood vessels and luminal stegnosis were found in chorionic villus, basement membrane of trophocytes were thickening. The hyperplasia syneytiotrophoblast were like nodosity, with focus infarction, fibrinoid necrosis, or thrombogenesis.While there was no the above mentioned pathological alteration in normal control group. (2)The levels of PEDF expression in mild and severe preeclampsia group were 0.63 ± 0.09, 0.93 ± 0.07, while 0.47 ± 0.04 in control group, which in mild and sever preeclampsia groups were significantly higher than that in normal group (P < 0.05). Compared to mild preeclampsia group, the expression of PEDF was significantly increased in severe preeclampsia group, there was statistical significance between the difference (P < 0.05).(3) The amount of microvessel density (MVD) in mild and severe preeclampsia group were 106 ± 9, 93 ± 8, while 136 ± 9 in control group, which were significantly reduced in mild and severe preeclampsia group, compared to that in normal control group (P < 0.05). And it was significantly lower in severe preeclampsia group than that in mild preeclampsia group (P < 0.05). (4) The expression of PEDF was negatively correlated with the amount of MVD in mild and severe preeclampsia group (r = -0.426, P < 0.05; and r = -0.646, P < 0.05 respectively), which was also negative in control group (r = -0.589, P < 0.05). Increased PEDF expression in placentas of women with preeclampsia induce the dysfunction of the placental vascular reconstruction and the pathological alteration like ischemic and hypoxia in placentas, which may be involved in pathogenesis and pathogenic progress of preeclampsia.

Umbilical cord activin A concentration in pregnancies complicated by mild preeclampsia and relationship between activin A levels and Doppler

To evaluate the significance of umbilical cord activin A concentration in preeclampsia and also explore the relationship between activin A levels and Doppler findings. Methods. The study population was constituted 40 pregnancies complicated with term mild preeclampsia and control group constituted 40 pregnancies with uneventful, term gestation. Umbilical cord blood samples were collected immediately after fetus delivery. Umbilical artery and middle cerebral artery flow velocity waveform were determined just before delivery. Activin A levels were high in preeclamptic group (p<0.0001). Marked increase of umbilical artery S/D rate and pulsatility index (PI)(p<0.0001) and also decrease of middle cerebral artery PI (p<0.05) were detected in preeclamptic group. No significant changes in middle cerebral artery S/D rate were observed between two groups (p>0.05). There were no correlation between Doppler examination and activin A level. Umbilical cord activin A levels reflected directly fetoplacental unit resistance in preeclampsia. <br/><a href=

Endostatina sérica en preeclampsia y eclampsia

ObjectiveTo compare serum endostatin concentrations in eclamptic, pre-eclamptic and normotensive pregnant women. Materials and methodThe study included 30 patients with mild preeclampsia (group A), 30 patients with severe pre-eclampsia (group B), and 30 patients with eclampsia (group C). A control group, consisting of 30 healthy pregnant women of similar age and body mass index to the studiy groups, was selected (group D). Only nuliparous patients were included. Blood samples were collected for serum endostatin determination from all patients before delivery, and from the study groups immediately after diagnosis. ResultsHigher values of endostatin were observed in eclamptic patients together with severe pre-eclamptic patients. Lower values were found in mild pre-eclamptic patients. The study groups had significantly higher values of endostatin compared with the control group (P<.05). Linear regression analysis, found that factors that significantly affected plasma endostatin concentrations were uric acid and 24-hour proteinuria. ConclusionThe findings of this study showed that eclamptic and pre-eclamptic patients had higher serum endostatin concentrations than normotensive pregnant women.

Polymorphisms in the activin A receptor type 2A gene affect the onset time and severity of preeclampsia in the Turkish population

To investigate the possible roles of selected single nucleotide gene polymorphisms (SNPs) of the activin A receptor type 2A (ACVR2A) gene in the pathogenesis of preeclampsia. Ninety-four patients with preeclampsia and 166 healthy pregnant women were included in this study. Genomic DNA was extracted from venous blood and were stored at -80°C before the analysis. Selected ACVR2A SNPs (rs10497025, rs1128919, rs13430086) were determined in an ABI 7900 HT Real-Time PCR instrument. For all three SNPs, no statistically significant difference was found between preeclampsia and control groups in terms of genotype and allele frequencies. In the late preeclampsia group, with regard to the rs1128919 SNP, the frequency of GG genotype was found to be significantly lower (P=0.02). Although the frequency of "A" allele was found to be higher (P=0.05; OR=1.54), and the "G" allele was found to be lower (P=0.05; OR=0.65), the results did not reach statistical significance in late preeclamptic patients. For the rs1128919 SNP, the frequency of the AA genotype was found to be significantly higher in both mild (P=0.004) and severe (P=0.0001) preeclampsia groups, whereas the frequency of GG genotype was found to be significantly lower (P=0.008, and P=0.0001, respectively). For the rs13430086 SNP, while the frequency of the AA genotype was found to be significantly lower in both mild (P=0.02) and severe (P=0.0001) preeclamptic patients, the frequency of TT genotype was found to be significantly higher in only severe preeclampsia group (P=0.0001). ACVR2A gene polymorphisms may play a role in the development of preeclampsia.

Interleucina 6 plasmática y velocimetría doppler de las arterias uterinas en preeclámpsicas y embarazadas normotensas sanas

ObjectiveTo determine interleukin-6 concentrations and analyse their relationship with doppler velocimetry in patients with preeclampsia and healthy normotensive pregnant women. Material and methodsA total of 160 patients were selected, of whom 47 were patients with severe preeclampsia (group A), 33 with mild preeclampsia (group B), and 80 healthy pregnant women with ages similar to patients in the two study groups selected as controls (group C). Blood samples for interleukin-6 and measurements of pulsatility index, resistance index and systolic/diastolic blood flow ratio of uterine arteries were performed before labour on all patients, and immediately after diagnosis in the preeclampsia groups. ResultsPatients in groups A and B (preeclampsia) had higher interleukin-6 concentrations than group C (P<.05). Measurements of pulsatility index, resistance index and systolic/diastolic blood flow ratio of uterine arteries were higher in both groups of preeclampsia patients (P<.05). There was a significant relationship between the plasma interleukin-6 concentrations and all three evaluated doppler velocimetry parameters (P<.05). ConclusionPreeclampsia patients had higher plasma interleukin-6 concentrations than normotensive pregnant women, and there was a significant correlation between plasma concentrations and parameters of doppler velocimetry of uterine arteries.

Expression of endoglin and transforming growth factor-β1 in placenta and superficial myometrium of women with gestational hypertension or preeclampsia

Objective To investigate the expression of transforming growth factor-β1 (TGF-β1),endoglin (Eng) and their mRNA in placenta and superficial myometrium of patients with gestational hypertension or preeclampsia and to explore the role of Eng and TGF-β1 in the pathogenesis of gestational hypertension or preeclampsia.Methods One hundred and ten pregnant women were selected in the Second Affiliated Hospital of Tianjin Medical University from April 2009 to April 2010 who underwent cesarean sections and were divided into four groups:gestational hypertension group (n=30),mild preeclampsia group (n=30),severe preeclampsia group (n=30) and control group (normal pregnant women without labor and perinatal complications,n=20).The tissues of placenta and superficial myometrium were collected during cesarean section.Protein levels of Eng and TGF-β1 were detected by Western Blot.Real-time fluorescence reverse transcription polymerase chain reaction was used to detect the Eng and TGF-β1 mRNA expression.One-way ANOVA was used to compare among groups,Student-Newman-Keuls test was used to compare the differences between groups; relation between groups was analyzed by Pearson relation and linear regression.Results In control group,gestational hypertension group,mild and severe preeclampsia group,the Eng mRNA level was 1.00,1.27±0.58,1.54±0.41 and 1.83±0.35,and the TGF-β1 mRNA level was 1.00,1.64 ± 0.33,1.92± 0.38 and 2.23 ± 0.53 in placenta respectively; those figures changed to 1.00,1.32±0.46,1.59±0.37 and 1.93±0.52,and 1.00,1.71 ± 0.45,1.91 ± 0.51 and 2.37 ± 0.46 in superficial myometrium respectively.The Eng and TGF-β1 mRNA levels of control group were lower than those of the other three groups (P＜0.05).The higher the mRNA level,the more severe the disease (P＜ 0.05).In control group,gestational hypertension group,mild and severe preeclampsia group,the Eng protein expression was 0.11±0.07,0.15± 0.05,0.18 ± 0.06 and 0.43 ± 0.04,and the TGF-β1 protein expression was 0.11 ±0.02,0.26 ± 0.05,0.27± 0.03 and 0.88 ± 0.09 in placenta respectively; those figures changed to 0.14±0.06,0.16±0.04,0.20±0.08 and 0.46±0.05,and 0.15±0.03,0.29±0.06,0.31±0.04 and 0.91 ±0.08 in superficial myometrium respectively.The Eng and TGF-β1 protein levels of control group were lower than those of the other three groups (P＜0.05).The higher the protein level,the more severe the disease (P＜0.05).In the gestational hypertension group,mild and severe preeclampsia group,there were positive correlations between Eng and TGF-β1 protein levels in placenta (r=0.57,0.61 and 0.60 respectively,P＜0.05) and superficial myometrium (r=0.59,0.62 and 0.61 respectively,P ＜ 0.05).Conclusions Eng and TGF-β1 might play a role in pathogenesis of gestational hypertension and preeclampsia. Key words: Hypertension,pregnancy-induced; Placenta; Myometrium; Transforming growth factor beta 1; Antigens,CD; Receptors,cell surface

Expression and significance of AT1-AA and ET1 in materal peripheral blood, umbilical cord blood and placenta in preeclampsia

To investigate the expression of autoantibodies to the angiotensin II type I receptor (AT1-AA) and endothelin-1 (ET-1) in pregnant women's blood and explore their correlation with the pathogenesis of preeclampsia. Ninety pregnant women who delivered from June 2011 to December 2011 in the First Affiliated Hospital of Zhengzhou University were chosen as the study objects. They were divided into mild preeclampsia group (n = 30), severe preeclampsia group (n = 30) and normal group (control group, n = 30). The levels of AT1-AA and ET1 in maternal peripheral blood and umbilical cord blood were detected by ELISA, and the mRNA expression levels of AT1-AA and ET1 in placenta tissues were determined by reverse transcription (RT) PCR. Moreover, the correlation clinical indexes were detected and analysed. (1) The levels of AT1-AA and ET1 in maternal peripheral blood of preeclampsia [mild group: (114 ± 19) ng/L and (31 ± 9) ng/L, severe group: (145 ± 15) ng/L and (38 ± 10) ng/L] were both significantly higher than that of control group [(59 ± 5) ng/L, (17 ± 4) ng/L]. In addition, compared with mild group, the levels of AT1-AA and ET1 in severe group were significantly higher (P < 0.05). (2) The levels of AT1-AA and ET1 in umbilical cord blood of preeclampsia [mild group: (105 ± 14) ng/L and (35 ± 6) ng/L, severe group: (118 ± 14) ng/L and (40 ± 5) ng/L] were significantly higher than that of control group [(61 ± 12) ng/L, (24 ± 5) ng/L]. In addition, compared with mild group, the levels of AT1-AA and ET1 in severe group were significantly higher (P < 0.05). (3) The mRNA expression levels of AT1-AA and ET1 in placenta tissues of mild group (0.313 ± 0.039, 0.296 ± 0.028) and severe group (0.568 ± 0.052, 0.577 ± 0.046) were significantly higher than that in control group (0.198 ± 0.017, 0.137 ± 0.012), and the levels in severe group were significantly higher than that in mild group (P < 0.05). (4) There was an evident positive correlation between AT1-AA and ET1 levels of preeclampsia women's peripheral blood, umbilical cord blood and placenta (P < 0.05). (5) The level of AT1-AA in umbilical cord blood of preeclampsia pregnant women was positively correlated with S/D value of umbilical artery (P < 0.05), and negatively correlated with the weight of the birth and the placental (P < 0.05). The AT1-AA in the blood of pregnant women plays an important role in promoting the generation and development of preeclampsia by increasing the ET1 secretion.

Serum levels of apelin, salusin-alpha and salusin-beta in normal pregnancy and preeclampsia

Objective: The purpose of this study was to investigate the relationship between the serum apelin, salusin-alpha and salusin-beta levels and preeclampsia. Method: Twenty-one healthy pregnant women (control group) and 48 patients with preeclampsia (study group) were included in the study between August 2010 and February 2011. Serum apelin, salusin-alpha and salusin-beta levels of the groups were compared. Results: The patients in the study group were divided into two categories: mild preeclampsia and severe preeclampsia. The mild preeclampsia group consisted of 31 patients, and the severe preeclampsia group consisted of 17 patients. Serum salusin-alpha and salusin-beta levels of the control and study groups were not significantly different (p > 0.05). Apelin levels were statistically significantly higher in the study group. No statistically significant difference was detected between the mild and severe preeclampsia groups in terms of the mean serum apelin levels. Conclusion: The serum levels of apelin were higher in the pregnant women with preeclampsia; however, there was no positive relationship between serum salusin-alpha and salusin-beta levels and the disease. Larger prospective studies are needed to validate our findings.

Increased MPV Is Not a Significant Predictor for Preeclampsia During Pregnancy

Preeclampsia, defined as the presence of hypertension and proteinuria, is usually related with maternal and neonatal adverse effects. However, the exact predictor of preeclampsia is still lacking. Even though there are some conflicting data, mean platelet value or MPV, that is, platelet ratio with or without Doppler velocimetry was determined as highly sensitive markers for preeclampsia. We aimed to investigate the utility of MPV in prediction of preeclampsia. Seventy-four preeclamptic pregnant women (21 in mild, 53 in severe preeclampsia groups) were included in the study. To assess the difference of MPV between preeclamptic, normal pregnant, and healthy control rather than mild and severe preeclamptic pregnant women, we included in the analysis 31 healthy pregnant women and 35 healthy nonpregnant women. Mean age of the preeclamptic patients was 25.3 (17-38) years. Platelet levels were higher in mild preeclampsia (group 1) than severe preeclampsia (group 2), whereas alanine aminotransferase (AST), hemoglobin, and hematocrit level was higher in group 2. MPV levels were found to be similar in groups 1 and 2, MPV level increased from healthy control to preeclamptic women (P = 0.003). MPV:platelet ratio was similar according to the severity of preeclampsia (P = 0.123). Doppler velocimetry did not add an additional benefit to predict preeclampsia or its severity. Our results showed that MPV level was higher in the pregnant than the control group. However, MPV did not differ both between mild and severe preeclampsia, and preeclampsia and non-preeclamptic pregnant women.

Association of high-sensitivity C-reactive protein serum levels in early pregnancy with the severity of preeclampsia and fetal birth weight

Abstract Objective: The aim of this study was to investigate the association between high-sensitivity C-reactive protein (hs-CRP) serum levels in early pregnancy with the severity of preeclampsia (PE) and birth weight. A prospective cohort study was conducted in Noor City (in the north of Iran) from February 2008 to March 2009. The maternal serum hs-CRP levels were measured in 778 healthy pregnant women between 14 and 20 weeks of gestation. They were followed up to delivery. The women were divided into three groups according to ACOG criteria: mild and severe PE and normal group. In total, 63 (8.1%) of the subjects developed PE: 30 (3.9%) mild and 33 (4.2%) severe PE. Mean±SD hs-CRP levels in mild (7.2±2.2 mg/L) and severe (9.4±3.9 mg/L) PE were significantly higher than the normal group (2.5±2.7 mg/L). Mean±SD birth weights in severe (3100±590 g) and mild (3150±742 g) PE were significantly lower than uncomplicated pregnancies (3340±590 g). Multiple and linear logistic regression analysis showed that there were significant relationships between hs-CRP levels in mild (odds ratio, 1.66; 95% confidence interval, 1.43-1.93) and severe PE (odds ratio, 2.35, 95% confidence interval, 1.90-2.92) and with birth weight (P<0.001). The receiver operator characteristic curve showed that hs-CRP >4.5 and >5 mg/dL could predict mild and severe PE, respectively. At this level, sensitivity and specificity for mild PE were 100% and 80.7%, and for severe PE were 93.9% and 75.7%, respectively. hs-CRP can be useful in identifying pregnant women at risk for PE and low-birth weight infants.