Mild Preeclampsia Patients Research Articles

Changes of coagulation function and platelet parameters in preeclampsia and their correlation with pregnancy outcomes.

Preeclampsia (PE) is a severe pregnancy complication characterized by significant alterations in coagulation function. This study aims to analyze the correlation between coagulation function, platelet parameters, and pregnancy outcomes in PE patients. Clinical data, along with blood and urine samples, were collected from 168 PE patients and 128 healthy pregnant women. General demographic and laboratory testing data were recorded, and maternal and fetal outcomes were followed up. Data were analyzed using Kaplan-Meier and logistic regression analyses. In mild PE patients, thrombin time (p=.000), platelet distribution width (PDW) (p=.000), and clot formation time (p=.000) were increased, while prothrombin time (p=.000) and fibrinogen (p=.045) were reduced. With increasing PE severity, prothrombin time (p=.000), platelet count (PLT) (p=.000), mean platelet volume (MPV) (p=.000), plateletcrit (p=.000), maximum amplitude (MA) (p=.000), and coagulation index (p=.001) decreased, whereas activated partial thromboplastin time (APTT) (p=.000), thrombin time (p=.002), D-dimer (p=.026), and PDW (p=.000) increased. Lower prothrombin time (p=.048), PLT (p=.004), and coagulation index (p=.026) or higher APTT (p=.032), thrombin time (p=.044), D-dimer (p=.023), and PDW (p=.016) were associated with a higher risk of poor pregnancy outcomes. Thrombin time was identified as an independent risk factor (p=.025, OR=2.918, 95% CI: 1.145-7.436), whereas gestational age was an independent protective factor (p=.000, OR=0.244, 95% CI: 0.151-0.395). This study demonstrates that specific coagulation and platelet parameters are significantly associated with PE severity and adverse pregnancy outcomes. These findings highlight the importance of monitoring coagulation function in PE patients to improve clinical management and outcomes.

Studi Penatalaksanaan dan Ketepatan Pengobatan Antihipertensi pada Wanita Hamil di RSUD Toto Kabila

Hypertension is a condition that can affect pregnancy. High blood pressure during pregnancy can hinder fetal and uterine growth, lead to fetal death in the womb, and result in premature birth. These complications can be minimized with appropriate antihypertensive therapy. The objective of this study is to determine the incidence rate, management, and accuracy of antihypertensive treatment according to the reference standards of the 2016 Preeclampsia National Medical Service Guidelines (PNPK). This research was an observational descriptive study where the data obtained were secondary data collected retrospectively from medical records at Regional Public Hospital of Toto Kabila from September 2022 to May 2023. The sample was taken using a saturated sampling technique, so the sample in this study included all pregnant women diagnosed with preeclampsia. The results of the study obtained 65 patients, consisting of 36 severe preeclampsia patients and 29 mild preeclampsia patients. The study showed that hypertension in pregnant women was often found in the age group of 26-35 years, with 25 patients (39%), and in the third trimester of pregnancy, with 23 cases, while 2 experienced hypertension in the first trimester. 12 patients were diagnosed with severe preeclampsia and 13 patients with mild preeclampsia. The treatment of hypertension in pregnant women for mild preeclampsia included methyldopa (34%) and nifedipine (7%). For severe preeclampsia, single therapy included methyldopa (39%), amlodipine (8%), and combination therapy such as nifedipine + methyldopa (36%) and methyldopa + amlodipine (17%). The accuracy of antihypertensive drug use in pregnant women based on the 2016 Preeclampsia PNPK was 86%, including appropriate indications, correct drugs and correct doses.

A Comparative Study of Coagulation Profile in Normal Pregnancy, Mild Preeclampsia, and Severe Preeclampsia Patients

A Comparative Study of Coagulation Profile in Normal Pregnancy, Mild Preeclampsia, and Severe Preeclampsia Patients

Combination of Maternal Serum ESM-1 and PLGF with Uterine Artery Doppler PI for Predicting Preeclampsia.

This study aimed to determine whether the combination of pregnancy-associated endothelial cell-specific molecule 1 (ESM-1), the placental growth factor (PLGF) in the first- and second-trimester maternal serum, and the uterine artery Doppler pulsatility index (PI) in the second trimester can predict preeclampsia (PE). The serum levels of ESM-1 and PLGF in 33 severe preeclampsia (SPE) patients, 18 mild preeclampsia patients (MPE), and 60 age-matched normal controls (CON) were measured. The Doppler ultrasonography was performed, and the artery pulsatility index (PI) was calculated for the same subjects. The 2nd PLGF level was significantly lower and the 2nd PI was higher than those in the MPE group. Combining the 2nd PLGF with the 2nd PI yielded an AUC of 0.819 (83.33% sensitivity and 70.00% specificity). In the SPE group, the 1st ESM-1 level and the 2nd PLGF level were significantly lower, and the 2nd ESM-1 level and the 2nd PI were significantly higher in the SPE group. The combination of the 1st ESM-1, the 2nd PLGF, and the 2nd PI yielded an AUC of 0.912 (72.73% sensitivity and 95.00% specificity). The 1st ESM-1 and the 2nd PLGF levels and the 2nd PI were associated with PE. The combination of serum biomarkers and the PI improved the screening efficiency of the PE prediction, especially for SPE.

Serum MOTS-c levels remain unchanged in patients with preeclampsia.

Mitochondrial open-reading-frame of the twelve S rRNA-c (MOTS-c) is a mitochondrial derived peptide which has beneficial effects on muscle metabolism, insulin sensitivity, weight regulation, and bone mineral density. This study aims to investigate whether serum levels of MOTS-c are altered in patients with preeclampsia. This is cross sectional a case-control study of 30 patients with uncomplicated pregnancy, 30 patients with mild preeclampsia and 30 patients with severe preeclampsia that were admitted to the study center between June 2020 and January 2021. When compared to the healthy controls and patients with mild preeclampsia, maternal smoking was significantly more frequent, systolic and diastolic blood pressures were significantly higher and platelet count was significantly lower in patients with severe preeclampsia (p = 0.045, p = 0.0001, p = 0.0001 and p = 0.024 respectively). Serum MOTS-c concentrations were statistically similar in healthy controls, mild and severe preeclampsia patients (159.1 ± 28.7 ng/mL vs 129.6 ± 54.7 ng/mL vs 146.4 ± 48.3, p = 0.166). When compared to the healthy controls, systolic and diastolic blood pressures were significantly higher and platelet count was significantly lower in patients with late onset preeclampsia (p = 0.0001, p = 0.0001 and p = 0.022 respectively). Healthy controls and patients with early and late onset preeclampsia were statistically similar with respect to MOTS-c levels (159.1 ± 28.7 ng/mL vs 126.7 ± 56.9 vs 153.7 ± 39.8, p = 0.102). This study failed to detect any significant relationship between MOTS-c and preeclampsia. Large scale research is needed to clarify if MOTS-c is a novel biomarker for preeclampsia and therapeutic target for preeclampsia patients.

An angiogenic marker for early prediction of preeclampsia

Background: Preeclampsia is a pregnancy-specific disease associated with a high incidence of maternal and fetal morbidity and mortality with classical features of hypertension, proteinuria, and edema. Aims and Objectives: The aims of the study were to study the angiogenic marker for the early predicting of preeclampsia. Materials and Methods: Blood samples were collected from 75 healthy singleton pregnant women from 19 to 29 years between 12 and 16 weeks of gestation with no underlying medical illness. The serum soluble endoglin (sEng) level and serum uric acid levels were estimated. Patients who developed preeclampsia were classified as mild and severe. They were classified as severe preeclampsia if their serum sEng levels are above 8.5 ng/ml and mild preeclampsia was grouped when the serum sEng level varies from 7.1–8.4 ng/ml. The serum sEng and serum uric acid levels were compared. Serum sEng was processed by ELISA technique and serum uric acid was measured by Uricase method in autoanalyzer. Results: The mean uric acid level was 4.0±0.5 mg/dl in severe preeclampsia and 3.6±0.2 mg/dl in mild preeclampsia patients. The levels were within normal limits. The serum sEng levels were 8.7±1.4 ng/ml in severe preeclampsia and 7.7±0.3 ng/ml in mild preeclampsia. The levels are elevated in preeclampsia. Women with serum sEng levels between 7.1 and 8.2 ng/ml developed symptoms of mild preeclampsia between 28 and 30 weeks of gestation, whereas women with serum sEng levels between 8.5 and 13.4 ng/ml developedsymptoms of severe preeclampsia between 26 and 28 weeks of gestation. Conclusion: Serum uric acid levels were within normal limits in preeclampsia patients, whereas serum sEng levels were elevated in these patients. Thus, this study concludes that serum sEng will be a good predictor of severity of preeclampsia compared to serum uric acid level.

High miR-200a-3p expression has high diagnostic values for hypertensive disorders complicating pregnancy and predicts adverse pregnancy outcomes

BackgroundHypertensive disorders complicating pregnancy (HDCP) are various heterogeneous conditions. microRNA (miR)-200a-3p is involved in HDCP diagnosis. This study explored the effects of miR-200a-3p on HDCP patients.MethodsA total of 126 singleton HDCP patients including 50 cases of gestation hypertension (GH), 42 cases of mild preeclampsia (MP) and 34 cases of severe preeclampsia (SP), were enrolled as study subjects, and 50 normal pregnant women were selected as the control. Serum miR-200a-3p expression was detected and its efficacy in HDCP diagnosis and grading was evaluated. GH, MP and SP patients were allocated to high/low miR-200a-3p expression groups. The correlation between miR-200a-3p expression and general clinical indexes was analyzed. HDCP patients were allocated to high/low miR-200a-3p expression group and maternal and fetal outcomes were followed up. Effects of miR-200a-3p expression on adverse pregnancy outcome incidence were analyzed.ResultsmiR-200a-3p expression in the serum of HDCP patients was upregulated. The sensitivity and specificity of serum miR-200a-3p level > 1.201 were 87.3% and 96.0%, respectively. Serum miR-200a-3p level in GH, MP and SP patients was increased with the aggravation of the disease. The cut-off value and area under the curve (AUC) of miR-200a-3p for GH, MP and SP diagnosis were 1.145 and 0.9094 (82.0% sensitivity and 88.0% specificity), 1.541 and 0.8126 (73.8% sensitivity and 76.0% specificity), and 1.866 and 0.7367 (64.7% sensitivity and 76.2% specificity), respectively. Serum miR-200a-3p level was correlated with general clinical indexes, fetal birth weight, systolic to diastolic ratio, and fetal growth restriction incidence. High serum miR-200a-3p expression in HDCP patients was associated with increased adverse pregnancy outcomes.ConclusionHigh miR-200a-3p expression could help to diagnose HDCP, judge severity and was associated with increased adverse pregnancy outcomes.

Analysis of differential expression of hypoxia-inducible microRNA-210 gene targets in mild and severe preeclamptic patients.

Preeclampsia (PE) is a multi-system disorder that is specific to human pregnancy. Inadequate oxygenation of uterus and placenta is considered as one of the leading causes for the disease. MicroRNA-210(miR-210) is one of the prime molecules that has emerged in response to hypoxia. The objective of this study was to determine miR-210 expression patterns in plasma from severe PE and mild PE patients, and how that affects the expression of miR-210 target genes. The expression levels of miR-210 were validated using reverse transcription-quantitative PCR in plasma of severe PE (15) and mild PE (15) patients in comparison to controls subjects (15) with normal pregnancy. Then, the association between miR-210 and its downstream genes was validated by using human miR-210 targets RT2 profiler PCR Array. Both the categories (mild and severe) showed significantly high miR-210 expression levels. Also out of the 84 hypoxia miR-210 associated genes screened using mRNA, 18 genes were found to be differentially expressed in severe PE whereas 16 genes in mild PE cases with varying magnitude. All the genes in both the PE groups were found downregulated in comparison to controls. These downregulated genes expressed in both the cases were shown to be participating in immunosuppression, apoptosis, cell growth, signaling, angiogenesis, DNA repair. This study provides novel data on the genes that work downstream of miR-210 and how dysregulated expression of miR-210 can affect their expression and in turn functioning which can be associated with PE risk and severity. This study is the very first to determine the effect of miR-210 expression levels on associated genes in plasma samples.

Reduced angiovasculogenic and increased inflammatory profiles of cord blood cells in severe but not mild preeclampsia

Preeclampsia (PE) is a prevalent pregnancy disorder that leads to high maternal and fetal morbidity and mortality. While defective vascular development and angiogenesis in placenta are known as crucial pathological findings, its pathophysiological mechanism remains elusive. To better understand the effects of PE on angio-vasculogenesis and inflammatory networks in the fetus and to identify their biological signatures, we investigated the quantitative and functional characteristics of cord blood-derived mononuclear cells (CB-MNCs) and CD31-positive MNCs. Flow cytometry analysis demonstrated that the CB-MNCs from the severe PE group had significantly decreased number of cells expressing CD3, CD11b, CD14, CD19, KDR, and CD31 compared with the normal group. Quantitative real time PCR (qRT-PCR) shows down-regulation of the major angiogenic factor VEGFA in MNCs and CD31+ MNCs in severe PE. The major inflammatory cytokines IL1 was highly upregulated in CD31+ CB-MNCs in the severe PE patients. Mild PE patients, however, did not display any significant difference in expression of all measured angiogenic genes and most inflammatory genes. These findings show distinct angiogenic and inflammatory signatures from severe PE, and they may play a significant role in the pathogenesis of vascular defects in placenta of severe PE.

Immediate versus delayed induction of labour in hypertensive disorders of pregnancy: a systematic review and meta-analysis

BackgroundMothers with hypertensive disorder of pregnancy can be managed with either immediate or delayed induction of labour with expectant monitoring of both mother and baby. There are risks and benefits associated with both the type of interventions. Hence, this review was conducted to compare outcomes of immediate and delayed induction of labour among women with hypertensive disorder of pregnancy based on disease severity and gestational age.MethodsWe conducted systematic searches in various databases including Medline, Cochrane Controlled Register of Trials (CENTRAL), Scopus, and Embase from inception until October 2019.Cochrane risk of bias tool was used to assess the quality of published trials. A meta-analysis was performed with random-effects model and reported pooled Risk ratios (RR) with 95% confidence intervals (CIs).ResultsFourteen randomized controlled trials with 4244 participants were included. Majority of the studies had low or unclear bias risks. Amongst late onset mild pre-eclampsia patients, the risk of renal failure was significantly lower with immediate induction of labour (pooled RR: 0.36; 95%CI: 0.14 to 0.92). In severe pre-eclampsia patients, immediate induction of labour significantly reduced the risk of having small-for-gestational age babies compared to delayed induction of labour (pooled RR: 0.49; 95%CI: 0.29–0.84).Delayed induction was found to significantly reduce the risk of neonatal respiratory distress syndrome risk among late onset mild pre-eclampsia patients (pooled RR: 2.15; 95%CI: 1.14 to 4.06) None of the other outcomes demonstrated statistically significant difference between the two interventions.ConclusionDelayed induction of labour with expectant monitoring may not be inferior to immediate induction of labour in terms of neonatal and maternal outcomes. Expectant approach of management for late onset mild pre-eclampsia patients may be associated with decreased risk of neonatal respiratory distress syndrome, while immediate induction of labour among severe pre-eclampsia patients is associated with reduced risk of small-for-gestational age babies and among mild pre-eclampsia patients, it is associated with reduced risk of severe renal impairment.

The relation between vitamin D level in the third trimester and preeclampsia

Introduction: Preeclampsia (PE) affects 2%–8% of all pregnancies and remains a leading cause of maternal and perinatal mortality and morbidity. Vitamin D was considered important for bone and calcium. There is some evidence now that low levels of Vitamin D are associated with the risk of preeclampsia but more studies are needed to prove the same.Aim of the work: The aim of our study was to assess the relation between the vitamin D deficiency and the occurrence of preeclampsia in the third trimester of pregnancy.Patients and Methods: This is a prospective case control study, where 90 pregnant women between 27-40 weeks of gestation were recruited from the outpatient clinic in Al zahraa university hospital, they subjected to 25(OH) vit D level estimations and transabdominal ultrasound. Follow up was done till delivery to assess occurrences of preeclampsia and assessment of fetal outcome. Cases were divided into control (n=30) and preeclampsia (n=60) groups. According to the severity, the preeclampsia cases were subdivided to mild (n=40) and severe preeclampsia(n=20)..Results: The two groups (PE and Control ) were comparable regarding maternal age, BMI and gestational age. There was significant relation between deficient 25-(OH) vitamin D and BMI. Patients with severe preeclampsia had significant lower level of 25-OH D than the mild preeclampsia and normotensive patients. There was no significant difference in 25(OH)vit D level between mild preeclampsia and control group.Conclusion: there were significant association between vitamin D deficiency and severe preeclampsia. Vitamin D deficiency may be a risk factor for preeclampsia and may be helpful for prediction of preeclampsia and its severity.

Genetic susceptibility analysis of GCLC rs17883901 polymorphism to preeclampsia in Chinese Han women

Preeclampsia (PE) is a specific obstetric disorder that may result in maternal and neonatal morbidity and mortality. Increasing evidence has been indicated that some candidate genes related to oxidative stress, such as glutamate-cysteine ligase, catalytic subunit (GCLC), glutamate-cysteine ligase, modifier subunit (GCLM), involve in the pathogenesis of PE. After the genetic contribution of GCLC rs17883901 polymorphism was analyzed by TaqMan allelic discrimination real-time PCR in 1001 PE patients and 1182 normal pregnant women, a case-control association analysis was performed. Although no statistical difference was found in genetic distribution of rs17883901 in GCLC between PE and control group (χ2 = 2.201, p = .333 by genotypic, χ2 = 0.524, p = .469, OR = 0.932, 95%CI = 0.771–1.128 by allelic), significant differences in the genotypic frequencies were investigated between mild PE group (χ2 = 6.999, p = .030) or late-onset PE group (χ2 = 6.197, p = .045) and control group. Furthermore, when dividing the mild PE patients, the late-onset PE patients and the controls into TT/CT + CC, TT + CT/CC, and TT/CC subgroups, we found statistical differences between mild PE and controls (TT/CT + CC:χ2 = 5.132, p = .023, OR = 2.948, 95%CI = 1.107–7.854; TT/CC:χ2 = 4.564, p = .033, OR = 2.793, 95%CI = 1.046–7.460) as well as late-onset PE and controls (TT/CT + CC:χ2 = 4.043, p = .044, OR = 2.248, 95%CI = 1.000–5.055). This is the first study to indicate GCLC rs17883901 polymorphism may be associated with a risk of mild PE and late-onset PE in Chinese Han women. However, additional well-designed studies with multi-ethnic and large-scale samples should be performed to validate our results.

Association between the estrogen receptor α gene polymorphisms rs2234693 and rs9340799 and severe and mild pre-eclampsia: a meta-analysis.

This meta-analysis was performed in order to determine the associations between the estrogen receptor α (ESR1) gene PvuII site (-397T/C, rs2234693) and XbaI site (-351A/G, rs9340799) polymorphisms with severe and mild pre-eclampsia. Eligible studies were identified by searching PubMed, Medline, Embase, China National Knowledge Infrastructure (CNKI), and WanFang databases until May 2018. The pooled odds ratio (OR) and 95% confidence interval (CI) were used to calculate the associations. Six articles (consisting of seven studies; one article was considered as two separate studies with two different subpopulations) investigated the ESR1 gene PvuII -397T/C and XbaI -351A/G polymorphisms in severe and mild pre-eclampsia patients and included controls. The pooled results indicated an increased risk of severe pre-eclampsia for the XbaI -351A/G polymorphism (OR = 1.67, 95% CI = 1.10–2.25, P=0.017 for GG compared with AA+GA; OR = 1.81, 95% CI = 1.17–2.82, P=0.008 for GG compared with GA). The GG genotype of the ESR1 XbaI polymorphism could be a genetic risk factor for severe pre-eclampsia susceptibility. However, the ESR1 gene PvuII -397T/C polymorphism was not significantly associated with the risk of severe pre-eclampsia, and there was no association between mild pre-eclampsia and the ESR1 gene PvuII -397T/C and XbaI -351A/G polymorphisms separately. The current meta-analysis indicates that the ESR1 XbaI genetic polymorphism may be associated with severe pre-eclampsia. However, there was no association of the ESR1 gene PvuII and XbaI polymorphisms with the risk of mild pre-eclampsia. Owing to the low statistical power, the results may not be sufficiently robust and this conclusion should be interpreted cautiously, which highlights the requirement for large-scale and high-quality studies in this field.

Relationship between severity of hypertension and renal impairment in preeclampsia

The aim of this study was to determine the relationship between the severity of hypertension and renal impairment in preeclampsia. This study was conducted on 92 diagnosed cases of mild (n=42) and severe (n=50) preeclampsia patients from August 2010 to July 2011. All the patients were almost identical in terms of age and socioeconomic status. The results of the study showed that the mean serum creatinine and uric acid levels were significantly high in severe preeclampsia patient compared to mild preeclampsia and both systolic and diastolic blood pressures had the positive and significant effects on the serum creatinine and uric acid levels. In conclusion, impairment of renal function has the positive and significant relationship with the severity of blood pressure in the preeclamptic patient.

Copper and ceruloplasmin levels are closely related to the severity of preeclampsia

Objective: The aim of this study was to investigate the maternal serum concentrations of copper (Cu) and ceruloplasmin (CP) in patients with mild preeclampsia, severe preeclampsia, hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and to determine their association with the severity of the disease.Methods: This study was carried out at the largest tertiary care health center in the southeast region in Turkey and Department of Obstetrics and Gynecology, Dicle University Hospital. A total of 179 pregnant women, including 58 healthy pregnant women and 71 mild preeclampsia, 26 severe preeclampsia, and 24 HELLP syndrome cases classified according to the American College of Obstetricians and Gynecologists’ 2013 guidelines were included in this prospective study. Blood samples were taken from all the pregnant women to evaluate the serum Cu and CP levels. The Cu level was determined via atomic absorption/emission spectroscopy, while the serum CP level was assessed with a nephelometric assay using an automatic image analyzer. Spearman’s rank correlation tests were used to determine the correlations between the serum levels of the antioxidative markers and the preeclampsia severity.Results: The mean ± SD of the Cu was 81.2 ± 11.84 µg/dl in the mild preeclampsia cases and 160.2 ± 20.89 µg/dl in the severe preeclampsia cases (p < .001). The mean ± SD of the CP was 33.0 ± 4.81 mg/dl in the mild preeclampsia cases and 65.3 ± 9.17 mg/dl in the severe preeclampsia cases (p < .001). The Cu and CP levels were significantly higher in the patients with HELLP syndrome, which is an advanced and more severe form of severe preeclampsia, than in the mild and severe preeclampsia patients (p < .001 and p < .001, respectively). Therefore, the serum Cu and CP levels were correlated with the severity of preeclampsia (r = 859, p < .001 and r = 786, p < .001, respectively). In addition, there was a positive correlation between the serum Cu and CP levels and the systolic and diastolic blood pressure values and aspartate amino transferase levels (AST), and a negative correlation between the serum Cu and CP levels and the platelet count.Conclusion: This was the first study in which the ceruloplasmin and Cu levels were investigated in HELLP syndrome patients. When considering the results obtained in the present study, there were significant relationships between the Cu, CP levels which are the markers of oxidative stress and the preeclampsia severity.

Use of serum and urinary soluble sFlt-1 and PLGF in the diagnosis of preeclampsia

ABSTRACTObjective: Preeclampsia (PE) is a disorder of pregnancy marked by hypertension and proteinuria with no known treatment aside from pregnancy termination. The pathogenesis of PE is poorly understood, but is thought to originate in the placenta. We assessed the value of measuring serum and urinary soluble deformylase-like tyrosine kinase receptor 1 (sFlt-1), a known target of placental factors, and placental growth factor (PLGF), a key placental signaling molecule, in the diagnosis of PE.Methods: Eighty patients with PE were classified as either exhibiting mild (44 cases) or severe (36 cases) symptoms of PE. Forty normal pregnant women were selected as controls. Serum and urinary PLGF and sFlt-1 levels, along with the ratio of sFlt-1 to PLGF, were compared across groups.Results: Serum and urinary sFlt-1 and sFlt-1/PLGF ratios in severe PE patients were significantly higher than those in the mild PE group, and measurements from mild PE patients were significantly higher than controls (all P values <0.01). The serum and urinary PLGF levels in severe PE patients were significantly lower than mild PE patients, and mild PE patients had significantly lower PLGF levels than controls (all P values <0.01). As expected, serum sFlt-1 and PLGF levels and ratios were highly correlated with urinary sFlt-1 and PLGF levels and ratios.Conclusions: The severity of PE was closely correlated with these measurements, suggesting that they may be useful tools in the diagnosis and evaluation of PE.

Concentraciones plasmáticas de isoprostano-8 en preeclampsia y eclampsia

ObjectiveTo compare plasma vascular 8-isoprostane concentrations in pregnant women with pre-eclampsia and eclampsia. Material and methodsPatients attending the Hospital Central Dr. Urquinaona in Maracaibo, Venezuela, were selected. The study included 30 patients with mild pre-eclampsia (group A), 30 patients with severe pre-eclampsia (group B), and 30 patients with eclampsia (group C). A control group was also included, consisting of 30 healthy pregnant women (group D) of similar age and body mass index to studied groups. Only nulliparous patients were included. Plasma samples were collected for the 8-isoprostane determination from all patients before delivery, and in the studied groups immediately after diagnosis. ResultsStatistically significant differences were found in gestational age between groups B and C compared with the control group (p<.05). Higher values of plasma 8-isoprostane were observed in severe pre-eclampsia patients (366.0±29.7pg/mL), as well as in eclampsia patients (354.2±26.9pg/mL). Lower values were found in mild pre-eclampsia patients (302.2±31.6pg/mL). The studied groups had significantly higher values of plasma 8-isoprostane compared with controls (209.3±19.1pg/mL; p<.05). Linear regression analysis found that the factor that was significantly associated with 8-isoprostane concentrations was the 24-h urine protein level (p<.05). ConclusionEclampsia and pre-eclampsia patients had higher plasma 8-isoprostane concentrations than healthy normotensive pregnant women.

65 Changes of maternal cardiac function in patients with mild and severe preeclampsia

Introduction Preeclampsia is one of the major causes of maternal and perinatal mortality and morbidities. Pregnancy is characterized by certain structural and functional changes in the cardiovascular systems. However, to date, few studies were conducted about the influence in severity of preeclampsia to maternal cardiac function and the structural changes. Objectives We examined maternal cardiac function in patients with preeclampsia during peripartum period and compared with normal pregnant women. Methods A total of 138 singleton patients with preeclampsia and 18 singleton pregnant women without preeclampsia were enrolled in this study. We defined severe preeclampsia as systolic blood pressure over 160 mmHg or diastolic blood pressure over 110 mmHg. Echocardiography was conducted three times during peripartum period; late stage of pregnancy, early postpartum and one-month postpartum. We did not perform echocardiography at one-month postpartum to the non-preeclamptic women. We measured intraventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVIDd), left ventricular end-systolic diameter (LVIDs), left ventricular posterior wall thickness (LVPWT), left ventricular ejection fraction (EF), left atrium diameter (LAD) and early transmitral velocity/early diastolic velocity of the mitral annulus (E/e′). Statistical analysis of covariance with age were performed with the SPSS software package. Results There were 87 patients who had severe preeclampsia, 51 patients with mild preeclampsia and 18 normal pregnant women. In these groups, there were no differences in pre-pregnancy BMI. In late stage of pregnancy, whereas only IVST was significantly dilated between the normal pregnant and mild preeclampsia, some parameters were significantly decayed in the patients with severe preeclampsia. All parameters excluded LVIDs and EF were dilated between the normal and severe preeclampsia. IVST, LVIDd and LAD were significantly different between the mild and severe preeclampsia. In early postpartum, there were no differences between the normal and mild preeclampsia. LVIDs was significantly dilated in severe preeclampsia compared with normal pregnant women. LVIDd, LVIDs and LAD were significantly different in the mild and severe preeclampsia. In one-month postpartum, LVIDd and LVIDs were significantly different between the preeclampsia patients. Concerned about EF, there was no significantly difference in three groups through these periods. The table shows these detailed results. Conclusion Mild preeclampsia had influences on maternal cardiac functions and, after delivery, the changes recovered within a few days. However, severe preeclampsia patients got cardiac remodeling and these changes did not recover completely even one-month postpartum. Not only anatomical changes but also left ventricular diastolic function deteriorated in severe preeclampsia compared with mild preeclampsia patients and normal pregnant women. Therefore, the severity of preeclampsia should be considered when examining maternal cardiac function and the risk of future cardiovascular disease in patients with preeclampsia. Download : Download high-res image (265KB) Download : Download full-size image

Urinary Tract Infection (UTI) as a Risk Factor of Severe Preeclampsia

&lt;p&gt;&lt;strong&gt;BACKGROUND: &lt;/strong&gt;Urinary tract infection (UTI) is a very common medical complication of pregnancy. The aim of this study is to determine the incidence of UTI in preeclamptic pregnancies and its association with severity of this disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;METHODS: &lt;/strong&gt;This cohort study was performed on 71 women with mild preeclampsia (PE), 70 women with severe PE, and 98 healthy pregnant women from October 2012 to April 2014 in the west of Iran. Mean diastolic pressure and level of proteinuria were used as indicators of disease severity. The main criteria for diagnosis of UTI was microbial count of higher than 10&lt;sup&gt;4&lt;/sup&gt; cfu/ml.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;RESULTS: &lt;/strong&gt;The prevalence of the UTI in severe PE patients was significantly higher than mild PE patients and non-hypertensive pregnants. 12 out of 70 women with severe PE (17.1%) and 7 out of 98 controls (7.1%) had UTI (&lt;em&gt;P&lt;/em&gt;&amp;lt;0.05), also 8 out of 71 women with mild PE (11.3%) had UTI (&lt;em&gt;P&lt;/em&gt;&amp;gt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;CONCLUSIONS: &lt;/strong&gt;Our data shows a significant increase in UTI in severe PE pregnancy. Thus, we can consider UTI as one of the risk factors for developing severe PE; so by screening UTI in the first visit of the pregnant women and repeating it at the second and third trimester of pregnancy we could decrease adverse effects of UTI such as severe PE in pregnant women.&lt;/p&gt;

Serum copper, zinc and lipid peroxidation in pregnant women with preeclampsia in gorgan.

The aim of study was to assay serum copper, zinc and lipid peroxidation levels in pregnant women with and without preeclampsia. There were significant differences between systolic, diastolic blood pressures and copper, Cu/Zn ratio and malondialdehyde among two groups. There were significant differences in weight, pre-pregnancy body mass index, systolic, diastolic blood pressures and copper, Cu/Zn ratio and malondialdehyde levels when compared to healthy pregnant women with mild and severe preeclampsia patients. A positive correlation was observed between systolic and diastolic blood pressure and copper, malondialdehyde and Cu/Zn ratio. Copper and malondialdehyde may play a role in the pathophysiology of preeclampsia.