Normotensive Pregnant Females Research Articles

Evaluation of diagnostic potential of maternal serum ischemia modified albumin in cases of pre-eclampsia.

The underlying causes and mechanisms of pre-eclampsia (PE), its exact etiology remains unclear and poorly understood. Hypoxia, ischemia, and oxidative stress induced by free radicals have been associated with development of PE. Ischemia-modified albumin (IMA) is a chemically modified albumin due to oxidative stress. IMA, a serum biomarker of hypoxia, ischemia, and oxidative free radicals is a potential biomarker for PE. The aim of the current proposal was to study serum IMA as a diagnostic biomarker of pre-eclampsia (PE) in pregnant females and to evaluate the correlation between serum IMA and different markers of pre-eclampsia (BP, urinary protein, LFT, KFT, serum total protein & uric acid). A total of 60 pregnant women aged between 21 and 35 years were recruited (30 PE cases and 30 normal pregnancy). Serum IMA was measured by spectrophotometric method developed by Bar-Or D. BP and biochemical parameters (urinary protein, LFT, KFT, serum total protein & uric acid) were also assayed and compared between two groups. Correlation analysis was done for analyzing the relationship between serum IMA and biochemical parameters. The mean serum IMA was significantly higher in normotensive pregnant females (0.93 ABSU) than PE cases (0.71 ABSU). Kidney function and liver function parameters were more deranged in PE cases than in controls. Serum IMA was positively correlated with serum creatinine (r=0.322), serum uric acid (r=0.54) and urinary protein (0.376) whereas negatively correlated with total serum bilirubin (r=-0.515) and serum albumin (r=-0.380). Elevated serum IMA concentrations in normotensive pregnant controls as compared to PE cases suggest that apart from ongoing ischemia and oxidative stress in placenta IMA values are influenced by many other mechanisms in pregnancy.

Comparison of flow-mediated dilation (FMD) of the brachial artery in normotensive versus preeclamptic pregnant females.

Flow-mediated dilation (FMD) of the brachial artery is an ultrasonography test that assesses the endothelial response to reactive hyperemia. The aim of this study was to assess the changes in FMD in preeclamptic pregnant patients and compare them with normotensive pregnant females. An analytical cross-sectional comparative study was conducted in the Department of Obstetrics and Gynaecology at King George's Medical University (KGMU) after obtaining ethical approval. A total of 110 normotensive and 100 preeclamptic patients were recruited for the study. Using a Toshiba Ultrasound Machine with a 7-12 MHz probe, the baseline diameter of the brachial artery D1 was measured. Afterward, the cuff of the sphygmomanometer was placed distally on the forearm and it was inflated up to ≥250 mm of Hg pressure and later slowly deflated. At 90th seconds after cuff deflation, the mean of three measurements of vessel caliber (D2) was obtained. The FMD% was obtained by the following equation: FMD (%) = [(D2 - D1)/D1] ×100, where D1 = basal diameter and D2 = post-occlusion diameter. All patients were followed till delivery for maternofetal outcome. FMD% was significantly lower in the preeclampsia group, and it went on decreasing with increasing severity of preeclampsia. At the cutoff of 9.4 for FMD%, its sensitivity for the prediction of preeclampsia was 65.3%, specificity was 89.3%, positive predictive value (PPV) was 94%, and negative predictive value (NPV) was 50%. FMD is a noninvasive test, and it gets decreased before clinical signs of preeclampsia, so it can be used as a predictor of preeclampsia.

Analysis of Serum Electrolytes Variation in Onset and Progression of Preeclampsia

Preeclampsia is one of the most common, life-threatening complications of pregnancy that is related to maternal as well as perinatal morbidity or mortality. One of the significant causes of preeclampsia is elevated blood pressure which is directly linked with concentrations of electrolytes in the blood. Objective: To evaluate the possible variations of electrolytes in preeclamptic pregnant females. Methods: A total of 90 pregnant females of 20 to 45 years of age were divided into three groups (n=30 in each group) viz normotensive, hypertensive, and preeclamptic pregnant females. All anthropometric and biophysical variables were measured. Among biochemical parameters, serum sodium, potassium, chloride, and calcium levels were determined using colorimetric assays while bicarbonate levels were determined by an enzymatic test using phosphoenolpyruvate carboxylase and a stable nicotinamide dihydrogen phosphate analogue. A comparison of serum electrolytes among different groups was executed by one-way analysis of variance. Results: Preeclamptic females had significantly higher BMI, and systolic and diastolic blood pressure than hypertensive and normotensive pregnant females (p<0.0001). Serum concentrations of sodium and calcium were significantly lower in preeclamptic pregnant females compared to hypertensive pregnant and normotensive pregnant females (p<0.0001). Conclusions: Alteration in the electrolyte levels may contribute to the onset and progression of preeclampsia. Nutritional sodium restriction along with adjuvant supplementation of Ca⁺⁺, Na⁺, K⁺, and Clˉ may minimize the risk of preeclampsia. On the basis of outcomes, it is recommended that pregnant females should eat a balanced diet that contains appropriate amounts of minerals micronutrients, and vitamins.

Comparing the Effect of Phenylephrine Bolus and Phenylephrine Infusion for Maintaining Arterial Blood Pressure During Cesarean Delivery Under Spinal Anesthesia: A Randomized Prospective Study.

Maternal hypotension is a common complication of spinal anesthesia in cesarean section and requires immediate intervention. Phenylephrine is most commonly used as a vasopressor agent for the treatment of hypotension due to subarachnoid block.Our aim was to compare the bolus dose of 50 µg of phenylephrine with a fixed infusion at 50 µg.min-1 of phenylephrine for maintaining arterial blood pressure during cesarean delivery. This was a prospective, randomized comparative study. One hundred normotensive pregnant females aged 18-35 years, body mass index 18-29kg.m2, American Society of Anesthesiologists (ASA) physical status classificationIIscheduled to undergo cesarean section (elective/emergency) under spinal anesthesia were randomly divided into two groups of 50 each. Group PB received a bolus dose of phenylephrine 50 µg after they developed hypotension i.e., a decrease in systolic blood pressure (SBP) ≥ 20% from the baseline. Similarly, patients in Group PI were administered prophylactic infusion using a syringe pump of phenylephrine 50 µg.min-1, started just after the administration of subarachnoid block. The phenylephrine infusion was continued either till the delivery of the baby or when SBP rises >20% above the baseline. Parameters like blood pressure, heart rate, and peripheral oxygen saturation were recorded.After the delivery of the baby, theneonatal APGAR score was assessed at one minute and five minutes. Demographic data were comparable in terms of demographic profile, duration of surgery, and ASA physical status classificationbetween the groups. The heart rate was higher in Group PB compared to Group PI throughout the monitoring period (P<0.001). The fall in mean blood pressure was more in Group PB compared to Group PI till 18 minutes of surgery and was statistically significant (P<0.05). After 18 minutes of surgery, mean blood pressure stabilized and was comparable between the groups. Other variables like APGAR score at one minute and five minutes were comparable between the groups.Bradycardia and hypertension were more common in Group PI whereas hypotension, nausea, and vomiting were more common in group PB. We concluded that during cesarean section under spinal anesthesia, phenylephrine infusion provides better hemodynamic stability and APGAR score during the perioperative period.

STUDY OF THYROID PROFILE, URIC ACID, CREATININE AND LIPID PROFILE IN PRE-ECLAMPSIA PATIENT

Objectives: (1) To evaluate and compare the thyroid profile and lipid profile in preeclampsia in a normotensive pregnant female in the third trimester of pregnancy. (2) To estimate and compare serum uric acid and serum creatinine in preeclampsia in normotensive pregnant females. Methods: In the present study, 154 patients, of which 79 preeclampsia (cases) and 75 (controls), were selected randomly and matched with their gestational age in patients who attended an ANC clinic at the Department of Obstetrics and Gynecology, NSCB Medical College, Jabalpur, from March 2016 to August 2017. All patients were evaluated for their lipid profile, thyroid profile, serum uric acid, and serum creatinine. The study includes patient’s specific detailed clinical history, physical examination findings, and a report of relevant investigations recorded from the patient who presented with pre-eclampsia and normotensive pregnant female attending the ANC Clinic of N.S.C.B. Medical College, Jabalpur. Results: The most common age group for preeclampsia was 20–24 years. Preeclampsia was most common in the nullipara as compared to the multipara. Pre-eclampsia cases commonly occur in low-socioeconomic and rural areas. In this study, pre-eclamptic women showed higher serum concentrations of total cholesterol (221.60±22.55), low density lipoprotein (LDL) (134.44±16.96), Very LDL (48.48±6.88) and Triglyceride (243.50±32.33) when compared to normotensive women, which was statistically significant. In this study, a statistically significant decrease in HDLC (34.55±5.37) was observed in pre-eclamptic women. An increase in serum creatinine was observed in women with pre-eclampsia. The mean serum creatinine level was (1.21±0.47). Conclusion: Our study concludes that nulliparous and low-socio-economic women had a higher risk of pre-eclampsia. Maternal age between 20 and 24 years are more prone to develop pre-eclampsia. Serum uric acid levels are significantly higher in pre-eclampsia patients and could be a useful indicator of maternal and fetal complications in hypertensive patients.

Clinical and ultrasonographic assessment of airway indices among non-pregnant, normotensive pregnant and pre-eclamptic patients: a prospective observational study

BackgroundPrediction of a difficult airway is of paramount importance for an anaesthesiologist. Various anatomical and physiological factors contribute to a difficult airway in pregnant females, especially those with pre-eclampsia. The aim of the study was to assess airway indices using both routinely used clinical methods and ultrasound. MethodsFifty-five non-pregnant females, 55 normotensive pregnant females and 55 females with pre-eclampsia were included in this prospective study. Clinical airway assessment was the modified Mallampati score, thyromental distance, hyomental distance, hyomental distance ratio, chest circumference, neck circumference and chest-to-neck circumference ratio. Sonographic assessment included tongue width, tongue volume, anterior neck soft tissue thickness at the level of hyoid, epiglottis and vocal cords, subglottic diameter, ratio of pre-epiglottic space to anterior, posterior and midpoint of anterior and posterior vocal folds. ResultsSeveral significant differences were observed between pregnant and non-pregnant females, with additional changes in pre-eclamptic females. These included clinical parameters such as the modified Mallampati score and sonographic measurements of tongue width, tongue volume, subglottic diameter, anterior neck soft tissue thickness at the level of hyoid, epiglottis and vocal cords, and the ratio of pre-epiglottic space to anterior, posterior and midpoint of anterior and posterior vocal folds. ConclusionRoutinely used clinical methods of airway assessment lack sensitivity and specificity. Ultrasound can visualise anatomical structures in the supraglottic and subglottic views and is encouraging as an airway assessment tool.

Serum immunoglobulins, C-reactive protein, and trace element level in preeclamptic Nigerian subjects.

The mechanism involved in the pathogenesis of preeclampsia (PE) remains uncertain, and the research into a better understanding, its possible prediction, and subsequent prevention continues. This study evaluated changes in serum immunoglobulins (IgG, IgA, and IgM), C-reactive protein, and trace elements (Zn, Cu, and Mn) in preeclamptic, normotensive pregnant, and non-pregnant females. The study was conducted among 150 subjects consisting of 50 preeclamptic subjects, 50 healthy normotensive pregnant women in their third trimester, and 50 non-pregnant women, all within the same age bracket. The serum concentration of the immunoglobulins and C-reactive protein were measured using standard immunoturbidimetric methods, whereas the trace elements were assayed using the atomic absorption spectrophotometric method. Serum IgG and IgM levels were observed to be significantly lower (P < 0.05) in preeclamptic subjects (101.22 ± 4.44 and 769.43 ± 1.43 mg/dl), respectively, when compared to the normotensive pregnant women (123.87 ± 1.81 and 881.71 ± 2.80 mg/dl), respectively. There was a non-significant difference in immunoglobulin A levels between the groups (P > 0.05). The C-reactive protein was significantly higher, whereas the trace elements were significantly lower (P < 0.05) in preeclamptic subjects compared to the normotensives. There was a positive correlation between the immunoglobulin G and Zn levels (r = 0.334; P = 0.046) and also between immunoglobulin G and C-reactive protein levels (r = 0.340; P = 0.043) and a negative correlation between systolic blood pressure and manganese levels in preeclamptic subjects (r = -0.375; P = 0.024). This study therefore reveals significantly lower levels of immunoglobulins and trace elements among the preeclamptic subjects. These micronutrient deficiencies and low levels of immunoglobulins could be risk factors for the development of high blood pressure and PE.

Coagulation profile and platelet parameters in pregnancy induced hypertension cases and normotensive pregnancies: A cross-sectional study

•PIH is a leading cause of maternal and perinatal morbidity and mortality worldwide.•Hypercoagulability is constantly associated with hypertensive disorders of pregnancy and particularly associated with pre-eclampsia.•The aims and objectives of this study were to compare the platelet parameters and coagulation profile in normotensive pregnant females along with gestational hypertension cases and pre-eclamptia patients.

Association of CRP Levels in 3rd Trimester with Fetal Birth Weight in Normotensive and Preeclamptic Pregnant Females

Aim: To assess the level of C-reactive protein, which is an inflammatory marker, in pregnant women with pre-eclampsia and with normal blood pressure, and to assess its relationship with fetal weight at birth. Study design: An analytical and Cross-sectional study. Place and duration of study: In the Obstetrics and Gynecology department of Chandka Medical Hospital, Larkana and Murshid Hospital, Karachi for nine months duration from January to September 2021. Methodology: A total 70 cases of pre-eclampsia and 70 pregnant women with normal blood pressure participated, all in the 3rd trimester of gestation. All females were in the 20-40 years of age group and had a BMI ranging from 18 to 25. Highly sensitive levels of C-reactive protein (hsCRP) were evaluated using the Enzyme Link immunosorbent assay. Statistical analysis was performed with SPSS program 20.0. The values were taken as significant at the significance level of 0.05. Results: C-reactive protein levels were significantly advanced in the pre-eclampsia group with a mean value of 8.4 (0.4 to 24.2) compared to 5.1 (0.21 to 10.1) mg / L in women with normal blood pressure (p-value &lt;0.001). Spearman's correlation coefficient between birth weight and CRP was -0.405 in the pre-eclampsia group (p = 0.001) and 0.118 in the normal blood pressure group. In the group with pre-eclampsia, the birth weights of children were also significantly lower. High CRP levels in the preeclampsia group were negatively correlated with fetal birth weight. Conclusions: High levels of C-reactive protein in pregnant women with pre-eclampsia are part of the excessive systemic maternal inflammatory response and are associated with low fetal weight. Keywords: Pre-eclampsia. C-reactive protein. Pregnancy. Third trimester

Predictive Value of Maternal Beta Human Chorionic Gonadotropin for Risk Assessment of Hypertensive Disorders of Pregnancy

Objective: This study was conducted to find out if measuring levels of beta HCG in early 2nd trimester can accurately predict HDP occurrence. Methods: This was a prospective observational study was conducted from August 2020 to September 2021 at OPD/IPD of Gynae Unit-II of Bahawal Victoria Hospital, Bahawalpur. The tests were done at Pathology Department, Quaid-e-Azam Medical College, Bahawalpur. Beta HCG levels of total 180 pregnant females who were in their second trimester (14-20) were assessed. Results: Out of 180 study subjects, 157 cases remained normotensive and 23 patients got hypertensive disorders of pregnancy. Out of these 23 patients , twelve patients had mild hypertensive disease while eleven patients had severe disease. We noticed a significantly raised serum β hCG levels in females with htn disorder of pregnancy as compared to normotensive pregnant females. Conclusion: The study indicated that pregnant women with raised beta HCG levels in early pregnancy are at an increased risk of adopting gestational hypertension and related disorders so beta HCG in second trimester can be used as a good predictive test for HDPs. Keywords: Pregnancy, Beta HCG, Hypertensive pregnancy disorders, trimester, hypertension

Comparison of frequency of low APGAR score in babies born to normotensive patients with and without hyperuricemia in a tertiary care hospital

Objective: To compare the frequency of low APGAR scores in babies born to normotensive patients with asymptomatic hyperuricemia with those without hyperuricemia.Study Design: Cohort Study.Place and Duration: This study was conducted at the department of gynaecology/obstetrics, Liaquat National Hospital Karachi from January 2015 to January 2016.Materials and Methods: The sample size was calculated by using openepic.com version 2, an open-source calculator. The sample size was calculated to be 165 in each group, which made a total of 330 patients. Non-probability consecutive sampling was chosen as the sampling technique. All normotensive pregnant females with blood pressure of less than 130/90 between 18 to 40 years of age, with singleton pregnancy at 37 weeks and beyond were included in the study. Normotensive pregnant females with hyperuricemia were the exposed group while normotensive pregnant females with normal uric acid levels were the non-exposed group. The exclusion criteria included patients with multiple gestations, medical disorders like gout, chronic renal failure, APLS, Rheumatoid Arthritis, etc, on anti-hypertensives and smokers. Fetal outcomes were assessed in all patients after delivery and a comparison of outcomes was made between two groups. Results: The study was designed to compare the frequencies of low APGAR scores in babies born to normotensive patients with asymptomatic hyperuricemia to those without hyperuricemia. The main outcome in group A i.e. exposed group was 29 babies with low APGAR score (&lt;7) with 17.5% and in group B, which was non-exposed, 12 (7.57%) of babies had low APGAR score (&lt;7). P-value came out to be 0.0010. The difference was statistically significant.Conclusion: It is concluded that there is a significant difference between the frequency of low APGAR scores in babies born to normotensive patients with hyperuricemia to those without hyperuricemia.

A Study Evaluating Correlation between Umbilical Cord Attachment on Placenta in Normotensive and Hypertensive Pregnant Females and its Effects on Fetus

Introduction: Well nourished newborn is a reflection of adequate placental function.The umbilical cordthat connects fetus and placenta can attach itself to placenta at different placenta.The incidence of central,eccentric, marginal and velamentous cord insertion is 18%,73%, 7% and 1-2%, respectively. This insertiontype significantly influences fetal growth and pregnancy outcomes.Methodology: This study was conducted in Department of Anatomy of SBKS MIRC, Vadodara. This was acomparative study between normotensive and hypertensive group in which 500 subjects, in each group wereincluded. Insertion of umbilical cord on placentawas determined and fetal growth and outcome with type ofinsertion were correlated.Results: The two groups were comparable in terms of demographics.Higher proportion of those inhypertensive group had marginal insertion of umbilical cord (23.40%) as compared to 2.90% in normotensivegroup. Mean systolic (150.10±7.51mmHg) as well as diastolic blood pressure (91.23±4.00mmHg) washigher in those with marginal insertion of placenta. Mean fetal birth weight and APGAR score at birth and 5minute and proportion of fetus reaching full term, live births were low in those in those in the hypertensivegroup especially in those with marginal insertion of placenta.Conclusion: Thus it can be concluded that abnormal attachment of umbilical cord on placenta has significantimpact on fetal growth and influences the outcomes of pregnancy directly and indirectly

Association of Xanthine Oxidase and Neutrophil Activation Marker Elastase in Preeclampsia: A Case-control Study

Introduction: Preeclampsia is an obstetric emergency for both mother and the foetus with unknown aetiology. Delivery is the only effective way in the prompt management. Due to oxidative stress factors, there is an increased conversion of xanthine dehydrogenase to xanthine oxidase, so there is more production of hydrogen peroxide. Hydrogen peroxide affects the cell function of trophoblast. Therefore, oxidative stress is one of the causative factor for complications of preeclampsia. Aim: To determine the association between xanthine oxidase and plasma elastase (Neutrophil activation marker) in preeclampsia. Materials and Methods: The case-control study was conducted from March 2019 to December 2019 on normotensive pregnant females and preeclamptic patient categorised as group 1 (control) and group 2 (case) respectively. The level of xanthine oxidase and plasma elastase were estimated spectrophotometrically. To compare means between the two groups, Student’s t-test was used and correlation between parameters were estimated through Pearson’s correlation coefficient. A p-value of &lt;0.05 was considered statistically significant. Results: A total of 60 subjects were included and analysed in two groups 1 and 2 respectively. Neutrophil activation marker (elastase) was elevated 4.5-fold in group 2 (26.81±7.9) but, it was non significant when compared to group 1 (6.02±3.4). Xanthine oxidase levels amongst group 1 was 34.01±38.26 U/L which was significantly elevated in pregnant group 2 patients as 218.78±220.42 U/L with probability p-value &lt;0.05 and positive correlation of r=0.320. Conclusion: Elevated levels of xanthine oxidase adds to oxidative stress and may result in trophoblastic dysfunction in preeclampsia. The situation is convoyed by increased concentration of pro- inflammatory signaling molecules like cytokines such as Tumour Necrosis Factor-α (TNF-α), activated neutrophils and positive acute phase plasma proteins. Elastase as neutrophil activation marker showed 4.5-fold increase in preeclampsia which shows aggravated inflammatory condition.

Assessing the impact of Glutathione on maternal and fetal outcome in pregnancy-induced hypertensive disorders: A case-control study

Background: Disorders related to hypertension in pregnancy, mainly Pre-eclampsia (PE), and Eclampsia, are the major causes of fetal and maternal morbidity and mortality. The placenta's ischemic blood supply leads to its endothelial dysfunction and reduced glutathione bioavailability involved in its pathogenesis. This study explored maternal serum Glutathione's level and changes and found out its association with fetal growth in pregnancy-induced hypertensive disorders.&#x0D; Methodology: A Multicenter, case-control study was conducted on 240 pregnant females. The investigational group included 180 pregnant females having blood pressure above 140/90 mmHg. The Investigational group was divided into different groups, i.e. Pregnancy-induced hypertension (PIH) group, PE group, and Eclamptic group. 60 normotensive pregnant females were kept in control. The blood samples were obtained to analyze serum Glutathione (GSH) through ELIZA (enzyme-linked immunosorbent assay), while urine samples were obtained for confirmation of the PE status. Fetal well-being and signs of growth restriction were observed using ultrasound.&#x0D; Results: A significant reduction was elucidated in serum glutathione, biparietal diameter, and femur length among all experimental groups p &lt; 0.001. However, no significant difference was observed in the abdominal circumference p=0.122 and Fetal weight p=0.51. A significantly inversely proportional relation was found between serum glutathione and gestational age, fetal weight as well as head circumference in all four groups control (r =-.305 p=0.018) PIH (r =-.618 p =0.000), PE (r=-.707 p=0.000) and Eclampsia (r=-.661 p=0.000).&#x0D; Conclusion: It is to conclude that the fetus's growth was markedly affected by reduced Glutathione in hypertensive disorders of pregnancy with the progression of the disease.

Relation of Endothelin-1 and Malondialdehyde with Pre-eclampsia in Pregnant Women

A case-control study was conducted in Kirkuk city in Kirkuk general hospital from first of March 2018 and to end of September 2018 to evaluate the role of endothelin-1 and malondialdehyde in pathogenesis of pre eclampsia in pregnant women. The study included 30 pregnant women with preeclampsia, patients were defined and divided according to the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. A control group of 30 healthy normotensive pregnant females was also included. All comparison groups were matched for mother’s age, parity, and gestational age at the time of enrollment and blood collection. Three ml of blood was collected by vein puncture, blood samples were placed into sterile test tubes and left for 30 minutes at 37 °C then were centrifuged at 3000 rpm for 15 minutes then the clot was removed and the obtained sera were then aspirated using automatic micropipette and transferred into clean test tubes and stored in deep freeze at -20°C for determination of endothelin-1 and malondialdehyde by usingELISA technique. The study showed that the highest mean level of endothelin-1 was found in pregnant women with pre-eclampsia(13.15±2.81 pg/ml) and the lowest mean was in the control group (0.41±0.31 pg/ml). The result was highly significant (P&lt;0.01). The study showed that the highest mean level of MDA was found in pregnant women with pre-eclampsia (6.75±2.94 nmol/ml) and the lowest mean was recorded in the control group (3.85±1.29 nmol/ml). The result was highly significant (P&lt;0.01). The current study showed that the mean age of patients enrolled in the study was 33.5 years, the highest mean of endothelin-1 in HD patients was recorded within the age group 20-29 year of pregnant women with pre-eclampsia. Although the results was non-significant. The study showed positive correlation between endothelin-1 and MDA levels pregnant women with pre-eclampsia. It was concluded that serum endothelin-1 and MDA levels were highly correlated with pregnant women with pre-eclampsia

Abstract P3038: Reduced Renal Responsiveness and Altered Fluid Volume in an African Green Monkey ( Chlorocebus Aethiops Sabaeus) Preeclampsia Model

Preeclampsia is a prevalent, multi-organ complication of late pregnancy characterized by de novo gestational hypertension (GH) and proteinuria. Our group has demonstrated that arginine vasopressin (AVP) secretion, as measured by copeptin, is predictive of the development of human preeclampsia. Altered regulation of AVP early in gestation has been demonstrated in human preeclampsia. Recently, the nonhuman primate, African Green Monkey (AGM) has been characterized as a spontaneous, translational model of chronic hypertension, GH and preeclampsia. AGMs also have similar gestation and placentation to humans. We hypothesized that the AGM model of preeclampsia would demonstrate similar AVP related plasma and fluid volume changes as humans with preeclampsia. AGMs (n=10) were anesthetized with ketamine during late third trimester of pregnancy to obtain physiologic and obstetric measurements. Compared to normotensive (NT, n=4) third trimester pregnant females, GH females (n=6) had higher systolic and diastolic blood pressures (106 ± 5 vs. 162 ± 11 mmHg; 46 ± 4 vs. 86 ± 12, p=0.01) with no differences in heart rates (158 ± 4 vs. 169 ± 18 bpm, p=0.64). Consistent with other models of GH and preeclampsia, the GH AGM had decreased offspring birthweight in comparison to NT offspring (352 ± 11 vs. 275 ± 12 g, p=0.01). Further, plasma osmolality of GH females was higher in late third trimester compared to NT females (286 ± 11 vs. 312 ± 9 mOsm, p=0.05). This higher plasma osmolality was associated with the GH female’s trend to higher AVP secretion as measured by copeptin (2 ± 2 vs. 4 ± 1 ng/g, p=0.280). In contrast to human pregnancies, late third trimester plasma [Na + ] of GH females was elevated compared to NT females (149 ± 3 vs. 157 ± 2 mMol/L, p=0.04). These data demonstrate that that the AGM model of preeclampsia replicates the plasma volume restricted findings consistent with human preeclampsia and possible insensitivity to control by AVP. Ongoing studies in early pregnancy will quantify changes in renal function during preeclampsia, differences in fluid volumes among NT and GH AGMs, and further the understanding of hormonal regulation of kidney function in the pathogenesis of preeclampsia in this translational AGM nonhuman primate.

Serum Uric acid levels in Preeclamptic and Normotensive pregnant females

Serum Uric acid levels in Preeclamptic and Normotensive pregnant females

WEIGHT AND VOLUME OF PLACENTA IN NORMOTENSIVE PREGNANCIES VERSUS PREGNANCY INDUCED HYPERTENSION

Background: Pregnancy-induced hypertension adversely affects the development of placenta and growth of fetus. The objective of the study was to compare the weight and volume of placentae in normotensive pregnancies versus patients with pregnancy-induced hypertension. Material &amp; Methods: This comparative cross-sectional study was conducted in the Department of Anatomy, Gomal Medical College, D.I.Khan, from January 2014 to October 2014. Sample size was 150. Consecutive sampling technique was used. Inclusion criteria was pregnant women of all ages and parity. Grouping variable was presence of PIH with two attributes of yes and no. Research variables were placental weight in grams and placental volume in milliliters. A total of 150 placentae with the cord were collected after delivery from pregnant women, from the labour room of obstetric unit, DHQ Teaching Hospital, D.I.Khan. Structured proforma was used to record the presence or otherwise of PIH. Subjects were divided into two groups on basis of presence or absence of PIH; group A with 50 normotensive pregnant females and group B with 100 patients with PIH. Placental weight and volume were measured in terms of mean ± SD, whereas categorical variables as frequency and percentage. Students t test was used in Social Sciences Online calculator. Results: Out of 150 patients, 50 were normotensive and 100 were having PIH. Mean weight of placentae in groups A and B were 421.40±17.90 g and 320.60 ±14.95 g respectively whereas mean volume of placentae in groups A and B were 396.10±10.40 ml and 280.50 ±10.35 ml respectively. (p

Assessment of Relationship of Serum Neurokinin-B Level in the Pathophysiology of Pre-eclampsia: A Case-Control Study.

Pre-eclampsia is a pregnancy-induced disorder that complicates approximately 5-7% of pregnancies. It is the leading cause of maternal and foetal morbidity and mortality worldwide. To determine the role of serum neurokinin-B level in the pathophysiology of pre-eclampsia. This was a case-control study. A total of 80 pregnant women in their third trimester of pregnancy were included in the study. They were divided into two groups (40 pre-eclamptic and 40 normotensive) according to the presence or absence of clinical parameters of pre-eclampsia. Serum level of neurokinin-B was measured with ELISA. Maternal age, weight, BMI, pulse, systolic BP and diastolic BP were statistically higher in the pre-eclampsia group compared to the normotensive group (P < 0.0001). Moreover, statistically higher levels were observed for neurokinin-B in the normotensive group as compared to the pre-eclamptic group. The mean value of neurokinin-B was 83.50ng/L in the pre-eclamptic group compared to 111.5ng/L in the normotensive group (P = 0.006). Higher levels of serum neurokinin-B were observed in the normotensive pregnant females as compared to the pre-eclamptic females. Thus, apparently, it seems that serum neurokinin-B plays no role in the pathophysiology of pre-eclampsia, and further large multicentre prospective studies may be required to ascertain its role.

An Evaluation of Applicability of Salivary Uric Acid Measurement in Preeclampsia and Normal Pregnancy and Its Correlation with Serum Uric Acid.

Hypertensive disorders complicate 5-10% of all pregnancies and contribute greatly to maternal morbidity and mortality. There are various biomarkers for detection of preeclampsia. Several studies have reported that positive correlation exists between serum uric acid (UA) levels and adverse maternal and fetal outcome. Significant advances have been made toward validation of salivary biomarkers. We conducted this study to determine levels of salivary UA and its correlation with serum UA normal pregnancy and preeclampsia. Present cross-sectional study was conducted in tertiary care teaching hospital in North India. One hundred and fifty participants were divided into control group (50 healthy non-pregnant females), study group I (50 normotensive pregnant females), study group II (50 pregnant females with preeclampsia), and both salivary and serum UA was estimated at the same time. Saliva UA of study group II (4.86 ± 2.37mg/dl) was significantly higher (p < 0.001) than that of control group (2.09 ± 1.33mg/dl) and study group I (3.32 ± 1.77mg/dl). Serum UA of study group II (6.63 + 2.78mg/dl) was significantly higher (p < 0.001) than that of control group (2.94 + 1.94mg/dl) and also study group I (5.18 + 2.31mg/dl) (p = 0.0006). UA is present in the saliva of women with preeclampsia and has linear correlation with serum UA. Therefore, salivary UA can be used in place of invasive serum UA to monitor women with preeclampsia. Saliva collection is easy, noninvasive and cost-effective. Salivary UA testing may be useful for monitoring preeclampsia at home-based and hospital setting.