Preeclamptic Pregnant Patients Research Articles

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.

Assessment of transcranial Doppler indices after MgSO4 administration in severe preeclamptic women with neurologic symptoms.

To investigate the effect of intravenous MgSO4 on maternal cerebral hemodynamics as well as the association between altered Doppler indices of the ophthalmic arteries and ocular lesions in patients with preeclampsia. After each of the 15 included patients was diagnosed with preeclampsia, MgSO4 was infused followed by transcranial Doppler tests of the indices of the ophthalmic, anterior, middle, posterior cerebral, vertebral, and basilar arteries, followed by a second MgSO4 infusion. The peak, mean, diastolic velocity, and pulsatile and resistance indices of each artery were automatically measured during testing. Based on the emergent data, the cerebral perfusion pressure, resistance-area product, and cerebral flow index were calculated. The cerebral perfusion pressure of the posterior cerebral arteries significantly decreased following the infusion of MgSO4 (p < 0.05). Before the infusion of MgSO4, cerebral perfusion pressure and cerebral flow index of the ophthalmic arteries were significantly increased (p < 0.05) in the preeclamptic pregnant patients with ocular lesions compared those without ocular lesions. After the infusion of MgSO4, the cerebral perfusion pressure and cerebral flow index of both ophthalmic arteries were slightly decreased, but the difference was not significant. Altered Doppler indices following the infusion of MgSO4 suggest significant changes in the hemodynamics of the posterior cerebral and ophthalmic arteries that are particularly related to the neurological signs and symptoms of women with preeclampsia. These findings may improve the understanding of the mechanism of the cerebral complications of preeclampsia. Advancing comprehension of these underlying mechanisms is postulated to play a pivotal role in the mitigation of hypertensive encephalopathy associated with preeclampsia.

Evaluation of Hypertension and Renal Function in Preeclamptic Women: A Follow-Up Study at 6th Week of Postpartum

OBJECTIVES: Chronic hypertension stands as the primary contributing factor for cardiovascular ailments among women who have experienced preeclampsia. The purpose of this research is to examine how often preeclamptic symptoms persist at the postpartum 6th week. STUDY DESIGN: The study included 50 singleton pregnant women in the third trimester who were diagnosed with preeclampsia according to ACOG criteria, were older than 18 years, had no known hypertension before the 20th gestational week, had no additional systemic disease, did not use medication, had no fetal chromosomal or structural abnormalities and delivered within 24-48 hours of hospitalization. RESULTS: The mean age of preeclamptic pregnant patients was 29.26±7.15 years, the mean gestational week was 35.6±2.8, and the mean BMI was 31.3±4.9. Twenty (40%) of 50 preeclamptic patients had severe preeclampsia. The mean decrease in systolic blood pressure was 34.6±15.2 mmHg, while the mean decrease in diastolic blood pressure was 22.88±11.68 mmHg (p&lt;0.001). The decrease in systolic and diastolic blood pressure at postpartum 6th week was statistically significant. The mean change in 24-hour urine protein value at postpartum 6th week was 2313.52 ± 2696.48 and the difference was statistically significant (p&lt;0.001). There were 14 patients (28%) with persistent hypertension and 19 patients (38%) with persistent proteinuria. CONCLUSIONS: Although preeclampsia is considered a complication of pregnancy, persistent hypertension, and proteinuria after delivery show us that preeclampsia is a disease that threatens maternal health even after delivery. These women should be followed up long-term period.

What is in common between preeclampsia, HPS70 and medieval headwear? Part I. Serum HPS70 in preeclampsia: systematic review and meta-analysis

The objective: to investigate the relationship between HSP70 concentrations in maternal serum and preeclampsia and assess the prospects of using HSP70 as a preeclampsia predictor.Materials and methods. The original publications, which study HSP70 in maternal serum of preeclamptic women, were searched and analyzed. Papers were identified with Scopus, PubMed Central, Virtual Health Library databases, published before January 2023, the keywords were «HSP70», «preeclampsia», «heat shock protein 70», «pregnant». Statistical analysis was performed via software EZR 1.55.Results. 16 case-control studies were included, making a total of 751 pregnant women with preeclampsia and 719 healthy pregnant women. The analysis found the statistically significant difference between HSP70 concentrations in maternal serum of preeclamptic and healthy pregnant patients. Cochrane Q-test showed high heterogeneity among studies (p&lt;0.01), the value of the І2 statistic was 97%. Dividing the studies into groups made it possible to reduce or remove heterogeneity completely. This high level of heterogeneity for publications together, but low within most groups, suggests that there are certain factors that significantly influence some studies.Conclusions. The conducted systematic review and meta-analysis confidently indicate an increased average serum concentration of HSP70 in pregnant women with preeclampsia compared to healthy pregnant women at the corresponding gestational age.No statistically significant relationship was found between increased HSP70 concentration in preeclampsia and pregnant women’s age, gestational age, systolic and diastolic blood pressure. Quantitative assessment of HSP70 levels is complicated by the lack of a single standard for laboratory diagnostics. The case-control design of the presented studies limits their significance.The use of HSP70 as a predictor of preeclampsia is promising, but requires further study and prospective cohort studies.

Frequency of hyperuricemia and fetal outcome in preeclampsia.

Objective: To determine the frequency of hyperuricemia and fetal outcome in pre-eclamptic pregnant patients. Study Design: Cross-Sectional Study. Setting: Department of OBG Allied Hospital Faisalabad. Period: January 15, 2022 to January 15, 2023. Material &amp; Methods: Total 200 preeclamptic patients were enrolled and 5c.c of blood was drawn for serum uric acid level. The normal values took 3.1-6.3 mg/dl. Fetal outcome were intrauterine death, premaurity, intrauterine growth restriction with low birth weight recorded. Results: Frequency of hyperuricemia was calculated as 42% (n=84) where normal uric acid levels were recorded in 58% (n=116). IUD in hyperuricemia was 8.33%(n=7) and 2.59%(n=3) in normal uric acid levels, p=0.06, preterm delivery in hyperuricemia was 52.38%(n=44) and 20.69%(n=24) in normal uric acid level, p=0.000, CS in 55.95%(n=47) in hyperuricemia and 22.41%(n=26) in normal uric acid levels whereas SVD was 44.05%(n=37) in hyperuricemia and 77.59%(n=90) in normal uric acid levels, p=0.000, low birth weight was recorded in 52.38%(n=44) in hyperuricemia whereas 14.66%(n=17) in normal uric acid levels, p=0.000. Conclusion: the frequency of fetal outcome is adverse in hyperuricemia in pre-eclamptic patients as compared to normal serum uric acid levels.

The Impact of Early Versus Delayed Umbilical Cord Clamping in Preeclamptic Pregnant Patients During Cesarean Section

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The serum level of soluble CXCL16 is increased in preeclampsia and associated with hepatic/renal damage

Objective To compare the serum level of the chemokine, CXCL 16, in preeclamptic and healthy pregnant patients. Methods This prospective case control study was conducted between January and December 2018 in a tertiary level hospital. The study group was formed of 70 pregnant women diagnosed with preeclampsia, and the control group was formed of 70 healthy pregnant women matched to the study group in respect of age, gestational week and body mass index (BMI). The study group was separated into two subgroups of mild preeclampsia (n = 35) and severe preeclampsia (n = 35). The groups were compared in terms of demographic and clinical parameters and the levels of serum CXCL 16. Results No statistically significant difference was determined between the study and control groups in respect of maternal age, gravida, parity, BMI, and gestational age at sampling. Neonatal birth weight was significantly lower in the study group than in the control group. Mean serum alanine aminotransferase (ALT), aspartate amino transferase (AST) and creatinine levels of the study group were significantly higher than those of the control group (p < .05 for all). There was a statistically significant difference between the study and control groups regarding the mean platelet count. Compared to the control group, the severe and mild preeclampsia groups had a significantly higher serum level of CXCL 16. The serum level of CXCL 16 was significantly higher in patients with severe preeclampsia than in patients with mild preeclampsia (2.94 ± 3.89 pg mL−1 vs. 1.08 ± 1.87 pg mL−1, p = .14). Correlation analysis revealed a significant positive correlation of serum CXCL 16 level with serum ALT level (r = 0.320, p ≤ .001) and serum AST level (r = 0.373, p ≤ .001) and serum creatinine level (r = 0.279, p = .01) in both groups. High values indicated presence of preeclampsia, with a diagnostic cut-off point of 0.225, sensitivity of 75.7% and specificity of 72.9% for CXCL 16 (area under curve: 0.820, p < .001 CI: 0.753–0.888). Conclusions This is the first study in literature to show a significantly higher level of CXCL 16 in patients with severe preeclampsia compared to those with mild preeclampsia. The study can also be considered of value in respect of showing that CXCL 16 could play a role in the etiopathogenesis of preeclampsia and the emergence of renal-hepatic damage. Blocking the CXCL 16/CXCR six axis in preeclampsia treatment could lay the ground for the development of new drugs which could be used in the treatment of preeclampsia.

Estimation of Umbilical Artery Resistive Index in Pregnant Women with Preeclampsia in Al-Najaf Province

This study was carried out on 105 pregnant women with preeclampsia in addition to 105 pregnant women without preeclampsia as a control at Al-Najaf province from September ,2017-May 2018. All the included patients were examined by Doppler study to assess the resistive index of umbilical artery RI in preeclamptic pregnant patients with PE and pregnant women without PE. The results reveals that there was significant difference of umbilical artery RI 0.658±0.304, concerning preeclamptic pregnant patients in comparison to pregnant women without PE(0.571±0.215) , ( PV lesser than0.05) . &#x0D; In addition to that the umbilical artery RI was (0.577±0.301) in preeclamptic pregnant patient with mild PE while it was (0.813±0.247) in preeclamptic pregnant patient with severe PE which displayed a statistically significant difference( PV less than0.05).Also this study showed that the umbilical artery RI in preeclamptic pregnant patients with H. pylori was(1.11±0.319) which was greater than that for preeclamptic pregnant patients without H. pylori (0.919±0.25) with a statistically significant difference ( PV less than 0.5). It was concluded that Umbilical artery resistive index is a useful parameter in detection of preeclampsia and its severity and the umbilical artery resistive index might be useful parameter in prediction of infection of positive H. pylori infection associated with preeclampsia.

Evaluation of Serum Thyrotropin and Urinary Protein level among Pre-eclamptic Pregnancies

&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study was done to evaluate serum thyrotropin (thyroid stimulating hormone,TSH) and urinary protein level among preeclamptic pregnancies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;This study was conducted at the Institute of Nuclear medicine and Allied Sciences, Rajshahi along with Department of Gynecology &amp;amp; Obstetrics, Rajshahi Medical College Hospital, Rajshahi during the period between 1&lt;sup&gt;st&lt;/sup&gt; July, 2011 and 31&lt;sup&gt;st&lt;/sup&gt; June, 2013.Total 66 preeclamptic pregnant patients who were referred for the assay of serum thyrotropin hormone level were included as sample under the basis of non-random purposive sampling technique. Their age, urinary protein level and level of serum thyrotropin hormone were recorded and analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among the total enrolled preeclamptic pregnant patients (n=66), Mean (± SD) age was 27 ± 3.88 years (range=19 to 35 years). Regarding urinary protein level, 26 (39.39 %) patients had 1+ urinary protein level and 40 (60.61%) patients had ≥ 2+ urinary protein level. Serum thyrotropin level was 6.16 ± 0.85 (mean ± SD) among total 66 patients. Among the preeclamptic pregnant patients having 1+ urinary protein level, thyrotropin level was 5.38 ± 0.70 (mean ± SD) and 6.67 ± 0.49 (mean ± SD) among the patients having ≥ 2+ urinary protein level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Thyrotropin level is higher in preeclamptic pregnant patients and reflects severity of preeclampsia.&lt;/p&gt;&lt;p&gt;Bangladesh J. Nuclear Med. 19(2): 120-122, July 2016&lt;/p&gt;

Maternal serum autotaxin levels in early- and late-onset preeclampsia

ABSTRACTPurpose: We aimed to compare the serum autotaxin levels in early- and late- preeclamptic and healthy pregnant patients at a university hospital.Methods: A total of 55 singleton preeclamptic women who delivered at Cerrahpasa Medical Faculty were included in the study. The patients were subdivided into two groups: early-onset preeclampsia (n = 31) and late-onset preeclampsia (n = 24). Demographic and clinical data were compared between early-onset and late-onset preeclamptic patients. The control group was composed of 32 healthy pregnant patients.Results: The mean autotaxin levels were 1.16 ± 0.97 and 0.7 ± 0.35 ng/ml in the early- and late-onset preeclampsia groups, respectively. Autotaxin levels were significantly higher in early-onset preeclampsia group compared with late-onset preeclampsia group. Autotaxin levels were found to be significantly higher in preeclamptic patients compared with control group. Serum autotaxin levels showed a significant positive correlation with maternal systolic, diastolic blood pressures and uric acid levels.Conclusion: Autotaxin might be a promising marker for detecting early-onset preeclampsia. However, further studies are necessary to confirm this hypothesis.

OP 53 Anti-hemolytic effects ofα1-microglobulin – A possible mechanism for pre-eclampsia treatment

Introduction The rupture of the red blood cells (RBCs), hemolysis, is followed by leakage of cytosolic components such as hemoglobin (Hb). Free Hb can be toxic to the cells and tissues mainly because of the heme-chelated iron which has strong oxidative reactivity. Oxidative stress is therefore seen in many diseases with hemolysis. One of the characteristics of pre-eclampsia (PE) is the increase of free fetal hemoglobin (HbF) in the maternal circulation, suggesting that fetal hemolysis contributes to the pathogenesis of PE. The tissue and plasma protein α 1-microglobulin (A1M) is a human endogeneous antioxidant protecting against Hb-induced oxidative stress. A1M has previously been shown to prevent heme-induced cell death in vitro and heme-and hemolysis induced damage in different animal models including PE, and has been suggested as a potential treatment of PE. Objectives 1. To compare the susceptibility to stress-induced hemolysis of maternal and fetal RBCs in healthy and pre-eclamptic patients. 2. To determine if A1M has protective effects and can reduce hemolysis when RBCs are subjected to stress. Patients and methods Blood was drawn from healthy, non-pregnant donors. Maternal and fetal (chord) blood was obtained from healthy and pre-eclamptic pregnant patients. Red blood cells were washed and incubated with A1M (recombinantly produced in E. coli) for up to 22 h while exposed to mechanical, osmotic (water-dilution) or oxidative (heme or Fenton-reaction) stress. The amount of hemolysis was assessed by measuring LDH- and Hb-release. Western blotting and transmission electron microscopy (TEM) were also performed to examine hemolysis and A1M-uptake of RBCs. Results A1M significantly reduced hemolysis of RBCs subjected to mechanical, osmotic or oxidative stress, measured by LDH- and Hb-release after 1, 3 and 22 h. Western blotting and TEM showed that A1M was taken up by RBCs. Fetal RBCs showed significantly higher degree of hemolysis (LDH-leakage), after subjection to mechanical or oxidative stress, compared to maternal RBCs, after 22 h incubation. Hemolysis of both maternal and fetal RBCs was significantly reduced with A1M. Conclusion Hemolysis of fetal RBCs may be a novel pathogenic mechanism of PE and our results suggest that the anti-hemolytic effects of A1M may be exploited into a potential treatment of the disease. Download : Download high-res image (355KB) Download : Download full-size image Download : Download high-res image (244KB) Download : Download full-size image

Homocisteína plasmática en la preeclampsia y eclampsia durante el pre y posparto

ObjectiveTo compare plasma homocysteine concentrations in preeclamptic, eclamptic and normotensive pregnant patients before and after delivery. MethodsWe 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 of 35 normotensive women (group D) was selected with a similar age and body mass index as the study groups. In all groups, blood samples were collected in all patients before delivery, and post-partum follow-up samples were collected at 7 days and 6 weeks. ResultsStatically significant differences were found between controls and the three study groups in birthweight (P<.05). Before delivery, the highest concentrations were seen in eclamptic patients followed by those with severe preeclampsia. Concentrations were significantly higher in the three study groups than in controls (P<.05). At 7 days and 6 weeks, mean homocysteine concentrations were significantly higher in groups A, B and C than in group D (P<.05). ConclusionsHomocysteine concentrations were significantly higher in pre-eclamptic and eclamptic patients than in normotensive pregnant women and remained higher at 6 weeks after delivery.

259: Polyunsaturated fatty acid profiles in the red blood cells of preeclamptic and normal pregnant patients

The importance of optimal levels of polyunsaturated fatty acid (PUFA) subsets such as omega-3, omega-6, and omega-9 fatty acids in various diseases has become clear. This descriptive, comparative study evaluates comprehensive PUFA profiles in the red blood cells (RBCs) of patients with preeclampsia (PE) compared to normal pregnant women. RBC profiles reflect long term PUFA status.

Changes in Blood Macrophage Colony Stimulating Factor Levels after Cesarean Section in Normotensive Pregnancy and Preeclampsia

Macrophage colony-stimulating factor (M-CSF) stimulates the proliferation and differentiation of placental trophoblasts and may regulate trophoblast invasion into the placental bed. M-CSF levels in peripheral blood show a significant increase in preeclampsia. Thus, the present study examined changes in blood levels of M-CSF before and after cesarean section and compared them between normotensive and preeclamptic pregnant women. Peripheral blood was collected before, 1 day after, and 10 days after cesarean section from 27 women, 12 of whom were preeclamptic pregnant patients with a mean blood pressure of 162/98 mm Hg and 15 were age- and gestational age-matched normotensive pregnant women (normotensive control subjects). Peripheral blood was also collected once from 15 age-matched healthy, normal cycling women (nonpregnant control subjects). M-CSF level was determined by the sandwich enzyme-linked immunosorbent assay (ELISA) method using 3 antibodies. In normotensive and preeclamptic pregnancies, the M-CSF levels increased significantly (P < 0.01) 1 day after surgery but then decreased significantly (P < 0.01) at 10 days after surgery. Before and 1 day after surgery, the M-CSF levels were significantly higher (P < 0.01) in preeclamptic patients than in normotensive control subjects, but not at 10 days after surgery. The blood M-CSF levels were significantly higher in preeclampsia than in normotensive pregnancies, before cesarean section. The M-CSF levels in the circulation at 1 day after surgery increased significantly. The increase was about 270 U/mL net and at similar levels in 2 groups. Thus, increases in M-CSF levels after cesarean section may occur via similar mechanisms in normotensive and preeclamptic pregnancies. The M-CSF level in normotensive pregnancies and preeclampsia decreased and returned to the normal level at 10 days after cesarean section.

Leptina, Elo Adicional na Fisiopatologia da Pré-eclâmpsia?

Purpose: to study in primigravid adolescents the behavior of serum leptin levels during the evolution of normal pregnancy, comparing the results with those obtained from preeclamptics. Methods: prospective, longitudinal study conducted in 15 normotensive pregnant adolescents and 5 preeclamptic adolescents. Serum leptin levels (ng/mL) were determined by radioimmunoassay. Blood pressure was measured by the oscilometric method by using DINAMAP 1846. Patients were evaluated in two different gestational periods: between the 21st and 30th week and between the 31st and 40th week. The ratio leptin/body mass index (BMI) was used to correct changes observed in BMI throughout gestation. Preeclamptic pregnant patients were diagnosed when the blood pressure was ³140/90 mmHg, proteinuria >300 mg/24 h and when arteriolar spasm was present in the optic fundi. Results: there was a trend towards an elevation of serum leptin at the end of pregnancy in both groups although more pronounced in preeclamptic patients. In pregnant normotensive patients serum leptin increased from 11.9±1.20 (21st to 30th week) to 13.9±2.23 ng/mL (31st to 40th week), and in preeclamptic from 11.9±1.20 to 17.6±4.565 ng/mL. In preeclamptic patients the BMI increased significantly in the period from the 21st to 30th week when compared to the period between the 31st and 40th week: 21.5±0.8 vs 27.4±1.7 kg/m2, p<0.05. In normotensive these values were maintained stable: 24.9±1.5 vs 25.1±1.00 kg/m2. At the end of gestation the ratio leptin/BMI was significantly higher in preeclamptics: 0.56±0.06 (21st to 30th week) vs 0.70±0.15, p<0.05. The values of the ratio leptin/BMI in normotensive pregnants varied from 0.44±0.02 between the 21st and 30th week to 0.41±0.04 between the 31st to 40th week. In normal pregnants there was a direct and significant correlation between the levels of leptin and BMI in both periods of pregnancy: r = 0.7, p<0.004 (31st to 40th ) vs r = 0.94, p<0.0001 (31st to 40th week). These correlations were lost in preeclamptic patients in both gestational periods. Conclusion: the higher concentrations of leptin and leptin/BMI ratio observed when preeclamptics were compared with normotensive patients, in both gestational periods, suggest a leptin resistance pattern in preeclampsia.

Automated cardiac output measurements by ultrasound are inaccurate at high cardiac outputs

The sonographic technique of automated cardiac output measurement (ACM) is a promising new method to measure cardiac output and could be of use in a high-risk obstetric unit in the treatment of pre-eclamptic patients. The aim was to determine the accuracy of the ACM method. Comparative study of the sonographic technique of ACM versus cardiac output measured by thermodilution (TD). The study included 39 intensive care patients, 21 men, 13 non-pregnant women and five severely pre-eclamptic pregnant patients, with a wide range of cardiac outputs, in whom TD catheters had been inserted for clinical reasons. Two separate experienced observers, blinded to the results obtained with the other method, performed four successive measurements in each patient with either the ACM or TD technique. The averaged cardiac output value per patient and method was used for comparison. Cardiac output was successfully measured with ACM and TD in 85 and 100% of patients, respectively. Mean cardiac output measured by ACM (6.77 +/- 1.90 L/min) was significantly lower than that measured by TD (9.12 +/- 3.06 L/min). Although cardiac output values obtained with ACM were significantly correlated with those measured by TD, the ACM values were consistently lower than TD values in the higher cardiac output range; the relationship was represented by ACM = 0.35 TD + 3.55 L/min (r = 0.57, P < 0.001). The (ACM - TD) difference increased significantly with cardiac output, through a difference in stroke volume, not in heart rate. The ACM is not an accurate tool to measure cardiac output in patients with a high cardiac output, including treated pre-eclamptic women.

Plasma type II phospholipase A 2 levels are elevated in severe preeclampsia

OBJECTIVE: Our purpose was to compare plasma concentrations of type II phospholipase A 2 in normal and preeclamptic pregnancies and to determine whether plasma from preeclamptic patients increases endothelial cell secretion of type II phospholipase A 2. STUDY DESIGN: We compared the plasma levels of type II phospholipase A 2 in 23 patients with normal pregnancies and 25 patients with strictly defined preeclampsia. Plasma samples were collected throughout pregnancy and stored at −80° C. Patients with preeclampsia wre matched as closely as possible with controls for maternal age, race, gestational age at blood sampling, and partly. Plasma levels of type II phospholipase A 2 were measured by enzyme immunoassay. To investigate endothelial cell type II phospholipse A 2 production, we measured levels of prostacyclin and type II phospholipase A 2 in conditioned media from cultured human umbilical vein endothelial cells exposed to plasma from preeclamptic and normal pregnant patients. RESULTS: The mean plasma type II phospholipase A 2 level in the mild preeclampsia group (6.1 ± 3.0 ng/ml, n = 6) was ot different from that in control patients (6.0 ± 3.2 ng/ml, n = 23). However, the mean type II phospholipase A 2 levelin patients with severe preeclampsia (19.9 ± 12.3 ng/ml, n = 19) was significantly higher when compared with the other two groups ( p < 0.001). Prostacyclin concentrations in conditioned media of endothelial cells exposed to plasma from patients with preeclampsia were elevated compared with cells incubated with control plasma (8.6 ± 1.7 vs 4.0 ± 5.0 ng/ml, p < 0.05). However, the concentration of type II phospholipase A 2 in conditioned medium was not significantly different (1.6 ± 0.3 vs, 1.8 ± 1.0 ng/ml, p = 0.40). CONCLUSIONS: Plasma concentrations of type II phospholipase A 2 are elevated in preeclampsia and correlate well with the severity of disease. Plasma from preeclamptic women increased secretion of prostacyclin, but not type II phospholipase A 2 by endothelial cells in culture.

Effect of variations of heart rate within the normal range on renal artery Doppler indices in nonpregnant and pregnant women

The effect of heart rate on Doppler indices in the renal artery was studied in 21 nonpregnant, 17 normal and 27 preeclamptic pregnant patients. The central hemodynamics was evaluated by Doppler ultrasound in all pregnant women. The study demonstrated no influence of heart rate on renal artery Doppler indices. Central hemodynamic parameters, such as cardiac output, stroke volume, mean arterial pressure and total systemic resistance did not change with increasing heart rate. We do not recommend any correction of the renal artery Doppler indices for heart rate in the range considered clinically normal (60 to 95 beats/min). Above or below this range further investigations are required to determine if corrections would be necessary.

Pre-Eclamptic and Healthy Term Pregnant Patients Have Different Chronotropic Responses to Isoproterenol

Pre-Eclamptic and Healthy Term Pregnant Patients Have Different Chronotropic Responses to Isoproterenol

Pre-Eclamptic and Healthy Term Pregnant Patients Have Different Chronotropic Responses to Isoproterenol

Assistant Professor of AnesthesiologyAssociate Professor of AnesthesiologyInstructor in AnesthesiologyAssistant Professor in Obstetrics and GynecologyProfessor of Pharmacology (Biostatistics) Department of Anesthesiology Jefferson Medical College 111 South 11th Street Philadelphia, Pennsylvania 19107