Preeclamptic Group Research Articles

Maternal serum uric acid: a reliable prognostic indicator of foetal outcome among pre-eclamptic patients in a low resource setting

Background Pre-eclampsia is a major cause of maternal and fetal morbidity and mortality in both developed and developing countries. Hyperuricemia is often associated with pre-eclampsia and when this occurs, fetal outcome may become worse. We evaluated the role of maternal serum uric acid as a prognostic indicator of fetal outcome in pre-eclamptic mothers. Methods A prospective case-control study in which 55 eligible pre-eclamptic patients at term were matched in maternal age and gestational age with 55 consecutive normotensive pregnant women. Venous blood samples were obtained and analyzed for serum uric acid. Following delivery, the fetal outcomes in the pre-eclamptic group and controls were determined. Data analysis was carried out using SPSS (version 21) and the level of statistical significance was set at p-value <.05. Results The mean serum uric acid levels of the pre-eclamptic subjects was significantly higher compared to their normotensive counterparts (12.7 ± 7.8 vs. 4.9 ± 1.2 mg/dL, p = .000). Babies with low birth weight, poor Apgar scores (at 1st and 5th minute of life) and those who required neonatal unit admission occurred more significantly among the pre-eclamptic women when compared with the controls (p = .000). However, the live birth rate of the case and control groups was comparable (94.5% vs. 100%, p = .079), Binary logistic regression analysis revealed a positive association between hyperuricemia and pre-eclampsia (OR = 18.8; 95% CI = 1.22–289.35, p = .035). Pre-eclamptic mothers with hyperuricemia had 4.41 odds of delivering babies with low birth weight when compared with pre-eclamptics without hyperuricemia (OR = 4.41; 95% CI = 0.76–25.5, p = .097); but Apgar scores and need for neonatal admission showed no association with maternal serum uric acid levels. Conclusion This study therefore suggests that hyperuricemia is a strong prognostic indicator of LBW babies among women with pre-eclampsia.

Fetal and Neonatal Modified Myocardial Performance Indices in Preeclamptic versus Normotensive Pregnancies: A Prospective Cohort Study.

ObjectiveTo compare fetal and neonatal cardiac functions in terms of global, systolic, and diastolic function between the preeclampsia and normotensive blood pressure of pregnancies.MethodsA prospective cohort study was conducted at a university hospital in Northeast Thailand. Twenty-nine pregnancies diagnosed as preeclampsia with or without severe features were compared with 29 normotensive pregnancies. Global cardiac, systolic, and diastolic function were assessed at prenatal and postnatal periods, by a professionally trained obstetrician and pediatric cardiologist, respectively.ResultsThe fetal left modified myocardium performance index (Mod-MPI) in preeclampsia and normotensive blood pressure were 0.60±0.08 and 0.59±0.08 (p-value=0.341), respectively, while fetal right Mod-MPI were 0.57±0.16 and 0.54±0.21 (p-value=0.861), respectively. There were no statistically significant differences in terms of fetal isovolumic contraction time (ICT), isovolumic relaxation time (IRT), ejection time (ET), aortic peak systolic velocity (Ao PSV), pulmonary artery peak systolic velocity (PA PSV), mitral valve (MV) E:A ratio, or tricuspid valve (TV) E:A ratios between the two groups. Neonatal mitral valve E peak systolic velocity (MV-E PV) in preeclamptic and normotensive blood pressure groups were significantly different at 51.1±8.02 cm/s and 43.56±5.21cm/s (p-value=0.036), respectively, whereas neonatal left Mod-MPI, mitral valve A peak systolic velocity (MV-A PV), MV E:A ratio, and Ao PSV were not significantly different (p-value=0.436, 0.119, 0.379, and 0.709), respectively.ConclusionNeonatal MV-E PV of the preeclampsia group was significantly higher than the normotensive blood pressure group, while there were no statistically significant differences in terms of global cardiac and diastolic functions during the fetal period between two groups.

Ultrasonographic Optic Nerve Sheath Diameter as A Surrogate Measurement of Intracranial Pressure in Preeclampsia

Background: Preeclampsia affects five to ten percent of pregnant women and accounts for about twelve percent of maternal mortality. It is the third most common cause of maternal mortality worldwide. Papilledema is an indirect and late indicator of raised intracranial pressure (ICP), whereas a pressure rise in optic nerve sheath (and the resulting enlargement of the optic nerve diameter) is a more dynamic process. The retrobulbar optic nerve sheath diameter (ONSD) can be measured at a position 3 mm posterior to the globe, where ultrasound contrast is greatest with more reproducible results. Objective: To evaluate the correlation between ultrasonographic measurement of ONSD with the degree of severity of preeclampsia. Patients and methods: This prospective observational study was conducted at Mansoura University Hospital Intensive Care Unit from July 2019 to June 2020. Just after delivery, 175 pregnant females aged between 18 and 45 years old were enrolled for participating in this study. Out of them, 25 females were excluded. Results: As regarding body weight, there was a significant difference between the control group (79.9±6.36 kg) and preeclamptic without severe feature group (87.7±10.58 kg). The mean body weight in severe preeclampsia group was (91.5 ±14.73kg) which showed no significant difference from that of the non-severe group. ONSD values showed significant difference between the studied groups. The control group had ONSD mean value of 4.85±0.32 mm, mild preeclamptic group had mean value of 6.05±0.096 mm, while severe preeclampsia group had a mean value of 6.76±0.25 mm. Conclusion: Ultrasonographic measurement of ONSD provides a non-invasive, quick and readily accessible tool for evaluation of raised intracranial pressure (ICP).

ASSOCIATION OF ASYMPTOMATIC BACTERIURIA AND PRE ECLAMPSIA IN EL SHATBY UNIVERSITY HOSPITAL

Background: Asymptomatic bacteriuria is defined as thepresence of significant bacteriuria>105 colony formingunits (cfu)/mL without the symptoms of an acute urinarytract infection. Pre-eclampsia is defined by blood pressureof greater than 140/90 mmHg after the 20th week of pregnancy and proteinuria of equal to or higher than 300 mg per24 hours.Objective: Detecting the incidence of asymptomatic bacteriuria among study group at El shatby antenatal care clinic and investigate the association between development ofPE and presence of ASB.Subjective: The study included 80 pregnant women.Quantitative culture remains the gold standard for diagnosis of urinary tract infection in pregnancy,Microscopic examination of a wet film of uncentrifuged urinewas carried out to detect the presence of pyuria, whichis considered when pus cells are >5 pus cells / HPF.Amount of urine (1 μl) is inoculated on MacConkeyagar,blood agar and sabouraud dextrose agar plates. Theplates are incubated for 24-48 hours at 37°C. After incubation, the colony count of a pure single organism is performed a significant bacteriuria is considered when the colony count is >105 (cfu/ml).Results: The net result of our study showed that the patients were screened for asymptomatic bacteriuria and theincidence was 30%. Asymptomatic bacteruria was morecommon in preeclamptic group (37%) than control group (22%) but with no significant difference.Conclusion: Asymptomatic bacteriuria was a commonfinding among pregnant women in our study ( 30% ofwhole cases).

Comparison of vitamin D, calcium and phosphorus values of essential hypertensive, preeclamptic and normotensive pregnant women

Abstract&#x0D; Objective: The aim of this study is; to examine the levels of 25 hydroxy vitamin D (25-OH D), calcium (Ca) and phosphorus (P) in preeclamptic, essential hypertensive and normotensive pregnant groups.&#x0D; Material and Method: A total of 120 pregnant women who came to our clinic for delivery between 35 and 40 weeks of gestation between April 2017 and November 2017 were included in the study. The study group consisted of 40 preeclamptic (n = 40) and 40 essential hypertensive (n = 40), and the control group consisted of 40 normotensive pregnant women (n = 40). The demographic, obstetric and laboratory results of the three groups were compared in terms of 25-OH D levels, calcium and phosphorus levels.&#x0D; Results: Maternal age, BMI and proteinuria were significantly lower in the preeclamptic and essential hypertensive group compared to the control group (p &lt;0.05). Week of gestation was observed to be earlier in the preeclamptic group compared to the other two groups (p &lt;0.05). The mean systolic and diastolic blood pressure of the preeclamptic and essential hypertensive groups were found to be statistically significantly higher than the control group (p &lt;0.05). No statistically significant difference was found between the groups in terms of transaminase. It was found that creatinine in the control group was statistically lower than the average creatinine level in the other two groups (p &lt;0.001). The Blood Urea Nitrogen (BUN) average of the control group was statistically significantly lower than the average of the other two groups (p = 0.001). Phosphorus levels were significantly higher in preeclamptic and essential hypertensive pregnant women compared to normotensive pregnant women (p&lt;0.05). However, no statistically significant difference was found between calcium and 25-OH D levels in all three groups.&#x0D; Conclusion: Low phosphorus level is likely to play a role in the etiology of essential hypertension and preeclampsia. The effects of maternal vitamin D and calcium level on the development of preeclampsia are uncertain, but more extensive research is required on potential positive effects.

Comparing Periodontal Status Between Pregnant Women with Preeclampsia and Normal Women

Background: Periodontal disease is a common disorder in approximately 5%-10% of all pregnant women. The evidence suggests that periodontitis can increase the risk of preeclampsia. It seems that chronic systemic inflammation resulting from periodontal disease may be an important factor. However, some studies have ruled out any correlation between periodontal disease parameters and blood pressure. Therefore, this study was conducted to determine the correlation between periodontal disease and preeclampsia in Iranian pregnant women. Methods: This case-control study was conducted on 40 randomly selected preeclamptic patients as the case group and 40 randomly selected healthy pregnant women as the control group aged up to 35 years with gestational age of less than 34 weeks. Preeclampsia was diagnosed by a gynecologist as sustained pregnancy-induced hypertension (BP≥140/90 mm Hg within 6 hours) with proteinuria (with urine protein concentrations ≥1 mg/dl on a catheterized urine sample). All the participants underwent periodontal examinations, including the measurements of the pocket depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), and plaque index (PI) in all the teeth except the third molar and second distal molar teeth. Statistical analysis was performed using the Mann-Whitney U test and P&lt;0.05 was considered as statistically significant. Results: The results showed that prevalence of periodontal disease was significantly higher in the preeclamptic group. The quantitative analysis of periodontal parameters between the groups indicated that mean values of the BOP, CAL, PD, and PI were significantly higher in the preeclamptic group, compared to those reported for the control group (P&lt;0.001). Conclusions: The results of the present study showed that periodontal indices are more severe in pregnant women with preeclampsia, compared to those reported for normal pregnant subjects.

Serum Hemoglobin Level in Preeclampsia

Background: Pre-eclampsia is the major cause of maternal and fetal mortality and morbidity. It affects approximately 5-8% of pregnant women.&#x0D; Objectives: The study was undertaken to find an association between Hemoglobin and preeclampsia.&#x0D; Methodology: This cross-sectional study was carried out in the Department of Physiology at Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh from July 2009 to June 2010. For this, 60 pregnant women of preeclampsia, age ranged from 18 to 39 years, more than 20th weeks of pregnancy were included in the study (group B). They were further divided into group B1 consisting of 30 mild preeclamptic women and group B2 consisting of 30 severe preeclamptic women. For comparison age and gestational period matched 30 normotensive pregnant women control (group A) were also studied. Both control (group A) and preeclamptic women were selected from Obstetric and Gynae in and out patient Department of BSMMU and Dhaka Medical College Hospital. Maternal hemoglobin concentration was measured by standard laboratory techniques.&#x0D; Result: In this study, hemoglobin levels were significantly higher in study (group B) than those of control (group A). Again Hemoglobin levels were higher in group B2 than B1, but not significant (P&gt;0.05). Hemoglobin level was positively correlated with systolic and diastolic blood pressure but it was statistically non-significant (P&gt;0.05).&#x0D; Conclusion: The study concluded that serum hemoglobin level is associated with preeclampsia.&#x0D; Journal of Current and Advance Medical Research, January 2021;8(1):39-43]

Evolution of cardiac geometry and function in women with severe preeclampsia from immediately post-delivery to 1year postpartum.

Preeclampsia is associated with left ventricular (LV) geometrical and functional changes, which could be related to cardiovascular risk later in life. The purpose of our study was to evaluate evolution of LV dimensions and function in severe preeclamptic women from immediately post-delivery to 1year postpartum. Twenty-five women with severe preeclampsia and 15 healthy term controls underwent standard and speckle-tracking echocardiography 1day after delivery and 1year postpartum. On day 1 post-delivery preeclamptic women were exposed to higher preload (p = 0.003) and afterload (p < 0.001) compared to controls. Parameter of longitudinal LV systolic function s' was significantly lower in preeclamptic compared to control group (p = 0.017) 1day post-delivery. Additionally, diastolic function parameters were significantly more impaired in preeclamptic compared to control group (lower e' (p = 0.02) and higher E/e' ratio (p = 0.003) in preeclamptic group). Larger LV mass (p = 0.03) and a trend of higher proportion of altered cardiac geometry (p = 0.061) were observed in preeclampsia 1day post-delivery. One year after delivery both groups had comparable geometric and functional parameters with similar afterload and preload (p > 0.05, for all). In preeclamptic group systolic and diastolic functional parameters improved significantly during follow-up (p < 0.05), while no such evolution was noted in controls (> 0.05). In women with severe preeclampsia subtle cardiac functional impairment immediately post-delivery completely resolved 1year postpartum. Observed cardiac alterations suggest intrinsic myocardial dysfunction in preeclampsia, which became unmasked or exacerbated by higher load imposed on the LV immediately post-delivery that disappeared in mid-term follow-up.

Association of Circulating miRNA Expression with Preeclampsia, Its Onset, and Severity.

MicroRNAs (miRNAs) are one of the important regulators of cellular functions fundamental for healthy pregnancy processes, including angiogenesis and differentiation of trophoblast cells, and their deregulation could be implicated in the pathogenesis of pregnancy complications, including preeclampsia (PE). The aim of this study was to assess the association of miRNA expression in plasma samples with PE, its onset, and severity. Our study enrolled 59 pregnant women, 27 in the preeclamptic study group and 32 in the control group with physiological pregnancy. Preeclamptic pregnancies were divided into subgroups based on the severity and onset of disease. Relative expression of miR-21-5p, miR-155-5p, miR-210-5p, miR-16-5p, and miR-650 isolated from plasma samples was analysed by quantitative real-time PCR and normalised to experimentally established reference genes. Our results revealed upregulation of miR-21-5p (1.16-fold change, p = 0.0015), miR-155-5p (1.62-fold change, p = 0.0005) in preeclamptic pregnancies, compared to controls. Overexpression of these two miRNAs was observed, especially in subgroups of severe and late-onset PE compared to healthy pregnancies. Although we hypothesised that the expression level of studied miRNAs could vary between PE subtypes (mild vs. severe, early onset vs. late-onset), no obvious differences were detected. In conclusion, our study could contribute to the large-scale studies for the identification of non-invasive biomarkers for PE detection to improve outcomes for women and their new-borns.

Association of Asymptomatic Bacteriuria and Preeclampsia in El Shatby University Hospital

ABSTRACT Background: Asymptomatic bacteriuria is defined as the presence of significant bacteriuria>105 colony forming units (cfu)/mL without the symptoms of an acute urinary tract infection. Pre-eclampsia is defined by blood pressure of greater than 140/90 mmHg after the 20th week of pregnancy and proteinuria of equal to or higher than 300 mg per 24 hours.Objective: Detecting the incidence of asymptomatic bacteriuria among study group at El shatby antenatal care clinic and investigate the association between development of PE and presence of ASB.Subjective: The study included 80 pregnant women. Quantitative culture remains the gold standard for diagnosis of urinary tract infection in pregnancy,Microscopic examination of a wet film of uncentrifuged urine was carried out to detect the presence of pyuria, which is considered when pus cells are >5 pus cells / HPF. Amount of urine (1 μl) is inoculated on MacConkey agar,blood agar and sabouraud dextrose agar plates. The plates are incubated for 24-48 hours at 37°C. After incubation, the colony count of a pure single organism is performed a significant bacteriuria is considered when the colony count is >105 (cfu/ml(Results: The net result of our study showed that the patients were screened for asymptomatic bacteriuria and the incidence was 30%. Asymptomatic bacteruria was more common in preeclamptic group (37%) than control group (22%) but with no significant difference.Conclusion: Asymptomatic bacteriuria was a common finding among pregnant women in our study ( 30% of whole cases).

Alterations in cardiac function in women with severe preeclampsia: return to normal in one year after delivery?

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. In peri-partum period women with preeclampsia have demonstrated signs of subtle left ventricular (LV) dysfunction. However, there is still controversy if these changes persist or improve late after delivery. Purpose. To evaluate LV dimensions and function in severe preeclamptic women and healthy controls immediately post-delivery and 1 year postpartum. Methods. The study population comprised 24 women with severe preeclampsia and 15 healthy term controls. All women underwent standard and speckle-tracking echocardiography to assess myocardial function and deformation parameters 1 day after delivery and 1 year postpartum. To examine the impact of preload and afterload on myocardial function LV end-diastolic volume and systolic blood pressure were used accordingly. Results. On day 1 post-delivery women with severe preeclampsia were exposed to increased afterload with significantly higher systolic blood pressure compared to controls (147 [136-157] in preeclamptic vs. 112 [102-118] mmHg in control group, p &amp;lt; 0.001). Similarly, preeclamptic women had also higher preload demonstrated with larger LV end-diastolic volume (114 [100-128] vs. 95 [92-102] ml, p = 0.003) and left atrial volume index (36 [33-38] vs. 32 [29-36] ml/m2, p = 0.02) than control group. Among other geometric parameters difference in LV mass index was observed between groups (preeclamptic group: (81 [70-96] vs. control group: 66 [61-74] g/m2, p = 0.01). Global systolic parameters (LV ejection fraction and global longitudinal strain) did not differ between groups; however, peak systolic myocardial velocity (s’) was significantly lower in preeclamptic compared to control group (7.6 [6.5-8.1] vs. 8.0 [7.5-8.9] cm/s, p = 0.02) immediately post-delivery. Diastolic function differed between groups with significantly higher E/e’ ratio in preeclamptic women than controls (8.7 [7.6-10.0] vs. 6.9 [6.4-7.8] p = 0.01) one day post-delivery. One year after delivery both groups had normal and similar arterial blood pressure and there were no differences in geometric, systolic and diastolic function parameters between groups (Figure A-D). Conclusions. Our results showed that women with severe preeclampsia had subtle cardiac dysfunction immediately post-delivery compared to healthy controls and recovered completely in one year after delivery. Subtle cardiac dysfunction in preeclampsia immediately post-delivery seemed to be related or unmasked by pronounced changes in loading conditions, which resolved in mid-term postpartum period. Long-term follow-up with larger study population is needed to identify subgroup of women who have persistent subclinical cardiac alterations and experience cardiovascular events later in life. Abstract Figure

Antepartum and postpartum changes in adipokines, endothelial dysfunction, inflammatory markers and other biochemical parameters in preeclamptic women: A prospective observational cohort study.

This study aimed at evaluating the role played by insulin resistance, lipid metabolism disorder, oxidative stress, resistin, vaspin, Interleukin-18 and asymmetric dimethyl arginine as a marker for endothelial dysfunction in the pathogenesis of preeclampsia. This prospective observational cohort study involved 60 women who were classified into: 20 non-pregnant women (group 1 or control group), 20 normally pregnant women (group 2) and 20 preeclamptic women (group 3) at their third trimester. The pregnant women were assessed at their third trimester and further re-evaluated four weeks after delivery. The assessment included demography, assessment of proteinuria and urinary protein to creatinine ratio, blood pressure measurement and assessment of fasting blood glucose, fasting insulin level, lipid panel and the circulating levels of malondialdehyde, resistin, vaspin, interleukin-18 and asymmetric dimethyl arginine. Preeclamptic women showed more atherogenic lipid profile, significantly higher Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and significantly elevated levels of malondialdehyde, resistin, vaspin and interleukin-18 than the other study groups. Serum asymmetric dimethyl arginine concentration showed non-significant difference among the three study groups. The levels of resistin and vaspin showed significant decrease four weeks postpartum in preeclamptic group. We concluded that, preeclampsia was associated with insulin resistance, dyslipidemia, oxidative stress, inflammation and significant changes in adipokines; resistin and vaspin. Furthermore, the significant increase in the serum levels of resistin and vaspin at the third trimester and their significant decline four weeks postpartum in preeclamptic group focus the attention on the role played by these adipokines in the pathogenesis of preeclampsia.

The value of maternal serum levels of growth differentiation factor-15 as a predictor of preeclampsia

Back ground Preeclampsia is a leading cause of maternal morbidity and mortality worldwide. Growth differentiation factor-15 (GDF-15) is a stress-induced cytokine and related to the prognosis of cardiovascular diseases. It was expressed in the placentae of both normal and preeclamptic pregnancies. Objective To evaluate the value of GDF-15 as a predictor of preeclampsia and its correlation with the severity of the disease. Patients and methods This was a prospective study in which we enrolled a number of primigravidae at gestational age between 19 and 20 weeks. After complete and thorough history taking and examination in addition to basal ultrasound, serum blood samples were taken from all women and were frozen at −20°C for later assay. After Institutional Ethics Committee approval, antenatal care for all women till delivery was done. Women who developed preeclampsia, 40 of them, were chosen as the study group (group B), and 40 women who were passed the antenatal period without complications were included as the control group (group A). Results We found that serum levels of GDF-15 were higher in preeclamptic group than control group, and this reached a highly significant level. The mean±SD level of GDF-15 in the preeclamptic group was 383.42±130.67 versus 118.73±28.88 pg/ml in the control group (P=0.000). The more the severity of preeclampsia, the higher GDF-15 level, with the highest level being detected in severe–early preeclampsia. Conclusion GDF-15 is increased in preeclampsia than normal physiological pregnancy, with the highest level detected in severe–early preeclampsia.

Apelin 13 and Blood Pressure, Is there any Association in Pre-eclampsia? - A Case-control Study

Introduction: Pre-eclampsia is a pregnancy specific disorder, characterised by the onset of hypertension and proteinuria. Pre-eclampsia is the leading cause of maternal, perinatal morbidity and mortality. The exact cause of pre-eclampsia is not known clearly and needs to be explored. Aim: To evaluate the maternal serum apelin 13 levels among pre-eclampsia and healthy pregnant women and also, to find the association between apelin 13 and blood pressure. Materials and Methods: A case-control study was conducted between Department of Biochemistry and Department of Obstetrics and Gynaecology, RL Jalappa Hospital and Research Centre, Kolar, Karnataka, India. After approval from the Institutional Ethics Committee and written informed consent from study subjects, a total of 270 pregnant women were recruited for this study. Among them, 135 pre-eclamptic women were considered as cases and 135 normotensive healthy pregnant women served as controls. According to the pre-eclampsia severity, cases were grouped into mild (n=47) and severe pre-eclampsia (n=88). Blood samples were collected from all the study subjects and was analysed for apelin 13 by Enzyme Linked Immunosorbent Assay (ELISA) method. Maternal and foetal adverse outcomes were recorded. Results were expressed as mean±Standard Deviation (SD). Categorical variables were expressed in percentages. Spearman’s correlation was applied and p&lt;0.05 was considered significant. Results: The mean gestational age was 36.66±3.69 weeks which was, significantly low in pre-eclamptic women compared with healthy pregnant women. BMI (26.94±3.81 kg/m2), systolic (157.82±15.14 mmHg), diastolic (101.68±11.02 mmHg) and Mean Arterial Pressure (MAP) (120.20±11.12 mmHg), pulse rate (88.14±5.82 bpm), Aspartate Transaminase (AST) (25.25±12.49 IU/L) and Alanine Transaminase (ALT) (19.01±10.95 IU/L) were significantly increased in pre-eclamptic women when compared with control group. Mean maternal serum apelin 13 (341.44±218.63 pg/mL) concentrations were significantly lower in pre-eclampsia compared with healthy pregnant women. Maternal serum apelin 13 concentrations were negatively correlated with Systolic Blood Pressure (SBP) (r = -0.196), Diastolic Blood Pressure (DBP) (r = -0.172) and MAP (r =-0.204). Adverse maternal outcomes such as epigastric pain 75 (55.55%), oedema 62 (45.92%) and persistent headache 35 (25.92%) were higher in pre-eclamptic group. Additionally, adverse foetal outcomes were more in pre-eclamptic cases including significantly decreased birth weight (2.40±0.65), babies requiring Neonatal Intensive Care Unit (NICU) admission were 54 (40%), preterm birth (≤37 wks) in 50 (37.03%), Respiratory Distress Syndrome (RDS) 31 (22.96%), Small for Gestational Age (SGA) in 4 (2.96%) and Intra Uterine Death (IUD) in 11 (8.14%) babies. Conclusion: It was concluded from the present study that there was low maternal serum apelin 13 concentrations in pre-eclampsia and had negative correlation with blood pressure, suggesting its potential role in the pathophysiology of pre-eclampsia.

A Study on Maternal Serum Triglycerides Level in Women with Pre-Eclampsia

Introduction: Preeclampsia is a potentially devastating disease of pregnancy that complicates 2%-8% of all pregnancies in the United States and can threaten the life of both the mother and her unborn child. Manifesting after 20 weeks of gestation, preeclampsia is a multi-organ disorder defined as de novo hypertension. Objectives of the study: The main objective study is to analyses the maternal serum triglycerides levels in women with pre-eclampsia. Methodology of the study: This study was conducted at Allied Hospital, Faisalabad during 2019 to 2020. The data were collected from 100 pregnant females. According to the criteria for the definition of pre-eclampsia given by the International Society for the Study of Hypertension in Pregnancy. Peripheral fasting blood specimens were collected from all control and pre-eclamptic subjects. Blood was always collected before onset of labor. Serum was separated for analysis. Triglycerides were determined after enzymatic hydrolysis with lipases. The indicator was a quinoneimine formed from hydrogen peroxide, 4-aminop- henazone and 4-cholorophenol under the under the catalytic influence of peroxidase. Results: The age of the studied pregnant females ranged between 16 and 42 years. The mean age of cases (pre-eclamptic) and controls (normal) pregnant women was 29.6 (6.1) and 29.5 (6.1) years respectively. There was no statistically significant difference in the maternal ages of both groups. Body mass index, which was only recorded at the time of blood sampling was not significantly different. Mean systolic and diastolic blood pressures were significantly higher in pre-eclamptic group than in the normal pregnant groups. Conclusion: It is concluded that the women who develop pre-eclampsia had disturbed lipid profile due to abnormal lipid metabolism. Increased triglycerides levels and delayed triglycerides clearance and high blood pressure are the reasons for the development of preeclampsia.

Antiangiogenic Biomarker Soluble Fms-like Tyrosine Kinase-1 in Pregnancy Complicated with Preeclampsia: A Cohort Study

Introduction: Preeclampsia (PE) is one of the leading obstetric diseases with significant morbidity and mortality in both mother and foetus. The etiology of preeclampsia is unknown. It may result from several reasons with imbalance between angiogenic regulatory factors in maternal circulation as one of the factor. High circulatory levels of Soluble Fms-like Tyrosine Kinase-1 (sFlt-1) are detectable several weeks before clinical presentation of preeclampsia. Aim: To determine association of serum levels of sFlt-1 with preeclampsia in second and third trimester of pregnancy. Materials and Methods: A prospective cohort study was conducted in the Department of Biochemistry in collaboration with the Department of Obstetrics and Gynaecology in a tertiary care hospital (Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India), from November 2018 to March 2021. The study participants were divided into two groups i.e, normotensive (group 1) and preeclamptic (group 2). The enrollment of participants was done during second trimester. Serum sFlt-1 concentration was measured in second trimester (24-28 weeks) and in third trimester (beyond 28 weeks) using Enzyme Linked Immunoassay (ELISA) kits. Receiver Operating Characteristics (ROC) curve analysis was done for evaluation of Area Under Curve (AUC), sensitivity and specificity using software defined cut-off values. Results: Total 60 participants were there in each group with maternal mean age of 25.8±3.2 years in group 1 and 30.6±5.5 years in group 2 (p-value &lt;0.001). sFlt-1 levels were significantly higher in preeclampsia group both in second and third trimesters when compared with normotensive group with median 313.07 versus 65.150 (p-value &lt;0.001) and 337.875 versus 76.925 (p-value &lt;0.001), respectively. The ROC curve analysis using 190.5 ng/mL as cut-off point in second trimester showed sensitivity 90%, specificity 85%, AUC was 0.832, 95% CI (0.745-0.918) and in third trimester at cut-off point 271.5 ng/mL showed sensitivity 90%, specificity 90%, AUC was 0.884, 95% CI (0.817-0.951). Conclusion: The soluble Fms-Like Tyrosine Kinase-1-1 (sFlt-1), may serve as biomarker for early diagnosis and can improve prediction of preeclampsia.

The relation of infectious and inflammatory markers with placental atherosclerosis in preeclampsia

Aim: The aim of this study was to compare CRP, TNF-α, CMV, Chlamydia pneumonia IgG and IgM levels between preeclamptic and uneventful pregnant womens, to explain the effects of infectious trigger on the placental pathology of preeclampsia. Materials and Methods: All cases of preeclamptic pregnants detected at or referred to Inonu Univrsty Faculty of Medicine Gynaecology and Obstetric Department between July 2006 and July 2007 were prospectively collected. The study group was a group of 40 women who are preeclamptic. The study also included 40 control subjects who were matched for age, gestational age and body mass index. Results: In the preeclamptic group the level of CRP was significantly higher [28 (1.9– 196); vs. 6.2 (1.2–23) (mg/L) (p0.999 and p=0.385). Plasma H.pylori IgA levels were higher in the study group with the value of [ 14 (35%) vs. 5 (12.5%) (p=0.035)].Conclusion: In the present study, serum CRP, TNF-α and H.pylori IgA levels were significantly higher than normal pregnant women.

Association of lipoprotein (a) and high-sensitive C-reactive protein in preeclampsia

Background: Preeclampsia is a hypertensive disorder associated with substantial perinatal morbidity and mortality. Neonates born to hypertensive mothers are at increased risk of prematurity and foetal growth restriction. Timely prediction and accurate diagnosis is the key to limiting the morbidity and mortality caused by preeclampsia. Early identification of PE using inflammatory biomarkers could reduce PE related comorbidities. Aim: To compare levels inflammatory markers: hsCRP and Lipoprotein (a) levels in preeclamptic pregnant women, with the levels of inflammatory markers among women with normal pregnancy at a tertiary care teaching hospital. Material and Methods: This comparative cross-sectional study included 50 Preeclamptic women and 50 apparently healthy singleton pregnant women matched for gestational age and parity. Data was analyzed in SPSS V:16. To find association between inflammatory markers and blood pressure levels, statistical tests like chi-square, independent student t–test were applied. Results: Lp (a) and hsCRP levels were significantly higher among preeclamptic group compared to normal pregnancy group and these levels had moderate positive correlation with SBP (r=0.650) and DBP (0.627) among preeclamptic women. Conclusion: Increased levels of lipoprotein (a) and hsCRP are found in the present study, which are correlating with the progression of preeclampsia by causing endothelial dysfunction and inflammatory cascade. Also, earliest detection of Lp (a) and hsCRP in pregnancy could help to detect preeclampsia and to prevent its further complications.

SOCIO-DEMOGRAPHIC PROFILE IN PREECLAMPSIA

Background: Pre-eclampsia is a complex multisystem condition. It affects 3-5% of all prenancies.It is defined as new onset hypertension after twenty weeks of pregnancy plus involvement of at least one organ system-renal, hepatic, neurological, hematological, pulmonary or cardiac system or as utero-placental dysfunction&#x0D; Methods: This was a hospital based comparative analytical cross sectional study carried out over 2 years period from may 2019 in the Department of Obstetrics and Gynecology, SMS Medical College and attached hospitals, Jaipur.&#x0D; Results: The mean age of cases (27.36 ± 3.66 years) was higher than the controls (23.43 ± 3.23 years). There was not much difference in the distribution of subjects according to residence. In the study group 26 (57.78%) women belonged to urban areas and 19 (42.22%) belonged to rural areas whereas in the control group, 26 (62.22%) women belonged to rural areas and 17 (37.78%) belonged to urban areas. There were more primigravida in pre eclamptic group compared to the control group.&#x0D; Conclusion: Identification of risk factor in the antenatal period helps in early detection of women who are at high risk of developing pre-eclampsia in order to reduce maternal morbidity and mortality.&#x0D; Keywords: Preclampsia, Age, Gravida

Correlation of maternal neutrophil to lymphocyte ratio with fetal birth weight in preeclampsia

Preeclampsia is a generalized inflammatory disorder complicating gestation, with most of the cases developing in the third trimester. To evaluate the neutrophil to lymphocyte ratio in diagnosed cases of preeclampsia and determine its correlation with fetal birth weight, a cross sectional analytical study was performed in Shaikh Zayed Medical Complex and Jinnah Hospital, Lahore. The participants included 60 cases of preeclampsia and 60 normotensive controls in the third trimester of pregnancy. All the participants were in the age group of 20 -40 years and body mass index of 18 -25. Total and differential leukocyte count was checked by automated hemoanalyzer, and the neutrophil lymphocyte ratio was calculated. Fetal birth weight was recorded immediately after birth. Statistical analysis was performed by SPSS (version 20). The p value of &lt; 0.05 was considered significant. Neutrophil to lymphocyte ratio was significantly high (p value &lt; 0.001) in the preeclamptic group with a median value of 2.64 (2.0-3.8) as compared to 1.87 (1.7-2.0) in the healthy group. The fetal birth weight was significantly low (p value &lt; 0.001) in the pregnancies complicated with preeclampsia. High neutrophil to lymphocyte ratio was negatively correlated with fetal birth weight in preeclampsia (p value &lt; 0.01). On logistic regression significant association of high neutrophil to lymphocyte ratio with low fetal birth weight was found after controlling for the confounder gestational age, with an odds ratio of 8.28 (95% confidence interval 2.84-24.17). The area under the receiver operating characteristic curve for neutrophil to lymphocyte ratio was 0.8. The optimum cutoff value of neutrophil to lymphocyte ratio was 2.3 with 79% sensitivity and 76% specificity. High maternal neutrophil to lymphocyte ratio in the third trimester in preeclampsia negatively correlates with fetal birth weight and is a simple promising biomarker to predict low fetal birth weight.