Pregnancy-induced hypertension (PIH) is a multi-system disorder unique to human pregnancy. Although the etiology of PIH is still unknown, there is a large evidence suggesting that abnormal trophoblast invasion is occurring in early pregnancy and that this may contribute to relative placental hypoxia and oxidative stress that may further exacerbate placental pathology. This study was undertaken to determine placental Cu/Zn superoxide dismutase (SOD) and Mn SOD activities and evaluate the use of M30 CytoDeath antibody to assess trophoblasts apoptotic activity in normal and PIH pregnancies. We also compared apoptotic rates as detected by M30 and TdT-mediated dUTP nickend labelling (TUNEL). Placental expression of Cu/Zn SOD and Mn SOD were reduced in PIH as compared to normal pregnancies. M30 immunoreactivity occurred predominantly in the syncytiotrophoblasts, and a significantly higher number of M30 positive cells in the preeclamptic placentas were found when compared with normal placentas. The number of M30 positive cells correlated with another apoptotic index previously detected by TUNEL method.
Anoxia ; Apoptosis ; Female ; Humans* ; Hypertension, Pregnancy-Induced* ; In Situ Nick-End Labeling ; Oxidative Stress ; Pathology ; Placenta ; Pregnancy ; Superoxide Dismutase ; Trophoblasts*

Benign primary headaches are common during the postpartum period. However, there are several other kinds of headaches caused by specific underlying pathologies like post-dural puncture headache (PDPH), pregnancy induced hypertension, cortical vein thrombosis, posterior reversible encephalopathy syndrome (PRES), subarachnoid hemorrhage, intracranial hemorrhage, brain tumor, and so on. These headaches are rare but each can be life threatening conditions when diagnosis is delayed. If a patient was treated for another type of headache, like a PDPH, the diagnosis would be even more difficult. We report on the case of a 24 year-old woman who suffered with PDPH followed by postpartum eclampsia with PRES.
Diagnosis ; Eclampsia ; Female ; Headache ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Intracranial Hemorrhages ; Pathology ; Post-Dural Puncture Headache ; Posterior Leukoencephalopathy Syndrome* ; Postpartum Period ; Pregnancy ; Seizures ; Subarachnoid Hemorrhage ; Thrombosis ; Veins

Paraganglioma in pregnancy is an extremely rare condition and its diagnosis is often delayed because the clinical symptoms can mimic those of preeclampsia or gestational hypertension. Here, we report the case of a 32-year-old, gravida 2, para 1 woman who presented with severe headache, palpitation, and sweating at 37 weeks' gestation. Although emergent cesarean section was performed on the assumption of severe preeclampsia, blood pressure fluctuated and heart rate remained tachycardiac. We suspected that she might have thromboembolic lesion in the chest or pheochromocytoma. Chest and abdominal computed tomography revealed a 4 cm mass in the left para-aortic space. Serum and urinary catecholamine levels were found to be significantly increased. She underwent laparoscopic mass removal and the pathology confirmed paraganglioma. When typical paroxysmal hypertension is accompanied by headache, palpitation, and sweating during pregnancy, adrenal tumors should be considered.
Adult ; Blood Pressure ; Cesarean Section ; Diagnosis ; Female ; Headache ; Heart Rate ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Paraganglioma ; Paraganglioma, Extra-Adrenal* ; Pathology ; Pheochromocytoma ; Pre-Eclampsia* ; Pregnancy ; Sweat ; Sweating ; Thorax

OBJECTIVETo investigate the relationship between pathological abnormalities of placenta and small-for-gestational-age neonates.

METHODSOne hundred placentas of small-for-gestational-age (SGA group) and 200 appropriate-for-gestational-age (AGA group) with single living birth in third trimester were investigated by gross and microscopic examination. The AGA placentas were collected from 2 cases following every SGA placenta. All cases were collected from Shanghai Changning District Maternity and Infant Health Hospital from January 2010 to December 2011.

RESULTSThe gestational week, neonatal birth weight, full-term neonatal birth weight, the preterm birth rate and vaginal spontaneous delivery rate were significantly lower in SGA group than that in AGA group (P < 0.002). Full-term placental volume, placental weight and fetal placental weight ratio were lower in SGA group than that in AGA group (P < 0.05). Unusual insertion and torsion of umbilical cord were more common in SGA group (P < 0.05). Syncytial knots increase, avascular villi and villous infarcts were significantly higher in SGA group (P < 0.005), but there were no significant difference between SGA group and AGA group in intervillous thrombi, chronic villitis and chorangiosis (P > 0.05). Gestational hypertension disease and abnormality of fetal monitoring were more common in SGA group (P < 0.05).

CONCLUSIONSGestational hypertension disease is the main clinical cause of SGA. Some placental abnormality can affect the growth and development of intrauterine fetus.

Birth Weight ; Female ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Newborn ; Infant, Small for Gestational Age ; Placenta ; pathology ; Pregnancy ; Torsion, Mechanical ; Umbilical Cord ; pathology

AIMTo investigate the protective effect of low molecular weight heparin (LMWH) on nephropathy in rats with pregnancy induced hypertension and to study its possible mechanism.

METHODSThe levels of the expression of renal ERK1/2 protein and mRNA were detected in PIH rats which were made by injection of L-NAME, normal pregnant rats and rats treated with LMWH by immunohistochemistry, Western blotting and reverse transcription-polymerase chain reaction(RT-PCR). The renal tissue was observed by using light microscopy.

RESULTSThe expression level of renal ERK1/2 protein and mRNA in LMWH-treated rats were significantly lower than that in PIH rats, while the expression level of renal ERK1/2 protein and mRNA in PIH rats was significantly higher than that in normal pregnant rats (P < 0.01), the intensity of ERK1/2 expression had no obvious differences among 3 groups. The average arterial pressure and urine protein in LMWH group were decreased, but no decrease was observed in normal rats. Mesangial expansion and basal membrane thickening were obviously retarded in LMWH- treated group.

CONCLUSIONLMWH has renal protective effect on PIH rats, whose mechanism may be associated partly with a down-regulation of ERK expression.

Animals ; Female ; Heparin, Low-Molecular-Weight ; therapeutic use ; Hypertension, Pregnancy-Induced ; drug therapy ; pathology ; Kidney ; pathology ; Kidney Diseases ; etiology ; prevention & control ; Pregnancy ; Rats ; Rats, Wistar

Animals ; Female ; Hypertension, Pregnancy-Induced ; metabolism ; pathology ; Kidney ; metabolism ; pathology ; Pregnancy ; Protein Kinase C-alpha ; genetics ; metabolism ; Rats ; Rats, Wistar ; Transcription, Genetic

The mechanism of apoptosis was first discovered at the end of the 19th century, but it was only recently that its importance was recognized. Not only in a pathologic environment but also in a normal environment, apoptosis has an important role in homeostasis. The number of cells is restricted by apoptosis which is controlled by several SlgBS lll VlVO. In pregnancy, the placenta regulates the maternal-fetal exchange of molecules and functions as a barrier for the protection of the fetus. As the pregnancy proceeds, changes occur in the number and components of placental cells. Observing the placental tissues, apoptosis was found in the syncytiotrophoblasts of early and late pregnancy. In particular, the fact that apoptosis observed in the placenta of late pregnancy supports the hypothesis that pmgrammed cell death is a normal sequence. Pregnancy-induced hypertension is usually accompanied by abnormal placenta and intrauterine growth restriction. In this study, using the TdT-FragEL DNA fragmentation detection kit, the changes in the nucleus by apoptosis in the placental tissues of 23 to 40 gestational weeks in preeclampsia and eclampsia were compared with normal placenta. Apoptosis was observed in the normal term placenta and in pregnancy-induced hypertension patients, regardless of whether vasculopathy was observed in Doppler ultrasound or confirmed by pathology, more apoptoses were observed aside from the number of gestational weeks.
Apoptosis ; Cell Death ; DNA Fragmentation ; Eclampsia ; Female ; Fetus ; Homeostasis ; Humans ; Hypertension, Pregnancy-Induced* ; Maternal-Fetal Exchange ; Pathology ; Placenta* ; Pre-Eclampsia ; Pregnancy ; Trophoblasts ; Ultrasonography

To examine the changes in number and function of endothelial progenitor cells (EPCs) from peripheral blood (PB) in hypertension disorder complicating pregnancy (HDCP), 20 women with HDCP and 20 normal pregnant women at the third trimester were studied. Mononuclear cells (MNCs) from PB were isolated by Ficoll density gradient centrifugation. EPCs were identified by positive expression of both CD34 and CD133 under fluorescence microscope and positive expression of factor VIII as shown by immunocytochemistry. The number of EPCs was flow-cytometrically determined. Proliferation and migration of EPCs were measured by MTT assay and modified Boyden chamber assay, respectively. The adhesion activity of EPCs was detected by counting the number of the adherent cells. The results showed that, compared with normal pregnant women, the number of EPCs was significantly reduced in HDCP (4.29%+/-1.21% vs 15.32%+/-2.00%, P<0.01), the functional activity of EPCs in HDCP, such as proliferation (13.45%+/-1.68% vs 18.45%+/-1.67%), migration (37.25+/-7.28 cells/field vs 67.10+/-9.55 cells/field) and adhesion activity (20.65+/-5.19 cells/field vs 34.40+/-6.72 cells/filed) was impaired (P<0.01). It is concluded that the number and function of EPCs are significantly decreased in HDCP.
Antigens, CD/metabolism ; Antigens, CD34/metabolism ; Case-Control Studies ; Cell Adhesion ; Cell Count ; Cell Movement ; Endothelial Cells/pathology ; Endothelial Cells/*physiology ; Glycoproteins/metabolism ; Hypertension, Pregnancy-Induced/*pathology ; Peptides/metabolism ; Stem Cells/pathology ; Stem Cells/*physiology