No abstract available.
Blood Platelets* ; Parturition* ; Platelet Count* ; Pre-Eclampsia* ; Pregnancy*

OBJECTIVETo investigate the alteration of serum resistin levels in normal pregnancy and preeclampsia.

METHODSBlood samples were take from 28 normal non-pregnant women, 27 women in the 1st, 26 in the 2nd and 26 in the 3rd trimester of normal pregnancy and 25 women with preeclampsia. Serum resistin concentration was determined using ELISA method.

RESULTSerum levels of resistin were not significantly different among non-pregnancy, the 1st and the 2nd trimester of pregnancy (P>0.05 for all). Serum resistin level was significantly elevated in the 3rd trimester of pregnancy as compared with non-pregnancy (P<0.01), the 1st (P<0.001) and the 2nd trimester of pregnancy (P<0.001). Serum resistin level was significantly lower in preeclampsia than in the 3rd trimester of normal pregnancy (P<0.001), but was comparable to that of non-pregnancy, the 1st and the 2nd trimester of pregnancy (P>0.05 for all).

CONCLUSIONThe decrease of serum resistin level in the preeclampsia may provide insight into the pathogenesis of the disease.

Adult ; Female ; Glucose Tolerance Test ; Humans ; Pre-Eclampsia ; blood ; Pregnancy ; Pregnancy Trimester, Third ; blood ; Resistin ; blood

The activity of the NK cells in patients with preeclampsia was studied to investigate the pathogenesis of preeclampsia. By using MTT and 51Cr releasing technique, the proliferation and killing ability of the NK cells in maternal and umbilical blood from preeclampsia patients (n = 18) and normal third trimester pregnant women (n = 18) were detected. The NK-92 cell line was as the positive control. The results showed that the NK cell counts of umbilical blood in preeclampsia patients and normal third trimester pregnant women were significantly greater than those of maternal blood (both P<0.05). Compared with that in normal third trimester pregnant women, the proliferative ability of the NK cells in preeclampsia patients was apparently increased (P<0.05). Compared with that in maternal blood, the proliferative ability of the NK cells in umbilical blood from both preeclampsia patients and normal third trimester pregnant women was dramatically increased. The killing ability of the NK cells in preeclampsia patients was significantly higher than that in normal third trimester pregnant women (P <0.05). It was suggested that both number and function of the NK cells in preeclampsia women were increased, and that in umbilical blood was greater than that in maternal blood, speculating that the function of the NK cells may affect the maintenance of the maternal and fetal immune tolerance during pregnancy.
Cytotoxicity, Immunologic/*immunology ; Fetal Blood/cytology ; Immune Tolerance ; Killer Cells, Natural/*immunology ; Killer Cells, Natural/pathology ; Pre-Eclampsia/blood ; Pre-Eclampsia/*immunology ; Pregnancy Trimester, Third

Of 119 full-term pregnant subjects studied from October, 1995 to March, 1996, 79 hadpreeclampsia(severe; 43, mild; 36) and 40 were normotensive controls. The plasma fibronectinlevels of each subject were assayed by turbidometric immunoassy(Boehringer Mannheim).The objective of this study was to evaluate the relationship of plasma fibronectin withpreeclampsia as a marker for vascular injury.The results were as follows:1. There were significant differences of plasma fibronectin values among the normotensivepregnancy, mild preeclampsia and severe preeclampsia. Within each group of patients,plasm a fibronectin values were 101.7 +/- 59.4 ng/ml and 249.7 +/- 96.3 ng/ml and 329.2 +/- 169.5 ng/ml, respectively (p < 0.001).2. Plasma fibronectin values had positive correlations with severity of preeclampsia,proteinuria, diastlic blood pressure and systolic blood pressure, but negative correlationswith birth weight and platelet count(p < 0.001).3. When the severity of proteinuria on preeclampsia were +1, +2, and +3 or more,plasma fibr onectin values revealed 246.0 +/- 93.3 ng/ml, 342.3 +/- 185.1 ng/ml and 345.0 +/- 168.1ng/ml, respectively and there were significant differences among three groups.4. To verify the variables correlated with plasma fibronectin by using mutiple regressionanalysis, the only variable which was selected significantly was the severity of preeclampsia(r(2) : 0.529).5. With receiver operating characteristic(ROC) curve analysis of the relationship betweenplasma fibronectin values and preeclampsia, if cut off value was selected at the levelof 175ng/ml or more, the sensitivity for diagnosis of preeclampsia was 87.3%, specificity90.0%, positive predictive value 94.5%, and negative predictive value 78.3%, respectively.
Birth Weight ; Blood Platelets ; Blood Pressure ; Diagnosis ; Fibronectins* ; Plasma* ; Pre-Eclampsia* ; Proteinuria

OBJECTIVETo explore the role of macrophage colony-stimulating factor (MCSF) in the pathogenesis of preeclampsia.

METHODSBy ELISA method, MCSF concentrations were determined in serum samples obtained from 39 patients with preeclampsia and 40 normal pregnant women as controls. The concentrations of serum MCSF were compared between preeclampsia and normal pregnancy, and between early-onset and late-onset preeclampsia.

RESULTSerum MCSF concentrations were significantly higher in preeclamptic women than those in controls (431.0 kIU compared with 179.1 kIU, P<0.001). There were no significant differences in serum MCSF levels between early-onset and late-onset preeclampsia (P>0.05). Serum MCSF was not correlated with maternal age, gestational age, and placenta weight (P>0.05 for all).

CONCLUSIONIncreased level of serum MCSF is an important indicator of preeclampsia and it may play a role in the pathogenesis of the disease.

Adult ; Female ; Humans ; Macrophage Colony-Stimulating Factor ; blood ; Pre-Eclampsia ; blood ; etiology ; Pregnancy

OBJECTIVE: The purpose of this study was to compare the umbilical artery blood gas analysis and assess the relationship between fetal oxygenation and placenta to birth weight ratios in preeclampsia and small for gestational age. METHODS: We compared the results of umbilical artery blood gas analysis and placenta to birth weight ratio in group of preeclampsia (N=28), group of small for gestational age (N=15), group of large for gestational age (N=15), and controls (N=24). And we also divided all of them into 3 groups by placenta to birth weight ratio at birth, <0.2 (N=25), 0.2-0.25 (N=39) and >0.25 (N=18). We compared umbilical artery gas analysis in each groups. RESULTS: The placenta to birth weight ratio in PE was significantly lower than control group (p<0.05). Umbilical artery pO2 and O2 saturations in each group of preeclampsia and small for gestational age were significantly lower than group of large for gestational age and controls (p<0.05). But we could not find any differences in other umbilical artery blood gas analysis (pH, pCO2, HCO3-). Umbilical artery pO2 and O2 saturations of higher placenta to birth weight ratio were stepwise lower than those of lower placenta to birth weight ratio but, pCO2 of higher placenta to birth weight ratio was stepwise lower than those of lower placenta to birth weight ratio. But there was no significant difference. CONCLUSION: Our data suggested that fetal oxygenation is significant determinant of fetal growth from small for gestational age and preeclampsia. And it may be related to placental implantaton and growth.
Birth Weight* ; Blood Gas Analysis* ; Fetal Development ; Gestational Age* ; Oxygen ; Parturition* ; Placenta* ; Pre-Eclampsia* ; Umbilical Arteries*

Most obstetric anesthesiologist now consider epidural anesthesia to be the preferred anesthetic technique for patients with preeclampsia. In the severe preeclampsia effective ciirculatory volume is usually low, so appropriate preanesthetic hydration is essential feature of safe management. We performed CVP monitoring before epidural anesthesia in nine severe preeclamptic patients undergoing cesarean section. Mean CVP of them was 2+/-1 mm Hg which was not significantly different from normal term parturient. In four patients whose CVP was less than 2 mmHg, preanesthetic hydration with Hartman's solution 500~700 rrd was performed under the monitoring of CVP until it became to rise 2~3 mmHg. Five patients out of nine whose systolic blood pressure dropped below 100 mmHg during anesthesia were IV injected ephedrine 4 mg immmediately and three of them needed repeat injection of ephedrine 4 mg. With the monitoring of CVP, the operations of all the nine severe preeclamptic patients were completed successfully without any problem during and after anesthesia. lt is important to reaUze the limitation of central venous pressure monitoring : but if used with caution in proper circumstance it can provide clinically useful information with minimal risk to the patient.
Anesthesia ; Anesthesia, Epidural* ; Blood Pressure ; Central Venous Pressure* ; Cesarean Section ; Ephedrine ; Female ; Humans ; Pre-Eclampsia* ; Pregnancy

The study performed a systematic review of screening for preeclampsia with the combination of vascular parameters and maternal serum markers in the first and early second trimester. We identified eligible studies through a search of Medline, and, for each included study, we focused on the relationship between the maternal serum markers and preeclampsia. In the selected literature, a combination of maternal serum markers was analyzed, also. Several tests suggested moderate or convincing prediction of early preeclampsia, but screening for late preeclampsia was poor. Literatures for serum markers were selected. Each serum marker was identified independently, and where relevant, a combination of these markers was analyzed. Encouraging results for the first trimester screening were observed when it was combined with other markers. Even in the first trimester of pregnancy, we can present the reliable results for the prediction of early preeclampsia. Detection rate for combination markers may yield higher detection rate and be promising to identify patients at high risk of developing preeclampsia.
Biomarkers ; Blood Pressure ; Female ; Humans ; Mass Screening ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second

OBJECTIVE: The aim of this study is to determine whether any association exists between preeclampsia and the maternal serum level of nitric oxide (NO) and platelet activating factor (PAF). METHODS: NO concentrations were measured using Stuehr's method and PAF concentrations were measured with [3H]PAF scintillation proximity assay (SPA) system (Amersham Pharmacia Biotech). Data were analyzed with SAS windows version 6.12, with significance established at p<0.05. RESULTS: The mean (+/-SD) maternal serum concentrations of NO were significantly higher in the group with severe preeclampsia (5.535+/-0.343 ug/ml) and mild preeclampsia (5.891+/-0.481 ug/ml) than in the normotensive pregnancy group (2.036+/-0.744 ug/ml) (p<0.05). The mean (+/-SD) maternal serum concentrations of PAF were significantly higher in the group with severe preeclampsia (928.9+/-32.3 ng/ml) and mild preeclampsia (789.1+/-63.9 ng/ml) than in the normotensive pregnancy group (435.8+/-59.5 ng/ml) (p<0.05). The mean birth weight was lower in the mild and severe preeclampsia groups than in the normotensive pregnancy group (p<0.05). CONCLUSION: Maternal serum NO and PAF concentrations were more increased in preeclampsia than normotensive pregnancy group. NO may therefore serve as compensatory mechanism for vasoconstriction of preeclampsia and PAF as a marker for the risk of preeclampsia.
Birth Weight ; Blood Platelets* ; Nitric Oxide* ; Platelet Activating Factor* ; Pre-Eclampsia* ; Pregnancy ; Vasoconstriction

Objective: To explore the associations between blood pressure trajectories during pregnancy and risk of future pre-eclampsia in a large cohort enrolling pregnant women at gestational age of ~12 weeks from community hospitals in Tianjin. Latent class growth modeling (LCGM) was used to model the blood pressure trajectories. Methods: This was a large prospective cohort study. The study enrolled pregnant women of ~12 weeks of gestation in 19 community hospitals in Tianjin from November 1, 2016 to May 30, 2018. We obtained related information during 5 antepartum examinations before gestational week 28, i.e., week 12, week 16, week 20, week 24 and week 28. LCGM was used to model longitudinal systolic (SBP) and diastolic blood pressure (DBP) trajectories. For the association study, the predictors were set as SBP and DBP trajectory membership (built separately), the outcome was defined as the occurrence of preeclampsia after 28 weeks of gestation. Results: A total of 5 809 cases with known pregnant outcomes were documented. After excluding 249 cases per exclusion criteria, 5 560 cases with singleton pregnancy were included for final analysis. There were 128 cases preeclampsia and 106 cases gestational hypertension in this cohort. Univariate logistic regression and multivariate logistic regression showed the higher baseline SBP level and DBP level were related with increased risk of preeclampsia. Four distinctive SBP trajectories and DBP trajectories from 12 weeks to 28 weeks of gestation were identified by LCGM. After controlling for potential confounders (baseline BMI, being primipara or not, white blood cell counts, hemoglobin level, platelet counts and alanine aminotransferase level), the OR for SBP latent classification trajectory_ 4 was 4.023 (95%CI: 2.368 to 6.835, P<0.001), and the OR for SBP latent classification trajectory_3 was 1.854 (95%CI: 1.223 to 2.811, P=0.004). Logistic regression showed that: using the DBP latent classification trajectory_1 as the reference group, the OR for DBP latent classification trajectory_4 was 4.100 (95%CI: 2.571 to 6.538, P<0.001), and 2.632 (95%CI: 1.570 to 4.414, P<0.001) for DBP latent classification trajectory_2. After controlling for potential confounders (baseline BMI, being primipara or not, white blood cell counts, hemoglobin level, platelet counts and alanine aminotransferase level), the OR for DBP_traj_4 was 2.527 (95%CI: 1.534 to 4.162, P<0.001), and the OR for DBP_traj_3 was 1.297 (95%CI: 0.790 to 2.128, P=0.303), and 2.238 (95%CI: 1.328 to 3.772, P=0.002) for DBP_traj_2. Therefore, BP trajectories from 12 weeks to 28 weeks identified by LCGM served as novel risk factors that independently associated with the occurrence of preeclampsia. Receiver operating characteristic (ROC) curve analysis showed incremental diagnostic performance by combing baseline blood pressure levels with blood pressure trajectories. Conclusion: By applying LCGM, we for the first time identified distinctive BP trajectories from gestational week 12 to 28, which can independently predict the development of preeclampsia after 28 weeks of gestation.
Female ; Humans ; Pregnancy ; Infant ; Blood Pressure ; Pre-Eclampsia/diagnosis* ; Prospective Studies ; Gestational Age ; Alanine Transaminase ; Hemoglobins