Female ; Humans ; Pre-Eclampsia ; etiology ; physiopathology ; Pregnancy

Preeclampsia is represented by hypertension and proteinuria in pregnancy. It usually occurs after 20 gestational weeks. There are few reports on preeclampsia before 20 gestational weeks. In this case, we report a patient with chronic hypertension superimposed with preeclampsia at 13 gestational weeks.
Adult ; Female ; Gestational Age ; Humans ; Hypertension ; physiopathology ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications

Antiphospholipid syndrome (APS) refers to a group of clinical symptoms and signs caused by antiphospholipid antibody (aPLA). We reported a rare case of poor outcome of a pregnant woman with APS. The pregnant woman had APS, hemolytic anemia, elevated liver function and low platelet count (HELLP) syndrome, and eclampsia and had a poor outcome from a second pregnancy. She was treated with antispasmodics, sedatives, and anti-hypertensive agents, along with anticoagulant therapy and infusion of immunoglobulin. APS during pregnancy often makes pregnancy even more complex and risky. Obstetricians should carry out anticoagulation treatment throughout the perinatal period.
Abortion, Induced ; adverse effects ; Adult ; Antiphospholipid Syndrome ; complications ; Eclampsia ; etiology ; Female ; HELLP Syndrome ; etiology ; Humans ; Pre-Eclampsia ; physiopathology ; Pregnancy

Aortic dissection accompanying with preeclampsia during pregnancy can be lethal to both the mother and the fetus and carries a high mortality. Of the 2 preeclampsia patients with aortic dissection, one was Type B aortic dissection, occurring in postpartum period. The patient was treated medically and underwent catheter-based stent-graft treatment with fenestration technique. Another patient was Type A acute dissection, occurring in the third trimester. This patient was undiagnosed and both died. Although extremely rare, aortic dissection might be a possibility in preeclampsia pregnant women, the differential diagnosis of chest and/or epigastric pain in preeclampia patient should be thoroughly investigated and treated.
Adult ; Aneurysm, Dissecting ; diagnosis ; etiology ; Female ; Humans ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications, Cardiovascular

OBJECTIVETo study the relationship between preeclampsia umbilical blood flow changes and the pregnancy outcomes.

METHODThe umbilical arterial blood flow parameters including the S/D, pulsatility index (PI), resistance index (RI) and the average birth weight, Apgar score and placental weight changes were analyzed in 106 preeclampsia patients (including 43 mild and 63 severe cases), with 89 women with normal pregnancy as the control. The relation between the blood flow parameters and the perinatal outcomes were analyzed.

RESULTSS/D, PI, and RI all tended to increase with the severity of preeclampsia, and these indices were significantly higher in patients with severe preeclampsia than in the control group (P<0.01) but showed no significant differences between mild preeclampsia group and the control group (P>0.05). The average birth weight of the newborns, Apgar scores, and placental weight were significantly lower (P<0.01), and the incidence of fetal growth restriction (FGR) and perinatal mortality significantly higher in severe preeclampsia group than in the control group (P<0.01). No significant differences were found in these parameters between the mild preeclampsia and the control groups (P>0.05).

CONCLUSIONSUmbilical artery blood flow parameters as indicators for determining the fetal status can be used to predict the pregnancy outcomes.

Adult ; Case-Control Studies ; Female ; Humans ; Perinatal Mortality ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Outcome ; Umbilical Cord ; blood supply ; Young Adult

Research on the association between maternal periodontal disease and the risk of preeclampsia has generated inconsistent results. This meta-analysis was conducted to evaluate the association between maternal periodontal disease and the risk of preeclampsia. A literature search of PubMed and Embase was performed to identify relevant papers published before March 2013. Only observational studies that assessed maternal periodontal disease and the risk of preeclampsia were selected. Patients' periodontal status was examined at different time points during pregnancy or after delivery (at 14-32 weeks of gestation, within 48 h prior to or within 5 days after delivery). Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated for cases and controls. Cases were defined as women with concurrent hypertension and proteinuria after 20 weeks of gestation. Eleven studies involving 1118 women with preeclampsia and 2798 women without preeclampsia were identified and analyzed. Women with periodontal disease before 32 weeks of gestation had a 3.69-fold higher risk of developing preeclampsia than their counterparts without periodontal disease (OR=3.69; 95% CI=2.58-5.27). Periodontal disease within 48 h prior to delivery was associated with a 2.68-fold higher risk of preeclampsia (OR=2.68; 95% CI=1.39-5.18). Pregnant women with periodontal disease within 5 days after delivery had a 2.22-fold higher risk of preeclampsia than women without periodontal disease (OR=2.22; 95% CI=1.16-4.27). In conclusion, this meta-analysis suggests that maternal periodontal disease is an independent predictor of preeclampsia.
Adult ; Female ; Humans ; Observational Studies as Topic ; Odds Ratio ; Periodontal Diseases ; physiopathology ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications ; physiopathology ; Risk Assessment ; statistics & numerical data ; Risk Factors

BACKGROUNDWomen with a history of preeclampsia have twice the risk of cardiovascular diseases, and there is a graded relationship between the severity of preeclampsia and the risk of cardiac disease. Moreover, metabolic scores are associated with developing preeclampsia. However, since there are no diagnostic criteria for metabolic syndrome during pregnancy and pregnant women undergo metabolic changes, it is difficult to elucidate the relationship between preeclampsia and metabolic syndrome. We carried out a cross-sectional study to investigate the relationship between metabolic syndrome and preeclampsia among women with a history of severe preeclampsia shortly after an indexed pregnancy.

METHODSWe recruited 62 women with a history of severe preeclampsia 1 to 3 years after an indexed pregnancy. Blood pressure and body compositional indices were recorded. Fasting blood samples were tested for glucose, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, triglycerides, and insulin. A questionnaire was used to collect demographic data including pre-pregnancy weight and family history of diseases associated with cardiovascular diseases. Criteria for metabolic syndrome were defined by the National Cholesterol Education Program, Adult Treatment Panel III 2001 (NCEP III) and International Diabetes Federation 2005 (IDF). Data were analyzed by the a2 test and multivariate Logistic regression.

RESULTSAccording to NCEP III and IDF standards, 17 (27%) and 24 (39%) women, respectively, were identified as having metabolic syndrome. Being overweight pre-pregnancy and currently overweight were risk factors, and currently overweight was an independent risk factor. A combination of blood pressure and waist circumference was predictive of metabolic syndrome with a sensitivity of 91.67% and specificity of 94.74%.

CONCLUSIONSAn unfavorable metabolic constitution in women may lead to metabolic syndrome, preeclampsia, and long-term cardiovascular disease. In women with severe preeclampsia, therapeutic interventions should include weight-control shortly after pregnancy, especially among women who were previously overweight.

Adult ; Cardiovascular Diseases ; epidemiology ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Metabolic Syndrome ; epidemiology ; physiopathology ; Middle Aged ; Pre-Eclampsia ; epidemiology ; etiology ; Pregnancy ; Risk Factors

OBJECTIVE: It is uncertain whether preeclampsia (PE) is caused by pre-existing factors or by pregnancy itself. We want to answer this important question in public health by conducting a large pre-conception cohort in China. METHODS: A prospective and pre-conception cohort study with a target recruitment of 5000 couples who plan to have a baby within 6 months was performed and their conception, delivery, and postpartum were followed up in Liuyang county, Hunan Province of P. R. China. RESULTS: A total of 1915 young couples have been recruited into this unique pre-conception cohort till now. In general, both systolic blood pressure and diastolic blood pressure decreased in early second trimester from pre-conception level but increased in third trimester and at delivery. CONCLUSION The proposed pre-conception cohort study will have important theoretical and practical implications on the prevention of PE and its associated cardiovascular disease risks.
Adult ; Blood Pressure ; physiology ; China ; Female ; Humans ; Pre-Eclampsia ; etiology ; physiopathology ; prevention & control ; Pregnancy ; Pregnancy Complications, Cardiovascular ; physiopathology ; prevention & control ; Prospective Studies ; Young Adult

OBJECTIVETo investigate the relationship between two polymorphisms immediately upstream of the cyclooxygenase 2 (COX2) gene and preeclampsia in a South West Han Chinese population.

METHODSBlood samples from 205 patients with preeclampsia and 276 normal pregnant women as controls from Han Chinese in Chengdu area were analyzed by polymerase chain reaction-restriction fragment length polymorphisms.

RESULTSG and A allele frequencies for -1195G>A site were 48.54% and 51.46% in the patient group, respectively, and 40.40% and 59.60% in the control group, respectively. G and C allele frequencies for -765G>C site were 94.15% and 5.85% in the case group, respectively, and 94.38% and 5.62% in the control group, respectively. The AA genotype and variant A allelic frequencies of the -1195G>A SNP were significantly lower in patients with preeclampsia than in the control group (P<0.05), and the odds ratio for the risk of preeclampsia was 0.665 (95% CI: 0.444-0.982) in women homozygous for the variant COX2 A allele ( x²=4.233, P=0.047). The genotype and allele frequencies of the -765G>C polymorphism in patients with preeclampsia and controls showed no significant differences (P>0.05). Additional subgroup analyses (mild vs severe preeclampsia) of the two polymorphisms failed to reveal significant correlation for either genotypic or allelic frequencies. Furthermore, there was no significant association between the polymorphisms and blood pressure levels in the patient or control groups.

CONCLUSIONCOX2 -1195A homozygosity is associated with a decreased risk for preeclampsia in a South West Han Chinese population. On the other hand, the -765G>C polymorphism has no effect.

Adult ; Alleles ; Blood Pressure ; Case-Control Studies ; China ; Cyclooxygenase 2 ; genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Polymorphism, Single Nucleotide ; Pre-Eclampsia ; enzymology ; genetics ; physiopathology ; Pregnancy ; Risk Factors

BACKGROUNDEarly and late-onset preeclampsia is thought to be different disease entities. This study aimed to determine the effects of early-onset preeclampsia-like symptoms on feto-placental outcomes and the adverse impacts of various factors on placental and fetal growth and development at different gestational stages in a mouse model.

METHODSPregnant C57BL/6J mice were divided into control and preeclampsia (PE) groups, and injected subcutaneously with the nitric oxide synthase inhibitor L-arginine methyl ester (L-NAME) 50 mgxkg(-1)d(-1). The PE group was divided into early-, mid- and late-PE groups with L-NAME injections starting on days 7, 11 and 16 of pregnancy, respectively. Corresponding control groups were injected with saline at the same time points. Blood pressure was measured until days 14 and 18, when the fetuses and placentas were removed under anesthesia. Blood pressure, urinary protein, and fetal and placental conditions were analyzed.

RESULTSBlood pressure and urinary protein increased following L-NAME injection. The fetal survival rate and fetal weight were reduced and the fetal absorption rate was increased in the early-PE group on days 14 and 18 of pregnancy, compared with the control group. There were no significant differences in these parameters between the late-PE group and the respective control group. Placental weights in the early- and mid-PE groups were significantly reduced at days 14 and 18 of pregnancy compared with the control groups, but there was no significant difference in placental weight between the late-PE group and the respective control group. Morphologic examination of placentas from the early- and mid-PE groups showed varying degrees of fibrinoid necrosis and villous interstitial edema, but no significant pathologic changes were found in the placentas from the late-PE or control groups.

CONCLUSIONPreeclampsia-like symptoms occurring during the early stage of pregnancy are more likely to affect placental and fetal development, whereas late onset preeclampsia-like symptoms have a direct impact on the mothers.

Animals ; Blood Pressure ; Disease Models, Animal ; Female ; Fetal Development ; Fetal Resorption ; etiology ; Fetal Weight ; Mice ; Mice, Inbred C57BL ; Organ Size ; Placenta ; pathology ; Pre-Eclampsia ; pathology ; physiopathology ; Pregnancy