A study of alpha-human atrial natriuretic peptide in normal pregnancy and in pre-eclampsia.

The object of this study was to compare plasma levels of alpha-human atrial natriuretic peptide (ANP) in patients with pre-eclampsia, normal pregnant women, and healthy non-pregnant women. This was an observational study carried out at Llandough Hospital, Cardiff, Wales on 85 age-matched women divided into three groups (30 patients with pre-eclampsia, 30 healthy pregnant women in the third trimester and 25 healthy non-pregnant women). Plasma ANP concentration was measured between 14.00 and 16.00 hours, in the recumbent position using pre-extraction radioimmunoassay. The following measurements were also performed: blood urea, serum creatinine, serum uric acid and serum sodium in all study subjects and 24-hour urinary protein in pregnant women. All women were eating a normal diet. It was shown that plasma ANP levels were significantly higher in healthy pregnant women in the third trimester of pregnancy than in non-pregnant women (18.12 +/- 7.36 vs. 13.68 +/- 6.41 pmol/l, P < 0.05). This difference was also observed in pre-eclamptic women (17.6 +/- 12.06 pmol/l vs. 13.68 +/- 6.41 pmol/l, P < 0.05) but the plasma hormone levels were not significantly different from healthy pregnant women. In all pregnant women, plasma ANP level was related to the gestational age and birth weight as shown by the regression coefficient (+ 0.39,-0.26 respectively, P < 0.05). In pre-eclamptic patients, there was no relationship between the severity of hypertension, assessed by the level of systolic and diastolic blood pressure, serum uric acid level and amount of proteinuria, and log (plasma) ANP levels. There was a significant negative correlation between serum sodium level and log (plasma) ANP level in all pregnant subjects (r=- 0.51, P < 0.05). Compared with non-pregnant women, plasma ANP levels are increased during the third trimester of normal pregnancy and in pregnancies complicated by pre-eclampsia. A relationship between ANP and pre-eclampsia seems unlikely but ANP is probably involved in the regulation of sodium and water balance in normal pregnancy and in pre-eclampsia.     

Serum cystatin C reflects glomerular endotheliosis in normal, hypertensive and pre-eclamptic pregnancies

Objective To study the correlation between serum cystatin C levels and renal structural changes in normal, hypertensive and pre-eclamptic pregnancy to evaluate it as a marker of the degree of renal involvement in pre-eclampsia.
Design An observational prospective study.
Setting University Hospital of Lund, Sweden.
Sample Thirty-six women with hypertensive disease in pregnancy and 12 healthy pregnant women in the third trimester recruited from maternal health care centres in the catchment area of the hospital.
Methods Renal biopsy samples were obtained from all participants and the degree of endotheliosis as well as the mean glomerular volume was evaluated by light microscopy in silver methenamin-stained sections. Serum cystatin C levels were measured and correlated to the structural changes.
Main outcome measures Correlation among degree of glomerular endotheliosis, glomerular volume andserum cystatin C.
Results Serum cystatin C levels differed between the different degrees of endotheliosis, showing a highly significant increasing linear trend. They also correlated significantly with glomerular volume (   r = 0.60, P < 0.001  ). Mean serum urate and creatinine levels also increased with the degree of endotheliosis, but not above the reference interval for normal term pregnancy, even in pre-eclamptic women.
Conclusion Serum cystatin C may be used as a marker, not only for impaired renal function, but also for the degree of glomerular endotheliosis and increase in glomerular volume in pregnancy. It may be of value in the monitoring of pregnancies complicated by pre-eclampsia.     

Serum cystatin C in pregnant women: reference values, reliable and superior diagnostic accuracy

BACKGROUND: A simple, endogenous, accurate and minimally invasive marker of glomerular filtration rate (GFR) is much desired in clinical nephrology. Cystatin C fulfills all criteria to be a marker for GFR. For early detection of renal impairment in pregnant women, it is necessary to determine serum cystatin C reference values and the correlation with GFR. The present study was therefore undertaken. METHOD: Healthy pregnant women were followed during pregnancy and the postnatal period. Patient demographics included age, height, weight, BMI, parity, total blood count, LFT, urea, creatinine, Na, K, and blood sugar. Serum cystatin C was estimated using particle enhanced nephlo-immunoassay method. All the parameters were recorded at the start of pregnancy and then in each trimester and the postnatal period. Regression analysis correlation coefficient, ANOVA and the Student's t-test were used for analysis using the SPSS statistical package. RESULTS: A total of 197 pregnant women were included. Mean serum cystatin C for all the women was 0.82 +/- 0.184 mg/l. Serum cystatin C levels were high -0.89 +/- 0.12 mg/l in the first trimester, decreased significantly to 0.651 +/- 0.14 mg/l during the second trimester (p = 0.0000 compared to first trimester), and increased again to 0.82 +/- 0.191 mg/l in the third trimester. After delivery the level rose to 0.94 +/- 0.12 mg/l. A strong correlation was found between serum cystatin C and serum creatinine. A strong negative correlation was found between GFR and cystatin C values in the women (r = -0.546, p = 0.000). A linear relationship was found between GFR and cystatin C levels. A significant increase in the GFR was noted with the progression of pregnancy from 128.06 +/- 29.7 ml/min in the first trimester to 155.2 +/- 29.59 ml/min during second trimester (p = 0.006). A decline in the level of cystatin C exactly parallel to the increase in the GFR was noted with the progression of pregnancy. Interestingly cystatin C was found to have a strong negative correlation with gestational age (r = -0.663, p = 0.000). CONCLUSION: Our results indicate that the mean serum cystatin C levels reflect changes in the GFR during the entire pregnancy and also in the postnatal period. Moreover, serum cystatin C levels are independent of age, height, weight, or blood sugar level. Cystatin C can be used for close supervision and early diagnosis of renal impairment in pregnant patients. Cystatin C is a reliable, useful and promising marker of GFR in pregnant women.     

Serum leptin levels and uterine Doppler flow velocimetry at 20 weeks' gestation as markers for the development of pre-eclampsia.

Altered Doppler flow velocimetry of the uterine arteries during the second trimester is correlated with the risk of developing pre-eclampsia. Serum levels of leptin, a protein regulating body weight and secreted by the placenta, are higher in women with severe pre-eclampsia. We investigated whether alterations of uterine arteries' Doppler flow velocimetry during the early second-trimester scan were accompanied by changes in leptin levels, and whether these changes might be an early risk factor for pre-eclampsia. We retrospectively selected 50 women with altered uterine artery velocimetry at the second-trimester scan who subsequently developed pre-eclampsia (group A) and 100 women who did not develop pre-eclampsia, divided into two groups: 50 women with normal velocimetry at the second-trimester scan (group B) and 50 women with altered velocimetry at the second-trimester scan (group C). Serum leptin levels during the second and third trimesters and bilateral uterine artery resistance index during the second trimester were evaluated. No differences were observed in serum leptin levels in the second trimester among the three groups. During the third trimester, women in group A showed significantly higher serum leptin levels in comparison with women in groups B and C (p < 0.01). Serum leptin levels do not seem to be a useful early marker for the development of pre-eclampsia in the presence of altered uterine blood flow, and may be a late compensatory mechanism or reflect a generalized response of the trophoblast to hypoxic stimuli.     

Metastin levels in pregnancies complicated by pre-eclampsia and their relation with disease severity

Aims: To evaluate the role of metastin levels in the pathophysiology of pre-eclampsia and to determine whether there is a relationship between the severity of the disease and Doppler velocimetry measurements. Methods: This cross-sectional study included 89 pregnant women (50 healthy normotensive pregnant women, 15 patients with mild pre-eclampsia, and 24 patients with severe pre-eclampsia) at the third trimester of pregnancy. The maternal levels of plasma metastin were determined by enzyme-linked immunosorbent assay. The umbilical artery and uterine artery blood flow velocities were measured by transabdominal color and pulsed Doppler ultrasound. Results: Plasma metastin levels were lower in patients with pre-eclampsia than those in the normotensive pregnant women. Four patients with mild pre-eclampsia and seven patients with severe pre-eclampsia had abnormal Doppler velocimetry findings. Metastin levels of pre-eclamptic patients with abnormal Doppler velocimetry findings were significantly lower than those in patients with normal Doppler velocimetry findings. Plasma metastin levels negatively correlated with proteinuria in 24 hours and with mean arterial pressure in the cases of pre-eclampsia. Conclusions: The findings suggest that decreased maternal concentrations of plasma metastin may be involved in the pathogenesis of pre-eclampsia. Plasma metastin levels may be useful in the assessment of the severity of pre-eclampsia. However, further trials are needed to clarify the role of metastin in pre-eclampsia.     

Tissue factor levels and high ratio of fibrinopeptide A:D-dimer as a measure of endothelial procoagulant disorder in pre-eclampsia.

To assess coagulation activation and endothelial cell injury in normotensive and pre-eclamptic pregnant women, a comparison was made of plasma levels of tissue factor, fibronectin, fibrinopeptide A and D-dimer. Samples were taken from 50 nonpregnant women, 40 normotensive pregnant women in the third trimester and 27 women with pre-eclampsia after diagnosis and before treatment. High levels of fibrinopeptide A and D-dimer were found in pre-eclamptic women. Moreover, the ratio fibrinopeptide A:D-dimer was much greater in the pre-eclampsia group than in normotensive pregnant women. The levels of fibronectin and tissue factor were also higher in the pre-eclampsia group. The increase of tissue factor levels suggests an alteration of the extrinsic coagulation pathway in pre-eclampsia. The increase of fibrinopeptide A:D-dimer ratio shows that the activation of coagulation is associated with a relative hypofibrinolysis in pre-eclampsia.     

Cystatin C in pre-eclampsia

Objective: To evaluate diagnostic value of cystatin C serum levels as alternative marker of renal function in pre-eclamsia (PE) and compare it with the traditional markers of renal function, creatinine and uric acid. In order to investigate the possible influence of inflammation on biochemical markers of renal function, serum levels of high sensitive CRP were measured (hsCRP). Methods: In this prospective study markers of kidney function were investigated in two groups of pregnant women: one with PE (n?=?32) and the other of healthy pregnant women (n?=?60). Serum cystatin C levels were measured as well as levels of traditional renal markers creatinin and uric acid and levels of high sensitive C-reactive protein. Results: Serum levels of cystatin C, creatinine and uric acid were significantly higher in the PE group than in the control group. Serum levels of hsCRP were higher in approximately the same number of patients with PE (50%) as in normal pregnancies (40%), without significant differences in CRP values between the two groups of patients. Conclusions: Cystatin C serum level may have significant role as a marker of pre-eclampsia specially when used in combination with uric acid levels.     

Nucleic acids and protein changes in normal and pre-eclamptic placentae.

DNA and RNA assayed in the placentae of three groups of pregnant women: normal second trimester (16-28), normal third trimester (28 weeks up to term) and in preeclampsia. The protein level in the placentae of the three groups was also assayed. The proteins, DNA and RNA all decreased after 28 weeks and up to term in normal pregnancy. In pre-eclampsia DNA and RNA showed a significant increase compared with cases of normal third trimester pregnancy. Whereas the proteins also showed an increased level, this was still less than its concentration during the second trimester of pregnancy. Protein/DNA and RNA/DNA ratios were calculated for the three groups. These ratios showed a gradual decrease during normal pregnancy from 16 weeks up to term, but with a sharper decrease in pre-eclampsia.     

Increased visfatin and leptin in pregnancies complicated by pre-eclampsia

Objective.?To evaluate the role of the adipokines, visfatin and leptin in the pathophysiology of pre-eclampsia and how their concentrations correlate with the severity of the disease and abnormal Doppler velocimetry.

Methods.?A cross-sectional study was carried out in 72 pregnant women (30 patients with mild pre-eclampsia, 20 patients with severe pre-eclampsia and 22 healthy normotensive pregnant women) during the third trimester of pregnancy. The maternal levels of plasma visfatin and serum leptin were determined in all cases by enzyme immunoassay and enzyme-linked immunosorbent assay, respectively. The uterine artery and umbilical artery RI were determined by Doppler analysis in all cases.

Results.?Plasma visfatin levels and serum leptin levels were higher in patients with pre-eclampsia than in the normotensive pregnant women. Six patients with mild pre-eclampsia and five patients with severe pre-eclampsia had abnormal Doppler velocimetry. Visfatin and leptin levels of pre-eclamptic patients with abnormal Doppler velocimetry were significantly higher than they were in those with normal Doppler velocimetry. Serum leptin levels were positively correlated with plasma visfatin level in cases of pre-eclampsia.

Conclusions.?These findings suggest that increased maternal levels of leptin and visfatin may be involved in the pathogenesis of pre-eclampsia, and measurement of these adipokines may be useful in assessment of the severity of disease.     

Activated protein C resistance in normal and pre-eclamptic pregnancies

OBJECTIVES: A lower ratio in the classic activated protein C resistance (APC-R) test has been reported during pregnancy, which has been called 'acquired' APC-R. However, little is known about the cause of the lowered ratio, and whether or not there is a correlation with blood coagulation activation. The primary objective of our study was to determine changes in APC-R levels in each of the trimesters of normal pregnancy. The secondary objective was to confirm whether APC-R levels were lower in pregnancies complicated by pre-eclampsia than in a control group. Finally, this prospective study was performed to investigate the prevalence of APC-R among pregnant women and to elucidate its obstetric consequences. METHODS: We enrolled 35 healthy pregnant women and 47 pregnant women affected by pre-eclampsia in our study. The following laboratory tests were performed: prothrombin time, partial thromboplastin time, fibrinogen levels, antithrombin III, plasmatic fibronectin (as a marker of endothelial damage), haptoglobin (as a marker of intravascular haemolysis), a functional test for APC-R and analysis of factor V Leiden mutation by polymerase chain reaction. RESULTS: The activated protein C sensitivity ratio was lower in the pathological group than in the control group (p = 0.008 and p = 0.02, respectively). Plasmatic fibronectin was found to be higher in the pathological group than in the control group (p = 0.05). Finally, the overall prevalence of factor V Leiden mutation was 5.4%, i.e. 2/35 women (5.7%) in the control group and 3/47 women in the pathological group (6.38%). CONCLUSIONS: The APC ratio decreased after 20 weeks of gestation until week 42. This decrease was most pronounced in the third trimester, in which resistance was demonstrated in 34.2% of control group patients. In pre-eclampsia, we found a greater reduction of the APC ratio than in controls. We hypothesise that this is due to a decrease in the plasmatic levels of coagulation inhibitors and an increase in coagulatory factors.     

Correlation between plasma neurotransmitters and memory loss in pregnancy

OBJECTIVE: To correlate the levels of plasma neurotransmitters epinephrine, norepinephrine, serotonin and dopamine with memory in healthy, pregnant women. STUDY DESIGN: Fifty healthy, pregnant women were selected in the first trimester and followed in the second and third trimesters of pregnancy. Nonpregnant women served as controls. Epinephrine, norepinephrine, serotonin and dopamine levels were analyzed with high-performance liquid chromatography. The plasma neurotransmitter levels were correlated with memory in each trimester of pregnancy. RESULTS: Significant decreases (P < .001) in plasma epinephrine, serotonin and dopamine were observed in healthy, pregnant women in each trimester of pregnancy when compared to nonpregnant women. A significant increase in plasma norepinephrine was observed in healthy, pregnant women in each trimester of pregnancy. A significant decrease (P < .001) in functional memory was observed in healthy, pregnant women when compared to nonpregnant women. CONCLUSION: Decreases in functional memory and of plasma epinephrine, norepinephrine and serotonin levels in the second trimester of healthy pregnancy suggests that decreased plasma neurotransmitter levels are responsible for loss of functional memory in healthy, pregnant women.     

Serum activin A and inhibin A elevated in pre–eclampsia: no relation to insulin sensitivity

Objective To assess the possible role of serum levels of activin A, inhibin A and pro-αC inhibin (pro-Design αC) in insulin sensitivity in pre-eclampsia.
Design A prospective study.
Setting Helsinki University Central Hospital.
Participants Twenty-two nulliparous women with proteinuric pre-eclampsia and 16 healthy nulliparous controls in the third trimester of pregnancy.
Methods Serum samples were collected before and after intravenous injection of glucose (0.3 g/kg) and insulin (0.03 IU/kg) (the minimal model for testing insulin sensitivity), and were assayed for activin A, inhibin A and pro–αC.
Main outcome measures Comparison of the levels of activin A, inhibin A and pro-αC between pre-eclamptic and healthy pregnant women, and the association of these proteins with insulin sensitivity.
Results In pre-eclampsia elevated levels of activin A (139%,  P = 0.0001  ), inhibin A (39%,   P = 0.003  ), and pro-αC (92%,   P = 0.0008  ) were observed. The amount of proteinuria (0.3–10.5 g/day) correlated positively with serum concentrations of activin A (   P = 0.01  ) and inhibin A (   P = 0.02  ). These glycol-proteins were not associated with insulin sensitivity either in women with pre-eclampsia or controls. A 2.9-fold rise in blood glucose and a 52.5-fold rise in insulin during testing using the minimal model were not accompanied by any significant changes in activin A, inhibin A, and pro-αC.
Conclusion Activin A, inhibin A, and pro–αC are elevated in pre-eclampsia but do not appear to relate to the insulin sensitivity in pre-eclamptic or normal pregnancies.     

内源性一氧化氮合酶抑制物与子痫前期关系的研究

目的:探讨子痫前期患者血浆内源性一氧化氮合酶抑制物-非对称性二甲基精氨酸(asymmetric dimethylarginine,ADMA)及胎盘内皮性一氧化氮合酶(endothelial nitricoxide synthase,eNOS)的表达与子痫前期的关系。方法:2004年1月至2005年1月广州医学院第三附属医院住院分娩的子痫前期孕妇30例,正常晚期妊娠10例,早孕12例。用高效液相色谱法(HPLC)测定血浆ADMA,免疫组化法检测胎盘组织中eNOS。结果:子痫前期组ADMA水平明显高于正常晚期妊娠组,分别为17.97±7.25μg/ml和10.27±1.67μg/ml,两组差异有统计学意义(P<0.01)。而子痫前期组胎盘eNOS表达则明显低于正常晚期妊娠组,两组差异有统计学意义(P<0.05)。结论:子痫前期患者体内eNOS抑制物ADMA升高,胎盘eNOS活性下降,提示ADMA作为eNOS的抑制调节因子在子痫前期病理生理改变中可能起重要作用。     

Magnesium, zinc and iron levels in pre-eclampsia

OBJECTIVE: To determine the change in erythrocyte and plasma magnesium, plasma zinc and serum iron concentrations in pre-eclampsia. METHODS: Twenty women with pre-eclampsia and 20 control subjects matched for gestational age were examined. The levels of magnesium, zinc and iron in all subjects were measured by flame atomic absorption spectrometry. In the pre-eclamptic women, who were supplemented with magnesium salts, these measurements were repeated after delivery. RESULTS: The intraerythrocytic magnesium levels before supplementation were significantly lower in the pre-eclamptic patients than in the healthy pregnant women (0.98 +/- 0.15 vs. 1.35 +/- 0.30 mmol/l; p < 0.001) and increased (to 1.25 +/- 0.25 mmol/l) after treatment with magnesium. The plasma magnesium and zinc, and the serum iron concentrations were not significantly different between the pre-eclamptic and the healthy pregnant women. CONCLUSIONS: Our results suggest that low cellular magnesium levels in women with pre-eclampsia may contribute to the development of hypertension in these patients, and that the measurements of plasma zinc and serum iron concentrations are of doubtful clinical value in the management of pre-eclampsia.     

Pre-symptomatic increase in urine-orosomucoid excretion in pre-eclamptic women

BACKGROUND: Although the pre-eclamptic pathogenesis begins at least around the 18th week of pregnancy, clinically evident disease often does not appear until the third trimester. This long pre-symptomatic latency period has led to intensive research for early markers of evolving disease. We evaluated urine excretion and plasma levels of orosomucoid and albumin longitudinally in healthy and pre-eclamptic pregnancies. Orosomucoid is an acute phase protein involved in inflammation and protection of the endothelium. METHODS: From a prospective, longitudinal cohort study consisting of 1,631 women, 32 women developed pre-eclampsia, and 5 controls for every case of pre-eclampsia were found. Blood samples were collected 4 times and urine samples 6 times from the 18/19th week and throughout pregnancy. Orosomucoid and albumin in plasma were analysed by standard methods, and in urine by sandwich ELISA. RESULTS: Orosomucoid/creatinin excretion ratio was significantly higher early in pre-eclamptic pregnancies (from the 20th week of pregnancy, p=0.0053) compared with healthy pregnancies, the difference increased throughout pregnancy. Albumin/creatinin ratio increased subsequent to the increase in orosomucoid. In the plasma samples, orosomucoid was significantly higher late in pre-eclamptic pregnancies (>or=36th week, p=0.0275). CONCLUSIONS: Pre-eclampsia is associated with a pre-symptomatic increase in the urine excretion of orosomucoid, and orosomucoid excretion precedes that of albumin. Orosomucoid excretion can probably be used as a prognostic tool in combination with other screening methods, and seems to be a more sensitive marker for evolving pre-eclampsia than albumin. Plasma orosomucoid is significantly increased late in pre-eclampsia. Thus, the increased excretion of orosomucoid must primarily originate from altered renal processing of orosomucoid.     

Plasma acid phosphatase in normal and pre-eclamptic pregnancy

Plasma acid phosphatase activity was measured in nonpregnant, normal pregnant, and severely pre-eclamptic women. The third trimester of pregnancy was associated with a rise in plasma acid phosphatase and severe pre-eclampsia with a marked rise in this enzyme. Possible sources of this elevation in acid phosphatase activity are the placenta, kidneys, pregnancy-associated plasma proteins, and blood platelets—with platelets the most likely.     

Plasma endothelin-1 and mean arterial pressure in the prediction of pre-eclampsia.

OBJECTIVE: To determine whether increased first trimester plasma endothelin-1 and/or increased midtrimester mean arterial blood pressure detected in pregnant women who are free of symptoms can predict the subsequent development of pre-eclampsia. METHOD: Eighty pregnant women were successfully followed from 10 weeks gestation until delivery. Pre-eclampsia and eclampsia developed in 29 and 2 women, respectively, whereas 49 women remained normotensive. Plasma endothelin-1 was determined in the first trimester (10-12 weeks gestation) by a competitive radioimmunoassay. RESULT: First trimester plasma endothelin-1 levels in pregnant women who subsequently developed mild, severe pre-eclampsia and eclampsia were significantly higher than those of pregnant women who remained normotensive. The release of endothelin-1 increases with the severity of the disease, age, body mass index and mean arterial blood pressure. The predictive values of plasma endothelin-1 for pre-eclampsia were: sensitivity 96.8%, specificity 51%, positive predictive value 55.5% and negative predictive value 91%, whereas those of MAP were 48.4, 45, 35.7 and 58%, respectively. CONCLUSION: Determination of first trimester plasma endothelin level may be a valuable marker to identify 55.5% of individuals at high risk of developing pre-eclampsia, if combined with midtrimester MAP, the positive predictive value increases to 68.2%.     

Altered plasma neurokinin B levels in patients with pre-eclampsia

Objective(s) This study determines the levels of Neurokinin B (NKB) in the plasma of South African coloured pregnant women with and without pre-eclampsia (PE) and correlates these results with clinical data. Additionally, the peptide radioimmunoassay (RIA) and peptide enzyme immunoassay (EIA) methods were compared in the determination of the Neurokinin B levels, using 58 samples from patients with PE. Methods At the Tygerberg Hospital, Cape Town, SA, 43 pregnant women with PE and 62 healthy pregnant women were recruited, and clinical data were gathered using questionnaires; 58 patient samples were tested by both RIA and EIA. Results The comparison of RIA and EIA revealed an r-value of 0.904. The mean NKB concentration in the PE group (23.5 ng/l) was significantly higher than in the control group (3.8 ng/l). Within the PE cohort, two NKB subgroups could be discerned: those with levels <30 ng/l and those with levels >30 ng/l. Conclusion(s) This study, carried out within a distinct population, confirms previous reports of elevated NKB levels in the plasma of pre-eclamptic women in the third trimester, and established the suitability of EIA for determining NKB levels. Whether the altered NKB levels are causative or merely associated with PE still remains to be determined. The split in the two NKB groups (high and low values) needs further evaluation, as does whether NKB could be used as a screening test or as a predictive factor.     

Magnesium,zinc and iron levels in pre-eclampsia

Objective: To determine the change in erythrocyte and plasma magnesium, plasma zinc and serum iron concentrations in pre-eclampsia. Methods: Twenty women with pre-eclampsia and 20 control subjects matched for gestational age were examined. The levels of magnesium, zinc and iron in all subjects were measured by flame atomic absorption spectrometry. In the pre-eclamptic women, who were supplemented with magnesium salts, these measurements were repeated after delivery. Results: The intraerythrocytic magnesium levels before supplementation were significantly lower in the pre-eclamptic patients than in the healthy pregnant women (0.98 &#45 0.15 vs. 1.35 &#45 0.30 mmol/l; p < 0.001) and increased (to 1.25 &#45 0.25 mmol/l) after treatment with magnesium. The plasma magnesium and zinc, and the serum iron concentrations were not significantly different between the pre-eclamptic and the healthy pregnant women. Conclusions: Our results suggest that low cellular magnesium levels in women with pre-eclampsia may contribute to the development of hypertension in these patients, and that the measurements of plasma zinc and serum iron concentrations are of doubtful clinical value in the management of pre-eclampsia.     

Serum protein pattern in normal pregnancy with special reference to acute-phase reactants

Summary. The concentrations of acute-phase protein reactants, total protein, albumin and globulin fractions were measured throughout normal pregnancy in 27 women. α₁-Antitrypsin and caeruloplasmin concentrations increased gradually to reach their highest levels in the third trimester. Orosomucoid and haptoglobin showed similar patterns: higher levels in the first and third trimester with a decline around 24 weeks gestation. C-Reactive protein showed levels similar to those of non-pregnant healthy individuals (< 5 mg/1) throughout pregnancy. α₁,-, α₂ and β-Globulin concentrations increased from the first trimester towards term. γ-Globulin concentration changed little during gestation. The data obtained provide reference ranges for serum proteins in healthy pregnancy.