Patient Initiated Home Blood Pressure Recordings Are Accurate in Hypertensive Pregnant Women

Objective. We undertook this study to determine the accuracy and reliability of patient initiated blood pressure measurement and recording. Methods. We recruited 72 women from the antenatal hypertension clinic in a university teaching hospital. All were at high risk for preeclampsia and were asked to measure and record their blood pressure three times per day at home using a validated blood pressure device with an internal memory. Results. From 979 measurements taken only 28 (2.9% were inaccurate). The inaccurate readings were restricted to three women. On further questioning two women admitted that the device had been used by other family members thus making comparison with the memory impossible. Thus the true nonconcordance rate amongst participants was 1/72 (1.4%). Conclusions. We conclude that blood pressure recordings taken and documented by high‐risk women at home are accurate. This allows more frequent measurements to be taken without the inconvenience of additional visits to hospital and may therefore lead to the earlier detection of preeclampsia.     

Fibrinogen Concentration and Factor VIII Activity in Women with Preeclampsia

Objective: To compare fibrinogen concentration and factor VIII activity obtained from pregnant women with preeclampsia with those obtained from women with either normal pregnancies or with complications unrelated to preeclampsia. Materials and Methods: Fibrinogen concentration and factor VIII activity were measured in the following groups: normal pregnancy, consisting of women at routine 16- to 28-week antenatal visits or after admission at term for elective cesarean section; women with non-preeclampsia (non-PE) related conditions, including women with threatened abortion, cholestasis, systemic lupus erythematosus (SLE), and previous deep venous thrombosis (DVT); and women with preeclampsia as defined by the Australasion Society for the Study of Hypertension in Pregnancy (ASSHP) criteria. Blood was collected from 44 women in each group. Fibrinogen concentration and factor VIII activity were measured. Results: Fibrinogen concentrations and factor VIII activities were higher in women with preeclampsia compared with those from women with either normal or complicated pregnancies (p < 0.05). It was twice as likely that a woman with preeclampsia would have a raised fibrinogen and factor VIII levels. The ranges for each analyte did, however, show overlap. Women with preeclampsia were more likely to have both a raised fibrinogen concentration and increased factor VIII activity than other pregnant women (p < 0.001). Conclusion: This study has shown a novel increase in both fibrinogen concentration and factor VIII activity in pregnant women with preeclampsia compared with values obtained from women with normal or non-preeclampsia complicated pregnancies, with women with preeclampsia twice as likely to have a raised fibrinogen concentration and increased factor VIII activity. These changes may contribute to the hypercoagulability seen in preeclampsia.     

Urinary Protein/Creatinine Ratio in Hypertensive Pregnant Women

Objectives: To determine the correlation between the protein/creatinine ratio and 24-h proteinuria; to estimate the sensitivity and specificity of this ratio for the diagnosis of significant proteinuria; to establish its cutoff point with the best predictive value for the diagnosis of significant proteinuria in patients with systemic arterial hypertension.

Study Design: A cross-sectional study of 47 hypertensive patients who had been pregnant for 20 weeks or more seen at the Maternity of the University Hospital of Porto Alegre. The studied factor was the protein/creatinine ratio measured in a single random urine sample and the outcome was protein determination in 24-h urine. The level of significance was set at 0.05.

Results: The correlation coefficient between the protein/creatinine ratio and 24-h proteinuria was 0.94 when urine was properly collected. A receiver-operator characteristic curve was constructed to determine the sensitivity and specificity of the ratio for the diagnosis of significant proteinuria (≥300 mg in 24 h). Specificity and predictive positive value were 100% for a ratio ≥0.8. The best values for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of proteinuria ≥300 mg in 24 h were obtained when the protein/creatinine ratio was 0.5 (0.96, 0.96, 0.96, and 0.96, respectively).

Conclusion: The protein/creatinine ratio measured in a single urine sample taken at random from hypertensive pregnant women showed good sensitivity and specificity for the diagnosis of 24-h proteinuria >300 mg and was strongly correlated with 24-h proteinuria. A ratio of 0.5 mg/mg is predictive of significant proteinuria and can be used for the diagnosis and follow-up of hypertensive pregnant women.     

Bioimpedance in Pregnant Women with Preeclampsia

To analyze the direct (resistance and reactance) and indirect (intra and extracellular total body water) BIA parameters in preeclamptic women, 51 healthy pregnant women and 65 preeclamptic women were submmited to bioeletric impedance on the thrid trimester of gestation. The significance value adopted was 5%. Preeclamptic women showed lower values for R (448 Ω vs. 542 Ω), Rc (40 Ω vs. 53 Ω) and ICW (49.45% vs. 51%) when compared to control group. They also showed higher values for TBW (49% vs. 47%), TBWcor (41.6% vs. 34%) and ECW (50% vs. 47%). Biolectric impedance allowed differentiating preeclamptic women from health pregnant women, indicating that preeclampsia changes body compartments during pregnancy. This method can help understand the mechanisms involved in preeclampsia and to be a prediction away of preeclampsia.     

糖筛查异常而糖耐量正常孕妇血糖变化与妊娠结局关系研究

目的了解糖筛查试验(GCT)异常而糖耐量试验(OGTT)正常孕妇的妊娠结局.方法采用回顾性研究方法,收集2003年1月至2004年12月在我院就诊的GCT异常而OGTT正常的孕妇359例.比较GCT和OGTT结果、胎儿大小、分娩方式.结果GCT异常而OGIT正常者巨大儿的发生率(11.1%)较GCT正常孕妇(5.8%)高.GCT异常而OGTT正常者巨大儿组孕妇空腹血糖、糖耐量中2小时血糖值和血糖累积浓度较其正常体重儿组大;糖耐量试验中.空腹血糖＞4.62 mmol/L、2小时血糖＞8.31 mmol/L、血糖累积浓度＞22.77 mmol/L者,其巨大儿发生率、剖宫产率增加.2小时血糖＞8.31 mmol/L时,血糖的值与胎儿的大小相关.结论围生期监护中,需重视GCT异常而OGTT正常孕妇的血糖控制,糖耐量中2小时血糖的监测对孕妇而言更为重要.     

The Association Between Maternal Obesity,Glucose Intolerance and Hypertensive Disorders of Pregnancy in Nondiabetic Pregnant Women

Objective. The aim of this study is to evaluate whether pregnancy-induced hypertension (PIH) among nondiabetic patients is associated with glucose intolerance. Materials and Methods. A retrospective case-control study was designed including a study group who had pregnancy-induced hypertension or preeclampsia. Patients with normal pregnancy were used as a control group matched to cases by parity. Diabetic patients, nonsingleton pregnancies, and women without prenatal care were excluded. Data concerning fasting glucose levels, glucose challenge test (GCT), and oral glucose tolerance test (OGTT) were collected from patients' files. Results. There were 131 patients in each study group. The study group had significantly higher mean maternal age, mean GCT levels, and mean pregestational body mass index (BMI) (28.0 ± 5.8 vs. 26.5 ± 5.3, p = 0.02; 5.8 ± 1.4 vs. 5.1 ± 1.1 p = 0.0018; 26 ± 5.1 vs. 23 ± 4.0 p < 0.001, respectively) than the control group. Mean gestational age and birthweight were also significantly lower in the study group (38.5 ± 2.1 vs. 39.4 ± 1.7 p < 0.001; 2929 g ± 614.7 vs. 3225 ± 461.1 p < 0.001, respectively). Stratified analysis according to parity demonstrated that pregestational BMI, weight gain during pregnancy, and cesarean section (CS) were significantly higher in women with pregnancy-induced hypertension than in controls in all parity groups. Maternal age and mean GCT levels of women with pregnancy-induced hypertension were higher in all parity groups but statistically significant only among multiparous patients. Multiple logistic regression demonstrated that BMI, weight gain, and maternal age were independently associated with pregnancy-induced hypertension, while GCT level was not. Conclusions. Elevated pregestational BMI is an independent risk factor for development of pregnancy-induced hypertension (PIH). Its association with elevated GCT levels implies that even without overt diabetes, glucose intolerance may play a role in the pathogenesis of preeclampsia in obese patients.     

Plasma antithrombin levels correlate with albumin and total protein in gestational hypertension and preeclampsia

ObjectiveTo analyze the antithrombin-III (AT-III) activity in the plasma in relation to the serum albumin and total protein in preeclampsia and gestational hypertension.Study designThe medical records of 139 patients who were diagnosed with gestational hypertension (n = 33) and preeclampsia (n = 106) were reviewed, and the relationships between the activity of AT-III and serum albumin or total protein were evaluated.Main outcome measuresThe plasma AT-III activity in gestational hypertension and preeclampsia was correlated with the serum albumin and TP levels.ResultsThere were significant correlations between AT-III activity and albumin in gestational hypertension (r = 0.504, p = 0.003) and preeclampsia (r = 0.343, p = 0.003). There were also significant correlations between AT-III activity and TP in gestational hypertension (r = 0.619, p = 0.001) and preeclampsia (r = 0.366, p = 0.001). Regression coefficients between AT-III and albumin and between AT-III and TP in gestational hypertension (23.7 and 14.0, respectively) were significantly steeper than those in preeclampsia (14.6 and 9.6, respectively).ConclusionsThe plasma AT-III activity in gestational hypertension and preeclampsia was correlated with the serum albumin and TP levels. This suggests that AT-III activity is more likely to decrease in gestational hypertension than in preeclampsia.     

Variation in the Urinary Protein/Creatinine Ratio at Four Different Periods of the Day in Hypertensive Pregnant Women

Objective. To assess the urine protein/creatinine ratio in urine samples of pregnant women with hypertension in regard to: 1) the presence of significant variation at different periods of the day; 2) the differences if they exist, to identify the most reliable period of the day for sampling; and 3) whether the first sample, obtained when the patient arrives at the clinic, correlates with the same accuracy, with the 24-hour proteinuria. Design. Cross-sectional study. Place. Obstetrics Emergency Department, Hospital de Clínicas de Porto Alegre, a teaching hospital in Porto Alegre, Brazil. Population. Seventy-five women with hypertension with 20-week gestation or over. Methods. Urine samples for determination of the protein/creatinine ratio were obtained on arrival (first specimen) and every 6 hours thereafter, totaling four samples in 24 hours. Four sampling periods were established: 1) from 8 am to 2 pm, 2) from 2 pm to 8 pm, 3) from 8 pm to 2 am, and 4) from 2 am to 8 am. The protein/creatinine ratio in the four different day periods were compared with the 24-hour proteinuria obtained simultaneously. The results were analyzed by the Spearman correlation and the receiver-operator characteristic (ROC) curve. Results. The urine protein/creatinine ratio is strongly correlated (Spearman correlation equal to 0.8 or greater) with the 24-hour proteinuria at all four periods of the day (p < 0.001), as well as the first sample obtained on arrival (p = 0.003). These findings were corroborated by the ROC curve in which the values of four day periods and that of the first sample were equal to or greater than 0.930. Conclusion. In hypertensive pregnant women, the single voided urine sample protein/creatinine ratio, irrespective of sampling time, is strongly correlated with the 24-hour proteinuria, as is the sample obtained on arrival.     

Blood Pressure Assessments in Different Subtypes of Hypertensive Pregnant Women: Office Versus Home Patient- or Nurse-Measured Blood Pressure

Objective:?To explore the difference between distinct methods of assessing blood pressure (BP) in pregnant women with different hypertensive disorders.?Methods:?We compared office BP to home patient- and nurse-measured diastolic BP in pregnant women with essential chronic hypertension (CH), preeclampsia (PE) and isolated hypertension (IOH).?Results:?Office BP was lower or similar to home patient- and nurse-measured BP in women with CH. Office BP was higher than home patient-measured BP in women with PE and in women with IOH (p < 0.0001). Nurse-measured BP was higher than patient-measured BP in women with PE (p < 0.01).?Conclusions:?BP assessments in women with PE are significantly influenced by the environment, which should be considered in managing these women.     

Plasma Hemopexin Activity in Pregnancy and Preeclampsia

Objective: Plasma hemopexin activity, associated with increased vascular permeability, was evaluated in healthy pregnant and non-pregnant women and in pre-eclamptic women. Methods: Hemopexin activity and the hemopexin inhibitor, extracellular ATP, were assayed in plasma from pregnant (n?=?10), preeclamptic (n?=?9), and non-pregnant women (n?=?10) using standard methods. Abdominal fascia tissue fragments from preeclamptic and pregnant women were immunohistochemically stained for vascular ecto-apyrase or ecto-5′nucleotidase. Results: The data show significantly enhanced Hx activity exclusively in plasma from pregnant women and significantly enhanced plasma ATP in pre-eclamptic women compared with the other groups. Dephosphorylation of preeclamptic plasma resulted in reactivation of Hx activity. Fascia tissue-samples from preeclamptic women showed reduced ecto-apyrase activity and enhanced ecto-5′nucleotidase activity compared to pregnant women. Conclusion: Enhanced hemopexin activity may be associated with normal pregnancy, but not with preeclampsia. Decreased hemopexin in pre-eclamptic patients may be due to enhanced plasma ATP, which is possibly promoted by diminished activity of vascular ecto-apyrase.     

Lower Rate of Preeclampsia After Antioxidant Supplementation in Pregnant Women with Low Antioxidant Status

Objective: To investigate maternal and neonatal outcomes after antioxidant supplementation relatively early in pregnancy (8 to 12 weeks) for pregnant women with low antioxidant status. Methods: A randomized, double-blind, placebo-controlled trial of daily antioxidant supplementation was performed on pregnant women screening positive for low antioxidant status at 8 to 12 weeks of gestation. Low antioxidant status was defined as a superoxidedismutase (SOD) level below 1102 U/g Hb or 164 U/mL. The supplementation group received the following antioxidants daily: vitamins A (1000 IU), B6 (2.2 mg), B12 (2.2 μg), C (200 mg), and E (400 IU), folic acid (400 μg), N-acetylcysteine (200 mg), Cu (2 mg), Zn (15 mg), Mn (0.5 mg), Fe (30 mg), calcium (800 mg), and selenium (100 μg). The control group received Fe (30 mg) and folic acid (400 μg). Maternal (preeclampsia, abortion, and hypertension) and perinatal outcomes were assessed. Results: In the supplementation group (29 subjects), we observed 2 cases of preeclampsia (6.8%, 1 mild and 1 severe), 1 of IUGR (birth weight 2300 g at 38 weeks), and 1 preterm delivery. In the control group (31 subjects), there were 8 abortions, 9 cases of preeclampsia (29%, 6 mild and 3 severe) with perinatal outcome: 3 preterm delivery cases and 1 IUGR (birth weight 2030 g at 39 weeks). Preeclampsia was significantly less frequent in the supplementation group when compared to the control group (2 vs. 9 cases, p = 0.043, OR = 0.18 [95% CI: 0.03, 0.92]). Finally we focused on the prediction of preeclampsia at 8 to 12 weeks. Combined sensitivity of markers of antioxidant status (SOD slutathione peroxidase, [GPx], and total anti-oxidant status [TAS]) was 33% (false-positive rate of 4.5%). Conclusion: Antioxidant supplementation was associated with better maternal and perinatal outcome in pregnant women with low antioxidant status than control supplementation with iron and folate alone. In a selected population already screened positive for low SOD, preeclampsia can be detected in 33% of asymptomatic cases in the first trimester using SOD, GPx, and TAS. It seems feasible that panels of both biochemical and molecular markers may be clinically useful in the prediction of this disease.     

抗血栓素Ⅲ抑制精子顶体素活性及其对小鼠体外受精能力的影响

通过免疫转移吸附试验，我们检出精浆内有抗血栓素Ⅲ抗原的存在，含量约为血浆的百分之一，分子量约５７ｋＤ。体外实验证明，纯抗血栓素Ⅲ能抑制人、猪和小鼠精子顶体素活性，其中抑制猪顶体素的二级速率常数为Ｍ－１ｓ－１，这种抑制反应是通过在ＳＤＳ－ＰＡＧＥ上形成稳定的复合物而起作用的。小鼠体外受精试验表明，在培养基中加入抗血栓素Ⅲ能抑制精－卵结合和受精率。本研究提示，抗血栓素Ⅲ不仅存在于血凝过程中，而且还可能是生殖过程的调节因子。     

Increased alpha-1 Adrenoceptor Expression in Pregnant Rats with Subrenal Aortic Coarctation

The progression of pregnancy is associated with attenuation in vasopressor response to adrenergic agonists. In pregnancy-induced hypertension this attenuation is reverted. It is not known if this reversion involves alpha-1 adrenoceptor expression. Objective. In this work we propose that in pregnant rats with subrenal aortic coarctation there are changes in the expression of alpha-1 adrenergic receptors in the thoracic and abdominal aorta during pregnancy. Methods. We used non-pregnant, normal pregnant and pregnant with subrenal aortic coarctation female Wistar rats. Pregnancy-induced hypertension indicators, systolic blood pressure, 24 hours proteinuria, pup weight and maternal weight were measured. Dose response curves to phenylephrine were carried out to determine vascular reactivity along pregnancy. Alpha 1-adrenoceptors were detected from thoracic and abdominal aorta using immunoblot. Results. Results show significant increases in arterial pressure and proteinuria in pregnant rats with SRAC at the end of the third week. Pregnancy reduces alpha_{-1-A, -B} and _-D adrenoceptor expression and this event is reverted by subrenal aortic coarctation. This phenomenon is more apparent in the abdominal segment of the aorta. Conclusions. These findings suggest that subrenal aortic coarctation is a good animal model of pregnancy-induced hypertension and that α₁-adrenoceptors participate in its physiopathology increasing their expression in a segment-dependent manner.     

Home Blood Pressure Levels in Pregnant Women with Chronic Hypertension

Objective: To explore the difference between office and home blood pressure (BP) monitoring in normotensive and hypertensive pregnant women. Methods: We compared the mean of 1 week home BP with office BP, measured by aneroid devices, in 20 normotensive women (68 BP assessments) and 100 women with mild essential chronic hypertension without superimposed gestational hypertension (429 BP assessments). Different approaches were used including the Bland-Altman method to investigate the discrepancies between office and home BP. Results: Systolic office BP in normotensive women (p = 0.004) and diastolic office BP in hypertensive women (p = 0.001) were lower than home BP. The concordance between office and home BPs was better for diastolic BP than for systolic BP. Only a small number of hypertensive women presented home BP ≥135/85 mm Hg. Conclusions: In our study population, the concurrence between office and home BPs is good with the exception of systolic BP in normotensive women. Home blood pressure measurement criteria used in nonpregnant individuals are not adequate in pregnancy.     

Continuous Non-Invasive Blood Pressure Monitoring,a Validation Study of Nexfin in a Pregnant Population

Objective: To assess the accuracy of a non-invasive beat-to-beat continuous blood pressure monitoring device (Nexfin) in pregnancy according to the International Protocol of the European Society of Hypertension.?Methods: The validation was performed according to the International Protocol of the European Society of Hypertension. The test device (Nexfin, BMEYE, Amsterdam, the Netherlands) calculates beat to beat blood pressure from finger pulse wave analysis. Measurements of systolic and diastolic BP in 33 volunteers were obtained using the mercury sphygmomanometer and the Nexfin alternatingly.?Results: The device passed phase 1 as 30 systolic and 32 diastolic readings fell within 5 mmHg (25 required). In addition, the device also passed phase 2.1 as 68 systolic and 67 diastolic readings fell within 5 mmHg (65 required). Finally, it failed to pass phase 2.2 as 24 subjects for systolic and 23 for diastolic had at least 2/3 of their comparisons falling within 5 mmHg (22 required) but 6 subjects for systolic and 8 for diastolic had all three comparisons more than 5 mmHg different from the mercury readings (three allowed). The mean differences were 2.3 mmHg (SD 6.8) for SBP and 0.8 mmHg (SD 6.3) for DBP.?Conclusion: The Nexfin device passed phase 1 and phase 2.1 but failed to pass phase 2.2. However, adaptation of the data to the more permissive AAMI (mean difference <5 ± 8 mmHg) and BHS (systolic grade B, diastolic grade A) protocols indicated adequate accuracy for application in research settings or for longitudinal within-patient tracking of blood pressure, given the possibility for continuous monitoring.     

Decreased Pathological Placental Findings in Aspirin-Treated Pregnant Women at Risk of Hypertensive Complications

Objective: The small controlled trials reporting large reductions in the incidence of preeclampsia and intrauterine growth restriction (IUGR) in highrisk pregnant women treated with low-dose aspirin have recently been followed by large clinical trials suggesting less beneficial results. The effect of low-dose aspirin on placental lesions associated with preeclampsia and IUGR has not yet been studied.

Methods: We participated in the large multicenter randomized collaborative low-dose aspirin study in pregnancy (CLASP) trial of low-dose aspirin for the prevention and treatment of preeclampsia and intrauterine growth restriction. As part of this study, we evaluated placentae submitted from 25 women treated with aspirin and 28 with placebo.

Results: More of the pathological findings classically described in preeclampsia and IUGR were demonstrated in the placentae from the placebo group than from the aspirin group (54% vs. 16%, P = 0.02). The placental findings did not correlate with clinical pregnancy outcome or Doppler flow parameters of the fetal umbilical artery in either group.

Conclusions: Our results support the assumption that aspirin may have some inhibitory effect on the uteroplacental circulatory ischemic changes typically occurring in preeclampsia and IUGR.     

The Activity of Erythrocyte Sodium-Proton Exchanger in Women with Pregnancy- Induced Hypertension

Background: Hypertension that develops after 20 gestational weeks and is defined as pregnancy-induced hypertension (PIH). The main cause of PIH is vasoconstriction and the thickening of vascular media, which decreases vascular capacity and increases peripheral resistance. One of the theories postulated to explain this phenomenon is that a transmembrane sodium transport disorder causes an increase in intracellular sodium concentration. In the latest literature, special attention is paid to the role of the increased intracellular sodium concentration in the pathogenesis of essential hypertension (EH). One of the best documented phenotypes for EH is the increased activity of the sodium-proton exchanger (NHE). The aim of this study was to assess if increased NHE activity could be the mechanism responsible for the development of PIH. Subjects and methods: The study included 30 women: 10 pregnant women with PIH after gestational week 30, 10 women with physiological pregnancy after 30 gestational weeks, and 10 healthy non-pregnant women. NHE activity was determined according to Orlov’s method as amiloride-sensitive H⁺ efflux from acid-loaded cells. Results: The NHE activity in the group of women with PIH was significantly higher than that in women with physiological pregnancy: 10.09 ± 1.65 vs. 6.81 ± 2.3 mmol/L RBC/h (p < 0.049) and in the group of non-pregnant women: 10.09 ± 1.65 vs. 7.56 ± 1.66 mmol/L RBC/h (p < 0.029). Erythrocyte NHE activity did not differ in the group of women with physiological pregnancy and in the group of non-pregnant women. Conclusion: These results seem to suggest that erythrocyte NHE activity is elevated in PIH pregnancies.     

Reported Calcium Intake is Reduced in Women with Preeclampsia

Objective: The purpose of this trial is to investigate the relationship between dietary calcium content and incidence of preeclampsia, comparing diet calcium content in normotensive and preeclampsia patients. Dietary calcium was measured by a dietary interview conducted at the day after delivery. Methods: This is a prospective cross-sectional study involving 1092 patients who delivered at Hospital de Clínicas de Porto Alegre – Brazil. Results: The average diet calcium content in the studied population was 1038 mg. The average calcium intake in the normotensive group was 1057 mg, in chronic hypertension group was 962 mg, in transient hypertension group was 963 mg, in mild preeclampsia was 902 mg and in severe preeclampsia group was 755 mg. The results of this study show that pregnant women who develop severe preeclampsia have a significant lower diet calcium intake when compared to normotensive women (P = 0.018). Conclusion: The results of the present study can provide the foundations for prospective trials, including randomised clinical trials involving only patients with a low content of calcium in their diet.     

Locomotion of Human Neutrophils in Response to Plasma and Serum of Women with Preeclampsia

Objective: To examine whether the previously reported neutrophil activation which occurs in the maternal circulation of women with preeclampsia is due to a factor(s) in plasma/serum which increases neutrophil locomotion.

Methods: The locomotory responses of human neutrophils to plasma/serum of women with preeclampsia were compared with normal, pregnant women matched for maternal age and gestational age at blood sampling. Twelve patients from each group were studied. Preeclampsia was defined as persistent diastolic blood pressure > 90 mm Hg, with proteinuria > 0.3 g/24 h, in patients who were normotensive before 20 weeks gestation. A simple microcomputer-based system for real-time, analysis of neutrophil behavior in vitro was used to measure the dynamic parameters of locomotion. Locomotion of human neutrophils in response to plasma, serum (20%), and heat-inactivated serum from both groups of patients was measured. Serum was heat inactivated to destroy complement-derived chemotactic activity.

Main Outcome Measures: Speed, persistence, and diffusion coefficient to describe the behavior of randomly moving cells.

Results: A significant stimulation of neutrophil locomotion in response to plasma, serum (20%), and heat-inactivated serum occurred in both groups compared with control cells incubated with phosphate-buffered saline; however, no significant differences were found in response to these three stimuli between the two groups of patients.

Conclusions: These studies found no evidence of a humoral factor in the plasma/serum of women with preeclampsia which alters the locomotion of human neutrophils. The existence of such a potential factor may be revealed, however, upon examination of subsequent stages of neutrophil activation, namely adhesion to endothelial cells and/or neutrophil metabolic activation.     

The effect of calcium supplementation on blood pressure in non-pregnant women with previous pre-eclampsia: An exploratory,randomized placebo controlled study

BackgroundEpidemiological findings suggest that the link between poverty and pre-eclampsia might be dietary calcium deficiency. Calcium supplementation has been associated with a modest reduction in pre-eclampsia, and also in blood pressure (BP).MethodsThis exploratory sub-study of the WHO Calcium and Pre-eclampsia (CAP) trial aims to determine the effect of 500 mg/day elemental calcium on the blood pressure of non-pregnant women with previous pre-eclampsia. Non-pregnant women with at least one subsequent follow-up trial visit at approximately 12 or 24 weeks after randomization were included.ResultsOf 836 women randomized by 9 September 2014, 1st visit data were available in 367 women of whom 217 had previously had severe pre-eclampsia, 2nd visit data were available in 201 women. There was an overall trend to reduced BP in the calcium supplementation group (1–2.5 mmHg) although differences were small and not statistically significant. In the subgroup with previous severe pre-eclampsia, the mean diastolic BP change in the calcium group (−2.6 mmHg) was statistically larger than in the placebo group (+0.8 mmHg), (mean difference −3.4, 95% CI −0.4 to −6.4; p = 0.025). The effect of calcium on diastolic BP at 12 weeks was greater than in those with non-severe pre-eclampsia (p = 0.020, ANOVA analysis).ConclusionsThere is an overall trend to reduced BP but only statistically significant in the diastolic BP of women with previous severe pre-eclampsia. This is consistent with our hypothesis that this group is more sensitive to calcium supplementation, however results need to be interpreted with caution.