Plasma From Women with Preeclampsia Has a Low Lipid and Ketone Body Content—A Nuclear Magnetic Resonance Study

Objective: Using ¹H-nuclear magnetic resonance spectroscopy and chemometrics, we sought to establish the metabolic profile for preeclampsia and to identify biomarkers that would permit a distinction between women with a normal pregnancy and those suffering from preeclampsia. Methods: Plasma samples from 11 normotensive pregnant women and 11 women with preeclampsia were analyzed. Principal component analysis was applied to differentiate between the two groups of patients. Results: Lipid concentrations were found to be significantly lower in the plasma of patients suffering from preeclampsia than those in normotensive pregnant women (p = 0.031). There is also evidence to suggest that ketone body constituents may contribute to the discrimination. Conclusion: ¹H-nuclear magnetic resonance-based metabolic profiling can detect patients with preeclampsia.     

PPARγ、MMP-9在子痫前期合并代谢综合征的表达

目的:探讨过氧化物酶体增殖物受体γ(PPARγ)、基质金属蛋白酶-9(MMP-9)与子痫前期发病的关系。方法:用免疫组织化学法检测20例正常妊娠组、20例重度子痫前期不合并代谢综合征组和20例重度子痫前期合并代谢综合征组患者胎盘组织中PPARγ、MMP-9的表达。结果:(1)重度子痫前期组MMP-9阳性表达明显弱于正常组(P<0.05);(2)重度子痫前期组PPARγ表达明显弱于正常组(P<0.05),而重度子痫前期合并代谢综合征组PPARγ表达弱于重度子痫前期不合并代谢综合征组(P<0.05);(3)重度子痫前期合并代谢综合征组PPARγ和MMP-9表达呈正相关(r=1.0,P>0.01)。结论:重度子痫前期患者MMP-9、PPARγ表达下降,提示MMP-9、PPARγ可能与子痫前期发生密切相关。     

Ultrastructural changes in omental resistance artery in women with preeclampsia

OBJECTIVE: The reduced function that is played by the endothelium has been suggested in the pathophysiologic condition of resistance arteries during preeclampsia. Our aim was to determine whether morphologic changes occur in these arteries in patients with preeclampsia. STUDY DESIGN: The omental resistance arteries were isolated from 11 women with preeclampsia and 10 normotensive pregnant women; the preparations were analyzed by light and electron microscopy. RESULTS: On light microscopic examination, no differences were apparent between both groups of women in cross-sectional preparations of the omental resistance arteries. However, after electron microscopic examination, characteristic changes were found in the subendothelial region of the resistance arteries from women with preeclampsia compared with specimens from normotensive pregnant women. The thickness of elastic lamina was irregular, and the basement membrane was, in part, incomplete. Thus, the arrangement of the location of endothelial cells was changed in the resistance arteries that were taken from women with preeclampsia. CONCLUSION: These results indicate that ultrastructural changes develop in the subendothelial region of omental resistance arteries in women with preeclampsia.     

Relationship of systemic hemodynamics, left ventricular structure and function, and plasma natriuretic peptide concentrations during pregnancy complicated by preeclampsia

OBJECTIVE: This study was done to evaluate left ventricular structure and function among pregnant patients with preeclampsia and compare them with those of normotensive pregnant and nonpregnant subjects. It also tested the hypothesis that abnormalities in left ventricular structure and function are associated with elevated plasma levels of natriuretic peptides. STUDY DESIGN: The study compared 75 pregnant women (n = 40 with preeclampsia; n = 35 normotensive pregnant women) and 10 nonpregnant normotensive control subjects undergoing an echocardiographic and biohumoral (renin activity and aldosterone, atrial natriuretic peptide, and brain natriuretic peptide concentrations) evaluation. The statistical analysis was carried out by analysis of variance, and significance was set at P <.05. RESULTS: Comparison of pregnant patients with preeclampsia versus both normotensive pregnant women and nonpregnant women showed significant increases in left ventricular mass and left ventricular endsystolic and end-diastolic volumes and significant reductions in left ventricular ejection fraction and percentage of fractional shortening. These changes coincided with increases in plasma levels of atrial natriuretic peptide and brain natriuretic peptide that were linearly related to the left ventricular structural and functional changes observed in patients with preeclampsia. CONCLUSION: Pregnant patients with preeclampsia showed adaptation to the increase in systemic blood pressure, with significant modification of left ventricular structure and function related to the plasma levels of both atrial natriuretic peptide and brain natriuretic peptide. A simple evaluation of plasma natriuretic peptide concentrations could help to discriminate patients with preeclampsia who have a condition of mild left ventricular overload.     

Serum leptin levels and the severity of preeclampsia

The aim of this study was to evaluate the serum leptin levels in preeclampsia patients and in normotensive pregnant women, as well as, to assess an association with the severity of the disease. A cross-sectional study was carried out in 14 patients with mild preeclampsia, 12 with severe preeclampsia, and in 32 normotensive pregnant women during the third trimester of pregnancy. Rigorous criteria of selection were considered. The leptin levels were tested by an enzyme-linked immunosorbent method. There were no significant differences in serum leptin concentrations between the patients with mild preeclampsia [13.6±11.2 (95% CI, 7.7–19.4) ng/mL], severe preeclampsia [14.8±11.5 (95% CI, 8.2–21.3) ng/mL] and normotensive pregnant women [12.5±7.9 (95% CI, 9.7–15.2) ng/mL]. In conclusion, serum leptin levels were similar in the patients with different grades of preeclampsia and normotensive pregnant women. Received: 30 November 1999 / Accepted: 16 March 2000     

Maternal plasma level of thrombomodulin is increased in mild preeclampsia

The purpose of this study was to determine if plasma thrombomodulin levels, a glycoprotein found on the surface of the endothelial cell, are elevated in pregnant women with mild preeclampsia and if these levels correlated with other features of disease severity. Parameters were compared in three groups of women: (I) 30 pregnant women with mild preeclampsia, (II) 30 normotensive pregnant women of similar lengths of gestation, and (III) 30 normotensive healthy young women. Thrombomodulin levels were significantly elevated in women with preeclampsia as compared with those of gestation-matched pregnant and non-pregnant controls. There was no correlation between plasma thrombomodulin levels and creatinine and uric acid blood levels. It is thus suggested that plasma thrombomodulin levels are elevated in preeclampsia, even in its mild stage, reflecting a vascular endothelial damage.     

Maternal circulating nitrite levels are decreased in both normal normotensive pregnancies and pregnancies with preeclampsia.

OBJECTIVE: To evaluate whether maternal nitric oxide synthesis in pregnancies with preeclampsia is different from that in normal normotensive pregnancies. MATERIALS: Maternal circulating combined nitrate and nitrite levels or nitrite level were compared between 10 normotensive nonpregnant women, 30 normotensive pregnant women (10 first-trimester, 10 second-trimester, and 10 third-trimester pregnancies), 20 normotensive postpartum women (10 at 1 week after delivery, and 10 at 4 weeks after delivery), and 13 preeclamptic women (32 to 40 weeks' gestation). End-products of nitric oxide synthesis were measured from maternal venous blood samples using a fluorometric assay. RESULTS: Maternal circulating nitrite levels in nonpregnant women (1.13 +/- 0.22 microM) were significantly higher than those in the first-trimester pregnant women (0.68 +/- 0.13 microM), second-trimester pregnant women (0.65 +/- 0.13 microM), third-trimester pregnant women (0.48 +/- 0.17 microM), first puerperal week women (0.36 +/- 0.16 microM), and fourth puerperal week women (0.67 +/- 0.17 microM), respectively (p < 0.05). Maternal circulating nitrite level was decreased with advancing gestation, still remained low just after delivery, and was increased 4 weeks later. There was no significant difference in maternal circulating nitrite level between preeclamptic women (0.40 +/- 0.17 microM) and third-trimester pregnant women (0.48 +/- 0.17 microM). However, there were no significant differences in maternal circulating combined nitrate and nitrite levels among the groups. CONCLUSION: These results suggest that the maternal nitric oxide synthesis is not changed in normal normotensive pregnancies and pregnancies with preeclampsia. However, plasma nitrite level, which has stronger spasmolytic activity than the activity of the nitrate, was decreased in both normal normotensive pregnancies and pregnancies with preeclampsia.     

Failure of serum beta2-microglobulin levels as an early marker of preeclampsia

OBJECTIVE: Our purpose was to determine whether second-trimester maternal serum beta(2)-microglobulin levels could be used to predict subsequent development of preeclampsia. STUDY DESIGN: We first did a cross-sectional study to compare serum concentrations of beta(2)-microglobulin between women with preeclampsia and normotensive women. Serum beta(2)-microglobulin concentrations of 11 consecutive patients hospitalized for preeclampsia were compared with those of 11 normotensive women hospitalized for threatened premature labor. The second part of the study consisted of a nested case-control study in which each woman in whom preeclampsia ultimately developed was matched with 2 women who remained normotensive throughout gestation. For that purpose a total of 450 consecutive healthy nulliparous women were studied prospectively. Blood samples were collected between 20 and 24.9 weeks' gestation and frozen at -20 degrees C until assay after groups had been selected. RESULTS: In the cross-sectional study serum beta(2)-microglobulin levels were significantly higher in women with preeclampsia than in control women (1.87 +/- 0.36 mg/L vs 1.01 +/- 0. 12 mg/L; t = 7.61; P <.0001). Among the 450 women who were followed up prospectively, preeclampsia developed in 7 (1.5 %). Fourteen of the women who remained normotensive were matched with the 7 women in whom preeclampsia ultimately developed. No difference was found in early serum beta(2)-microglobulin concentrations between women in whom preeclampsia subsequently developed and those who remained normotensive throughout gestation (1.02 +/- 0.12 vs 0.95 +/- 0.12 mg/L). CONCLUSIONS: Serum beta(2)-microglobulin levels do not predict subsequent preeclampsia.     

Investigation of adhesion molecules (sVCAM-1) in serum of nonpregnant women, normotensive pregnant women and in patients with pregnancy complications]

OBJECTIVE: An increased expression of endothelial adhesion molecules combined with neutrophil activation in the placental bed is to be assumed aetiopathogenetically relevant in preeclampsia. MATERIAL AND METHODS: Ranges of sVCAM-1 serum concentrations of both control persons (29 nonpregnant and 25 normotensive pregnant women) and patients with different complications of pregnancy (HELLP-syndrome n = 10, preeclampsia n = 12, gestational hypertension n = 38, diabetes n = 24, growth retardation n = 21) were determined by means of ELISA. Frozen placental samples of 5 normotensive and 10 hypertensive pregnant women were investigated immunhistochemically to study the distribution of VCAM-1 in the placenta. RESULTS: Significantly elevated sVCAM-1 serum levels (p < 0.05) were identified in samples of patients with HELLP syndrome, preeclampsia, diabetes and gestational hypertension compared with serum levels of normotensive pregnant women. The cut-off level (97.5% percentile of normotensive serum levels) was calculated (775 ng/ml). VCAM-1 was localized immunhistochemically at capillaries of villi and main villi. CONCLUSIONS: There are closed relations between elevated serum levels of sVCAM-1 during pregnancy and diseases with vasculopathies of placental bed.     

Different levels of platelet activation in preeclamptic, normotensive pregnant, and nonpregnant women

OBJECTIVE: The aims of our study were to determine the basal platelet activation state in women with preeclampsia compared with normotensive pregnant women and nonpregnant women and to investigate the platelet reactivity on in vitro stimulation with adenosine diphosphate or thrombin receptor activation peptide. STUDY DESIGN: Platelet expression of CD61 (fibrinogen receptor), CD42a (von Willebrand factor receptor), CD62P (P-selectin), CD63 (Glycoprotein 53), and PAC-1 binding (activated fibrinogen receptor) were determined in 20 pairs of women with preeclampsia/normotensive pregnant women and in 12 nonpregnant women, with the use of flow cytometry. RESULTS: Basal platelet expression of CD61, CD42a and CD62P, and adenosine diphosphate-stimulated CD62P expression were increased in women with preeclampsia compared with normotensive pregnant women. Platelets from women with preeclampsia and normotensive pregnant women differed from platelets from nonpregnant women by expressing higher basal CD63 levels and being more responsive to in vitro agonist stimulation, which was demonstrated by increased expression of CD61, CD62P, and CD63. CONCLUSION: This study supports the notion that platelets are important in the pathophysiologic condition of preeclampsia.     

Bradykinin-mediated relaxation of isolated maternal resistance arteries in normal pregnancy and preeclampsia

OBJECTIVE: The aim of the study was to investigate bradykinin-mediated vasodilator function in small arteries from normotensive pregnant and nonpregnant women and from women with preeclampsia. STUDY DESIGN: Small subcutaneous arteries (approximately 250 μm luminal diameter) were dissected from biopsy specimens obtained at cesarean section from 24 normotensive pregnant women and 6 women with preeclampsia and during abdominal surgery in 15 nonpregnant women. Vascular function was assessed after arteries were mounted on a small vessel myograph. RESULTS: Preconstricted arteries from normotensive pregnant women demonstrated enhanced relaxation to bradykinin compared with those from nonpregnant women (p < 0.05), whereas arteries from women with preeclampsia showed blunted responses compared with those from normotensive pregnant women (p < 0.01). Relaxation in all groups was attenuated in the presence of the nitric oxide synthase inhibitor N^ω-nitro-l-arginine so that it became similar in the three groups. Indomethacin had a small but significant inhibitory effect on bradykinin-induced relaxation, but this component of relaxation was no different among groups. Sensitivity of arteries to norepinephrine and sodium nitroprusside showed no significant differences in the three groups of women. CONCLUSION: This study provides evidence for an increase in bradykinin-mediated nitric oxide synthesis from the vascular endothelium of small arteries from the peripheral circulation of normotensive pregnant women and a relative reduction in women with preeclampsia. In turn, these changes may contribute to vasodilation in normal pregnancy and elevation of the blood pressure in preeclampsia. (Am J Obstet Gynecol 1996;175:1668-74.)     

Elevated circulating concentrations of platelet activating factor in preeclampsia

OBJECTIVE: The aim of this study was to determine whether any association exists between preeclampsia and circulating platelet activating factor levels. STUDY DESIGN: We performed a cross-sectional observational study of circulating platelet activating factor concentrations in nonpregnant women, normotensive pregnant women in the third trimester, women with preeclampsia in the third trimester, and normotensive men. Platelet activating factor concentrations were measured with a commercially available platelet activating factor-specific radioimmunoassay (NEN Life Science Products, Inc, Boston, Mass). The primary outcome measure was the difference in mean platelet activating factor concentrations among the 4 study groups. Preeclampsia was determined according to the criteria of The American College of Obstetricians and Gynecologists. Data were analyzed with the Student t test, the chi(2) test, the Fisher exact test, analysis of variance, and the Tukey test for pairwise multiple comparisons, with significance established at P <.05. RESULTS: The mean (+/-SD) circulating concentration of platelet activating factor was significantly higher in the group with preeclampsia (338.1 +/- 26.9 ng/mL) than in either the normotensive pregnant group (217.9 +/- 25.9 ng/mL; P <.05) or the nonpregnant female group (237.9 +/- 20.9 ng/mL; P <.05). The 2 pregnant groups were similar with respect to selected demographic characteristics and gestational age at time of collection. There were no significant differences in the mean platelet activating factor concentrations between the group with preeclampsia and the normotensive male group or between the normotensive pregnant female group and the nonpregnant female group. CONCLUSION: Circulating platelet activating factor concentrations were increased in women with pregnancies complicated by preeclampsia with respect to those in normotensive pregnant women and normotensive nonpregnant women. Platelet activating factor may therefore serve as a marker for the risk of preeclampsia.     

Platelet aggregation and TGF-beta(1) plasma levels in pregnant women with preeclampsia

OBJECTIVES: Platelets and transforming growth factor-beta(1) (TGF-beta(1)) are thought to be involved in the pathogenesis of preeclampsia. Our objectives were to determine plasma concentration of TGF-beta(1) in normotensive and preeclamptic women in the third trimester of pregnancy and to evaluate the correlation of TGF-beta(1) plasma levels with platelet count and agonist-induced aggregation capacity. METHODS: Thirty-three women with preeclampsia were compared with 36 healthy women with uncomplicated pregnancies. Peripheral venous blood samples were obtained, and TGF-beta(1) plasma levels measured by an enzyme-linked immunoassay. Platelet aggregation was induced by the agonist agents adenosine diphosphate (ADP), collagen and epinephrine, and was determined in platelet-rich plasma by aggregometry. RESULTS: Plasma concentrations of active TGF-beta(1) were significantly higher in preeclamptic women (10.41+/-2.07ng/mL) compared with normotensive pregnant women (7.01+/-3.29ng/mL). Platelet number and platelet agonist-induced aggregation percent were significantly lower in patients with preeclampsia than in healthy pregnant women. A significant correlation was observed between TGF-beta(1) plasma levels and platelet agonist-induced aggregation percent as between plasma levels of TGF-beta(1) and platelet number in preeclamptic patients. CONCLUSION: The association between impairment in platelet responsiveness and higher levels of TGF-beta(1) in the plasma of patients with preeclampsia suggests that this cytokine may play a role in the pathophysiological events of preeclampsia that are dependent on platelet activation.     

Relation between plasma endothelin 1 levels and T helper 1: T helper 2 cell immunity in women with preeclampsia.

The aim of this study was to investigate the relationship between plasma endothelin 1 (ET-1) levels and T helper (Th)-1:Th2 cell immunity in women with preeclampsia. The percentage of Th1 and Th2 cells and the Th1:Th2 cell ratios in peripheral blood from 11 normal pregnant women and 11 patients with preeclampsia at 29-34 weeks of gestation were calculated using flow cytometry. The plasma ET-1 level was also determined using a modified radioimmunoassay. The plasma ET-1 concentrations and the Th1:Th2 cell ratios in normal pregnancies were significantly lower than those in patients with preeclampsia. Negative correlations were found between plasma ET-1 levels and Th2 cells in both the preeclamptic pregnancy groups and in the normal pregnant women. Our results indicate that elevated ET-1 levels are associated with a Th1:Th2 imbalance in preeclampsia.     

Cerebrospinal fluid leptin levels in preeclampsia: relation to maternal serum leptin levels

BACKGROUND: To determine whether cerebrospinal fluid (CSF) and circulating levels of leptin differ between women with preeclampsia and women who had an uncomplicated pregnancy. METHODS: Maternal serum and CSF leptin concentrations obtained in the third trimester of the gestation were compared in 16 women with mild preeclampsia and 23 normotensive pregnant women who underwent cesarean section. Before administering local anesthetic for spinal anesthesia, 2 mL CSF and 4 mL venous blood sample were taken and were stored at -30 degrees C until serum and CSF leptin levels were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Mean CSF leptin concentrations were not significantly different between the two groups (preeclampsia 9.7 +/- 4.2 ng/mL, normotensive 13.6 +/- 4.3 ng/mL, p = 0.952). Similarly, mean serum leptin concentrations were similar between the two groups (mild preeclampsia 21.7 +/- 7.1 ng/mL, normotensive 18.3 +/- 6.7 ng/mL, p = 0.698). CSF leptin levels are inversely related to the serum leptin concentrations in preeclamptic patients (r = -0.87, p = 0.000). An inverse relationship was also detected between CSF and serum leptin levels in normotensive pregnant subjects (r = -0.66, p = 0.000). CONCLUSIONS: CSF and serum leptin levels were similar in patients with preeclampsia and normotensive pregnant women. However, the CSF leptin was negatively correlated with the serum leptin concentrations in preeclamptic and normotensive control subjects, suggesting that leptin enters the brain by a saturable transport system. Further work is needed to confirm our findings.     

Anticardiolipin antibodies and the severity of preeclampsia-eclampsia.

OBJECTIVE: To identify and compare anticardiolipin antibodies (aCL) in patients with eclampsia, different grades of preeclampsia and women with normotensive pregnancy. METHODS: A cross-sectional study was conducted in 13 patients with eclampsia, 39 with preeclampsia (13 severe, 26 mild), and 52 normotensive pregnant women. All of them were studied in the 3rd trimester of pregnancy. The aCL were determined by an ELISA method. RESULTS: There were no significant differences in IgG aCL (F = 0.33, p = 0.80) and IgM aCL (F = 1.64, p = 0.18) between patients with eclampsia (6.9 +/- 3.9 U/GPL and 4.0 +/- 2.0 U/MPL), severe preeclampsia (5.7 +/- 3.5 U/GPL and 2.9 +/- 1. 3 U/MPL), mild preeclampsia (6.8 +/- 3.9 U/GPL and 2.8 +/- 1.0 U/MPL) and normotensive pregnant women (6.4 +/- 3.4 U/GPL and 3.0 +/- 1.8 U/MPL). None of the values of the aCL were considered as positive. CONCLUSION: Serum aCL levels were similar in patients with different grades of preeclampsia-eclampsia and women with normotensive pregnancy.     

Increased concentrations of plasma neuropeptide Y in patients with eclampsia and preeclampsia

OBJECTIVE: Epinephrine and norepinephrine are associated with the hyperstimulation of the sympathetic nervous system. Neuropeptide Y is a potent vasoconstrictive substance that is released in response to sympathetic nerve stimulation. STUDY DESIGN: The concentrations of plasma neuropeptide Y in pregnant patients with eclampsia (n = 8), preeclampsia (n = 8), and normotension (n = 8) were measured by radioimmunoassay on admission and 6 days after delivery. Correlations between plasma concentration of neuropeptide Y and mean arterial blood pressure were also evaluated in these patients on admission and 6 days after delivery. RESULTS: The plasma level of neuropeptide Y in women with eclampsia (P <.001) and preeclampsia (P <.003) was found to be significantly elevated with respect to that in normotensive pregnant women. At 6 days after delivery the concentration of plasma neuropeptide Y was significantly decreased in women with eclampsia, women with preeclampsia, and women with normotensive pregnancies compared with the value measured on admission (P <.0001, P <.0001, and P <.002, respectively). At admission the plasma neuropeptide Y level was positively correlated with mean arterial blood pressure in women with eclampsia and preeclampsia. However, no significant correlations were observed between plasma neuropeptide Y concentration and mean arterial blood pressure both at admission and 6 days after delivery in normotensive pregnant women and 6 days after delivery in women with eclampsia and preeclampsia. CONCLUSION: We have concluded that the level of neuropeptide Y in plasma is increased in women with eclampsia and preeclampsia. Elevated plasma neuropeptide Y levels may play a key role in the development of eclampsia and preeclampsia.     

Anticardiolipin and anti-beta2-glycoprotein-I antibodies in preeclampsia

OBJECTIVE: To estimate whether antiphospholipid antibodies, specifically anticardiolipin and anti-beta(2)-glycoprotein-I antibodies, are associated with preeclampsia. METHODS: Plasma was prospectively obtained from four groups of pregnant women: those with 1) mild preeclampsia (n = 109); 2) severe preeclampsia (n = 134); 3) hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome (n = 57); and 4) normotensive controls (n = 100). Anticardiolipin and anti-beta(2)-glycoprotein-I levels were determined by enzyme-linked immunoassay. RESULTS: Subjects with mild preeclampsia, severe preeclampsia, and HELLP syndrome did not have significantly elevated levels of immunoglobulin G (IgG) and IgM anticardiolipin and anti-beta(2)-glycoprotein-I antibodies compared with normotensive controls (P >.05, Kruskal-Wallis). Similarly, subjects with mild preeclampsia, severe preeclampsia, and HELLP syndrome did not have a significantly higher proportion of women testing positive for each autoantibody compared with normotensive controls (chi(2)). The proportion of patients testing positive for anticardiolipin and anti-beta(2)-glycoprotein-I antibodies were similar in patients with preeclampsia developing before and after 34 weeks' gestation (chi(2)). CONCLUSION: Circulating levels of both anticardiolipin and anti-beta(2)-glycoprotein-I antibodies were not increased in patients with mild preeclampsia, severe preeclampsia, or HELLP syndrome compared with normotensive controls. Our data do not support routine testing for anticardiolipin and anti-beta(2)-glycoprotein-I antibodies in women with preeclampsia.     

Increased cerebral blood flow in preeclampsia with magnetic resonance imaging

OBJECTIVE: The purpose of this study was to compare third trimester and nonpregnant cerebral blood flow of women with preeclampsia to normotensive control subjects with the use of magnetic resonance imaging techniques. STUDY DESIGN: Nine normotensive pregnant women and 12 untreated women with preeclampsia underwent velocity-encoded phase contrast magnetic resonance imaging of the bilateral middle and posterior cerebral arteries in the third trimester and at 6 to 8 weeks after delivery. The Student t test was used for comparison, with a probability value of <.05 considered significant. RESULTS: Third-trimester large cerebral artery blood flow was significantly higher in preeclampsia. Mean vessel diameter was unchanged, except for the left posterior cerebral artery. There was no difference in mean vessel diameter or cerebral blood flow between the 2 groups while the women were not pregnant. CONCLUSION: Cerebral blood flow is increased significantly in preeclampsia. We hypothesize that increased cerebral blood flow ultimately could lead to eclampsia through hyperperfusion and the development of vasogenic edema.     

Plasma, urinary, and salivary 8-epi-prostaglandin f2alpha levels in normotensive and preeclamptic pregnancies

OBJECTIVE: Our purpose was to measure and compare plasma, urinary, and salivary concentrations of 8-epi-prostaglandin F(2alpha) (8-isoprostane) in women with normotensive pregnancies and the respective concentrations in pregnancies complicated by preeclampsia. STUDY DESIGN: Plasma, urinary, and salivary 8-isoprostane levels were measured in pregnant women with preeclampsia (n = 40), normotensive pregnant women (n = 20), and nonpregnant women (n = 10). One-way analysis of variance was used to determine significant differences. RESULTS: Plasma free 8-isoprostane concentrations were increased in women with severe preeclampsia (342 +/- 50 pg/mL), in comparison with nonpregnant women (129 +/- 17 pg/mL) and normotensive pregnant women (150 +/- 11 pg/mL; P =.003, and.0001, respectively). Urinary excretion of 8-isoprostane was slightly but not significantly decreased in preeclampsia (1200 +/- 227 pg/mL), in comparison with urinary excretion in nonpregnant women (1625 +/- 364 pg/mL) and normotensive pregnant women (2149 +/- 432 pg/mL). Salivary concentrations of 8-isoprostane were increased in normotensive women (496 +/- 113 pg/mL), in comparison with nonpregnant women (150 +/- 27 pg/mL) but were not related to preeclampsia (419 +/- 96 pg/mL; P 相似文献