Serum activin A, inhibin A, and follistatin concentrations in preeclampsia or small for gestational age pregnancies

OBJECTIVE: To determine whether maternal serum activin A, inhibin A, and follistatin concentrations in idiopathic small for gestational age (SGA) pregnancies are similar to those in normal pregnancies or elevated as in preeclampsia. METHODS: Maternal serum activin A, inhibin A, and follistatin concentrations were determined in 1) nulliparous women with idiopathic SGA (birth weight <10th percentile; n = 18), preeclampsia (systolic blood pressure > or =140 mmHg or diastolic blood pressure > or =90 mmHg plus proteinuria > or =2+ or >0.3 g/24h; n = 22), and normotensive controls, matched for gestational age at sampling (n = 22), and 2) a longitudinal series of samples collected at five intervals throughout pregnancy from nulliparous women with idiopathic SGA (n = 19), preeclampsia (n = 22), preeclampsia plus SGA (n = 15), or who had uncomplicated pregnancies (n = 20). RESULTS: Serum concentrations of activin A and inhibin A were similar in idiopathic SGA pregnancies to controls. In preeclampsia, activin A and inhibin A levels were markedly increased compared with controls or women with idiopathic SGA (P <.001), particularly in those with early-onset disease. Follistatin concentrations were only modestly (相似文献   

Serum hyaluronic acid levels during pregnancy and labor

OBJECTIVE: To study the changes in concentrations of serum hyaluronic acid in uncomplicated human pregnancies. METHODS: We determined the concentrations of serum hyaluronic acid, using a specific enzyme-linked immunosorbent assay, in 70 nonpregnant women, 250 women during their pregnancies, and 68 women at the time of parturition. Results were analyzed for statistical significance with Scheffé test for multiple comparisons. RESULTS: During pregnancy, mean (+/- standard deviation) serum hyaluronic acid levels were 11.4 +/- 4.5, 13.6 +/- 2.8, 20.6 +/- 1.5, and 46.9 +/- 7.9 ng/mL at 5-14 (n = 47), 15-26 (n = 46), 27-37 (n = 58), and 38-40 (n = 99) weeks' gestation, respectively. Pregnant women in labor (n = 68) had significantly higher levels (100.4 +/- 11.3 ng/mL) than did women at term but not in labor (P < .01). CONCLUSION: Maternal serum hyaluronic acid concentrations increase as pregnancy progresses and serum levels increase significantly at term. Hyaluronic acid may be associated with cervical ripening during parturition.     

Circulating and placental endoglin concentrations in pregnancies complicated by intrauterine growth restriction and preeclampsia

Inadequate trophoblast invasion and spiral artery remodeling leading to poor placental perfusion and hypoxia are believed to underlie preeclampsia (PE) and intrauterine growth restriction (IUGR). Recent studies implicate increased circulating endoglin as a contributor to the pathogenesis of PE. The objective of this study was to determine whether placental and circulating endoglin concentrations are altered in pregnancies complicated by intrauterine growth restricted (IUGR) infants and to address the role of hypoxia on the regulation of placental endoglin. We analyzed 10 placentas each from normal pregnant (NP), PE, and IUGR subjects. Endoglin levels were 2.5-fold higher in preeclamptic placentas compared to NP (15.4+/-2.6 versus 5.7+/-1.0, p<0.01). In contrast, endoglin levels were similar in NP and IUGR placentas (5.7+/-1.0 vs 5.9+/-1.1, p=NS). Placentas from pregnancies with both PE and IUGR exhibited endoglin levels comparable to the PE group and significantly different from normotensive pregnancies with and without IUGR pregnancies (mean 14.9+/-4.0, n=9, p=0.013). Soluble endoglin concentrations in maternal plasma were comparable in NP and IUGR, but higher in women with PE (n=10 per group, p<0.05). Despite a 2-fold increase in hypoxia inducible factor, HIF-1alpha, we did not observe endoglin upregulation in NP, PE, or IUGR placental villous explants exposed to hypoxia (2% oxygen). In contrast to PE, placental or circulating endoglin is not increased in normotensive women delivering small, asymmetrically grown (IUGR) infants at term. The placentas of women with IUGR appear to be fundamentally different from PE women with respect to endoglin, despite the proposed common pathology of deficient trophoblast invasion/spiral artery remodeling and poor placental perfusion.     

Body composition of patients with hypertensive complications during pregnancy.

OBJECTIVE: To determine the body composition of women with the diagnoses of gestational hypertension or preeclampsia. METHODS: Cross-sectional study, including four groups of patients who were in the third trimester: those with an uncomplicated pregnancy (n = 110), those with a diagnosis of gestational hypertension (n = 38), those with mild preeclampsia (n = 8), and those with severe preeclampsia (n = 11). Their fat mass, fat-free mass, and total body water were estimated by bioelectric impedance. RESULTS: The fat mass was 20 +/- 7 kg in the control group and 26 +/- 13 kg in the group with gestational hypertension (p < 0.05). The total body water was 36 +/- 6 L in the control group, 50 +/- 10 L in the patients with gestational hypertension, 52 +/- 10 L in those with mild preeclampsia, and 48 +/- 9 L in those with severe preeclampsia (p < 0.05). CONCLUSION: The results suggest that maternal body composition shows significant differences in patients with hypertensive complications during pregnancy. These data may be related to a possible inadequate distribution of the volume of water as a result of alterations in capillary permeability.     

Levels of asymmetric dimethylarginine throughout normal pregnancy and in pregnancies complicated with preeclampsia or had a small for gestational age baby

Objective: The aim of this study was to investigate maternal asymmetric dimethylarginine (ADMA) concentrations at the three trimesters of pregnancy in uncomplicated pregnancies and in women who developed preeclampsia or had small for gestational age infants (SGA) without preeclampsia. Methods: ADMA concentrations were retrospectively determined in the first, second and third trimester of pregnancy in 41 uncomplicated pregnancies, 10 pregnancies complicated with preeclampsia and 14 pregnancies that delivered a SGA baby. ADMA was measured with an ELISA kit. Results: Mean (±SD) concentrations of ADMA (µmol/L) in uncomplicated l pregnancies were: 0.51?±?0.14; 0.52?±?0.13; 0.58?±?0.16 in the three trimesters, respectively. ADMA concentrations in SGA pregnancies were significantly lower in each trimester compared to uncomplicated pregnancies: (0.40?±?0.10, p?=?0.005 1st trim; 0.42?±?0.10, p?=?0.007 2nd trim; 0.45?±?0.10, p?=?0.007 3rd trim). Although pregnancies that developed preeclampsia had higher ADMA concentration in all trimesters compared to uncomplicated pregnancies (0.58?±?0.10; 0.63?±?0.14; 0.68?±?0.11), the difference was statistically significant only in the 2nd trimester (p?=?0.02). Conclusions: Maternal serum ADMA concentration tends to increase during normal pregnancy. Pregnancies with SGA infants had significantly lower ADMA levels in all trimesters of pregnancy. ADMA concentrations in the 2nd trimester was significantly elevated in pregnancies that later developed preeclampsia.     

Maternal plasma homocysteine concentrations are not increased in twin pregnancies.

OBJECTIVE(S): We tested the hypothesis that twin pregnancies would lead to increased maternal plasma homocysteine. We further hypothesized that twin pregnancies complicated by preeclampsia would have increased plasma homocysteine compared to twin pregnancies without preeclampsia and normal singleton pregnancies. METHODS: Plasma was collected at delivery from 127 nulliparous subjects: 57 women with normal singleton pregnancies, 39 women with singleton and preeclampsia, 17 women with uncomplicated twin pregnancies, and 14 women with twins and preeclampsia. Subjects were group matched for prepregnancy body mass index (BMI) and race. Plasma homocysteine was analyzed by high pressure liquid chromatography (HPLC) with fluorescence detection, and plasma folic acid was measured by radio immunoassay (RIA). RESULTS: The mean plasma concentration of homocysteine was significantly increased in all women with preeclampsia (7.4+/-2.9 microM) compared to all normal pregnant women (5.9+/-2.1 microM, p=0.002). However, homocysteine was not significantly increased in all women with twins (6.7+/-2.1 microM) compared to all women with singleton pregnancies (6.5+/-2.7 microM, p=0.61). In addition, women with twins and preeclampsia did not have increased homocysteine (6.8+/-2.1 microM) compared to women with twins and normal pregnancy (6.7+/-2.1 microM, p=0.72). As expected, because of extra supplementation, plasma folic acid was significantly increased in women with twins (27.9+/-11.6 ng/mL) compared to women with singleton pregnancies (20.8+/-8.5 ng/mL, p=0.0003). However, folic acid was not different between preeclamptics and controls (23.5+/-10.8 vs. 21.9+/-9.2 ng/mL respectively, p=0.36). Lastly, there was a significant inverse correlation between homocysteine and folic acid among all the subjects (r2=- 0.053, p< 0.01), and this correlation persisted in the women with singleton pregnancies (r2=- 0.078, p< 0.01), but was lost in the twins (r2=- 0.073, p=0.14). CONCLUSIONS: With contemporary management including increased folic acid supplementation, plasma homocysteine is not increased in twin pregnancies with or without preeclampsia.     

Plasma placenta growth factor levels in midtrimester pregnancies

OBJECTIVE: Previous studies have shown decreased levels of placenta growth factor in serum of pregnant women with preeclampsia. The aim of this study was to investigate whether levels of placenta growth factor are decreased before the clinical onset of preeclampsia, and whether placenta growth factor levels are decreased in pregnancies complicated by intrauterine growth restriction. METHODS: From an ongoing longitudinal study, 101 plasma samples were collected from 72 pregnant women at weeks 11-21 of gestation. Placenta growth factor levels were determined retrospectively in plasma using an enzyme-linked immunosorbent assay. Correlations between plasma concentrations of placenta growth factor and pregnancy outcome were evaluated. RESULTS: Plasma samples of 72 patients were analyzed. Forty-four patients had no pregnancy complications, 18 developed preeclampsia, and 10 women had pregnancies complicated by intrauterine growth restriction. Between week 17 and week 21 of pregnancy, a significantly lower level of placenta growth factor was found in plasma of patients who later developed preeclampsia (n = 10), compared with control pregnancies (n = 25, P = .004). In women with a growth-restricted baby at birth (n = 5), levels of placenta growth factor were also low. CONCLUSIONS: Our results show that plasma placenta growth factor levels are decreased before preeclampsia is clinically evident. The data suggest that placenta growth factor may be useful to determine the relative risk of developing preeclampsia and intrauterine growth restriction.     

Recurrent preeclampsia and perinatal outcome: a study of women with recurrent preeclampsia compared with women with preeclampsia who remained normotensive during their prior pregnancies

OBJECTIVE: To evaluate the impact of preeclampsia recurrence on perinatal outcome. MATERIALS AND METHODS: A case-controlled study was performed in multiparous women who developed preeclampsia in index pregnancy (n = 64). Among these, women who had preeclampsia in previous pregnancies (n = 21) were compared to those who remained normotensive during their prior pregnancies (n = 43). Maternal and fetal variables were compared. Multivariate logistic analyses were performed to examine the impact of preeclampsia recurrence on fetal loss, preterm delivery, small for gestational age (SGA) occurrence and respiratory distress syndrome adjusted for confounding variables. RESULTS: No statistical significant difference was observed between the two groups in terms of age, delivery weeks, steroid use and laboratory markers. Fetal loss was higher in women with recurrent preeclampsia (19.0%) than in women with preeclampsia who had a normotensive pregnancy history (4.7%), with adjusted odds ratio (OR) of 5.77 [95% confidence interval (CI) 0.84-39.54]. CONCLUSION: Women with recurrent preeclampsia had a higher rate of perinatal loss compared to women with preeclampsia who were normotensive in their prior pregnancies.     

Plasma endothelin levels in preeclampsia: elevation and correlation with uric acid levels and renal impairment.

OBJECTIVE: The purpose of this study was to determine if endothelin levels are elevated in women with preeclampsia and if these levels correlated with other laboratory features of disease severity. STUDY DESIGN: Parameters were compared in four groups of women volunteers by means of analysis of variance: (1) 16 women with preeclamptic pregnancies, (2) 11 pregnant women without preeclampsia, of similar lengths of gestation, (3) six otherwise normal women with pregnancies at term or beyond (greater than 38 weeks), and (4) 22 normotensive young women. RESULTS: Endothelin levels were elevated in women with preeclampsia as compared with those of gestation-matched pregnant and nonpregnant controls (22.6 +/- 2.0 vs 12.0 +/- 1.0 vs 10.4 +/- 1.3 pmol/L, p less than 0.005, preeclampsia vs controls) and also were increased in late gestation (17.7 +/- 2.0 pmol/L). Endothelin correlated positively with plasma levels of uric acid (r = 0.698, p less than 0.005) and inversely with creatinine clearance (r = -0.659, p less than 0.05). CONCLUSION: Circulating endothelin levels are elevated in women with preeclampsia and correlate closely with serum uric acid levels and measures of renal dysfunction. These observations suggest that endothelin may contribute to renal vasoconstriction in preeclampsia.     

Low plasma levels of oxidized low density lipoprotein in preeclampsia

BACKGROUND: Markers of lipid peroxidation are commonly used to assess oxidative stress in preeclampsia. The aim of this study was to assess the concentration of oxidized low density lipoprotein (oxLDL), a novel marker for lipid peroxidation, and that of the thiobarbituric acid reactive substances (TBARS) in the pathogenesis of severe preeclampsia and to investigate the influence of gestational age on these parameters. METHOD: Plasma levels of oxLDL and TBARS were assayed in women with severe preeclampsia (n = 40), normotensive pregnant controls matched for gestational age (n = 24) and normotensive pregnant controls at full term (n = 16). RESULTS: Women with preeclampsia showed lower oxLDL levels (mean +/- SE) than matched controls (181 +/- 12 vs. 219 +/- 14; p = 0.027), whereas no differences were found for the TBARS concentration (3.8 +/- 0.6 vs. 3.7 +/- 0.4). When women with preeclampsia were compared to control women at full term, TBARS were elevated (3.8 +/- 0.6 vs. 1.5 +/- 0.2; p = 0.01). However, in women with normotensive pregnancy TBARS were also lower in full-term control pregnancy compared to early third-trimester values (p < 0.0001). CONCLUSION: Plasma TBARS decreased during the third trimester of pregnancy, underlining the importance of matching for gestational age when studying markers of lipid peroxidation in pregnant women. Women with preeclampsia had lower plasma levels of oxLDL compared to gestational age-matched controls, indicating that oxLDL could be a marker for preeclampsia.     

The frequency of acute atherosis in normal pregnancy and preterm labor,preeclampsia, small-for-gestational age,fetal death and midtrimester spontaneous abortion

Objective: Acute atherosis is characterized by subendothelial lipid-filled foam cells, fibrinoid necrosis and perivascular lymphocytic infiltration. This lesion is generally confined to non-transformed spiral arteries and is frequently observed in patients with preeclampsia. However, the frequency of acute atherosis in the great obstetrical syndromes is unknown. The purpose of this study was to determine the frequency and topographic distribution of acute atherosis in placentas and placental bed biopsy samples obtained from women with normal pregnancy and those affected by the “great obstetrical syndromes”. We also examined the relationship between acute atherosis and pregnancy outcome in patients with preeclampsia.

Material and methods: A retrospective cohort study of pregnant women who delivered between July 1998 and July 2014 at Hutzel Women’s Hospital/Detroit Medical Center was conducted to examine 16?345 placentas. Patients were classified into the following groups: (1) uncomplicated pregnancy; (2) spontaneous preterm labor (sPTL) and preterm prelabor rupture of membranes (PPROM); (3) preeclampsia; (4) gestational hypertension; (5) small-for-gestational age (SGA); (6) chronic hypertension; (5) fetal death; (6) spontaneous abortion and (7) others. A subset of patients had placental bed biopsy. The incidence of acute atherosis was compared among the different groups.

Results: (1) The prevalence of acute atherosis in uncomplicated pregnancies was 0.4% (29/6961) based upon examination of nearly 7000 placentas; (2) the frequency of acute atherosis was 10.2% (181/1779) in preeclampsia, 9% (26/292) in fetal death, 2.5% (3/120) in midtrimester spontaneous abortion, 1.7% (22/1,298) in SGA neonates and 1.2% (23/1,841) in sPTL and PPROM; (3) among patients with preeclampsia, those with acute atherosis than in those without the lesion had significantly more severe disease, earlier onset, and a greater frequency of SGA neonates (p?Conclusions: Acute atherosis is rare in normal pregnancy, and occurs more frequently in patients with pregnancy complications, including preeclampsia, sPTL, preterm PROM, midtrimester spontaneous abortion, fetal death and SGA.     

Reduction of the disintegrin and metalloprotease ADAM12 in preeclampsia

OBJECTIVES: The secreted form of ADAM12 is a metalloprotease that may be involved in placental and fetal growth. We examined whether the concentration of ADAM12 in first-trimester maternal serum could be used as a marker for preeclampsia. METHODS: We developed a semiautomated, time-resolved, immunofluorometric assay for the quantification of ADAM12 in serum. The assay detected ADAM12 in a range of 78-1248 microg/L. Serum samples derived from women in the first trimester of a normal pregnancy (n = 324) and from women who later developed preeclampsia during pregnancy (n = 160) were obtained from the First Trimester Copenhagen Study. ADAM12 levels were assayed in these serum samples. Serum levels of ADAM12 were converted to multiples of the median (MoM) after log-linear regression of concentration versus gestational age. RESULTS: Serum ADAM12 levels in women who developed preeclampsia during pregnancy had a mean log MoM of -0.066, which was significantly lower than the mean log MoM of -0.001 for ADAM12 levels observed in serum samples from women with normal pregnancy (P = .008). The mean log MoM was even lower in serum derived from preeclamptic women whose infant's weight at birth was less than 2,500 g (n = 27, mean log MoM of -0.120, P = .053). CONCLUSION: The maternal serum levels of ADAM12 are significantly lower during the first trimester in women who later develop preeclampsia during pregnancy when compared with levels in women with normal pregnancies. Because the secreted form of ADAM12 cleaves insulin-like growth factor binding protein (IGFBP)-3 and IGFBP-5, the IGF axis may play a role in preeclampsia. ADAM12 may be a useful early marker for preeclampsia. LEVEL OF EVIDENCE: II-2.     

A prospective study on the occurrence of autoantibodies in low-risk pregnancies

OBJECTIVE: This investigation was done to study the prevalence of anti-nuclear antibodies (ANA), anti-cardiolipin antibodies (aCL), and rheumatoid factor (RF), in presumed healthy women during their pregnancies. STUDY DESIGN: During an 18 month period blood samples were taken in the first, second and third trimester from 1200 pregnant women, representing a low-risk population. Clinical data on the pregnancy outcome were obtained by birth statistics after their deliveries. The diagnoses of preeclampsia, intrauterine growth retardation, fetal death, or abruptio placentae were stated in 57 of these women. An age- and parity-matched control group of 207 women with normal pregnancy outcome was drawn from the same low-risk population (n= 1200). A nonpregnant control group consisted of 157 women. The prevalence of ANA (immunofluorescence microscopy on HEp-2 cells), aCL-immunoglobulin G (enzyme-linked immunosorbent assay), and RF (latex agglutination test) in preeclampsia, intrauterine growth retardation, fetal death, or abruptio placentae were compared to the normal pregnancies, and to the nonpregnant controls. RESULTS: ANA occurred significantly more often (P<0.05) in pregnancies complicated by preeclampsia when compared to normal pregnancies. aCL occurred sparsely in normal as well as complicated pregnancies. RF was infrequently seen among all women in this study. CONCLUSION: An association was noted between the occurrence of ANA and preeclampsia. However, this association was too insensitive to use as a clinical tool.     

Maternal and perinatal outcome of preeclampsia with an onset before 24 weeks' gestation. Audit in a tertiary referral center

OBJECTIVE: Preeclampsia, with an onset before 24 weeks' gestation is a rare but severe condition in pregnancy with little data of maternal and perinatal outcome, particularly after expectant management. We therefore, evaluated pregnancy outcome in these women at our department where temporising management was introduced as the standard policy in early onset preeclampsia. STUDY DESIGN: We analysed retrospectively all consecutive women with preeclampsia, with an onset before 24 weeks' gestation, between 1 January 1993 and 31 December 2002 at a tertiary university referral center. RESULTS: Twenty-six pregnancies, of which two were twin pregnancies, resulted in 65% of the women in at least one major maternal complication: maternal death (n=1), HELLP syndrome (n=16), eclampsia (n=5) and pulmonary edema (n=4). Thirty percent of these women presented already with serious morbidity at admission. The median prolongation of the pregnancy was 24 days (range 3-46 days). The overall perinatal mortality was 82%: 19 fetal deaths and 4 neonatal deaths. CONCLUSION: Early onset preeclampsia, with an onset before 24 weeks' gestation, results in considerable maternal and perinatal morbidity and mortality. Therefore, expectant management should not be considered as a routine treatment option in these patients.     

An immunohistologic study of endothelialization of uteroplacental vessels in human pregnancy--evidence that endothelium is focally disrupted by trophoblast in preeclampsia.

OBJECTIVE: Our objective was to study the endothelial status of the luminal lining of uteroplacental vessels in the human placental bed in normal and abnormal pregnancy in the third trimester. STUDY DESIGN: Six placental basal plates from uncomplicated pregnancies and five from pregnancies complicated by preeclampsia (n = 3), preeclampsia and a small-for-gestational-age infant (n = 1), and diabetes mellitus (n = 1) were accessioned from the archives because of documentation of their containing uteroplacental vessels. Five placental bed biopsy specimens with intraluminal endovascular trophoblast in the third trimester were also studied. Sections were subjected to immunohistochemical analysis with monoclonal and polyclonal antibodies labeling endothelium and trophoblast. RESULTS: In third-trimester normal uncomplicated pregnancies the uteroplacental arteries and veins were completely endothelialized with no disruption of the endothelium. In third-trimester abnormal pregnancies the uteroplacental veins were also completely endothelialized. However, intraluminal endovascular trophoblast was seen within the uteroplacental arteries in eight of the 10 complicated pregnancies; this finding was associated with disruption of the endothelium. CONCLUSION: In preeclampsia there is an aberrant wave of endovascular trophoblast migration in the third trimester, resulting in focal disruption of the endothelium. This may be responsible for the endothelial cell dysfunction thought to be of pathogenetic importance in preeclampsia.     

Mast cells as a source of nitric oxide in the human placenta--morphometric analysis in preeclampsia complicated pregnancy

The aim of the study was to test hypothesis, that in placenta mast cells are significant source of iNOS. Material: Placentas were collected after term delivery from healthy (control, n=13) and preeclamptic (n=11) women. Mast cells and iNOS expression were detected in obtained samples with monoclonal anti-iNOS and anti-tryptase antibodies. Next, morphometric analysis were performed. There were no significant difference between iNOS expression and number of iNOS-positive cells in normal and preeclamptic placentas. There was a significant increase in mast cells number in preeclamptic placentas (8.32 +/- 1.3 SD vs 5.14 +/- 1.2 SD in control) and decrease in percentage of iNOS positive cells among them (68.1% vs 23.6%). We conclude, that in uncomplicated pregnancies, mast cells are the main source of iNOS in placenta while in preeclampsia they loss their potential to synthetase iNOS.     

激活素A和卵泡休止素与先兆子痫的相关性研究

目的　探讨先兆子痫患者血清中激活素A和卵泡休止素水平及其mRNA在胎盘组织中的表达 ,及其与先兆子痫发病的关系。方法　 2 0例足月妊娠先兆子痫孕妇作为先兆子痫组 ,2 0例足月妊娠血压正常孕妇作为对照组。应用酶联免疫吸附试验 (ELISA)检测两组孕妇血清中激活素A和卵泡休止素水平。应用半定量逆转录 聚合酶链反应 (RT PCR)技术检测两组孕妇分娩后胎盘组织中激活素AmRNA和卵泡休止素mRNA的相对表达强度。将两组孕妇的胎盘组织激活素AmRNA的表达强度与血清激活素A水平进行直线相关分析。结果　 (1)先兆子痫组孕妇血清中激活素A水平为 (33 7± 6 6 ) μg/L ,明显高于对照组的 (9 9± 2 1) μg/L(P <0 0 1)。先兆子痫组孕妇血清中卵泡休止素水平为 (5 1± 0 6 ) μg/L ,与对照组的 (4 7± 0 3) μg/L比较 ,差异无显著性 (P >0 0 5 )。 (2 )先兆子痫组胎盘组织中激活素AmRNA为 1 11± 0 2 1,明显高于对照组的 0 6 1± 0 17(P <0 0 1)。先兆子痫组胎盘组织中卵泡休止素mRNA为 0 5 7± 0 31,与对照组的 0 5 4± 0 2 7比较 ,差异无显著性 (P >0 0 5 )。(3)在先兆子痫组和对照组孕妇中 ,血清中激活素A水平与胎盘组织激活素AmRNA相对表达强度呈正相关 [相关系数 (r) =0 89,P <0 0 1]。结论     

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   

Plasma hepatocyte growth factor as a marker for small-for-gestational age fetuses

OBJECTIVE: To study the association between hepatocyte growth factor (HGF) levels and pregnancy outcome. STUDY DESIGN: Hepatocyte growth factor levels were measured in 42 plasma samples between weeks 14 and 21 of gestation using an enzyme-linked immunosorbent assay (ELISA). Results were correlated to pregnancy outcome and Mann-Whitney U-test applied to study the differences. RESULTS: Hepatocyte growth factor values in pregnancies that develop preeclampsia (n=12) were not significantly different from unaffected pregnancies (n=21, multiples of the median (MoM)=1.38, P=0.47). However, hepatocyte growth factor values were significantly elevated in pregnancies of small-for-gestational age (SGA) fetuses (n=9) compared to uncomplicated pregnancies (MoM=2.66, P<0.001). CONCLUSION: Measurement of hepatocyte growth factor in peripheral blood between 14 and 21 weeks gestation may offer new possibilities in the early diagnosis and prediction of fetal birth weight but not of preeclampsia.     

Intraplatelet cyclic guanosine-3',5'-monophosphate levels during pregnancy and preeclampsia.

OBJECTIVE: To investigate the intraplatelet cyclic guanosine-3',5'-monophosphate (cGMP) levels during normal pregnancy and preeclampsia. STUDY DESIGN: Pregnant women (n = 15), women with preeclampsia (n = 15), and nonpregnant, normotensive women (n = 15) were included. Intraplatelet cyclic guanosine-3',5'-monophosphate levels were measured by an enzyme-linked immunosorbent assay. RESULTS: Intraplatelet cGMP levels were significantly different among all groups (p < 0.02). The values were higher in normal pregnant women (mean 19.8 SD 2.6 fmol/10(5) platelets) in comparison to nonpregnant women (mean 7.6 SD 0.3 fmol/10(5)platelets; p = 0.001) and women with preeclampsia (mean 11.3 SD 1.8 fmol/10(5) platelets; p = 0.05). Plasma nitric oxide levels did not reveal differences between all groups. CONCLUSIONS: The results of this study in a high-risk Andean population demonstrated that intraplatelet cyclic guanosine-3',5'-monophosphate levels are decreased during preeclampsia compared to normal pregnancy, suggesting a lack in action of nitric oxide.