健康妊娠和子痫前期血浆血栓炎症表达谱的差异分析

目的观察正常妊娠过程和子痫前期(PE)血栓炎症性反应差异,为PE的早期诊断和预防策略改进提供工作基础。方法定制抗体芯片(覆盖大量细胞因子、止血相关蛋白质等)检测健康育龄女性、健康妊娠女性和子痫前期患者血浆,分析各组间差异蛋白质特征。结果健康妊娠组和健康育龄组有37种蛋白质水平差异有统计学意义,相对于健康育龄组,健康妊娠组有解整合素-金属蛋白酶12、趋化因子CCL2等16种蛋白质水平升高,粒-单细胞集落刺激因子(GM-CSF)和载脂蛋白F等21种水平降低;PE组和健康妊娠组有27种蛋白质水平差异存在统计学意义,相对于健康妊娠组,PE组有GM-CSF和血管内皮生长因子受体2(VEGFR2)等16种水平升高,肿瘤坏死因子相关凋亡诱导配体、干扰素Ω1等11种水平降低。进一步综合分析健康育龄组、健康妊娠组和PE组血浆蛋白质发现,PE患者血浆蛋白质出现更复杂的变化,更多参与炎症和免疫反应的细胞因子和急性期反应蛋白水平升高,更多控制炎症反应的细胞因子水平降低,促进血栓形成和参与补体反应的蛋白质水平升高,肾素水平降低以及VEGFR2水平升高。结论 PE存在着比与健康妊娠更严重的炎症反应、止血和血管内皮系统失衡,提示研究PE的血栓炎症反应将有助于改进PE的诊断和预防策略。     

低分子肝素钙联合硫酸镁对重度子痫前期患者血清PLGF、PAPP-A、sFlt-1、sEng水平的影响

目的：探讨低分子肝素钙联合硫酸镁对重度子痫前期患者血清胎盘生长因子、妊娠相关血浆蛋白A、可溶性血管内皮生长因子受体-1、可溶性内皮因子水平的影响。方法：选择2018年5月~2020年5月就诊的82例重度子痫前期患者作为研究对象,采用随机数字表法分为对照组和观察组,各41例。对照组给予硫酸镁治疗,观察组加用低分子肝素钙治疗,比较两组血清胎盘生长因子、妊娠相关血浆蛋白A、可溶性血管内皮生长因子受体-1、可溶性内皮因子水平及肾功能。结果：治疗后,观察组血清胎盘生长因子、妊娠相关血浆蛋白A水平高于对照组,血清可溶性血管内皮生长因子受体-1、可溶性内皮因子、肌酐、尿素氮水平低于对照组,差异有统计学意义（P＜0.05）。结论：重度子痫前期采用低分子肝素钙联合硫酸镁治疗可有效改善患者血清胎盘生长因子、妊娠相关血浆蛋白A、可溶性血管内皮生长因子受体-1、可溶性内皮因子水平及肾功能。     

子痫前期患者组织因子、组织因子途径抑制物与血清可溶性血管内皮生长因子受体1的相关性

目的探讨子痫前期患者外周血组织因子(TF)、组织因子途径抑制物(TFPI)与及可溶性血管内皮生长因子受体1(s Flt-1)水平的相关性。方法酶联免疫吸附试验(ELISA)检测健康孕妇、非重度子痫前期孕妇、重度子痫前期孕妇血浆TF、TFPI水平以及血清s Flt-1水平;免疫组化检测各组胎盘TF抗原的表达。结果 3组患者血浆及胎盘TF、血清s Flt-1水平均有显著差异,且随病变程度的增加逐渐升高。3组TF/TFPI比值有显著差异,随病变程度的增加亦逐渐升高。与非重度PE组相比,重度PE组血清s Flt-1水平显著升高(P0.05)。在子痫前期患者中,血浆TF、TF/TFPI比值与血清s Flt-1水平呈正相关。3组中胎盘TF表达与血清s Flt-1水平无相关性。在TF165.9 pg/m L组中,血浆、胎盘TF、血浆TFPI与血清s Flt-1水平呈正相关。结论子痫前期患者血浆TF、TF/TFPI比值与血清s Flt-1水平存在正相关关系。     

血浆sCD40L、sICAM-1及血管内皮损伤相关细胞与子痫前期严重程度的相关性分析

目的探讨血浆白细胞分化抗原可溶性CD40配体(sCD40L)、可溶性细胞间粘附因子-1(sICAM-1)及血管内皮损伤相关细胞与子痫前期严重程度的相关性。方法选择年龄、BMI、检测孕周等临床一般资料相匹配的重度子痫前期、轻度子痫前期患者以及健康孕妇(对照组)各45例作为研究对象,采用ELISA法检测血浆sCD40L、sICAM-1水平,采用流式细胞仪检测内皮祖细胞(EPC)、血管生成性T细胞(Tang)含量,比较并分析其相关性。结果子痫前期组的血浆sICAM-1、sCD40L水平均明显高于对照组(P0.05),同时重度子痫前期组上述指标明显高于轻度子痫前期组(P0.05);重度子痫前期组及轻度子痫前期组EPC、Tang含量均明显低于对照组(P0.05),重度子痫前期组和轻度子痫前期组上述指标相比较均无明显差异(P0.05);健康对照组孕妇血浆EPC细胞含量与Tang细胞含量、血浆sICAM-1水平与sCD40L水平均无明显相关性;重度子痫前期组、轻度子痫前期组孕妇血浆EPC细胞含量和Tang细胞含量呈正相关(r=0.654,P0.05),且两组孕妇血浆sICAM-1水平与sCD40L水平也呈正相关(r=0.624;P0.05)。结论子痫前期孕妇外周血EPC和Tang细胞含量明显降低,而血浆sICAM-1、sCD40L水平显著升高,二者可能通过诱发内皮细胞损伤进而影响机体免疫和炎症反应参与子痫前期的发病过程。血浆sCD40L、sICAM-1及血管内皮损伤相关细胞水平变化与子痫前期严重程度密切相关。     

妊娠期高血压患者与正常妊娠凝血功能及血栓前状态对比观察

目的：比较观察妊娠期高血压患者与正常妊娠患者凝血功能、血小板指标及血栓前状态（PTS）分子标志物水平。方法选择妊娠期高血压患者妊娠晚期50例,分为妊娠期高血压26例,轻度子痫前期组 l1例和重度子痫前期组13例;另外选择正常妊娠晚期（正常组）50例。所有病例均于入院后空腹抽取静脉血,分离血浆,采用酶联免疫吸附试验（ELISA）,严格按照试剂盒说明书,检测凝血功能（凝血酶时间、活化部分凝血活酶时间、血浆凝血酶原时间及纤维蛋白原）及血小板指标（PLT、MPV、PDW）,血栓前状态分子标志物 D 二聚体（D-D）、血管性血友病因子（vWF）水平。结果重度子痫前期组凝血功能、vwF 水平均明显高于妊娠期高血压组及轻度子痫前期组（P ＜0．05）,高于正常（P ＜0．01）。妊娠期高血压组及轻度子痫前期组与正常组比较,差异均无统计学意义（P ＞0．05）。结论重度子痫前期妊娠晚期患者血小板相关 PTS 分子标志物水平较正常妊娠晚期患者显著升高,其存在 PTS。且随着妊娠期高血压疾病加重,PTS 风险增高。     

子痫前期患者血清干扰素γ诱导蛋白10的水平变化及其意义

目的:观察子痫前期患者血清干扰素γ诱导蛋白10(IFN-γinducible protein 10,IP-10)的水平变化,探讨其与子痫前期发病的关系.方法:入选子痫前期患者共40例,其中轻度子痫前期22例,重度子痫前期18例;早发型子痫前期12例,晚发型子痫前期28例;同时随机挑选同期血压正常的晚期正常妊娠妇女20例,同期血压正常的非妊娠育龄妇女20例作为对照.采用ELISA法测定所有病例血清IP-10水平.结果:(1)正常妊娠组IP-10水平高于育龄组[正常妊娠组(118.8±29.0) pg/mL vs育龄组(94.8±14.5) pg/mL,P＜0.05];(2)晚发型子痫前期组IP-10水平较正常妊娠组明显升高[晚发型子痫前期组(172.2±27.4) pg/mLvs正常妊娠组(118.8±29.0) pg/mL,P＜0.05];(3)IP-10水平在轻度子痫前期组与重度子痫前期组之间无统计学差异[轻度子痫前期组(174.9±29.8) pg/mL vs重度子痫前期组(162.8±27.8) pg/mL,P＞0.05];(4)IP-10水平在早发型子痛前期组与晚发型子痫前期组之间无统计学差异[早发型子痫前期组(161.0±31.0) pg/mLv5晚发型子痫前期组(172.2±27.4) pg/mL,P＞ 0.05].结论:子痫前期患者血清IP-10水平升高,可能与其介导炎症反应及抑制血管新生有关,从而导致子痛前期的发生.     

血浆肾素、血管紧张素Ⅱ、醛固酮水平与先兆子痫的关系研究

目的 探讨血浆肾素(PRA)、血管紧张素Ⅱ(AngⅡ)以及醛固酮(Ald)的水平与妊娠期先兆子痫的关系.方法 选择妊娠期先兆子痫患者27例作为病例组,随机选取同期健康妊娠妇女51例、健康未妊娠妇女35例作为对照组,检测其血浆PRA、AngⅡ及Ald水平,并对各指标进行组间比较.结果 与健康妊娠妇女相比,先兆子痫患者的AngⅡ水平明显升高,而PRA、Ald水平明显下降,差异均有统计学意义(P<0.05);与健康未妊娠妇女相比,先兆子痫患者的AngⅡ水平也明显升高(P<0.05).结论 先兆子痫患者的血浆PRA、AngⅡ、Ald水平发生变化,可能与它们参与先兆子痫的病理生理过程有关.     

硫酸镁联合拉贝洛尔治疗妊娠高血压孕妇的应用效果

目的 探析在妊娠高血压孕妇中采用硫酸镁、拉贝洛尔治疗的应用效果。方法 选取2020年9月至2022年12月白银市第二人民医院收治的112例妊娠高血压孕妇开展回顾性研究,根据治疗方法将其分为对照组和观察组,各56例。予以对照组硫酸镁治疗,观察组在对照组基础上添加拉贝洛尔治疗。对比两组患者治疗前后的血压水平、血管内皮功能水平、炎性细胞因子水平,统计两组治疗后的母婴结局。结果 治疗后,两组孕妇收缩压和舒张压均降低,且观察组均低于对照组（均P <0.05）。治疗后,两组孕妇血浆内皮素水平均降低,一氧化氮水平均升高,且观察组上述指标变化幅度均大于对照组（均P <0.05）。治疗后,观察组不良母婴结局总发生率低于对照组（P <0.05）。治疗后,两组孕妇各项炎性细胞因子均降低,且观察组均低于对照组（均P <0.05）。结论 在妊娠高血压孕妇中联合使用硫酸镁、拉贝洛尔治疗,可降低血压水平,减轻炎症反应,改善血管内皮功能和母婴结局。     

血栓性疾病患者外周血IL-6、IL-8、IL-10及TNF-α水平及意义探讨

目的：探讨炎性细胞因子IL-6、IL-8、IL10、TNF—α在血栓性疾病中的水平及意义。方法：选择40例未经治疗的急性脑梗死（CI）患者作为动脉血栓疾病组（称作AT组）,40例未经治疗的下肢深静脉血栓形成（DVT）患者40例作为静脉血栓组（VT组）,与前2组年龄、性别比无统计学差异的健康志愿者30例作为对照组（NT组）。均在发病后48h内采集血液。用放射免疫分析检测血浆IL-6、IL-8、TNF—α水平,用酶联免疫吸附试验检测血浆IL-10水平。并对各组间细胞因子水平进行比较分析。结果：与NT组相比,AT组和VT组IL-6、IL-8、IL-10及TNF-α水平均明显升高,差异有统计学意义（P〈0．001）。结论：炎性细胞因子IL-6、IL-8、IL-10及TNF—α在血栓性疾病中起着重要的作用。     

子痫前期患者血清肾功能生化指标变化及临床意义

目的探讨子痫前期（PE）患者尿酸（UA）、肌酐（Ccr）和尿素氮（BUN）水平的变化及其临床意义。方法采用生化分析仪检测42例PE患者及38例健康妊娠晚期孕妇血清UA、Cr和BUN水平。结果（1）PE患者与健康妊娠孕妇相比,血清UA、Cr和BUN含量显著升高,差异有统计学意义（P〈0．05）。（2）轻度PE患者血清UA、Cr及BUN含量呈升高趋势,但与健康妊娠晚期孕妇比较,仅血清UA含量增高;重度PE患者与健康孕妇比较,3项指标均明显增高,差异有统计学意义（P〈0．05）。（3）重度PE患者血清UA、Cr和BUN含量显著高于轻度PE患者,差异有统计学意义（P〈0．05）。结论血清UA、Cr和BUN水平的升高可提示妊娠高血压患者肾功能受损;血UA可作为判断PE肾功能损害较敏感的指标;血清UA、Cr和BUN对评价和监测妊娠高血压肾功能受损程度具有一定应用价值。     

Pregnancy-induced hypertension and preeclampsia: levels of angiogenic factors in malaysian women

Preeclampsia (PE) is a major contributor to maternal and fetal mortality. The cause of preeclampsia remains unclear, but oxidative stress on the endothelium leading to endothelial dysfunction is said to be the root cause of the disease. The aim of this study was to measure and determine the plasma levels of key angiogenic factors in pregnancy as an indicator for the early onset of preeclampsia in pregnancy. Plasma levels of circulating a soluble fms like tyrosine kinase-1 (sFlt-1), an anti-angiogenic factor, vascular endothelial growth factor (VEGF) and placental growth factor (PIGF), both pro-angiogenic factors were analyzed in normal pregnant Malaysian women (control group, n = 34), women with pregnant induced hypertension (PIH, n = 34) and women with preeclampsia (PE, n = 34) all at three gestational ages, 24–28 weeks (early pregnancy: EP), 32–36 weeks (late pregnancy: LP) and 6 weeks after delivery (postpartum: PN). The plasma levels of angiogenic factors were determined by ELISA. sFlt-1 levels were elevated in PIH and PE patients as compared to controls. PIGF and VEGF were significantly decreased in PIH and PE as compared to the controls. These results suggest that elevated concentration of sFlt-1 and suppressed levels of PIGF and VEGF may contribute to the development of hypertension in pregnancy which precedes preeclampsia.     

The changes of trace elements,malondialdehyde levels and superoxide dismutase activities in pregnancy with or without preeclampsia

OBJECTIVES: Increased free radical activity and lipid peroxidation may be implicated in the pathogenesis of preeclampsia. This study was initiated to assess antioxidant enzyme and trace metals's status in preeclampsia. DESIGN AND METHODS: The comparison was made between the pregnant women with or without preeclampsia and healthy controls in this study. Samples were obtained from 24 normal nonpregnant (controls), 30 normal pregnant and 21 preeclamptic women in the third trimester. Lipid peroxidation end product, malondialdehyde (MDA), free radical scavenging enzyme activity, superoxide dismutase (SOD) and serum zinc (Zn), copper (Cu) levels were measured in either plasma/serum or erythrocytes of patients. Data were analyzed statistically using Student's t-test. RESULTS: In the preeclamptic group malondialdehyde, Cu levels were significantly increased, while Zn and SOD levels were significantly decreased compared to normal control group and healthy pregnant women. CONCLUSIONS: Our findings give support that radical scavenging SOD is consumed by the increased lipid peroxidation in preeclampsia. This data may indicate an involvement of free radicals in the pathophysiology of preeclampsia. This study suggests a relationship between increased MDA, Cu levels and decreased SOD, Zn levels in pregnancy and preeclampsia.     

Serum IGF-I and IGFBP-3 in healthy pregnancies and patients with preeclampsia

DESIGN AND METHODS: We studied serum levels of IGF-I and IGFBP-3 in 68 pregnant women; 28 mild preeclampsia, 13 severe preeclampsia, and 27 healthy pregnant control subjects. RESULTS: When compared with the healthy pregnant group preeclampsia groups had markedly decreased mean serum IGF-I levels. The difference was also significant between the mild and severe preeclampsia groups. Serum mean IGFBP-3 level was also lower in both preeclampsia groups than in healthy pregnancy group, but the difference between the preeclampsia groups did not reach significance. For IGF-I/IGFBP-3 ratio, the mean levels were significantly lower in mild and severe preeclampsia groups than in healthy pregnancy group. Also the mean IGF-I/IGFBP-3 ratio was significantly lower in the severe preeclampsia group compared with the mild preeclampsia group. CONCLUSIONS: IGF-1 and IGFBP-3 levels in patients with preeclampsia were compared with healthy pregnant control subjects. IGF-I and IGF-I/IGFBP-3 ratio may be useful for estimate the severity of preeclampsia.     

New scope in angiogenesis: role of vascular endothelial growth factor (VEGF), NO, lipid peroxidation, and vitamin E in the pathophysiology of pre-eclampsia among Egyptian females.

OBJECTIVES: The purpose of this study was to investigate the role of VEGF, NO, MDA, and Vitamin E in the pathophysiology of preeclampsia (PE) among Egyptian women. PATIENTS AND METHODS: Our study included 20 pregnant women with mild PE, 40 pregnant women with severe PE, 20 normal control women and 20 normal control pregnant women. Plasma from all women were subjected to estimation of VEGF using ELISA kit, estimation of nitrates (as end product of NO) and MDA by chemical methods and measurement of Vitamin E using HPLC. RESULTS: The obtained data from this study revealed that, VEGF may be used as a useful marker for PE which is elevated in plasma of women with PE (mild and severe) compared to controls. VEGF could differentiate between PE and controls at a cut-off value of: 70 ng/mL with a sensitivity of 95% and a specificity of 90%. Moreover, at a cut-off value of 250 ng/mL, VEGF could discriminate mild PE from severe PE with a sensitivity of 77.5% and a specificity of 85%. With respect to nitrate levels, they were significantly elevated in normal pregnant women compared with normal controls. Meanwhile, nitrate levels showed a highly significant decrease in PE in relation to both controls, explaining the vasoconstriction and high blood pressure occurring in preeclamptic women. Correlation analysis revealed significant inverse correlation between nitrate levels and VEGF. Lipid peroxidation as indicated by MDA was enhanced in preeclamptic women as compared to healthy controls. The increase in MDA levels was correlated to the severity of PE. A highly significant fall in vitamin E as an antioxidant-scavenging vitamin was seen in preeclamptic women as compared to the controls. Also, a significant drop in the vitamin level was found in severe PE in comparison to mild PE. The oxidant/antioxidant correlation was illustrated by the inverse correlation between vitamin E and MDA(r = -0.837, p = 0.000). CONCLUSION: The findings from this study indicated that VEGF may be used as a clinically useful biomarker for PE for better diagnosis, to differentiate between mild and severe PE, and may also be a target for therapeutic intervention of PE. The increase in levels of VEGF together with reduction in NO levels could confirm the existence of vascular reactivity and endothelial disturbance in PE. The decrease in the vasodilator, NO may in part lead to the vasospasm of preeclampsia, which consequently produces hypoxia. The latter may be a cause of an elevation of VEGF (angiogenic factor) levels in PE. Meanwhile, elevated levels of lipid peroxides together with impaired antioxidant defense mechanisms may play a role in the etiology of PE.     

New reference values for routine blood samples and human neutrophilic lipocalin during third-trimester pregnancy

Reference values are usually based on blood samples from healthy men or nonpregnant women. Blood samples from pregnant women may be compared with these reference values. Correct references for pregnancy can be extremely important for clinical decisions such as ablatio placentae, appendicitis, premature rupture of membranes and preeclampsia. Previous studies of normal variations during third-trimester pregnancy are incomplete. Blood samples during pregnancy weeks 33, 36 and 39 as well as 1-3h postpartum were collected from pregnant women with dietary iron supplement and at least one previous pregancy without a history of hypertension or preeclampsia. When the sampled values were compared with the present reference values from men and non-pregnant women, the following differences were found during normal pregnancy: Haemoglobin and ferritin were reduced, CRP was slightly elevated, WBC (white blood cell count) and HNL (human neutrophilic lipocalin) were elevated during pregnancy and significantly increased postpartum. Albumin was reduced, ALT and AST were slightly elevated and GGT was unchanged during pregnancy. ALP, D-dimer and fibrinogen were elevated. Uric acid increased during the third trimester and thrombocyte count decreased. Separate reference values for pregnant women are essential for correct diagnostic decisions during third-trimester pregnancy. Elevated levels of D-dimer do not necessarily indicate ablatio placentae. A diagnosis of progressive preeclampsia cannot be based on increasing uric acid levels and reduced platelet count in a stable clinical condition. HNL signals activation of neutrophilic granulocytes and can thereby offer a helpful tool for diagnosing infection during pregnancy and postpartum.     

New reference values for routine blood samples and human neutrophilic lipocalin during third-trimester pregnancy.

Reference values are usually based on blood samples from healthy men or non-pregnant women. Blood samples from pregnant women may be compared with these reference values. Correct references for pregnancy can be extremely important for clinical decisions such as ablatio placentae, appendicitis, premature rupture of membranes and preeclampsia. Previous studies of normal variations during third-trimester pregnancy are incomplete. Blood samples during pregnancy weeks 33, 36 and 39 as well as 1-3 h postpartum were collected from pregnant women with dietary iron supplement and at least one previous pregancy without a history of hypertension or preeclampsia. When the sampled values were compared with the present reference values from men and non-pregnant women, the following differences were found during normal pregnancy: Haemoglobin and ferritin were reduced, CRP was slightly elevated, WBC (white blood cell count) and HNL (human neutrophilic lipocalin) were elevated during pregnancy and significantly increased postpartum. Albumin was reduced. ALT and AST were slightly elevated and GGT was unchanged during pregnancy. ALP, D-dimer and fibrinogen were elevated. Uric acid increased during the third trimester and thrombocyte count decreased. Separate reference values for pregnant women are essential for correct diagnostic decisions during third-trimester pregnancy. Elevated levels of D-dimer do not necessarily indicate ablatio placentae. A diagnosis of progressive preeclampsia cannot be based on increasing uric acid levels and reduced platelet count in a stable clinical condition. HNL signals activation of neutrophilic granulocytes and can thereby offer a helpful tool for diagnosing infection during pregnancy and postpartum.     

Serum homocyst(e)ine levels in women with preeclampsia

BACKGROUND: Endothelial dysfunction has been described as the final common pathophysiological pathway in the development of preeclampsia. Since it has been suggested that homocyst(e)ine damages endothelial cells, we measured serum homocyst(e)ine levels in women with preeclampsia and in healthy pregnant women in order to find a new prognostic parameter for women with preeclampsia. METHODS: Forty-five women with preeclampsia and 45 healthy women with uncomplicated pregnancies, matched for age and parity, were entered into the study. Serum homocyst(e)ine levels were measured by gas chromatography-mass spectrometry analysis and correlated to clinical data. Logistic regression models were used to analyse the influence of serum homocyst(e)ine levels on the presence of preeclampsia versus healthy pregnant women and on the risk of premature termination of pregnancy due to preeclampsia. RESULTS: Median serum homocyst(e)ine levels in women with preeclampsia and healthy pregnant women were 14.2 (range 5.7-38.1) mumol/L and 15.1 (range 5.2-23.1) mumol/L, respectively (Mann-Whitney U-test, p = 0.8). In univariate logistic regression models, serum homocyst(e)ine levels had no significant influence on the odds of presenting with preeclampsia versus healthy pregnant women (univariate logistic regression model, p = 0.8) and on the odds of premature termination of pregnancy due to preeclampsia (univariate logistic regression model, p = 0.3). CONCLUSIONS: Serum homocyst(e)ine levels are not elevated in women with preeclampsia and are not associated with clinical outcome in women with preeclampsia.     

Delta-aminolevulinate dehydratase activity and oxidative stress markers in preeclampsia

Preeclampsia is an important pregnancy-specific multisystem disorder characterized by the onset of hypertension and proteinuria. It is of unknown etiology and involves serious risks for the pregnant women and fetus. One of the main factors involved in the pathophysiology of preeclampsia is oxidative stress, where excess free radicals produce harmful effects, including damage to macromolecules such as lipids, proteins and DNA. In addition, the sulfhydryl delta-aminolevulinate dehydratase enzyme (δ-ALA-D) that is part of the heme biosynthetic pathway in pro-oxidant conditions can be inhibited, which may result in the accumulation of 5-aminolevulinic acid (ALA), associated with the overproduction of free radicals, suggesting it to be an indirect marker of oxidative stress. As hypertensive pregnancy complications are a major cause of morbidity and mortality maternal and fetal where oxidative stress appears to be an important factor involved in preeclampsia, the aim of this study was to evaluate the activity of δ-ALA-D and classic oxidative stress markers in the blood of pregnant women with mild and severe preeclampsia. The analysis and quantification of the following oxidative stress markers were performed: thiobarbituric acid-reactive species (TBARS); presence of protein and non-protein thiol group; quantification of vitamin C; Catalase and δ-ALA--D activities in samples of blood of pregnant women with mild preeclampsia (n = 25), with severe preeclampsia (n = 30) and in a control group of healthy pregnant women (n = 30). TBARS was significantly higher in women with preeclampsia, while the presence of thiol groups, levels of vitamin C, catalase and δ-ALA-D activity were significantly lower in groups of pregnant women with preeclampsia compared with healthy women. In addition, the results showed no significant difference between groups of pregnant women with mild and severe preeclampsia. The data suggest a state of increased oxidative stress in pregnant women with preeclampsia compared to healthy pregnant women, which may be related to the complications of this disease.     

Thromboelastography (TEG) in normal pregnancy and its diagnostic efficacy in patients with gestational hypertension,gestational diabetes mellitus,or preeclampsia

BackgroundThromboelastography (TEG) provides global assessment of hemostatic function and has been recommended to monitor potential coagulopathies during pregnancy in which hypercoagulable state is favored. In present study, we established the reference intervals (RIs) of the TEG parameters (R, K, MA, and α‐angle) with Chinese pregnant women of third trimester. In addition, we examined the diagnostic efficacies of the TEG parameters in the patients diagnosed of gestational hypertension (GH), gestational diabetes mellitus (GDM), or preeclampsia (PE).MethodsWith specified including and excluding criteria, non‐pregnant controls, healthy pregnant women, and pregnant women with GH, GDM, or PE had their venous blood drawn at Beijing Obstetrics and Gynecology Hospital, followed by TEG tests performed in the clinical laboratory.ResultsThe RIs determined with the healthy pregnant women (in third trimester) for R, K, MA, and α‐angle were 4.0‐7.7, 1.2‐3.2, 51.9‐70.1, and 41.4‐74.4, respectively. When compared with the healthy pregnancy group, the K value was significantly decreased in GH patients but increased in PE patients; MA was significantly lower in the PE group. In the receiver operating characteristic curve (ROC) analyses, K value was able to efficiently distinguish normal pregnancy from the GH patients, with an AUC of 0.86 which is far better than those of R (AUC = 0.57) and MA (AUC = 0.56). For the PE patients, the AUC of MA (0.69) was significantly greater than that of R (0.50).ConclusionsThromboelastography may provide more accurate experimental basis for monitoring coagulation functions especially in pregnant women with complications of GH and PE.