子痫颅脑CT表现及与临床关系

目的分析子痫颅脑CT表现及与临床相关性。方法18例子痫患者均行颅脑CT平扫,其中3例行增强扫描,8例进行CT复查。结果14例患者显示脑白质内广泛低密度水肿区,枕叶脑白质累及为主,并多伴有额叶、顶叶受侵。4例表现为脑内局限性低密度区,2例合并脑出血,呈散在小斑片状分布。结论CT是子痫脑内病灶较好的影像检查手段,既可发现早期病灶,又可评价预后。     

子痫发生相关因素的探讨

目的 探讨与子痫发生相关的临床因素。方法 回顾５年间孕产妇妊高征中先兆子痫的发生情况,探讨产前检查、妊高征的程度、硫酸镁用量与子痫发生的关系,并对子痫的先兆症状及其出现时进行分析。结果 子痫发生率占财期孕产女的０．５６％（５１／９１０１）,占妊高征的８．３３％（５１／６２）。产前检查次数与子亲的发生明显相关,中、重度妊高征中子痫的发生率较高,硫酸镁日用量小于１５ｇ时子痫的发生率升高明显。轻度妊高征     

妊娠并发脑血管病临床研究

目的 探讨妊娠合并脑血管病的发病时间、病因、危险因素与临床表现,早期诊断,改善母儿预后.方法 对1998年1月～2005年12月我院收治的妊娠合并脑血管病的10例临床病例资料进行回顾性分析.结果 10例妊娠合并脑血管病的病例,确诊脑出血5例,上矢状窦血栓3例,腔隙性脑梗死1例,羊水栓塞致脑栓塞1例.脑出血患者中重度子痫前期(子痫)3例,脑血管畸形1例,血小板减少性紫癜1例.孕妇死亡2例,其余保守治疗好转出院.8例围生儿全部存活.结论 妊娠合并脑血管病好发于重度子痫前期(子痫)、脑血管畸形,血液高凝状态与上矢状窦血栓有关.当出现神经症状及体征时,临床医生应考虑到脑血管病的可能,及时诊治,多数孕产妇可取得较好结局.     

抗滋养细胞膜抗原抗体水平与妊娠期高血压疾病的关系

目的：探讨抗滋养细胞膜抗原(TA)抗体水平与妊娠期高血压疾病(HDCP)的关系。方法：应用酶联免疫吸附方法(ELISA)检测40例正常妇女和92例HDCP晚孕妇女［包括妊娠期高血压或轻度子痫前期23例，重度子痫前期41例，子痫28例；并发胎儿生长迟缓(FGR)21例］外周静脉血和新生儿脐血血清中抗TA IgG、IgM水平。结果： HDCP组、子痫组及重度子痫前期组母血中抗TAIgG、IgM阳性率均比正常组显著增加，且随HDCP 加重IgM阳性率显著增加(P<0.05)。 HDCP组、子痫组及重度子痫前期组脐血中抗TA IgG、IgM阳性率均比正常组显著增加，且HDCP组及子痫组IgM阳性率均比正常组显著增加(P<0.05) 。HDCP未并发FGR组脐血中IgM阳性率低于并发FGR组(P<0.05)。结论：HDCP患者母血及脐血中 抗TA IgG、IgM升高可能是妊娠期高血压疾病发生的主要原因。     

Molecular actions of heparin and their implications in preventing pre‐eclampsia

Summary

Pre‐eclampsia, a hypertensive disorder of pregnancy, continues to be a significant cause of global maternal morbidity. Low‐dose aspirin remains the only standard‐of‐care prophylactic therapy for preventing pre‐eclampsia, but is limited in efficacy. Heparin and its derivatives may further enhance the efficacy of aspirin therapy to prevent pre‐eclampsia, but the mechanisms mediating this augmentative effect are not known. Although heparin is an anticoagulant agent, it also possesses many anticoagulant‐independent properties that may be relevant in the prevention of pre‐eclampsia, including effects on placental, vascular and inflammatory function. This review summarizes the non‐anticoagulant properties of heparin, and extrapolates how these actions may influence the trajectory of pre‐eclampsia pathogenesis as a means of pathway‐specific therapy.

     

Genome‐Wide Association Study of Pre‐Eclampsia Detects Novel Maternal Single Nucleotide Polymorphisms and Copy‐Number Variants in Subsets of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cohort

A genome‐wide association study was undertaken to identify maternal single nucleotide polymorphisms (SNPs) and copy‐number variants (CNVs) associated with pre‐eclampsia. Case‐control analysis was performed on 1070 Afro‐Caribbean (n = 21 cases and 1049 controls) and 723 Hispanic (n = 62 cases and 661 controls) mothers and 1257 mothers of European ancestry (n = 50 cases and 1207 controls) from the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. European ancestry subjects were genotyped on Illumina Human610‐Quad and Afro‐Caribbean and Hispanic subjects were genotyped on Illumina Human1M‐Duo BeadChip microarrays. Genome‐wide SNP data were analyzed using PLINK. CNVs were called using three detection algorithms (GNOSIS, PennCNV, and QuantiSNP), merged using CNVision, and then screened using stringent criteria. SNP and CNV findings were compared to those of the Study of Pregnancy Hypertension in Iowa (SOPHIA), an independent pre‐eclampsia case‐control dataset of Caucasian mothers (n = 177 cases and 116 controls). A list of top SNPs were identified for each of the HAPO ethnic groups, but none reached Bonferroni‐corrected significance. Novel candidate CNVs showing enrichment among pre‐eclampsia cases were also identified in each of the three ethnic groups. Several variants were suggestively replicated in SOPHIA. The discovered SNPs and copy‐number variable regions present interesting candidate genetic variants for pre‐eclampsia that warrant further replication and investigation.     

Metabolomics revealed decreased level of omega‐3 PUFA‐derived protective eicosanoids in pregnant women with pre‐eclampsia

Pre‐eclampsia (PE) is considered a leading cause of mortality and morbidity in pregnant women worldwide. Eicosanoids derived from polyunsaturated fatty acids (PUFAs) might play an important role in the occurrence and development of PE. Omega‐3 PUFAs are nutrients that are popular supplements for pregnant women and can reduce blood pressure. However, the levels of eicosanoids derived from omega‐3 PUFAs in women with PE is not clear. The purpose of this study was to investigate the eicosanoid metabolic signature of PE. We performed a case–control study using data for pregnant women (n = 10) with PE and normotensive pregnant women (n = 10). We investigated the difference in eicosanoid profile between the groups by LC‐MS/MS‐based metabolomics. The plasma levels of arachidonic acid metabolites and some of the lipoxygenase metabolites of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) showed an increasing trend, and those of the cytochrome P450 metabolites of EPA and DHA were decreased in women with PE. Levels of leukotriene B4, 14,15‐dihydroxy‐eicosatetraenoate, 16‐hydroxydocosahexaenoic acid and 8,9‐epoxy eicosatetraenoic acid were significantly correlated with PE occurrence. These eicosanoids might take part in the progression of PE in pregnant women.