Hypertension in Pregnancy最新文献

Objective: Pregnancy can be associated with maternal hypertension leading to possible complications in pregnancy outcome. Antioxidant status may be proned to changes during pregnancy with hypertension. The aim of our study was to estimate antioxidant status through high-risk pregnancies.

Methods: Seventy-nine pregnant women with high-risk for preeclampsia development were included and 46 of them developed some hypertensive disorder in pregnancy. Superoxide-dismutase (SOD) and paraoxonase 1 (PON1) activities and relative proportion of PON1 activiity on different HDL subclasses were determined in 1^st, 2^nd, and 3^rd trimester and prior to delivery.

Results: SOD activity was significantly lower in 2^nd and 3^rd trimesters when compared to 1^st trimester (P˂0.001) whereas PON1 activity was significantly higher in 3^rd than in 1^st trimester (P˂0.05) in group of hypertensive women. This group had significantly higher SOD and PON1 activities and relative proportion of PON1 on HDL_3c subclasses in the 1^st trimester, significantly increased PON1 in the 3^rd trimester and prior to delivery and significantly higher PON1 activity on HDL_3c subclasses (P˂0.05) than nonhypertensive group. In 1^st trimester and prior to delivery, total PON1 activity and relative proportion of PON1 on HDL_3c subclasses exhibited significant ability to mark out hypertension in pregnancy (P˂0.05).

Conclusions: SOD activity decreased whereas total PON1 activity increased during pregnancy with hypertension. Pregnant women with hypertension had higher activities of PON1 and SOD and relative proportion of PON1 on HDL_3c subclasses than nonhypertensive ones. PON1 activity and relative proportion of PON1 on HDL_3c subclasses exhibited significant association with hypertension in pregnancy.

Objective: Pre-eclampsia (PE) is a pregnancy-associated disease characterized by placental dysfunction and increased oxidative stress. Apocyanin is a potent antioxidant and anti-inflammatory which has shown beneficial effects on PE pathogenesis. Aspirin is recognized as the recommendable drug in PE prevention and therapy. Therefore, we aimed to investigate the effects of combining apocyanin and aspirin to treat PE on rat models induced by N-nitro-L-arginine methyl ester (L-NAME) from gestational day (GD) 6 to 16 and elucidate the potential mechanisms.

Methods: First, female pregnant rats were divided into five different groups: pregnant control, PE, PE + apocyanin, PE + aspirin, and PE + apocyanin + aspirin. Animals received apocyanin (16 mg/kg/day) orally or aspirin by gavage (1.5 mg/kg BM/day) from GD 4 to 16. Blood pressure and urine protein content were monitored every 4 days.

Results: In the PE rat model, elevated systolic blood pressure and proteinuria were ameliorated by the combination of apocyanin and aspirin. Meanwhile, compared with single-dose apocyanin or aspirin, the combined treatment significantly corrected abnormal pregnancy outcomes, decreased sFlt-1 and PlGF, and alleviated oxidative stress both in blood and placental tissues. Moreover, the combined treatment upregulated PI3K, Akt, Nrf2, and HO-1 protein levels in the placental tissues from PE rats.

Conclusion: Overall, our results suggested that combined treatment of apocyanin and aspirin ameliorates the PE symptoms compared with single-dose apocyanin or aspirin in a PE rat model. Also, we demonstrated that activating the PI3K/Nrf2/HO-1 pathway can be a valuable therapeutic target to improve the pregnancy outcomes of PE.

To evaluate total Th1/Th2 cytokines in CD3⁺ cells (immunocompetent T-lymphocytes) and peripheral blood lymphocytes, mostly CD4+ (T helper cells) and CD8+ (T-cytotoxic cells) subpopulations in preeclampsia. Total blood leukocytes and lymphocytes counts, percent cells: CD3⁺, INF-g⁺/CD3⁺, IL-4⁺/CD3⁺, and IL-10⁺/CD3⁺, CD4⁺/CD8⁺ were determined by flow-cytometry. Preeclampsia (n= 26) and normal pregnancy (n= 25) participants were age and gestational age matched. CD4⁺ lymphocytes count was higher in preeclampsia, compared with normal pregnancy (43.6 ± 5.8 vs 37.6 ± 5.6%; P< 0.001). CD3⁺ cells Th1/Th2 shift was not detected in preeclampsia, yet may be present in other cell types, such as CD4⁺ and CD3 - lymphocytes.

Objectives: This study seeks to discover how the concentration of complement proteins, factors B and P are affected in HIV-associated PE.

Methods: This study included 72 pregnant women: 36 preeclamptic and 36 normotensive. Serum concentrations of factors B and P were measured using a Bioplex immunoassay.

Results: A significant decrease of factor B in the HIV+ compared to the HIV- group was noted. No significant difference across all groups for both analytes was observed.

Conclusion: Our results suggest the alternative pathway (AP) is inhibited by HIV evading immune detection. The AP is not excessively activated in PE during the third trimester.

Objectives: To explore variables associated with adverse maternal/fetal/neonatal outcomes among pregnant/postpartum patients admitted to ICU for hypertensive disorders of pregnancy (HDP).

Methods: Multicenter, prospective, national cohort study.

Results: Variables independently associated with maternal/fetal/neonatal mortality among 172 patients were as follows: Acute Physiology and Chronic Health Evaluation-II (APACHE-II)(OR1.20[1.06-1.35]), gestational age (OR0.698[0.59-0.82]) and aspartate aminotransferase (AST)(OR1.004[1.001-1.006]). Positive likelihood ratio for headache, epigastric pain, and visual disturbances to predict composite adverse outcomes were 1.23(1.16-1.30), 0.76(0.59-1.02), and 1.1(0.98-1.2), respectively.

Conclusions: Maternal/fetal mortality due to HDP was independently associated with severity of illness on admission, gestational age, and elevated AST. Accuracy of clinical symptoms to predict composite adverse outcomes was low.

Objective: Examine white blood cell (WBC) proportions across preeclamptic (n = 28 cases) and normotensive (n = 28 controls) pregnancy in individuals with overweight/obesity.Methods: WBC proportions were inferred from genome-wide DNA methylation data and compared by case/control status and self-identified race.Results: In Trimester 1, ean B cell proportions were suggestively lower in cases in the overall sample and significantly lower in White participants but not in Black participants. More significant WBC proportion changes were observed across normotensive than preeclamptic pregnancy.Conclusions: These findings in a small sample demonstrate need for additional studies investigating the relationship between self-identified race and WBCs in pregnancy.

Objective:To compare the effect of comorbidities on the phenotype and outcomes of preeclampsia.Methods: A matched retrospective cohort study of women delivering at a tertiary maternity center following a diagnosis of preeclampsia. We collected data on signs and symptoms, biochemical markers, and maternal and perinatal outcomes.Results:We studied 474 women; 158 women with and 316 without comorbidities. Compared to women without comorbidities, women with comorbidities delivered earlier. They suffered fewer maternal but more neonatal complications.Conclusion: Women with comorbidities receive earlier intervention than women without comorbidities, which may lead to fewer maternal complications but worse neonatal outcomes.

Objective: To investigate the expression of complement system's activation factors in patients with HELLP syndrome.

Methods: A case-control study was performed. Sixteen HELLP syndrome patients, 32 severe preeclampsia patients, and 48 normal pregnancy women were involved in this studyELISA was used to test C1q, C4d, MBL, Bb, C3a, C5a, sC5b-9, s-Endoglin, and sflt-1 in the plasma.

Results: The levels of C5a (P < 0.01) and sC5b-9 (P = 0.014) in HELLP syndrome were higher than those in severe preeclampsia patients.

Conclusions: The abnormal activation of the complement system is more significant in the pathogenesis of HELLP syndrome than in severe preeclampsia.

Objective: assessing the incidence of preeclampisa (PE) in women with diabetic kidney disease (DKD) and analyzing the significance of clinical characteristics and changes in laboratory findings throughout the pregnancy on the onset of PE.Methods: the study included 79 patients with DKD. All patients had elevated urinary protein loss (30-299 mg/24 h) or proteinuria (≥300 mg/24 h) in the first trimester of pregnancy. PE was diagnosed in 22,8% patients with DKD.Results: women with proteinuria and/or proliferative retinopathy at the admission developed preeclampsia significantly more frequently than those without these findings. The degree of proteinuria was significantly associated with the risk of PE development in each trimester of pregnancy. Patients with chronic hypertension developed PE significantly more frequently than those who had no chronic hypertension.Conclusion: chronic hypertension and the degree of primary kidney injury and dysfunction are crucial determinants of PE development in women with DKD. Proteinuria seems to be the best renal predictive factors of PE.