BACKGROUND Preeclampsia(PE)is a multisystemic metabolic disease with an undetermined etiology.PE is a worldwide cause of maternal and perinatal morbidity,subdivided into early(EoPE)and late-onset(LoPE)according to 34 ...BACKGROUND Preeclampsia(PE)is a multisystemic metabolic disease with an undetermined etiology.PE is a worldwide cause of maternal and perinatal morbidity,subdivided into early(EoPE)and late-onset(LoPE)according to 34 wk of gestation as a divider.Many researchers investigated biomarkers for predicting PE to halt its consequences on the feto-maternal outcome.Elabela(Ela)is a newly discovered peptide hormone that was implicated in PE pathogenesis.Earlier rodent studies discussed Ela’s role in controlling blood pressure.Moreover,Ela deficiency was associated with PE development.AIM To test whether plasma Ela could serve as a reliable marker for predicting PE based on the time of onset(EoPE vs LoPE)compared to age and body mass matched healthy controls since no definitive treatment exists for PE but to terminate a pregnancy.METHODS This case-control study recruited(n=90)pregnant who fulfilled inclusion criteria;they were allocated into three groups:EoPE(30/90)(<34 wk of gestation);LoPE(30/90)(≥34 wk of gestation);and healthy pregnant(30/90).Demographic criteria;biochemical,hematological,and maternal plasma Ela levels were recorded for comparison.RESULTS Serum Ela was significantly reduced in EoPE compared to LoPE and healthy controls(P=0.0023).The correlation confirmed a strong inverse relationship with mean atrial blood pressure(r=-0.7,P<0.001),while gestational age and platelets count showed a moderate correlation with(r=0.4 with P<0.0001).No correlation was confirmed between the body mass index(BMI)and urine albumin.The predictive ability of 25 centile serum Ela had an Odds ratio of 5.21,95%confidence interval(1.28,21.24),P=0.02 for predicting EoPE.The receiver operator characteristic curve defined the Ela cutoff value at>9.156 with 96.7%and 93.3%sensitivity and specificity,P<0.0001 in predicting EoPE.CONCLUSION A strong correlation of serum Ela with PE parameters with excellent sensitivity and specificity in distinguishing EoPE independent of the BMI,age,and blood pressure which makes Ela a recommendable marker in screening.Further research is warranted to explore prognostic and therapeutic applications for Ela in PE.展开更多
Background:Preeclampsia(PE),characterized by hypertension and proteinuria,leads to serious maternal and infant complications.Uridine-cytidine kinase 2(UCK2)belongs to the UCK family,a class of enzymes that catalyzes t...Background:Preeclampsia(PE),characterized by hypertension and proteinuria,leads to serious maternal and infant complications.Uridine-cytidine kinase 2(UCK2)belongs to the UCK family,a class of enzymes that catalyzes the conversion of uridine and cytidine to monophosphate form.However,the role of UCK2 in PE has not been reported.Methods:The expression of UCK2 was detected in the placenta of PE patients and N(ω)-nitro-L-arginine methyl esterinduced PE mouse model.Through forced up-regulation or down-regulation of UCK2 in vitro,we examined the effects of UCK2 on the proliferation,apoptosis,migration,and invasion of trophoblast cells.Stattic,the inhibitor of STAT3 pathway,was used to investigate whether the STAT3 pathway mediates the biological function of UCK2 in trophoblast cells.Results:The present study found that UCK2 showed low expression in the placenta of PE patients and PE mouse model.MTT(3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide)and flow cytometry assays verified that up-regulation of UCK2 promoted the proliferation of trophoblast cells,while the silence of UCK2 suppressed cell proliferation.Besides,flow cytometry and TdT-mediated dUTP Nick-End Labeling assays demonstrated that knockdown of UCK2 resulted in apoptosis of trophoblast cells.The wound healing and transwell assays showed that the migration and invasion activities of the trophoblast cells were facilitated by the overexpression of UCK2 and were blocked by the silence of UCK2.Furthermore,the expression of phosphorylated STAT3 was increased with the upregulation of UCK2 and decreased with the inhibition of UCK2.When the STAT3 pathway was blocked by its inhibitor stattic,the promotion effects of UCK2 on trophoblast cells were suppressed.Conclusion:UCK2 promotes the proliferation,migration,and invasion of trophoblast cells,and these effects may be partly mediated by the activation of the STAT3 pathway.展开更多
Objective:In determining the effects of yoga practice on mild preeclampsia,this study examines the blood pressure,blood platelet(PLT)count,and proteinuria status in pregnant women over 20 weeks of pregnancy.Materials ...Objective:In determining the effects of yoga practice on mild preeclampsia,this study examines the blood pressure,blood platelet(PLT)count,and proteinuria status in pregnant women over 20 weeks of pregnancy.Materials and Methods:This research is an experimental study with a pre–post intervention design.We collected forty pregnant women with mild preeclampsia from all populations.All participants agreed to practice 30 min of yoga every week for 1 month.The blood pressure,the blood PLT count,and proteinuria were measured before and after the yoga intervention.The statistical analysis used the t‑test for the blood PLT count variable,the McNemar test for the proteinuria variable,and the Wilcoxon test for the blood pressure variable.Results:The results showed a decrease in systole blood pressure from 134.17±7.17 mmHg before a yoga intervention to 120±4.17 mmHg after yoga intervention(P<0.001)and a decrease in diastole blood pressure from 89.58±5.5 mmHg before the intervention to 79.38±4.25 mmHg after the intervention(P<0.001).However,there was no significant difference in blood PLT count(P=0.104)and proteinuria(P=0.063)before and after a yoga intervention in pregnant women with mild preeclampsia patients.Conclusions:Yoga exercise during pregnancy(upper 20 weeks of gestation)significantly decreased systolic and diastolic blood pressure in mild preeclampsia patients.展开更多
Introduction: Preeclampsia can lead to several maternal and perinatal adverse effects. There are few published data on the association between transmembrane serine protease 6 (TMPRSS6) gene polymorphism and preeclamps...Introduction: Preeclampsia can lead to several maternal and perinatal adverse effects. There are few published data on the association between transmembrane serine protease 6 (TMPRSS6) gene polymorphism and preeclampsia. Objective: To assess the association between TMPRSS6 gene polymorphism rs855791SNP in women with preeclampsia compared with healthy pregnant women. Method: A case-control study (60 women in each arm) was conducted at Saad Abuaela Maternity Hospital in Khartoum, Sudan. Sociodemographic and clinical data were gathered through a questionnaire. The participant was genotype for TMPRSS6 gene rs855791SNP using Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP). The results were confirmed by DNA sequencing. Result: There was no significant difference in the median of age, parity, and body mass index. The distribution of the genotypes and alleles of TMPRSS6 rs855791 was consistent with the HWE. The overall TMPRSS6 rs855791 polymorphism was not significantly associated with preeclampsia. However, the proportion of heterozygotes (TC) was considerably higher in the women with preeclampsia (46.7%) than in the control group (23.3%) (p = 0.001;OR = 2.71;95% CI = 1.21 - 6.07). The proportion of homozygotes (TT) and T alleles was not significantly different between women with preeclampsia and the control group. Conclusion: The overall TMPRSS6 rs855791 polymorphism was not significantly associated with preeclampsia and healthy control.展开更多
Objective:In this study,we aimed to explore the expression of TUSC3 in Preeclampsia and to research the potential function of TUSC3 in placental trophoblast cells.Methods:We collected 10 cases of normal placental tiss...Objective:In this study,we aimed to explore the expression of TUSC3 in Preeclampsia and to research the potential function of TUSC3 in placental trophoblast cells.Methods:We collected 10 cases of normal placental tissues and preeclampsia placental tissues,respectively.These parturient received treatment at the First Affiliated Hospital of Hainan Medical University between June 1,2020,and December 31,2022.The expression of TUSC3 in placenta was detected by immunohistochemistry.The effect of TUSC3 on the migration and invasion of HTR8/SVneo cells was analyzed by migration assay and Transwell assay.Results:The expression of TUSC3 was slightly increased in placental villis in preeclampsia.Immunohistochemistry and qRT-PCR were used to detect the expression of TUSC3 protein and mRNA in placental tissues.TUSC3 was markedly upregulated in PE placental tissues(P<0.01).The results of migration assay and Transwell assay showed that the migration rate and the number of invasive cells were significantly decreased in HTR8 overexpressing TUSC3(P<0.01).Conclusions:TUSC3 was markedly increased in PE placental tissues and inhibited trophoblast cells migration and invasion.展开更多
Objective:To investigate the effect of exosomes secreted by decidual macrophages on trophoblast cells and their molecular mechanism.Methods:The decidual tissues of patients with preeclampsia(PE)and normal-term pregnan...Objective:To investigate the effect of exosomes secreted by decidual macrophages on trophoblast cells and their molecular mechanism.Methods:The decidual tissues of patients with preeclampsia(PE)and normal-term pregnant women were collected.Macrophages were obtained by the density gradient method and then flow cell sorting,then the exosomes were extracted.The structure of the exosomes was observed by transmission electron microscope.The expression of CD63,a marker protein of the exocrine body,was detected by western blot,and the exosomes were identified.CCK-8 was used to detect the effect of exosomes on trophoblast cell viability.Transwell migration experiment was used to detect the influence on migration ability.The expression of miR-146a-5p in exosomes was detected by qPCR.The effect of exosomes on the expression of HIF1αprotein in trophoblasts was detected by western blot and detection of the binding site between miR-146a-5p and HIF1αby double luciferase reporter gene was conducted.Results:The exosomes of macrophages present a"cake"structure with a middle depression about 30-130 nm in diameter,and CD63 is highly expressed,which conforms to the characteristics of exosomes.Compared with the normal group,the exosomes of decidual macrophages in the PE group inhibited the activity and migration of trophoblast cells(P<0.001).The expression of miR-146a-5p in the exosomes of decidual macrophages in the PE decreased significantly,and after exosomes of PE decidual macrophages treating trophoblast cells,the protein expression of HIF1αin trophoblast cells was significantly increased.There are targeted binding sites between miR-146a-5p and HIF1α.Conclusion:PE decidual macrophage exosomes can inhibit the viability and migration of trophoblast cells,which may be related to the decreased expression of miR-146a-5p in exosomes,thus promoting HIF1αprotein expression of trophoblast cells.展开更多
Background: FoxP3 gene variants have been linked to endometriosis, infertility, and autoimmune illnesses, according to numerous researches. Maternal sensitivity to the PE gene and the genetic variations of FoxP3 has n...Background: FoxP3 gene variants have been linked to endometriosis, infertility, and autoimmune illnesses, according to numerous researches. Maternal sensitivity to the PE gene and the genetic variations of FoxP3 has not been thoroughly investigated. Objective: Investigation of the immune-histochemical expression of FoxP3 in placental tissue of PE patients. Methods: A total of 26 pre-eclamptic women as a case and 26 ethnically matched healthy pregnant women as a control group aged between 18 and 40 years old of different gravidity and parity referred to the labor ward for delivery either by vaginal delivery or cesarean section was enrolled to investigate the immunohistochemical expression of FOXP3 in placental tissue of PE patients. Results: Lower expression of FOXP3 IHC was statistically significant and noted in the group of preeclampsia compared to the healthy control group. Lower gestational age at delivery and a higher percentage of cesarean section were statistically significant and noted in the group of preeclampsia compared to the healthy control group. Conclusion: In comparison to the healthy control group, preeclampsia patients had statistically significantly lower FOXP3 IHC expression, and FOXP3 polymorphism was associated with the development of PE. Our findings can serve as a guide for statistical analyses and functional investigations that are more in-depth.展开更多
BACKGROUND Preeclampsia is a pregnancy-specific multi-system disease with multi-factor and multi-mechanism characteristics.The cure for preeclampsia is to terminate the pregnancy and deliver the placenta.However,it wi...BACKGROUND Preeclampsia is a pregnancy-specific multi-system disease with multi-factor and multi-mechanism characteristics.The cure for preeclampsia is to terminate the pregnancy and deliver the placenta.However,it will reduce the perinatal survival rate,prolong the pregnancy cycle,and increase the incidence of maternal complications.With relaxation of the birth policy,the number of elderly pregnant women has increased significantly,and the prevalence rate of preeclampsia has increased.Inappropriate treatment can seriously affect the normal postpartum life of pregnant women.Studies have shown that postpartum anxiety in women with preeclampsia can affect physical and mental health,as well as infant growth and development.AIM To analyze the factors influencing preeclampsia in pregnant women complicated with postpartum anxiety,and to construct a personalized predictive model.METHODS We retrospectively studied 528 pregnant women with preeclampsia who delivered in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine between January 2018 and December 2021.Their basic data were collected,and various physiological and biochemical indicators were obtained by laboratory examination.The self-rating anxiety scale was used to determine whether the women had postpartum anxiety 42 d after delivery.The independent factors influ-encing postpartum anxiety in early pregnant women with eclampsia were analyzed with multifactor logistic regression and a predictive model was constructed.The Hosmer-Lemeshow test and receiver operating characteristic(ROC)curve were used to evaluate the calibration and discrimination of the predictive model.Eighty pregnant women with preeclampsia admitted to our hospital from January 2022 to May 2022 were retrospectively selected to verify the prediction model.RESULTS We excluded 46 of the 528 pregnant women with preeclampsia because of loss to follow-up and adverse outcomes.A total of 482 cases completed the assessment of postpartum anxiety 42 d after delivery,and 126(26.14%)had postpartum anxiety.Bad marital relationship,gender discrimination in family members,hematocrit(Hct),estradiol(E2)hormone and interleukin(IL)-6 were independent risk factors for postpartum anxiety in pregnant women with preeclampsia(P<0.05).Prediction model:Logit(P)=0.880×marital relationship+0.870×gender discrimination of family members+0.130×Hct-0.044×E2+0.286×IL-6-21.420.The area under the ROC curve of the model was 0.943(95%confidence interval:0.919-0.966).The threshold of the model was-1.507 according to the maximum Youden index(0.757),the corresponding sensitivity was 84.90%,and the specificity was 90.70%.Hosmer-Lemeshowχ^(2)=5.900,P=0.658.The sensitivity,specificity and accuracy of the model were 81.82%,84.48%and 83.75%,respectively.CONCLUSION Poor marital relationship,family gender discrimination,Hct,IL-6 and E2 are the influencing factors of postpartum anxiety in preeclampsia women.The constructed prediction model has high sensitivity and specificity.展开更多
Objective: This study is to observe the effects of Salvia miltiorrhiza injection on blood pressure and cardiac function in rats with pregnancy-induced hypertension and preeclampsia. Methodology: Syncytiotrophoblast mi...Objective: This study is to observe the effects of Salvia miltiorrhiza injection on blood pressure and cardiac function in rats with pregnancy-induced hypertension and preeclampsia. Methodology: Syncytiotrophoblast microvilli (stbm) and l-arginine nitrosyl methyl ester were screened out via caudal vein injection. Twenty gestational hypertension-preeclampsia model SD (Sprague Dawley) rats successfully induced by L-NAME (L-arginine Nitrosyl methyl ester) were randomly divided into 2 groups (model group and Danshen injection group, n = 10). Then another 10 normal pregnant SD rats without model were selected as blank control group. The Salvia miltiorrhiza injection group was given Salvia miltiorrhiza injection (0.5 g?kg?1?d?1) through tail vein, and the control group and model group were given equal volume of normal saline through tail vein injection. All three groups were treated by tail vein injection once a day (d) for 7 days. After treatment, heart rate (HR), Systolic pressure (SP), diastolic pressure (DP) and mean arterial pressure (MAP) were measured by tail artery. Left ventricular end-diastolic diameter (LVDd) and Left ventricular end systolic diameter (LVDs) were recorded by echocardiography. Left ventricular end diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), left ventricular ejection fraction (left ventricular ejection) fraction, LVEF) and the maximum rate of increase/decrease of left ventricular pressure during isovolemic systole (+dp/dtmax/?dp/dtmax);Endothelin-1 (ET-1) levels in rat tail vein blood were detected by ELISA. Results: SP, DP, MP, HR, LVSP, LVDs and ?dp/dtmaxx were all decreased, plasma ET-1 expression was low, and LVDd, LVEDP, LVEF, and +dp/dtmax were all increased in the Salvia miltiorroot injection group, with statistical significance compared to the model group (p Conclusion: Salvia miltiorrhiza injection can improve the cardiac function and reduce blood pressure in rats with pregnancy-induced hypertension and preeclampsia, and the mechanism may be related to alleviating systemic arteriolar spasm by regulating ET-1 level.展开更多
Background: Knowledge of temporal evolution of preeclampsia (PE) in its various aspects is essential in strategies to reduce maternal and perinatal morbidity and mortality. Preeclampsia is a public health problem due ...Background: Knowledge of temporal evolution of preeclampsia (PE) in its various aspects is essential in strategies to reduce maternal and perinatal morbidity and mortality. Preeclampsia is a public health problem due to maternal mortality associated with it worldwide (5.6%). Improving quality of its management is a major challenge in low-income countries where, despite progress made in this field, PE remains a major factor in maternal morbidity and mortality. Objective: To evaluate temporal evolution of frequency, risk factors and complications of PE at the University clinics of Kinshasa (UCK). Methods: Descriptive and cross-sectional study concerning minimum simple size of 119 pregnant women who consulted for antenatal care at the University clinics of Kinshasa from January 2012 to December 2022. Results will be reported as percentage proportion, mean and standard deviation. Comparison of proportion and means between groups will be made using Student’s t-test and Pearson’s chi-square test, respectively. The test will be statistically significant for a p value ≤ less than 0.05. Data will be collected and analysed anonymously and confidentially. Conclusion: This study will allow us to evaluate the effectiveness of different prevention and treatment modalities used over time in management of preeclampsia in our setting.展开更多
In tropical countries, malaria and preeclampsia/eclampsia are common diseases of pregnancy;and placenta have been implicated in the pathophysiology of both disease processes. The two diseases have pathophysiologic sim...In tropical countries, malaria and preeclampsia/eclampsia are common diseases of pregnancy;and placenta have been implicated in the pathophysiology of both disease processes. The two diseases have pathophysiologic similarities in the placenta such as placenta ischaemia, endothelial dysfunction and production of pro-inflammatory cytokine. Yet, there is paucity of studies on the association of these two disease processes. Determining the association between the two disease processes may help to unravel the pathogenesis of preeclampsia and also help in its prevention and patient management. Objective: Determined the association between placenta malaria parasitemia and preeclampsia/eclampsia among parturients at Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Methods: This was a case control study that was conducted in the Labour wards of department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) and Mile 4 Missionary Hospital Abakaliki, a comprehensive health care centre in Abakaliki, Ebonyi state. It was conducted over a period of 6 months between 1<sup>st</sup> October 2021 and 31<sup>st</sup> March, 2022. The cases in this study were parturients that developed preeclampsia/eclampsia in the course of pregnancy, while the controls were parturient without preeclampsia/eclampsia. Interviewer-administered questionnaires were used to collect data on socio-demographic characteristics, obstetrics and medical histories. Histological examinations were conducted to isolate plasmodium falciparum parasites from placenta samples obtained from the maternal surface of the placenta. The data was processed using Epi Info software. Categorical variables were analyzed using Mc Nemar X<sup>2</sup> test, with a p-value of 0.05 considered statistically significant. Logistic regression models were used to estimate the odds ratios (OR) and 95% CI of the association between placenta malaria parasites and preeclampsia/eclampsia was conducted. Relative risk with 95% CI was used to determine both fetal and maternal outcomes. Results: The prevalence of preeclampsia during the study period was 2.9%. Placenta malaria was positive in twenty one (21) of the 67 cases of preeclampsia/eclampsia analyzed, giving a prevalence of 31.3% and in eleven (11) out of 68 controls (normotensive) patients analyzed, giving a prevalence of 16.2%. The presence of placenta malaria significantly increased the odds of developing preeclampsia/eclampsia among parturients (OR = 2.4, 95% CI = 1.0 - 5.4, P value = 0.04). Presence of placenta malaria in mothers with preeclampsia/eclampsia was associated with adverse pregnancy outcomes such as cerebrovascular accident (RR = 19.2, 95% CI = 1.1 - 341.7, P value = 0.04), DIC (RR = 10.9, 95% CI = 1.4 - 88.0, P value = 0.02), abruptio placenta (RR = 2.4, 95% CI = 1.2 - 4.8, P value = 0.01), pulmonary edema (RR = 2.7, 95% CI = 1.1 - 25.9, P value = 0.03), IUGR (RR = 2.1, 95% CI = 1.1 - 4.5, P value = 0.03) and IUFD (RR = 3.8, 95% CI = 1.3 - 11.7, P value = 0.02). Presence of placenta malaria also increased the risk of NICU admission (RR = 2.6, 95% CI = 1.1 - 6.0, P value = 0.03), Low 1<sup>st</sup> minute APGAR score (RR = 2.7, 95% CI = 1.2 - 6.1, P value = 0.02) and Low 5<sup>th</sup> minute APGAR score (RR = 3.0, 95% CI = 1.0 - 8.6, P value = 0.04) among neonates delivered by mothers with preeclampsia/eclampsia. However, presence of placenta malaria did not significantly increase maternal and perinatal mortalities. Conclusion: There is a higher prevalence of placenta malaria among mothers with preeclampsia/eclampsia when compared with normotensive controls and this was associated with increased risk of certain maternal and perinatal morbidities. Placental malaria was not associated with increased risk of either maternal or perinatal mortality.展开更多
Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is charact...Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.展开更多
BACKGROUND Preeclampsia(PE)is a pregnancy syndrome of undetermined etiology;inflammation was one of the proposed theories for its development.AIM To examine the platelet to lymphocyte ratio(PLR),an inflammatory biomar...BACKGROUND Preeclampsia(PE)is a pregnancy syndrome of undetermined etiology;inflammation was one of the proposed theories for its development.AIM To examine the platelet to lymphocyte ratio(PLR),an inflammatory biomarker,as a marker to predict poor maternal-neonatal outcomes in early-onset PE(EoPE).METHODS A cross-sectional study enrolled 60 pregnant women with EoPE(at 32-30 wk of gestation)at a university hospital.Demographic criteria and hematological indices were collected,including platelet counts and indices(mean platelet volume and platelet distribution width),PLR,and the Doppler study,which calculated estimated fetal weight(EFW),amniotic fluid index(AFI),resistance index(RI),and pulsatility index(PI).Participants were followed until delivery,where maternal outcomes were recorded,including;delivery mode and reason for cesarean section,and neonatal outcomes,including fetal growth restriction(FGR),meconium-stained liquid,the 5-min Apgar score,and admission to the intensive care unit.RESULTS There was a trend of insignificant increases in cesarean sections.Sixty-one-point two percent(37/60)fetuses were admitted to the neonatal care unit;70.0%of admitted fetuses were meconium-stained liquor,and 56.7%of them had FGR.PLR was positively correlated with AFI and EFW as r=0.98,0.97,P<0.001;PLR showed negative correlations with PI and RI as r=-0.99,-0.98,P<0.001.The Apgar score and the number of days admitted to the intensive care unit had a positive and negative correlation(0.69,-0.98),P<0.0001,respectively.Receiver operating characteristic calculated a PLR cutoff value(7.49)that distinguished FGR at 100%sensitivity and 80%specificity.CONCLUSION Strong,meaningful relationships between PLR and FGR parameters and a poor neonatal outcome with a significant P value make it a recommendable biomarker for screening EoPE-related complications.Further studies are suggested to see the impact on maternal-neonatal health.展开更多
Objective: To study the effect of hypoxia on the expression of placental trophoblast cells SATB1 and β-catenin and its correlation with the pathogenesis of preeclampsia. Methods: Trophoblastic cell lines HRT8/SVneo w...Objective: To study the effect of hypoxia on the expression of placental trophoblast cells SATB1 and β-catenin and its correlation with the pathogenesis of preeclampsia. Methods: Trophoblastic cell lines HRT8/SVneo were cultured, SATB1 and β-catenin expression and cell biological behavior were determined after hypoxia reoxygenation treatment; cell biological behavior and the expression of related genes were determined after the transfection of SATB1 and β-catenin siR NA; preeclampsia placenta and normal placenta tissues were collected and the expression of SATB1 and β-catenin were determined. Results: OD value, cell migration rate, m RNA contents of SATB1 and β-catenin of H/R group were significantly lower than those of Nor group, cell apoptosis rate was higher than that of Nor group and the number of invasive cells was less than that of Nor group; OD value and bcl-2 mRNA content of SATB1-siRNA group were lower than those of NC group; cell apoptosis rate as well as Bax, Caspase-3, caspase-6 and caspase-9 mRNA contents were higher than those of NC group; cell migration rate as well as CTSB, CTSD, MMP2 and MMP9 mRNA contents of β-catenin-siRNA group were lower than those of NC group; the number of invasive cells was less than that of NC group; the expression levels of SATB1 and β-catenin in preeclampsia placenta tissue were significantly lower than those in normal placenta tissue. Conclusions: Hypoxia can inhibit the expression of SATB1 and β-catenin in the pathogenesis of preeclampsia, which can affect the proliferation, apoptosis, migration and invasion of cells.展开更多
This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients ...This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients with severe preeclampsia (PE group) and 20 normal pregnant women (control group) to prepare monocytes which were then treated with LXA 4 at different concentrations of 0,10,100 nmol/L respectively.IL-1β level in the supernatant of monocytes was detected by enzyme linked immunoassay.The [Ca 2+ ] i of monocytes was measured by laser scanning confocal microscopy.The results showed that the IL-1β level and the [Ca 2+ ] i of monocytes in the PE group were significantly higher than those in the control group.LXA 4 significantly decreased the generation of IL-1β in a dose-dependent manner in the PE group.After treatment with 100-nmol/L LXA 4,in the PE group,the [Ca 2+ ] i concentration of monocytes was significantly reduced.It was concluded that LXA 4 may inhibit the IL-1β production of monocytes from severe preeclampsia women by inhibiting extracellular calcium influx.展开更多
BACKGROUND Very few studies have been published on the hemodynamic changes associated with spinal anesthesia induced with ropivacaine during cesarean deliveries in preeclamptic women.AIM To record and analyze hemodyna...BACKGROUND Very few studies have been published on the hemodynamic changes associated with spinal anesthesia induced with ropivacaine during cesarean deliveries in preeclamptic women.AIM To record and analyze hemodynamic data in women with preeclampsia undergoing cesarean delivery after spinal anesthesia induced with ropivacaine.METHODS Ten eligible women with preeclampsia were enrolled in this prospective observational study.Spinal anesthesia was performed with 2.4 mL of 0.5%ropivacaine.Hemodynamic changes were then analyzed at multiple time points.The hemodynamic responses to vasopressor interventions and uterotonic agents,as well as maternal and neonatal outcomes were also recorded.RESULTS Stable hemodynamic trends were observed in this study.Cardiac output(CO)and stroke volume increased mildly during surgery.In contrast,mean arterial pressure and systemic vascular resistance showed a moderate decrease from induction until the end of surgery.Central venous pressure dramatically increased after delivery.Oxytocin administration was associated with the most significant hemodynamic fluctuations during surgery,namely,an increase in CO and heart rate.Phenylephrine intervention was only required in three patients,and caused an increase in mean arterial pressure and systemic vascular resistance along with a decrease in heart rate,stroke volume,and CO.No maternal and neonatal complications were observed during this study,except transient episodes of hypotension.CONCLUSION Spinal anesthesia for caesarian delivery with ropivacaine in women with preeclampsia is linked to modest hemodynamic changes of no clinical significance in this study.Careful cardiovascular monitoring is still recommended,particularly after the delivery of the fetus or the use of oxytocin.展开更多
The expression of Toll-like receptor 4 (TLR4) in neonatal cord blood mononuclear cells (MNCs) and serum TNF-α were investigated in order to explore the roles of TLR4 in the pathogenesis of preeclampsia.The study enro...The expression of Toll-like receptor 4 (TLR4) in neonatal cord blood mononuclear cells (MNCs) and serum TNF-α were investigated in order to explore the roles of TLR4 in the pathogenesis of preeclampsia.The study enrolled 27 patients suffering from preeclampsia (experimental group) and 21 normal pregnancy patients (control group).After MNCs were separated, the expression of TLR4 mRNA and protein was detected by using real-time quantitative PCR and Western blotting respectively, and the expression of TNF-α by using ELISA.The results showed the TLR4 mRNA level in cord blood MNCs (2-CT:0.07±0.17), TLR4 protein expression level (absorbance ratio:0.81%±0.15%) and TNF-α level (9.5±1.73 pg/mL) were all increased in experimental group as compared with control group with the differences being statistically significant (P<0.05).There was a positive correlation between the expression of TLR4 mRNA and TNF-α in both experimental group and control group (r=0.54 and 0.53, respectively, P<0.05).It was concluded that TLR4 expression in the experimental group of cord blood MNCs was increased and there was a positive correlation between the expression of TLR4 mRNA and TNF-α in both groups.TLR4-mediated release of inflammatory cytokines may be one of the important reasons leading to preeclampsia.展开更多
This study examined the association of expression of vascular endothelial growth factor(VEGF),a promoter of angiogenesis,with endothelium dysfunction in preeclampsia.The level of VEGF protein and mRNA in the placenta ...This study examined the association of expression of vascular endothelial growth factor(VEGF),a promoter of angiogenesis,with endothelium dysfunction in preeclampsia.The level of VEGF protein and mRNA in the placenta and peripheral blood samples of 30 preeclampsia patients and 30 normotensive pregnant women was measured by immunohistochemistry,real-time reverse transcriptase-polymerase chain reaction(RT-PCR) and enzyme-linked immunosorbent assay(ELISA),respectively.VEGF expression in the human umbilical vein endothelial cells(HUVECs) was blocked by small interfering RNAs(siRNAs).The monolayer barrier function of HUVECs was determined by measuring the fluorescence intensity of BSA that crossed the HUVEC monolayers.The cell proliferation and cell-secreted nitric oxide(NO) level were detected by MTT method and nitrate reductase assay,respectively.The results showed that VEGF was expressed in the syncytiotrophoblasts and endothelial cells of vessels and capillaries in the placenta tissue.The serum level of VEGF in the preeclampsia patients was significantly decreased as compared with that in normal pregnant subjects,although VEGF mRNA expression in the placenta tissue of preeclampsia patients remained still high.Moreover,VEGF deficit could lead to endothelium cell dysfunction,and the administration of VEGF could protect endothelium cells from injury.It was concluded that lack of VEGF contributes to endothelium dysfunction,which may lead to the occurrence and development of preeclampsia.展开更多
Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the go...Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the gold standard diagnostic method at present. Recently, the spot urinary protein-to-creatinine ratio (P/C ratio) has been used to detect suspected preeclampsia, because it can be used to estimate the amount of 24-hour urinary protein. The aim of this study is to investigate whether an increase in P/C ratio precedes emergence of hypertension among inpatients with preeclampsia. Method: The P/C ratio in normotensive (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) pregnant women was measured during regular prenatal checkups and in inpatients with preeclampsia between April 1, 2013 and March 31, 2014. Results: We included in this study 4074 normotensive pregnant women. The 95th percentile values for the trimester of pregnancy were 0.100, 0.157, and 0.195, respectively. The 95th percentile value for each trimester of pregnancy and gestational age were determined as criterion (Y) and predictive variables (X), respectively. In a simple regression analysis, the regression line was calculated as Y = 0.0035X + 0.0849 (R2 = 0.9913). Twenty-one women were diagnosed with preeclampsia. In 14 patients with preeclampsia, the timing of the increase in P/C ratio to higher than the regression line preceded the emergence of hypertension. Six patients had no data on P/C ratio, and 1 patient had hypertension before the increase in P/C ratio. Conclusions: An increase in P/C ratio to higher than the 95th percentile value can be a useful predictor of preeclampsia.展开更多
Background: Preeclampsia (PE) still ranks as one of obstetrics major problems and is still a serious threat, mainly in underdeveloped countries where its incidence and mortality rates are higher and is a major cause o...Background: Preeclampsia (PE) still ranks as one of obstetrics major problems and is still a serious threat, mainly in underdeveloped countries where its incidence and mortality rates are higher and is a major cause of preterm birth and intra-uterine growth restriction. Aim: To evaluate the role of oxidative stress and dyslipidemia as indicators of pathogenesis and risks of preeclampsia in pregnant Sudanese women attending Wad-Medani Obstetrics and Gynecology Teaching Hospital. Material and Method: This was a cross-sectional (case-control) study carried out in preeclamptic pregnant Sudanese women attending Wad-Medani Obstetrics and Gynecology Teaching Hospital. A total of 208 pregnant women were enrolled in the study, 111 patients and 97 women with normal pregnancy as controls;pregnant women suffering from any systemic or endocrine disorder were excluded. We compared the serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, nitric oxide, and total antioxidant capacity between preeclamptic and controls. Result and Conclusion: Pregnant women with increase in BMI have a higher chance of developing PE. Low level of high-density lipoprotein cholesterol and high level of low-density lipoprotein cholesterol define that dyslipidemia increases the risk of PE. Decreased levels of NO and TAC might reflect the oxidative stress and likely contribute to the pathophysiological mechanisms of PE.展开更多
基金approved by the Scientific-Ethical Committee of the Mustansiriyah University(Approval No.IRB126).
文摘BACKGROUND Preeclampsia(PE)is a multisystemic metabolic disease with an undetermined etiology.PE is a worldwide cause of maternal and perinatal morbidity,subdivided into early(EoPE)and late-onset(LoPE)according to 34 wk of gestation as a divider.Many researchers investigated biomarkers for predicting PE to halt its consequences on the feto-maternal outcome.Elabela(Ela)is a newly discovered peptide hormone that was implicated in PE pathogenesis.Earlier rodent studies discussed Ela’s role in controlling blood pressure.Moreover,Ela deficiency was associated with PE development.AIM To test whether plasma Ela could serve as a reliable marker for predicting PE based on the time of onset(EoPE vs LoPE)compared to age and body mass matched healthy controls since no definitive treatment exists for PE but to terminate a pregnancy.METHODS This case-control study recruited(n=90)pregnant who fulfilled inclusion criteria;they were allocated into three groups:EoPE(30/90)(<34 wk of gestation);LoPE(30/90)(≥34 wk of gestation);and healthy pregnant(30/90).Demographic criteria;biochemical,hematological,and maternal plasma Ela levels were recorded for comparison.RESULTS Serum Ela was significantly reduced in EoPE compared to LoPE and healthy controls(P=0.0023).The correlation confirmed a strong inverse relationship with mean atrial blood pressure(r=-0.7,P<0.001),while gestational age and platelets count showed a moderate correlation with(r=0.4 with P<0.0001).No correlation was confirmed between the body mass index(BMI)and urine albumin.The predictive ability of 25 centile serum Ela had an Odds ratio of 5.21,95%confidence interval(1.28,21.24),P=0.02 for predicting EoPE.The receiver operator characteristic curve defined the Ela cutoff value at>9.156 with 96.7%and 93.3%sensitivity and specificity,P<0.0001 in predicting EoPE.CONCLUSION A strong correlation of serum Ela with PE parameters with excellent sensitivity and specificity in distinguishing EoPE independent of the BMI,age,and blood pressure which makes Ela a recommendable marker in screening.Further research is warranted to explore prognostic and therapeutic applications for Ela in PE.
基金supported by“Heart Health Research Fund,”Special Fund for Cardiovascular Disease Development of China,China International Medical Foundation(Grant No.Z-2019-42-1908-3),Tianjin Key Medical Discipline(Specialty)Construction Project,and the Young Talents Training Program of Tianjin First Central Hospital.
文摘Background:Preeclampsia(PE),characterized by hypertension and proteinuria,leads to serious maternal and infant complications.Uridine-cytidine kinase 2(UCK2)belongs to the UCK family,a class of enzymes that catalyzes the conversion of uridine and cytidine to monophosphate form.However,the role of UCK2 in PE has not been reported.Methods:The expression of UCK2 was detected in the placenta of PE patients and N(ω)-nitro-L-arginine methyl esterinduced PE mouse model.Through forced up-regulation or down-regulation of UCK2 in vitro,we examined the effects of UCK2 on the proliferation,apoptosis,migration,and invasion of trophoblast cells.Stattic,the inhibitor of STAT3 pathway,was used to investigate whether the STAT3 pathway mediates the biological function of UCK2 in trophoblast cells.Results:The present study found that UCK2 showed low expression in the placenta of PE patients and PE mouse model.MTT(3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide)and flow cytometry assays verified that up-regulation of UCK2 promoted the proliferation of trophoblast cells,while the silence of UCK2 suppressed cell proliferation.Besides,flow cytometry and TdT-mediated dUTP Nick-End Labeling assays demonstrated that knockdown of UCK2 resulted in apoptosis of trophoblast cells.The wound healing and transwell assays showed that the migration and invasion activities of the trophoblast cells were facilitated by the overexpression of UCK2 and were blocked by the silence of UCK2.Furthermore,the expression of phosphorylated STAT3 was increased with the upregulation of UCK2 and decreased with the inhibition of UCK2.When the STAT3 pathway was blocked by its inhibitor stattic,the promotion effects of UCK2 on trophoblast cells were suppressed.Conclusion:UCK2 promotes the proliferation,migration,and invasion of trophoblast cells,and these effects may be partly mediated by the activation of the STAT3 pathway.
文摘Objective:In determining the effects of yoga practice on mild preeclampsia,this study examines the blood pressure,blood platelet(PLT)count,and proteinuria status in pregnant women over 20 weeks of pregnancy.Materials and Methods:This research is an experimental study with a pre–post intervention design.We collected forty pregnant women with mild preeclampsia from all populations.All participants agreed to practice 30 min of yoga every week for 1 month.The blood pressure,the blood PLT count,and proteinuria were measured before and after the yoga intervention.The statistical analysis used the t‑test for the blood PLT count variable,the McNemar test for the proteinuria variable,and the Wilcoxon test for the blood pressure variable.Results:The results showed a decrease in systole blood pressure from 134.17±7.17 mmHg before a yoga intervention to 120±4.17 mmHg after yoga intervention(P<0.001)and a decrease in diastole blood pressure from 89.58±5.5 mmHg before the intervention to 79.38±4.25 mmHg after the intervention(P<0.001).However,there was no significant difference in blood PLT count(P=0.104)and proteinuria(P=0.063)before and after a yoga intervention in pregnant women with mild preeclampsia patients.Conclusions:Yoga exercise during pregnancy(upper 20 weeks of gestation)significantly decreased systolic and diastolic blood pressure in mild preeclampsia patients.
文摘Introduction: Preeclampsia can lead to several maternal and perinatal adverse effects. There are few published data on the association between transmembrane serine protease 6 (TMPRSS6) gene polymorphism and preeclampsia. Objective: To assess the association between TMPRSS6 gene polymorphism rs855791SNP in women with preeclampsia compared with healthy pregnant women. Method: A case-control study (60 women in each arm) was conducted at Saad Abuaela Maternity Hospital in Khartoum, Sudan. Sociodemographic and clinical data were gathered through a questionnaire. The participant was genotype for TMPRSS6 gene rs855791SNP using Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP). The results were confirmed by DNA sequencing. Result: There was no significant difference in the median of age, parity, and body mass index. The distribution of the genotypes and alleles of TMPRSS6 rs855791 was consistent with the HWE. The overall TMPRSS6 rs855791 polymorphism was not significantly associated with preeclampsia. However, the proportion of heterozygotes (TC) was considerably higher in the women with preeclampsia (46.7%) than in the control group (23.3%) (p = 0.001;OR = 2.71;95% CI = 1.21 - 6.07). The proportion of homozygotes (TT) and T alleles was not significantly different between women with preeclampsia and the control group. Conclusion: The overall TMPRSS6 rs855791 polymorphism was not significantly associated with preeclampsia and healthy control.
基金Hainan Natural Science Foundation project(822MS175)National Nature Science Foundation of China(No.82072880,82003144,81960283,82201874)+1 种基金Supported by the Specific Research Fund of the Innovation Platform for Academicians of Hainan ProvinceProject supported by Hainan Province Clinical Medical Center。
文摘Objective:In this study,we aimed to explore the expression of TUSC3 in Preeclampsia and to research the potential function of TUSC3 in placental trophoblast cells.Methods:We collected 10 cases of normal placental tissues and preeclampsia placental tissues,respectively.These parturient received treatment at the First Affiliated Hospital of Hainan Medical University between June 1,2020,and December 31,2022.The expression of TUSC3 in placenta was detected by immunohistochemistry.The effect of TUSC3 on the migration and invasion of HTR8/SVneo cells was analyzed by migration assay and Transwell assay.Results:The expression of TUSC3 was slightly increased in placental villis in preeclampsia.Immunohistochemistry and qRT-PCR were used to detect the expression of TUSC3 protein and mRNA in placental tissues.TUSC3 was markedly upregulated in PE placental tissues(P<0.01).The results of migration assay and Transwell assay showed that the migration rate and the number of invasive cells were significantly decreased in HTR8 overexpressing TUSC3(P<0.01).Conclusions:TUSC3 was markedly increased in PE placental tissues and inhibited trophoblast cells migration and invasion.
基金Hainan Provincial Natural Science Foundation Project(821MS128,822MS164)Hainan Provincial People's Hospital National Natural Science Foundation Cultivation Project(530)(2021MSXM04)。
文摘Objective:To investigate the effect of exosomes secreted by decidual macrophages on trophoblast cells and their molecular mechanism.Methods:The decidual tissues of patients with preeclampsia(PE)and normal-term pregnant women were collected.Macrophages were obtained by the density gradient method and then flow cell sorting,then the exosomes were extracted.The structure of the exosomes was observed by transmission electron microscope.The expression of CD63,a marker protein of the exocrine body,was detected by western blot,and the exosomes were identified.CCK-8 was used to detect the effect of exosomes on trophoblast cell viability.Transwell migration experiment was used to detect the influence on migration ability.The expression of miR-146a-5p in exosomes was detected by qPCR.The effect of exosomes on the expression of HIF1αprotein in trophoblasts was detected by western blot and detection of the binding site between miR-146a-5p and HIF1αby double luciferase reporter gene was conducted.Results:The exosomes of macrophages present a"cake"structure with a middle depression about 30-130 nm in diameter,and CD63 is highly expressed,which conforms to the characteristics of exosomes.Compared with the normal group,the exosomes of decidual macrophages in the PE group inhibited the activity and migration of trophoblast cells(P<0.001).The expression of miR-146a-5p in the exosomes of decidual macrophages in the PE decreased significantly,and after exosomes of PE decidual macrophages treating trophoblast cells,the protein expression of HIF1αin trophoblast cells was significantly increased.There are targeted binding sites between miR-146a-5p and HIF1α.Conclusion:PE decidual macrophage exosomes can inhibit the viability and migration of trophoblast cells,which may be related to the decreased expression of miR-146a-5p in exosomes,thus promoting HIF1αprotein expression of trophoblast cells.
文摘Background: FoxP3 gene variants have been linked to endometriosis, infertility, and autoimmune illnesses, according to numerous researches. Maternal sensitivity to the PE gene and the genetic variations of FoxP3 has not been thoroughly investigated. Objective: Investigation of the immune-histochemical expression of FoxP3 in placental tissue of PE patients. Methods: A total of 26 pre-eclamptic women as a case and 26 ethnically matched healthy pregnant women as a control group aged between 18 and 40 years old of different gravidity and parity referred to the labor ward for delivery either by vaginal delivery or cesarean section was enrolled to investigate the immunohistochemical expression of FOXP3 in placental tissue of PE patients. Results: Lower expression of FOXP3 IHC was statistically significant and noted in the group of preeclampsia compared to the healthy control group. Lower gestational age at delivery and a higher percentage of cesarean section were statistically significant and noted in the group of preeclampsia compared to the healthy control group. Conclusion: In comparison to the healthy control group, preeclampsia patients had statistically significantly lower FOXP3 IHC expression, and FOXP3 polymorphism was associated with the development of PE. Our findings can serve as a guide for statistical analyses and functional investigations that are more in-depth.
文摘BACKGROUND Preeclampsia is a pregnancy-specific multi-system disease with multi-factor and multi-mechanism characteristics.The cure for preeclampsia is to terminate the pregnancy and deliver the placenta.However,it will reduce the perinatal survival rate,prolong the pregnancy cycle,and increase the incidence of maternal complications.With relaxation of the birth policy,the number of elderly pregnant women has increased significantly,and the prevalence rate of preeclampsia has increased.Inappropriate treatment can seriously affect the normal postpartum life of pregnant women.Studies have shown that postpartum anxiety in women with preeclampsia can affect physical and mental health,as well as infant growth and development.AIM To analyze the factors influencing preeclampsia in pregnant women complicated with postpartum anxiety,and to construct a personalized predictive model.METHODS We retrospectively studied 528 pregnant women with preeclampsia who delivered in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine between January 2018 and December 2021.Their basic data were collected,and various physiological and biochemical indicators were obtained by laboratory examination.The self-rating anxiety scale was used to determine whether the women had postpartum anxiety 42 d after delivery.The independent factors influ-encing postpartum anxiety in early pregnant women with eclampsia were analyzed with multifactor logistic regression and a predictive model was constructed.The Hosmer-Lemeshow test and receiver operating characteristic(ROC)curve were used to evaluate the calibration and discrimination of the predictive model.Eighty pregnant women with preeclampsia admitted to our hospital from January 2022 to May 2022 were retrospectively selected to verify the prediction model.RESULTS We excluded 46 of the 528 pregnant women with preeclampsia because of loss to follow-up and adverse outcomes.A total of 482 cases completed the assessment of postpartum anxiety 42 d after delivery,and 126(26.14%)had postpartum anxiety.Bad marital relationship,gender discrimination in family members,hematocrit(Hct),estradiol(E2)hormone and interleukin(IL)-6 were independent risk factors for postpartum anxiety in pregnant women with preeclampsia(P<0.05).Prediction model:Logit(P)=0.880×marital relationship+0.870×gender discrimination of family members+0.130×Hct-0.044×E2+0.286×IL-6-21.420.The area under the ROC curve of the model was 0.943(95%confidence interval:0.919-0.966).The threshold of the model was-1.507 according to the maximum Youden index(0.757),the corresponding sensitivity was 84.90%,and the specificity was 90.70%.Hosmer-Lemeshowχ^(2)=5.900,P=0.658.The sensitivity,specificity and accuracy of the model were 81.82%,84.48%and 83.75%,respectively.CONCLUSION Poor marital relationship,family gender discrimination,Hct,IL-6 and E2 are the influencing factors of postpartum anxiety in preeclampsia women.The constructed prediction model has high sensitivity and specificity.
文摘Objective: This study is to observe the effects of Salvia miltiorrhiza injection on blood pressure and cardiac function in rats with pregnancy-induced hypertension and preeclampsia. Methodology: Syncytiotrophoblast microvilli (stbm) and l-arginine nitrosyl methyl ester were screened out via caudal vein injection. Twenty gestational hypertension-preeclampsia model SD (Sprague Dawley) rats successfully induced by L-NAME (L-arginine Nitrosyl methyl ester) were randomly divided into 2 groups (model group and Danshen injection group, n = 10). Then another 10 normal pregnant SD rats without model were selected as blank control group. The Salvia miltiorrhiza injection group was given Salvia miltiorrhiza injection (0.5 g?kg?1?d?1) through tail vein, and the control group and model group were given equal volume of normal saline through tail vein injection. All three groups were treated by tail vein injection once a day (d) for 7 days. After treatment, heart rate (HR), Systolic pressure (SP), diastolic pressure (DP) and mean arterial pressure (MAP) were measured by tail artery. Left ventricular end-diastolic diameter (LVDd) and Left ventricular end systolic diameter (LVDs) were recorded by echocardiography. Left ventricular end diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), left ventricular ejection fraction (left ventricular ejection) fraction, LVEF) and the maximum rate of increase/decrease of left ventricular pressure during isovolemic systole (+dp/dtmax/?dp/dtmax);Endothelin-1 (ET-1) levels in rat tail vein blood were detected by ELISA. Results: SP, DP, MP, HR, LVSP, LVDs and ?dp/dtmaxx were all decreased, plasma ET-1 expression was low, and LVDd, LVEDP, LVEF, and +dp/dtmax were all increased in the Salvia miltiorroot injection group, with statistical significance compared to the model group (p Conclusion: Salvia miltiorrhiza injection can improve the cardiac function and reduce blood pressure in rats with pregnancy-induced hypertension and preeclampsia, and the mechanism may be related to alleviating systemic arteriolar spasm by regulating ET-1 level.
文摘Background: Knowledge of temporal evolution of preeclampsia (PE) in its various aspects is essential in strategies to reduce maternal and perinatal morbidity and mortality. Preeclampsia is a public health problem due to maternal mortality associated with it worldwide (5.6%). Improving quality of its management is a major challenge in low-income countries where, despite progress made in this field, PE remains a major factor in maternal morbidity and mortality. Objective: To evaluate temporal evolution of frequency, risk factors and complications of PE at the University clinics of Kinshasa (UCK). Methods: Descriptive and cross-sectional study concerning minimum simple size of 119 pregnant women who consulted for antenatal care at the University clinics of Kinshasa from January 2012 to December 2022. Results will be reported as percentage proportion, mean and standard deviation. Comparison of proportion and means between groups will be made using Student’s t-test and Pearson’s chi-square test, respectively. The test will be statistically significant for a p value ≤ less than 0.05. Data will be collected and analysed anonymously and confidentially. Conclusion: This study will allow us to evaluate the effectiveness of different prevention and treatment modalities used over time in management of preeclampsia in our setting.
文摘In tropical countries, malaria and preeclampsia/eclampsia are common diseases of pregnancy;and placenta have been implicated in the pathophysiology of both disease processes. The two diseases have pathophysiologic similarities in the placenta such as placenta ischaemia, endothelial dysfunction and production of pro-inflammatory cytokine. Yet, there is paucity of studies on the association of these two disease processes. Determining the association between the two disease processes may help to unravel the pathogenesis of preeclampsia and also help in its prevention and patient management. Objective: Determined the association between placenta malaria parasitemia and preeclampsia/eclampsia among parturients at Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Methods: This was a case control study that was conducted in the Labour wards of department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA) and Mile 4 Missionary Hospital Abakaliki, a comprehensive health care centre in Abakaliki, Ebonyi state. It was conducted over a period of 6 months between 1<sup>st</sup> October 2021 and 31<sup>st</sup> March, 2022. The cases in this study were parturients that developed preeclampsia/eclampsia in the course of pregnancy, while the controls were parturient without preeclampsia/eclampsia. Interviewer-administered questionnaires were used to collect data on socio-demographic characteristics, obstetrics and medical histories. Histological examinations were conducted to isolate plasmodium falciparum parasites from placenta samples obtained from the maternal surface of the placenta. The data was processed using Epi Info software. Categorical variables were analyzed using Mc Nemar X<sup>2</sup> test, with a p-value of 0.05 considered statistically significant. Logistic regression models were used to estimate the odds ratios (OR) and 95% CI of the association between placenta malaria parasites and preeclampsia/eclampsia was conducted. Relative risk with 95% CI was used to determine both fetal and maternal outcomes. Results: The prevalence of preeclampsia during the study period was 2.9%. Placenta malaria was positive in twenty one (21) of the 67 cases of preeclampsia/eclampsia analyzed, giving a prevalence of 31.3% and in eleven (11) out of 68 controls (normotensive) patients analyzed, giving a prevalence of 16.2%. The presence of placenta malaria significantly increased the odds of developing preeclampsia/eclampsia among parturients (OR = 2.4, 95% CI = 1.0 - 5.4, P value = 0.04). Presence of placenta malaria in mothers with preeclampsia/eclampsia was associated with adverse pregnancy outcomes such as cerebrovascular accident (RR = 19.2, 95% CI = 1.1 - 341.7, P value = 0.04), DIC (RR = 10.9, 95% CI = 1.4 - 88.0, P value = 0.02), abruptio placenta (RR = 2.4, 95% CI = 1.2 - 4.8, P value = 0.01), pulmonary edema (RR = 2.7, 95% CI = 1.1 - 25.9, P value = 0.03), IUGR (RR = 2.1, 95% CI = 1.1 - 4.5, P value = 0.03) and IUFD (RR = 3.8, 95% CI = 1.3 - 11.7, P value = 0.02). Presence of placenta malaria also increased the risk of NICU admission (RR = 2.6, 95% CI = 1.1 - 6.0, P value = 0.03), Low 1<sup>st</sup> minute APGAR score (RR = 2.7, 95% CI = 1.2 - 6.1, P value = 0.02) and Low 5<sup>th</sup> minute APGAR score (RR = 3.0, 95% CI = 1.0 - 8.6, P value = 0.04) among neonates delivered by mothers with preeclampsia/eclampsia. However, presence of placenta malaria did not significantly increase maternal and perinatal mortalities. Conclusion: There is a higher prevalence of placenta malaria among mothers with preeclampsia/eclampsia when compared with normotensive controls and this was associated with increased risk of certain maternal and perinatal morbidities. Placental malaria was not associated with increased risk of either maternal or perinatal mortality.
文摘Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.
基金the ethical committee of Mustansiriyah University(No.160).
文摘BACKGROUND Preeclampsia(PE)is a pregnancy syndrome of undetermined etiology;inflammation was one of the proposed theories for its development.AIM To examine the platelet to lymphocyte ratio(PLR),an inflammatory biomarker,as a marker to predict poor maternal-neonatal outcomes in early-onset PE(EoPE).METHODS A cross-sectional study enrolled 60 pregnant women with EoPE(at 32-30 wk of gestation)at a university hospital.Demographic criteria and hematological indices were collected,including platelet counts and indices(mean platelet volume and platelet distribution width),PLR,and the Doppler study,which calculated estimated fetal weight(EFW),amniotic fluid index(AFI),resistance index(RI),and pulsatility index(PI).Participants were followed until delivery,where maternal outcomes were recorded,including;delivery mode and reason for cesarean section,and neonatal outcomes,including fetal growth restriction(FGR),meconium-stained liquid,the 5-min Apgar score,and admission to the intensive care unit.RESULTS There was a trend of insignificant increases in cesarean sections.Sixty-one-point two percent(37/60)fetuses were admitted to the neonatal care unit;70.0%of admitted fetuses were meconium-stained liquor,and 56.7%of them had FGR.PLR was positively correlated with AFI and EFW as r=0.98,0.97,P<0.001;PLR showed negative correlations with PI and RI as r=-0.99,-0.98,P<0.001.The Apgar score and the number of days admitted to the intensive care unit had a positive and negative correlation(0.69,-0.98),P<0.0001,respectively.Receiver operating characteristic calculated a PLR cutoff value(7.49)that distinguished FGR at 100%sensitivity and 80%specificity.CONCLUSION Strong,meaningful relationships between PLR and FGR parameters and a poor neonatal outcome with a significant P value make it a recommendable biomarker for screening EoPE-related complications.Further studies are suggested to see the impact on maternal-neonatal health.
基金supported by National Natural Science Foundation of China(No.39770176)National Natural Science Funds for Distinguished Young Scholar(No.3 9925012)
文摘Objective: To study the effect of hypoxia on the expression of placental trophoblast cells SATB1 and β-catenin and its correlation with the pathogenesis of preeclampsia. Methods: Trophoblastic cell lines HRT8/SVneo were cultured, SATB1 and β-catenin expression and cell biological behavior were determined after hypoxia reoxygenation treatment; cell biological behavior and the expression of related genes were determined after the transfection of SATB1 and β-catenin siR NA; preeclampsia placenta and normal placenta tissues were collected and the expression of SATB1 and β-catenin were determined. Results: OD value, cell migration rate, m RNA contents of SATB1 and β-catenin of H/R group were significantly lower than those of Nor group, cell apoptosis rate was higher than that of Nor group and the number of invasive cells was less than that of Nor group; OD value and bcl-2 mRNA content of SATB1-siRNA group were lower than those of NC group; cell apoptosis rate as well as Bax, Caspase-3, caspase-6 and caspase-9 mRNA contents were higher than those of NC group; cell migration rate as well as CTSB, CTSD, MMP2 and MMP9 mRNA contents of β-catenin-siRNA group were lower than those of NC group; the number of invasive cells was less than that of NC group; the expression levels of SATB1 and β-catenin in preeclampsia placenta tissue were significantly lower than those in normal placenta tissue. Conclusions: Hypoxia can inhibit the expression of SATB1 and β-catenin in the pathogenesis of preeclampsia, which can affect the proliferation, apoptosis, migration and invasion of cells.
文摘This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients with severe preeclampsia (PE group) and 20 normal pregnant women (control group) to prepare monocytes which were then treated with LXA 4 at different concentrations of 0,10,100 nmol/L respectively.IL-1β level in the supernatant of monocytes was detected by enzyme linked immunoassay.The [Ca 2+ ] i of monocytes was measured by laser scanning confocal microscopy.The results showed that the IL-1β level and the [Ca 2+ ] i of monocytes in the PE group were significantly higher than those in the control group.LXA 4 significantly decreased the generation of IL-1β in a dose-dependent manner in the PE group.After treatment with 100-nmol/L LXA 4,in the PE group,the [Ca 2+ ] i concentration of monocytes was significantly reduced.It was concluded that LXA 4 may inhibit the IL-1β production of monocytes from severe preeclampsia women by inhibiting extracellular calcium influx.
基金the Beijing Municipal Administration of Hospitals Youth Program Grant,No.QML20161403.
文摘BACKGROUND Very few studies have been published on the hemodynamic changes associated with spinal anesthesia induced with ropivacaine during cesarean deliveries in preeclamptic women.AIM To record and analyze hemodynamic data in women with preeclampsia undergoing cesarean delivery after spinal anesthesia induced with ropivacaine.METHODS Ten eligible women with preeclampsia were enrolled in this prospective observational study.Spinal anesthesia was performed with 2.4 mL of 0.5%ropivacaine.Hemodynamic changes were then analyzed at multiple time points.The hemodynamic responses to vasopressor interventions and uterotonic agents,as well as maternal and neonatal outcomes were also recorded.RESULTS Stable hemodynamic trends were observed in this study.Cardiac output(CO)and stroke volume increased mildly during surgery.In contrast,mean arterial pressure and systemic vascular resistance showed a moderate decrease from induction until the end of surgery.Central venous pressure dramatically increased after delivery.Oxytocin administration was associated with the most significant hemodynamic fluctuations during surgery,namely,an increase in CO and heart rate.Phenylephrine intervention was only required in three patients,and caused an increase in mean arterial pressure and systemic vascular resistance along with a decrease in heart rate,stroke volume,and CO.No maternal and neonatal complications were observed during this study,except transient episodes of hypotension.CONCLUSION Spinal anesthesia for caesarian delivery with ropivacaine in women with preeclampsia is linked to modest hemodynamic changes of no clinical significance in this study.Careful cardiovascular monitoring is still recommended,particularly after the delivery of the fetus or the use of oxytocin.
文摘The expression of Toll-like receptor 4 (TLR4) in neonatal cord blood mononuclear cells (MNCs) and serum TNF-α were investigated in order to explore the roles of TLR4 in the pathogenesis of preeclampsia.The study enrolled 27 patients suffering from preeclampsia (experimental group) and 21 normal pregnancy patients (control group).After MNCs were separated, the expression of TLR4 mRNA and protein was detected by using real-time quantitative PCR and Western blotting respectively, and the expression of TNF-α by using ELISA.The results showed the TLR4 mRNA level in cord blood MNCs (2-CT:0.07±0.17), TLR4 protein expression level (absorbance ratio:0.81%±0.15%) and TNF-α level (9.5±1.73 pg/mL) were all increased in experimental group as compared with control group with the differences being statistically significant (P<0.05).There was a positive correlation between the expression of TLR4 mRNA and TNF-α in both experimental group and control group (r=0.54 and 0.53, respectively, P<0.05).It was concluded that TLR4 expression in the experimental group of cord blood MNCs was increased and there was a positive correlation between the expression of TLR4 mRNA and TNF-α in both groups.TLR4-mediated release of inflammatory cytokines may be one of the important reasons leading to preeclampsia.
文摘This study examined the association of expression of vascular endothelial growth factor(VEGF),a promoter of angiogenesis,with endothelium dysfunction in preeclampsia.The level of VEGF protein and mRNA in the placenta and peripheral blood samples of 30 preeclampsia patients and 30 normotensive pregnant women was measured by immunohistochemistry,real-time reverse transcriptase-polymerase chain reaction(RT-PCR) and enzyme-linked immunosorbent assay(ELISA),respectively.VEGF expression in the human umbilical vein endothelial cells(HUVECs) was blocked by small interfering RNAs(siRNAs).The monolayer barrier function of HUVECs was determined by measuring the fluorescence intensity of BSA that crossed the HUVEC monolayers.The cell proliferation and cell-secreted nitric oxide(NO) level were detected by MTT method and nitrate reductase assay,respectively.The results showed that VEGF was expressed in the syncytiotrophoblasts and endothelial cells of vessels and capillaries in the placenta tissue.The serum level of VEGF in the preeclampsia patients was significantly decreased as compared with that in normal pregnant subjects,although VEGF mRNA expression in the placenta tissue of preeclampsia patients remained still high.Moreover,VEGF deficit could lead to endothelium cell dysfunction,and the administration of VEGF could protect endothelium cells from injury.It was concluded that lack of VEGF contributes to endothelium dysfunction,which may lead to the occurrence and development of preeclampsia.
文摘Objectives: Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. Early diagnosis of preeclampsia is important to help patients with preeclampsia. However, 24-hour urine collection is the gold standard diagnostic method at present. Recently, the spot urinary protein-to-creatinine ratio (P/C ratio) has been used to detect suspected preeclampsia, because it can be used to estimate the amount of 24-hour urinary protein. The aim of this study is to investigate whether an increase in P/C ratio precedes emergence of hypertension among inpatients with preeclampsia. Method: The P/C ratio in normotensive (systolic blood pressure < 140 mm Hg and diastolic blood pressure < 90 mm Hg) pregnant women was measured during regular prenatal checkups and in inpatients with preeclampsia between April 1, 2013 and March 31, 2014. Results: We included in this study 4074 normotensive pregnant women. The 95th percentile values for the trimester of pregnancy were 0.100, 0.157, and 0.195, respectively. The 95th percentile value for each trimester of pregnancy and gestational age were determined as criterion (Y) and predictive variables (X), respectively. In a simple regression analysis, the regression line was calculated as Y = 0.0035X + 0.0849 (R2 = 0.9913). Twenty-one women were diagnosed with preeclampsia. In 14 patients with preeclampsia, the timing of the increase in P/C ratio to higher than the regression line preceded the emergence of hypertension. Six patients had no data on P/C ratio, and 1 patient had hypertension before the increase in P/C ratio. Conclusions: An increase in P/C ratio to higher than the 95th percentile value can be a useful predictor of preeclampsia.
文摘Background: Preeclampsia (PE) still ranks as one of obstetrics major problems and is still a serious threat, mainly in underdeveloped countries where its incidence and mortality rates are higher and is a major cause of preterm birth and intra-uterine growth restriction. Aim: To evaluate the role of oxidative stress and dyslipidemia as indicators of pathogenesis and risks of preeclampsia in pregnant Sudanese women attending Wad-Medani Obstetrics and Gynecology Teaching Hospital. Material and Method: This was a cross-sectional (case-control) study carried out in preeclamptic pregnant Sudanese women attending Wad-Medani Obstetrics and Gynecology Teaching Hospital. A total of 208 pregnant women were enrolled in the study, 111 patients and 97 women with normal pregnancy as controls;pregnant women suffering from any systemic or endocrine disorder were excluded. We compared the serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, nitric oxide, and total antioxidant capacity between preeclamptic and controls. Result and Conclusion: Pregnant women with increase in BMI have a higher chance of developing PE. Low level of high-density lipoprotein cholesterol and high level of low-density lipoprotein cholesterol define that dyslipidemia increases the risk of PE. Decreased levels of NO and TAC might reflect the oxidative stress and likely contribute to the pathophysiological mechanisms of PE.
