Prediction and prevention of pre-eclampsia
... Pre-eclampsia occurs in 2 to 8% of all pregnancies. Every year 70,000 women die due to pre-eclampsia and its complications. Most of these deaths occur in developing countries. In developed countries, the risk of maternal or fetal death is low, but the complications of pre-eclampsia may be severe. Early-onset disease may end in a very preterm birth, since delivery is the only treatment available. We studied prediction and prevention of pre-eclampsia in the PREDO cohort, which involved 947 pregnant women with risk factors of pre-eclampsia and 117 controls. Our study included also a meta-analysis showing that low-dose aspirin, 100 mg per day, prevents pre-eclampsia (risk ratio [RR] 0.6, ...https://helda.helsinki.fi/handle/10138/216691
Prediction and prevention of pre-eclampsia
... Pre-eclampsia occurs in 2 to 8% of all pregnancies. Every year 70,000 women die due to pre-eclampsia and its complications. Most of these deaths occur in developing countries. In developed countries, the risk of maternal or fetal death is low, but the complications of pre-eclampsia may be severe. Early-onset disease may end in a very preterm birth, since delivery is the only treatment available. We studied prediction and prevention of pre-eclampsia in the PREDO cohort, which involved 947 pregnant women with risk factors of pre-eclampsia and 117 controls. Our study included also a meta-analysis showing that low-dose aspirin, 100 mg per day, prevents pre-eclampsia (risk ratio [RR] 0.6, ...https://helda.helsinki.fi/handle/10138/216691?locale-attribute=sv
The importance of genetic and environmental effects for pre-eclampsia and gestational hypertension: a family study - Nilsson -...
Objectives To determine the importance of genetic effects in the aetiology of pre-eclampsia and gestational hypertension and to investigate whether pre-eclampsia and gestational hypertension share genetic aetiology.. Design Individual record linkage between the population-based Swedish Multi-Generation and the Medical Birth Registers.. Setting Sweden.. Population 1,188,207 births between 1987 and 1997 and their parents.. Methods Similarities in relatives were measured by the number of pairs concordant and discordant for disease, the odds ratio (OR) and tetrachoric correlations. Estimates of genetic and environmental effect for gestational hypertension, pre-eclampsia and pregnancy-induced hypertension were calculated from structural equation model fitting.. Main outcome measures Pre-eclampsia and gestational hypertension.. Results Full sisters and ...http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2004.00042x.x/abstract
Recurrent pre-eclampsia and subsequent cardiovascular risk | Heart
Results Women with recurrent pre-eclampsia had higher incidence of cardiovascular hospitalisation (281.4 per 1000) than women with non-recurrent (167.7 per 1000) or no pre-eclampsia (72.6 per 1000). Mean time to cardiovascular hospitalisation was 10.5 years for recurrent, 11.6 years for non-recurrent and 12.7 years for no pre-eclampsia, a difference of 17.3% for recurrent and 8.7% for non-recurrent relative to no pre-eclampsia. Compared with no pre-eclampsia, recurrent pre-eclampsia was associated with 2 times the risk of heart disease (95% CI 1.69 to 2.29) and 3 times the risk of cerebrovascular disease (95% CI 2.25 to 4.05). Pre-eclampsia in women with one delivery was associated with 3 times greater risk of cardiovascular hospitalisation compared with no ...http://heart.bmj.com/content/early/2016/08/16/heartjnl-2016-309671
Selectins in normal pregnancy, pre-eclampsia and missed abortus » Brill Online
Selectins, are known to be increased in the serum of patients with pre-eclampsia, indicating that these molecules are possible markers of endothelial cell injury. In this study, we investigated P,Eand Lselectin levels in normal pregnancy,pre-eclampsia, and missed abortus. Plasma P and L selectins levels were significantly higher in normal pregnancy and pre-eclampsia than healthy controls; but plasma concentrations of E selectins were not different between these groups. Plasma P selectin was significantly higher in pre-eclampsia than normal pregnancy. Plasma concentrations of all selectins were significantly higher in missed abortus than healthy control. L selectin levels were higher in pre-eclampsia and missed abortus than normal pregnancy. We found the levels of selectins ...http://booksandjournals.brillonline.com/content/journals/10.1163/15685590151092670
北京大学医学部机构知识库(IR@PKUHSC): High Levels of Activin A Detected in Preeclamptic Placenta Induce Trophoblast Cell Apoptosis by...
Context: The pregnancy-specific disorder preeclampsia is a major cause of maternal mortality and morbidity. Activin A has been suggested as a potential biomarker of the disease, but whether it plays a role in the pathology of preeclampsia or is just a manifestation of the disease is not fully understood.. Objective: The objective of the study was to examine the roles of ActivinAon placental trophoblast cells under pathological conditions of preeclampsia.. Design: Placental and plasma productions of ActivinAin healthy pregnant women and preeclamptic patients were compared by using clinical samples obtained from Peking University First Hospital during November 2005 to November 2007. The role of Activin A at pathological doses was investigated in human trophoblast cells.. Results: Plasma and ...http://ir.bjmu.edu.cn/handle/400002259/67253
Pregnancy - Pregnancy Topics - Pre-eclampsia - hypertension in pregnancy
Pre-eclampsia is a disorder of pregnancy where there is high blood pressure and protein in the urine. It occurs in five to eight percent of pregnancies, and is the leading known cause of preterm birth. Pre-eclampsia can occur at any time during pregnancy, and up to six weeks after birth. It is most common after 20 weeks of pregnancy and in first pregnancies. It can develop gradually over many weeks, or come on suddenly over a few hours. It can only be cured by the birth of your baby and usually has gone within 48 hours after the birth. A woman with pre-eclampsia may feel well and have no symptoms. It is therefore vital to have regular antenatal checks of blood pressure and urine to detect the condition before it becomes dangerous for mother and baby. The causes of ...http://cyh.com/HealthTopics/HealthTopicDetails.aspx?p=438&np=462&id=2783
Reduced risk of pre-eclampsia with organic vegetable consumption: results from the prospective Norwegian Mother and Child...
Pre-eclampsia is one of the major causes of maternal and perinatal morbidity and mortality worldwide, affecting 2-8% of pregnancies.1 ,2 The aetiology of pre-eclampsia is largely unknown, but increasing evidence suggests an excessive maternal systematic inflammatory response to pregnancy.3-7 Pre-eclamptic pregnancies are characterised by endothelial dysfunction, disturbed placentation, oxidative stress and an exaggerated inflammatory response to pregnancy.8 Known risk factors include first pregnancy, obesity and other cardiovascular risk factors.2 ,9. The maternal diet is one of many factors suggested to play a role in the aetiology of pre-eclampsia.10 ,11 In a previous study in the Norwegian Mother and Child Cohort Study (MoBa), we found that high scores on a healthy diet ...http://bmjopen.bmj.com/content/4/9/e006143
First-Trimester Risk Assessment for Early-Onset Preeclampsia - ACOG
In general, models that incorporate multiple predictive factors demonstrate better detection rates than those using only a single factor. Models also tend to have better predictive value (ie, proportion of patients with positive test results who develop preeclampsia) for early-onset preeclampsia and severe preeclampsia. Overall, most studies have reported modest PPVs. The case-control design, the small number of cases of early-onset preeclampsia, and the large number of predictors in available screening models raise concerns that reported detection rates are overly optimistic. These models also have not been validated independently in prospective cohorts. For a predictive test for preeclampsia to be useful, it would need a high sensitivity and a high PPV, such that women who ...https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/First-Trimester-Risk-Assessment-for-Early-Onset-Preeclampsia
Pre-Eclampsia Affects Cord Blood NK Cell Expression of Activation Receptors and Serum Cytokine Levels but Not CB Monocyte...
ProblemMaternal immunopathology in pre-eclampsia is well studied; however, less is known regarding the immunological effects on the newborns. Increased inflammation and activation of immune cells at the fetal-maternal interface in pre-eclampsia could influence the neonatal immune compartment. Method of StudyMonocytes and natural killer (NK) cells from cord blood (CB) of children with pre-eclamptic or healthy mothers were analyzed by flow cytometry for surface markers and intracellular cytokines. In addition, serum cytokine profiles were investigated using ELISA or cytometric bead array. ResultsNeonates born to pre-eclamptic mothers had an inflammatory serum cytokine profile. While CB monocyte characteristics seemed unaffected, CB NK cells from pre-eclamptic pregnancies had higher NKp30, but borderline lower NKG2D expression. ConclusionIn utero inflammatory ...http://su.diva-portal.org/smash/record.jsf?pid=diva2:696603
A Retrospective Review of the Seasonality of Pre-Eclampsia - Full Text View - ClinicalTrials.gov
This study is a retrospective review of obstetrics charts of women who gave birth at OSU Medical Center between January 01, 2005 and December 31, 2007.. Included will be patient charts of women , 18 years old who were admitted to OSUMC for delivery (both cesarean and vaginal deliveries) between 1/1/05 and 12/31/07, with and without a diagnosis of pre-eclampsia. The data collected will be recorded in a spreadsheet by month/day of delivery, and whether pre-eclampsia was a diagnosis. Also included will be total number of deliveries per month and total number of pre-eclampsia diagnoses per month. The rate of pre-eclampsia will be calculated.. A contingency table with corresponding chi square test will be performed to determine whether there is a significant relationship of the diagnosis of pre-eclampsia with seasonality, defined ...https://clinicaltrials.gov/ct2/show/NCT00826696
A Retrospective Review of the Seasonality of Pre-Eclampsia - Full Text View - ClinicalTrials.gov
This study is a retrospective review of obstetrics charts of women who gave birth at OSU Medical Center between January 01, 2005 and December 31, 2007.. Included will be patient charts of women , 18 years old who were admitted to OSUMC for delivery (both cesarean and vaginal deliveries) between 1/1/05 and 12/31/07, with and without a diagnosis of pre-eclampsia. The data collected will be recorded in a spreadsheet by month/day of delivery, and whether pre-eclampsia was a diagnosis. Also included will be total number of deliveries per month and total number of pre-eclampsia diagnoses per month. The rate of pre-eclampsia will be calculated.. A contingency table with corresponding chi square test will be performed to determine whether there is a significant relationship of the diagnosis of pre-eclampsia with seasonality, defined ...https://clinicaltrials.gov/ct2/show/NCT00826696?term=eclampsia&rank=17
Detection and Identification of Preeclampsia Via Volatile Biomarkers - Tabular View - ClinicalTrials.gov
Preeclampsia is a form of hypertension that is unique to human pregnancy. The clinical findings of preeclampsia can manifest as either a maternal syndrome (hypertension and proteinuria with or without other multisystem abnormalities) or as a fetal syndrome (fetal growth restriction, reduced amniotic fluid, and abnormal oxygenation).. The incidence of preeclampsia ranges between 2 and 7 percent in healthy nulliparous women. In these women, preeclampsia is generally mild, with the onset near term or intrapartum (75 percent of cases), and the condition conveys only a minimally increased risk for adverse pregnancy outcome. In contrast, the incidence and severity of preeclampsia are substantially higher in women with multifetal gestation, chronic hypertension, previous ...https://clinicaltrials.gov/ct2/show/record/NCT01291342?term=%22High+Blood+Pressure%22&lup_s=01%2F28%2F2013&lup_d=14&show_rss=Y&sel_rss=mod14
AT1 Receptor Agonistic Antibodies From Preeclamptic Patients Stimulate NADPH Oxidase | Circulation
A role for oxidative stress in the pathogenesis of preeclampsia is compelling.15 Preeclampsia is associated with a distinct pathological placental lesion of the decidual arterioles known as acute "atherosis" that has a striking resemblance to atherosclerotic lesions in coronary arteries and elsewhere. The endothelium is disrupted, platelet aggregates are formed, and lipid-laden macrophages accumulate.16 Interestingly, increased NADH-oxidase-mediated superoxide production has been identified in the early stages of atherosclerosis and endotoxemia. APO-E−/− mice that were also missing the p47phox gene had less total area atherosclerotic lesions than APO-E−/− control mice.17 Preeclamptic women exhibit insulin resistance and dyslipoproteinemia. Indeed, dyslipoproteinemia appears to persist in women with a history of preeclampsia. Such women have an increased long-term ...http://circ.ahajournals.org/content/107/12/1632
Myometrial and placental artery reactivity alone cannot explain reduced placental perfusion in pre-eclampsia and intrauterine...
OBJECTIVES: (1) To investigate a possible association between myometrial and placental artery vasoreactivity and perfusion at the basal and chorionic plates, respectively. (2) To confirm that myometrial arteries from women with pre-eclampsia and intrauterine growth restriction exhibit an attenuated endothelium-dependent vasodilatory response. METHODS: Women with normal pregnancy, pre-eclampsia and intrauterine growth restriction had a magnetic resonance scan to assess placental perfusion using a technique called intravoxel incoherent motion. At delivery, myometrial and chorionic plate placental arteries were assessed on a wire myograph. Vessels were pre-constricted with the thromboxane mimetic U46619 and dilated with incremental doses of bradykinin. RESULTS: Pre-constricted myometrial arteries from women with ...https://www.neuroscience.ox.ac.uk/publications/247736
... The Mouse Pre-Eclampsia RT Profiler PCR Array profiles the expression of 84 key genes involved in dysregulation of placental development. Pre-eclampsia, a life-threatening disease, presents with high blood pressure during pregnancy, and delivery of the placenta provides the only cure. This disease is considered early-onset if the pregnancy is less than 32 weeks, and is otherwise called late-onset. The causes of pre-eclampsia are not entirely understood. Many patients show poor placental implantation, suggesting that pre-eclampsia begins very early in pregnancy, even though the symptoms only arise later. A potential molecular mechanism involves defective vascular remodeling by trophoblasts early in ...http://sabiosciences.com/rt_pcr_product/HTML/PAMM-163Z.html
Hemorrhagic Shock, Pre-Eclampsia And Keloids Pipeline Review To H1 2015: Radiant Insights | Phoenix News Desk
http://www.radiantinsights.com/research/hemorrhagic-shock-pipeline-review-h1-2015. Pre-Eclampsia - Pipeline Review, H1 2015. Summary. Global Markets Direct's, 'Pre-Eclampsia - Pipeline Review, H1 2015', provides an overview of the Pre-Eclampsia's therapeutic pipeline.. This report provides comprehensive information on the therapeutic development for Pre-Eclampsia, complete with comparative analysis at various stages, therapeutics assessment by drug target, mechanism of action (MoA), route of administration (RoA) and molecule type, along with latest updates, and featured news and press releases. It also reviews key players involved in the therapeutic development for Pre-Eclampsia and special features on late-stage and discontinued projects.. Global Markets Direct's report features investigational drugs from ...http://www.phoenixnewsdesk.com/story/53639/hemorrhagic-shock-preeclampsia-and-keloids-pipeline-review-to-h1-2015-radiant-insights.html
Assessment of T helper 17-associated cytokines in third trimester of pregnancy
Background: Preeclampsia is a common pregnancy-specific disorder associated with significant maternal and fetal morbidity and mortality worldwide. It has been proposed that the imbalance between two CD4+ T cell subtypes, regulatory T cells (Treg) and T-helper 17 cells (Th17), is involved in the pathophysiology of preeclampsia. Objectives: To determine the serum levels of IL-17, IL-21, IL-23 and TGF-β in patients with preeclampsia. Methods: Blood samples were collected from 30 preeclampsia patients, 30 normotensive pregnant women and 30 healthy individuals with no history of malignancies or autoimmune disorders based on simple sampling. The serum levels of IL-17, IL-21, IL-23 and TGF-β were measured by the enzyme linked immunosorbent assay (ELISA). Results: The serum levels of IL-17 and TGF-β were significantly higher in ...http://iji.sums.ac.ir/article_39307.html
A review of the literature on the association between vitamin D status and the risk of preeclampsia
Complications related to pregnancy and childbirth are the leading causes of disability and death among women of reproductive age in developing countries, constituting at least 18% of the global burden of disease in this age-group. Preeclampsia is a serious, pregnancy-specific disorder that affects up to 8% of pregnant women. Preeclampsia may lead to maternal and offspring mortality and it increases the risk of premature birth and fetal growth restriction. Vitamin D is a potent immunomodulatory agent. There is an evidence pointing toward an association between the vitamin D status and preeclampsia risk. The purpose of the present study is to review the available literature investigating the role of serum levels of vitamin D in preeclampsia.The study findings further highlight the possibility ...http://rcm.mums.ac.ir/article_3659.html
Pre-Eclampsia Prediction By Doppler Screening Of Uterine Arteries And Angiogenic Factors In Second Trimester Of Pregnancy -...
BACKGROUND: Pre-eclampsia complicates about 2% of pregnancies. It accounts for at least 50 000 maternal deaths per year worldwide and is the second most common cause of maternal death in the developing world. Also, Pre-eclampsia is the commonest cause of iatrogenic prematurity, It frequently coexists with intrauterine growth restriction (IUGR) and placental abruption, other important causes of adverse prenatal outcome.. There have been many studies investigating whether the disease can be prevented. In order to achieve this, one needs to be able to identify firstly those women that are at highest risk of the disease.. Early studies showed that impedance to flow in the uterine arteries decreases with gestation in normal pregnancies, while in pregnancies with established pre-eclampsia or IUGR ...https://clinicaltrials.gov/ct2/show/NCT00725660?term=ultrasound+%5BTREATMENT%5D+AND+prenatal+%5BALL-FIELDS%5D&recr=Open&rank=19
Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young AdulthoodNovelty and Significance | Hypertension
In this prospective study of ≈16 000 young adults, offspring whose mothers had hypertension in pregnancy had an adverse cardiovascular risk factor profile in young adulthood (mean: 29 years of age) compared with offspring of normotensive pregnancies. Intrauterine exposure to maternal gestational hypertension or term preeclampsia was associated with higher systolic and diastolic blood pressure, BMI, and waist circumference, and in the term preeclampsia group, non-HDL cholesterol and triglyceride concentrations were slightly higher. Among siblings, we found a cardiovascular risk factor profile that was nearly identical between those who were exposed to maternal hypertension in pregnancy and siblings who were born after a normotensive pregnancy.. In this study, we were able to follow a large number of offspring from birth until young adulthood. Maternal ...http://hyper.ahajournals.org/content/69/4/591
Is proteinuric pre-eclampsia a different disease in primigravida and multigravida? | Clinical Science
This study aimed to identify if the clinical features of proteinuric pre-eclampsia or the biochemical markers of endothelial dysfunction associated with this syndrome are altered according to parity in a direction that would suggest a different pathophysiology. Groups of 27 primigravid and 35 multigravid women with pre-eclampsia (defined as blood pressure , 140/90 mmHg and 2+ proteinuria) were studied ante-partum, and at 6 weeks and 6 months post-partum. Clinical markers of severity of pre-eclampsia, including blood pressure, markers of renal, hepatic and coagulatory function, and biochemical markers of endothelial dysfunction were measured. Fetal outcome was assessed by birthweight and birthweight percentile. Ante-partum systolic blood pressure was 10 mmHg higher in the primigravida, and this difference was independent of age and anti-hypertensive ...http://www.clinsci.org/content/97/4/475
Decreased placental oxygenation capacity in pre-eclampsia: clinical application of a novel index of placental function...
Objective: We have previously described placental oxygenation capacity as an index of placental function. The aim of this study was to utilize this test to evaluate placental gas exchange capacity in pre-eclampsia and fetal growth restriction (FGR). Study design: Two nested case-control studies were conducted between: (i) pre-eclamptic appropriate-for-gestational-age fetus (AGA) and non-pre-eclamptic AGA; and (ii) pre-eclamptic FGR and non-pre-eclamptic FGR based on gestational age match. Umbilical A-V gas differences were compared between groups. Results: Pre-eclamptic AGA was associated with smaller A-V pO2 and A-V pCO2 differences compared to non-pre-eclampsia (A-V pO2, 7.1±3.8 mm Hg vs. 11.3±5.9 mm Hg, P=0.001; A-V pCO2, 7.8±5.7 mm Hg vs. 10.7± 5.9 mm Hg, P=0.01). ...https://edoc.hu-berlin.de/handle/18452/12055
Umbilical sP-selectin levels are different in preeclamptic pregnancies with intrauterine normal growth and growth restricted...
Objective. The aim of this study was the analysis of the umbilical cord serum sP-selectin levels in pregnancies complicated by severe preeclampsia with and without intrauterine growth restriction and in normotensive pregnancies. Patients and methodhttp://www.biomedsearch.com/nih/Umbilical-sP-selectin-levels-are/21534853.html
Vasopressin in Preeclampsia | Hypertension
Preeclampsia, a cardiovascular disorder of late pregnancy, is characterized as a low-renin hypertensive state relative to normotensive pregnancy. Because other nonpregnant low-renin hypertensive disorders often exhibit and are occasionally dependent on elevated arginine vasopressin (AVP) secretion, we hypothesized a possible use for plasma AVP measurements in the prediction of preeclampsia. Copeptin is an inert prosegment of AVP that is secreted in a 1:1 molar ratio and exhibits a substantially longer biological half-life compared with AVP, rendering it a clinically useful biomarker of AVP secretion. Copeptin was measured throughout pregnancy in maternal plasma from preeclamptic and control women. Maternal plasma copeptin was significantly higher throughout preeclamptic pregnancies versus ...http://hyper.ahajournals.org/content/early/2014/07/07/HYPERTENSIONAHA.114.03848