A5082 Excessive Umbilical Cord Coiling Confers Risk of Elevated Nocturnal Blood Pressure and Severe/Early-Onset Preeclampsia

Objective: To evaluate the serum neutrophil gelatinase-associated lipocalin levels in pregnant women with and without preeclampsia, early-onset preeclampsia and late-onset preeclampsia, preeclampsia with and without severe features, and investigate the correlation with the neonatal outcomes.Study Design: A total of 79 pregnant women, 27 with uncomplicated pregnancies, 30 with early-onset preeclampsia, and 22 with late-onset preeclampsia were evaluated in a cross-sectional study. Neutrophil gelatinase-associated lipocalin was measured with a colorimetric Sandwich-ELISA method. Age; body mass index; systolic and diastolic blood pressure; umbilical-artery Doppler results; serum urea, bilirubin, uric acid, AST, ALT; 24-hour protein test; birth-weight; and Apgar-scores were recorded. Results: Serum neutrophil gelatinase-associated lipocalin levels were significantly higher in women with preeclampsia compared to those without preeclampsia (p<0.001); in women with early-onset preeclampsia compared to those with late-onset preeclampsia (p<0.001); and in women with late-onset preeclampsia compared to those without preeclampsia (p=0.028). Mean serum neutrophil gelatinase-associated lipocalin levels were comparable in women with preeclampsia with and without severe features (p=0.076). The correlation analysis showed that neutrophil gelatinase-associated lipocalin was not affected by age or body mass index. Neutrophil gelatinase-associated lipocalin had a positive correlation with systolic and diastolic blood pressure and the umbilical-artery PI and RI. Serum neutrophil gelatinase-associated lipocalin had a positive correlation with serum urea (r=0.416, p=0.031) however had no significant correlation with birth-weight, Apgar-scores, uric acid and amount of proteinuria in women with preeclampsia. Conclusion: Serum neutrophil gelatinase-associated lipocalin levels were significantly higher in women with preeclampsia compared to those without preeclampsia; in women with early-onset preeclampsia compared to those with late-onset preeclampsia, and in women with late-onset preeclampsia compared to women without preeclampsia. Mean serum neutrophil gelatinase-associated lipocalin levels were comparable in women with preeclampsia with and without severe features.

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Plasma Level of Umbilical Cord Hemeoxygenase-1 (HO-1) and Neonatal Outcome in Early Onset and Late Onset Severe Preeclampsia

Molecular and Cellular Biomedical Sciences ◽

10.21705/mcbs.v3i1.57 ◽

2019 ◽

Vol 3 (1) ◽

pp. 54

Author(s):

Muhammad Ilham Aldika Akbar ◽

Indah Mayang Sari ◽

Ernawati Ernawati ◽

Aditiawarman Aditiawarman

Keyword(s):

Plasma Level ◽

Umbilical Cord ◽

Early Onset ◽

Low Birthweight ◽

Neonatal Outcome ◽

Late Onset ◽

Severe Preeclampsia ◽

Enzyme Linked Immunosorbent Assay ◽

Vessel Development ◽

Early Onset Preeclampsia

Background: Many studies had discovered that early onset severe preeclampsia (EO-PE) has worst maternal and neonatal outcome compared to late-onset type (LO-PE), related to its placental involvement. Severe preeclampsia was defined as newly onset severe hypertension developed after 20 weeks gestation in previously normal blood pressure women, with coexistence of proteinuria, or maternal organ or uteroplacental dysfunction. Hemeoxygenase-1 (HO-1) is an enzyme with multiple effect which is protective to pregnancy.Materials and Methods: The total study subjects were 40 pregnant women consisted of 10 EO-PE, 10 normal early onset pregnancy (EO-NP), 10 LO-PE, and 10 normal late onset pregnancy (LO-NP). As much as 5 cc of plasma from umbilical cord was taken as soon as the baby was born, and the HO-1 level was examined by enzyme-linked immunosorbent assay (ELISA). The primary outcome were umbilical cord HO-1 level and neonatal composite morbidity (low Apgar score, low birthweight, length of stay >5 day, respiratory distress syndrome, jaundice and neonatal death).Results: The plasma level of HO-1 in EO-PE subjects were lower than EO-NP (0.96±0.37 ng/mL vs. 2.43±0.58 ng/mL, p<0.001). There were no significant differences in the level of HO-1 in LO-PE and LO-NP (2.18±1.07 ng/mL vs. 3.02±0.64 ng/mL, p=0.277). Plasma level of umbilical cord HO-1 of EO-PE patients was lower compared to LO-PE (0.96±0.37 ng/mL vs. 2.18±1.07 ng/mL, p=0.034). Neonatal outcome of EO-PE was worse than EO-NP (p=0.033), and LO-PE (p=0.003), while in LO-PE did not different with LO-NP (p=0.211).Conclusion: EO-PE is associated with lower plasma umbilical cord level of HO-1 and worse neonatal outcome compared to LO-PE. This indicating abnormal placental blood vessel development, placental ischemia in EO-PE, lead to reduced uteroplacental perfusion and significantly worse neonatal outcome compared to LO-PE.Keywords: severe preeclampsia, early onset preeclampsia, late onset preeclampsia, hemeoxygenase-1

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