scholarly journals Do N-Terminal Pro-C-Type Natriuretic Peptide Levels Relate to Severity of Preeclampsia?

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Dogan Vatansever ◽  
Pınar Vatansever ◽  
Burak Giray ◽  
A. Aktug Ertekin ◽  
Serpil Bilsel
Keyword(s):  
Pregnant Women ◽  
Natriuretic Peptide ◽  
Venous Blood ◽  
Severe Preeclampsia ◽  
Study Group ◽  
Women Patients ◽  
Significant Difference ◽  
Mild Preeclampsia ◽  
Age Range ◽  
Circulating Levels

Aim. To compare the plasma N-terminal pro-C-type natriuretic peptide concentrations of normotensive pregnant women, patients with mild preeclampsia, and patients with severe preeclampsia. Methods. We collected venous blood samples from 25 normotensive pregnant women, 15 patients with mild preeclampsia, and 15 patients with severe preeclampsia. The women were at 30th to 40th weeks of gestation and in an age range of 20 to 35. The N-terminal pro-C-type natriuretic peptide levels were measured by ELISA. Statistical comparisons were made by one-way analysis of variance, Kruskal–Wallis, and Mann–Whitney U tests. Results. The median (interquartile range-IQR) values of the N-terminal pro-C-type natriuretic peptide were 6.48 (3.33) pmol/L in the normotensive women group, 7.37 (3.43) pmol/L in patients with mild preeclampsia, and 11.52 (6.13) pmol/L in patients with severe preeclampsia. The N-terminal pro-C-type natriuretic peptide was significantly elevated in the severe preeclampsia study group (P<0.001), whereas there was no significant difference between those with mild preeclampsia and the normotensive groups (P>0.05). Conclusion. Our data indicate that the plasma concentration of the N-terminal pro-C-type natriuretic peptide is significantly increased in patients with severe preeclampsia, but not in patients with mild preeclampsia. The severity of preeclampsia may be related to the circulating levels of the N-terminal pro-C-type natriuretic peptide concentrations.

scholarly journals Association between maternal serum beta human chorionic gonadotropin levels and hypertensive disorders of pregnancy

2020 ◽  
Vol 9 (8) ◽  
pp. 3157
Author(s):  
Archana Kumari ◽  
Vahini M.
Keyword(s):  
Pregnant Women ◽  
Late Onset ◽  
Maternal Serum ◽  
Severe Preeclampsia ◽  
Control Group ◽  
Study Group ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Significant Difference ◽  
Β Hcg

Background: A major challenge in obstetrics is early identification of hypertensive disorders of pregnancy (HDP). This study was performed to determine the association between elevated maternal serum β-hCG levels and HDP, the correlation between serum β-hCG level and severity of preeclampsia and to determine the value of serum β-hCG level as a diagnostic marker for early diagnosis of HDP.Methods: This was a hospital based observational study conducted in the department of obstetrics and gynecology, Rajendra Institute of Medical Sciences, Ranchi on 375 pregnant women with period of gestation more than 20 weeks, including 250 pregnant women with HDP as study group and 125 normotensive pregnant women as controls. Serum β-hCG concentration was measured and its level was compared between two groups.Results: The maternal mean serum β-hCG levels (51161.08±30038.21 IU/L) of study group of HDP were higher than the normotensive control group (17603.23±16748.21 IU/L). In non-severe preeclampsia, the mean serum levels were 36417.32±23876.74 IU/L while in severe preeclampsia, 60030.34±28771.31 IU/L. There was statistically significant difference (p<0.001) with higher levels in early onset preeclamptic mothers than late onset preeclampsia. The cut-off point of β-hCG for predicting HDP was 32077 IU/L with sensitivity of 65% and specificity of 86%.Conclusions: Serum β-hCG level is higher in HDP when compared to normotensive women. Higher levels of β-hCG are associated with increasing severity of hypertensive disorders of pregnancy. The utility of serum β-hCG as a diagnostic test is limited because of low sensitivity and difficulty in deciding the cut-off value.

scholarly journals Can brain natriuretic peptide predict cardiovascular complications in severe preeclampsia? A case-control study

2019 ◽  
Author(s):  
Nayereh Ghomian ◽  
Farveh Vakilian ◽  
Bahram Shahri ◽  
Vesam Rostaminejad ◽  
Majid Khadem-Rezaiyan
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Case Control Study ◽  
Venous Blood ◽  
Normal Pregnancy ◽  
Cardiovascular Complications ◽  
Case Control ◽  
Severe Preeclampsia ◽  
Significant Difference ◽  
Control Study

Background: Preeclampsia is one of the most common pregnancy complications, which is one of the major causes of fetal and maternal mortality. Objective: To compare the serum Brain Natriuretic Peptide (BNP) level in patients with severe preeclampsia and normal pregnancy and investigate associated cardiovascular complications. Materials and Methods: This case-control study was performed on 94 women with a singleton pregnancy (severe preeclampsia and normal pregnancy) at Imam Reza Hospital in Mashhad, Iran. The venous blood samples were collected to evaluate the serum BNP level. All patients were subjected to echocardiography performed by a single cardiologist. Results: The mean pro-BNP levels were 480.36 ± 754.52 and 67.46 ± 106.24 pg/dL in the severe preeclampsia and normal pregnancy patients, respectively (p < 0.001). However, adjusted BNP for maternal and gestational age was not different in the two groups (ANCOVA, p = 0.69). Furthermore, the two study groups showed no significant difference in terms of the cardiac parameters, including ejection fraction (EF), left ventricle end-diastolic and -systolic diameters (LVEDD and LVESD, respectively), tricuspid annular plane systolic excursion (TAPSE), and ratio of the early transmitral flow velocity to the early diastolic tissue velocity (E/Em). However, the serum BNP level showed a significant correlation with EF (r = -0.39, p = 0.008), TAPSE (r = -0.47, p = 0.001), and E/Em ratio (r = 0.48, p = 0.001) in patients with severe preeclampsia. Conclusion: It seems that BNP can be used as a predictor for some of the main cardiac functional indices (i.e., E/Em, EF, and TAPSE) in severe preeclampsia patients.

scholarly journals Περιεγχειρητική κινητική αγγειορυθμιστικών παραγόντων σε ασθενείς με καρκίνο του μαστού

2014 ◽  
Author(s):  
Γεώργιος Γεωργίου
Keyword(s):  
Breast Cancer ◽  
Breast Adenocarcinoma ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Study Group ◽  
Rt Pcr ◽  
Altered Expression ◽  
Female Patients ◽  
Significant Difference ◽  
Circulating Levels

Βackground: angiogenesis is seen during the multiple stages of carcinogenesis, aswell as during the process of surgical wound healing, a fact which has led tosubstantial debate over the last decades about the potential impact of surgery upon thefinal outcome of ceratin patients treated for breast cancer.Aim: the present research aims at investigating the potential effect of surgery on theprocess of angiogenesis, by studying a number of factors that are related to the latter,in patients suffering from breast cancer before and after the time of the procedure,whilst comparing these results with those of patients that were operated on their breastfor non-malignant disease.Material-Methods: blood from 10 female patients with breast adenocarcinoma(Study Group) was collected via venipuncture before surgery (labeled as PRO), aswell as on post-operative day 3 (labeled as D3) and day 7 (labeled as D7). Moreover,blood samples were also taken from 6 female patients with fibroadenoma (ControlGroup) before surgery (PRO) and on day 3 afetr surgery (D3). These samples weremeasured for detection of circulating levels of three established angiogenesisbiomarkers using ELISA (Enzyme-Linked ImmunoSorbent Assay): VascularEndothelial Growth Factor-A (VEFG-A), Interleukin-8 (IL-8) and basic FibroblastGrowth factor (bFGF or FGF-2). In addition, circulating transcripts of 84 agiogenesirelatedgenes were determined using RT-PCR (Real Time Polymerase ChainReaction). The two groups of patients were firstly compared to each other regardingtheir results. Also, patients belonging to the Study Group were analized at differenttime points regarding surgery. Finally, the results were investigated againstclinicopathological data and patient outcome.Results: using ELISA we were able to detect increased levels of circulating VEGF-Aand IL-8 in the Study Group patients compared to the Control Group patientspreoperatively (p=0,0381 and p=0,0218 respectively), while for bFGF there was nostatistically significant difference documented. Surgery resulted in a significantincrease in VEGF-A levels on D3 (p=0,0389) and D7 (p=0,0172) as compared toPRO levels. Perioperative kinetics of IL-8 showed a mild trend towards increase,which, however, was not statistically significant. Postoperative levels of bFGF wereslightly increased on D3, but on D7 they were even lower than preoperative values(p=0,0205). Using RT-PCR certain differences between the Study Group and theControl Group were recorded regarding the circulating transcripts of a great numberof angiogenesis-related genes preoperatively: upregulation of VEGF-C, EGF, IL-8,FGF-1, SPHK1, NRP1, LAMA5, COL4A3, TEK, EFNA3, EFNB2. AKT1, ITGB3,THBS1, CCL11, TIMP3 and downregulation of CXCL10. Moreover, mastectomyinduced an altered expression in several key-genes in breast cancer patients:upregulation of THBS1, COL4A3, BAI1, ITGB3 and downregulation of EREG,SERPIFN1, CXCL9, CXCL10, IL1B, CCL2, CXCL1, HIF1A, NOTCH4. Conclusions: patients suffering from breast cancer have a different angiogenic profilein comparison to patients with fibroadenoma, as documented through their differencesin circulating levels of angiogenic factors. These levels are greatly changed after thesurgical procedure. VEGF showed a transient increase, while bFGF initially increasedbut only to finally decrease to levels that were even lower than the preoperative ones.Moreover, mastectomy promoted a shift in the expression pattern of a broad panel ofangiogenesis-related gene transcripts.

scholarly journals A Comparative Study of Relationship between Micronutrients and Gestational Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Farideh Akhlaghi ◽  
Seyyed Majid Bagheri ◽  
Omid Rajabi
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Gestational Age ◽  
Control Group ◽  
Study Group ◽  
Inclusion Criteria ◽  
Control Groups ◽  
Significant Difference ◽  
Micronutrient Concentration ◽  
And Control

In this paper, we studied the relation between the micronutrient and gestational diabetes. Therefore, we measured micronutrient concentration including Ni, Al, Cr, Mg, Fe, Zn, Cu, and Se in serum of women with gestational diabetes between 24 and 28 weeks of gestational age (study group) who had inclusion criteria and comparison with micronutrient levels in normal pregnant women with same gestational age (control group). Results showed that there was no significant difference between the serum micronutrient level (Ni, Al, Cr, Mg, Zn, Cu, Se) in study and control groups except serum level of iron which in serum of gestational diabetic women was lower than normal pregnant women and difference was significant.

scholarly journals Correlation Between Nutritional Status of Pregnant Women Based on Upper Arm Circumference and Preeclampsia/Eclampsia Severity Degree at Jagir Public Health Center During January 2014 - March 2014

2018 ◽  
Vol 1 (2) ◽  
pp. 120
Author(s):  
Dian Nirmala Aprilia ◽  
Budi Prasetyo ◽  
Sulistiawati Sulistiawati
Keyword(s):  
Public Health ◽  
Nutritional Status ◽  
Pregnant Women ◽  
Health Center ◽  
Severe Preeclampsia ◽  
Upper Arm ◽  
Chi Square ◽  
Public Health Center ◽  
Arm Circumference ◽  
Mild Preeclampsia

Introduction: Preeclampsia/eclampsia is one of the causes of maternal mortality besides bleeding and infection. The exact etiology of this condition is still unknown. Nutritional status of pregnant women who are overweight can increase the risk. This study aims to determine the correlation between obesity and the severity of preeclampsia/eclampsia through upper arm circumference (UAC) measurement.Methods: This study is a cross-sectional analytic study. Data on preeclampsia/eclampsia and UAC obtained from patient medical records in Jagir Public Health Center Surabaya. Data were analyzed using Chi-square test.Results: Prevalence of mild preeclampsia was greater than severe preeclampsia (87.5% and 12.5%). The majority of patients with mild preeclampsia have normal UAC size (91.3%). Severe preeclampsia found higher in obesity group than normal nutritional status group (22.2% and 9.1%). From Chi-square test analysis, found that p = 0.557.Conclusion: There was no significant correlation between the nutritional status of pregnant women based on UAC measurement of and the severity of preeclampsia/eclampsia.

scholarly journals "PROM"

2009 ◽  
Vol 16 (03) ◽  
pp. 438-444
Author(s):  
SHAKILA YASMIN ◽  
NAHEED FATIMA ◽  
SHAZIA SAEED
Keyword(s):  
Pregnant Women ◽  
Sample Size ◽  
Comparison Group ◽  
Active Management ◽  
Study Group ◽  
Oral Misoprostol ◽  
Active Labour ◽  
Number Of Patients ◽  
Significant Difference ◽  
Fetal Complications

Objective: To assess and compare the number of subjects in both groups (Study and comparison), who went into active labourwithin 24 hours and to compare the various complications (maternal & fetal) in both groups. Study Design: Quasi experimental. Sampling Technique: Convenience sampling. Sample Size & Setting: A total of 100 pregnant women presenting with history of leaking amniotic fluid at term (>37 wks) to labour ward of obstetrics and Gynaecology unit, Bahawal Victoria Hospital, Bahawalpur were included in the study. Material & Method: The pregnant women fulfilling the inclusion criteria were enrolled as our study subjects. Rupture of membranes was confirmed by nitrazine test.Thepatients were randomized into two groups (50 women in study and 50 in comparison group). In study group, 50 (Ligm of misoprostol was givenorally after initial assessment of mother and fetus. The dose was repeated 4 hourly, if there was no uterine activity. The number of patients going into active labour and delivering within 24 hours were noted. Different complications (maternal & fetal) faced during all procedure were also recorded and managed. In comparison group, patients were managed were also recorded and managed. In comparison group, patients were managed conservatively for 24 hours. Like in study group, number of patients gong into active labour and delivering with in 24 hours were noted. Different maternal & fetal complications occurring in this group were also recorded and managed. Results: A total of 100 Pregnant women were included in the study. The sample size (100 patients with PROM at term) was completed in 5 months. During that period over all 1105 deliveries were conducted, so the incidence of PROM at term in the study was 9.4%. It was observed in the study group, that all the patients (100%) went into active labour and 96% were delivered within 24 hours of PROM. While in comparison group 72% patients went into active labour and only 62% were delivered within 24 hours of PROM. The results showed that in study group 36 patients went into active labour with only one dose of oral misoprostol, 9 patients required 2 doses and 5 patients required 3 doses of oral misoprostol for going into active labour. When maternal complications were compared in both groups, 92% patients in study group had no complication while only 8% patients had to face different complications. In comparison group 86% had no complication and in 14% patients different complications occurred. Regarding fetal complications 4% fetus/neonates had to face different complications in each group. In current study there was no significant difference in the mode of delivery between the two groups. Conclusion: It was concluded that active management of pre labour rupture of membrances at term with oral misoprostol is a better option than the expectant management. Oral misoprostol in dose of 50 jugm is an effective agent for cervical ripening and induction of labour in PROM at term as significantly high percentage of patients delivered within 24 hours with no increase in maternal and fetal complications.

scholarly journals Micronutrient Deficiency in Severe Preeclampsia

2013 ◽  
Vol 8 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Selina Akhter ◽  
Taskina Ali ◽  
Shelina Begum ◽  
Sultana Ferdousi
Keyword(s):  
Pregnant Women ◽  
Serum Calcium ◽  
Serum Magnesium ◽  
Serum Zinc ◽  
Micronutrient Deficiency ◽  
Severe Preeclampsia ◽  
College Hospital ◽  
Calcium Magnesium ◽  
Mild Preeclampsia ◽  
Zinc Levels

Background:. Micronutrient such as calcium, magnesium and zinc deficiency are associated with preeclampsia. Objective: To observe serum calcium, magnesium and zinc levels in severe preeclamptic women. Methods: This cross sectional study was carried out in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka from July 2009 to June 2010. 60 cases of preeclampsia, aged 18-39 years and >20th weeks of pregnancy were included in the study group. They were further sub divided into group B1 (30 mild preeclampsia) and group B2 (30 severe preeclampsia). Age and gestational period matched 30 normotensive pregnant women (Group A) were also studied as control. All the preeclamptic women were selected from the Obstetric and Gynaecology in and out patient Department of BSMMU and Dhaka Medical College Hospital. Serum calcium and magnesium was measured by colorimetric and serum zinc was measured by spectrophotometric method. For statistical analysis one way ANOVA, independent sample t test and ÷2 test were used. Results: The mean serum calcium, magnesium and zinc levels were significantly (p<0.001) lower in both group of preeclampsia than normotensive pregnant women. Again serum calcium and zinc levels were significantly lower (P<0.05) in severe preeclampsia compared to mild preeclampsia whereas serum magnesium levels were found almost similar in both group of preeclampsia (P>0.05). Again in this study, 40% mild, 73.3 % severe preeclamptic women and 20% normotensive pregnant women had hypocalcaemia. 36.7% mild, 30.0% severe preeclamptic women and 3.3% normotensive pregnant women had hypomagnesaemia and 6.7% mild, 20 % severe preeclamptic women and no normotensive pregnant women had hypozincemia. Conclusion: This study may conclude that micronutrient deficiency may be one of the risk factor of preeclampsia and increases the risk of its severity. Therefore early detection and supplementation to treat this deficiency may reduce the incidence of preeclampsia. DOI: http://dx.doi.org/10.3329/jbsp.v8i1.16644 J Bangladesh Soc Physiol. 2013, June; 8(1): 26-32

scholarly journals Can serum prolactin be a reliable marker for preeclampsia? A hospital based study on Nepalese mothers

2015 ◽  
Vol 5 (1) ◽  
pp. 2-5
Author(s):  
S Timalsina ◽  
P Gyawali
Keyword(s):  
Pregnant Women ◽  
Severe Preeclampsia ◽  
Serum Prolactin ◽  
Poor Correlation ◽  
Major Function ◽  
Median Concentration ◽  
Specific Complication ◽  
Mild Preeclampsia ◽  
The Difference ◽  
Reliable Marker

Preeclampsia is a pregnancy specific complication characterized by hypertension, proteinuria and oedema. It has remained as a major cause of maternal and perinatal morbidity and mortality worldwide. The major function of prolactin is its role in lactation during pregnancy, but many authors have claimed that this hormone is also involved in angiogenesis, thus linking it with the pathogenesis of preeclampsia. In this context, our study aims to compare the serum prolactin level between preeclamptic and healthy pregnancies and correlate with the severity.A total of 54 pregnant women diagnosed with preeclampsia and 60 age and gestational weeks matched healthy pregnant women were recruited in this case control study. Preeclampsia was defined as per Australasian Society Consensus Statement research definition. Among 54 preeclamptic women, 41 had mild preeclampsia and 13 had severe preeclampsia. The mean age and the gestational weeks of the preeclamptic cases and pregnant controls were not significantly different. This study showed that the median concentration of prolactin was significantly higher in preeclampsia than in normal pregnancies (156.6 vs. 129.8 ng/mL, P=0.012). Though the median concentration of prolactin was higher in severe preeclampsia in comparison to mild one, the difference did not reach the significant level (228.3 vs.152.9 ng/mL, P=0.061). No significant correlation of prolactin was found with mean arterial pressure and 24h UTP. Due to poor correlation with established markers of severity, serum prolactin is not a reliable marker of preeclampsia.DOI: http://dx.doi.org/10.3126/jcmc.v5i1.12558

Differences in the Coagulation Profile in Women with Mild and Severe Preeclampsia

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 15-16
Author(s):  
Elmina Lefkou ◽  
Patrick Van Dreden ◽  
Aurélie Rousseau ◽  
Grigorios T. Gerotziafas
Keyword(s):  
Pregnant Women ◽  
Prothrombin Time ◽  
Cell Activation ◽  
Severe Preeclampsia ◽  
Clotting Time ◽  
Endothelial Cell Activation ◽  
Mild Preeclampsia ◽  
The Mean ◽  
Group D ◽  
D Dimer

Introduction:Different coagulations abnormalities have been referred in women with early oncet preeclampsia (EOP), but there are only few studies comparing those changes regarding to the severity of the disease. Aim:In this study we aimed to investigate the differences between the coagulation profile in women with mild and severe preeclampsia. Methods:This is an observational retrospective case-control study. Plasma samples were collected from 84 women divided into three groups, the healthy pregnant (HP) group (n=35), the mild preeclampsia (MP) group (n=34) and the severe preeclampsia (SP) group (n=15). The study population general characteristics are shown in Table 1. We studied the following biomarkers of hypercoagulability and endothelial cell activation: Tissue factor activity (TFa), Procoagulant phospholipid activity (PPL), Protein S, D-Dimers, Antithrombin, thrombomodulin, TFPI levels. All women were assessed with classic coagulation tests (aPTT and PT) fibrinogen levels and hemogram. Statistical analysis was performed using the PASW Statistics 17.0.2 (SPSS Inc.) for Windows. Results:Women with preeclampsia - mild or severe- showed significant increase of TFPI, TFa and TMa levels as compared to healthy pregnant women. No significant difference of TFPI, TFa was observed between MP and SP groups. In contrast, TMa levels were significantly increased in SP as compared to MP group. The ratio TFa/TFPI was also lower in SP as compared to MP-group. Women in MP or SP group had similarly shorter PPL clotting time as compared to HP group. D-dimer levels were increased in women with preeclampsia as compared to the HP group. D-Dimer levels were significantly higher in SP as compared to MP group. The levels of free PS activity in HP as well as MP and SP groups were lower than normal range in non-pregnant women and the value in MP was significantly lower than that of the HP or SP. Fibrinogen levels were not significantly different in the three studied groups of pregnant women. Prothrombin time was found to be increased in cases as compared to that in the controls. The mean value of prothrombin time in mild preeclampsia was 13.24±0.80 seconds and in severe preeclampsia it was seconds 14.77±0.96 and in pregnant controls 12.23±0.59 seconds (p&lt;0.05 and p&lt;0.001 respectively). The mean prothrombin time was found to increase with increasing severity of disease (p&lt;0.001). The mean activated partial thromboplastin time were increased in mild preeclampsia and was 32.64±1.83 seconds and in severe preeclampsia it was 35.59±1.53 seconds and in pregnant controls 29.53±1.62 seconds (p&lt;0.001). The activated partial thromboplastin time was found to increase with increasing severity of disease (p&lt;0.001). The antithrombin III decreased in severe SP and MP or compared to pregnant controls (76.33±4.32 and 88.06±9.68 versus 95.40±0.36 respectively; p&lt;0.001). This decrease is more pronounced in SP compared to MP (p&lt;0.001). Conclusions:Preeclampsia is associated with endothelial cell activation as documented by the increase of TFa, soluble TM levels and TFPI levels in plasma. Release of soluble thrombomoduline and TFPI rather than TFa by endothelial cells appear to be related with degree of preeclampsia severity. Women with preeclampsia showed marked decrease of PPL clotting time indicating enhanced platelet activation that was independent of the severity of preeclampsia. In contrast, women with severe preeclampsia showed signs of enhanced hypercoagulability documented by the increase of D-dimer levels consumption of natural coagulation inhibitors and particularly of AT. This phenomenon tended to be reflected on the prolongation of PT and aPTT in women with severe preeclampsia. Disclosures No relevant conflicts of interest to declare.

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