Folic acid participates in the metabolism of homocysteine and lowers plasma homocysteine levels directly or indirectly. To establish a hyperhomocysteinemic pregnant rat model, 2 mL of DL-homocysteine was administered ...Folic acid participates in the metabolism of homocysteine and lowers plasma homocysteine levels directly or indirectly. To establish a hyperhomocysteinemic pregnant rat model, 2 mL of DL-homocysteine was administered daily by intraperitoneal injection at a dose of 200 mg/kg from day 10 to day 19 of gestation. Folic acid was administered by intragastric administration at a dose of 20 mg/kg during the period of preeclampsia induction. Results showed that systolic blood pressure, proteinuria/creatinine ratio, and plasma homocysteine levels in the hyperhomocysteinemic pregnant rats increased significantly, and that body weight and brain weight of rat pups significantly decreased. Folic acid supplementation markedly reversed the above-mentioned abnormal changes of hyperhomocysteinemic pregnant rats and rat pups. These findings suggest that folic acid can alleviate the symptoms of hyperhomocysteinemia- induced preeclampsia in pregnant rats without influencing brain development of rat pups.展开更多
Research on the association between maternal periodontal disease and the risk of pree- clampsia has generated inconsistent results. This meta-analysis was conducted to evaluate the asso- ciation between maternal perio...Research on the association between maternal periodontal disease and the risk of pree- clampsia has generated inconsistent results. This meta-analysis was conducted to evaluate the asso- ciation between maternal periodontal disease and the risk of preeclampsia. A literature search of PubMed and Embase was performed to identify relevant papers published before March 2013. Only observational studies that assessed maternal periodontal disease and the risk of preeclampsia were selected. Patients＇ periodontal status was examined at different time points during pregnancy or after delivery （at 14-32 weeks of gestation, within 48 h prior to or within 5 days after delivery）. Pooled odds ratios （ORs） and corresponding 95% confidence intervals （CIs） were calculated for cases and controls. Cases were defined as women with concurrent hypertension and proteinuria after 20 weeks of gestation. Eleven studies involving 1118 women with preeclampsia and 2798 women without preeclampsia were identified and analyzed. Women with periodontal disease before 32 weeks of ges- tation had a 3.69-fold higher risk of developing preeclampsia than their counterparts without perio- dontal disease （OR=3.69; 95% CI=2.58-5.27）. Periodontal disease within 48 h prior to delivery was associated with a 2.68-fold higher risk of preeclampsia （OR=2.68; 95% CI=1.39-5.18）. Pregnant women with periodontal disease within 5 days after delivery had a 2.22-fold higher risk of pree- clampsia than women without periodontal disease （OR=2.22; 95% CI= 1.16-4.27）. In conclusion, this meta-analysis suggests that maternal periodontal disease is an independent predictor ofpreeclampsia.展开更多
Preeclampsia is a pregnancy specific syndrome of elusive etiology, developing in 2nd trimester and associated with high maternal and perinatal morbidity and mortality. The spectrum ranges from mild preeclampsia with n...Preeclampsia is a pregnancy specific syndrome of elusive etiology, developing in 2nd trimester and associated with high maternal and perinatal morbidity and mortality. The spectrum ranges from mild preeclampsia with no systemic involvement to multi-system involvement. The course is unpredictable and delivery is the only curative treatment. Elevated blood pressure(> 160/110 mm Hg) should be reduced gradually to a safe level(140/90) using antihypertensive drugs. Prophylaxis and treatment of convulsions using Mg SO4 is indicated for severe preeclampsia. Fluid therapy is controversial due to potential delicate balance between constricted plasma volume and risk of fluid overload and pulmonary oedema secondary to increased capillary permeability and reduced colloid osmotic pressure. Single shot spinal anaesthesia is the technique of choice for caesarean delivery unless contraindicated. General anaesthesia is indicated in patients with coagulopathy or eclampsia but is associated with risk of difficult airway and exaggerated sympathetic response during laryngoscopy. Epidural analgesia and anaesthesia is safe in absence of coagulopathy.展开更多
Preeclampsia is still a major risk factor for maternal-fetal health. Therefore, early identifcation of pregnant women at risk for preeclampsia is a big priority in ob-stetrics in order to decrease the mortality and mo...Preeclampsia is still a major risk factor for maternal-fetal health. Therefore, early identifcation of pregnant women at risk for preeclampsia is a big priority in ob-stetrics in order to decrease the mortality and morbidity associated with this disease. On the basis of well known and new pathophysiological mechanisms of preeclamp-sia, different biochemical and ultrasonographic param-eters have been investigated in the literature, without fnding an ideal marker for early screening. In this brief review, we present the best studied ultrasonographic markers and the most recent genetic factors and prom-ising emerging biomarkers of preeclampsia, to date. We hope that in the future the combination of these tests will allow us to predict which women are at risk of preeclampsia.展开更多
Preeclampsia(PE)remains a leading cause of maternal and perinatal morbidity and mortality in obstetrics worldwide.No effective treatments to reduce its incidence and severity in clinical practice are currently availab...Preeclampsia(PE)remains a leading cause of maternal and perinatal morbidity and mortality in obstetrics worldwide.No effective treatments to reduce its incidence and severity in clinical practice are currently available.A variety of hypotheses have been generated aiming to explain the origins of PE,notably being the genetic predispositions and placental dysfunction.As regard to placental dysfunction,much progress has been made in basic research and several potential therapeutic targets have been identified.This review will discuss in detail the potential therapeutic targets in PE models including uteroplacental blood flow,oxidative stress,vasoactive factors and inflammation/immune response,and introduce the evolving technologies for placental research nowadays.展开更多
AIM To study liver stiffness(LS) during pregnancy and its association with complications during pregnancy.METHODS In this observational, diagnostic study, 537 pregnant women were prospectively enrolled at the Departme...AIM To study liver stiffness(LS) during pregnancy and its association with complications during pregnancy.METHODS In this observational, diagnostic study, 537 pregnant women were prospectively enrolled at the Department of Obstetrics and Gynecology, University hospital Heidelberg and Salem Medical Center. LS was measured using the Fibroscan device(Echosens, Paris) in all women and in 41 cases 24 h after delivery. Clinical and morphological data were recorded and abdominal ultrasound and standard laboratory tests were performed. No complications were observed in 475 women(controls) while preeclampsia and intrahepatic cholestasis of pregnancy(ICP) developed in 22 and 40 women, respectively.RESULTS In controls, LS increased significantly from initially 4.5 ± 1.2 kPa in the second trimester to 6.0 ± 2.3 kPa(P < 0.001) in the third trimester. In the third trimester, 41% of women had a LS higher than 6 kPa. Elevated LS in controls was significantly correlated with alkaline phosphatase, leukocytes, gestational age and an increase in body weight and body mass index(BMI). In women with pregnancy complications, LS was significantly higher as compared to controls(P < 0.0001). Moreover, in multivariate analysis, LS was an independent predictor for preeclampsia with an odds ratio of 2.05(1.27-3.31) and a cut-off value of 7.6 kPa. In contrast, ICP could not be predicted by LS. Finally, LS rapidly decreased in all women within 24 h after delivery from 7.2 ± 3.3 kPa down to 4.9 ± 2.2 kPa(P < 0.001).CONCLUSION During pregnancy, LS significantly and reversibly increases in the final trimester of pregnant women without complications. In women with preeclampsia, LS is significantly elevated and an independent noninvasive predictor.展开更多
基金The Medical Science and Technology Foundation of Chinese PLA during Twelfth "Five-year" Development Period(General Program),No. CWS11J003
文摘Folic acid participates in the metabolism of homocysteine and lowers plasma homocysteine levels directly or indirectly. To establish a hyperhomocysteinemic pregnant rat model, 2 mL of DL-homocysteine was administered daily by intraperitoneal injection at a dose of 200 mg/kg from day 10 to day 19 of gestation. Folic acid was administered by intragastric administration at a dose of 20 mg/kg during the period of preeclampsia induction. Results showed that systolic blood pressure, proteinuria/creatinine ratio, and plasma homocysteine levels in the hyperhomocysteinemic pregnant rats increased significantly, and that body weight and brain weight of rat pups significantly decreased. Folic acid supplementation markedly reversed the above-mentioned abnormal changes of hyperhomocysteinemic pregnant rats and rat pups. These findings suggest that folic acid can alleviate the symptoms of hyperhomocysteinemia- induced preeclampsia in pregnant rats without influencing brain development of rat pups.
文摘Research on the association between maternal periodontal disease and the risk of pree- clampsia has generated inconsistent results. This meta-analysis was conducted to evaluate the asso- ciation between maternal periodontal disease and the risk of preeclampsia. A literature search of PubMed and Embase was performed to identify relevant papers published before March 2013. Only observational studies that assessed maternal periodontal disease and the risk of preeclampsia were selected. Patients＇ periodontal status was examined at different time points during pregnancy or after delivery （at 14-32 weeks of gestation, within 48 h prior to or within 5 days after delivery）. Pooled odds ratios （ORs） and corresponding 95% confidence intervals （CIs） were calculated for cases and controls. Cases were defined as women with concurrent hypertension and proteinuria after 20 weeks of gestation. Eleven studies involving 1118 women with preeclampsia and 2798 women without preeclampsia were identified and analyzed. Women with periodontal disease before 32 weeks of ges- tation had a 3.69-fold higher risk of developing preeclampsia than their counterparts without perio- dontal disease （OR=3.69; 95% CI=2.58-5.27）. Periodontal disease within 48 h prior to delivery was associated with a 2.68-fold higher risk of preeclampsia （OR=2.68; 95% CI=1.39-5.18）. Pregnant women with periodontal disease within 5 days after delivery had a 2.22-fold higher risk of pree- clampsia than women without periodontal disease （OR=2.22; 95% CI= 1.16-4.27）. In conclusion, this meta-analysis suggests that maternal periodontal disease is an independent predictor ofpreeclampsia.
文摘Preeclampsia is a pregnancy specific syndrome of elusive etiology, developing in 2nd trimester and associated with high maternal and perinatal morbidity and mortality. The spectrum ranges from mild preeclampsia with no systemic involvement to multi-system involvement. The course is unpredictable and delivery is the only curative treatment. Elevated blood pressure(> 160/110 mm Hg) should be reduced gradually to a safe level(140/90) using antihypertensive drugs. Prophylaxis and treatment of convulsions using Mg SO4 is indicated for severe preeclampsia. Fluid therapy is controversial due to potential delicate balance between constricted plasma volume and risk of fluid overload and pulmonary oedema secondary to increased capillary permeability and reduced colloid osmotic pressure. Single shot spinal anaesthesia is the technique of choice for caesarean delivery unless contraindicated. General anaesthesia is indicated in patients with coagulopathy or eclampsia but is associated with risk of difficult airway and exaggerated sympathetic response during laryngoscopy. Epidural analgesia and anaesthesia is safe in absence of coagulopathy.
文摘Preeclampsia is still a major risk factor for maternal-fetal health. Therefore, early identifcation of pregnant women at risk for preeclampsia is a big priority in ob-stetrics in order to decrease the mortality and morbidity associated with this disease. On the basis of well known and new pathophysiological mechanisms of preeclamp-sia, different biochemical and ultrasonographic param-eters have been investigated in the literature, without fnding an ideal marker for early screening. In this brief review, we present the best studied ultrasonographic markers and the most recent genetic factors and prom-ising emerging biomarkers of preeclampsia, to date. We hope that in the future the combination of these tests will allow us to predict which women are at risk of preeclampsia.
基金the National Natural Science Foundation of China(No.2016YFC1000405).
文摘Preeclampsia(PE)remains a leading cause of maternal and perinatal morbidity and mortality in obstetrics worldwide.No effective treatments to reduce its incidence and severity in clinical practice are currently available.A variety of hypotheses have been generated aiming to explain the origins of PE,notably being the genetic predispositions and placental dysfunction.As regard to placental dysfunction,much progress has been made in basic research and several potential therapeutic targets have been identified.This review will discuss in detail the potential therapeutic targets in PE models including uteroplacental blood flow,oxidative stress,vasoactive factors and inflammation/immune response,and introduce the evolving technologies for placental research nowadays.
基金Supported by the Dietmar Hopp Foundation(in part,DFG),No.MU 1373/9-1
文摘AIM To study liver stiffness(LS) during pregnancy and its association with complications during pregnancy.METHODS In this observational, diagnostic study, 537 pregnant women were prospectively enrolled at the Department of Obstetrics and Gynecology, University hospital Heidelberg and Salem Medical Center. LS was measured using the Fibroscan device(Echosens, Paris) in all women and in 41 cases 24 h after delivery. Clinical and morphological data were recorded and abdominal ultrasound and standard laboratory tests were performed. No complications were observed in 475 women(controls) while preeclampsia and intrahepatic cholestasis of pregnancy(ICP) developed in 22 and 40 women, respectively.RESULTS In controls, LS increased significantly from initially 4.5 ± 1.2 kPa in the second trimester to 6.0 ± 2.3 kPa(P < 0.001) in the third trimester. In the third trimester, 41% of women had a LS higher than 6 kPa. Elevated LS in controls was significantly correlated with alkaline phosphatase, leukocytes, gestational age and an increase in body weight and body mass index(BMI). In women with pregnancy complications, LS was significantly higher as compared to controls(P < 0.0001). Moreover, in multivariate analysis, LS was an independent predictor for preeclampsia with an odds ratio of 2.05(1.27-3.31) and a cut-off value of 7.6 kPa. In contrast, ICP could not be predicted by LS. Finally, LS rapidly decreased in all women within 24 h after delivery from 7.2 ± 3.3 kPa down to 4.9 ± 2.2 kPa(P < 0.001).CONCLUSION During pregnancy, LS significantly and reversibly increases in the final trimester of pregnant women without complications. In women with preeclampsia, LS is significantly elevated and an independent noninvasive predictor.
