Eating Disorders and Pregnancy: The Case of Anorexia

The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from ED are able to access maternity. ED and pregnancy can either have an easy evolution or experience a lot of trouble. Many studies describe obstetrical and foetal complications (low birthweight, inadequate intra-uterine growth, small head circumference, miscarriage, caesarean section). Those patients are frequently reluctant to address their disease with their specialist, who also often doesn’t know how to screen the signs. The lack of official data to train the specialists further increases these difficulties. However, ED are frequent in the general population and young patients are likely to eventually want to become mothers. It is thus essential to know how to screen those patients early and accurately to improve their treatment and care. Eating disorders impact the pregnancy, the delivery and the postpartum as well as the growth of the baby. It is an important public health problem. The evolution from being a woman to becoming a mother is a difficult one, and even more so when the women is suffering from ED. Those patients must handle their nutritional fears, the anxiety about their body changing with pregnancy and the daily challenges. The early interactions with their baby have consequences on their development. It seems necessary to evaluate how to improve the screening and the patient care in ED patients. Screening should begin from the pregnancy desire to the postpartum. This patient care should be based on a multidisciplinary care team.

Risk Prediction Model for Hypertensive Disorders of Pregnancy Based on Routine Laboratory Indicators and Risk Factors: A Retrospective Analysis

Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.

Abnormal Umbilical Doppler: Incidence and Neonatal Outcomes among Hypertensive Disorders in Pregnancy at KCMC: A Hospital-Based Prospective Cohort Study

Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.

Helicobacter pylori and pregnancy-related disorders

Helicobacter pylori (H. pylori) infection is investigated in gastric diseases even during pregnancy. In particular, this Gram-negative bacterium seems to be associated with hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy. During the last decade, the relationship among H. pylori and several extra-gastric diseases strongly emerged in literature. The correlation among H. pylori infection and pregnancy-related disorders was mainly focused on iron deficiency anemia, thrombocytopenia, fetal malformations, miscarriage, pre-eclampsia and fetal growth restriction. H. pylori infection may have a role in the pathogenesis of various pregnancy-related disorders through different mechanisms: depletion of micronutrients (iron and vitamin B12) in maternal anemia and fetal neural tube defects; local or systemic induction of pro-inflammatory cytokines release and oxidative stress in gastrointestinal disorders and pre-eclampsia; cross-reaction between specific anti-H. pylori antibodies and antigens localized in placental tissue and endothelial cells (pre-eclampsia, fetal growth restriction, miscarriage). Since H. pylori infection is most likely acquired before pregnancy, it is widely believed that hormonal and immunological changes occurring during pregnancy could activate latent H. pylori with a negative impact not only on maternal health (nutritional deficiency, organ injury, death), but also on the fetus (insufficient growth, malformation, death) and sometime consequences can be observed later in life. Another important issue addressed by investigators was to determine whether it is possible to transmit H. pylori infection from mother to child and whether maternal anti-H. pylori antibodies could prevent infant’s infection. Studies on novel diagnostic and therapeutic methods for H. pylori are no less important, since these are particularly sensitive topics in pregnancy conditions. It could be interesting to study the possible correlation between H. pylori infection and other pregnancy-related diseases of unknown etiology, such as gestational diabetes mellitus, obstetric cholestasis and spontaneous preterm delivery. Since H. pylori infection is treatable, the demonstration of its causative role in pregnancy-related disorders will have important social-economic implications.

Maternal mental disorders in pregnancy and the puerperium and risks to infant health

Prenatal and postnatal period presents the highest prevalence of mental disorders in women's lives and depression is the most frequent one,affecting approximately one in every five mothers.The aggravating factor here is that during this period psychiatric symptoms affect not only women's health and well-being but may also interfere in the infant's intra and extra-uterine development.Although the causes of the relationship between maternal mental disorders and possible risks to a child's health and development remain unknown,it is suspected that these risks may be related to the use of psychotropic drugs during pregnancy,to substance abuse and the mother's lifestyle.Moreover,after delivery,maternal mental disorders may also impair the ties of affection(bonding) with the newborn and the ma-ternal capacity of caring in the post-partum period thus increasing the risk for infant infection and malnutrition,impaired child growth that is expressed in low weight and height for age,and even behavioral problems and vulnerability to presenting mental disorders in adulthood.Generally speaking,research on this theme can be divided into the type of mental disorder analyzed: studies that research minor mental disorders during pregnancy such as depression and anxiety find an association between these maternal disorders and obstetric complications such as prematurity and low birth weight,whereas studies that evaluate severe maternal mental disorders such as schizophrenia and bipolar disorder have found not only an association with general obstetric complications as well as with congenital malformations and perinatal mortality.Therefore,the success of infant growth care programs also depends on the mother's mental well being.Such findings have led to the need for new public policies in the field of maternal-infant care geared toward the population of mothers.However,more research is necessary so as to confirm the association between all factors with greater scientific rigor.

Iron supplementation for non-anaemic pregnant women and the incidence of hypertensive disorders in pregnancy:A systematic review and meta-analysis

Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with its synonyms or related words:"iron","supplement",“hypertensive disorders in pregnancy”through MEDLINE(OVID),CINAHL,PubMed,Cochrane Library,Scopus,Web of Science,ICTRP,and ClinicalTrials.gov,and manual search of references was used in seven potential resources.The inclusion criteria were randomized control trials(RCTs),published in English,full-text available,having healthy pregnant women without anaemia for study participants,and having hypertensive disorders in pregnancy at the end of pregnancy as the outcome.The risk of bias assessment tool was used for quality appraisal.Meta-analysis was conducted by calculating the fixed and random effects of the odds ratio(OR)for iron supplementation among non-anaemic pregnant women compared with the incidence of hypertensive disorders in pregnancy.The range of the study’s estimation accuracy was reflected by a 95%confidence interval(CI).Results:Four RCTs were included in the meta-analysis.The pooled results showed that iron supplementation possibly had no effect on the incidence of hypertensive disorders in pregnancy(OR 0.93,95%CI 0.81-1.07;P=0.30),gestational hypertension(OR 1.37,95%CI 0.69-2.73;P=0.36)as well as on the development of preeclampsia(OR 1.45,95%CI 0.71-2.97;P=0.31).Conclusions:Iron supplementation has no effect on the incidence of hypertension in non-anaemic pregnant women.In general,there is a lack of evidence for the association between iron supplementation and the incidence of hypertensive disorders in pregnancy among non-anaemic pregnant women,and further studies are needed.

Eating disorders and pregnancy: Proposed treatment guidelines for obstetricians and gynecologists

Pregnant women with eating disorders are at risk for multiple complications to both the woman and the fetus. Eating disorders are particularly prevalent among adolescent girls and young women. This paper suggests a road map for the obstetrician gynecologist caring for women who either have an active eating disorder, report a history of a prior eating disorder, or when the clinician suspects that the woman may have an eating disorder which has not been previously identified. Proposed treatment guidelines are outlined.

Association of maternal hypertensive disorders in pregnancy with infant neurodevelopment

Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.

Factors Associated with Hypertensive Disorders of Pregnancy in Public Maternities of the City of Parakou In 2019

The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: It has been a descriptive cross-sectional study with a prospective collection of data using a questionnaire in prenatal consultation in the health center of Parakou’s commune for 4 months (May 1 to August 31, 2019). Result: A proportion of 8.2% (55/671) of the pregnancy had the hypertensive disorders of pregnancy. The Gestational HyperTension was the most common type of arterial hypertension (AHT) with a proportion of 49.1%. The factors associated with HDP were the age of 30 to 34 (OR: 11.9;95% CI: 1.54 - 92.29;p = 0.0346), the family history of Arterial HyperTension (AHT) (OR: 1.5;95% CI: 1.03 - 4.66;p = 0.0481), the BMI > 30 (OR:14.2;95% IC: 7.02 - 28.69;p = 0.0235), being married or in a common-law relationship (OR = 2.51;95% CI: 1.30 - 4.86;p = 0.0412), the stress (OR: 2.0;95% CI:1.09 - 3.32;p = 0.0209), the history of HDP (OR: 9.0;95% CI: 2.53 - 15.23;p < 0.05). Conclusion: HDP are common in Parakou. Some factors previously described in the literature are associated with them.

Prognosis of Patients with Pregnancy Hypertensive Disorders Followed in University Hospital to Parzakou in 2020

Introduction: Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae. The objective of this study was to describe the prognosis in the postpartum period of patients with HDP in Departmental University Hospital of Borgou CHUD-B from Parakou in 2020. Methods: The study was prospective with a descriptive and analytical design and was conducted from January 2020 to September 2020. Patients with HDP were recruited from the gynecology-obstetrics department and each followed for 3 months in the cardiology department. HDP was classified according to the International Society for the Study of Hypertension in Pregnancy, and blood pressure (BP) was taken according to WHO recommendations. Self-measurement of BP at home was performed to assess blood pressure control outside the hospital. Epidata 3.1 and SPSS 21 software were used for data processing and analysis. P values < 5% were considered statistically significant. Results: During the study period, the hospital frequency of HDP was 15.6%. The frequency of maternal complications in the postpartum period was 28% (severe hypertension: 23.2%;eclampsia: 3.6%;puerperal psychosis: 1.2%). At the end of the three-month follow-up, blood pressure returned to normal in 73.2% of cases;it persisted in 26.8% of women. Factors associated with persistence of hypertension after multivariate analysis were, overweight/obesity RRa 8.664 [1.566 - 47.941], (p = 0.013);family history of hypertension RRa 6.499 [1.493 - 28.289], (p = 0.013);history of hypertension in previous pregnancies RRa 7.764 [1.561 - 38.601], (p < 0.012). Conclusion: The frequency of HDP is not negligible at CHUD-B/A. The evolution of these HDP was marked in more than a quarter of cases by complications in the postpartum period followed by a persistence of hypertension 3 months after childbirth predicted by cardiovascular risk factors.

Pregnancy and Childbirth during COVID-19 Lockdown in Patients under Treatment for Psychological Disorders

This article aims to discuss the psychological consequences of the COVID-19 lockdown for patients being treated for psychological disorders and preparing for childbirth.Two clinical examples are used for illustration.

Changes in Number and Biological Function of Endothelial Progenitor Cells in Hypertension Disorder Complicating Pregnancy

To examine the changes in number and function of endothelial progenitor cells （EPCs） from peripheral blood （PB） in hypertension disorder complicating pregnancy （HDCP）, 20 women with HDCP and 20 normal pregnant women at the third trimester were studied. Mononuclear cells （MNCs） from PB were isolated by Ficoll density gradient centrifugation. EPCs were identified by positive expression of both CD34 and CD133 under fluorescence microscope and positive expression of factor Ⅷ as shown by immunocytochemistry. The number of EPCs was flow-cytometrically determined. Proliferation and migration of EPCs were measured by MTT assay and modified Boyden chamber assay, respectively. The adhesion activity of EPCs was detected by counting the number of the adherent cells. The results showed that, compared with normal pregnant women, the number of EPCs was significantly reduced in HDCP （4.29%±1.21% vs 15.32%±2.00%, P〈0.01）, the functional activity of EPCs in HDCP, such as proliferation （13.45%±1.68% vs 18.45%±1.67%）, migration （37.25±7.28 cells/field vs 67.10±9.55 cells/field） and adhesion activity （20.65±5.19 cells/field vs 34.40±6.72 cells/filed） was impaired （P〈0.01）. It is concluded that the number and function of EPCs are significantly decreased in HDCP.

The Association between Polymorphism of TNF-α Gene and Hypertensive Disorder Complicating Pregnancy

To study whether the development of hypertensive disorder complicating pregnancy is associated with --308G→A, -850C→T mutation at promoter of TNF-α gene, the --308G→A, --850C→T polymorphism was examined in patients and healthy pregnant women by PCR-RFLP technique. The frequencies of genotype and allele were compared between the two groups. The results showed that with-308G→A polymorphism distribution, the allele frequency of TNF2 and the frequency of the genotype TNF2/1 in the patient group was significantly higher in the patient group than in control group （P〈0.05）. A significant difference in genotype distribution of --850C→T polymorphism was observed between the two groups. The allele frequencies of T in patient group was higher in the control group as compared with the patient group. The frequencies of CT and TT genotypes were lower in the patient group. It is concluded that the TNF2 allele of -308 is associated with the occurrence of hypertensive disorder complicating pregnancy, while T allele of--850 may be the protective factor against the development of the disease. TNF2/1 CC may be susceptibility genotype of hypertensive disorder complicating pregnancy.

Endogenous Ouabain in Hypertensive Disorder Complicating Pregnancy

Expression of endogenous ouabain in placenta and the concentrations of serum ET-1 and NO were examined in 30 patients with hypertensive disorder complicating pregnancy （HDCP） and 30 healthy pregnant women to investigate the effect of endogenous ouabain on HDCP. Compared with the healthy pregnant group, the expression of endogenous ouabain dramatically increased in the HDCP groups （P〈0.01）. There was a significantly positive correlation between the expression of en- dogenous ouabain with ET-1 （r= 0.5567, P〈0.01）, while the correlation of endogenous ouabain and NO was significantly negative （r=-0.6895, P〈0.01）. As expected, the correlation between ET-1 and NO was negative （r=-0.7796, P〈0.01）. ET-1 concentrations of maternal and cord sera in HDCP groups were significantly higher in comparison with healthy pregnant group （P〈0.01）. On the contrast, NO concentrations were much lower in the maternal and cord sera of HDCP groups as compared with healthy pregnant group （P〈0.01）. Our data suggest that endogenous ouabain is directly involved in the nosogenesis of HDCP, with accompanying decreased NO and the elevated of ET-1.

The investigation for the relationship among serum leptin, erythrocyte membrane Ca^(2+)-ATPase activity and hypertensive disorder complicating pregnancy

Objective： To study the significance of Leptin and the activity of erythrocyte membrane Ca^2＋-ATPase（EMCA） in the development of hypertensive disorder complicating pregnancy. Methods： Radioimmunoassay was used to test the level of serum Leptin, and the activity of EMCA was determined chemically in 38 pregnant women with hypertensive disorder complicating pregnancy and 36 normotensive pregnant women. Results： The level of serum Leptin in hypertensive disorder complicating pregnancy（gestational hypertension： 13.76 ± 3.46 ng/ml; preeclampsia： 15.76 ± 5.47 ng/ml; eclampsia： 18.32 ± 6.38 ng/ml）was significantly higher than that in normotensive pregnant women （11.33 ± 2.93 ng/ml） ,respectively. The average EMCA activity of patients with hypertensive disorder complicating pregnancy （gestational hypertension： 1.65 ± 0.24 μmol·pi/mg.h ; preeclampsia： 1.37 ± 0.19 μ mol·pi/mg·h;eclampsia：1.12 ± 0.14 μmol·pi/mg·h） was significantly lower than that of normotensive pregnant women（1.83 ± 0.38 μ mol·pi/mg·h）,respectively. There was a negative correlation between the level of serum Leptin and the activity of RMCA in hypertensive disorder complicating pregnancy （r = -0.63）. Conclusion： Inhibition of EMCA activity of erythrocyte in hypertensive disorder complicating pregnancy may increase cytoplasmic free calcium, which contributes to the development of hypertensive disorder complicating pregnancy. The negative correlation between the level of serum Leptin and the activity of EMCA, also suggested that serum Leptin and the activity of EMCA may play a role in the development of hypertensive disorder complicating pregnancy.

Ultrasonic evaluation of central retinal artery hemodynamics in patients with hypertensive disorder complicating pregnancy and the correlation with disease

Objective:To study the correlation between central retinal artery hemodynamic characteristics in patients with hypertensive disorder complicating pregnancy and endothelial injury molecules as well as trophoblast cell apoptosis molecules.Methods: 45 healthy pregnant women, 37 patients with gestational hypertension and 24 patients with preeclampsia who gave birth in Obstetrics Department of our hospital between May 2013 and December 2015 were selected and included in the control group, GH group and PE group respectively. Central retinal artery ultrasonography was done to determine peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI), serum was collected to determine interleukin-6 (IL-6), IL-17, IL-24, chemokine ligand 10 (CXCL10) and cartilage glycoprotein 40 (YKL40) content, and placenta tissue was collected to determine Fas, FasL, Bax, Caspase-3, Caspase-9, XIAP, Survivin and Livin expression.Results: Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of GH group and PE group were significantly lower than those of control group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of control group (P<0.05). Central retinal artery PSV and EDV as well as XIAP, Survivin and Livin expression in placenta of PE group were significantly lower than those of GH group (P<0.05) while central retinal artery RI, serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were significantly higher than those of GH group (P<0.05). Serum IL-6, IL-17, IL-24, CXCL10 and YKL40 content as well as Fas, FasL, Bax, Caspase-3 and Caspase-9 expression in placenta were negatively correlated with PSV and EDV, and positively correlated with RI;XIAP, Survivin and Livin expression in placenta were positively correlated with PSV and EDV, and negatively correlated with RI. Conclusions:Central retinal artery blood flow characteristics in patients with hypertensive disorder complicating pregnancy are the significantly increased blood flow resistance and the significantly decreased blood flow volume, and the above blood flow characteristics are associated with maternal endothelial injury and trophoblast cell apoptosis.

Changes and Clinical Value of Serum Cortisol Levels in Patients with Hypertensive Disorder in Pregnancy

Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects.90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology,including 30 cases in each of the hypertension group,the preeclampsia group,and the eclampsia group.Another 30 healthy pregnant women were selected as the control group.The serum cortisol levels of pregnant women in the above four groups were measured.Results:Compared with the control group,the serum cortisol levels in the other three groups were significantly increased.In perinatal outcome,compared with the control group,the three groups of patients had an increase in Apgar score,preterm birth,stillbirth rate,growth restriction rate and neonatal asphyxia rate.There were significant differences between groups(P<0.05),and showed as gestational hypertension<preeclampsia<eclampsia.Conclusion:With the exacerbation of hypertensive disorders during pregnancy,the serum cortisol level continues to increase,which has a serious adverse effect on the prognosis of the perinatal infants.

Effect of low molecular weight heparin therapy on maternal endothelial injury and placental pathological injury after hypertensive disorder complicating pregnancy

Objective: To study the effect of low molecular weight heparin therapy on maternal endothelial injury and placental pathological injury after hypertensive disorder complicating pregnancy. Methods: A total of 70 patients with hypertensive disorder complicating pregnancy who were treated in the hospital between September 2014 and May 2016 were divided into control group and observation group according to the random number table method, 35 cases in each group. Control group received conventional therapy, the observation group received low molecular weight heparin combined with conventional therapy, and both therapies lasted until delivery. The differences in the levels of endothelial injury indexes in serum as well as the expression of oxidative stress indexes and apoptosis molecules in the placental grinding fluid were compared between the two groups of patients. Results: After treatment, serum ET and VCAM-1 levels of both groups of patients were lower than those before treatment while NO and PGE levels were higher than those before treatment, and serum ET and VCAM-1 levels of observation group were lower than those of control group while NO and PGE levels were higher than those of control group;after delivery, AOPP and MDA levels in placental grinding fluid were significantly lower than those of control group while SOD and GSH-Px levels were higher than those of control group;Fas, p53 and caspase-3 mRNA expression in placental grinding fluid were lower than those of control group while Bcl-2 and bax mRNA expression were higher than those of control group. Conclusion: Adjuvant low molecular weight heparin therapy can help to reduce the maternal endothelial injury, reduce the systemic oxidative stress and suppress the placental cell apoptosis in patients with hypertensive disorder complicating pregnancy.

Ultrasonic evaluation of fetal ventricular systolic function in hypertensive disorder complicating pregnancy and its correlation with the expression of placental hypoxia-related genes

Objective: To discuss the ultrasonic evaluation of fetal ventricular systolic function in hypertensive disorder complicating pregnancy and its correlation with the expression of placental hypoxia-related genes. Methods: A total of 98 late pregnant women with hypertensive disorder complicating pregnancy who were treated in the hospital between December 2014 and February 2017 were selected as hypertensive disorder complicating pregnancy group and 100 normal late pregnant women who received physical examination in the hospital during the same period were selected as normal control group. The ultrasonic parameters of fetal ventricular systolic function in two groups of pregnant women were detected before delivery, and the expression of hypoxia-related genes in placental tissue was detected by fluorescence quantitative PCR. Pearson test was used to assess the correlation between the parameters of fetal ventricular systolic function and placental hypoxia in hypertensive disorder complicating pregnancy. Results: The fetal left ventricular fractional shortening and right ventricular fractional shortening levels of hypertensive disorder complicating pregnancy group were lower than those of normal control group. Angiogenesis-related genes VEGF, netrin-1 and XIAP mRNA expression in placental tissue of hypertensive disorder complicating pregnancy group were lower than those in placental tissue of normal control group while HIF-1α mRNA expression was higher than that in placental tissue of normal control group;oxidative stress-related genes Nrf2, TAC3 and PrxⅡ mRNA expression in placental tissue were lower than those in placental tissue of normal control group;apoptosis genes Fas, p53 and caspase-9 mRNA expression in placental tissue were higher than those in placental tissue of normal control group while Bcl-2 and SFRP2 mRNA expression were lower than those in placental tissue of normal control group. Pearson test showed that the ultrasonic parameter levels of fetal ventricular systolic function in hypertensive disorder complicating pregnancy were directly correlated with the degree of placental hypoxia. Conclusion:Ultrasonic testing of fetal ventricular systolic function in hypertensive disorder complicating pregnancy can be used as a reliable method to measure the degree of placental hypoxia.

Effect of folic acid and vitamin supplement on endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy

Objective: To study the effect of folic acid and vitamin supplement on endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy. Methods: A total of 62 patients who were diagnosed with preeclampsia in Wuhan Red Cross hospital between March 2015 and February 2017 were selected as the research subjects and randomly divided into two groups, the observation group received folic acid, vitamin and conventional symptomatic treatment, and control group accepted conventional symptomatic treatment. Serum contents of endothelial injury markers and oxidative stress indexes were detected before treatment and 2 weeks after treatment;the expression of apoptosis genes in the placenta were detected after delivery. Results: 2 weeks after treatment, serum ET-1, tTG, sFlt-1, sEng, MPO, IMA, MDA and AOPP levels of both groups of patients were significantly lower than those before treatment, and serum ET-1, tTG, sFlt-1, sEng, MPO, IMA, MDA and AOPP levels of observation group were significantly lower than those of control group;after delivery, Fas, Bax and Caspase-3 mRNA expression levels in placenta tissue of observation group were significantly lower than those of control group while Bcl-2, Survivin and Livin mRNA expression levels were significantly higher than those of control group. Conclusion:Folic acid and vitamin supplement can significantly improve the endothelial injury and placental blood perfusion in patients with hypertensive disorder complicating pregnancy.