• Title/Summary/Keyword: Pre-eclampsia

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Biomarkers and genetic factors for early prediction of pre-eclampsia

  • Kim, Hannah;Shim, Sung Shin
    • Journal of Genetic Medicine
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    • v.14 no.2
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    • pp.49-55
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    • 2017
  • Pre-eclampsia is known to cause considerable maternal morbidity and mortality. Thus, many studies have examined the etiopathogenesis of pre-eclampsia. While many pathophysiological factors related to pre-eclampsia have been identified, the precise etiopathogenesis of pre-eclampsia remains unclear. Numerous studies have identified factors for the early prediction for pre-eclampsia to lead to preparation and closer observation on pre-eclampsia when it occurs. This article reviews on current studies of biomarkers and genetic factors related to pre-eclampsia, which may be important for developing strategies for early prediction of pre-eclampsia.

Genetics of Pre-eclampsia

  • Kim, Shin-Young;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.8 no.1
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    • pp.17-27
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    • 2011
  • Pre-eclampsia is a major cause of maternal and perinatal mortality and morbidity worldwide, but remains unclear about the underlying disease mechanisms. Pre-eclampsia is currently believed to be a two-stage disease. The first stage involves shallow cytotrophoblast invasion of maternal spiral arteriole, resulting in placental insufficiency. The hypoxic placenta release soluble factors, cytokines, and trophoblastic debris into maternal circulation, which induce systemic endothelial damage and dysfunction. This cause the second stage of the disease: maternal syndrome. Epidemiological research has consistently demonstrated a familial predisposition to pre-eclampsia. Intensive research efforts have been made to discover susceptibility genes that will inform our understanding of the pathophysiology of preeclampsia and that may provide direction for therapeutic or preventative strategies. In this review, we summarize the current understanding of the role of genetic factors in the pathophysiology of pre-eclampsia and explain the molecular approach to search for genetic clues in pre-eclampsia.

A Study on Overseas Traditional Chinese Medicine Treatment of Pre-eclampsia (자간전증의 국외 중의학 치료 고찰)

  • You-Lim Kang;Deok-Sang Hwang;Jin-Moo Lee;Chang-Hoon Lee;Jun-Bock Jang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.4
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    • pp.21-39
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    • 2023
  • Objectives: The purpose of this study is to review the overseas clinical study trends on Chinese Medicine treatment for Pre-eclampsia. Methods: We searched articles published from Pubmed, Embase and CNKI. The period was set from 2004 to 2023. Searched keywords were "Pre-eclampsia", "Preeclampsia", "Chinese medicine", "Herbal medicine", "子癎前期", "子癎前症", "中藥", "中醫". Results: 21 articles were finally selected. There were 16 RCTs, 3 case control studies, 2 case series. 2 articles used both acupuncture and western medicine, 19 articles used both herbal medicine and western medicine. 風池 (GB20), 太衝 (LR3), 足三里 (ST36) were the most frequently used acupoints, Paeoniae Radix alba (白芍藥) is the most frequently used in herbal medicine treatment. Conclusions: Our review found that chinese medicine combined with western medicine is more effective for alleviating symptoms of pre-eclampsia.

A Clinical Study about Prolonging Pregnancy in Patient with Pre-eclampsia (임신중독증 임신부의 임신 연장에 대한 임상보고 1례)

  • Kim, Bo-kyun;Park, Sang-Yeon;Jeong, Dae-Seong;Han, Won-Ju
    • Journal of Korean Medical Ki-Gong Academy
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    • v.13 no.1
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    • pp.36-45
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    • 2013
  • Objective : We studied whether Antaeeum and Saahm Spleen-tonifying acupuncture had effects of prolonging pregnancy in pregnant women with pre-eclampsia. Methods : We have administered Antaeeum and applied Saahm Spleen-tonifying acupuncture for 8 weeks and the patient stopped taking steroids she had taken before. Furthermore, we observed edema, fatigue, albuminuria and hypertension. Results : In consequence of administering Antaeeum and applying Saahm Spleen-tonifying acupuncture for 8 weeks, edema and fatigue were improved and albuminuria and hypertension were not changed significantly. However pregnancy was prolonged from 28 weeks to 36 weeks and the patient could give birth successfully. Conclusions : In conclusion, Antaeeum and Saahm Spleen-tonifying acupuncture have effects of prolonging pregnancy in patients with pre-eclampsia.

Late Onset Postpartum Seizure and Magnetic Resonance Image Findings

  • Hwang, Sung-Nam;Park, Jae-Sung;Park, Seung-Won
    • Journal of Korean Neurosurgical Society
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    • v.37 no.6
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    • pp.453-455
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    • 2005
  • Two young women were brought to the Emergency room with generalized tonic and clonic seizures. Seizure developed seven and ten days after delivery respectively without the clinical signs of pre-eclampsia throughout the pregnancies. Magnetic resonance(MR) image of the brain showed characteristically symmetrical abnormal signals in the parietal and occipital regions. After several days of medical treatment, they were discharged without neurologic sequelae and follow-up MR images taken three months after discharge showed complete disappearance of the previous abnormal signals.

The Effect of Diabetes, Gestational Diabetes or Pre-eclampsia on Urinary Protein and Mineral Excretion during Pregnancy

  • Joo, Eun-Jung;Janet C. King
    • Preventive Nutrition and Food Science
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    • v.2 no.3
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    • pp.225-231
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    • 1997
  • Thirteen healthy control, 13 pre-eclamptic, 7 diabetic(DM) and 12 gestational diabetic(GDM) pregnant women participated in a study ofthe interrelationships between the levels of protein, calcium, magnesium, phosphorus, zinc and copper in urine. Urinary protein, magnesium and copper levels were significantly higher (p<0.0005, p<0.0003, p<0.005 respectively) in pre-eclamptic women than those of control, DM and GDM women. Urinary zinc excretion in pre-eclamptic women (1.61 mg/g creatinine) was higher than that of DM women (0.81mg/g creatinine); urinary zinc losses of control and GDM women were wre between the other two rups. The GDM women excreted significantly ore phosphorus in their urine in comparison to control and preeclamptic women (p<0.02), but this was not seen in DM women. Among the DM women, urinary protein excretion was positively correlated with glycosylated hemoglobin(r=0.940) and fasting blood glucose concentration (r=0.889). Urinary zinc excretion also was correlated with glycosylated hemoglobin (r=0.853) and fasting blood glucose (r=0.956). In the GDM and pre-eclamptic women there were also significant correlations between urinar calcium and magnesium (r=0.857, r=0.749 respectively) and between urinary protein and copper(r=0.638, r=0.778 respectively).

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Altered expression of norepinephrine transporter and norepinephrine in human placenta cause pre-eclampsia through regulated trophoblast invasion

  • Na, Kyu-Hwan;Choi, Jong Ho;Kim, Chun-Hyung;Kim, Kwang-Soo;Kim, Gi Jin
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.1
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    • pp.12-22
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    • 2013
  • Objective: We investigated the norepinephrine transporter (NET) expression in normal and pre-eclamptic placentas and analyzed the invasion activity of trophoblastic cells based on norepinephrine (NE)-NET regulation. Methods: NET and NE expression levels were examined by western blot and enzyme-linked immunosorbent assay, respectively. Trophoblast invasion activity, depending on NE-NET regulation, was determined by NET-small interfering RNA (siRNA) and NET transfection into the human extravillous trophoblast cells with or without NE treatment and invasion rates were analyzed by zymography and an invasion assay. Results: NET mRNA was expressed at a low level in pre-eclamptic placentas compared with normal placentas and NE concentration in maternal plasma increased significantly in pre-eclamptic women compared to normal pregnant women (p<0.05). NET gene upregulation and NE treatment stimulated trophoblast cell invasion up to 2.5-fold (p<0.05) by stimulating matrix metalloproteinase-9 activity via the phosphoinositol-3-kinase/AKT signaling pathway, whereas NET-siRNA with NE treatment reduced invasion rates. Conclusion: NET expression is reduced by inadequate regulation of NE levels during placental development. This suggests that a complementary balance between NET and NE regulates trophoblast cell invasion activities during placental development.

How Well Do U.S. Primary Care and Obstetrics and Gynecology Clinicians Screen for Pregnancy Complications at Well Woman Visits? A Retrospective Cohort Study

  • Eli D. Medvescek;Sorana Raiciulescu;Andrew S. Thagard;Katerina Shvartsman
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.2
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    • pp.190-195
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    • 2023
  • Objectives: Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology. Methods: We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate. Results: In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively). Conclusions: Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.

Ovarian stimulation and liver dysfunction: Is a clinical relationship possible? A case of hepatic failure after repeated cycles of ovarian stimulation

  • Giugliano, Emilio;Cagnazzo, Elisa;Pansini, Giancarlo;Vesce, Fortunato;Marci, Roberto
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.1
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    • pp.38-41
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    • 2013
  • Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the literature. However, there has never been a fruitful debate on this topic. The present manuscript tried to fill this gap. We reported a case of a 35-year-old nulliparous woman admitted to our obstetric emergency room for severe pre-eclampsia. She had been subjected to four cycles of controlled ovarian stimulation for intrauterine insemination. At 32 weeks of gestation, she developed severe pre-eclampsia, which led to HELLP syndrome complicated by fatal liver failure. The etiological link between ovarian stimulation and HELLP syndrome is intriguing. Further investigations are needed to understand whether repeated ovarian stimulation may represent a risk factor in pre-eclamptic patients.

Maternal and neonatal outcomes in Korean women with type 2 diabetes

  • Jang, Hye-Jung;Kim, Hee-Sook;Kim, Sung-Hoon
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1143-1149
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    • 2018
  • Background/Aims: The purpose of this study was to compare maternal and neonatal outcomes in Korean women with type 2 diabetes and nondiabetic controls. Methods: We performed a retrospective survey of 200 pregnancies in women with type 2 diabetes (n = 100) and nondiabetic controls (n = 100) who delivered from 2003 to 2010 at Cheil General Hospital & Women's Healthcare Center, Korea. We compared maternal characteristics as well as maternal and neonatal outcomes between groups matched by age, pre-pregnancy weight, body mass index, parity, and gestational age at delivery. Results: The number of infants that were small for gestational age and the rate of major congenital malformations were not significantly different. However, women with type 2 diabetes showed a slightly higher risk for primary caesarean section (35.0% vs. 18.0%, p = 0.006) as well as pre-eclampsia (10.0% vs. 2.0%, p = 0.017), infections during pregnancy (26.0% vs. 2.0%, p < 0.001), neonatal weight ($3,370{\pm}552.0$ vs. $3,196{\pm}543.3$, p = 0.025), large for gestational age (22.0% vs. 9.0%, p = 0.011), and macrosomia (15.0% vs. 5.0%, p = 0.018) compared to nondiabetic controls. Conclusions: Maternal and neonatal outcomes for women with type 2 diabetes were worse than those for nondiabetic controls. Diabetic women have a higher risk for primary caesarean section, pre-eclampsia, infections during pregnancy, large neonatal birth weight, large for gestational age, and macrosomia.