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Menstrual abnormalities and predisposition to pregnancy-related hypertensive disorders: a retrospective study

Londero Ambrogio DGYE-2009-0139.r1 [ID 463718] 6 PAG

Objective: Pregnancy-related hypertensive disorders (PRHDs) are a leading cause of maternal and perinatal morbidity and mortality in developed countries. This study investigated a possible association of PRHDs with menstrual abnormalities.
Materials and methods: We contacted all women with PRHDs who delivered in our clinic between 2004 and 2007 as well as a random control cohort without pregnancy complications and asked them about their menstrual cycle characteristics. Statistical analyses were performed using R, with significance set at p<0.05. Results: We collected data for 237 women with normal pregnancies and 255 women with PRHDs, among whom 143 had gestational hypertension and 70 had mild and 41 severe preeclampsia. By monovariate analysis, PRHDs correlated with dysmenorrhea, hypermenorrhea and menstrual irregularity (p<0.05). By multivariate analysis, the occurrence of PRHDs was influenced by dysmenorrhea and menstrual irregularity (p<0.05).
Conclusions: PRHDs usually affect women with painful or irregular menstrual cycles, perhaps due to metabolic syndrome or molecular pathways involving vasoactive substances, with clear vascular implications.

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RELATION BETWEEN FIRST TRIMESTER MATERNAL SERUM LEPÈTIN LEVELS AND BODY MASS INDEX IN NORMOTENSIVE AND PREECLAMPTIC PREGNANCIES. ROLE OF LEPTIN AS A MARKER OF PREECLAMPSIA: A PROSPECTIVE CASE-CONTROL STUDY.

Panagopoulos Perikles DGYE-2009-0143 [ID 451579]

OBJECTIVE: We measured first trimester plasma leptin concentrations in 37 women who subsequently developed preeclampsia and 53 normotensive controls to determine the interrelation between leptin and body mass index in both groups. We further investigated the association between the risk for preeclampsia with maternal leptin levels.
METHODS: Bloods samples were collected at 13 weeks. Non parametric tests, Spearman’s correlation, linear regression analysis and multiple logistic regression analysis were applied in our data.
RESULTS:
One kg/m2 increase in pre-pregnancy body mass index was related to a 2.747 (95% CI: 3.242-2.252) ng/ml rise in leptin concentration among cases and 2.502 (95% CI: 2.873-2.131) ng/ml rise in leptin concentrations among controls. Increased leptin concentration ( ≥ 25.3ng/ml ) in lean women is associated with a 18.8-fold increased risk of preeclampsia (adjusted OR: 18.8, CI: 1.8-194, p=0.014 ). Leptin treated as a continuous variable is a significant predictor of preeclampsia (adjusted OR: 1.08, CI: 1.018-1.133, p=0.009). CONCLUSION: Increased leptin concentration can definitely contribute to the prediction of preeclampsia in lean women, but this is not the case in overweight women. Further research in terms of longitudinal case control studies is required to clarify the predictive value of preeclampsia.

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COMPUTERIZED ANALYSES OF FETAL HEART RATE IN PREGNANCIES COMPLICATED BY GESTATIONAL DIABETES

Busicchio

Abstract: OBJECTIVE We evaluated the value of computerized CTG in pregnancies complicated by gestational diabetes mellitus (GDM). PURPOSE OF STUDY We studied FHR recordings from 100 pregnant women affected by GDM on diet therapy, 60 pregnant women affected by GDM on insulin therapy and 100 normal pregnant controls. The results were compared among the groups and related to neonatal umbilical artery cord blood analysis at birth. RESEARCH DESIGN AND METHODS Baseline FHR and the duration of episodes of low variation were significantly higher in diabetic than in controls and were negatively related to umbilical artery glycemia at birth, whereas the short-term variation in diabetics was significantly lower than in controls and was positively related to. CONCLUSIONS Our study demonstrates that GDM does impact FHR. The alteration is slight but evident; it reflects fetal well being and correlate with neonatal reactivity. Only computerized cardiotocography may allow to detect those slight but significant differences.

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The molecular mechanisms of action of sVEGFRs in preeclampsia

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The molecular mechanisms of action of sVEGFRs in preeclampsia
Foidart Jean-Michel

(14th World Congress of Gynecological Endocrinology – March 4-7 2010)

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AUTOMATED ASSAYS FOR SVEGF R1 AND PLGF AS AN AID IN THE DIAGNOSIS OF PRETERM PREECLAMPSIA: A PROSPECTIVE CLINICAL STUDY.

3) Am J Obstet Gynecol. 2010 Jan;202(1):40.e1-7.

Sunderji S, Gaziano E, Wothe D, Rogers LC, Sibai B, Karumanchi SA, Hodges-Savola C.

OBJECTIVE: The purpose of this study was to assess the utility of soluble vascular endothelial growth factor 1 (sVEGF R1) and placental growth factor (PlGF) levels in the clinical diagnosis of preeclampsia. STUDY DESIGN: Plasma was collected prospectively from 457 subjects (n = 409 without preeclampsia, n = 48 with preeclampsia) at 20-36 weeks’ gestation. Automated immunoassays were used to measure free sVEGF R1 and free PlGF. RESULTS: Clinical sensitivities of 0.96 and specificities of 0.96 and 0.95 were calculated for sVEGF R1 and PlGF, respectively, for aiding in the diagnosis of preeclampsia. Among subjects with chronic hypertension, sVEGFR1 was dramatically elevated and PlGF decreased in those with superimposed preeclampsia (P < .001 for superimposed preeclampsia vs chronic hypertension for both biomarkers). The ratio of sVEGFR1/PlGF provided a better test to aid in the diagnosis of preeclampsia than either analyte alone (3% false positive rate). CONCLUSION: Free sVEGF R1 and PlGF were useful in differentiating women with preterm preeclampsia from normotensive and hypertensive subjects.

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