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Asian pacific Journal of Reproduction 2021年第6期10卷 241-251页

作者： Shonitha Sagadevan Oorvashree Sri Hari Mohamed Jahangir Sirajudeen Gopi Ramalingam Roopa Satyanarayan Basutkar Department of Pharmacy Practice JSS College of PharmacyJSS Academy of Higher Education&ResearchOotyThe NilgirisTamil NaduIndia

Objective:To summarize whether the supplementation of L-arginine in pregnant women helps in management of preeclampsia and its impact on maternal and neonatal outcomes.Methods:Studies conducted from the past 17 years(1999 to 2016).were referred from database like Cochrane Central Registry of Controlled Trials(CENTRAL),Scopus,Google Scholar and PubMed.Out of 134 studies,7 studies were included.L-arginine versus placebo was considered for quantitative analysis.Modified Cochrane data extraction form was used to collect the data.The risk of bias was assessed using Cochrane’s risk of bias assessment tool in RevMan 5.4 and the summary of findings was determined using GradePro software.Results:L-arginine showed a significant reduction of preeclampsia[odds ratio(OR)0.38;95%confidence interval(CI)0.25,0.58)].There was a significant reduction in systolic blood pressure[mean difference(MD)-2.47;95%CI-4.53,-0.42]and diastolic blood pressure(MD-0.97;95%CI-3.83,1.89).The effects of L-arginine on secondary outcomes like maternal gestational age,latency,neonatal weight,and appearance,pulse,grimace,activity,respiration(APGAR)score at 1st and 5th minute were not statistically significant.Conclusions:L-arginine supplementation is effective in lowering systolic and diastolic blood pressure of preeclamptic patients.However,it has no noticeable effects on maternal and neonatal outcomes.

关键词： L-arginine Amino acid supplementation preeclampsia Pregnancy Arginine supplementation

Detection of maternal serum thromboxane B2 in different durations of pregnancy and prediction of preeclampsia

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Frontiers of Medicine 2010年第2期4卷 235-240页

作者： Ge-Qing XIA Yu HU Ze-Hua WANG Li ZOU Chao-Ying WU Department of Obstetrics and Gynecology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Institute of Hematology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

This study was aimed to detect maternal serum levels of thromboxane B2(TXB2)in different durations of pregnancy and explore the predictive value of TXB2 for preeclampsia.By employing a prospective and double-blind study method,180 pregnant women with previously normal blood pressures during their progestation were included in the study.Peripheral venous blood samples were obtained during 10+0–14+6(period I),20+0–24+6(period II)and 30+0–34+6(period III)weeks of gestation.Maternal serum levels of TXB2 were measured by enzyme-linked immunoassay.The pathogenetic condition and pregnancy outcomes of these cases were observed.(1)Among the 180 previously normotensive women,ten developed preeclampsia(case group;four severe and six mild preeclampsia).One hundred and seventy remained normal till the end of pregnancy(control group).(2)With development of pregnancy,the levels of maternal serum TXB2 in the 180 cases gradually ascended as seen through the Wilcoxon Signed Ranks Test.There was a statistical signiﬁcance in maternal TXB2 levels between two different gestational stages(P0.05);the levels of TXB2 were signiﬁcantly higher in the case group than in the control group during periods II and III of gestation(both Ppreeclampsia were 80%,69.5%,13.3%,98.33%,9.11 and 90%,68.82%,13.84%,99.13,19.86,respectively.Higher levels of maternal serum TXB2 were detected a long time before clinical symptoms appeared.The maternal serum TXB2 after 20 weeks of gestation had predictive value,and the index after 30 weeks was superior to that prior to 30 weeks.

关键词： thromboxane B2 preeclampsia

The Role of Metformin in Treating preeclampsia

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Maternal-Fetal Medicine 2021年第3期3卷 203-207页

作者： Decui Cheng Xuexin Zhou Xianming Xu Department of Obstetrics and Gynecology Shanghai General HospitalShanghai 201600China

preeclampsia(PE)is a principal cause of maternal and newborn mortality that poses financial and physical burdens to tens of thousands of families each year.Unfortunately,there is no effective management to arrest the progression of this disease unless delivery.Therefore,standardized management or preventive treatments are needed urgently.PE is closely associated with placental hypoxia,which increases the secretion of soluble fms-like tyrosine kinase 1(sFlt-1)as well as soluble endoglin(sEng)into the maternal circulation.Metformin has been found to inhibit those anti-angiogenic factors so it might be a candidate to prevent or treat PE.Women who are diagnosed with gestational diabetes mellitus(GDM)are more likely to have complications of hypertension or PE,so this review aims to demonstrate that the application of metformin in GDM might prevent the onset or progression of PE complicated with GDM.

关键词： Gestational diabetes Gestational hypertension Metformin preeclampsia

Imaging of pregnancy-related liver diseases

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iLIVER 2023年第1期2卷 56-66页

作者： Zongxue Li Ze Zhang Jing Yu Xia Du Pinggui Lei Zhibing Ruan Bo Gao Department of Radiology The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550004GuizhouChina

Pregnancy-related liver diseases are the most frequent cause of liver dysfunction in pregnancy and pose a real threat to fetal and maternal survival.Although hepatobiliary disorders are uncommon in pregnancy,they may be severe enough to cause risk to both the mother and fetus.There are five different types of liver disease that are unique to pregnancy,including hyperemesis gravidarum,intrahepatic cholestasis of pregnancy,preeclampsia,hemolysis,elevated liver enzyme,and low platelet count syndrome,and acute fatty liver of pregnancy.Ultrasound,computed tomography,and magnetic resonance imaging play important roles in the rapid diagnosis and evaluation of complications.An accurate diagnosis can guide further treatment or the induction of labor to prevent intrauterine fetal death.This review highlights the pathogenesis,clinical features,imaging features,and treatment of pregnancy-related liver diseases with the aim of enhancing awareness of these rare but potentially life-threatening diseases of pregnancy.

关键词： Liver diseases preeclampsia HELLP syndrome Acute fatty liver of pregnancy

Prolactin and risk of preeclampsia: A single institution, cross-sectional study

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Asian pacific Journal of Reproduction 2019年第3期8卷 112-117页

作者： Thabat JAl-Maiahy Ali IAl-Gareeb Hayder MAl-kuraishy Department of Gynecology and Obstetrics College of Medicine Almustansiriya UniversityBaghdadIraq Department of Pharmacology Toxicology and MedicineCollege of Medicine Almustansiriya UniversityBaghdadIraq

Objective: To illustrate the association between prolactin serum level and severity of preeclampsia. Methods: In this cross-sectional study, 31 pregnant women with preeclampsia were enrolled as GroupⅠand 20 healthy pregnant women as GroupⅡ. Routine investigations and prolactin serum levels were assessed together with blood pressure changes. The unpaired t-test was used to determine the differences and correlation coefficient for the evaluation of correlation. Results: Prolactin serum levels were higher in preeclampsia patients compared with those of the healthy pregnant women (Ppreeclampsia was linked with prolactin serum levels since 20 patients with preeclampsia showed mild preeclampsia that illustrated relatively lower prolactin serum levels compared with 11 patients with severe preeclampsia (Ppreeclampsia and correlated with the severity of preeclampsia. High but not normal prolactin might be implicated in the pathogenesis of preeclampsia.

关键词： preeclampsia Prolactin Proteinuria Hypertension

Comparison of p38 MAPK, soluble endoglin and endothelin-1 level in severe preeclampsia and HELLP syndrome patients

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Asian pacific Journal of Reproduction 2019年第2期8卷 83-87页

作者： Efendi Lukas Maisuri T Chalid Upik A Miskad Syakib Bakri Department of Obstetrics and Gynecology Faculty of MedicineHasanuddin University of MakassarIndonesia Department of Phatology Faculty of MedicineHasanuddin University of MakassarIndonesia Departement of Internal Medicine Faculty of MedicineHasanuddin University of MakassarIndonesia

Objective: To compare the levels of p38 mitogen-activated protein kinase (MAPK), soluble endoglin and endothelin-1 in the serum of patients with severe preeclampsia, hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and normal pregnancies. Methods: This study was an observational analytic cross-sectional study performed at Wahidin Sudirohusodo Hospital, Makassar, Indonesia, in the period of 5th February 2016 to 20th January 2017. P38 MAPK, soluble endoglin and endothelin-1 levels of patients with normal pregnancies, severe preeclampsia and HELLP syndrome were measured by enzyme-linked immunoabsorbentassay technique, using kits of human soluble endoglin, endothelin-1 and p38 MAPK, Quantikine immunoassay: R&D System Inc. Results: Level of serum p38 MAPK in HELLP syndrome group was higher than in severe preeclampsia and normal pregnancy groups. Soluble endoglin and endothelin-1 levels in pregnancies with severe preeclampsia and HELLP syndrome were higher than normal pregnancy but there was no significant difference between these two groups (P>0.05). Levels of p38 MAPK, soluble endoglin and endothelin-1 also had a positive linear correlation with systolic and diastolic blood pressures (P<0.05). Conclusions: P38 MAPK in serum may be a marker for evidence of the severe hypoxia and its application may be considered for the diagnosis of HELLP syndrome.

关键词： preeclampsia HELLP syndrome p38 MAPK Soluble endoglin Endothelin-1

Value of α-fetoprotein,β-HCG, inhibin A, and UE3 at second trimester for earlyscreening of preeclampsia

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Asian pacific Journal of Reproduction 2019年第1期8卷 30-33页

作者： Farah Farzaneh Mohaddeseh Sharifi Nasim Nourinasab Sarang Younesi Shahid Beheshti University of Medical Sciences Iran

Objective: To study the value ofα-fetoprotein (α-FP),β-human chorionic gonadotropin (β-HCG), inhibin A, and uncojugated estriol (UE3) at the second trimester for early screening of preeclampsia. Methods: This cohort study was performed on 1713 consecutive pregnant women with gestational age from 15 to 18 weeks. We measured the serum levels ofα-FP, β-HCG, inhibin A, and UE3 and they were followed-up for 48 h after delivery. Results: A total of 1713 women were recruited and through the study 151 women (8.8%) were diagnosed with preeclampsia (n=123, 21.5% in the pregnant women with high risk, n=28, 2.5% in the pregnant women with low risk;Ppreeclampsia. Although these markers have a low positive predictive value, they present a high negative predictive value. Also, the combination ofα-FP,β-HCG and inhibin A and the combination ofα-FP and inhibin A have the highest value in screening preeclampsia.

关键词： preeclampsia Screening Second trimester Biomarkers

Prediction of severe preeclampsia in machine learning

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Medicine in Novel Technology and Devices 2022年第3期15卷 148-153页

作者： Xinyuan Zhang Yu Chen Stephen Salerno Yi Li Libin Zhou Xiaoxi Zeng Huafeng Li Department of Applied Mechanics College of Architecture and EnvironmentSichuan Province Biomechanical Engineering LaboratorySichuan UniversityChengdu610065SichuanChina Department of Biostatistics University of MichiganAnn ArborMIUSA Medical Big Data Center Sichuan UniversityChengdu610065SichuanChina Department of Computer Science University of WisconsinMadisonWIUSA West China Second University Hospital Sichuan UniversityChengdu610041China Department of Applied Mechanics Sichuan UniversityChengdu610065SichuanChina

This study aimed to find out the blood data characteristics of patients and explore the correlation between severe preeclampsia and blood index value.Provide assistance for the early attention direction of severe preeclampsia diagnosis and treatment.19,653 pregnant women presenting to the West China Second University Hospital,Sichuan University from January 2017 to April 2019.After screening,a total of 248 patients,124 severe preeclampsia cases,and 124 controls were selected for this study.Forty-three blood examination variables were obtained from routine blood work,hepatic,renal and coagulation function examination.Light gradient boosting machine(light GBM),decision tree and random forest were used for date diving.We randomly divided 35%of the original data as a testing set to conduct internal validation of the performance of the prediction model.The area under receiver operating characteristic curve(AUC)was used as the main score to compare the three methods.Finally,a binary classification light GBM model based on aspartate aminotransferase,direct bilirubin and activated partial thromboplastin time ratio can predict severe preeclampsia with sensitivity of 88.37%,specificity of 77.27%,AUC of 89.74%and positive predictive value of 65.96%.We believe relevant quantifiable indicators can establish an effective prediction model,which can provide guidance for early detection and prevention of severe preeclampsia.

关键词： preeclampsia Screening Prediction Blood examination Data characteristics

COVID-19 and hemolysis,elevated liver enzymes and thrombocytopenia syndrome in pregnant women-association or causation?

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World Journal of Virology 2022年第5期11卷 310-320页

作者： Prashant Nasa Deven Juneja Ravi Jain Ruchi Nasa Department of Critical Care Medicine NMC Specialty HospitalDubai 7832United Arab Emirates Department of Internal Medicine College of Medicine and Health SciencesAl Ain 17666Abu DhabiUnited Arab Emirates Institute of Critical Care Medicine Max Super Specialty Hospital SaketNew Delhi 110017India Department of Critical Care Medicine Mahatma Gandhi Medical College and HospitalJaipur 302001India Department of Pathology Fakeeh University HospitalDubai 00000United Arab Emirates

Pregnant women are among the high-risk population for severe coronavirus disease 2019(COVID-19)with unfavorable peripartum outcomes and increased incidence of preterm births.Hemolysis,the elevation of liver enzymes,and low platelet count(HELLP)syndrome and severe preeclampsia are among the leading causes of maternal mortality.Evidence supports a higher odd of pre-eclampsia in women with COVID-19,given overlapping pathophysiology.Involvement of angiotensin-converting enzyme 2 receptors by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)for the entry to the host cells and its downregulation cause dysregulation of the renin-angiotensin-aldosterone system.The overexpression of Angiotensin II mediated via p38 Mitogen-Activated Protein Kinase pathways can cause vasoconstriction and uninhibited platelet aggregation,which may be another common link between COVID-19 and HELLP syndrome.On PubMed search from January 1,2020,to July 30,2022,we found 18 studies on of SARS-COV-2 infection with HELLP Syndrome.Most of these studies are case reports or series,did not perform histopathology analysis of the placenta,or measured biomarkers linked to pre-eclampsia/HELLP syndrome.Hence,the relationship between SARS-CoV-2 infection and HELLP syndrome is inconclusive in these studies.We intend to perform a mini-review of the published literature on HELLP syndrome and COVID-19 to test the hypothesis on association vs causation,and gaps in the current evidence and propose an area of future research.

关键词： SARS-CoV-2 preeclampsia Hypertension Pregnancy-induced Liver dysfunction Pregnancyinduced

preeclampsia and eclampsia: Etiopathogenesis and perioperative management

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World Journal of Anesthesiology 2014年第2期3卷 154-161页

作者： Uma Srivastava Veena Asthana Amrita Gupta Department of Anaesthesia and Critical Care SN Medical College Department of Anaesthesia HIMS Lecturer Department of Anaesthesia and Critica Care SN Medical College

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.

关键词： preeclampsia Eclampsia Regional anaesthesia Caesarean section Fluid therapy