Serum collectrin levels in patients with early- and late-onset preeclampsia

The Importance of Doppler Analysis of Uterine Circulation in Pregnancy for a Better Understanding of Preeclampsia

BACKGROUND

The etiology of preeclampsia has still not been completely explained. Early identification of women with the risk of developing preeclampsia is a key goal of antenatal care.

OBJECTIVE

To investigate risk factors for preeclampsia from the history, laboratory and ultrasound findings (Doppler).

METHODS

Pregnant women with normal Doppler sonography in the second trimester of pregnancy were classified as a control group, while pregnant women with impaired Doppler in the second trimester were considered as the investigated group with presumably increased risk for preeclampsia. A total number of 80 patients was included in the study (40 patients in each group).

RESULTS

The difference of urea, uric acid and lactate dehydrogenase (LDH) in the serum of the control and investigated group was statistically significant, while the differences were not statistically significant for creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The presence of a notch sign during assessment of blood flow in uterine arteries in subjects in the investigated group with the diagnosis of preeclampsia had the specificity of 47.62%, and sensitivity of 88.89%. The positive predictive value of a notch sign during assessment of blood flow in uterine arteries as a marker for diagnosis of preeclampsia in the second trimester of pregnancy was 90.91%, and its negative. Systolic and diastolic blood pressure are dependent variables which are predicting preeclampsia, whilst a notch sign in uterine arteries was designated as an independent variable predicting preeclampsia.

CONCLUSION

From the laboratory tests the following parameters were considered as the risk factors for preeclampsia: increasing levels of urea, uric acid, and LDH. Notch sign was considered to be a very strong predictor of preeclampsia, especially if present bilaterally. Doppler sonography in the second trimester of pregnancy is a good predictor for early diagnosis of preeclampsia.

Correlation of serum collectrin level and preeclampsia onset: A case control study

BACKGROUND

Pre-eclampsia is a major contributor to pregnancy-associated morbidity and mortality and the management of this complex syndrome needs to be improved. Recently serum collectrin has emerged as a new member of the renin-angiotensin system that regulates the blood pressure through nitric oxide -endothelial nitric oxide synthase pathway.

OBJECTIVE

To evaluate the correlation of serum collectrin level and preeclampsia onset.

STUDY DESIGN

A prospective case control study.

PATIENTS AND METHODS

Ninety pregnant women attended the outpatient clinic Al-Yarmook Teaching Hospital in Baghdad / Iraq along the period from April 2018 until December 2018 had been divided into three groups. Group A included 30 pregnant women presented with early onset pre-eclampsia (before 34 weeks of gestation), group B included 30 pregnant women presented with late onset pre-eclampsia (at or after 34 weeks of gestation) and group C included 30 apparently healthy term pregnant women. Serum collectrin levels were measured for each pregnant woman by using enzyme-linked immunosorbent assay analyzer.

RESULTS

The mean serum collectrin was the lowest in pregnant women with early onset pre-eclampsia (61.65 ± 3.62 pg/ml) while it was (82.61 ± 6.41 pg/ml) for pregnant women with late onset pre-eclampsia and (101.11 ± 8.27 pg/ml) for healthy term pregnant women. These differences were found to be significant (p value = 0.001). This significant decrement was inversely correlated with the systolic blood pressure (r = -0.565, p-value = 0.001) and diastolic blood pressure and (r = -0.748, p-value = 0.001).

CONCLUSION

Serum collectrin levels had a significant role in controlling the blood pressure in pregnant women with a significant inverse correlation between serum collectrin concentrations and blood pressure.