Vascular control during pregnancy: extending experimental findings to humans

Plasma and Aorta Biochemistry and MMPs Activities in Female Rabbit Fed Methionine Enriched Diet and Their Offspring

This study investigated whether a high Met diet influences biochemical parameters, MMPs activities in plasma, and biochemical and histological remodeling in aorta, in both pregnant female rabbits and their offspring. Four female rabbit groups are constituted (each n = 8), nonpregnant control (NPC), pregnant control (PC) that received normal commercial chow, nonpregnant Met (NPMet), and pregnant Met (PMet) that received the same diet supplemented with 0,35% L-methionine (w/w) for 3 months (500 mg/d). All pregnant females realize 3 successive pregnancies. Plasma results showed that Met excess increased Hcy, raised CRP in NPMet and decreased it in PMet, enhanced significantly proMMP-2 and proMMP-9 activities in NPMet, and reduced them in PMet. Aorta showed a rise in collagen level, essentially in PMet, a reduction of elastin content in both PMet and NPMet, and a significant decrease in lipid content in PMet, with histological changes that are more pronounced in NPMet than PMet. Met excess enhanced proMMP-9 activities in NPMet while it decreased them in PMet. PMet newborn presented increase in uremia and CRP and significant rise of active MMP-2 and MMP-9 forms. In aorta, media and adventitia thickness increased, total lipids content decreased, proMMP-9 activity decreased, and proMMP-2 activity increased.

Intraplatelet cyclic guanosine-3',5'-monophosphate levels during pregnancy and preeclampsia

OBJECTIVE

To investigate the intraplatelet cyclic guanosine-3',5'-monophosphate (cGMP) levels during normal pregnancy and preeclampsia.

STUDY DESIGN

Pregnant women (n = 15), women with preeclampsia (n = 15), and nonpregnant, normotensive women (n = 15) were included. Intraplatelet cyclic guanosine-3',5'-monophosphate levels were measured by an enzyme-linked immunosorbent assay.

RESULTS

Intraplatelet cGMP levels were significantly different among all groups (p < 0.02). The values were higher in normal pregnant women (mean 19.8 SD 2.6 fmol/10(5) platelets) in comparison to nonpregnant women (mean 7.6 SD 0.3 fmol/10(5)platelets; p = 0.001) and women with preeclampsia (mean 11.3 SD 1.8 fmol/10(5) platelets; p = 0.05). Plasma nitric oxide levels did not reveal differences between all groups.

CONCLUSIONS

The results of this study in a high-risk Andean population demonstrated that intraplatelet cyclic guanosine-3',5'-monophosphate levels are decreased during preeclampsia compared to normal pregnancy, suggesting a lack in action of nitric oxide.

New insights in hypertensive disorders of pregnancy

Research reported during the past year has enhanced our understanding of conditions that lead to the complex changes that are observed in hypertensive disorders of pregnancy. An association between placental pathology and a multisystem disorder that is characterized by endothelial dysfunction which involves genetic and immunological investigations has been identified. On the basis of these findings, promising screening tools for early detection of pre-eclampsia were identified. No marked changes in anaesthetic approach to hypertensive disorders of pregnancy occurred during the period of review, apart from a reappraisal of spinal anaesthesia as a safe technique in caesarean section, even in patients with severe pre-eclampsia. A multidisciplinary approach to management and therapy is needed and the right balance must be sought between the needs of the mother and baby, both of which are jeopardized by the hypertensive disorders of pregnancy.