Comparative morphological differences between umbilical cords from chronic hypertensive and preeclamptic pregnancies.

To compare morphological changes in the umbilical cords from chronic hypertensive and preeclamptic patients having normal or pathological umbilical artery Doppler ultrasonographic results. Umbilical cords from 34 normotensive, 31 chronic hypertensive and 70 preeclamptic women with normal and abnormal Doppler flow velocity waveforms (FVW) at 35-40 gestational weeks were studied. Morphological changes in the umbilical cords were examined on formalin-fixed, paraffin-embedded sections. The total umbilical cord area, total vessel area, and wall thickness of umbilical vessels were measured in systematic random samples using unbiased stereology methods. An ANOVA test was used for statistical analysis. In the chronic hypertensive and preeclamptic groups with normal Doppler FVW, the thickness of the umbilical cord vessels remained nearly constant, whereas both the total area and the lumen area were reduced. These changes correlate with the histopathological findings, suggesting a mainly vasoconstrictive effect. By contrast, analysis of the preeclamptic group with pathologic Doppler FVW showed a comparable reduction of all parameters of the umbilical cord. Histopathological findings were related to smaller, contracted smooth muscle cells of the vessel wall, which is suggestive of a predominant hypoplastic mechanism. As a result of reduced uteroplacental perfusion, fetal hypoxia and intrauterine growth retardation become unavoidable in preeclampsia. The histopathological changes in the umbilical cord between the chronic hypertensive and preeclamptic patients depend on the Doppler results. In conclusion, the umbilical artery Doppler FVW indices provide good values for predicting intrauterine growth retardation in preeclamptic patients.</p

Procalcitonin: A Severity Marker for Pre-Eclampsia?

Introduction: Pre-eclampsia is a common and potentially dangerous disorder of human pregnancy. The maternal syndrome of hypertension and proteinuria is part of a severe systemic inflammatory response that includes leukocyte and endothelial cell activation.PCT is a polypeptide consisting of 116 aminoacids and is the precursor of calcitonin. Over the last decade, PCT has become increasingly popular as a novel marker of infection in the intensive care unit setting. The aim of our study was to evaluate changes in serum levels of PCT in pregnancies complicated with mild pre-eclampsia or severe pre-eclampsia and further investigate the correlation with CRP.Methods: Throughout the study period, 80 pregnant women complicated with mild preeclampsia, 80 pregnant women complicated with severe preeclampsia and 80 healthy pregnant women as a control group, giving a total of 240 pregnant women were enrolled into study.Results: Both severe pre-eclampsia and mild pre-eclampsia groups showed significantly higher PCT values when compared with control healthy group (p&lt;0.05). Also, severe pre-eclampsia group showed significantly higher PCT values when compared with mild pre-eclampsia group (p&lt;0.05).A statistically significant correlation was observed in between presence of pre-eclampsia and procalcitonin positivity (p&lt;0.05). And also severity of pre-eclampsia has shown a statistically significant correlation with high values of procalcitonin (p&lt;0.05).Conclusion: Procalcitonin might be a diagnostic marker for investigating women especially with suspected severe preeclampsia

The evaluation of knowledge and behavior of pregnant women living in the Aegean region about pregnancy exercises

Objectives: The knowledge and behavior of pregnant women living in the Aegean region about pregnancy exercises are evaluated