الفهرس 
introductionOnly 14 pages are availabe for public view
 |  | from | 98 |  |  |
| | | from | 98 | | |
Abstract
127
SUMMARY
Pre-eclampsia (PE), a syndrome of pregnant women, is one of the most important complications for pregnancy. It complicates 5-7% of all pregnant women and about 10-12% of all primigravida . It is the most common cause of maternal and foetal morbidity and mortality.In preeclampsia , there is development of hypertension and proteinuria after 20 weeks of gestation in a previously normotensive, non-proteinuric pregnant women . Leptin is 16 KDa protein hormone that plays a key role in energy intake and energy expenditure . It is produced by a specific gene found in fat cells called the obese(ob) gene. Circulating maternal leptin levels are substantially elevated during pregnancy due to the gradual increase of the body mass index throughout gestation, whereas the placenta seems to be an independent source of leptin. The human placenta has been shown to be a source of leptin. it has become clear recently that leptin is produced and secreted from placental trophoblast cells into the maternal circulation in considerable amounts. Leptin is produced in the human placenta and secreted into both maternal and foetal circulations. The presence of leptin mRNA transcripts in the placental syncytiotrophoblast initially lead to the contention that the increase in maternal levels with advancing gestation might originate there
The aim of this study was to improve follow up and prognosis of patients with preeclampsia , to compare between serum leptin level in normal pregnancy and preeclampsia , to explore the possibility of serum leptin being a marker of severity of preeclampsia so that the risk of imminent eclampsia and eclampsia can be reduced and to explore if the maternal serum leptin can be used as a prognostic indicator for preeclampsia .
128
The study was carried out in the department of obstetric and gynecology in suez canal university hospital as a descriptive study., it was carried out on 72 patients who were divided into two groups: Group 1 ( control group):
36 pregnant women with gestational age (28-38) weeks and with blood pressure ‹140/90mmhg and proteinuria ˂1+ on dipstick testing. Group 2(study group): 37 pregnant women (28-38)weeks in gestational age, high systolic and diastolic blood pressure ≥140/90mmhg, proteinuria ≥1+ on dipstick testing. serum leptin concentration was measured by radoimunoassay . Blood pressure and serum leptin was measured weekly from the time of admission till termination of pregnancy for all the study population .Serum leptin was measured by obtaining 5ml of venous blood from all patitents in the study population several times through out the pregnancy . Total circulating leptin concentration was measured by radoimunoassay. The results of the current study showed There was significance difference between the preeclampsia and normal groups as regard mean blood pressure with mean 116 mmHg , 85 mmHg respectively.
It also showed that patients with preeclampsia had higher serum leptin than normal control group with mean 24.42 ng∕ml in preeclamptic group , 7.28 ng∕ml in control group . and serum leptin is elevated more in severe preeclampsia than in mild preeclampsia with mean 30.11 ng∕ml in severe preeclampsia , 16.45 ng∕ml in mild preeclampsia ,which indicates that serum leptin increases with the severity of preeclampsia .That indicates that leptin increase in preeclamptic woman is related to increased placental production of it. Increase of placental leptin production reflects placental hypo perfusion and/or hypoxia.
129
In our study serum leptin was measured several times during the following up visits of both control group and preeclamptic group and it was found that serum leptin was higher in severe and mild preeclamptic group than control group at time of admission (17.64 ng/mL ± 5.838 ng/mL in severe preeclampsia , 10.89 ng/mL ± 4.910 ng/mL in mild preeclampsia , 9.84 ng/mL ± 3.385 ng/mL in control group) P =0.000 and with progression of pregnancy and with severity of the disease it was measured weekly till time of delivery of all study population and it was higher in severe and mild preeclamptic group than control group (42.58 ng/mL ± 10.153 ng/mL in severe preeclampsia , 22.00 ng/mL ± 4.404 ng/mL in mild preeclampsia , 4.73 ng/mL ± 1.594 ng/mL in control group) p=0.000 , It also was found that during following up of the control (normal ) group serum leptin was found to be reduced with the progression of pregnancy , as it was found that circulating leptin concentrations rose gradually to 32 weeks and thereafter declined slightly in normal patients till delivery , So serum leptin can be used as a prognostic marker fo preeclampsia and it can be used to improve the prognosis and follow up of patients who have preeclampsia.