الفهرس 
Hypertensive pregnancy disordersOnly 14 pages are availabe for public view
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Abstract
One of hypertensive disorders of pregnancy is preeclampsia,
which may cause maternal and fetal morbidity and mortality
worldwide. Around 5-10% of pregnancies are complicated with
preeclampsia. Preeclampsia is described as a multisystem disorder
that causes maternal complications include eclampsia, seizures,
HELLP syndrome (hemolysis, elevated liver enzymes and
thrombocytopenia), renal impairment and liver dysfunction.
Women who have or develop high blood pressure during
pregnancy are all at increased risk of complications antenatally,
intrapartum and in the puerperium. The increased risk applies to
the mother as well to the fetus.
The main sign of preeclampsia in the unborn baby is slow
growth. This is caused by poor blood supply through the placenta
to the baby. The growing baby receives less oxygen and fewer
nutrients than it should, which can affect development. This is
called ‘intrauterine growth restriction’, or ‘intrauterine growth
retardation’.
Preeclampsia, also can raise the risk of some long-term
health issues related to preterm birth, including learning disorders,
cerebral palsy, epilepsy, deafness, and blindness. Infants born
preterm also risk extended hospitalization and small size. Infants
who experienced poor growth in the uterus may later be at higher of diabetes, congestive heart failure and hypertension.
In the past 2 decades the incidence of preeclampsia has
increased by 25%, so the search of biomarkers that could help in
predicting and monitoring disorder is a main goal to improve the
mother and fetus health.
Although the symptoms of PE manifest clinically after the
20th week of pregnancy, this is believed to originate in a perturbed
molecular cascade initiating during early pregnancy. Longitudinal
biochemical, bio-functional and molecular monitoring of maternal
serum/plasma, cell-free DNA, urine or micro particles during
pregnancy can thus possibly mirror the state of events at the
maternal-fetal interface. However, the heterogeneous nature that
the disease presents have hampered the search for, discovery of
biomarkers applicable to the majority of the patient population.
Reliable antenatal identification of PE is crucial to costeffective
allocation of monitoring resources and to use possible
preventative treatment with the hope of improving maternal and
perinatal outcomes.
The availability of highly sensitive and specific
physiological and biochemical markers would allow not only the
detection of patients at risk, but also permit a close surveillance, an
exact diagnosis, timely intervention (e.g. lung maturation), as well
as simplified recruitment for future studies looking at therapeutic
medications and additional prospective markers. Today, several markers may offer the potential to be used, most likely in a
combinatory analysis, as predictors or diagnostic tools.
The present study was designed to evaluate the clinical value
of cell free DNA and pentraxin 3 as non-invasive biomarkers in the
early diagnosis of preeclampsia disorder.
A total of seventy five pregnant women were enrolled in this
study and divided into two groups: Control group (n=25) normal,
healthy pregnant women and PE group (n=50) women with
preeclampsia. All patients were attending antenatal care unit or
labor room in their third trimester of pregnancy.
The levels of serum C-reactive protein (CRP), total protein
(TP), albumin (ALB), blood urea nitrogen (BUN), pentraxin 3
(PTX3) and cfDNA were evaluated in two groups. There was a
significant increase in CRP, BUN, PTX3 and cfDNA levels while a
significant decrease in TP and ALB levels in the PE group
compared to normotensive group. There was no correlation
between PTX3/cfDNA and with other tested parameters in
preeclamptic group, on the other hand, there is a positive
correlation between ALB/TP and between SBP/BUN in
preeclamptic group, in contrast, a negative correlation observed
between DBP/TP, ALB/age and BUN/TP. The significant elevated
values of serum PTX3 and cfDNA can be used as independent
useful biomarkers for early detection of preeclampsia disorder.