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Visceral fat accumulation stimulates the production of adipocytokines in patients with metabolic syndrome. Excess body weight gain during pregnancy is a risk factor for preeclampsia. To evaluate whether the pathogenesis of preeclampsia is similar to that of metabolic syndrome, we measured plasma adipocytokine concentrations and investigated the association between plasma adiponectin concentrations and body weight gain or endothelial function in preeclamptic women. We investigated 15 preeclamptic and 17 women with uncomplicated pregnancies. Women with preeclampsia had significantly lower plasma concentrations of adiponectin (10.2 ± 2.0 vs. 7.3 ± 2.2 lg ml À1 , Po0.01), but higher concentrations of leptin, plasminogen activator inhibitor-1, interleukin-6, vascular cell adhesion molecule-1, E-selectin and C-reactive protein. Plasma triglyceride levels were significantly higher in preeclamptic patients, but the levels of other lipids did not differ significantly between the two groups. We found that flow-mediated vasodilation was significantly decreased in preeclamptic women compared with controls (10.6 ± 6.4 vs. 3.8 ± 2.0%, Po0.001). Plasma adiponectin concentrations correlated negatively with body mass index (r¼À0.50, Po0.05) and body weight gain during pregnancy (r¼À0.63, Po0.01), and positively with flow-mediated vasodilation (r¼0.50, Po0.05) in preeclamptic women, but not in women with uncomplicated pregnancies. Similar to the patients with metabolic syndrome, we found that dysregulation of adipocytokines, such as low adiponectin levels and high levels of other adipocytokines, and excess body weight gain during pregnancy, may decrease plasma adiponectin concentrations that are associated with endothelial dysfunction in preeclamptic women.

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Renovascular hypertension due to renal artery stenosis associated with fibromuscular dysplasia during pregnancy can lead to maternal and fetal complications. Although conventional percutaneous angiography and angioplasty are recommended for patients with renal artery stenosis due to fibromuscular dysplasia, the influence of these procedures on women and fetuses is unknown. A 27-year-old primigravida was diagnosed with renovascular hypertension possibly due to fibromuscular dysplasia. Percutaneous transluminal angioplasty in conjunction with renal angiography was initially planned, but she became pregnant and was referred to our department at 9 weeks of gestation. At 22 weeks of gestation, she was administered intravenous nicardipine (24-120 mg /day) for blood pressure control until 32 weeks of gestation. At 33 weeks 2 days of gestation, her hypertension was uncontrollable, and she delivered a healthy infant by cesarean section. Intravenous administration of nicardipine may present an effective and safe method to control blood pressure in women with fibromuscular dysplasia.