Preeclampsia (PE) is a leading cause of maternal mortality and morbidity worldwide. It occurs in women with first or multiple pregnancies and is characterized by new onset hypertension and proteinuria. Improper placentation is mainly responsible for the disease. If PE remains untreated, it moves towards more serious condition known as eclampsia. Hypertension, diabetes mellitus, proteinuria, obesity, family history, nulliparity, multiple pregnancies and thrombotic vascular disease contribute as the risk factors for PE. PE triggered metabolic stress causes vascular injury, thus contributing to the development of cardiovascular disease (CVD) and/or chronic kidney disease (CKD) in future. This risk appears to be increased especially in women with a history of recurrent PE and eclampsia. Clinically increased serum levels of sFlt-1 and decreased placental growth factor (PIGF) and vascular endothelial growth factor (VEGF) represent the severe condition of PE. The clinical findings of sever PE are assorted by the presence of systemic endothelial dysfunction, microangiopathy, the liver (hemolysis, elevated liver function tests and low platelet count, namely HELLP syndrome) and the kidney (proteinuria). The early detection of PE is one of the most important goals in obstetrics.

The nephroprotective effect of coenzyme Q10 and epigallocatechin gallate was investigated in rats with acute renal injury induced by a single nephrotoxic dose of cisplatin. Two days prior to cisplatin administration, epigallocatechin gallate and coenzyme Q10 alone and in four different combinations were given for 6 days. The treatment with antioxidants significantly protected the cisplatin-induced increase in the levels of blood urea nitrogen and serum creatinine. Both the antioxidants alone or in different combinations significantly compensated the increased malondialdehyde and reduced glutathione levels. Moreover, the decrease in the activities of superoxide dismutase, catalase, and glutathione peroxidase and the concentration of selenium, zinc, and copper ions were significantly attenuated in renal tissue. In conclusion, epigallocatechin gallate and coenzyme Q10 are equally effective against cisplatin-induced nephrotoxicity, whereas the intervention by combining these two antioxidants was found to be highly effective at low doses in attenuating oxidative stress in rat kidney.

Preeclampsia is a serious medical complication during pregnancy. In response to an increasing number of preeclamptic cases and scarcity of data concerning the interrelation between trace element levels and preeclampsia, we carried out a hospital based case-control study in Riyadh, Saudi Arabia to study the correlation between levels of serum trace elements and risk of preeclampsia. One hundred and twenty pregnant women were enrolled in this study and divided into three groups of 40 each-Control group, HR group (women at high risk of preeclampsia) and PET group (Preeclampsia group). Serum trace element levels were estimated by inductively coupled plasma optical emission spectrophotometer. The analysis found that mean values of Ca, Mg and Zn were 90.08 ± 6.38, 19.33 ± 3.32 and 1.30 ± 0.83 mg/L respectively in normotensive control and 77.85 ± 4.47, 15.44 ± 1.43 and 0.98 ± 0.63 mg/L respectively in the HR group. The mean values of Ca, Mg and Zn in the preeclamptic group were 70.37 ± 4.66, 13.58 ± 1.98 and 0.67 ± 0.59 mg/L, respectively. Interelement analysis reflected a negative correlation between Ca and Mg and between Mg and Zn whereas positive correlation between Ca and Zn in preeclamptic women. However the correlation was not statistically significant. In conclusion, our study suggests that decreased levels of these trace elements in serum may act as predisposing factors in pathogenesis of Preeclampsia.

Recurrent pregnancy loss (RPL) is loss of three or more consecutive pregnancies during first trimester of pregnancy. The etiology in most of the recurrent miscarriages is unknown. The main cause of recurrent miscarriage is the abnormal karyotype. Apart from this, number of factors are responsible like defects in maternal endometrium, placenta, and autoimmune malfunctions. Additionally exaggerated immune response by the cytokines seems to play a crucial role in the termination of pregnancies. Analysis of serum cytokines in women with recurrent pregnancy loss would add to better and clear understanding of the role of cytokines in miscarriage. The study enrolled 60 pregnant women aged 26-48 y; the RPL group comprised of 30 women with first trimester miscarriage and the control group included 30 women with first trimester successful pregnancy with no history of miscarriage. Serum cytokines were measured by Milliplex Luminex with XMAP (Multianalyte profiling) technology. Cytokines like tumor necrosis factor-α, interferon-γ, interleukin-8 increased and interleukin-6 decreased significantly (p<0.001) in RPL group compared to control. There was no significant correlation between cytokines and fertility hormones like follicle stimulating hormone and luteinizing hormone whereas interferon-γ was strongly correlated with luteinizing hormone and prolactin in miscarriage group. Our data suggests that cytokines the immunological mediators are major determining factors for poor pregnancy outcomes. Though fertility hormones play role in occurrence and maintenance of pregnancy, termination of pregnancy could be due to altered immune response and there is no correlation of tumor necrosis factor-α, interleukins 6 and 8 with follicle stimulating hormone, luteinizing hormone and prolactin hormones.

Background: Preeclampsia is characterized by development of high blood pressure and proteinuria. It affects 5-8% of all pregnancies and is a major contributor to maternal and fetal morbidity and mortality. There is no single test that fulfils all the criteria for a good predictor of preeclampsia and associated renal damage. Aims & Objectives: To evaluate the role of serum and urine biochemical parameters as early predictors of preeclampsia. To investigate the role of BUN: Creatinine ratio in diagnosing preeclampsia and evaluating prognosis of the disease. Material and Methods: In the present prospective study, one hundred and twenty pregnant women divided into three groups: normotensive (control), women at high risk and with preeclampsia were included. Analyses of different biochemical parameters including BUN: Creatinine were carried out. Results: There was significant difference in the mean value of serum uric acid, blood urea nitrogen, creatinine, urinary protein and BUN: Creatinine ratio in preeclampsia group compared to control group (p < 0.001). There was significant difference (p < 0.05) in serum uric acid between control and preeclampsia group. However, there was no significant change in haematocrit, serum creatinine and urine protein between control and high risk group. Conclusion: BUN: Creatinine ratio in pregnant women with preeclampsia and also in high risk group was significantly increased (t = 15.55, p < 0.001 and t = 8.66, p < 0.001 respectively) in comparison to the control group. This index could be useful in evaluating the severity of preeclampsia and could be used as a predictor in prognosis of preeclampsia and subsequent early renal disease.