This case-control study was conducted in Lima, Peru, from June 1997 through January 1998 to assess whether plasma concentrations of carotenoids (alpha-carotene, beta-carotene, lycopene, lutein, zeaxanthin, beta-cryptoxanthin), retinol, and tocopherols (alpha-tocopherol and gamma-tocopherol) are decreased in women with preeclampsia. A total of 125 pregnant women with preeclampsia and 179 normotensive pregnant women were included. Plasma concentrations of antioxidants were determined using high performance liquid chromatography. After adjusting for maternal demographic, behavioral, and reproductive characteristics and total plasma lipid concentrations, the authors found a linear increase in risk of preeclampsia with increasing concentrations of alpha-tocopherol (odds ratio of the highest quartile = 3.13; 95% confidence interval: 1.06, 9.23, with the lowest quartile as the reference group; p value of the test of linear trend = 0.040). The risk of preeclampsia decreased across increasing quartiles of concentrations for retinol (odds ratio of the highest quartile = 0.32; 95% confidence interval: 0.15, 0.69, with the lowest quartile as the reference group; p value of the test of linear trend = 0.001). Some of these results are inconsistent with the prevailing hypothesis that preeclampsia is an antioxidant-deficient state. Preliminary findings confirm an earlier observation of increased plasma concentrations of alpha-tocopherol among women with preeclampsia as compared with normotensive pregnant women.
Our results confirm an association between TGF-beta1 and risk of preeclampsia and extend the literature by indicating a strong association in women with systemic inflammation.
Diffuse vascular endothelial dysfunction, secondary to oxidative stress, is an important pathological feature of preeclampsia. Oxidative conversion of low density lipoproteins (LDL) to oxidized-LDL (Ox-LDL) is considered an important step in transforming macrophages into lipid-laden foam cells destined to develop into early atherosclerotic-like lesions. In our study of 95 women with preeclampsia and 100 controls, we evaluated the association between maternal plasma Ox-LDL concentrations and preeclampsia risk. Ox-LDL concentrations were measured using a solid phase two-site enzyme immunoassay. Plasma lipids were measured using standard enzymatic procedures. We used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for confounders. Plasma Ox-LDL concentrations were positively correlated with cholesterol, triglyceride (TG), and LDL concentrations in cases and controls, (Spearman's r ranging from 0.39-0.48, p-values all <0.01). There was no evidence of an increased risk of preeclampsia across increasing quartiles of Ox-LDL. The ORs for successive quartiles, with the lowest as the reference group, were as follows: 1.0, 1.1, 0.6, and 1.2. Women with extremely high concentrations of Ox-LDL (> or =73 U/L, the upper decile), as compared with those with lower values (<73 U/L) had a 2.7-fold increased risk of preeclampsia (95% CI 1.0-6.8). Women with high Ox-LDL and high TG concentrations (> or =284 mg/dl), as compared with those without these two factors, had a 9.6-fold increased preeclampsia risk (95% CI 2.0-45.6). Elevated Ox-LDL, particularly in conjunction with elevated TG, appears to be a risk factor of preeclampsia.
There was no evidence to suggest that pre-eclampsia risk is positively associated with the T/T genotype overall, or in the context of folate deficiency.
El progreso de la obtetricia en los últimos tiempos, demuestra una orientación marcada hacia la cirugía, con tendencia, como es de suponer, a reemplazar viejos métodos, inspirándose no sólo en el deseo de salvar la vida de la madre y del feto, sino también en el de prevenir serias y graves complicaciones y accidentes del embarazo o del parto, consecuencias muchas veces de la aplicación de los procedimientos no quirúrgicos.
En resumen, se presentan tres casos de distocia por circulares del cordón: el primero se trató de una multípara, con presentación de vértice encajada, contracciones regulares, que en el curso del trabajo presenta alteraciones de los latidos fetales que descienden hasta 84 al minuto y que el examen clínico hace pensar en circulares del cordón, y en el cual la aceleración del parto por inyección de pitocín con rotura precoz de las membranas permite la expulsión del feto vivo con circulares del cordón a nivel del cuello y del miembro superior izquierdo. El segundo caso, es una primípara, con cabeza encajada, que comienza su trabajo con contracciones irregulares y alteraciones del ritmo del corazón fetal, 154 al minuto, que suben a 170 irregulares, apenas perceptibles, en la que se sospecha la existencia de circulares, que por estar iniciándose el trabajo obligan en defensa del feto a practicar cesárea segmentaria, extrayéndose feto vivo con dos circulares a nivel del miembro inferior izquierdo; el tercer coso se refiere a una primípara con cabeza profundamente encajado con rotura prematura de membranas a quien se le induce el parto, presentándose contracciones intensos que después desaparecen con latidos fetales de 152, 160, 170 al minuto, irregulares, que hace pensar en la presencia de circulares que obligan a practicar cesárea segmentaria, extrayéndose feto vivo con circulares en el cuello y en los miembros superior e inferior izquierdo. Se estudió después la etiopatogenia de las distocias por circulares, su repercusión sobre el embarazo y el parto, el sufrimiento fetal y se termina señalando la conducta terapéutica que se debe seguir.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.