The relation between plasma urate and placental bed vascular adaptation to pregnancy

Abstract

Placental bed biopsies were obtained at caesarean section from 34 women. Their plasma urate was directly related to maximum mean arterial pressure and inversely t o adjusted birthweight; but it was related most closely t o the histological appearances of the spiral arteries in the placental bed. Nine women had physiological changes in the spiral arteries: their mean urate (233, SD 28.9 pmol/l) was significantly (P<O-OOl) lower than the mean urate in those who did not have adequate physiological changes (339, SD 90.3 pmo1A) or that in the nine women who had atherosis (397, SD 153.2 pmol/l). Raised plasma urate appears t o b e better related t o maternal vascular pathology than to the clinical condition or infant birthweight.

Immunocytochemical localization of neutrophil elastase in term placenta decidua and myometrium in pregnancy‐induced hypertension

“…There was a direct correlation between plasma urate and decidual elastase suggesting that elastase staining parallels disease severity as judged by plasma urate. McFadyen et al (1986) noted previously that raised plasma urate was related to maternal vascular damage judged histologically on pla‐cental bed biopsies. This would be in keeping with our hypothesis that neutrophil elastase may contribute to the vascular damage in the placental bed.…”

Maternal endothelial soluble cell adhesion molecules with isolated small for gestational age fetuses: comparison with pre‐eclampsia

“…Thus, we can speculate that patients with both hyperuricemia and high levels of soluble E‐selectin represent a group of small for gestational age fetuses patients with more severe disease and more pronounced vascular abnormalities of the fetoplacental unit. Consistent with this hypothesis, McFayden et al 30 have demonstrated that increased plasma urate levels are related to abnormal placental bed vascular adaptation to pregnancy. The mechanism of hyperuricemia in small for gestational age fetuses has not yet been documented.…”

Maternal endothelial soluble cell adhesion molecules with isolated small for gestational age fetuses: comparison with pre-eclampsia

“…Compared with cellular fibronectin, considered as a predictive marker of vascular complications of preeclampsia, soluble E-selectin is specific for the endothelium. Consistent with this hypothesis, McFayden et al 30 have demonstrated that increased plasma urate levels are related to abnormal placental bed vascular adaptation to pregnancy. We noted that high levels of soluble E-selectin tended to be present in our small for gestational age fetus group together with high levels of uric acid.…”