Utility of B-type natriuretic peptides in preeclampsia: a systematic review

Afshani, Nura; Moustaqim‐Barrette, Amina; Biccard, Bruce; Rodseth, Reitze; Dyer, Robert A.

doi:10.1016/j.ijoa.2012.11.001

Cited by 42 publications

(34 citation statements)

References 33 publications

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“…Although the actual pathways that may connect this biomarker to heart failure remain unclear, these pathways are somehow related to a concordant pattern of fluctuations with the B‐type natriuretic peptide (BNP) . This latter biomarker has been already implicated in the pathophysiology of preeclampsia …”

Section: Introductionmentioning

confidence: 99%

Serum CA‐125 levels in preeclampsia: A systematic review and meta‐analysis

et al. 2019

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Background Preeclampsia is a leading cause of perinatal morbidity, although an optimal screening model is still under investigation. The aim of the present meta‐analysis is to accumulate current evidence and evaluate the diagnostic accuracy of CA‐125 in preeclampsia. Materials and Methods Medline, Scopus, CENTRAL, Clinicaltrials.gov and Google Scholar were systematically searched. All studies reporting serum CA‐125 among preeclamptic and healthy pregnant women were selected. Results Nine studies involving 977 women were included. Meta‐analysis revealed significant differences among patients with preeclampsia and control pregnant women (MD 15.86 IU/mL, 95% CI, 9.03‐22.69). Patients with severe preeclampsia had significantly higher levels of CA‐125 compared to patients with mild preeclampsia (MD 13.21 IU/mL, 95% CI, 1.94‐24.49). Meta‐regression analysis revealed that gestational age <34 weeks could positively affect this association. Conclusions The present meta‐analysis suggests that serum CA‐125 levels are increased in preeclamptic women during the third trimester of pregnancy. This association should be interpreted with caution as there are concerns for significant selection bias. Future studies are needed to corroborate these findings and investigate the diagnostic accuracy of this biomarker during early pregnancy.

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Section: Introductionmentioning

confidence: 99%

Serum CA‐125 levels in preeclampsia: A systematic review and meta‐analysis

et al. 2019

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“…(1) Age 40 years or older (2) Nulliparity (3) Pregnancy interval of more than 10 years (4) Family history of preeclampsia (5) Previous history of preeclampsia (6) BMI of 30 kg m À2 or above (7) Preexisting vascular disease such as hypertension (8) Preexisting renal disease (9) Diabetes mellitus (10) Multiple pregnancy They suggest that there is both a genetic and an immunological component to the development of the disease in addition to a contribution from preexisting maternal diseases such as obesity and renal impairment. Support for a genetic link comes from the higher incidence in pregnant women with a maternal history of the disorder.…”

Section: Risk Factors: a Role For Genetics And Immunology?mentioning

confidence: 99%

“…In a systematic review, Afshani et al 8 concluded that preeclampsia is associated with elevated natriuretic peptide concentrations, but larger prospective trials are required to determine whether elevated concentrations predict development of severe preeclampsia and its complications. More recently, there has been interest in the possibility that Btype natriuretic peptides may be used to predict complications in preeclampsia.…”

Section: Prediction By B-type Natriuretic Peptidesmentioning

confidence: 99%

Preeclampsia

Stocks

2014

European Journal of Anaesthesiology

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Preeclampsia continues to be a leading cause of maternal and foetal mortality and morbidity worldwide. It is defined as hypertension and proteinuria after 20 weeks' gestation, which resolves after delivery. It is complicated by intracerebral haemorrhage, pulmonary oedema and respiratory and hepatic failure, which form the commonest causes of death. There is a genetic and immunological element to the pathophysiology of the disease, which is still not completely understood, but the underlying cause is an abnormality of placentation and placental hypoxia. This is thought to result in an imbalance of angiogenic and antiangiogenic proteins that leads to systemic endothelial disruption and multiorgan involvement. Successful treatment requires delivery of the placenta and management should be undertaken by a multidisciplinary team, aiming primarily to stabilise the condition of the mother before delivery is contemplated. Guidelines and protocols all have common management goals which are to treat hypertension, prevent seizures, control fluid intake and optimise the timing of delivery. Hypertension can be treated with a range of antihypertensive drugs, but labetalol is regarded as first-line therapy. Magnesium sulphate is the treatment of choice for eclampsia because it reduces the risk of seizures by more than 50%. A fluid restriction policy should be used to prevent iatrogenic pulmonary oedema. Effective anaesthetic management relies on neuraxial techniques. Epidural, combined spinal-epidural and single-shot spinal anaesthetic techniques are all perfectly acceptable and should be actively promoted to the mother unless contraindications such as thrombocytopaenia exist.

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“…19 Some researchers have found elevated natriuretic peptide levels in preeclampsia, 15,16,20 and others have reported that asymptomatic cardiac dysfunction may be detected at mid-gestation in women who subsequently develop preeclampsia. 19 Some researchers have found elevated natriuretic peptide levels in preeclampsia, 15,16,20 and others have reported that asymptomatic cardiac dysfunction may be detected at mid-gestation in women who subsequently develop preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

“…As expected, in our study, women who developed HDP in the third trimester had higher UtA PI, lower Quta and higher Ruta at 22-24 weeks. Untreated women with HDP, especially those with placental insufficiency, have high SVR and low cardiac index,35,36 and plasma levels of ANP and BNP are reported to be higher in preeclamptic women than in normotensive pregnant women 15,16,20. On the other hand, CNP correlated positively with UtA blood flow and negatively with UtA resistance.…”

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confidence: 96%

Maternal cardiac function, uterine artery hemodynamics and natriuretic peptides at 22‐24 weeks of gestation and subsequent development of hypertensive disorders of pregnancy

Liang

Vårtun

Flo

et al. 2019

Acta Obstet Gynecol Scand

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Introduction:Maternal cardiac dysfunction as well as abnormal uterine artery (UtA) Doppler are associated with hypertensive disorders of pregnancy (HDP), but their relation is unclear. We investigated the correlation between maternal cardiac function, UtA hemodynamics and natriuretic peptides, and explored differences between women who subsequently developed HDP and those who did not. Material and methods:This was a prospective cross-sectional cohort study of 347 pregnant women at 22-24 weeks. Maternal cardiac function and systemic hemodynamics were investigated at baseline and after 90 seconds of passive leg raising using impedance cardiography. Preload reserve was defined as percent change (Δ%) in stroke volume and cardiac output from baseline to passive leg raising. UtA hemodynamics was studied using Doppler ultrasonography. UtA blood flow, resistance and pulsatility index were calculated. Fasting venous blood samples were analyzed for natriuretic peptides (pro atrial natriuretic peptide [proANP], N-terminal pro brain natriuretic peptide [Nt-proBNP] and C-type natriuretic peptide [CNP]). The course and outcome of pregnancy were recorded. Results: At baseline, ProANP correlated significantly with cardiac output (r = −0.122; P = .023) and left cardiac work index (r = −0.112; P = .037), whereas Nt-ProBNP correlated significantly with acceleration index (r = .127; P = .018) and velocity index (r = −0.111; P = .039. CNP correlated significantly with UtA blood flow (r = .118; P =.028) and resistance (r = −0.112; P = .037) but not with UtA pulsatility index (r = .034; P = .523). None of the natriuretic peptides correlated with preload reserve. At 22-24 weeks, women who subsequently developed HDP had lower UtA blood flow (552 vs 692 mL/min; P = .028), higher UtA resistance (0.28 vs .17 mmHg/mL/min; P = .004) and higher mean UtA pulsatility index (1.12 vs .84; P < .001) compared with

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Utility of B-type natriuretic peptides in preeclampsia: a systematic review

Cited by 42 publications

References 33 publications

Serum CA‐125 levels in preeclampsia: A systematic review and meta‐analysis

Serum CA‐125 levels in preeclampsia: A systematic review and meta‐analysis

Preeclampsia

Maternal cardiac function, uterine artery hemodynamics and natriuretic peptides at 22‐24 weeks of gestation and subsequent development of hypertensive disorders of pregnancy

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