ABSTRACT
Nitric oxide [NO] and adrenomedullin [ADM] are potent vasodilators synthesized in the vascular endothelium and they have an important role in control of vascular tonus. NO and ADM are involved in the regulation of fetoplacental circulation in human pregnancy. Preeclampsia increases the risk of intrauterine growth restriction and low birth weight. The aim of this study was to compare the levels of ADM and NO in plasma, colostrum and mature milk of preeclamptic lactating mothers with those levels in healthy normotensive lactating mothers. This study included 18 preeclamptic lactating mothers [Group I] and 10 healthy lactating Mothers as controls [Group II]. All lactating mothers wore chosen from Department of Gynecology and Obstetrics and from Department of Pediatrics, El-Minya University Hospital during the period from May 2004 to April 2005. ADM and NO levels were performed by ELIZA in Biochemistiry Department Faculty of Medicine, El Minya University. The results of this study showed significant decreased levels of ADM in plasma, colostrum, and mature milk of preeclamptic lactating mothers compared with those of healthy lactating mothers [all p=0.001]. Also there was significant decreased levels of NO in plasma, colostrum, and mature milk of preeclamptic lactating mothers compared with those of healthy lactating mothers with p= 0.001, 0.01 and 0.01 respectively. There was significant decreasing of the levels of both ADM and NO across the plasma, the colostrum, and the mature milk in both preeclamptic [p=0.001 and 0.0001 respectively] and healthy lactating mothers [both p=0.0001]. The study showed negative correlations between either of plasma ADM or NO levels in preeclamptic lactation mothers with systolic blood pressure [r=-0.712 and -0.831; p=0.0001 and 0.0001 respectively] and with diastolic blood pressure [r=-0.695 and -0.736 respectively; both p=0.001], while there was no significant correlation between either plasma ADM or plasma NO with proteinuria, BUN and serum creatinine. There were positive correlations between ADM and NO levels in plasma [r=0.860 and p=0.001], in colostrum [r=0.860 and p=0.001] and in mature milk [p=0.750 and p=0.002] in preeclamptic lactating mothers with similar correlations in the healthy lactating mothers. From the results of this study, we concluded that both ADM and NO may have important role in the pathogenesis of preeclampsia. Also the preeclampsia may cause decrease of the levels of both ADM and NO in colostrum and mature milk of preeclapmtic lactating mothers