ABSTRACT
The objective of this study was to investigate the association between urinary prostaglandin E2 [PGE2] levels and uteroplacental blood flow and to test whether PGE2 contributes to the vasospasm and altered renal functions in pregnancies complicated by preeclampsia. Serum and urine samples of 63 pregnant women [29 preeclamptic and 34 normotensive] were investigated by means of PGE2 levels and urea, creatinine and creatinine clearance values. To all participants of the study, uteroplacental blood flow was assessed by uterine artery Doppler sonography flow patterns. Data from preeclamptic patients were compared with normotensive pregnancies as controls. Mean urinary PGE2 levels were significantly lower in preeclamptic patients than in normotensive women [2.67 +/- 0.65 vs. 4.35 +/- 0.89 pg/g creatinine, respectively, P < 0.001]. Preeclamptic patients had significantly higher serum urea and creatinine concentrations, and significantly lower creatinine clearance values compared to normal controls. Preeclamptic patients also showed significantly higher mean uterine artery resistance index [RI] values than controls. Correlation analysis revealed a significant inverse correlation between urinary PGE2 levels and uterine artery RI values [r = -0.84, P < 0.001]. Prostaglandin E2 [PGE2] is a relevant mediator of uteroplacental blood flow and its deficiency suggests a possible role in the vasospasm of preeclampsia. PGE2 deficiency is of relevance to preeclampsia by leading to reduced uteroplacental blood flow and altered renal functions
Subject(s)
Humans , Female , Kidney Function Tests/blood , Dinoprostone/urine , Placental Circulation , Blood Flow VelocityABSTRACT
To compare the long term serum electrolytes and arterial acid-base changes following the use of rectosigmoid bladder [RSB] and the urethral Kock reservoir [UKR] for continent urinary diversion. Serum electrolytes and arterial acid-base changes were studied in 50 patients with RSB and 40 with UKR after cystectomy for bladder carcinoma. All the patients have a cancer free survival of at least 5 years. No significant serum electrolytes disturbances were noticed apart from hyperchloraemia which was significantly more common in RSB than in UKR [p < 0.001]. Chronic metabolic acidosis was diagnosed in 13 [32.5%] and in 25 [88%] of UKR and RSB respectively [p < 0.001]. The severity of acidosis was generally less in UKR, moderate to marked acidosis was found in 30% and 92% of the patients with acidosis in UKR and RSB consecutively. Patients with continent urinary reservoirs are at risk of developing chronic metabolic acidosis. The incidence and severity was lower following UKR compared to RSB. UKR imparts an insignificant metabolic insult over the long term to patients with normal renal function. Regarding absorptive complications the ileum is favoured than the rectosigmoid segment in the construction of continent urinary reservoirs