Study of some haemostatic and inflammatory parameters in preeclamptic and normotensive pregnant females

Preeclampsia is an idiopathic multisystem disorder specific to human pregnancy characterized by gestational hypertension and proteinuria. It complicates many pregnancies and is the third common cause of maternal and neonatal mortality and morbidity. The aim of the present work was to elucidate the relationship between serum maternal levels of C-reactive protein [CRP] as an inflammatory marker and coagulation and fibrinolysis as haemostatic markers in preeclamptic and normotensive pregnant females compared to non-pregnant females. Sixty females were enrolled in the study divided into ten non pregnant healthy females as the control group [Group I], twenty five normotensive pregnant females [Group II], twenty five preeclamptic pregnant females [Group III]. The pregnant females all were primigravidae, in the third trimester of pregnancy. For all these females C-reactive protein was measured as an inflammatory marker. Haemostatic parameters included platelet count, prothrombin time, activated partial thromboplastin time and thrombin time as coagulation parameters while fibrinolytic parameter included euglobulin clot lysis time. The results showed a significant negative correlation between CRP and platelet count in preeclamptic group. It also showed a higher positive correlation between CRP and Euglobulin Clot Lysis Time [fibrinolysis parameter] in preeclampsia than in the normotensive and control groups

Thrombomodulin as a marker of endothelial damage and severity in pre-eclampsia/eclampsia syndrome

Preeciampsia is an idiopathic multisystem disorder specific to human pregnancy characterized by gestational hypertension and proteinuria. It complicates many pregnancies and is the third common cause of maternal mortality. It is also associated with a high perinatal mortality and morbidity. The aim of the present work was to study Thrombomodulin [TM] as a marker of endothelial damage in pre-eclampsia/ eclampsia syndrome Eighty pregnant females in the second half of pregnancy were enrolled in the study divided into control group [I], mild preeclampsia [IIa], severe preeclampsia [IIb], and eclampsia [IIc]. Thrombomodulin was measured by ELISA technique at presentation and 3 days post partum. The results showed that the level of TM is higher in patients with eclampsia and preeclampsia compared to the control group, furthermore, the level decreased with delivery and subsidence of the condition. In conclusion TM can be used as a marker for monitoring preeclampsia/ eclampsia syndrome

Evaluation of the effect of sildenafil citrate in pre-eclampsia

This study was undertaken to evaluate the effect of Sildenafil citrate [Viagra] on clinical course, biochemical parameters as well as Doppler ultrasound indices in cases of mild pregnancy-induced hypertension [PIH] and to evaluate the role of Sildenafil, if any, as a new therapeutic modality in mild PIH. The present study was conducted on 60 mild pre-eclamptic pregnant women; they were divided into 2 groups: Group I: included 40 cases and were subdivided into 2 subgroups: Group I A [20 cases] received 100mg sildenafil citrate in 2 daily divided doses for 1 week Group IB [20 cases] received 100 mg sildenafil citrate in 2 daily divided doses for 2 weeks Group II [control]: included 20 cases and were subjected to placebo [iron preparation] and bed rest for 1 week. Both groups were subjected to clinical, biochemical and Doppler ultrasound to assess the changes in blood pressure, uric acid, serum creatinine, serum proteins, serum albumin, ultrasound assessment of amniotic fluid index [AFI] and Doppler ultrasound indices [RI, Pl, S/D ratio] respectively before and after the treatment. The study revealed that there was significant decrease in systolic and diastolic blood pressure measurements and all Doppler indices after the use of 100 mg sildenafil for 1 week in group I A and a more significant reduction after longer duration of treatment in group IB without significant change of all these parameters in group II that was subjected to placebo and bed rest for 1 week. Such discussion is still controversial; the subject is still open for much future validation on larger study groups. It is too early for such preliminary study to arrive at sharp conclusions regarding the clinical utility of sildenafil for amelioration of pregnancy-induced hypertension. However it is convenient to report that at least in the current series, significant lowering of blood pressure and improvement of blood flow indices by Doppler ultrasound was attained by 100 mg sildenafil citrate- The possibility of cumulative effect is still hopeful based on more marked effect of the drug with longer duration of administration