Relation of urinary prostaglandin E2 levels to uteroplacental blood flow and renal functions in preeclampsia

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