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Objective To explore the association between preeclampsia and the level of related screening markers during the first and second trimester. Methods The concentration of PAPP - A,free β - hCG of the pregnant women in the first trimester(from 10th to 13 + 6 th weeks)were detected. The concentration of AFP,free β - hCG and uE3 were detected by the same method in the second trimester(from 14th to 19 + 6 th weeks). Protein in the urine and blood pressure of the pregnant women was closely monitored during pregnancy,and the late pregnancy outcomes were followed up. The difference of the concentration of PAPP - A,free β - hCG in the first trimester and free β - hCG,AFP,uE3 in the second trimester between women with pregnancy hypertension and those without were analyzed. Results A total of 7 476 women accepted prenatal screening. There were 668 women developed pregnancy hypertension and the incidence rate was 8. 70% . And 260 women developed preeclampsia and the incidence rate was 3. 4% . There were 50 cases of early - onset preeclampsia and 210 cases of late - onset preeclampsia. The concentration of PAPP - A and free β - hCG of preeclampsia women, especially the early - onset preeclampsia women,were lower than those of normal women in the first trimester. In the early pregnancy diagnosis,accuracy of the area of early - onset preeclampsia under the ROC curve was 0. 823. There was no difference of concentration of free β - hCG,AFP,uE3 in the second trimester between women with or without preeclampsia (P > 0. 05). Conclusion The level of PAPP - A has a certain value for diagnosis of early - onset preeclampsia. Serum screening markers in the second trimester showed little clinical value on preeclampsia.
RESUMO
Objective To study the effect of different levels of iodine nutrition on secretion of placental hormone in pregnant rats.Methods Two hundred and twenty five Wistar rats (165 female,60 male),weighing about 80 - 100 g were used in the study.Female rats were randomly divided into five groups according to their body weights:low iodine group Ⅰ(LⅠ),low iodine group Ⅱ (LⅡ),adequate iodine(control) group(Al),high iodine group Ⅰ ( HⅠ ),and high iodine group Ⅱ (H Ⅱ ),and 33 rats in each group.Animals in the low iodine groups were fed low-iodine diet,the iodine content was 13.46 μg/kg,in addition,these rats drank deionized water which containing potassium iodated,the dose was 0 and 5 μg/L,respectively.The rats of adequate and the two high iodine groups were fed normal diet,the iodine content was 22.00 μg/kg,they also drank deionized water,containing potassium iodated 50,3000,and 10000 μg/L,respectively.The rats mated after 3 months of feeding,and were respectively sacrificed at early pregnancy(5 ± 2)d,second trimester( 12 ± 2)d,and third trimester of pregnancy(17 ± 2)d,and then their serum was taken.Serum human chorionic gonadotropin(HCG),human chorionic thyrotropin(HCT),and progesterone were measured by enzyme-linked immunosorbent assay (ELISA).Results In the third trimester,the serum levels of rat HCG were significantly different between groups(F =4.16,P ＜ 0.05).The means of rats serum HCG of the two low iodine groups [ (16.08 ± 4.45),(17.43 ± 2.70)U/L] were significantly higher compared with that of AI group[ (13.68 ± 3.52)U/L] in the third trimester(all P ＜ 0.01 ).In the second and third trimester,the levels of rats serum HCT were significantly different between groups(F =3.59,3.40,all P ＜ 0.05).The means of rats serum HCT of HI group [(70.11 ± 10.97)μU/L] in the second trimester and HII group[(74.93 ± 13.22)μU/L] in the third trimester were higher than those of AI group[ (57.14 ± 12.56),(58.17 ± 8.54)μU/L] significantly(all P ＜ 0.01 ).There were statistical differences of the means of serum progesterone among trimester of pregnancy(F =4.06,4.43,all P ＜ 0.05).The level of serum progesterone of the third trimester[ ( 1462.80 ± 286.48 )pmoL/L] compared to those of the first[ (1929.93 ± 158.37) pmol/L] and the second trimester[ (1856.44 ± 542.08)pmol/L] was decreased significantly(all P ＜ 0.05) in LI group.In the control group,the level of serum progesterone of the second trimester [ (2046.45 ± 475.67)pmol/L ] was significantly higher than the first trimester[ (1714.39 ± 461.71 )pmol/L,P ＜ 0.05 ].Conclusions During pregnancy,placenta could promote HCG secretion under iodine-deficient conditions.In addition,the placenta increases the secretion of HCT under conditions of excess iodine.In the condition of severe iodine deficiency,the secretion of serum progesterone decreases,and further decreases with prolongation of pregnancy,but it is opposite to the change of HCG during pregnancy.This phenomenon could lead to harmful pregnant outcomes easily.
