Riza Madazli

Maternal plasma levels of cytokines in normal and preeclamptic pregnancies and their relationship with diastolic blood pressure and fibronectin levels.

Background.  To determine the plasma concentrations of placental growth factor (PLGF), vascular endothelial growth factor (VEGF), transforming growth factor‐β1 (TGF‐β1), soluble tumor necrosis factor α receptor (sTNFp55), interleukin‐2 receptor (IL‐2R), and interleukins 6 and 10 (IL‐6, IL‐10) in normotensive and preeclamptic women, and to evaluate the correlations between these cytokines and the diastolic blood pressure and fibronectin levels.

Plasma malondialdehyde, superoxide dismutase, sE-selectin, fibronectin, endothelin-1 and nitric oxide levels in women with preeclampsia

OBJECTIVE The purpose of this study was to determine plasma malondialdehyde (MDA), superoxide dismutase (SOD), soluble E-selectin (sE-selectin), fibronectin, endothelin-1 (ET-1) and nitric oxide (NO) levels in women with preeclampsia and to find out the relations of diastolic blood pressure with these variables. STUDY DESIGN We performed a case-control study consisting of randomly selected 34 healthy pregnant women and 35 patients diagnosed as preeclampsia. Lipoperoxidation was ascertained by the formation of MDA. SOD activity was determined by the method of Sun et al. Plasma concentration of NO was estimated using colorimetric assay. Plasma ET-1 and sE-selectin were measured by enzyme-linked immunosorbent assay (ELISA). A nephelometric method for fibronectin quantitation was used. RESULTS The mean plasma level of MDA was significantly higher and SOD was significantly lower in preeclamptic pregnancies (P<0.001). Plasma concentrations of fibronectin, sE-selectin and ET-1 were significantly increased, whereas NO was significantly decreased in women with preeclampsia than normotensive women (P<0.001). CONCLUSION Increased plasma levels of MDA, fibronectin, sE-selectin, ET-1, and decreased plasma levels of NO and SOD in preeclamptic patients suggest that poorly perfused fetoplacental unit is the origin of oxygen free radicals and lipid peroxides.

The plasma and placental levels of malondialdehyde, glutathione and superoxide dismutase in pre-eclampsia.

The aim of the study is to investigate the plasma and placental levels of malondialdehyde, glutathione and superoxide dismutase in normotensive and pre-eclamptic pregnancies. Peripheral venous blood samples were collected before labour (35·3 - 1·1 and 34·2 - 3·4 weeks for normotensive and pre-eclamptic, respectively) and placental tissues was obtained after delivery from 34 pre-eclampsia and 33 normotensive pregnancies. The mean plasma and placental levels of malondialdehyde were significantly higher, glutathione and superoxide dismutase levels were significantly lower in pre-eclamptic compared with normotensive patients ( P < 0·01). The plasma and placental levels of malondialdehyde significantly increased, glutathione and superoxide dismutase significantly decreased with the increments in diastolic blood pressure. As a conclusion maternal circulating and placental tissue levels of lipid peroxides increase whereas antioxidants decrease in pre-eclampsia. The magnitude of oxidative stress and antioxidant changes correlate well with diastolic blood pressure.

The Incidence of Placental Abnormalities, Maternal and Cord Plasma Malondialdehyde and Vascular Endothelial Growth Factor Levels in Women with Gestational Diabetes Mellitus and Nondiabetic Controls

Background/Aims: To evaluate the incidence of placental abnormalities, cord plasma erythropoietin (EPO) levels and nucleated red blood cell (NRBC) counts, maternal and cord plasma malondialdehyde (MDA) and vascular endothelial growth factor (VEGF) levels in women with gestational diabetes mellitus (GDM) and nondiabetic controls. Methods: Twenty-two women with GDM, diagnosed according to the current criteria of the American Diabetes Association, were compared with 22 controls. Maternal and cord blood and placental samples were obtained from all pregnant women. Cord plasma EPO levels and NRBC counts, maternal and cord plasma MDA and VEGF levels were determined. Placental tissues were examined histologically. Results: Maternal and cord plasma levels of MDA and cord plasma EPO levels and NRBC counts were significantly higher in GDM pregnancies (p < 0.01). The presence of villous immaturity, chorangiosis and ischemia were significantly increased in the placentas of women with GDM (p < 0.05). The maternal and cord plasma levels of MDA increased (p = 0.007 and p = 0.001, respectively), whereas VEGF decreased (p = 0.046 and p = 0.001, respectively) with the presence of villous immaturity. Conclusion: The complex process of villous development and maturity might be influenced by the maternal and fetal oxidative and angiogenetic milieu. The placenta that shows abnormalities in angiogenesis and maturation may lead to fetal hypoxia and compromise.

Correlation between placental bed biopsy findings, vascular cell adhesion molecule and fibronectin levels in pre‐eclampsia

Objective To determine the correlation between placental bed biopsy findings, and blood levels of the vascular cell adhesion molecule (VCAM‐1) and fibronectin in pre‐eclampsia/eclampsia, and to evaluate the relationship between these variables and severity of the disease.

Lipid peroxidation and antoxidants in preeclampsia

Objective: To determine the changes in plasma levels of lipid peroxide, vitamin E and vitamin C in women with preeclampsia and to investigate their relationship with diastolic blood pressure. Study Design: Cross sectional study consisting of 22 preeclamptic and 21 healthy pregnant women. Fasting venous blood samples were collected during the antepartum period and plasma levels of malondialdehyde, α-tocopherol and ascorbic acid were measured. Results: In the preeclamptic group malondialdehyde, a lipid peroxidation product, was significantly increased, while vitamins E and C were significantly decreased compared to healthy pregnant women. A strong correlation was detected between malondialdehyde and antioxidant factors (vitamins E and C) with blood pressure. Conclusion: Our findings are consistent with previous studies suggesting that lipid peroxidation is an important factor in the pathogenesis of preeclampsia. In preeclampsia, antioxidant nutrients are excessively utilised to counteract the cellular changes mediated by free radicals.

Prediction of preeclampsia with maternal mid-trimester placental growth factor, activin A, fibronectin and uterine artery Doppler velocimetry

To assess whether alterations in the serum levels of placental growth factor, activin A and fibronectin could be detected in patients before they become preeclamptic. And to evaluate and compare the clinical utility of these markers and uterine artery Doppler velocimetry in predicting preeclampsia.

Clinical variability of asphyxiating thoracic dystrophy (Jeune) syndrome: Evaluation and classification of 13 patients.

Asphyxiating thoracic dystrophy‐Jeune syndrome (JS) is a rare autosomal recessive disease characterized by small thorax and short limb dwarfism. Besides the clinical variability, prognosis also differs greatly among patients. Pulmonary involvement is predominant in some cases whereas renal involvement is much more evident in others. We aimed to investigate the clinical variability and prognosis in 13 patients with JS from 11 families. Two of them, who had been diagnosed in the prenatal period were assessed by autopsy findings. All patients had a bell‐shaped or long narrow short thorax and brachydactyly at varying degrees from mild to severe. Short stature was common feature emerging in the postnatal period. One patient had atlantoaxial instability and spinal cord compression which have not been reported in JS before. In the postnatal follow up of 11 patients, respiratory distress was observed in eight patients and proved lethal in six, one patient died of chronic renal failure, and the remaining four patients were still alive at the end of the study. Patients were classified into three groups consisting of severe pulmonary involvement, renal involvement, and mild form in terms of prognosis. Patients with severe pulmonary involvement had bell‐shaped thorax and mild brachydactyly, the one patient with renal involvement had long narrow thorax and severe brachydactyly, and patients with mild involvement presented with polydactyly and moderate to severe brachydactyly. It is important to establish a correct diagnosis both in severe and mild forms since JS might recur within the same family.

Maternal serum and fetal cord blood irisin levels in gestational diabetes mellitus

AIM To investigate the relationship between maternal and cord blood irisin in gestational diabetes mellitus (GDM). METHODS Twenty women with GDM and 20 pregnant women with uncomplicated pregnancies were recruited for this case-control study. Maternal serum irisin and cord blood irisin levels were measured by enzyme-linked immunosorbent assay kit at the time of birth. The association of maternal serum and cord blood irisin levels with metabolic parameters was analyzed. RESULTS Women with GDM had significantly lower mean serum irisin levels compared to control group (258.3±127.9 vs. 393±178.9ng/ml, p<0.05). Mean cord blood irisin levels for GDM and control groups were not significantly different (357.2±248.0 vs. 333.2±173.4ng/ml, p>0.05). No significant differences were found in terms of maternal age, gestational week at birth, BMI at birth, birth weight, neonatal height, systolic and diastolic blood pressure between the groups as well (p>0.05). Serum irisin level was negatively correlated with BMI at birth and HOMA-IR (r=-0.401, p=0.010; r=-0.395, p=0.012, respectively). No correlations between irisin levels and others parameters were found in both groups. CONCLUSIONS Maternal serum irisin levels of patients with GDM are significantly lower compared with non-GDM controls. However, no significant difference was found between cord blood irisin levels of patients with GDM and healthy pregnant women.

Doppler assessment of umbilical artery, thoracic aorta and middle cerebral artery in the management of pregnancies with growth restriction

Background. The aim of the study was to determine the best use of information obtained from Doppler studies of umbilical artery, thoracic aorta and middle cerebral artery in the management of pregnancies with growth restriction.