Author:
Fitzgerald D J,Entman S S,Mulloy K,FitzGerald G A
Abstract
Patients who develop pregnancy-induced hypertension exhibit a lesser increment in prostacyclin biosynthesis than healthy pregnant subjects. Whether this precedes the development of clinical disease and therefore may be important in the pathogenesis of pregnancy-induced hypertension or is a secondary event is unknown. We prospectively determined prostacyclin biosynthesis in pregnant subjects at risk of developing pregnancy-induced hypertension by use of noninvasive approach, measurement of the urinary metabolite 2,3-dinor-6-keto-prostaglandin F1 alpha. Patients were recruited at less than 20 weeks gestation. After delivery, patients were retrospectively allocated by use of preset criteria, to one of four groups: pregnancy-induced hypertension (n = 12), hypertension in labor (n = 22), chronic hypertension (n = 9), and normotension (n = 24). There was a significant increase in prostacyclin biosynthesis in all study groups during gestation. However, patients who developed pregnancy-induced hypertension exhibited a lesser increment and this difference persisted throughout gestation. These results are consistent with a pathophysiologic role for altered prostacyclin biosynthesis in women with pregnancy-induced hypertension. In addition, decreased prostacyclin formation identifies a population at risk of developing pregnancy-induced hypertension. Such information would assist the design of clinical trials of drugs, such as aspirin, that might prevent the development of this disease.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Reference40 articles.
1. Whorley RJ: Pregnancy-induced hypertension. In Danforth DW Scott JR editors: Obstetrics and gynecology. Philadelphia 1986. JB Lippincott Co. p 446
2. Pritchard JA McDonald PC Gant NF: William's Obstetrics. Norwalk CT 1985 Appleton-Centurty-Crofts p 525
3. Estimated rate of prostacyclin secretion into the circulation of normal man.
4. Brash AR Goodman RP FitzGerald GA: Endogenous prostaglandin biosynthesis in human pregnancy. In Lewis PJ Moncada S O'Grady J editors: Prostacyclin in pregnancy. London 1983 Raven Press p 71
5. Arterial walls generate from prostaglandin endoperoxides a substance (prostaglandin X) which relaxes strips of mesenteric and coeliac arteries and inhibits platelet aggregation
Cited by
241 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献