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Protein?ria e ?cido ?rico s?rico maternos em pacientes com s?ndrome de HELLPCunha, Hilda Helena Souza da 28 August 2012 (has links)
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Previous issue date: 2012-08-28 / Objective: To evaluate the association of maternal serum uric acid (UA) and
proteinuria with clinical and demographic data of pregnant women with preeclampsia
syndrome (PES) complicated by HELLP syndrome.
Methods: One hundred and nine pregnant women were divided into two groups:
group 1 - HELLP pregnant women with PES complicated by HELLP syndrome
(n=64); group 2 PES pregnant women with PES but no HELLP syndrome
(n=105).
Results: Age, ethnicity, parity, delivery mode and perinatal mortality were not
statistically different between groups. Systolic and diastolic blood pressure, protein to
creatinine (P/C) ratio, uric acid, creatinine and maternal complications were
statistically different between groups; values were higher and events, more frequent
among pregnant women with HELLP syndrome. The newborns of pregnant women
with HELLP syndrome were more premature, had a lower birth weight and a lower
APGAR score.
Conclusion: Uric acid equal to or higher than 6.0 gm/dL and P/C ratio equal to or
higher than 5 were more frequent in gestations with HELLP syndrome, which
suggests that elevated proteinuria and uric acid levels in pregnant women with PES
may increase the chances of developing HELLP syndrome / Objetivo: Avaliar a associa??o dos n?veis maternos de ?cido ?rico s?rico (AU) e protein?ria e os dados cl?nicos e demogr?ficos em gesta??es complicadas por s?ndrome de pr?-ecl?mpsia (SPE), com s?ndrome de HELLP. M?todos: Cento e sessenta e nove gestantes foram divididas em dois grupos: Grupo 1 - HELLP gestantes com SPE complicada pela s?ndrome de HELLP (n=64); Grupo 2 SPE gestantes com SPE sem s?ndrome de HELLP (n=105). Resultados: N?o ocorreram diferen?as estatisticamente significativas quanto ?s vari?veis idade, cor, paridade, via de parto e mortalidade perinatal entre os grupos. Press?o arterial sist?lica, press?o arterial diast?lica, ?ndice protein?ria/creatinin?ria (P/C), ?cido ?rico, creatinina e complica??es maternas apresentaram diferen?a estatisticamente significativa entre os dois grupos, sendo mais elevados e mais frequentes nas gestantes com s?ndrome de HELLP. Observou-se que os RN de gestantes com s?ndrome de HELLP foram mais prematuros, apresentaram menor peso ao nascimento e menor ?ndice de APGAR. Conclus?o: ?cido ?rico igual ou maior do que 6,0 mg/dL e ?ndice P/C igual ou maior do que 5 foram mais frequentes nas gesta??es com s?ndrome de HELLP, o que permite supor que maiores valores de ?cido ?rico e de protein?ria em gestantes com SPE aumentam a chance de desenvolvimento de s?ndrome de HELLP.
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Fatores de risco individuais e familiares no desenvolvimento da pr?-ecl?mpiaPereira, Flavio Ven?cio Marinho 23 July 2010 (has links)
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Previous issue date: 2010-07-23 / Preeclampsia is a spectral disease, with different clinical forms which can evolve
with severe multisystemic complications. This present study aimed to determine the
risk factors associated with preeclampsia (PE); to validate the existence of
aggregation of hypertensive disease in families of women with preeclampsia and
verify the existence of association between polymorphisms in the VEGF gene and
level of VEGF and its soluble receptor (sFlt1). A case-control study was performed
(n = 851). Genotyping of VEGF was performed and serum levels of VEGF and sFlt1
were measured by ELISA. It was observed that 38% of mothers (173, 455) of a
case of preeclampsia and 30.8% (78 of 361) of controls had history of hypertension
(p <0.0001). Similarly, when examining the history of maternal preeclampsia, we
observed that 14.6% (48 of 328) of mothers of women with preeclampsia and 9.6%
(12 of 294) of mothers of controls had a history of preeclampsia (p = 0.0001). As for
maternal history of preeclampsia, we found that 5.1% (15 of 295) of cases and 3.6%
(7 of 314) of controls had a history of preeclampsia (p = 0.0568). Sisters of women
with preeclampsia also had a history of hypertensive disease in 9% (41 of 455)
versus 6.6% (13 of 361), p = 0.002. Similarly when examining the history of
preeclampsia in sisters, it was observed that 22.7% (57 of 251) of a sister of case
versus 11.4% (26 of 228) of controls had a history of preeclampsia (P = 0.0011).
We observed a decrease in free VEGF in the serum of patients (P <0.05) and
increased soluble VEGF receptor. There was no association between
polymorphisms in the VEGF gene and preeclampsia. The data obtained in this work
validate that hypertensive disease in mothers and sisters with preeclampsia are risk
factors for preeclampsia. The risk of illness in the family is higher according to
disease severity. High incidence of preeclampsia can be assumed by the high
incidence of this disease among the controls. Significant differences between the
frequency of preeclampsia in mothers of cases and controls indicate familial factors.
Work is being conducted with the to eventually perform genome wide association
studies to identify susceptibility loci / A pr?-ecl?mpsia ? uma doen?a espectral, com formas distintas, podendo evoluir com
complica??es multissist?micas graves. Este presente trabalho teve como objetivos
determinar os fatores de risco envolvidos com a pr?-ecl?mpsia (PE); validar a
exist?ncia de agrega??o de doen?a hipertensiva em fam?lias de gestantes com pr?ecl?mpsia;
verificar a exist?ncia de associa??o entre polimorfismo no gene do VEGF e
determinar os n?veis de VEGF e seu receptor sol?vel (sFlt1). Um estudo caso-controle
foi realizado (n=851). A genotipagem do VEGF foi realizada e os n?veis s?ricos de
VEGF e sFlt1 foram determinados por ELISA. Foi observado que 38 % das m?es (173
de 455) de um caso de pr?-ecl?mpsia e 30.8% (78 de 361) dos controles apresentavam
hist?ria de hipertens?o (p<0.0001). De forma que 14.6% (48 de 328) das m?es das
gestantes com pr?-ecl?mpsia e 9.6% (12 de 294) das m?es dos controles tinham
hist?ria de pr?-ecl?mspia (p=0.0001). Quanto ? hist?ria materna de ecl?mpsia,
observou-se que 5.1% (15 de 295) dos casos e 3.6% (7 de 314) dos controles tinham
hist?ria de pr?-ecl?mpsia (p=0.0568). Irm?s das gestantes com pr?-ecl?mpsia tinham
tamb?m hist?ria de doen?a hipertensiva em 9% (41 de 455), versus 6.6% (13 de 361)
dos controles, p=0.002. Da mesma forma ao ser examinada a hist?ria de pr?-ecl?mpsia
em irm?s, observou-se que 22.7% (57 de 251) das irm?s dos casos de pr?-ecl?mpsia,
versus 11.4% (26 de 228) dos controles apresentavam hist?ria de pr?-ecl?mpsia
(P=0.0011). O VEGF livre estava diminu?do no soro dos casos (P<0.05) enquanto que
o receptor sol?vel do VEGF estava aumentado. N?o foi observada associa??o entre
polimorfismos nos genes do VEGF e pr?-ecl?mpsia. Os dados obtidos neste trabalho
validam que doen?a hipertensiva em m?es e irm?s com pr?-ecl?mpsia s?o fatores de
risco para pr?-ecl?mpsia. O risco de doen?a na fam?lia ? maior de acordo com a
gravidade da doen?a. A hist?ria de pr?-ecl?mpsia elevada em familiares dos controles
respectivamente, 9,6% e 11,4%, em m?es e irm?s dos controles demonstram que a
pr?-ecl?mpsia ? uma done?a freq?ente nesta popula??o. Trabalho est? sendo
conduzido para realizar estudos de varredura ampla do genoma, para permitir
identificar loci de susceptibilidade
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