Made available in DSpace on 2015-04-14T13:35:36Z (GMT). No. of bitstreams: 1 443764.pdf: 1879751 bytes, checksum: a84345f48429752c882a6b33df97af04 (MD5) 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.

Made available in DSpace on 2014-12-17T14:13:38Z (GMT). No. of bitstreams: 1 FlavioVMP_TESE.pdf: 2484442 bytes, checksum: a01024c65d8fb94c5394db6d7689663e (MD5) 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