Eclampsia in a lowland gorilla

Baird, James N.

doi:10.1016/s0002-9378(16)32642-4

Cited by 40 publications

(11 citation statements)

References 2 publications

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“…Even among primates, the spontaneous appearance of PE/eclampsia has been reported only rarely in great apes, including chimpanzees and gorillas [23,24,25]. There is one report on the patas monkey [26] and a case of edema, proteinuria and hypertension in a pregnant baboon, i.e.…”

Section: Preeclampsia the ‘Disease Of Theories'mentioning

confidence: 99%

Preeclampsia and Maternal Cardiovascular Disease: Consequence or Predisposition?

Osol

Bernstein²

2014

J Vasc Res

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Formerly preeclamptic women stand a higher chance of developing cardiovascular disease (CVD) later in life and may experience a shortened life span. This review updates the pathophysiology and definition of this complex disease and highlights the protective role of pregnancy by considering the relationship between pregnancy interval and likelihood of disease recurrence. The evidence for persistent maternal cardiovascular impairment following preeclampsia (PE) is considered, e.g. postpartum changes in CVD occurrence, blood pressure elevation and changes in the renin-angiotensin-aldosterone system). Since maternal endothelial dysfunction is a hallmark of PE, we summarize the evidence for reduced flow-mediated dilation in women with previous PE, and consider the utility and shortcomings of this clinical measure. In addition to viewing postpartum changes as a consequence of this disease, we consider the alternative view that PE might be the manifestation of a maternal phenotype that already has some predisposition to or is in the earlier stages of CVD; in this case, some of the postpartum residual deficits (or their antecedents) may have already been present prior to pregnancy. Finally, we consider the use of novel biomarkers for predicting or detecting PE prior to the appearance of clinical symptoms.

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Section: Preeclampsia the ‘Disease Of Theories'mentioning

confidence: 99%

Preeclampsia and Maternal Cardiovascular Disease: Consequence or Predisposition?

Osol

Bernstein²

2014

J Vasc Res

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“…It is commonly stated, often with Chez (1976) as the authority, that preeclampsia is a uniquely human disease. However, there are several case reports of eclampsia in gorilla and chimpanzee (Stout & Lemon 1969, Baird 1981, Thornton & Onwude 1992. In one instance, a renal biopsy was taken, and the distinctive features associated with human preeclampsia were shown (Stout & Lemon 1969).…”

Section: Trophoblast Invasion In Non-human Primatesmentioning

confidence: 99%

Comparative studies of placentation and immunology in non-human primates suggest a scenario for the evolution of deep trophoblast invasion and an explanation for human pregnancy disorders

Carter

2011

Reproduction

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Deep trophoblast invasion in the placental bed has been considered the hallmark of human pregnancy. It occurs by two routes, interstitial and endovascular, and results in transformation of the walls of the spiral arteries as they traverse the decidua and the inner third of the myometrium. Disturbances in this process are associated with reproductive disorders such preeclampsia. In contrast, trophoblast invasion in Old World monkeys occurs only by the endovascular route and seldom reaches the myometrium. Recently, it was shown that this pattern is maintained in gibbons, but that the human arrangement also occurs in chimpanzee and gorilla. There is an interesting parallel with results from placental immunology regarding the evolution of the major histocompatability complex class I antigen HLA-C and its cognate receptors. HLA-C is not present in Old World monkeys or gibbons. It emerged in the orangutan and became polymorphic in the lineage leading to gorilla, bonobo, chimpanzee, and human. Interaction between HLA-C1 and HLA-C2 on the surface of trophoblast and killer immunoglobulin-like receptors (KIRs) expressed by uterine natural killer cells are important regulators of trophoblast invasion. Evolution of this system in great apes may have been one prerequisite for deep trophoblast invasion but seems to have come at a price. The evidence now suggests that certain combinations of maternal genotype for KIRs and fetal genotype for HLA-C imply an increased risk of preeclampsia, fetal growth restriction, and recurrent abortion. The fetal genotype is in part derived from the father providing an explanation for the paternal contribution to reproductive disorders.

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“…3 Two case reports describe convulsions associated with oedema in lowland gorillas in the latter stages of pregnancy, including one with evidence of placental abruption and infarction. [4][5] The pathophysiology of pre-eclampsia in humans relates to defective deep trophoblastic invasion and spiral artery remodelling of the developing placenta. In healthy cases, extravillous trophoblasts invade the maternal decidua and uterine arteries resulting in lower resistance and increased blood flow.…”

Section: Introductionmentioning

confidence: 99%

“…7 Additionally, analysis of placental tissue in a lowland gorilla who developed convulsions late in pregnancy showed evidence of syncytial knotting of the chorionic villi, a feature seen in human placental tissue in cases of preeclampsia. 4 Collaboration between specialists in human obstetrics and veterinarians in the management of captive gorilla pregnancies and complications was first described in 1978, when an infant gorilla was delivered via caesarean section in an attempt to prevent infanticide by the mother. 8 Magnesium sulphate has been used successfully in cases of suspected eclampsia in lowland gorillas.…”

Section: Introductionmentioning

confidence: 99%

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Caesarean delivery of a Western Lowland gorilla with fetal distress and suspected pre-eclampsia

Walter

Ali

Killick

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Pre-eclampsia is a well-recognised complication of human pregnancy however case reports suggest that it also affects non-human primates. The authors present the case of a primigravid western lowland gorilla (Gorilla gorilla gorilla) who developed behavioural changes, significant proteinuria, and ultrasound features of suspected fetal distress at term, three days prior to her estimated due date. A working diagnosis of pre-eclampsia was made, and the baby was delivered by emergency caesarean section. In spite of a prolonged recovery complicated by sepsis, anaemia and persistent proteinuria in the mother, both mother and baby made a good recovery. This case highlights how the application of basic principles of obstetric medicine and collaboration between obstetricians and veterinarians in the care of captive gorillas resulted in the successful management of pregnancy complications.

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Eclampsia in a lowland gorilla

Cited by 40 publications

References 2 publications

Preeclampsia and Maternal Cardiovascular Disease: Consequence or Predisposition?

Preeclampsia and Maternal Cardiovascular Disease: Consequence or Predisposition?

Comparative studies of placentation and immunology in non-human primates suggest a scenario for the evolution of deep trophoblast invasion and an explanation for human pregnancy disorders

Caesarean delivery of a Western Lowland gorilla with fetal distress and suspected pre-eclampsia

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