Pre-Eclampsia, Severe Pre-Eclampsia and Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome: What is New?

Ciantar, Etienne; Walker, James J.

doi:10.2217/whe.11.57

Cited by 22 publications

(19 citation statements)

References 83 publications

(84 reference statements)

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“…Other microarrays used in the study were downloaded from Gene Expression Omnibus (GEO)10. GSE95 and GSE97 (GDS59624) contained gene expression profiles of normal human and mouse tissues.…”

Section: Methodsmentioning

confidence: 99%

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Integrative transcriptome analysis reveals dysregulation of canonical cancer molecular pathways in placenta leading to preeclampsia

Moslehi

Mills

Signore

et al. 2013

Sci Rep

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We previously suggested links between specific XPD mutations in the fetal genome and the risk of placental maldevelopment and preeclampsia, possibly due to impairment of Transcription Factor (TF)IIH-mediated functions in placenta. To identify the underlying mechanisms, we conducted the current integrative analysis of several relevant transcriptome data sources. Our meta-analysis revealed downregulation of TFIIH subunits in preeclamptic placentas. Our overall integrative analysis suggested that, in the presence of hypoxia and oxidative stress, EGFR signaling deficiency, which can be caused by TFIIH impairment as well as by other mechanisms, results in ATF3 upregulation, inducing mediators of clinical symptoms of preeclampsia such as FLT1 and ENG. EGFR- and ATF3-dependent pathways play prominent roles in cancer development. We propose that dysregulation of these canonical cancer molecular pathways occurs in preeclampsia and delineate the relevance of TFIIH, providing etiologic clues which could eventually translate into a therapeutic approach.

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“…Other microarrays used in the study were downloaded from Gene Expression Omnibus (GEO)10. GSE95 and GSE97 (GDS59624) contained gene expression profiles of normal human and mouse tissues.…”

Section: Methodsmentioning

confidence: 99%

“…Preeclampsia has the potential to develop into severe preeclampsia or hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, potentially fatal conditions for both mother and infant10. Nearly all candidate-gene and genome-wide association studies (GWAS) of preeclampsia to date have focused on markers on the maternal genome.…”

mentioning

confidence: 99%

Integrative transcriptome analysis reveals dysregulation of canonical cancer molecular pathways in placenta leading to preeclampsia

Moslehi

Mills

Signore

et al. 2013

Sci Rep

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“…However, unlike CKD that may be subdivided according to agreed criteria, such as the type of primary kidney disease, there are no univocal and objective criteria allowing stratification or sub-classification of PE [24][25][26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

Piccoli

Cabiddu

Castellino³

et al. 2017

J Nephrol

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Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide. The increased awareness of the role of chronic kidney disease in pregnancy, complicating up to 3% of pregnancies, and the knowledge that PE is associated with an increased risk for development of CKD later in life have recently increased the interest and redesigned the role of the nephrologists in this context. However, while the heterogeneous definitions of PE, its recent reclassification, an emerging role for biochemical biomarkers, the growing body of epidemiological data and the new potential therapeutic interventions lead to counsel long-term follow-up, the lack of resources for chronic patients and the increasing costs of care limit the potential for preventive actions, and suggest tailoring specific interventional strategies. The aim of the present position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature and to try to identify theoretical and pragmatic bases for an agreed management of PE in the nephrological setting, with particular attention to the prevention of the syndrome (recurrent PE, presence of baseline CKD) and to the organization of the postpartum follow-up.

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“…Severe preeclampsia, remote from term, occurs in about 25% of these women. 1 In developing countries it continues to be a major cause of maternal mortality. Both maternal and fetal morbidity and mortality are reported to be higher in early onset preeclampsia (less than 34 weeks gestation) compared to those with late onset preeclampsia (at or more than 34 weeks gestation).…”

Section: Introductionmentioning

confidence: 99%

“…2 The perinatal mortality rate also increases proportionate to the severity of preeclampsia. 1 Women who develop severe preeclampsia are delivered as soon as fetal lung maturity is attained, at or after 34 weeks of gestation or due to worsening of maternal condition. This is often necessary as termination of pregnancy remains the definitive treatment for prevention of progressive deterioration due to preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

Fetal and maternal outcome following expectant management of severe pre-eclampsia remote from term

Deepak

Reena

Anirudhan

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Expectant management of severe preeclampsia, remote from term is often a difficult decision. Maternal and foetal complications may occur while trying to achieve a more favourable perinatal outcome. We wanted to find out the foetal and maternal outcomes of expectant management in these women.Methods: A prospective cohort study was conducted at Government Medical College, Thrissur, India between May 2013 and April 2015. Women with severe preeclampsia remote from term, who were admitted, managed expectantly and delivered in our hospital during the study period, were recruited. The study subjects were grouped into: Group A (between 28 weeks and 31 weeks 6 days) and Group B (between 32 weeks and 33 weeks 6 days). A structured proforma was used to collect demographic and clinical details. The maternal and foetal outcomes were noted.Results: There were 4786 deliveries during the study period. Among them 76 (1.58% of total deliveries) women with severe preeclampsia between 28 weeks and 33-week 6 days gestation on expectant management were included in the study. The mean duration of expectant management was 7.92 days in group A (27 women) and 6.67 days in group B (49 women). Most women required termination of pregnancy for foetal distress (36.8%). HELLP syndrome and imminent eclampsia were the maternal complications that occurred. Perinatal loss was significantly more in Group A when compared to Group B.Conclusions: Expectant management of women with severe preeclampsia remote from term, especially between 32weeks and 33weeks 6 days, with antenatal corticosteroids and close monitoring, seems a reasonable option in developing countries.

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Pre-Eclampsia, Severe Pre-Eclampsia and Hemolysis, Elevated Liver Enzymes and Low Platelets Syndrome: What is New?

Cited by 22 publications

References 83 publications

Integrative transcriptome analysis reveals dysregulation of canonical cancer molecular pathways in placenta leading to preeclampsia

Integrative transcriptome analysis reveals dysregulation of canonical cancer molecular pathways in placenta leading to preeclampsia

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

Fetal and maternal outcome following expectant management of severe pre-eclampsia remote from term

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