- Email: [email protected]
[207-POS]
104
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 53–156
Moscow, Russian Federation)
e
Maxima Medical Center, Veldhoven, Netherlands, Maastricht University Medical Center, Netherlands, g Isala Clinics Zwolle, Netherlands, h Leiden University Medical Center, Netherlands, i Amsterdam Medical j Center, Netherlands, Erasmus Medical Center, Rotterdam, Netherlands, k Radboud UMC Nijmegen, Netherlands) f
Objectives: To study the morphological/immunohistochemical alterations of endometrial and placental sites and relation of apoptosis, proliferation and angiogenesis in preeclampsia (PE). Methods: 30 women 18–40 y.o. were delivered by CS for severe PE: 15 women with early PE, and 15 with the late PE. 15 women without hypertensive disorders were matched for GA at delivery with PE-patients and formed a control group. Samples of the placental site were obtained during CS after informed consent. Morphological and immunohistochemical analysis was used. Results: Dramatic thickening of spiral arterial walls with severe stenosis of the basal membrane, hyperplasia of smooth muscle cells, perivascular lymphohistiocytic infiltration dominated in the cases of late PE. Multiple sclerosis (100%), hyalinosis (100%) and intimal atheromatosis (70%) due to sharp thickness of spiral arteries with severe stenosis of the basal membrane occurred in early PE. Thrombosis was often seen equally in both groups (80%). Apoptosis predominated in the intima and smooth muscle cells of the spiral arteries. Compensatory increased formation of VEGF (5 ± 1.1 score) and IGF (6 ± 0.5 score) in myometrial stromal cells and spiral arteries was observed in all samples. Expression of VEGF in EVT cells and cytotrophoblasts significantly was reduced in patients with PE compared to the control group. Reduction of VEGF receptors in endometrial stroma and its absence in endothelial cells occurred. The levels of Apo-Cas (5% ± 1.4%, and 15% ± 2.7%), VEGF (4 ± 0.5 and 5 ± 1.1 scores) and IGF (5.5 ± 1.1 and 6 ± 0.5 scores) in myometrial stromal cells and spiral arteries in the early-onset group were slightly higher compared to the late-onset group. Conclusions: These violations of utero-placental circulation were observed as a result of pathological remodeling of spiral arteries due to imbalance between proliferation and apoptosis in the placental site. These changes that have led to deficient physiologic vessel transformation are likely immunohistochemical markers of remodeling spiral arteries and endothelial dysfunction. Disclosures: Z. Khodzhaeva: None. E. Kogan: None. T. Demura: None. A. Akatyeva: None. O. Vavina: None. A. Safonova: None. A. Kholin: None. G. Sukhikh: None.
Objectives: To ascertain the incidence and demographic data of TOP for hypertensive disorders at the limits of fetal viability. Methods: We conducted a retrospective cohort study. All terminations for hypertensive disorders between 2000 and 2009 in the ten Dutch tertiary care centers with a gestational age between 22 and 28 weeks were included. In all cases the fetus was judged to be non-viable, either because of the low gestational age or because of the effects of the maternal condition on the fetus. There was no intention to intervene for fetal indications. Results: During the study period TOP for hypertensive disorders occurred in 0.8 promille (131/163.052) of all deliveries in these 10 centers, of which there were 126 singleton and five twin pregnancies. 94 women were nulliparous and 37 multiparous. The main indication for TOP was HELLP syndrome. General history revealed hypertension in 24 women (18.3%). History was unremarkable in 98 cases (75%). The mean gestational age at admission was 166 days ± 9.6 days (GA 23+5), and at delivery this was 173 days ± 9.7 days (GA 24 + 5 weeks). The mean birth weight was 472 ± 123 g (70% < p10). The overall perinatal mortality was 99.3%. There were no maternal deaths. Conclusions: In 10 years there we identified 131 cases of TOP for hypertensive disorders prior to fetal viability in The Dutch tertiary care centers. Ninety-eight women (75%) had no preexisting maternal disease.
Table 1. Indications for termination of pregnancy. N = number. Indication
N (%)
HELLP syndrome
80 (61.1)
Preeclampsia
40 (30.5)
Eclampsia
7 (5.3)
Refractory hypertension
4 (3)
doi:10.1016/j.preghy.2014.10.212
Disclosures: L. van Eerden: None. [207-POS] Termination of pregnancy for hypertensive disorders prior to fetal viability in the Netherlands: A retrospective cohort study in 10 Dutch tertiary care centers Leonoor van Eerden a, G.G. Zeeman b, G.C.M. Christiaens c, F. Vandenbussche d, S.G.. Oei e, H.C.J. Scheepers f, J. van Eyck g, J.M. Middledorp h, E. Pajkrt i, J.J. Duvekot j, C.J.M. de Groot a, A.C. Bolte k (a VU Medical Center, Amsterdam, Netherlands, b University Medical Center Groningen, Netherlands, c University Medical Center, Utrecht, Netherlands, d Radboud UMC Nijmegen, Netherlands,
doi:10.1016/j.preghy.2014.10.213
[208-POS] An accurate semi-automated oscillometric blood pressure device for use in pregnancy, including pre-eclampsia, in a low- and middle-income country population: The Microlife 3AS1-2 Hannah L. Nathan, Annemarie de Greeff, Natasha L. Hezelgrave, Kate E. Duhig, Lucy C. Chappell, Andrew H.
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 53–156
Moscow, Russian Federation)
e
Maxima Medical Center, Veldhoven, Netherlands, Maastricht University Medical Center, Netherlands, g Isala Clinics Zwolle, Netherlands, h Leiden University Medical Center, Netherlands, i Amsterdam Medical j Center, Netherlands, Erasmus Medical Center, Rotterdam, Netherlands, k Radboud UMC Nijmegen, Netherlands) f
Objectives: To study the morphological/immunohistochemical alterations of endometrial and placental sites and relation of apoptosis, proliferation and angiogenesis in preeclampsia (PE). Methods: 30 women 18–40 y.o. were delivered by CS for severe PE: 15 women with early PE, and 15 with the late PE. 15 women without hypertensive disorders were matched for GA at delivery with PE-patients and formed a control group. Samples of the placental site were obtained during CS after informed consent. Morphological and immunohistochemical analysis was used. Results: Dramatic thickening of spiral arterial walls with severe stenosis of the basal membrane, hyperplasia of smooth muscle cells, perivascular lymphohistiocytic infiltration dominated in the cases of late PE. Multiple sclerosis (100%), hyalinosis (100%) and intimal atheromatosis (70%) due to sharp thickness of spiral arteries with severe stenosis of the basal membrane occurred in early PE. Thrombosis was often seen equally in both groups (80%). Apoptosis predominated in the intima and smooth muscle cells of the spiral arteries. Compensatory increased formation of VEGF (5 ± 1.1 score) and IGF (6 ± 0.5 score) in myometrial stromal cells and spiral arteries was observed in all samples. Expression of VEGF in EVT cells and cytotrophoblasts significantly was reduced in patients with PE compared to the control group. Reduction of VEGF receptors in endometrial stroma and its absence in endothelial cells occurred. The levels of Apo-Cas (5% ± 1.4%, and 15% ± 2.7%), VEGF (4 ± 0.5 and 5 ± 1.1 scores) and IGF (5.5 ± 1.1 and 6 ± 0.5 scores) in myometrial stromal cells and spiral arteries in the early-onset group were slightly higher compared to the late-onset group. Conclusions: These violations of utero-placental circulation were observed as a result of pathological remodeling of spiral arteries due to imbalance between proliferation and apoptosis in the placental site. These changes that have led to deficient physiologic vessel transformation are likely immunohistochemical markers of remodeling spiral arteries and endothelial dysfunction. Disclosures: Z. Khodzhaeva: None. E. Kogan: None. T. Demura: None. A. Akatyeva: None. O. Vavina: None. A. Safonova: None. A. Kholin: None. G. Sukhikh: None.
Objectives: To ascertain the incidence and demographic data of TOP for hypertensive disorders at the limits of fetal viability. Methods: We conducted a retrospective cohort study. All terminations for hypertensive disorders between 2000 and 2009 in the ten Dutch tertiary care centers with a gestational age between 22 and 28 weeks were included. In all cases the fetus was judged to be non-viable, either because of the low gestational age or because of the effects of the maternal condition on the fetus. There was no intention to intervene for fetal indications. Results: During the study period TOP for hypertensive disorders occurred in 0.8 promille (131/163.052) of all deliveries in these 10 centers, of which there were 126 singleton and five twin pregnancies. 94 women were nulliparous and 37 multiparous. The main indication for TOP was HELLP syndrome. General history revealed hypertension in 24 women (18.3%). History was unremarkable in 98 cases (75%). The mean gestational age at admission was 166 days ± 9.6 days (GA 23+5), and at delivery this was 173 days ± 9.7 days (GA 24 + 5 weeks). The mean birth weight was 472 ± 123 g (70% < p10). The overall perinatal mortality was 99.3%. There were no maternal deaths. Conclusions: In 10 years there we identified 131 cases of TOP for hypertensive disorders prior to fetal viability in The Dutch tertiary care centers. Ninety-eight women (75%) had no preexisting maternal disease.
Table 1. Indications for termination of pregnancy. N = number. Indication
N (%)
HELLP syndrome
80 (61.1)
Preeclampsia
40 (30.5)
Eclampsia
7 (5.3)
Refractory hypertension
4 (3)
doi:10.1016/j.preghy.2014.10.212
Disclosures: L. van Eerden: None. [207-POS] Termination of pregnancy for hypertensive disorders prior to fetal viability in the Netherlands: A retrospective cohort study in 10 Dutch tertiary care centers Leonoor van Eerden a, G.G. Zeeman b, G.C.M. Christiaens c, F. Vandenbussche d, S.G.. Oei e, H.C.J. Scheepers f, J. van Eyck g, J.M. Middledorp h, E. Pajkrt i, J.J. Duvekot j, C.J.M. de Groot a, A.C. Bolte k (a VU Medical Center, Amsterdam, Netherlands, b University Medical Center Groningen, Netherlands, c University Medical Center, Utrecht, Netherlands, d Radboud UMC Nijmegen, Netherlands,
doi:10.1016/j.preghy.2014.10.213
[208-POS] An accurate semi-automated oscillometric blood pressure device for use in pregnancy, including pre-eclampsia, in a low- and middle-income country population: The Microlife 3AS1-2 Hannah L. Nathan, Annemarie de Greeff, Natasha L. Hezelgrave, Kate E. Duhig, Lucy C. Chappell, Andrew H.