Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 53–156
Objectives: To determine maternal outcomes of hypertensive disorders in pregnancy (HDP) at Korle Bu Teaching Hospital (KBTH) Methods: A cross-sectional study conducted at KBTH between 1st January to 28th February 2013. The study design was two-fold. The first part involved baseline data collection on all the obstetric patients delivering at KBTH to identify those with HDP. The second part involved tracing those women with HDP to their respective maternity wards followed by administration of a structured questionnaire after obtaining an informed consent. Their medical records were also reviewed to determine if they developed any complications of HDP. Results: A total of 368 women with HDP among 1856 deliveries were analyzed. Most of them (80.2%) were married and 77.2% had obtained at least secondary education. Also, 35.5% were nulliparous, 21.2% primiparous and 43.5% multiparous. The mean gestational age, systolic and diastolic BP at diagnosis for preeclampsia and gestational hypertension were 34.85 ± 5.25 versus 35.38 ± 7.15 weeks (p = 0.090), 166.65 ± 21.02 versus 148 ± 14.24 (p < 0.001) and 106.07 ± 13.38 versus 96.04 ± 8.94 (p < 0.001) respectively. Among the 368 women with hypertensive disorders 65 (17.7%) had had a previous vaginal delivery. Adverse maternal outcomes determined included high cesarean delivery rate (45.7%), placental abruption (4.3%), pulmonary edema (3.0%), HELLP syndrome (0.8%), ARF (0.5%), CVA (0.8%), admission to ICU (5.7%), intracerebral hemorrhage (0.8%), DIC (1.8%) and eclampsia (15.8%). HDP accounted for 30% of maternal deaths. Most of the adverse maternal outcomes were significantly more common in preeclampsia compared to the other types of HDP. Ten maternal deaths occurred resulting in a maternal mortality ratio of 541.13 per 100,000 live births. Conclusions: Obstetric burden of HDP in Ghanaian population is huge as evidenced by high frequency of adverse maternal outcomes which were associated more with preeclampsia than other HDP. Multi-departmental involvement is pivotal in achieving significant improvement in the quality of care for women with HDP. Disclosures: K. Adu-Bonsaffoh: None. S.A. Obed: None. J.D. Seffah: None. doi:10.1016/j.preghy.2014.10.201
[196-POS] The expression of human leucocyte antigen-E (HLA-E) and natural killer cell (NK cell) in preeclampsia Sri Sulistyowati Sr. a, Sahat Siburian a, Supriyadi Hari a, Erry G. Dachlan Sr. b (a Dept.of Obs&Gyn MedicalFac. Sebelas Maret University, Dr. Moewardi General Hospital, Surakarta, Indonesia, b Dr. Soetomo General Hospital Surabaya Indonesia, Surabaya, Indonesia) Objectives: To investigate the etiopathogenesis of HLA-E and NK cell expression in preeclampsia. Methods: This research was an observational analytic study with cross sectional approach. This study was enrolled
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36 pregnant women who were divided into 2 groups, which were preeclampsia group (n = 18) and normal pregnancies group (n = 18). We did the immunohistochemical examination of HLA-E and NK cell in the trophoblast of all samples from both groups. The statistical analysis was performed with t-test Results: The mean expression of HLA-E in the trophoblast of preeclampsia group was 15.13 ± 8.60 compared to the normal pregnancies group which was 29.17 ± 4.62, with the p value of 0,000 (p < 0.05). The mean expression of NK cell in the trophoblast of preeclampsia group was 42.70 ± 7.54 compared to the normal pregnancies group which was 31.71 ± 18.63, with the p value of 0,002 (p < 0.05). Conclusions: HLA-E expression in the trophoblast of preeclampsia group was decrease in the normal pregnancies group. NK cell expression in the trophoblast of preeclampsia group was higher than in the normal pregnancies group. The increased expression of NK cell protein in the severe preeclampsia patient was not always associated with the decrease expression of HLA-E Disclosures: S. Sulistyowati Sr.: None. S. Siburian: None. S. Hari: None. E.G. Dachlan Sr.: None. doi:10.1016/j.preghy.2014.10.202
[197-POS] Maternal lipid- and steroid hormone concentrations during the course of pregnancy and in pregnancy pathologies Ulrich Pecks a, Nicola Kleine-Eggebrecht a, B. Sophia Winkler a, Markus Mohaupt b, Geneviève Escher b, Werner Rath a (a University Hospital of the RWTH, Dept. of O&G, Aachen, Germany, b Inselspital, University of Bern, Dept. of Clinical Research. Division of Hypertension, Berne, Switzerland) Objectives: Lipids and steroid hormones are closely and interactively linked. While cholesterol is substrate for (placental) steroid hormone synthesis, steroid hormones regulate hepatic lipid production. We therefore aimed to estimate the interaction between lipid metabolism and steroid hormones in normal and diseased pregnancy with emphasis on those with hepatic and/or placental pathologies. Methods: A total of 223 serum samples were analyzed. In group A 33 patients with uncomplicated pregnancies were analyzed at three different time points (first through third trimester) and postpartum. Group B consisted of 45 patients (24–42 weeks of gestation) with pregnancy pathologies (IUGR n = 14, preeclampsia n = 14, HELLP n = 10, intrahepatic cholestasis n = 7) and 45 gestational age matched controls. Steroid profile including estradiol, progesterone, cortisone, and dehydroepiandrosterone was measured by GC–MS and related to cholesterol and triglyceride concentrations. Statistics: Spearman’s rank coefficient and Kruskal–Wallis test with Dunn’s multiple comparisons.