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Pathophysiology of hypocalciuria in preeclampsia: Measurement of intestinal calcium absorption
Citations from the LiteraturelInt.
and 26.5%; P < 0.001) din the conjugated equine estrogen and conjugated equines estrogen/exercise groups, respectively. However, there were no differences in the changes observed in the conjugated equine estrogen groups with versus without exercise. No direct correlation was seen between measures of exercise performance and the changes seen in lipids and lipoproteins. Conclusions: Estrogen therapy alone had the greatest beneficial effect on lipids and lipoproteins. Exercise alone resulted in a significant reduction in cholesterol, triglycerides, and LDL cholesterol, and an increase in the HDL-LDL ratio. However, combined conjugated equine estrogen and exercise did not demonstrate an added improvement in lipid metabolism. Physical fitness levels increased in the exercise groups, but not in the control group or the estrogen-alone treated women.
PREGNANCY AND DELIVERY Inereascdplateletvolume and aggregation precede the onset of -a Hutt R.; Ogunniyi SO.; Sullivan M.H.F.; Elder M.G.
J. Gynecol. Obster. 47 (1994) 83-91
89
Objective: To analyze calcium absorption using stable isotopes in patients with preeclampsia and in normotensive controls. Methods: Fifteen pregnant subjects were studied: eight with preeclampsia (hypertension and proteinuria) and seven normotensive controls. All patients were ingesting their normal diet. The subjects received two stable calcium isotopic tracers. An oral tracer (44Ca, 0.0124 mmol/kg) was given with milk, while an intravenous tracer (42Ca, 0.00 249 mmol/kg) was infused over 7-10 min Calcium concentration was determined by atomic absorption spectrophotometry, and isotope ratios by thermal ionization mass spectrometry from pooled 24h urine samples. Results: No difference was noted in fractional intestinal absorption between preeclampsia subjects (0.282 f 0.051) and normotensive controls (0.306 * 0.079) (P = 0.49). However, the fraction of dietary calcium appearing in the urine differed significantly (0.06 for preeclamptic subjects and 0.087 for normotensive controls; P = 0.008). Conclusions: Despite the indirect evidence of others, calcium absorption does not appear to be impaired in patients with preeclampsia. The retention site of the unexcreted calcium is unidentified.
GBR
OBSTET GYNECOL 1994 83/l (146-149) Objective: To determine whether changes in platelet aggregation, numbers, or mean volume precede the onset of preeclampsia in patients given anti-platelet therapy. Methods: Changes in platelet aggregation, numbers, and volumes were followed longitudinally in 17 women who had previously lost 44 of 56 pregnancies and were thus considered to be at risk of preeclampsia. The subjects were treated with low-dose aspirin. Mean platelet volume, platelet numbers, and platelet aggregation were monitored every 2-4 weeks during pregnancy. Results: All eight subjects who developed preeclampsia delivered growth-retarded infants before term. All showed increased platelet aggregation in vitro, accompanied by increased platelet volumes (by at least 0.8 fL) and decreased platelet numbers (by at least 60 x 109/L) in five subjects, increased volumes alone in one, and decreased numbers alone in one. The increases in platelet aggregation and volumes predated the development of preeclampsia by 2-5 weeks. Nine subjects had pregnancies that progressed normally to term (beyond 37 weeks), with the delivery of eight normal and one growth-retarded infant; platelet aggregation, numbers, and volumes did not change to the same extent as in the subjects who developed preeclampsia. Conclusions: Increased mean platelet volume and increased platelet aggregation compared to the individual patient’s first-trimester data were detected 2-5 weeks before the development of all cases of preeclampsia. In contrast, normal pregnancies did not show significant changes in mean platelet volume or platelet aggregation. f’dopbydobgy
of i~ypocakiurinin preedampsia: Measurement
OfiEltddC~UIO~bsapHoa
Tolaymat A.; Sanchez-Ramos L.; Yergey A.L.; Vieira N.E.; Abrams S.A.; Edelstein P. USA
OBSTET GYNECOL 1994 83/2 (239-243)
A new method using vaginal ultrasoundand twdundal pressure to evaluate the asymptomatic iocompetent cervix Guxman E.R.; Rosenberg J.C.; Houlihan C.; Ivan J.; Waldron R.; Knuppel R. USA
OBSTET GYNECOL 1994 83/2 (248-252) Objective: To evaluate the ability of ultrasound with transfundal pressure to detect the incompetent cervix in pregnant women at risk for this condition. Methods: One hundred fifty pregnant women with no prior pregnancy losses were scanned transabdominally, and 31 asymptomatic pregnant women with a prior history of cervical incompetency or risk for this condition were scanned transvaginally. The control patients were scanned once between 16-24 weeks, and the patients at risk were studied 73 times between 8-25 weeks. After evaluating the cervix and its internal OS, transfundal pressure was applied. Cervical cerclages were placed for cervical funneling and shortening in response to transfundal pressure or for a grossly incompetent cervix on ultrasound evaluation. Results: Transfundal pressure elicited no changes in the internal cervical OSof the 150 control patients, of whom 141 delivered at term, two miscarried at 22 and 23 weeks, and seven delivered prematurely (4.7%). Fourteen of the 31 pregnancies at risk for cervical incompetency revealed opening of the internal OSor descent of the fetal membranes with transfundal pressure. Thirteen of these 14 pregnancies were treated with cerclage, with nine (64%) proceeding to term, three (21%) delivering prematurely, and two (14%) aborting. The one patient who did not receive a cerclage also aborted. In six cases, the cervix and its internal OSappeared normal but the membranes protruded into the endocetvical canal in response to transfundal pressure. Conclusions: Application of transfundal pressure during transvaginal ultrasound evaluation of the cervix and its internal OS may assist in detecting the asymptomatic incompetent cervix.
and 26.5%; P < 0.001) din the conjugated equine estrogen and conjugated equines estrogen/exercise groups, respectively. However, there were no differences in the changes observed in the conjugated equine estrogen groups with versus without exercise. No direct correlation was seen between measures of exercise performance and the changes seen in lipids and lipoproteins. Conclusions: Estrogen therapy alone had the greatest beneficial effect on lipids and lipoproteins. Exercise alone resulted in a significant reduction in cholesterol, triglycerides, and LDL cholesterol, and an increase in the HDL-LDL ratio. However, combined conjugated equine estrogen and exercise did not demonstrate an added improvement in lipid metabolism. Physical fitness levels increased in the exercise groups, but not in the control group or the estrogen-alone treated women.
PREGNANCY AND DELIVERY Inereascdplateletvolume and aggregation precede the onset of -a Hutt R.; Ogunniyi SO.; Sullivan M.H.F.; Elder M.G.
J. Gynecol. Obster. 47 (1994) 83-91
89
Objective: To analyze calcium absorption using stable isotopes in patients with preeclampsia and in normotensive controls. Methods: Fifteen pregnant subjects were studied: eight with preeclampsia (hypertension and proteinuria) and seven normotensive controls. All patients were ingesting their normal diet. The subjects received two stable calcium isotopic tracers. An oral tracer (44Ca, 0.0124 mmol/kg) was given with milk, while an intravenous tracer (42Ca, 0.00 249 mmol/kg) was infused over 7-10 min Calcium concentration was determined by atomic absorption spectrophotometry, and isotope ratios by thermal ionization mass spectrometry from pooled 24h urine samples. Results: No difference was noted in fractional intestinal absorption between preeclampsia subjects (0.282 f 0.051) and normotensive controls (0.306 * 0.079) (P = 0.49). However, the fraction of dietary calcium appearing in the urine differed significantly (0.06 for preeclamptic subjects and 0.087 for normotensive controls; P = 0.008). Conclusions: Despite the indirect evidence of others, calcium absorption does not appear to be impaired in patients with preeclampsia. The retention site of the unexcreted calcium is unidentified.
GBR
OBSTET GYNECOL 1994 83/l (146-149) Objective: To determine whether changes in platelet aggregation, numbers, or mean volume precede the onset of preeclampsia in patients given anti-platelet therapy. Methods: Changes in platelet aggregation, numbers, and volumes were followed longitudinally in 17 women who had previously lost 44 of 56 pregnancies and were thus considered to be at risk of preeclampsia. The subjects were treated with low-dose aspirin. Mean platelet volume, platelet numbers, and platelet aggregation were monitored every 2-4 weeks during pregnancy. Results: All eight subjects who developed preeclampsia delivered growth-retarded infants before term. All showed increased platelet aggregation in vitro, accompanied by increased platelet volumes (by at least 0.8 fL) and decreased platelet numbers (by at least 60 x 109/L) in five subjects, increased volumes alone in one, and decreased numbers alone in one. The increases in platelet aggregation and volumes predated the development of preeclampsia by 2-5 weeks. Nine subjects had pregnancies that progressed normally to term (beyond 37 weeks), with the delivery of eight normal and one growth-retarded infant; platelet aggregation, numbers, and volumes did not change to the same extent as in the subjects who developed preeclampsia. Conclusions: Increased mean platelet volume and increased platelet aggregation compared to the individual patient’s first-trimester data were detected 2-5 weeks before the development of all cases of preeclampsia. In contrast, normal pregnancies did not show significant changes in mean platelet volume or platelet aggregation. f’dopbydobgy
of i~ypocakiurinin preedampsia: Measurement
OfiEltddC~UIO~bsapHoa
Tolaymat A.; Sanchez-Ramos L.; Yergey A.L.; Vieira N.E.; Abrams S.A.; Edelstein P. USA
OBSTET GYNECOL 1994 83/2 (239-243)
A new method using vaginal ultrasoundand twdundal pressure to evaluate the asymptomatic iocompetent cervix Guxman E.R.; Rosenberg J.C.; Houlihan C.; Ivan J.; Waldron R.; Knuppel R. USA
OBSTET GYNECOL 1994 83/2 (248-252) Objective: To evaluate the ability of ultrasound with transfundal pressure to detect the incompetent cervix in pregnant women at risk for this condition. Methods: One hundred fifty pregnant women with no prior pregnancy losses were scanned transabdominally, and 31 asymptomatic pregnant women with a prior history of cervical incompetency or risk for this condition were scanned transvaginally. The control patients were scanned once between 16-24 weeks, and the patients at risk were studied 73 times between 8-25 weeks. After evaluating the cervix and its internal OS, transfundal pressure was applied. Cervical cerclages were placed for cervical funneling and shortening in response to transfundal pressure or for a grossly incompetent cervix on ultrasound evaluation. Results: Transfundal pressure elicited no changes in the internal cervical OSof the 150 control patients, of whom 141 delivered at term, two miscarried at 22 and 23 weeks, and seven delivered prematurely (4.7%). Fourteen of the 31 pregnancies at risk for cervical incompetency revealed opening of the internal OSor descent of the fetal membranes with transfundal pressure. Thirteen of these 14 pregnancies were treated with cerclage, with nine (64%) proceeding to term, three (21%) delivering prematurely, and two (14%) aborting. The one patient who did not receive a cerclage also aborted. In six cases, the cervix and its internal OSappeared normal but the membranes protruded into the endocetvical canal in response to transfundal pressure. Conclusions: Application of transfundal pressure during transvaginal ultrasound evaluation of the cervix and its internal OS may assist in detecting the asymptomatic incompetent cervix.