- Email: [email protected]
PP168. The role of calcium supplementation in prevention endothelial cell activation, and possible relevance to preeclampsia
330
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012) 240–339
of BOS has been done, analyzing its efficiency, barriers and formulate improvement points. Objectives: Gynecologists, residents and clinical midwives from seven hospitals using BOS were asked to fill in the questionnaire. Methods: A questionnaire was developed on the following items: efficiency, barriers and improvement. Results: Thirty four completed questionnaires useful for analysis. 63.6% of the respondent also consulted the NVOG guideline or local protocol, mainly for confirmation of information, background information, medication. Technical problems were found in 44.1%. Positive opinions on user friendliness varied from 73.5% to 100%. No significant difference was found between the user frequency of BOS compared to the NVOG guidelines or local protocol, or between the time needed to consult them. Improvements mentioned by the respondents were mainly regarding the lay-out. Most respondents (85.3%) found it useful to make a computer based support system for other guidelines and 79.4% would also use this. Conclusion: BOS is regarded suitable as an instrument for implementing guidelines and respondents find it useful to develop it for other guidelines as well. Technical problems and poor implementation are important areas of improvement. Disclosure of interest: None declared. doi:10.1016/j.preghy.2012.04.278
PP168. The role of calcium supplementation in prevention endothelial cell activation, and possible relevance to preeclampsia Q. Chen 1,*, M. Tong 1, M. Wu 2, P. Stone 1, S. Snowise 1, L. Chamley 1 (1 The University of Auckland, Auckland, New Zealand, 2 Wuxi Maternity and Child Health Hospital, Wuxi, China) Introduction: Preeclampsia remains a leading causing of maternal and perinatal mortality and morbidity. Preeclampsia is currently thought to be primarily a disease of endothelial activation and inflammation. Objectives: The deportation of trophoblast debris form the placenta was first linked to the pathogenesis of preeclampsia over a hundred years ago and it is hypothesised that deportation of necrotic trophoblast debris may contribute to maternal endothelial cell activation in preeclampsia. We have previously shown that treating placental explants with IL-6 results in shedding of more necrotic trophoblast debris from placental explants and that this debris when phagocytosed by endothelial cells results in activation of the endothelial cells. Although delivery remains the only definitive cure for preeclampsia a number of studies suggest that calcium supplementation may reduce the risk of developing preeclampsia by up to 50% but the protective mechanism of calcium supplementation is unclear. The aim of this work was to determine whether calcium supplementation affects
either the production of necrotic trophoblast debris from the placenta or influences endothelial cell activation. Methods: First trimester placental explants were cultured with IL-6 in the presence or absence of increasing concentrations of calcium (CaCl2) for 24 h. Trophoblastic debris was collected from the explants and then exposed to monolayers of endothelial cell for 24 h and endothelial cell activation measured by ICAM-1 ELISA. In other experiments, endothelial cells were treated with IL-6 or necrotic trophoblastic debris in the presence of increasing concentrations of CaCl2, ranging from 230 lg/mL to 700 lg/mL, for 24 h. In some experiments, ebdothelial cells were treated with low concentration of CaCl2, ranging from 0 lg/mL to 230 lg/mL for 24 h. Endothelial cell activation was measured by quantifying cell-surface ICAM-1 levels by ELISA. Results: (1) Increasing the concentration of CaCl2 in the medium of placental explants treated with IL-6 did not significantly reduce the activation of endothelial cells induced by phagocytosis of the trophoblasts debris from these explants (p > 0.05). (2) Increasing the concentration of CaCl2 in the medium of endothelial cells treated with either IL-6 or necrotic trophoblastic debris significantly reversed the activating effects of IL-6 and necrotic trophoblast debris in a dose dependent fashion. (3) Reducing the amount of CaCl2in the culture of otherwise untreated endothelial cells caused a significant increase in endothelial cell activation as measured by ICAM-1 levels. Conclusion: Our results demonstrate that calcium levels are important to endothelial cell activation and supplemental calcium may reverse the activation of the endothelium induced by proinflammatory mediators while having no effect on the production of trophoblast debris. These results may in part help to explain the benefits of calcium supplementation in the reduction of risk for developing preeclampsia. Disclosure of interest: None declared. doi:10.1016/j.preghy.2012.04.279
PP169. Management of fetal and maternal prognosis during severe toxemia M. Radhouane 1,*, M. Basly 2, C. Mounir 2, R. Rachdi 2 (1 Military Hospital, Tunis, Tunisia, 2 Gyn Obs, Military Hospital, Tunis, Tunisia) Introduction: Severe gravidic toxemia gives heavy maternal and fetal morbidity and mortality. Objectives: The purpose of our data is to identify bad maternal and fetal factors during severe toxemia and the outcome of pregnancy. Methods: It is a retrospective and comparative study about 200 cases of severe toxemia reported during 8 years 2004–2011 among 25,000 deliveries (control group). Toxe-
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012) 240–339
of BOS has been done, analyzing its efficiency, barriers and formulate improvement points. Objectives: Gynecologists, residents and clinical midwives from seven hospitals using BOS were asked to fill in the questionnaire. Methods: A questionnaire was developed on the following items: efficiency, barriers and improvement. Results: Thirty four completed questionnaires useful for analysis. 63.6% of the respondent also consulted the NVOG guideline or local protocol, mainly for confirmation of information, background information, medication. Technical problems were found in 44.1%. Positive opinions on user friendliness varied from 73.5% to 100%. No significant difference was found between the user frequency of BOS compared to the NVOG guidelines or local protocol, or between the time needed to consult them. Improvements mentioned by the respondents were mainly regarding the lay-out. Most respondents (85.3%) found it useful to make a computer based support system for other guidelines and 79.4% would also use this. Conclusion: BOS is regarded suitable as an instrument for implementing guidelines and respondents find it useful to develop it for other guidelines as well. Technical problems and poor implementation are important areas of improvement. Disclosure of interest: None declared. doi:10.1016/j.preghy.2012.04.278
PP168. The role of calcium supplementation in prevention endothelial cell activation, and possible relevance to preeclampsia Q. Chen 1,*, M. Tong 1, M. Wu 2, P. Stone 1, S. Snowise 1, L. Chamley 1 (1 The University of Auckland, Auckland, New Zealand, 2 Wuxi Maternity and Child Health Hospital, Wuxi, China) Introduction: Preeclampsia remains a leading causing of maternal and perinatal mortality and morbidity. Preeclampsia is currently thought to be primarily a disease of endothelial activation and inflammation. Objectives: The deportation of trophoblast debris form the placenta was first linked to the pathogenesis of preeclampsia over a hundred years ago and it is hypothesised that deportation of necrotic trophoblast debris may contribute to maternal endothelial cell activation in preeclampsia. We have previously shown that treating placental explants with IL-6 results in shedding of more necrotic trophoblast debris from placental explants and that this debris when phagocytosed by endothelial cells results in activation of the endothelial cells. Although delivery remains the only definitive cure for preeclampsia a number of studies suggest that calcium supplementation may reduce the risk of developing preeclampsia by up to 50% but the protective mechanism of calcium supplementation is unclear. The aim of this work was to determine whether calcium supplementation affects
either the production of necrotic trophoblast debris from the placenta or influences endothelial cell activation. Methods: First trimester placental explants were cultured with IL-6 in the presence or absence of increasing concentrations of calcium (CaCl2) for 24 h. Trophoblastic debris was collected from the explants and then exposed to monolayers of endothelial cell for 24 h and endothelial cell activation measured by ICAM-1 ELISA. In other experiments, endothelial cells were treated with IL-6 or necrotic trophoblastic debris in the presence of increasing concentrations of CaCl2, ranging from 230 lg/mL to 700 lg/mL, for 24 h. In some experiments, ebdothelial cells were treated with low concentration of CaCl2, ranging from 0 lg/mL to 230 lg/mL for 24 h. Endothelial cell activation was measured by quantifying cell-surface ICAM-1 levels by ELISA. Results: (1) Increasing the concentration of CaCl2 in the medium of placental explants treated with IL-6 did not significantly reduce the activation of endothelial cells induced by phagocytosis of the trophoblasts debris from these explants (p > 0.05). (2) Increasing the concentration of CaCl2 in the medium of endothelial cells treated with either IL-6 or necrotic trophoblastic debris significantly reversed the activating effects of IL-6 and necrotic trophoblast debris in a dose dependent fashion. (3) Reducing the amount of CaCl2in the culture of otherwise untreated endothelial cells caused a significant increase in endothelial cell activation as measured by ICAM-1 levels. Conclusion: Our results demonstrate that calcium levels are important to endothelial cell activation and supplemental calcium may reverse the activation of the endothelium induced by proinflammatory mediators while having no effect on the production of trophoblast debris. These results may in part help to explain the benefits of calcium supplementation in the reduction of risk for developing preeclampsia. Disclosure of interest: None declared. doi:10.1016/j.preghy.2012.04.279
PP169. Management of fetal and maternal prognosis during severe toxemia M. Radhouane 1,*, M. Basly 2, C. Mounir 2, R. Rachdi 2 (1 Military Hospital, Tunis, Tunisia, 2 Gyn Obs, Military Hospital, Tunis, Tunisia) Introduction: Severe gravidic toxemia gives heavy maternal and fetal morbidity and mortality. Objectives: The purpose of our data is to identify bad maternal and fetal factors during severe toxemia and the outcome of pregnancy. Methods: It is a retrospective and comparative study about 200 cases of severe toxemia reported during 8 years 2004–2011 among 25,000 deliveries (control group). Toxe-