Preeklamptik gebelerde maternal kan, kordon kanı ve plasental dokuda Malondialdehit düzeylerinin fetomaternal Doppler değerleri ile korelasyonu

Abstract

Amaç Bu çalışmada preeklamptik gebelerde maternal kan, fetal kan ve plasental yataktaki malondialdehit (MDA) düzeylerinin fetomaternal Doppler değerleri ile korelasyonunun değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem Çalışma 52 sağlıklı, 22 preeklamptik gebe olmak üzere toplam 74 olgu ile yürütülmüştür. Gebelerin maternal kan, kordon kanı, plasenta dokularında MDA düzeyleri ölçüldü. Uterin ve umbilikal arterlerde Doppler sonografik ölçümler yapıldı. Preeklamptik ve sağlıklı gebelerin Doppler değerleri ile MDA düzeyleri karşılaştırıldı. Veriler SPSS programında analiz edildi. İstatistiksel anlamlılık düzeyi p<0.05 kabul edildi. Bulgular Preeklamptik gebelerde maternal kan ve plasental dokudaki MDA seviyeleri, sağlıklı gebelere göre anlamlı şekilde yüksekti (p<0.05). Umbilikal arter ve umbilikal ven MDA düzeyleri çalışma grubunda, kontrol grubuna göre daha yüksek bulunsa da istatistiksel olarak anlamlı değildi (p>0.05). Umbilikal arter ve uterin arterlerdeki Doppler sonografik indeksler, preeklamptik grupta kontrol grubuna göre anlamlı şekilde daha yüksekti (p<0.05). Tüm hastalar değerlendirildiğinde maternal ve plasental malondialdehit değerleri ile umbilikal ve uterin arter Doppler değerleri arasında anlamlı bir korelasyon saptanmadı. Sonuç Preeklamptik gebelerde, kan ve plasental dokudaki MDA düzeyleri ve fetomaternal Doppler değerleri kontrol grubuna göre anlamlı şekilde daha yüksek bulunmuş, ancak MDA düzeyleri ile Doppler değerleri arasında anlamlı bir korelasyon saptanmamıştır.

Keywords

• Oksidatif stres
• lipid peroksidasyonu
• malondialdehit
• Doppler sonografi
• plasental yetmezlik
• preeklampsi

Correlation of maternal blood, cord blood and placental tissue malondialdehyde levels with fetomaternal Doppler values in preeclamptic pregnant women

Abstract

Aim In this study, it was aimed to evaluate the correlation of malondialdehyde (MDA) levels in maternal blood, fetal blood and placental bed with fetomaternal Doppler values in preeclamptic pregnant women. Material and Methods The study was carried out with a total of 74 cases, 52 of whom were healthy and 22 were pregnant with preeclampsia.MDA levels were measured in maternal blood, cord blood and placenta tissues of the pregnant women. Doppler sonographic measurements were made in the uterine and umbilical arteries. Doppler values and MDA levels of preeclamptic and healthy pregnant women were compared. Results MDA levels in maternal blood and placental tissue in preeclamptic pregnant women were significantly higher than healthy pregnant women (p<0.05).Although umbilical artery and umbilical vein MDA levels were higher in the study group than in the control group, they were not statistically significant (p>0.05). Doppler sonographic indexes in the umbilical and uterine arteries were significantly higher in the preeclamptic group than in the control group (p<0.05). When all patients were evaluated, there was no significant correlation between maternal and placental malondialdehyde values and umbilical and uterine artery Doppler values. Conclusion MDA levels and fetomaternal Doppler values in blood and placental tissue were significantly higher in preeclamptic pregnants compared to the control group. However, no significant correlation was found between MDA levels and Doppler values.

Keywords

• Oxidative stress
• lipid peroxidation
• malondialdehyde
• Doppler sonography
• placental insufficiency
• preeclampsia
• Oksidatif stres
• lipid peroksidasyonu
• malondialdehit
• Doppler sonografi
• plasental yetmezlik
• preeklampsi

References

1. 1. Gestational Hypertension and Preeclampsia. "ACOG practice bulletin, number 222." Obstet Gynecol. (2020); 135(6): e237-e260.
2. 2. Young BC, Levine RJ, Karumanchi SA. Pathogenesis of preeclampsia. Annual review of pathology. 2010;5:173.
3. 3. Sibai B, Dekker G. Kupferminc M. Pre-eclampsia Lancet. 2005;365(9461):785-99.
4. 4. Tranquilli AL, Landi B, Giannubilo SR, Sibai BM. Preeclampsia: No longer solely a pregnancy disease. Pregnancy Hypertension: an International Journal of Women'S Cardiovascular Health. 2012;2(4):350-7. 5. Duley L, editor The global impact of pre-eclampsia and eclampsia. Seminars in perinatology; 2009: Elsevier.
5. 6. Brett SE, Jiang BY, Turner C, Ritter JM, Chowienczyk PJ. Elevation of plasma homocysteine by methionine loading increases the diastolic blood pressure response to exercise. Journal of hypertension. 2006;24(10):1985-9.
6. 7. Roberts JM, editor Pathophysiology of ischemic placental disease. Seminars in perinatology; 2014: Elsevier.
7. 8. Nelson DM, Kay H, Wang Y. The placenta: from development to disease: John Wiley & Sons; 2011.
8. 9. Luppi P, DeLoia JA. Monocytes of preeclamptic women spontaneously synthesize pro-inflammatory cytokines. Clinical immunology. 2006;118(2-3):268-75.

9. 10. Hubel CA. Oxidative stress in the pathogenesis of preeclampsia. Proceedings of the Society for Experimental Biology and Medicine. 1999;222(3):222-35.
10. 11. Kim YJ, Park H, Lee HY, Ahn Y-m, Ha EH, Suh SH, et al. Paraoxonase gene polymorphism, serum lipid, and oxidized low-density lipoprotein in preeclampsia. European journal of obstetrics & gynecology and reproductive biology. 2007;133(1):47-52.
11. 12. Alfirevic Z, Stampalija T, Medley N. Fetal and umbilical Doppler ultrasound in normal pregnancy. Cochrane Database of Systematic Reviews. 2015(4).
12. 13. Lopez-Mendez MA, Martinez-Gaytan V, Cortes-Flores R, Ramos-Gonzalez RM, Ochoa-Torres MA, Garza-Veloz I, et al. Doppler ultrasound evaluation in preeclampsia. BMC research notes. 2013;6(1):1-6.
13. 14. Yu J, Shixia C, Wu Y, Duan T. Inhibin A, activin A, placental growth factor and uterine artery Doppler pulsatility index in the prediction of pre‐eclampsia. Ultrasound in obstetrics & gynecology. 2011;37(5):528-33.
14. 15. Arauz JFR, León JCR, Velásquez PR, Jiménez GÁ, Pérez CJM. Umbilical artery Doppler velocimetry and adverse perinatal outcome in severe pre-eclampsia. Ginecología y Obstetricia de México. 2008;76(08):440-9.
15. 16. Gomez O, Martinez J, Figueras F, Del Rio M, Borobio V, Puerto B, et al. Uterine artery Doppler at 11–14 weeks of gestation to screen for hypertensive disorders and associated complications in an unselected population. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2005;26(5):490-4.
16. 17. Schwarze A, Nelles I, Krapp M, Friedrich M, Schmidt W, Diedrich K, et al. Doppler ultrasound of the uterine artery in the prediction of severe complications during low-risk pregnancies. Archives of gynecology and obstetrics. 2005;271(1):46-52.
17. 18. Newnham JP, Patterson LL, James IR, Diepeveen DA, Reid SE. An evaluation of the efficacy of Doppler flow velocity waveform analysis as a screening test in pregnancy. American journal of obstetrics and gynecology. 1990;162(2):403-10.
18. 19. Skotnicki MZ, Flig E, Urban J, Hermann TW. Doppler examinations in the prognosis of birth status of the newborn. Medical Science Monitor. 2000;6(3):MT611-MT5.
19. 20. Cruz-Martinez R, Figueras F. The role of Doppler and placental screening. Best practice & research Clinical obstetrics & gynaecology. 2009;23(6):845-55.
20. 21. Werner S, Obstetri KA. Jinekolojide Renkli Doppler Sonografi çeviri editörü Ertan Kubilay, Tanrıverdi H. Alper Nobel Tıp Kitabevleri. 2003:131-36.
21. 22. ACOG. American College of Obstetricians and Gynecologists. Hypertension in Pregnancy. American College of Obstetricians and Gynecologists Washington, DC; 2013.
22. 23. Wasowicz W, Neve J, Peretz A. Optimized steps in fluorometric determination of thiobarbituric acid-reactive substances in serum: importance of extraction pH and influence of sample preservation and storage. Clinical chemistry. 1993;39(12):2522-6.
23. 24. Esterbauer H, Cheeseman KH. [42] Determination of aldehydic lipid peroxidation products: malonaldehyde and 4-hydroxynonenal. Methods in enzymology. 186: Elsevier; 1990. p. 407-21.
24. 25. Mohseni R, Karimi J, Tavilani H, Khodadadi I, Hashemnia M. Carvacrol downregulates lysyl oxidase expression and ameliorates oxidative stress in the liver of rats with carbon tetrachloride‐induced liver fibrosis. Indian Journal of Clinical Biochemistry. 2020;35(4):458-64.
25. 26. Adiga U, D'souza V, Kamath A, Mangalore N. Antioxidant activity and lipid peroxidation in preeclampsia. Journal of the Chinese Medical Association. 2007;70(10):435-8.
26. 27. Veronica M, Jaime L, Alvaro C. Antioxidant activity and lipid peroxidation in preeclampsia. Biol Res. 2006;39:229-36.
27. 28. Gupta S, Aziz N, Sekhon L, Agarwal R, Mansour G, Li J, et al. Lipid peroxidation and antioxidant status in preeclampsia: a systematic review. Obstetrical & gynecological survey. 2009;64(11):750-9.
28. 29. Aydın S, Benian A, Madazli R, Uludaǧ S, Uzun H, Kaya S. Plasma malondialdehyde, superoxide dismutase, sE-selectin, fibronectin, endothelin-1 and nitric oxide levels in women with preeclampsia. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2004;113(1):21-5.
29. 30. Çelik H, Sapmaz E, Kılınç N, Çıkım G, Tuğ N, Parmaksız C, et al. Dergi Kimliği. Perinatoloji Dergisi. 2002;10(3):3.
30. 31. Bogavac M, Lakic N, Simin N, Nikolic A, Sudji J, Bozin B. Biomarkers of oxidative stress in amniotic fluid and complications in pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine. 2012;25(1):104-8.
31. 32. Myatt L, Clifton RG, Roberts JM, Spong CY, Hauth JC, Varner MW, et al. The utility of uterine artery Doppler velocimetry in prediction of preeclampsia in a low-risk population. Obstetrics & Gynecology. 2012;120(4):815-22.