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 (ISBN-13: 9780511286988)

Pre-eclampsia
Cambridge University Press
978-0-521-83189-5 - Pre-eclampsia: Etiology and Clinical Practice - by Fiona Lyall and Michael Belfort
Index

Subject Index



(tables in bold, figures in bold italics)

abrupto placentae 259, 372, 375, 377, 388, 417, 418, 446, 476, 526, 527, 530

absent or reversed end-diastolic flow (AREDF) 156, 501

acetylcholine 189

acute fatty liver of pregnancy (AFLP) 486

acute fatty metamorphosis of pregnancy (AFMP) 391, 394

acute renal failure (ARF) 54, 352, 417–18

causes 417

incidence in pre-eclampsia 352, 437, 438, 446, 476

treatment 352

adenosine triphosphate 140, 143

adhesion molecules. See cell adhesion molecules

adipocytes 104, 104, 106, 165, 225

adipogenesis 177

adrenal glands 404

adrenaline 55

adult respiratory distress syndrome (ARDS) 478

aldosterone and aldosteroism 382, 384, 403

alkalosis 404

α-actin 12

alpha-adrenergic blockers 331

α2-globulin angiotensinogen (Aogne) 78, 82, 83

American Association for the Advancement of Medical Instrumentation (AAMI) 250

American College of Obstetricians and Gynecologists (ACOG) 244, 245, 261, 331, 445

American Society of Anesthesiologists (ASA) 463

anesthesia

for Cesarean section 466–8

evaluation 463–6

for labor 375, 444, 453–4, 463–8, 467

maternal monitoring following 464

patient-controlled epidural (PCEA) 466

postoperative care following 468–9

regional 466–8

angiogenesis

adipogenesis and 177

circulating factors 62

proteins associated with 223–4

regulation 40

renin-angiotensin system effects on 85

soluble fms-like tyrosine kinase 1 (sFlt-1)

stimulation by hypoxia 156

suppression in villus 141

vascular endothelial growth factor and 62, 84

angiography 141, 143, 395, 403, 415, 441, 477

angiotensin

(1-7) 81

II 51, 56, 80, 84–5, 87, 112, 211, 225

III 81

IV 81–2

AGT gene for 210

fragments 81

polymorphisms 185

receptor antibodies 225–6

synthesis of 79, 211, 300–1

angiotensinase 80

angiotensin-converting enzyme (ACE) and inhibitors 56, 80, 86, 349, 363, 511

animal models 3, 209–10, 210, 211, 212

anticoagulants. See blood clotting

antigens. See specific antigen

antiphospholipid(s) 318

antiphospholipid syndrome (APS) 333

antioxidant(s)

ascorbic acid (vitamin C) 123

defense against oxidative stress 121–3

enzymatic 122–3

lipid-soluble 124

pathways 123

pre-eclampsia and 126, 128–32

prophylaxis 190

proteins 123

water-soluble 123

apolipoprotein B 176

apoptosis

cascade 157, 158

cellular 9, 30–1, 41, 43, 127, 146

definition 30

endothelial 6

inhibition 132

macrophage regulation of 41, 44

markers 112

nitric oxide and 131

nucleus shedding and (see nucleus shedding)

placental 187, 188, 307

in pre-eclampsia 112, 146

syncytial 111

appendicitis 388

ARED. See absent or reversed end-diastolic blood flow

arginine vasopressin (AVP) 343

arteriovenous malformations (AVMs) 398

ascites 389–91

ascorbic acid 123

aspirin. See pre-eclampsia: aspirin therapy

Association for the Advancement of Medical Instrumentation 250, 258, 267

asthma, in pre-eclampsia 335

asymmetric dimethylarginine (ADMA) 53, 54, 64

atelectasis 478, 483, 512

atherosclerosis 52, 54, 56, 185, 238

atherosis

acute 3, 4, 9, 11, 13, 14, 63, 139, 140, 147, 148, 172

incidence 13

lesions 4, 15

lipoprotein(A) as early indicator of 13

origin 147

Australasian Society of Hypertension in Pregnancy (ASSHP) 243

pre-eclampsia classification 245, 245, 247, 248, 253

Barker hypothesis 520

benzodiazepines 440, 481, 482

beta-blockers 331, 349, 411. See also hypertension: treatment

biliverdin, carbon monoxide production and 26

birth. See Cesarean section; pregnancy; premature birth

Bishop score 375

blood clotting

anticoagulants 307–9

coagulation cascade in 184, 305, 458

endothelium role in 57

factors 306, 311–14, 312–13, 315

gain of function defects in 308–9

hypercoagulability 458–9

mechanism 305–6

in pre-eclampsia 219–21, 455

during pregnancy 61, 173, 306–7

pro-thrombin time (PT) 458

tissue factor (TF) and 305

See also thrombin; thrombophilia; thrombosis

blood plasma proteins 13

blood pressure

ambulatory monitoring of 267–8

Korotkoff sounds and 264, 264–5

measurement 249, 249–50, 258, 262–3, 265–9, 479

physiological control of 351

postural effects on 265, 266

variability 263

See also heart; hemodynamics; hypertension; pregnancy: hypertension during

blood urea nitrogen (BUN) 346, 346–7, 394, 396, 418, 458

blood volume 198, 259

bradycardia, fetal 406, 440, 523, 524, 528

British Hypertension Society (BHS) 250, 258, 267

cadherin 24

calcium channel agonists and antagonists 331, 349–50, 409, 462, 480. See also nicardipine; nifedipine

cAMP. See cyclic adenosine monophosphate

Canadian consensus statement on pre-eclampsia 244

carbon monoxide 26

cardiovascular system. See blood pressure; heart; hemodynamics; hypertension; hypotension; vascular

catecholamines 141, 189, 199, 200, 383–4, 507

cell adhesion molecules (CAMs) 21, 24, 56

abnormal expression of 22

cadherins 22

cytotrophoblast invasion and 22, 24–5

intracellular adhesion molecule (ICAM) 22

ligands for 22

melanoma (MCAM) 44

platelet endothelial (PECAM-1) 22, 24

pre-eclampsia and 24–5

selectins 22, 56

trophoectoderm attachment and 22

vascular (VCAM) 22, 24

cell columns 21, 37, 44

cell culture

cell lifespan extension in 39, 43

cytotrophoblast 37–9, 42–5

of endothelial cells 66

extravillous trophoblasts in 41–2

of fibroblasts 40

of human umbilical vein endothelial cells (HUVECs) 40

limitations of 39

of macrophages 40–1

oxygen levels and 38, 40

of placental endothelial cells 40

proliferation in 38, 43

syncytiotrophoblast 37–8

techniques 37–40, 42–5

of villous mesenchymal cells 40

cell islands 21

cell migration 41, 43, 44, 169–71, 516

central nervous system

Circle of Willis 424, 425, 427

disease in later life 236–7

dysfunction in neonates 516–17

edema 428, 429, 430, 476. See also edema

hemodynamics 424–8, 428, 430–2, 459

hemorrhage in 428, 438, 443, 476, 479, 516, 522

hyperexcitability 459

hyperreflexia 459

ischemic infarction 425, 428, 433, 520

pre-eclampsia and 428–33, 459

therapeutic agents 130, 432–3

cerebral perfusion pressure (CPP) 430–2

cerebrospinal fluid 401

Cesarean section 125, 145, 147, 364, 375, 514

in abruption placentae 372, 527

biopsies during 4, 20, 45, 60

eclampsia and 444

pre-eclampsia and 365, 484, 528

chest pain. See pain: chest

cholesterol 56, 106, 112, 166, 168, 169, 171, 173, 175, 185. See also lipoprotein

cineradioangiography. See angiography

clotting. See blood clotting

coagulation. See blood clotting

collagen. See extracellular matrix: collagen

complement 13, 105, 106

computed tomography imaging 477, 482

abdominal 392, 401, 407

cerebral 429, 430, 441, 476, 517

consanguinity studies 298

contraceptives 236, 282, 283

convulsions and seizures 399–401

eclamptic 402, 444–5

from lupus 399

prevention 460 (see also diazepam; magnesium sulfate; phenytoin)

therapy 444, 481, 529

corticosteroids 27, 335, 371

corticotrophin releasing hormone (CRH) 189, 225

cough 385

counseling, for pre-eclampsia 301–2, 335

C-reactive protein (CRP) 104–6, 110, 169

creatinine, serum

in pre-eclampsia 245, 346, 394–5, 455

in pregnancy 346

protein ratio 252–3

and renal function 346

Cushing's syndrome 403, 404

cyclic adenosine monophosphate (cAMP) 44, 54

cyclic guanylate monophosphate (cGMP) 58–9, 63, 456, 460, 462, 468

cytokeratins 5, 10, 11, 13, 21, 25, 38, 43

cytokines

in cell culture 38

in decidual tissue 30

effects 38, 41, 51

hypoxia and 29, 187, 201

inflammatory 9

maternal cell derived 9

MMP release and 27

in pre-eclampsia 9, 28, 289

synthesis and release by macrophages 9, 14, 41, 106, 146

transforming growth factor-βs (see transforming growth factor-βs)

tumor necrosis factor-α (TNF-α) (see tumor necrosis factor-α)

cytotrophoblast(s)

adhesion molecule expression and 22

cell adhesion molecules and 22, 24–5

in cell culture 37–9, 43

endothelial CAM expression 24

endovascular 21

hemeoxygenase expression 26

HLA-G expression 30

integrin expression 24, 29

integrin switching 22–3

interstitial 21

invasion 22, 276

late gestation 23

placental bed 23

pre-eclampsia and 24–5, 31, 67

proliferation 154, 154

stroma and 44

cystatin C 347

diabetes

blood volume and 198

gestational 172, 173

insipidus (DI) 343

and intrauterine growth restriction 520

placental bed lesion and 14

pre-eclampsia and 62, 105, 112, 113, 185, 253–4, 332–3

See also metabolic syndrome

dialysis 352, 446

diazepam 440, 441, 442

disseminated intravascular coagulation (DIC) 396, 437, 438, 446

diuretics 331, 349, 352, 515

donor

embryos 329

oocyte 286–9, 329

semen 286–9, 329

dopamine 483

Doppler imaging

for arcuate arteries 358

academia and 492–4

assessment 7, 67, 139, 364, 382, 384, 392, 395, 425, 479, 492–8

in cerebral arteries 426, 428, 432, 433, 443, 477, 489, 490, 494

color 425, 489, 490

for ductus venosus 489–92, 494–5, 496

for early diastolic notch 223, 358

in fetal assessment 364, 491

of hepatic artery 459

hypoxemia and 489–92

indices 489, 492–6

in pre-eclampsia 223, 497–8 (see also Doppler imaging: assessment; Doppler imaging: umbilical artery; Doppler imaging: uterine artery)

umbilical artery 364, 455, 489, 490, 492, 494, 495, 498–9, 506

uterine artery 189, 202, 217, 223, 358, 489–90, 491, 492, 497, 497–8

waveform acquisition and interpretation 489–92

waveform indices 489

dysfibrinogenemia 309

dyslipidemia 168

cardiovascular risk and 172–4

causes 164–6, 173, 175

pre-eclampsia and 105, 168, 174–6, 185

dyspnea 381, 383, 412

echocardiography 384–5, 479, 483

eclampsia 245, 406–7, 452, 480–2

clinician's perspective on 247

complications 441, 443

delivery and 444

diagnosis 245, 440, 441, 452–3

fetal outcome of 417, 440

incidence 289, 406, 437

long-term maternal outcome of 439, 445–6

management 438–45, 481, 529

natural history of 438

post-delivery 366

prevention (see magnesium sulfate: for eclampsia treatment and convulsion prevention)

prognosis 438

symptoms 437, 438

treatment (see magnesium sulfate: for eclampsia treatment and convulsion prevention)

See also convulsions and seizures

edema,

cerebral 428, 429, 476

cytotoxic 430, 433

facial 383

in late pregnancy 215, 383

peripheral 383

pharyngolaryngeal and glottic 413–14, 452

pulmonary 244, 382–3, 412–13, 437, 438, 446, 454, 476, 477, 480, 483, 484

vasogenic 430

elastin 21, 27

electrocardiography 385

ELISA 29, 130

embryonic stem cells (ES) 23, 39, 307

endometrium 83, 138

endothelial cell(s)

activation 184

damage 56–7, 174, 307

dysfunction 164

interactions with leukocytes and trophoblasts 38

in spiral arteries 24

villous 24

endothelial derived vaso-active factors 50–6, 51, 61, 109, 456. See also nitric oxide synthase; prostacyclins; prostaglandins

endothelial vasodilator bradykinin (BK) 60

endothelins 51, 55, 61, 64–5, 109, 112

endothelium

angiotensin-converting enzyme (ACE) expression 56

apoptosis 6

blood clotting factors 57

and cardiovascular adaptation to pregnancy 50 (see also pregnancy: cardiovascular changes during)

-derived vaso-active factors 50–5

dysfunction in pre-eclampsia 175, 176, 185, 217, 221, 259

estrogen receptors 53

function 40, 50, 55, 109, 217

healthy pregnancy and 57–8

inflammatory network and 103

markers of dysfunctional 63

pathologies induced by 50

placental 40

repair 6, 12

replacement by trophoblasts 6, 10

structure of 6, 12, 40, 50

thrombosis and 61–2, 456

tissue plasminogen activator (t-PA) secretion by 57

vaso-active factors and (see endothelial derived vaso-active factors)

See also endothelial cell(s)

endothelium-derived hyperpolarizing factor (EDHF) 50, 51, 55, 60, 61, 81

enzymes, matrix degrading. See matrix-degrading enzymes

epinephrine. See catecholamines

epigastric pain. See pain: epigastric

erythrocytes 128, 129

estrogen 52–3, 82, 98, 139, 165, 165, 199

European Society for Hypertension 267

extracellular matrix 12, 21–3, 40

collagen 21–3, 40

fibronectin 13, 21–3, 40, 57

fibrinogen 22, 62, 106, 305, 306, 458, 459

glycosaminoglycans (GAGs) and 21

laminin 21–3, 27

thrombospondin 22

vitronectin 22, 23

von Willebrand factor 22, 40, 57, 62, 306, 307, 485

factor V Leiden 301, 308–14, 312–13, 318, 319, 328. See also thrombophilia

fetal

antigens 13

assessment 364–5, 374

blood characteristics 508, 509

bradycardia 406, 440, 523, 524, 528

brain damage 526, 528

distress 511–16, 527–30 (see also respiratory distress syndrome)

growth (see intrauterine growth restriction)

heart rate monitoring 498–501, 500, 506, 527, 532 (see also heart: rate)

hypothermia 509

hypoxia 365, 508, 512

intrauterine growth restriction (see intrauterine growth restriction)

lung maturity (FLM) assay 511

nutrient availability 188

/placental signal 186, 187–90

programming 520

reserve 372

surfactants 511

See also fetus; neonate(s)

fetus

as allograft 97, 99, 201, 276

early impairment of 364, 522

HLA-C combinations with mother 97, 97

long-term complications of PIH 514–16, 520

maternal drugs and 511

small for gestational age (SGA) 507

See also fetal; neonate(s)

fibroblast proliferation 12

fibrin deposition 13, 139, 140, 159, 305, 318, 458, 459

fibrinogen. See extracellular matrix: fibrinogen

fibrinoid necrosis 6, 172

fibrinolysis 62

fibrinolytic system 169, 306

fibroblasts 5, 12, 21, 40, 41, 43

fibronectin. See extracellular matrix: fibronectin

foam cells 3, 9, 11, 13, 14, 140, 172

free fatty acids (FFAs) 105, 164–6, 165, 167, 168–71, 171. See also lipid(s)

free radicals 121–2, 127, 127–8, 144, 145

superoxide 121, 122, 144, 145, 226

See also reactive oxygen species

FII G20210A and pre-eclampsia 308, 309, 311, 315, 318, 319 (see also blood clotting: factors)

gene

arrays 45

association studies 298–300

mapping 295, 298

See also specific gene or expression product

gestosis index 282

glucose tolerance 173, 221, 302

haplotype mapping 295

headache 245, 397–8, 438, 445, 459

heart

cardiac output 57, 195, 199, 200, 259, 265, 301, 343, 382, 384, 398, 411, 413, 425, 453, 453–5, 461, 466, 466, 478, 479, 481, 482, 489, 493

diastolic dysfunction 410

disease 112, 171, 173, 437, 520

ischemia 174, 236, 238, 327, 381

rate 57, 58, 200, 259, 371, 372, 374, 375, 403, 408, 413, 440, 453, 461, 466, 467, 479, 490, 499, 506, 525, 526, 529

rate monitoring, fetal (see fetal: heart rate monitoring)

stroke volume 57, 58, 425, 413, 453, 461, 479, 480

ventricular arryhthmias 411–12

See also blood pressure; bradycardia, fetal; hemodynamics; hypertension; hypotension; tachycardia; vascular

HELLP syndrome 14, 82, 244, 277, 289, 295, 302, 343, 372, 389, 414–17, 417, 437, 445, 452, 455–7, 459, 465, 468, 476, 478, 483–4, 506, 513, 522

hemeoxygenase (HO) 26

hemodynamics

autoregulation and 408, 424, 425, 430–2, 459, 477, 480, 516

kidney 341–2

spiral artery 7, 113, 139, 141, 437

systemic vascular resistance 453, 455, 480

See also blood pressure; heart; hypertension

hemolysis 372, 389, 390–1, 391, 394–7, 414, 452, 453. See also HELLP syndrome

hemolytic uremic syndrome (HUS) 394, 396, 397, 485, 522

hemoptysis 385

hemostasis (see blood clotting; thrombin; thrombophilia; thrombosis)

heparin sulfate 22, 23, 57, 334

hepatic. See liver

hepatocytes 38, 104, 104, 165

high altitude

pregnancy hypertension 195–201

immune function 195

placenta and 195, 201–3

ischemia 195, 202

pre-eclampsia 195, 196

sympathoadrenal effects 200

high performance liquid chromatography (HPLC) 81, 200

histocompatibility antigen 30, 96–8, 107

Hofbauer cells. See macrophage(s): isolated placental

homocysteine 128, 185, 221, 310, 314

Hon pattern asphyxia 527, 528, 529

human chorionic gonadotrophin (HCG) 38, 39, 225

human umbilical vein endothelial cells (HUVECs) 40, 66

hydralazine 331, 348, 348, 371, 376, 377, 408, 409, 409, 411, 443, 461, 480, 525 (see also hypertension: treatment)

hydrogen peroxide 56, 121

hyperglycemia 112, 384, 403–4, 409

hyperhomocysteinemia 185, 310, 314

hyperlipidemia 105, 115, 166, 168, 173

hyperoxia, placental 140–1, 145

hypertension

cardiomyopathy and 410–11

chronic (essential) 12–14, 85, 112, 113, 253–4, 301, 330–2

classification 246, 263–4, 479–80

early diagnosis 258

in eclampsia 437, 446

elevated asymmetric dimethylarginine (ADMA) and 54

genetic basis for 210

gestational (see hypertension: in pregnancy)

hemorrhage from 408, 476

high altitude and 195–6 (see also high altitude)

long-term effects 234–6, 514–16, 520

management 258

metabolic syndrome and 106 (see also metabolic syndrome)

nitric oxide synthase and 52

in non-pregnant women 13

placental contribution to 211–12

and pre-eclampsia (see pre-eclampsia: hypertension and)

in pregnancy 13–15, 82, 86, 128, 129, 174, 195, 199, 234–7, 243–4, 246, 248, 250, 260, 263, 283, 285, 287, 295, 298, 357–9, 369, 428, 451, 506, 507

pregnancy-induced (PIH) (see hypertension: in pregnancy)

proteinuric 14

reproductive history and 238

treatment 331, 345, 348, 377, 348, 363–5, 376–7, 409 (see also alpha-adrenergic blockers; calciumchannel agonists and antagonists; hydralazine; nitroglycerin; sodium nitroprusside)

See also blood pressure; heart; hemodynamics; hypotension

hypertriglyceridemia 169, 171–3

hyperuricemia 393–4

hypoglycemia 392, 399, 441, 461, 486, 507, 508, 509, 510, 511, 512

hypokalemia 382, 384, 403

hypotension 109, 258

hypoxia

biochemical effects 55, 84, 143, 144

fetal growth restriction and 3, 29

in intervillous space 111

placental 111, 140, 143

pre-eclampsia and 29, 140

resistance to 143

trophoblasts and 29

See also oxygen level

hypoxia inducible factor 1α (HIF1α) 29–30, 84, 202

hysterectomy 5, 9, 20, 45, 485

imaging. See computed tomography imaging; Doppler imaging; magnetic resonance imaging

immune system

cells 40, 99

danger hypothesis 99

inflammatory (innate) 104, 108

missing self hypothesis 99

responses 40, 103, 104, 107–8, 114

self/infectious non-self model 99

immunoglobulins

in atherosis 13

intracellular adhesion molecule (ICAM) 22, 24, 25, 56, 218

platelet-associated G (IgG) 309, 397, 456, 513

platelet endothelial cell adhesion molecule (PECAM-1) 22, 24, 25

vascular cell adhesion molecule (VCAM) 22, 24, 25, 68, 218

immunohistochemistry 5, 22, 24, 29, 40, 145, 146

implantation 12, 27, 62, 183, 276, 289

infant. See neonate(s)

inflammation

adhesion molecules and 56

cytokine-mediated 307

immunological basis for 94, 104, 164, 185

nuclear factor kappa-B (NF-κB) regulation of 106

oxidative stress in 105

in pregnancy 94, 98, 106–7

response (see inflammatory: response)

systemic 104–5, 113

inflammatory

cascade 173, 190

cells 9, 14

network 103–4, 109

response 103–10, 113, 131, 184, 186

insulin

resistance 105, 107, 164, 165, 169, 173, 175, 176, 185, 221, 237, 238

sensitivity 164, 170

serum SHBG and 221

insulin-like growth factor II (IGFII) 44, 211, 212, 223

integrins 22–4, 42, 56

interbirth interval 278, 279

interleukins 30, 40, 45, 223, 286

International Society for the Study of Hypertension in Pregnancy (ISSHP) 130, 260, 261

intimal thickening 6, 7, 12, 14

intrauterine growth restriction (IUGR)

adult onset disease and 520

animal models for 210, 211, 212

Aogen and

asymmetrical 507, 519

Barker hypothesis and 520

cause 148, 507. See also placenta(l)

circulatory changes in 185, 198, 493

fetal/maternal signal and 189

hypoxia and 29, 141, 145, 156, 365

lupus in 333

in pre-eclampsia 138, 140, 147, 164, 188, 372, 437, 506–8, 519

without pre-eclampsia 13, 14

severe 158, 372, 518, 519

symmetrical 507

trophoblasts and 146, 224

ischemia. See high altitude; hypoxia; placenta(l)

ischemia-reperfusion

hypoxia comparison 146–7

free radicals in 145, 146

in vitro model of 146

injury from 141, 143–7

in pre-eclampsia 141–2

ischemic heart disease 174, 236, 238, 327, 381. See also heart

isoprostanes 124, 126, 175, 187, 188, 222

IUGR. See intrauterine growth restriction

jaundice 388–92, 394, 396, 486, 509. See also liver

kidney(s)

allografts 13

antenatal assessment of 345

biopsy 350, 394

blood flow 222, 394

dialysis 352, 446, 483

disease 13, 253–4, 259, 334–5, 339, 381, 478

effective renal plasma flow (ERPF) 341, 342

elevated asymmetric dimethylarginine (ADMA) and 54

failure (see acute renal failure)

fluid management 350–1

glomerular changes in pre-eclampsia 339, 340

glomerular filtration rate (GFR) 222, 341, 342, 454

hemodynamics 341–2

inulin clearance 346

ion excretion 222

non-reversible damage to 345

performance in normal pregnancy 341

performance in pre-eclampsia 334–5, 339–42, 344–52, 392, 455, 478, 482–3

protein excretion by 250, 252–3, 343–4

sodium homeostasis 343

tubular function 343

urea 222

urinalysis 395

urine output 252, 343–4, 350, 351

See also proteinuria

killer immunoglobulin-like receptors (KIR) 94, 95, 95, 97, 99

labetalol 348, 349, 363, 409, 461, 480, 507, 511

laminin. See extracellular matrix: laminin

legal issues

ambulatory women's health care services 531

communication among health professionals 524

concept of notice 531

documentation 524

foreseeability of harm 523–5, 531, 532

malpractice lawsuits in obstetrics 522, 524

outpatient care 530

outpatient vs. inpatient care 530–1

pre-eclampsia litigation 525–7, 531, 533

telephone liability 531–2

timing of delivery 532–3

training of physicians and lawyers 523

leptin 38, 85, 106, 165, 168, 185, 189–90, 219

leukocytes 22, 25–7, 38, 68, 103. See also macrophage(s); natural killer cells; T cells

liability. See legal issues

linkage disequilibrium 295, 299–301, 300. See also gene lipid(s)

lipid(s)

markers 168

metabolism 130, 164–70, 172

peroxides 168

in pre-eclampsia 130, 166–9, 174–6, 185

See also dyslipidemia; lipoprotein

lipoprotein

(A) 13

cholesterol 56, 106, 112, 166, 168, 169, 171, 173, 175, 185

high density (HDL) 113, 165, 166, 168, 169, 171, 173, 175, 185

intermediate density (IDL) 165, 165, 169

lipase 166, 169, 173

low density (LDL) 113, 130, 165, 166, 168, 169, 171, 172, 175, 185, 187, 297, 369

metabolism 165

receptors 169

triglyceride-rich 171 (see also triglycerides)

very low-density (VLDL) 165, 166, 169, 171, 173, 175, 185

See also dyslipidemia; lipid(s)

liver

dysfunction 390–1, 415, 437, 459, 478, 483, 486

cells (see hepatocytes)

enzymes 244

function tests 391–2

rupture 415–17, 438, 459

See also hepatocytes; jaundice

lymphocytes, natural killer (see natural killer cells)

lung(s)

bronchodilators 515

edema symptoms 385

fetal maturity assay (FLM) 511

function testing 386

lamellar body count 511

neonatal 369, 371

ventilation 197, 512

lupus

anticoagulant 333

erythematosus 254, 318, 326, 330, 333–4, 389, 397, 399, 481, 484, 485

inhibitors 309

renal 333, 478

macrophage(s)

apoptosis induced by 41, 44

cell culture 40, 43

cytokine synthesis 9

functions 40, 223

infiltrations 9

inflammatory responses and 103

isolated placental 41

isolation techniques 40

lipid-rich (see foam cells)

placental 40–1

renin-angiotensin system in 84

magnesium sulfate

dose 442, 460

for eclampsia treatment and convulsion prevention 350, 365, 371, 373–6, 386, 399, 403, 407, 407, 442, 429, 432, 440–2, 444, 460, 468, 469, 477, 511, 525

mechanism 433, 442, 460, 481

toxicity 407, 407–8, 414, 442, 461, 481

magnetic resonance imaging 142, 172, 382, 401, 427–30, 427–9, 431, 432, 433, 437, 476, 477, 482. See also computed tomography imaging; Doppler imaging

major histocompatibility complex (MHC) antigens 38, 40, 94, 96–8, 107, 286

malpractice lawsuits 522, 524. See also legal issues

matrix-degrading enzymes 6, 22, 23

matrix metalloproteinases (MMPs) 26–8, 44

metabolic syndrome 105, 106, 169, 170, 173, 176, 184, 219

methyldopa 331, 348, 349, 363, 364, 377

methylene tetrahydrofolate reductase 310, 314, 316–17

microarray analysis 43, 219

microparticles 37–41, 43–5, 127. See also apoptosis; inflammation

monocytes 106, 188

MR. See magnetic resonance imaging

myo-intimal cells 12

myometrium 4, 8, 12, 21, 53

National High Blood Pressure Education Program Working Group Report on High Blood Pressure in Pregnancy 258, 260, 383, 451

natural killer cells 43, 94–7, 99, 103, 276

neonate(s)

antibiotic therapy for 513

bronchopulmonary dysplasia (BPD) 514

central nervous system problems 516–20

chronic lung disease 514, 515

colony stimulating factors (G-CSF, GMCSF) 513

death 525

feeding 509–11

hypoglycemia

infection 513–14

long-term complications and outcome of PIH 507, 508, 514–18

periventricular dysfunction 516–17

physiotherapy 518

premature 164, 243, 362, 370, 518–19

protective effect of vaginal birth for 514

short stature 519

steroid use 515

vision and hearing problems 518–19

neutrophils 68, 106, 122, 146, 188

nicardipine 462

nifedipine 331, 348, 349, 350, 371, 373, 374, 376, 377, 409, 409, 462. See also calcium channel agonists and antagonists

nimodipine 432

nitric oxide

and angiotensin (1-7) 81, 87

asymmetric dimethylarginine (ADMA) and 64

biochemistry 25–6, 52, 59, 63–4, 171, 211

functions 51, 170, 512

in pre-eclampsia 131, 212–13, 222

reactive oxygen species and 56

shear-stress and 55

syncytiotrophoblasts and 25

synthase (see nitric oxide synthase)

nitric oxide synthase 25–6, 52

activation 52–3, 59–60

functions 52, 60–1

in healthy pregnancy 58–62

inhibitors 53–4, 60

isoforms 52

NOS3 gene for 210

pathologies linked to 52

polymorphisms 219

in pre-eclampsia 131

upregulation in pregnancy 60

nitroglycerin 61, 375, 409, 409, 410, 462

NK cells. See natural killer cells

non-insulin-dependent diabetes mellitus (NIDDM) 172, 173, 326

norepinephrine. See catecholamines

nuclear magnetic resonance (NMR) spectroscopy. See magnetic resonance imaging

nucleus shedding 156–60, 161

apnecrotic 158–60, 159, 161

arrested apoptotic 158, 159, 161

knot-like apoptotic 157–8, 161

necrotic 159, 160, 161

wave-like apoptotic 158, 159, 161

See also apoptosis

obesity 106, 110, 112, 113, 113, 164, 169, 173, 175, 190, 195, 218, 220, 221, 234, 237, 278, 279, 326, 404

outpatient care 530–1. See also legal issues

oxidative stress

antioxidant defense for 105, 121–3

assessment 124–5

biochemistry 127, 128, 170–1

cytokine-mediated 307

in endothelial cells 145

free radicals (see free radicals)

markers 107, 110, 126, 175, 187, 188, 221

in normal pregnancy (see pregnancy: oxidative stress in)

placental 131, 138, 148, 188

in pre-eclampsia 110, 121, 125–31, 127, 185, 187, 187, 319

rapid cellular response to 122

systemic inflammation and 105, 131

target 128

vascular dysfunction and 170–2

oxygen consumption 143, 197, 199, 442, 453, 468

oxygen level

in cell cultures 38, 40

effect on trophoblast gene expression 42

in intervillous space 38, 144, 145

in maternal blood 140

in placental tissue 29, 125, 156

See also hypoxia

oxytocin 142, 407, 484, 528

pain

chest 380–1, 388

epigastric 245, 259, 374, 381, 383, 400, 414, 415, 438, 445, 459, 483

pancreatitis 387, 388, 392, 415, 416, 437

para-aminohippurate (PAH) 341, 346

patient management

antenatal daycare units (ADU) 360–4, 366

home monitoring programs 361–2

outpatient 360

perinatal. See fetus; pregnancy

periodic acid Schiff (PAS) 5, 7, 9, 10, 465

petechiae 394, 395, 397

phenytoin 406, 407, 407, 441, 442, 442, 444, 481

pheochromocytoma 141, 254, 331, 332, 382, 395

placenta(l)

abruption (see abrupto placentae)

animal models 210

apoptosis (see apoptosis)

blood flow 3, 7, 93, 125, 139, 142, 184, 186, 188, 459–60, 529

biopsies 4, 8, 14, 20, 22, 24, 30, 188, 189

blood pressure 139, 265

cardiovascular regulation 211

debris 112

development 3, 14, 20, 21, 42, 66, 67, 139, 195, 307

endothelial cells 40

free radical synthesis in pre-eclampsia 125

function 110–12, 225

histopathology 110, 152

hormones 189, 225

infarcts 3, 13

ischemia-reperfusion (see ischemia-reperfusion)

ischemia and infarction 94, 141–2, 154, 318, 319

leptin synthesis 190 (see also leptin)

lipid perodication 172

maternal circulation 138–9, 143

metabolism 140, 143

oxidative stress 126, 188 (see also oxidative stress)

oxygen levels 140–3, 145

pre-eclampsia and (see pre-eclampsia: cardiovascular changes during; pre-eclampsia: hypertension and)

reserve capacity 13

syncytial knotting (see syncytial: knotting)

placenta-like growth factor 224, 437

plasminogen activator inhibitor (PAI) 29, 51, 56, 57, 62, 81, 219, 221, 226

platelet(s)

activation 220, 305

adhesion and aggregation 62

consumption 358, 397, 455

inflammatory network and 104

normal values 220, 243–4

in pre-eclampsia 220, 455–8

polycythemia 394, 508–9

pre-eclampsia

abdominal pain 387–9 (see also pain: epigastric)

age and 319, 325–6

anesthesia during (see anesthesia)

angiogenic factor circulation and 66–7

angiotensin polymorphisms and 185

antioxidants 126, 128–30

apoptosis 112 (see also apoptosis)

aspirin therapy 66, 131, 216, 218, 220, 222, 302, 334, 457 (see also pre-eclampsia: therapy/treatment)

assisted reproduction and 286, 329–30

asthma and 335

asymmetric dimethylarginine (ADMA) in 54, 64

blood clotting 219–21, 455 (see also blood clotting)

carboxyhemoglobin levels 453

cardiovascular changes during 259, 452, 453, 454, 462–3, 477–8 (see also heart; hemodynamics; hypertension; hypotension; vascular)

cardiovascular disease and 164

causes 40, 68, 164

cell adhesion molecules and 24–5, 56

cGMP and 63 (see also cyclic guanylate monophosphate)

classifications 113, 215, 216, 243–5, 247, 253, 377

cognitive changes 398, 399

consequences 218–19, 259

counseling 301–2, 335

cytokine levels 9

cytotrophoblast invasion and 24–5

dangerous partner effect in 288

diabetes and 332–3

diagnosis and assessment 93–4, 184, 216, 246, 249, 260–2, 344–5, 359, 362–3, 451, 484–6 (see also pre-eclampsia: symptoms)

Doppler assessment (see Doppler imaging)

dyslipidemia and 174–6 (see also dyslipidemia; lipid(s); lipoprotein; pre-eclampsia: lipid profile)

early fetal problems due to 507–13

edema 215 (see also edema)

endocrine disorders 403

endometrial abnormalities 138, 184

endothelial dysfunction 62–8, 221, 259

endothelin levels and 64–5

epidemiology and etiology 92–3, 216, 217–18, 226, 288, 289

evolutionary perspective 289

fetal monitoring. See fetal: heart rate monitoring

fetal signal 189

fibronectin elevation 57

free radical synthesis 125–8

gastrointestinal function and 386–91

genetics 93, 188, 210, 219–20, 288, 289, 295–7, 299, 300

hemeoxygenase expression during 26 (see also hemeoxygenase)

high altitude and 195, 196 (see also high altitude)

history of 3–4

hypoxia and 29, 140, 186

hyperoxia and 140–1

hypertension and 247 (see also blood pressure; hemodynamics; hypertension: in pregnancy; vascular)

inflammation (see inflammation; inflammatory: response)

immune factors 68, 92, 93, 96, 222–3, 276 (see also immune system)

incidence 196, 217, 305, 328–9, 406, 438, 476, 498, 522

insulin resistance and (see diabetes: pre-eclampsia and; insulin: resistance)

intrauterine growth reduction (see intrauterine growth restriction)

kidney and (see kidney(s): performance in pre-eclampsia)

labor induction and delivery in 365–6, 375, 463, 527

and disease in later life 237–8

lipid profile 56, 130, 166–9 (see also dyslipidemia; lipid(s); lipoprotein; pre-eclampsia: dyslipidemia and)

litigation 525–7 (see also legal issues)

management 335, 352–3, 359–60, 366, 372–5, 373, 374, 532

markers 130, 154, 188, 215, 216, 217, 222

maternal death from 377, 437

maternal-fetal interactions in 185–6

maternal health and 232–4, 278, 279, 329, 377, 525

maternal predisposing factors 112–13, 164, 185, 186, 226, 296

matrix metalloproteinases MMPs and (see matrix metalloproteinases)

metabolic changes in 184 (see also metabolic syndrome)

models 6, 109, 209–10, 211, 232–4, 377, 525 (see also rodents)

nervous system in 67, 476–7

nitric oxide and 63, 64 (see also nitric oxide)

nitric oxide synthase and 52 (see also nitric oxide synthase)

obesity and 185, 219, 326–7, 333 (see also obesity)

organ failure during 479–84 (see also acute renal failure; heart: disease)

oxygen consumption in 453

oxidative stress and damage in 110, 125–31, 127, 185, 187, 187, 319

pancreatitis in 415 (see also pancreatitis)

paternal HLA and 284–6

placental oxidative stress in 125–7, 186

platelet activation in (see platelet(s): activation)

predictors (see pre-eclampsia: risk factors)

primipaternity and 276–81, 289, 290, 344

previous pregnancies and 92, 281, 286, 328–9

prostaglandins and (see prostaglandins)

proteinuria in 184, 215, 245, 260, 344, 357, 359, 393 (see also pre-eclampsia: symptoms; proteinuria)

renin-angiotensin suppression in 82

risk factors 9, 62, 69, 92, 190, 195, 216, 218, 221, 226, 234, 318, 319, 325–35, 326, 357–8, 365

screening 246, 357, 358

severe 369–70, 370, 372, 373–5, 374, 445

smoking and 111

stages 113–14, 114, 183–8, 190

symptoms 3, 63, 139–40, 183, 184, 190–1, 211, 215, 216, 245, 259–60, 344, 357, 359, 369, 380–1, 393, 395, 479, 483 (see also hypertension: in pregnancy; pre-eclampsia: hypertension and; proteinuria)

systemic lupus erythematosus and 333–4

T cells during 97–9

therapy/treatment 216, 227, 348, 360, 363, 370–3, 460–3, 478–9

TIMPs and 27–8

TNF-α in (see tumor necrosis factor-α)

triglycerides in (see triglycerides)

trophoblasts and

villous surfaces of 152

visual dysfunction in 398–401, 408, 438, 445

pregnancy

as allograft 96

amniotic fluid embolism in 484–5

anaphylactoid syndrome of 484–5

animal models 209–10, 210 (see also rodents)

cardiovascular changes during 57–8, 211, 258–9, 301, 343, 384, 413, 426, 429, 453 (see also hypertension: in pregnancy; hypotension)

as cardiovascular stress test 218

endothelial factors in 58

headache during 398 (see also headache)

high altitude 140, 196, 197, 201 (see also high altitude)

hypertension during (see hypertension: in pregnancy; pregnancy: cardiovascular changes during)

hypovolemia and 198

induced hypertension (PIH) (see hypertension: in pregnancy; pregnancy: cardiovascular changes during)

matrix metalloproteinases (MMPs) during (see matrix metalloproteinases)

metabolic changes during 107 (see also oxygen consumption)

molar 253, 297, 437, 438, 451

oxidative stress in 125, 127, 127–31, 185, 187, 319 (see also oxidative stress)

nitric oxide synthase and 58–62 (see also nitric oxide synthase)

risk factors 92, 196

ROS synthesis during (see reactive oxygen species)

prostaglandin effects during 65

superoxide (O2) generation in 132, 188

systemic inflammatory response during 106–7

T cell responses during 97–9

transforming growth factor-βs and 28–9

tissue inhibitors (TIMPs) and 27–8

premature birth 164, 243, 362, 370, 518–19. See also neonate(s)

primigravidae 3

primipaternity 276–81, 289, 290, 344

progesterone 199

prostacyclins 51, 54, 81, 211, 222, 457

prostaglandins 41, 50, 51, 54–6, 61, 66, 80, 127, 130, 131, 147, 211, 222, 286, 365

prostanoids 65–6, 147, 286, 334

protein

C 219, 220, 305–6, 308–14, 318

S 57, 305–6, 308, 314

See also proteinuria

proteinases 8, 22, 31, 105

proteinuria

assessment and measurement 250–2, 251, 345, 347–8

causes 344

in eclampsia 437

high altitude and 195

in pre-eclampsia 184, 215, 245, 260, 344, 357, 359, 393 (see also pre-eclampsia: symptoms)

See also kidney(s)

proteomics 45, 254

prothrombin 113, 219, 305, 306, 309, 314, 458. See also thrombin; thrombophilia

prothrombin time 415, 458, 468

pulmonary

arrest 438

artery (PA) catheter 412, 463, 479, 483. See also lung(s)

edema (see edema: pulmonary)

rales 412

reactive oxygen species (ROS) 56, 84, 86, 121–3, 122, 125, 128, 130, 131, 145, 170, 188. See also free radicals

real time PCR 28, 83, 84

renal. See kidney(s)

rennin and renin-angiotensin system 56, 78–80, 82–6, 211, 384

respiratory distress syndrome (RDS) 370, 494, 495, 496, 499, 512

rodents

advantages as model 210, 213

pregnancy dysfunction in 209–13

pregnancy comparison with humans 209–10

systemic endothelial activation in 212

transgenic and knockout 210, 212

See also pre-eclampsia: models

seizures. See convulsions and seizures

selectins 22, 24, 56

sepsis 109

serpins 85, 305

shedding. See nucleus shedding

smoking 195, 218, 226, 236, 249, 263, 280, 318, 515

sodium nitroprusside 377, 382, 409, 409, 410, 410, 461, 468

soluble fms-like tyrosine kinase 1 (sFlt-1) 51, 62, 67, 110–11, 224, 437

sperm and pre-eclampsia protection 282–5, 289

sphygmomanometer. See blood pressure: measurement

spiral arteries

adhesion molecule and 24

Aogen in 83

decidua 4, 6, 12, 20, 21, 83

disorganization 8

endovascular invasion 4, 5, 9, 12

hemodynamics 7, 113, 139, 141, 437

histopathology 4, 9–13, 139, 140, 142, 148, 455

impaired physiological changes in 3–7

nitric oxide synthase and 25

PECAM positive cells lining 24

physiological conversion 5, 10, 11, 139

renin in 83

structure 4, 6, 7, 12, 13, 20, 125, 138, 141 (see also spiral arteries: histopathology)

vascular remodeling 3, 6, 7, 8, 12, 83, 164, 184, 188, 300–1, 307

stem cells 23, 39, 157, 306

superoxide dismutase (SOD) 56, 122, 125, 126, 129, 130

superoxide radicals. See reactive oxygen species

sympathetic nervous system 67, 185, 190, 199, 477

syncytial

degeneration/regeneration 39, 154

knotting 152–4, 155, 156, 157, 158, 160

sprouting 154, 154–5

syncytiotrophoblasts

apoptosis and necrosis 112, 144, 146, 160, 187

cell culture 37–8

exchange across 307

immune response 97

in rodents 210

as interface between mother and fetus 107

oxidative stress in 145

reactive oxygen species in 145

secretions 25, 111, 146

shedding of microparticles by 112, 156, 187, 307

in spiral arteries 307

systemic lupus erythematosus. See lupus: erythematosus

T cell(s) 97–9, 146, 223

tachycardia 390–1, 403, 409, 409, 411, 412, 440, 461, 529

tachypnea 383, 385–6, 412

Tenney-Parker changes. See syncytial: knotting

thrombin 52, 62, 104, 113, 122, 305–7, 319, 458

thromboastenia 455

thrombocytopenia 244, 245, 377, 393, 395–7, 402, 414, 415, 444, 452, 455–8, 461, 464, 465

thromboelastogram (TEG) 457, 457, 458, 465, 465

thromboembolism 237, 308, 437

thrombomodulin 40, 57, 305–8, 310, 318

thrombophilia 186, 307–11, 318. See also factor V Leiden

thrombosis 57, 61–3, 139, 289, 307–10, 318, 319, 383, 398, 399, 401, 407, 408, 441, 481. See also blood clotting; thrombophilia

thrombotic thrombocytopenic purpura (TTP) 394, 396–7, 415, 485, 522

thromboxane A2 51, 56, 109

tissue inhibitors (TIMPs) 27–8

transforming growth factor-βs 28–9, 285, 286, 288

triglycerides 56, 166, 167, 169, 171–2, 175, 185. See also hypertriglyceridemia; lipid(s), lipoprotein

trophoblast(s)

biochemistry 8, 26, 29, 122

cell culture 38

degeneration and death of 8, 9, 125

extravillous (EVT) 21, 30, 41–2, 94, 97, 492

gene expression and mapping 7, 42

interactions with leukocytes and endothelial cells 38

interstitial 4, 6, 8

invasive 4, 7–9, 217, 492 (see also trophoblast invasion)

markers 21, 42

multinucleate 38

mural 13

precursors 8, 94

secretions 8, 22, 27, 68, 80, 94, 122

senescent 13

shedding 158

syncytio- (see syncytiotrophoblasts)

uterine invasion by 21

trophoblast invasion

cell adhesion molecules and 21 (see also cell adhesion molecules)

of endovascular tissue 7–9, 10, 20

extracellular matrix and 21 (see also extracellular matrix)

extravillous 3, 139, 146

maternal immune system and 94

matrix metalloproteinases and (see matrix metalloproteinases)

nitric oxide pathway and 25–6

oxygen tension and 29–30

pre-eclampsia 21, 41, 125, 148

proteins associated with 223–4

regulation 27, 29, 66, 94

troponins 383

tumor necrosis factor-α (TNF-α) 9, 68, 105, 106, 109, 111, 146, 165, 169, 187, 201, 223, 289 (see also cytokines)

twin studies 298

ultrasound. See Doppler imaging

umbilical artery 364, 455, 489, 490, 492, 494, 495, 498–9, 506

urea, serum. See blood urea nitrogen

uric acid 99, 122, 122, 123, 145, 175, 185, 188, 222, 335, 347, 358, 393–4, 455

urinary. See kidney(s)

uterine artery 7, 189, 202, 217, 223, 358, 489–90, 491, 492, 497, 497–8

uterus 3, 21, 67, 142

vascular

defects in pregnancy 13–15, 170–2 (see also placenta(l); pre-eclampsia; spiral arteries)

estrogen receptors 53

leakage 13

medial disorganization 6, 12

medial hyperplasia 12

medial vacuolation 6

remodeling (see spiral arteries: vascular remodeling)

resistance 198

smooth muscle 6, 14, 86

tone 50

See also heart; hemodynamics; hypertension; hypotension

vascular endothelial growth factor (VEGF) 29, 51, 84

antagonists (see soluble fms-like tyrosine kinase 1 (sFlt-1))

hypoxic stimulation of 84, 145

in pre-eclampsia 66, 217, 224, 437

receptors 110

regulation of angiogensis by 62, 84

synthesis 84

vasculitis 396, 399, 399

ventricular. See heart

vision dysfunction 398–401, 408, 438, 445, 459

vitamin

A 129

C 123, 123, 129, 132, 147, 171, 175

E (tocopherol) 123–9, 131, 132, 166

von Willebrand factor. See von Willebrand factor

Western blot analysis 28, 29, 84, 122

white blood cell activation 173. See also natural killer cells

xanthine dehydrogenase/oxidase 53, 145, 145, 187, 188

X-rays 386, 412


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