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001-es BibID:	BIBFORM048836
Első szerző:	Csorba Roland (szülész-nőgyógyász, gyermeknőgyógyász)
Cím:	Rheological parameters in the umbilical cord blood in moderate and severe forms of preeclampsia / Roland Csorba, Asli Yilmaz, Panagiotis Tsikouras, Christian Wieg, Alexander Teichmann, Georg-Friedrich von Tempelhoff
Dátum:	2013
ISSN:	1386-0291
Megjegyzések:	Previous studies have dealt with maternal blood rheology in preeclampsia (PE), but only a few focused on the fetal rheological parameters in this maternal state. PE is one of the most common severe complications of pregnancy world-wide associated with high maternal morbidity and mortality and intrauterine fetal growth restriction. Our objective was to explore the rheological parameters in the umbilical cord blood at term in the presence of moderate and severe forms of PE.METHODS:A subgroup analysis was performed in a community based retrospective study of 4,951 consecutively recorded singleton pregnant women of whom 423 had PE. In the latter, umbilical cord blood was collected during delivery for testing of hematological and blood rheological parameters of their fetus. Fetal results from uneventful pregnancy were compared with those associated with preeclampsia. Furthermore, results were also evaluated in the presence of moderate and severe forms of PE. Plasma viscosity (pv) was examined using KSPV 1 Fresenius and Red Blood Cell (RBC) aggregation (stasis: E0 and low shear: E1) using MA1-Aggregometer; Myrenne.RESULTS:According to the definition of the German Society of Gynecology and Obstetrics (DGGG) 314 women had moderate (74.2%), while 109 had severe forms of PE due to the presence of a blood pressure > 170/110 mmHg (n = 41; 9.7%), and/or IUGR < 5th percentile (n = 28; 6.6%), and/or HELLP-Syndrome (n = 10; 2.4%), and/or proteinuria ? 5 g/24 h (n = 30; 7.1%). When comparing the fetal results from pregnancies with and without preeclampsia mean hemoglobin values (p < 0.001) and hematocrit (p < 0.001) were markedly higher, while plasma viscosity (p = 0.006) and erythrocyte aggreagtion (stase: p = 0.35; low shear: p = 0.08) were lower in association with preeclampsia. Gestational age, fetal birth-weight and umbilical arterial cord blood pH in women with severe PE was statistically significant lower as compared to those with moderate disease (p < 0.001). Mean hemoglobin level and hematocrit were higher in fetus from women with severe compared to moderate PE, while plasma viscosity (1.03 ? 0.07 mPas vs. 1.05 ? 0.07; p = 0.05) and erythrocyte aggregation in stase (2.3 ? 2.47 vs. 2.41 ? 2.46; p = 0.11) as well as under low shear (7.86 ? 4.63 vs. 8.06 ? 4.60; p = 0.15) were lower. HELLP-Syndrome was associated with the lowest plasma viscosity (1.00 ? 0.07 mPas; p = 0.019) and erythrocyte aggregation (low shear: 5.1 ? 5.0; p = 0.04) in fetus.CONCLUSION:The results of this study including a notable number of patients with PE and their newborns revealed an in part statistically significant association between variables of blood rheology and the presence, severity and type of preeclampsia with a trend towards hyper viscosity in severe forms of preeclampsia. The behaviour of blood rheological components in the neonate is remarkable since the number of red blood cells is raised while RBC aggregability and plasma viscosity is low.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Pregnancy fetal hemorheology plasma viscosity preeclampsia red blood cell aggregation
Megjelenés:	Clinical Hemorheology and Microcirculation 55 : 4 (2013), p. 391-401. -
További szerzők:	Yilmaz, Asli Tsikouras, Panagioti Wieg, Christian Teichmann, Alexander Tempelhoff, Georg-Friedrich von
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM048839
035-os BibID:	PMID:23089882
Első szerző:	Soliman, Amr A.
Cím:	Rheologic results and their correlation to hemostatic changes in patients with moderate and severe preeclampsia : an observational cross-sectional study / Amr A. Soliman, Roland Csorba, Asli Yilmaz, Georg-Friedrich von Tempelhoff
Dátum:	2015
ISSN:	1386-0291
Megjegyzések:	Previous study have shown an association between failure of physiological hemodilution during 2nd trimester and an increased risk for the development of subsequent pregnancy complications such as early birth, birth of a growth retarded newborn (IUGR), low fetal birth weight and preeclampsia. The latter complication in particular goes along with dramatic changes in the placental perfusion as well as systemic maternal blood flow. Severity of preeclampsia may be preceded by distinct impaired hemodilution and reflected by the results of rheological parameters. A subgroup analysis was performed in a community based retrospective study of 4,985 consecutively recorded singleton pregnant women of whom 423 had preeclampsia. Mean 2nd trimester hemoglobin levels and blood rheological results at the time of delivery were assessed and compared in women with moderate and severe preeclampsia. Mean 2nd trimester hemoglobin levels were calculated from the maternal records. Rheological variables included plasma viscosity (KSPV 1 Fresenius) and Red blood cell aggregation in stasis and under low shear conditions (MA1-Aggregometer; Myrenne). According to the definition of the German Society of Gynecology and Obstetrics (DGGG) 314 women had moderate preeclampsia (74.2%), while 109 had severe preeclampsia due to the presence of a blood pressure >170/110 mmHg (n = 41; 9.7%), and/or IUGR <5th percentile (n = 28; 6.6%), and/or HELLP-Syndrome (n = 10; 2.4%), and/or proteinuria ?5 g/24 h (n = 30; 7.1%). Age, BMI, smoking, and maternal weight were comparable in the groups, while gestational age at delivery as well as fetal outcome parameter were statistically significant unfavourable in patients with severe preeclampsia. Mean 2nd trimester hemoglobin level were statistically significantly higher in women who developed severe vs. moderate preeclampsia (m = 12.75 ? 0.99 g/dL vs. m = 12.50 ? 1.05 g/dL; p = 0.033). However, in the ROC calculations a hemoglobin value of 12.05 g/dL revealed best sensitivity (78%) and specificity (33.8%) in women with subsequent diagnosis of severe preeclampsia, whereas sensitivity was 100% for a value >10.95 g/dL. There were no statistically significant differences for none of the rheological parameters at the time of delivery between groups of patient with moderate v.s severe preeclampsia. Severe preeclampsia and IUGR, however, was associated with statistically significantly higher RBC aggregation as compared to patients with moderate preeclampsia. Plasma viscosity was statistically significantly (p < 0.05) correlated with Fibrinogen values (r = 1.69), leukocyte-(r = 0.11) and platelets-count (r = 0.127), and hemoglobin/hematocrit values in particular (r = 0.23/0.26). Although mean 2nd trimester hemoglobin concentration are higher in patients with subsequent development of severe preeclampsia, due to the low sensitivity and specificity of this parameter clinical use for identifying women at risk is of limited value. On the other hand, a hemoglobin value below 11.0 g/dL excluded the risk for severe preeclampsia to 100%. Blood rheological parameters at the time of delivery in the absence of IUGR are not markedly influenced by severity of preeclampsia.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban Blood fluidity haemostasis pregnancy preeclampsia red blood cell aggregation
Megjelenés:	Clinical Hemorheology and Microcirculation. - 59 : 1 (2015), p. 1-15. -
További szerzők:	Csorba Roland (1972-) (szülész-nőgyógyász, gyermeknőgyógyász) Yilmaz, Asli Tempelhoff, Georg-Friedrich von
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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