Evaluation of coagulation factors and serum ferritin in preeclamptic Pakistani women.

Preeclampsia (PE) is a pregnancy-related disorder involving multiple organ systems and characterised by an increase in hypertension and proteinuria after 20 weeks of gestation. The study aimed to determine the role of coagulation factors and ferritin in relation to PE susceptibility in Pakistani women. Blood samples of 100 normotensive and 100 preeclamptic women, including 73 with mild PE and 27 with severe PE were taken for the study to evaluate activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalising ratio (INR), fibrinogen levels, platelet count (PLT) and ferritin levels. Prolonged aPTT, PT and INR were recorded in both PE groups with a decrease in platelets and fibrinogen levels, compared to the control groups. Ferritin levels were not significantly (p=0.23) different in any of the groups. In conclusion, coagulopathic disorder should be clinically suspected and the coagulating factors in PE patients should be examined for early detection, effective antenatal care and for the proper management of this disorder to decrease maternofoetal mortality, morbidity and perinatal mortality.

Role of ACE I/D polymorphism in pathological assessment of preeclampsia in Pakistan.

BACKGROUND: Preeclampsia (PE) is a pregnancy-related hypertensive disorder, which may stem from impair placentation. Renin-angiotensin system is one of the mediators of decidualization and trophoblastic proliferation. In the present study women with PE were studied in a comparison of normotensive controls to determine whether Angiotensin-converting enzyme (ACE) gene I/D polymorphism affect the placental villi and umbilical cord formation with the assessment of biochemical and clinical risk factors. METHODS: Total 400 blood (PE/controls = 200), 400 urine (PE/controls = 200), 90 tissue samples of UC (PE = 50, controls = 40) and 90 placental tissue samples (PE = 50, controls = 40) were recruited. Histomorphological and Histomorphometric analysis were done for placental and umbilical cord tissues. Blood and serum parameters were analyzed, samples were genotyped for I/D polymorphism. Data were statistically analyzed by Independent sample t-test, Chi-square test and the odds ratio. RESULTS: Histological study revealed significant increase (p < 0.001) in distance from Wharton jelly (in both artery and vein) and outer layer thickness of vein; significant reduction (p < 0.01 and p < 0.05) in the lumen area of artery and vein. Abnormal villi, more syncytial knots (SK) and a significant decrease in elongated and large villi in PE placentas. Analysis of ACE gene determined that genotypic frequencies were statistically significant (p < 0.02) among both groups and DD genotype was predominant in the PE group. CONCLUSION: Present study reveals that ACE I/D polymorphism might affect the normal placental villi and umbilical cord formation in women with PE. In addition, histological studies and genetic evaluation can provide useful information in the determination of various reasons and mechanisms involved in the pathogenesis of PE in Pakistan.