Преэклампсия: физиология и иммунологические аспекты. Артериальная гипертензия в беременности, страница 14

AB: There is increasing evidence in the literature, that the endothelium of the microcirculation as site of production of vasoactive substances (prostacyclin, endothelin and nitric oxide) plays a central role in the pathophysiology of pre-eclampsia. In this investigation, we studied skin microcirculation of the forearm and the volar hand at rest, after a cooling procedure and during reactive hyperemia in 13 patients with pre-eclampsia and 13 healthy pregnant controls. For our measurements we used Laser-Doppler Flowmetry, because this method is non-invasive and of no measurable influence to the microcirculation during measurement. Our main findings were: In pre-eclampsia there is a higher skin vasodilatory reserve during reactive hyperaemia compared to the control group indicating an increased resting vasomotor tone in skin vessels. Vascular reactivity to a vasoconstrictor stimulus (local cooling) was significantly greater in pre-eclamptic patients than in controls. Laser-Doppler Flowmetry is suited to measure alterations in skin vascular reactivity in pre-eclampsia, but there is a wide overlapping range in the results of patients with pre-eclampsia and healthy pregnant controls. A clear distinction between normal pregnancy and pre-eclampsia by Laser Doppler flowmetry is not possible.

: Там увеличивает признак в литературе, что эндотелий микроциркуляции как участок продукции вазоактивных веществ(сущностей) (простациклин, эндотелин и оксид азота) играют центральную роль в патофизиологии преэклампсии. В этом исследовании, мы изучили микроциркуляцию кожи предплечья и руки volar в покое, после охлаждающейся процедуры и в течение реактивной гиперемии в 13 пациентах с преэклампсией и 13 здоровыми беременными контрольными группами. Для наших размеров(измерений) мы использовали Лазер-doppler flowmetry, потому что этот метод атравматичный и никакого измеримого влияния к микроциркуляции в течение измерения. Наши основные результаты были: В преэклампсии есть более высокая кожа, сосудорасширяюще предназначают в течение реактивного hyperaemia по сравнению с контрольную группу, указывающую увеличенный отдыхающий вазомоторный тон в сосуде кожи. Сосудистая реактивность к сосудосуживающему стимулу (местное охлаждение) была значительно большая в пред--eclamptic пациентах чем в контрольных группах. Лазер-doppler flowmetry подходит для альтераций меры кожи сосудистая реактивность в преэклампсии, но есть широкий диапазон перекрывания в результатах пациентов с преэклампсией и здоровыми беременными контрольными группами. Ясное различие между нормальной беременностью и преэклампсией Лазером doppler flowmetry - не возможно.

TI: [Fetal development in late gestosis and nicotine consumption]

TI: [Эмбриональное развитие в последнем гестозе и потреблении никотина]

TO: Die fetale Entwicklung bei Spatgestose und Nikotinkonsum.

AU: Warkentin-B

AD: Geburtshilflich-gynakologische Abteilung des Stadtischen Krankenhauses Lorrach.

SO: Geburtshilfe-Frauenheilkd. 1994 May; 54(5): 262-7

AB: In pre-eclamptic and in smoking women, the foetus often develops growth retardation. Hence, nicotine as vasoconstrictive substance increases the blood pressure, therefore causes a higher incidence for pre-eclamptic toxaemia in smoking pregnant women. By means of perinatal inquiry in Baden-Wurttemberg, not only the frequency of preeclamptic toxaemia was proven in smoking women, but also the frequency of toxaemia in mothers with low, of normal and high weight of the newborn. Hypertension is more frequent in mothers with overweight babies than in mothers with babies of normal weight. In case of overweight newborns, toxaemia is less often caused by proteinuria than in underweight babies. Hypertension is less frequent in smoking pregnant women than in non-smoking women. These findings can be explained by a new theory, which interprets pre-eclamptic toxaemia as a compensatory mechanism in foetal growth retardation. For the foetus, which is insufficiently supplied by the placenta, this regulatory mechanism enhances the blood supply of the placenta. The higher incidence of toxaemia in pregnant women with overweight babies is explained by an increased demand on the placenta, which causes a better foetal blood supply of the placenta in developing the toxaemia. In this case, the toxaemia is compensated. In the stage of decompensation with foetal growth retardation, all reserves are mobilised by an increased permeability of the vessels, which leads to an improved passage through the placenta, but also to proteinuria and increased incidence of oedema.