Agarwal Rachna, Kumari Neelam, Kar Rajarshi, Chandra Nilesh, Nimesh Archana, Singh Alpana, Radhakrishnan Gita
1Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur, Delhi, 110095 India.
2Department of Biochemistry, University College of Medical Sciences and Guru Teg Bahadur, Delhi, 110095 India.
J Obstet Gynaecol India. 2019 Apr;69(2):142-148. doi: 10.1007/s13224-018-1128-2. Epub 2018 May 12.
The aim of our case-control study was to determine expression of VEGFA mRNA in placentae of preeclamsia (PE) versus uncomplicated pregnancy to further clarify its differential expression in pregnancy hypertensive disorders.
The PE group was subdivided into severe and non-severe; those with or without HELLP syndrome and placental VEGFA characteristics were compared for these cohorts. Additionally, the neonatal and maternal outcomes were recorded. The quantification of placental VEGFA was done using quantitative real-time PCR and results were expressed as fold change.
Out of 42 PE cases, 23 (55%) were non-severe and 19 cases (45%) were severe PE. Out of 19 severe PE patients, 8 (42%) were HELLP syndrome (complete HELLP) and remaining 11 (58%) were non-HELLP severe PE. Compared to controls, the true fold change in PE, HELLP, non-HELLP, severe PE, non-severe PE was - 2.186, - 13.333, - 6.698, - 8.950 and 1.466, respectively.
Our results showed a lowered VEGFA expression in PE placentae compared to uncomplicated controls. The finding of initial increase of VEGFA in non-severe PE and subsequent marked lowering in HELLP strengthens the existing hypothesis of decompensated VEGF being a major role player in PE.
我们的病例对照研究旨在确定子痫前期（PE）胎盘与正常妊娠胎盘中VEGFA mRNA的表达情况，以进一步阐明其在妊娠高血压疾病中的差异表达。
将PE组细分为重度和非重度；比较这些队列中伴有或不伴有HELLP综合征及胎盘VEGFA特征的情况。此外，记录新生儿和母亲的结局。使用定量实时PCR对胎盘VEGFA进行定量，结果以倍数变化表示。
42例PE病例中，23例（55%）为非重度，19例（45%）为重度PE。19例重度PE患者中，8例（42%）为HELLP综合征（完全性HELLP），其余11例（58%）为非HELLP重度PE。与对照组相比，PE、HELLP、非HELLP、重度PE、非重度PE的真实倍数变化分别为-2.186、-13.333、-6.698、-8.950和1.466。
我们的结果显示，与正常对照相比，PE胎盘组织中VEGFA表达降低。非重度PE中VEGFA最初升高，随后在HELLP中显著降低，这一发现强化了现有假说，即VEGF失代偿是PE的主要影响因素。
