Maternal plasma endothelin levels and fetal status in normal and preeclamptic pregnancies.

Endothelin (ET) is a potent vasoconstrictor peptide. In this study, we investigated maternal venous plasma ET levels measured by Sandwich-enzyme immunoassay within a week before the onset of labor, and measured plasma renin activity and plasma aldosterone concentration by radioimmunoassay in normal and severely preeclamptic pregnancies. Also, we determined umbilical cord blood pH and gas concentrations after spontaneous vaginal deliveries and cesarean sections. There was a significant (p < 0.01) negative correlation between maternal ET levels within 1 week before the onset of labor and birth weights. There was no significant correlation between maternal ET levels and umbilical gas concentrations. These data suggest that the correlation is the result of decreasing uteroplacental blood flow. We speculate that increased maternal ET expresses not only maternal renal vascular endothelial injury but also other vascular endothelial injuries. These vascular injuries may occur at least 1 week before the clinical manifestation in the preeclamptic mothers and their fetuses.