The Clinical Implications of Cellular Adhesion Molecules in Patients with Pregnancy Induced Hypertension

Abstract

Pregnancy induced hypertension leads to high perinatal morbidity and mortality for both the mother and fetus, which is relatively common. The pathophysiological mechanism is as yet unestablished but recent developments point to abnormal placentation as a possible mechanism, that is, activation and dysfunction of maternal endothelial cells resulting overproduction of vasoconstrictors by abnormally functioning vascular endothelial cells. This study sampled the venous blood of 35 women with pregnancy induced hypertension(15 mild and 20 severe forms of preeclampsia) and 15 normal pregnant women, and measured VCAM-1 and E-selectin, subtypes of adhesion molecules related to vascular integrity to study if there is any difference between hypertensive and normal pregnant women, and to ascertain if it is applicable in the predictive marker of hypertensive disorders in pregnancy. There was significant statistical differences between the hypertensive and normal groups in the levels of VCAM-1(517.5±192.4 vs 343.7±90.4 ng/mL, p＝0.000) and E-selectin(37.7±28.4 vs 18.8±5.2 ng/mL, p＝0.001), and differences between the mild and severe forms of preeclampsia groups(VCAM-1: 414.2±140.0 vs 564.4±197.0 ng/mL, p＝0.038; E-selectin: 27.7±12.6 vs 42.2±32.4 ng/mL, p＝0.18). This study suggests that endothelial damage and dysfunction was a part of pathophysiological features of pregnancy induced hypertension and VCAM-1 and E-selectin may be useful for predicting the disorder. However, further study of hypertensive pregnant women of variable gestational age and types of severity are indicated.