Open AccessProstacyclin, thromboxane A 2 and the effect of low‐dose ASA in pregnancies at high risk for hypertensive disorders
Author(s) -
Vainio Merja,
Riutta Asko,
Koivisto AnnaMaija,
Mäenpää Johanna
Publication year - 2004
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.0001-6349.2004.00396.x
Subject(s) - medicine , gestation , prostacyclin , thromboxane , pregnancy , placebo , preeclampsia , gestational hypertension , obstetrics , thromboxane a2 , gestational age , gynecology , platelet , genetics , alternative medicine , pathology , biology
Background. The aim of this study was to investigate the prostanoid production in pregnancies at high risk for hypertensive disorders, and the effect of low‐dose acetylsalicylic acid (ASA) on prostanoids. Material and methods. Ninety women with a bilateral notching in uterine arteries screened by Doppler ultrasound at 12–14 gestational weeks were randomized to the ASA (0.5 mg/kg/day) or placebo group. Forty‐three women in both groups were followed up throughout the pregnancy. Urine samples were taken at baseline, and at 24–26 and 32–34 weeks of gestation to determine the urinary 11‐dehydrothromboxane B 2 (u‐11‐dehydro‐TxB 2 ) and 2,3‐dinor‐6‐keto‐prostaglandin F 1α (u‐2,3‐dinor‐6‐keto‐PGF 1α ), the metabolites of thromboxane A 2 and prostacyclin, respectively. Results. In the pregnancies with pregnancy‐induced hypertension (PIH) before 37 gestational weeks, the 2,3‐dinor‐6‐keto‐PGF 1α /11‐dehydro‐TxB 2 ratio did not increase as much as in other pregnancies ( P = 0.028). In the placebo group pregnancies with preeclampsia had significantly lower 2,3‐dinor‐6‐keto‐PGF 1α ( P = 0.019) at 12–14 weeks of gestation compared to other pregnancies. In the placebo group the 2,3‐dinor‐6‐keto‐PGF 1α /11‐dehydroTxB 2 ratio remained unchanged throughout the pregnancy, with no significant difference between pregnancies with a normal or an adverse outcome. In the ASA group the 2,3‐dinor‐6‐keto‐PGF 1α /11‐dehydro‐TxB 2 ratio increased ( P < 0.001, early vs. midpregnancy). Again, the changes were similar in pregnancies with a normal or an adverse outcome. Conclusion. The balance of prostacyclin and thromboxane A 2 shifted in an unfavorable direction in pregnancies complicated by PIH. ASA had a favorable effect on the prostanoids.