thromboxane-a2 and Placental-Insufficiency

Our understanding of the pathophysiology underlying the hypertensive diseases of pregnancy has clearly progressed during the past ten years. The key phenomenon is an early defect of placentation occurring at the end of the first trimester and associated with a more widespread endothelial disorder. This results in early activation of the coagulation cascade and imbalance between prostacyclin and thromboxanes. Hypertension and proteinuria only occur after several weeks or months of placental dysfunction. This explains why antihypertensive treatments are ineffective in improving the prognosis of such pregnancies. In contrast, early preventive treatments, such as antiplatelet therapy, seem to be very promising for these patients. In this respect, early prediction of the risk associated with pregnancy has become a key goal.

Topics: Adult; Antihypertensive Agents; Aspirin; Epoprostenol; Female; Hemostasis; Humans; Hypertension; Kidney Diseases; Placental Insufficiency; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Thromboxane A2

Topics: Aspirin; Cyclooxygenase Inhibitors; Dose-Response Relationship, Drug; Epoprostenol; Female; Fetal Growth Retardation; Humans; Placenta; Placental Insufficiency; Pre-Eclampsia; Pregnancy; Prostaglandin-Endoperoxide Synthases; Thromboxane A2

Topics: Contraceptives, Oral; Endometriosis; Epoprostenol; Female; Genital Neoplasms, Female; Humans; Hysterectomy; Placental Insufficiency; Pre-Eclampsia; Pregnancy; Prostaglandins; Thromboxane A2; Time Factors; Uterine Neoplasms; Uterus

By means of drug administration a further decrease of the placental circulation in premature sonographic maturity of the placenta could be prevented via influencing the TXA2/PGI2 balance. Treatment of premature sonographic placental maturity with 50 mg acetylsalicylic acid (ASA) per day and three times daily 100 mg Rocornal, respectively, resulted in a significant increase of the birth weights. In a second series of experiments, three groups were treated with 50 mg/day ASA or 250 mg ASA/once per week and three times/day 100 mg Rocornal, respectively, from the 18th or 20th week of gestation to the 35th week. Subsequently, they were compared to a group of untreated controls. The birth weights of all treated groups were statistically significantly higher. The underlying mechanism is suggested to be an improved microcirculation.

Topics: Aspirin; Epoprostenol; Female; Gestational Age; Humans; Microcirculation; Placenta Diseases; Placental Insufficiency; Pregnancy; Thromboxane A2; Trapidil; Ultrasonics