Urinary protein/creatinine ratio before and during pregnancy in women with diabetes mellitus

Article Abstract:

Pregnant diabetic women are routinely tested for excess protein in their urine as a marker of possible kidney disease or other complications, such as preeclampsia; the most commonly used test measures the protein excreted in urine collected during a 24-hour period. Such collection is inconvenient, and it has been suggested that results from a single urine sample could possibly yield equally useful data. The protein/creatinine ratio has been shown to correlate well with the 24-hour urinary protein excretion for other populations, including nonpregnant women with diabetes and kidney disease, and women with preeclampsia. The extent to which this ratio predicts the 24-hour urinary protein excretion was tested by reviewing records from all women who were treated for diabetes mellitus before pregnancy occurred, and who also met certain other enrollment criteria. Results for the 329 urine specimens (from 133 women) studied showed that the urinary protein/creatinine ratio was highly correlated with the 24-hour urinary protein excretion level before and during pregnancy. This was true even for high or low values of urinary protein. Three different ways of estimating 24-hour urinary protein excretion are presented and evaluated. The predicted values differed from the actual 24-hour protein excretion by between 19 percent and 27 percent, with 6 percent to 13 percent of the predictions in error by at least 50 percent. Thus, it is concluded that the protein/creatinine ratio, as calculated from a single sample, cannot accurately predict the true level of urinary protein excretion in a 24-hour sample; this method is not useful for evaluating pregnant diabetic women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Testing, Complications and side effects, Pregnant women, Diabetes in pregnancy, Gestational diabetes, Proteinuria

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Experimental preeclampsia produced by chronic constriction of the lower aorta: validation with longitudinal blood pressure measurements in conscious rhesus monkeys

Article Abstract:

Surgical reduction in pressure in the lower aorta led to development of a syndrome similar to preeclampsia in pregnant rhesus monkeys. The aorta is the main trunk of arterial circulation in the heart. Preeclampsia is a serious complication of pregnancy characterized by extremely high blood pressure, protein in the urine and edema. Catheters to measure blood flow through the uterus and placenta and to measure systemic arterial pressure were surgically implanted in pregnant monkeys. Eleven monkeys later had a second procedure to induce artificial blockage of the abdominal aorta. This reduced lower aortic blood pressure by approximately 30%. Four of the 11 monkeys in the experimental group lost their fetuses. One of these monkeys died nine days after blockage of the aorta. Two of these monkeys had significant increases in systemic arterial pressure and spontaneously aborted their fetuses. One suffered abruptio placenta. Four of the remaining monkeys in the experimental group developed high blood pressure and protein in their urine three and four weeks after the blockage was induced. Three monkeys had no change in blood pressure and no protein in their urine.

Models, Development and progression, Preeclampsia, Hypertension in pregnancy, Gestational hypertension

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Increased depth of trophoblast invasion after chronic constriction of the lower aorta in rhesus monkeys

Article Abstract:

Cytotrophoblasts were found to invade uterine tissue to a deeper level in monkeys with aortic strictures surgically placed to reduce lower aortic pressure. Cytotrophoblasts are the cells that form the placenta that implants in the uterine wall soon after fertilization occurs. Biopsies were performed on the placental beds of monkeys that had surgery to reduce aortic pressure and on monkeys that did not have the surgery. Cytotrophoblasts were present in all levels of the uterine wall in samples from the monkeys that had surgery. In the group that did not have surgery, the trophoblast invasion stopped approximately halfway through the lining of the uterus known as the endometrium. In both groups cytotrophoblasts were found at both the decidual and myometrial levels of the uterine blood vessels. It is hypothesized that cytotrophoblasts deprived of oxygen by the aortic stricture have the ability to move toward oxygen sources.

Physiological aspects, Placenta, Trophoblast, Trophoblasts

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