Aspirin resistance in pregnancy is associated with reduced interleukin-2 (IL-2) concentrations in maternal serum: Implications for aspirin prophylaxis for preeclampsia.

Objectives: To evaluate the impact of aspirin resistance on the incidence of preeclampsia and maternal serum biomarker levels in pregnant individuals at high-risk of preeclampsia receiving low dose aspirin (LDA).

Study Design: We performed a secondary analysis of a randomized, placebo-controlled trial of LDA (60 mg daily) for preeclampsia prevention in high-risk individuals (N = 524) on pregnancy outcomes and concentrations of PLGF, IL-2, IL-6, thromboxane B2 (TXB), sTNF-R1 and sTNF-R2 from maternal serum.

Main Outcome Measures: LDA-resistant individuals were defined as those having a TXB concentration >10 ng/ml or <75 % reduction in concentration at 24-28 weeks after LDA administration.

Signs or symptoms of suspected preeclampsia - A retrospective national database study of prevalence, costs, and outcomes.

Background: Most patients with signs or symptoms (s/s) of suspected preeclampsia are not diagnosed with preeclampsia. We sought to determine and compare the prevalence of s/s, pregnancy outcomes, and costs between patients with and without diagnosed preeclampsia.

Methods: This retrospective cohort study analyzed a large insurance research database.

Racial differences in healthcare utilization among patients with suspected or diagnosed preeclampsia: A retrospective cohort study.

Objectives: To analyze healthcare resource utilization and severe maternal morbidity (SMM) in Black and White patients with preeclampsia diagnosis versus signs/symptoms.

Study Design: This was a retrospective cohort study analyzing data from the IBM® Explorys Database between 7/31/2012-12/31/2020. Demographic, clinical, and laboratory data were extracted.

Cost effectiveness of the sFlt1/PlGF ratio test as an adjunct to the current practice of evaluating suspected preeclampsia in the United States.

Objective: Preeclampsia is a major obstetric disorder that can lead to severe maternal, fetal and infant outcomes. In women with suspected preeclampsia, measurement of the soluble fms-like tyrosine kinase-1 (sFlt1) and placental growth factor (PlGF) ratio has been shown to have a high negative predictive value (>97%). Our aim was to estimate the value to the US healthcare system of adopting this test into clinical practice.

Placental growth factor predicts time to delivery in women with signs or symptoms of early preterm preeclampsia: a prospective multicenter study.

Background: There is a robust association between altered angiogenic factor concentrations, which includes placental growth factor and clinically recognized preeclampsia. Alterations in concentrations of angiogenic factors precede the clinical onset of preeclampsia by several weeks. The temporal relationship between the measured angiogenic factors and the time to delivery in women with suspected preeclampsia at <35 weeks gestation, however, remains to be clarified.

Novel mutation in as a cause of recurrent hydrops fetalis from Hennekam lymphangiectasia-lymphedema syndrome-1.

Whole exome sequencing (WES) was used to determine the etiology of recurrent hydrops fetalis in this case of Hennekam lymphangiectasia-lymphedema syndrome-1. WES is a useful approach for diagnosing rare single-gene conditions with nonspecific phenotypes and should be considered early in the diagnostic process of investigating fetal abnormalities.

Massive Urinary Protein Excretion Associated with Greater Neonatal Risk in Preeclampsia.

 The objective of this study was to compare clinical outcomes of preeclamptic pregnancies according to the proteinuria level.  Secondary analysis of a multicenter prospective cohort study of women with preeclampsia (PE) symptomatology. Nonproteinuria, mild-proteinuria, and massive-proteinuria PEs were defined as: < 165 mg in 12 hours or < 300 mg in 24 hours, 165 mg to 2.

Abnormal uterine artery Doppler velocimetry predicts adverse outcomes in patients with abnormal analytes.

Objectives: Our aim was to determine if uterine artery (UtA) Doppler studies would risk-stratify women with abnormal serum analytes on prenatal genetic screening into those at baseline and increased risk for preeclampsia and small-for-gestational age (SGA).

Study Design: This retrospective cohort study examined outcomes of patients with ⩾one abnormal analyte (PAPP-A<0.3, hCG>3.

The effects of umbilical cord milking on hemodynamics and neonatal outcomes in premature neonates.

Objective: To determine whether umbilical cord milking (UCM) improves systemic blood flow and reduces neonatal morbidities compared with immediate cord clamping (ICC).

Study Design: Women admitted to a tertiary care center and delivering before 32 weeks' gestation were randomized to receive UCM or ICC. Three blinded serial echocardiograms were performed in the first 2 days of the infant's life.

Accidental acetaminophen overdose results in liver transplant during second trimester of pregnancy: a case report.

Acetaminophen overdose is the most rapidly growing cause of fulminant hepatic failure in Western countries. Pregnant women are counseled that acetaminophen is safe during pregnancy and an alternative to nonsteroidal anti-inflammatory medications. This report describes a case of acetaminophen overdose during the second trimester of pregnancy with resultant fulminant hepatic failure requiring liver transplantation.

Abnormal second-trimester serum analytes are more predictive of preterm preeclampsia.

Objective: We sought to determine the association of abnormal second-trimester serum analytes with early preterm preeclampsia.

Study Design: We conducted a retrospective study of 7767 subjects undergoing second-trimester serum aneuploidy screening. Values of maternal serum α-fetoprotein (AFP), β-human chorionic gonadotropin (hCG), and inhibin (INH) were calculated as multiples of the median (MoM) and evaluated by gestational age at delivery and occurrence of preeclampsia.

PP153. Noninvasive assessment of maternal hemodynamic function by electrical impedance cardiography (EIC) and correlation with uterine and umbilical vascular resistance in mid-pregnancy.

Introduction: Maternal vascular adaptation to pregnancy involves the coordinated augmentation of both systemic and uteroplacental circulations, with the concomitant development of a new fetoplacental circuit. Disturbances of maternal hemodynamic adaptation in early pregnancy are often associated with compromise in the other circulations, although the assessment of maternal vascular function by conventional means is cumbersome and expensive.

Objectives: We sought to assess maternal hemodynamic function with a noninvasive cardiographic monitor, and to correlate the findings to both uteroplacental and fetoplacental vascular resistance.

PP143. Relationship between mid-pregnancy placenta growth factor and hemodynamics in the mother, fetus, and uterus.

Introduction: Placental Growth Factor (PlGF) is an angiogenic and vasoregulatory peptide member of the vascular endothelial growth factor family. Reduction of free, circulating PlGF is associated with preeclampsia and fetal growth restriction, and precedes the clinical manifestations of disease by several weeks. It is not known whether aberrant PlGF is related for alterations in endothelial vascular function that cause or exacerbate the placental syndromes of pregnancy.

Oxidation-specific epitopes are dominant targets of innate natural antibodies in mice and humans.

Atherosclerosis is a chronic inflammatory disease characterized by the accumulation of oxidized lipoproteins and apoptotic cells. Adaptive immune responses to various oxidation-specific epitopes play an important role in atherogenesis. However, accumulating evidence suggests that these epitopes are also recognized by innate receptors, such as scavenger receptors on macrophages, and plasma proteins, such as C-reactive protein (CRP).

The role of natural antibodies in atherogenesis.

Atherosclerosis is now widely recognized as a chronic inflammatory disease that involves innate and adaptive immune responses. Both cellular and humoral components of the immune system have been implicated in atherogenesis. Natural antibodies can be considered humoral factors of innate immunity, and their functional role in health and disease has been reexamined in recent years.

Changes in the pharmacokinetics of the low-molecular-weight heparin enoxaparin sodium during pregnancy.

Objective: We sought to evaluate the pharmacokinetics of subcutaneously administered enoxaparin sodium during and after pregnancy.

Study Design: Daily subcutaneous injections of enoxaparin sodium (40 mg) were administered to 13 pregnant women. On 3 separate occasions, once early in pregnancy (12-15 weeks), once late in pregnancy (30-33 weeks), and once in the nonpregnant state (6-8 weeks post partum), serial blood samples were collected, and plasma was analyzed for antifactor Xa activity.