Background:
In Pakistan, It has been strongly suggested that women with hypertensive disorders of pregnancy are at risk of developing cardiovascular disorders.
Objective:
Our objective was to ascertain the persistence of endothelial activation in hypertensive pregnancies compared to women with normal pregnancies.
Methadology:
Case control study design was chosen in two matched group. Endothelial activation was determined by the evaluation of adhesion molecules namely P selectin, E-selectin, Intercellular adhesion molecules-1(ICAM-1) and vascular cellular adhesion molecules-1 (VCAM-1).
Results:
In the first study, adhesion molecules were measured in 40 women with hypertensive pregnancies and in a matched control group with an uncomplicated pregnancy one month and three months after delivery. In the second study, adhesion molecules were measured in 40 patients with a history of HELLP syndrome several years after pregnancy and in 40 matched controls. Shortly after the delivery, increased levels of soluble adhesion molecules were found in women with hypertensive complications. However women with uncomplicated pregnancy did not have any increase level of soluble adhesion molecules. Significant differences were still present, several years after delivery comparing levels of adhesion molecules in women with a history of HELLP syndrome with those found in control patients.
Conclusion:
An abnormal activation of endothelium was seen in hypertensive pregnancies. It has also been concluded that is abnormal activation of endothelium remains increased even after delivery which pre disposes the patient towards cardiovascular disorder. The risk of cardiovascular complications including ischemic heart diseases, chronic hypertension and stroke is more commonly seen in women experiencing HELLP syndrome