الفهرس 
PreeclampsiaOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Preeclampsia is a pregnancy-specific disorder characterized by
hypertension and excess protein excretion in the urine (Pennington et al.,
2012). It occurs after the 20thweek of gestation (Sabine et al., 2010).
Preeclampsia (PE) affects 5% of pregnancies and is a significant
contributor to maternal mortality and morbidity .The effects of PE extend
beyond pregnancy, with associated risk of type II diabetes, hypertensive
disorders,and coronary artery disease in later life (Anthony et al., 2011).
L-carnitine is a natural amino acid that plays an important role in
fatty acid metabolism (Orkut et al., 2013).
L-carnitine is intrinsically involved in mitochondrial metabolism
and function as it plays a key role in fatty acid oxidation and energy
metabolism. In addition to the transportation of free fatty acids across the
inner mitochondrial membrane, L-carnitine modulates their oxidation rate
and is involved in the regulation of vital cellular functions such as
apoptosis (Santica et al., 2013).
Plasma carnitine analysis is an important diagnostic tool for
recognizing deficiencies in fatty acid oxidation (Osmanağaoğlu et al.,
2011).
This study is a case control study which was conducted in the
Antenatal Clinic, Antenatal Department and the Casualty Room in Ain
Shams University Maternity Hospital from August 2013 to December
2013. This study was approved by Ethical Committee of Ain Shams
University Maternity Hospital to compare the total plasma carnitine level
in preeclampsia and in normal pregnancy. It included eighty pregnant
women aged 20 - 40 years, Primigravida or multigravida 28 - 40 weeks of
gestation in a previously healthy ones. Excluded were multiple
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Summary
pregnancies, women with preexisting hypertension, diabetes, renal
dysfunction and immune disease divided into two groups:
Group A: Included 40 pregnant women fulfilling the criteria of preeclampsia
according to American College of Obstetrics and Gynecology 2010.
Group B: Included 40 healthy pregnant women without hypertension or
proteinuria matched for gestational age.
Total plasma carnitine level was measured for each woman.
In this study there was a statistical significant difference in GA.
Mean (±SD) GA in preeclampsia group was 37.25(± 1.875) while in other
normal group mean (±SD) GA was 38.52 (± 1.57) and P-value was 0.002
(Table 1).
The present study showed a statistical significant difference in
systolic blood pressure. Mean (±SD) systolic blood pressure in
preeclampsia group was 156.65 (± 10.54) while in other normal group
mean (±SD) systolic blood pressure was 110.5 (± 7.6) and p value was
0.000 (Table 2) .
The current study showed a statistical significant difference in
diastolic blood pressure. Mean (±SD) diastolic blood pressure in
preeclampsia group was 102.65 (± 8.874) while in other normal group
mean (±SD) diastolic blood pressure was 70.5 (± 5.1) and p value was
0.000 (Table 2).
Also there was a statistical significant difference in edema
between the two groups as number of patients (percentage) who had
edema in preeclampsia group was 38 (95%) while in other normal group
was 2 (5%) and p value was 0.000 (Table 2).
As regard Protein in urine the present study showed a statistical
significant difference between the two groups as number of patients
(percentage) who had Protein in urine (+2, +3) in preeclampsia group was
17 (42.5%) while in other normal group no women had Protein in urine
(+2, +3) and this gives p value 0.000 (Table 2).
Total plasma carnitine was statistically significantly higher in
preeclampsia group. Mean (±SD) total plasma carnitine level in
preeclampsia group was 15 (± 8.975) while in other normal group was 5.7
(± 4.1) and P-value was 0.000 (Table 5). Also there was a rising trend of
the mean level of carnitine among women in PE group with mean (±SD)
total plasma carnitine level in mild preeclampsia was 18.670 (± 2.448)
while in severe preeclampsia was 28.652 (± 5.445) and p value was
<0.001 (Table 6). So plasma carnitine is considered as marker of
preeclampsia.
In the present study, the lower birth weight, together with the lower
gestational age at birth and the high caesarean delivery rate, underline the
severity of the disease in preeclampsia group, there was statistical
significant difference between normal group and PET group as regards
these aspects. Mean (±SD) birth weight in preeclampsia group was
2626.25 (± 352.54) while in other normal group was 3070 (± 115.2) and
P-value 0.000 (Table 4). Number of patients (percentage) who delivered
by caesarean section in preeclampsia group was 27 (67.5%) compared to
4(10%) in normal group (Table 3).
In table (7) the current study has shown that, there was a
statistically significant correlation between total plasma carnitine level
and gestational age (P-0.001), systolic blood pressure, diastolic blood
pressure and protein in urine (P<0.001).
The correlation with gestational age, systolic blood pressure,
diastolic blood pressure and protein in urine were positive (Table 7)