Analysis Of Pregnancy Outcomes And Pathogenesis Of Preeclampsia

Preeclampsia(PE),a hypertensive syndrome that occurs during pregnancy,characterized by new-onset of hypertension,accompanied by one or more of the following ne w-onset conditions at or after 20 weeks’ gestation:Proteinuria,Other maternal organ dysfunction,including acute kidney injury,liver involvement,neurological complications,haematological complications and uteroplacental dysfunction such as fetal growth restriction,abnormal umbilical artery Doppler wave form analysis,or stillbirth.It affects an estimated 2–5% of pregnancies worldwide,PE is still one of the main reason leading to maternal and neonatal mortality,preeclampsia can be lethal,and this disorder is one reason of maternal and child mortality.In the absence of curative treatment,the management of pre-eclampsia involves perinatal blood pressure control,preconception counseling and management of complications,followed by delivery at an optimal time.In addition,multiple pregnancies increase the risk of preeclampsia,and these clinical data provide e vidence for the theory of placental origin of preeclampsia.The widely recognized pathogenesis of preeclampsia is characterised by defective placental angiogenesis.Abnormal placentation and failure in the remodelling of spiral arteries leads to the secretion of placental factors into the maternal circulation,and to widespread systemic effects in the mother.In view of the fact that preeclampsia seriously affects the safety of mother and fetus,it is important to investigate the pathogenesis of preeclampsia.We compared the maternal clinical characteristics and outcomes of preeclampsia patients,Then we intended to investigate the potential role of FOS in PE pathogenesis and explored its molecular mechanism.First,We intended to analyze the clinical characteristics and pregnancy outcomes of 124 preeclampsia patients admitted to the first affiliated hospital of Wannan Medical College from October 2017 to January 2019.We found the risk factors related to the incidence of preeclampsia including onset time,gestational weeks of termination and blood pressure.Patients with preeclampsia were all at high risk of complications.Most patients were suffered from fetal growth restriction or fetal distress,often they needed cesarean section to terminate pregnancy.Second,we intended to determine the potential role of FBJ osteosarcoma oncogene(FOS)in PE pathogenesis and explored its molecular mechanism.We found that FOS expression was significantly lower in preeclamptic placentas than that in the controls,overexpression of FOS promoted the proliferation of trophoblasts.And the expression of proliferating cell nuclear antigen(PCNA)and Ki67 decreased after knockdown of FOS,while overexpression FOS revealed the opposite condition.It is concluded that FOS inhibits trophoblasts proliferation by regulating proliferative biomarkers and participating in the pathogenesis of preeclampsia.Part Ⅰ Analysis on Pregnancy outcomes in 124 preeclampsia patients Objective: To explore the high risk factors of preeclampsia by analyzing the clinical data and pregnancy outcomes.Methods:The clinical data of 124 preeclampsia patients admitted to the first affiliated hospital of Wannan Medical College from October 2017 to January 2019 was analyzed retrospectively.According to the time of onset,the patients were divided into three groups.group A(<28 weeks),group B(28 weeks≤Gestational age<34 weeks),group C(≥34 weeks).To analyze the clinical characteristics,maternal and perinatal complications and pregnancy outcomes.Results: The main complications of preeclampsia included postpartum hemorrhage,placental abruption,hypoproteinemia and HELLP syndrome.There were no significant differences in the total incidence of complications among the three groups(P>0.05).we found no significant difference in the maternal age,parity,body mass index,family history of hypertension and previous history of preeclampsia among three groups(P>0.05).There were significant differences in the time of onset,termination of pregnancy,systolic blood pressure and diastolic blood pressure among the three groups(P<0.01).there were significant differences in neonatal complications among the three groups.the incidences of neonatal asphyxia,neonatal death,stillbirth and low birth weight in group A were obviously higher than those in the other two groups(P<0.05).The incidence of fetal growth restriction and NICU admission was the highest in group B(P<0.05).Patients in group A terminate pregnancy with induction of labor(57.89%).while cesarean section was the mainly way in group B and C,the cesarean section rate was 69.23% and 88.68%(P<0.05).Conclusion: Patients with preeclampsia were all at a high risk of complications,resulting in adverse outcomes of newborns.Cesarean section was the mainly way to terminate pregnancy in preeclampsia patients.It is necessary for pregnant women to know how to prevent preeclampsia.In order to reduce the adverse pregnancy outcomes,We need to adopt a positive attitude to make early diagnosis and take effective treatment measures for preeclampsia patients.Part Ⅱ Analysis of biological function and pathogenesis of trophoblast regulated by FOS Objective: The relative expression of FOS in placenta tissues from preeclampsia patients and non-infections of preterm premature rupture of membranes patients.was detected by q-PCR.Experiments in vitro were conducted to determine the effect of FOS on the biological function of trophoblasts.Methods: The HTR-8/SVneo and JAR cells were selected to establish the cell model in vitro.To knockdown FOS with Small interfering RNAs,plasmid pCDNA was designed to overexpression FOS.MTT assay,clone formation assay and EdU incorporation assay were conducted to clarify the regulation of FOS on trophoblasts proliferation.Western-blot were used to detect the expression of proliferation markers PCNA and Ki67 after knockdown FOS and overexpression FOS.Results: MTT assay,clone formation assay and EdU incorporation assay showed that the proliferative ability of trophoblastic cells was inhibited by knockdown of FOS,while FOS overexpression revealed the opposite condition.Western-blot showed that overexpression FOS could promote the expression of PCNA and Ki67.Conclusion: FOS is involved in the pathogenesis of preeclampsia by affecting trophoblasts proliferation and regulating the expression of PCNA and Ki67.