SVIBOR - Project code: 3-01-012

MINISTRY OF SCIENCE AND TECHNOLOGY

Strossmayerov trg 4, HR - 10000 ZAGREB
tel.: +385 1 459 44 44, fax: +385 1 459 44 69
E-mail: ured@znanost.hr

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Project code: 3-01-012


PREGNANCY AND HYPERTENSION


Main researcher: ĐELMIŠ, JOSIP (125576)



Assistants
Type of research: applied
Duration from: 04/30/91.

Papers on project (total): 33
Papers on project quoted in Current Contents: 6
Institution name: Medicinski fakultet, Zagreb (108)
Department/Institute: Department of Obstetrics and Gynecology School of Medicine, Zagreb
Address: Petrova 13, Zagreb, Hrvatska
City: 10000 - ZaGREB, HRVATSKA
Communication
Phone: 385 (01) 444022

Summary: Hypertension in pregnancy is a perinatal complication which increases perinatal mortality and morbidity due to relatively high percent of fetal loss, perinatal asphyxia, IUGR or preterm birth. For the first time we plan to conduct a controlled study by which one will be able to compare and evaluate anticoagulation therapy: heparin therapy, aspirin therapy and omega-3-unsaturated fatty acids (fish flesh oil) therapy. Patophysiology of maternal circulatory maladaptation to pregnancy is due to inhibition of the second wave of endovascular trophoblast migration. Recently, an imbalance in prostanoid production or catabolism has been suggested as responsible for the patophysiologic changes in patients with PIH (pregnancy induced hypertension). Prostacyclin (PIG2) production is reduced in patients with PIH and the concetracion of potent vasoconstirctor TXA2 increases. Hypertension during pregnancy causes activation of maternal coagulation system. The target of this study is to evaluate the effect of antithrombic agents: heparin, aspirin and fish flesh oil; and estimate the beneficial effect of these therapeutics on coagulation system of fetus and mother (coagulation parameters, ATIII and protein C); improve placental respiratory and nutritive function; measure the level of eicosapentanoic acid in maternal and fetal plasma and placental tissue; determine maternal and fetal plasma concentracion of PGI and TXA in study group 2 and 3; analyze lupus anticoagulant antibody and anticardiolipin in all studied groups, and measure fibrin deposition in placental blood vessels and intervillous space. The benefit of antithrombic therapy introduced early in pregnancy is the essence of the pregnancy induced hypertension.

Keywords: pregnancy, hypertension, coagulation disorders, heparin therapy, low dose aspirin therapy, antithrombin III, protein C, lupus anticoagulant, anticardiolipin, prostaciclyn, thromboxan, fish flesh oil

Research goals: Present study of prophylactic or therapeutic benefit of antitrombic agents in patients with pregnancy induced hypertension further goals: 1. Establish the clinical effect of antitrombic agents 2. Effect of antitrombic therapy on coagulation parameters, ATIII and protein C in mother and fetus. 3. Improvement of respiratory and nutritive placental function by single or combination of antithrombic agents. 4. Measure the level of eicosapentanoic acid in maternal and fetal plasma and placental tissue. 5. Determine maternal and fetal plasma concentracion of PGI and TXA in study group 2 and 3 6. Analyze lupus anticoagulant antybody and anticardiolipin in all studied groups 7. Measure fibrin deposition in placental blood vessels and intervillous space 8. Of the particular interest is to investigate whether prophylactic use of heparin, or aspirin or fish flesh oil offers good prognosis in pregnancies complicated with hypertension, with or without renal lesions, and in those patients who already had recurrent stillbirths and IUGR with eclampsia or placental abruption.

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Last update: 07/18/95
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