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High fetal plasma adenosine concentration: a role for the fetus in preeclampsia?

      Objective

      Clinical observations suggest a role for the fetus in the maternal manifestations of preeclampsia, but the possible signaling mechanisms remain unclear. This study compares the fetal plasma concentrations of adenosine from normal pregnancies with those from preeclampsia.

      Study Design

      This secondary data analysis included normal pregnancies (n = 27) and patients with preeclampsia (n = 39). Patients with preeclampsia were subclassified into patients with (n = 25) and without (n = 14) abnormal uterine artery Doppler velocimetry (UADV).

      Results

      Fetal plasma concentrations of adenosine were significantly higher in patients with preeclampsia (1.35 ± 0.09 μmol/L) than in normal pregnancies (0.52 ± 0.06 μmol/L; P < .0001). Fetal plasma concentrations of adenosine in patients with preeclampsia with abnormal UADV (1.78 ± 0.15 μmol/L), but not with normal UADV (0.58 ± 0.14 μmol/L), were significantly higher than in normal pregnancies (P < .0001).

      Conclusion

      Patients with preeclampsia with sonographic evidence of chronic uteroplacental ischemia have high fetal plasma concentrations of adenosine.

      Key words

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      Linked Article

      • Adenosine plasma levels in the fetoplacental circulation in preeclampsia
        American Journal of Obstetrics & GynecologyVol. 206Issue 4
        • Preview
          We have read with much interest the article by Espinoza et al1 in which they reanalyzed data regarding high umbilical adenosine plasma level in fetuses from pregnancies coursing with preeclampsia that were presented in this Journal by the same group in 2 different articles in 1994 and 1996. We here intend to contribute to the discussion by incorporating ideas into the complex regulatory scenario that modulates the human umbilical adenosine level. In consequence with the proposal of Espinoza et al, the high extracellular level of adenosine that results from reduced expression and activity of human equilibrative nucleoside transporters 1 were described, for the first time, by our groups in primary cultures of human placental microvascular endothelial cells (hPMEC) from preeclampsia.
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