HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (39) Citing Articles via Google Scholar Google Scholar Articles by Swinkels, D. W. Articles by Steegers, E. A.P. Search for Related Content PubMed PubMed Citation Articles by Swinkels, D. W. Articles by Steegers, E. A.P. Related Collections Molecular Diagnostics and Genetics Endocrinology and Metabolism

Hemolysis, Elevated Liver Enzymes, and Low Platelet Count (HELLP) Syndrome as a Complication of Preeclampsia in Pregnant Women Increases the Amount of Cell-free Fetal and Maternal DNA in Maternal Plasma and Serum

¹ Departments of Clinical Chemistry,
² Epidemiology and Biostatistics, and
³ Obstetrics and Gynaecology, University Medical Centre, Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands

^aaddress correspondence to this author at: Department of Clinical Chemistry/564, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands; fax 31-243541743, e-mail D.Swinkels@CKCL.azn.nl

Fetal DNA in plasma and serum of pregnant women has been reported to be significantly increased in preeclampsia (1)(2). This increase may even precede clinical diagnosis (3). We hypothesized that subsequent development of hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome will further increase fetal DNA in maternal plasma and serum. In addition, total cell-free DNA may be increased in plasma as a result of tissue destruction, which generally occurs in HELLP syndrome.

To confirm our hypothesis, we recruited three groups of pregnant women with informed consent and matched for maternal age [(MA), in years] and gestational age [(GA), in weeks^+days] at the time of blood drawing; the median ages (and ranges) were as follows: normotensive women (n = 10), MA, 30 (24–37) and GA, 32⁺⁶ (27⁺⁰-34⁺³); preeclamptic women without HELLP syndrome (n = 7), MA, 28 (24–36) and GA, 33⁺⁰ (27⁺⁶-34⁺³); and preeclamptic women with HELLP syndrome (n = 10), MA, 31 (26–38) and GA, 26⁺⁶-33⁺⁶. All women in the latter group had HELLP syndrome at the time of the blood drawing, except two who developed HELLP only after delivery. All participants were carrying single male fetuses. Preeclampsia was defined as a diastolic blood pressure >90 mmHg on two or more consecutive occasions after 20 weeks of pregnancy in previously normotensive women, with proteinuria >0.3 g/L in a 24-h collection period. HELLP syndrome was defined as the simultaneous occurrence of hemolysis (lactate dehydrogenase, >600 U/L), increased liver enzymes (serum aspartate aminotransferase and alanine aminotransferase >70 U/L), and low platelets (<100 x 10⁹/L) (4). Diastolic blood pressure [median (ranges) in mmHg] was 70 (60–80), 120 (110–130), and 118 (110–140) for women with normotensive and preeclamptic pregnancies without and with HELLP syndrome, respectively.

. . . [Full Text of this Article]

References

The following articles in journals at HighWire Press have cited this article:

				A. F. Orozco, C. J. Jorgez, C. Horne, D. A. Marquez-Do, M. R. Chapman, J. R. Rodgers, F. Z. Bischoff, and D. E. Lewis Membrane Protected Apoptotic Trophoblast Microparticles Contain Nucleic Acids: Relevance to Preeclampsia Am. J. Pathol., December 1, 2008; 173(6): 1595 - 1608. [Abstract] [Full Text] [PDF]

				O. Lapaire, H. Stroh, I. Peter, J. M. Cowan, U. Tantravahi, B. O'Brien, D. W. Bianchi, and K. L. Johnson Larger Columns and Change of Lysis Buffer Increase the Yield of Cell-Free DNA Extracted from Amniotic Fluid Clin. Chem., January 1, 2006; 52(1): 156 - 157. [Full Text] [PDF]

				Y.M. D. Lo Recent Advances in Fetal Nucleic Acids in Maternal Plasma J. Histochem. Cytochem., March 1, 2005; 53(3): 293 - 296. [Abstract] [Full Text] [PDF]

				F. Z. Bischoff, D. E. Lewis, and J. L. Simpson Cell-free fetal DNA in maternal blood: kinetics, source and structure Hum. Reprod. Update, January 1, 2005; 11(1): 59 - 67. [Abstract] [Full Text] [PDF]

				Y. Li, X. Y. Zhong, A. Kang, C. Troeger, W. Holzgreve, and S. Hahn Inability to Detect Cell Free Fetal DNA in the Urine of Normal Pregnant Women nor in Those Affected by Preeclampsia Associated HELLP Syndrome Reproductive Sciences, December 1, 2003; 10(8): 503 - 508. [Abstract] [PDF]

				E. K.O. Ng, T. N. Leung, N. B.Y. Tsui, T. K. Lau, N. S. Panesar, R. W.K. Chiu, and Y.M. D. Lo The Concentration of Circulating Corticotropin-releasing Hormone mRNA in Maternal Plasma Is Increased in Preeclampsia Clin. Chem., May 1, 2003; 49(5): 727 - 731. [Abstract] [Full Text] [PDF]

				E. K. O. Ng, N. B. Y. Tsui, T. K. Lau, T. N. Leung, R. W. K. Chiu, N. S. Panesar, L. C. W. Lit, K.-W. Chan, and Y. M. D. Lo From the Cover: mRNA of placental origin is readily detectable in maternal plasma PNAS, April 15, 2003; 100(8): 4748 - 4753. [Abstract] [Full Text] [PDF]

				D. W. Swinkels, E. Wiegerinck, E. A.P. Steegers, and J. B. de Kok Effects of Blood-Processing Protocols on Cell-free DNA Quantification in Plasma Clin. Chem., March 1, 2003; 49(3): 525 - 526. [Full Text] [PDF]

				T.-W. Lau, T. N. Leung, L. Y.S. Chan, T. K. Lau, K.C. A. Chan, W. H. Tam, and Y.M. D. Lo Fetal DNA Clearance from Maternal Plasma Is Impaired in Preeclampsia Clin. Chem., December 1, 2002; 48(12): 2141 - 2146. [Abstract] [Full Text] [PDF]