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      Therapeutics and Clinical Risk Management (submit here)

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      Are the blood groups of women with preeclampsia a risk factor for the development of hypertension postpartum?


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          Preeclampsia (PE) is a pregnancy-related disorder characterized by hypertension (HT) and proteinuria noticeable after 20 weeks of gestation. PE is now considered as a cardiovascular disease risk factor and a number of studies have shown that experiencing PE increases the prevalence of various cardiovascular risk factors, such as metabolic syndrome and HT. In this study, we aimed to investigate any possible relationship between the ABO/Rh blood group system and PE in Turkey. In the second part of the study, we examined the relationship between the ABO blood group system and development of HT after PE.

          Patients and methods

          A total of 250 patients with PE from Kayseri Training and Research Hospital between 2002 and 2012 were included in the study. Patients were classified according to blood groups (A, B, AB, and O) and Rh status (+/−).


          There was a significant difference between the patients with PE and the control group in terms of distribution of ABO blood groups and the percentage of group AB was found to be higher in patients with PE compared to the control group ( P=0.029). The risk of developing PE was significantly higher in group AB than other blood groups ( P=0.006). The risk of developing HT after PE was significantly higher in group O than other blood groups ( P=0.004).


          In this study, we found that the patients with blood group AB have a higher risk for PE. The patients with PE of blood group O are at high risk of developing HT, and Rh factor was identified as another risk at this point and these patients should be closely followed postpartum.

          Most cited references21

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          Pre-eclampsia: pathophysiology, diagnosis, and management

          The incidence of pre-eclampsia ranges from 3% to 7% for nulliparas and 1% to 3% for multiparas. Pre-eclampsia is a major cause of maternal mortality and morbidity, preterm birth, perinatal death, and intrauterine growth restriction. Unfortunately, the pathophysiology of this multisystem disorder, characterized by abnormal vascular response to placentation, is still unclear. Despite great polymorphism of the disease, the criteria for pre-eclampsia have not changed over the past decade (systolic blood pressure >140 mmHg or diastolic blood pressure ≥90 mmHg and 24-hour proteinuria ≥0.3 g). Clinical features and laboratory abnormalities define and determine the severity of pre-eclampsia. Delivery is the only curative treatment for pre-eclampsia. Multidisciplinary management, involving an obstetrician, anesthetist, and pediatrician, is carried out with consideration of the maternal risks due to continued pregnancy and the fetal risks associated with induced preterm delivery. Screening women at high risk and preventing recurrences are key issues in the management of pre-eclampsia.
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            An influence of ABO blood group on the rate of proteolysis of von Willebrand factor by ADAMTS13.

            The susceptibility of von Willebrand factor (VWF) of blood group O, A, B and AB to proteolysis by the ADAMTS13 metalloprotease was investigated. Multimeric analysis indicated that the rate of VWF proteolysis differed between blood groups and was greater for group O VWF than for non-O VWF in the rank order O >/= B > A >/= AB. Measurement of the collagen binding activity of VWF of each blood group following proteolysis for a fixed time interval corroborated the results obtained on multimer analysis: the loss of collagen binding activity was greater for VWF of group O compared with non-O VWF, in the rank order O >/= B > A >/= AB. Ristocetin was found to increase the rate of VWF proteolysis approximately two-fold; the differential between blood groups was retained in the presence of ristocetin.
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              The genetics of pre-eclampsia and other hypertensive disorders of pregnancy

              Hypertension is the most frequent medical complication occurring during pregnancy. In this chapter, we aim to address the genetic contribution to these disorders, with specific focus on pre-eclampsia. The pathogenic mechanisms underlying pre-eclampsia remain to be elucidated; however, immune maladaptation, inadequate placental development and trophoblast invasion, placental ischaemia, oxidative stress and thrombosis are all thought to represent key factors in the development of disease. Furthermore, all of these components have genetic factors that may be involved in the pathogenic changes occurring. The familial nature of pre-eclampsia has been known for many years and, as such, extensive genetic research has been carried out in this area using strategies that include candidate gene studies and linkage analysis. Interactions between fetal and maternal genotypes, the effect of environmental factors, and epistasis will also be considered.

                Author and article information

                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                19 April 2016
                : 12
                : 617-622
                [1 ]Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey
                [2 ]Internal Medicine Department, Acıbadem Kayseri Hospital, Kayseri, Turkey
                Author notes
                Correspondence: Abdulsamet Erden, Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri Eğ itim Araştırma Hastanesi, ˙Iç Hastalıkları Kliniği, 9. Blok 3. Kat, Kocasinan, Kayseri, 38010, Turkey, Tel +90 532 7803805, email drsameterden@ 123456gmail.com
                © 2016 Avci et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Original Research

                abo blood groups,rh factor,preeclampsia,proteinuria,pregnancy,hypertension,postpartum
                abo blood groups, rh factor, preeclampsia, proteinuria, pregnancy, hypertension, postpartum


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