Exploratory Study. Endothelial Function and Vascular-tropic Biomarkers: Predictive Indicators of the Progression of Hypertensive Disorders in Pregnancy to Pre-eclampsia?

Status: Recruiting
Location: See all (3) locations...
Intervention Type: Other, Procedure
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Hypertension during pregnancy remains a leading cause of maternal and fetal morbidity and mortality. The frequency (5 to 10% of pregnancies) and potential severity of these diseases, both for the mother and the child, are reasons for standardizing and optimizing medical practices. The cause of hypertension during pregnancy is quite complex, as it depends on a number of factors. Among the hypertensive disorders in pregnancy (HDP), the pathophysiology of pre-eclampsia (one of the most studied in terms of severity) remains poorly understood. The evolution of international guidelines in recent years has made it possible to distinguish various HDP, but schematically we distinguish two main entities by the existence of proteinuria from and after the 20th week of amenorrhea and by maternal-fetal complications, more serious in pre-eclampsia than in gestational hypertension. Acute placental vasculature and blood flow abnormalities were observed during gestational hypertension and preeclampsia, and maybe due to generalized vascular endothelial activation and vasospasm resulting in systemic hypertension and organ hypoperfusion. Endothelial dysfunction (ED) and abnormal expression of several specific blood biomarkers are now well accepted as characteristics of preeclampsia as a leader. However, the progression of any HDP to preeclampsia is possible, but difficult to predict. By way of example, among between 15 and 40 % of gestational hypertension cases progress to preeclampsia, suggesting that it is the same worsening disease. ED could be pre-existing (chronic, white-coat or masked hypertension) but also at the origin of gestational hypertension (unclassified hypertension, transient pregnancy hypertension), and subsequent development of preeclampsia through an imbalance between pro- and anti-angiogenic factors. An imbalance of pro-angiogenic and anti-angiogenic proteins can testify to ED, as can adequate levels of endothelial microparticles. The main objective of this research is to assess the presence of urinary endothelial microparticles in stable pregnant women with hypertensive disorder of pregnancy as a marker for the occurrence of pre-eclampsia during pregnancy.

Eligibility
Participation Requirements
Sex: Female
Minimum Age: 18
Maximum Age: 40
Healthy Volunteers: f
View:

• Patients with a hypertension disorder in pregnancy and/or preeclampsia from the 20th amenorrhea week until the 26th ± 2 amenorrhea week.

• Age between 18 and 40 years old.

• Having given written consent.

• Patients affiliated to a social security scheme.

Locations
Other Locations
France
AP-HP Avicenne Hospital, Department of internal medicine
RECRUITING
Bobigny
AP-HP Jean Verdier Hospital, Gynecology and Obstetrics Department
RECRUITING
Bondy
AP-HP Laribosière Hospital, Gynecology and Obstetrics Department
RECRUITING
Paris
Contact Information
Primary
Marilucy LOPEZ-SUBLET, MD
marilucy.lopez-sublet@aphp.fr
+33 (0)148955391
Backup
Lionel CARBILLON, MD PhD
lionel.carbillon@aphp.fr
+33 (0)148026030
Time Frame
Start Date: 2023-08-11
Estimated Completion Date: 2026-12
Participants
Target number of participants: 110
Treatments
Experimental: Women with a hypertension disorder in pregnancy and/or preeclampsia
Pregnant patients from the 20th week of amenorrhea with the initial diagnosis of a hypertension disorder in pregnancy and/or preeclampsia. Patients in a stable state undergoing follow-up consultation (day hospital and week hospitalization)
Authors
Amélie BEBARA
Related Therapeutic Areas
Sponsors
Leads: Assistance Publique - Hôpitaux de Paris

This content was sourced from clinicaltrials.gov