PP079. Evidence of placental and vascular endothelial apotosis and dysfunction by elevated serum human chorionic gonadotropin, soluble selectin and soluble Fas in HELLP syndrome.

INTRODUCTION

The etiology of Hemolysis, Elevated Liver enzyme, and Low Platelets (HELLP) syndrome remains unknown. We hypothesized that placental and vascular endothelial apoptosis and dysfunction might be the pathogenesis of HELLP syndrome.

OBJECTIVES

To determine maternal serum levels and association among human chorionic gonadotropin (hCG), soluble Fas (sFas), and E-selectin (sE-selectin) in HELLP syndrome.

METHODS

Forty-two singleton pregnant women were studied. Fourteen patients were with HELLP syndrome and 28 patients were healthy gravidas. The serum levels of total beta-hCG, sFas, and sE-selectin were measured by enzyme-linked immunoassays. Mann-Whitney test and Spearman rank correlation were used for statistical analyses. Data were expressed as median and ranges. P value less than 0.05 is considered statistically significant.

RESULTS

There were no significant differences in maternal age, gestational age, parity or race in patients with and without HELLP syndrome. The median levels of serum total beta-hCG, sFas, and sE-selectin were significantly higher in women with HELLP syndrome than in healthy gravidas {total beta-hCG: 52,168 (14,936-213,445)mIU/mL vs. 17,942 (966-176,600)mIU/mL, p=0.016; sFas: 8.20 (3.0-22.6)U/ml vs. 5.8 (1.2-18.5)U/ml, p=0.001; sE-selectin: 107.7 (26.2-194.7)ng/mL vs. 23.0 (11.1-107.7)ng/mL, p<0.0001}. Moreover, serum total beta-hCG levels were significantly correlated with serum sFas (r=0.32, p=0.039) and sE-selectin levels (r=0.32, p=0.038). Serum sFas levels were also significantly correlated with serum sE-slectin (r=0.47, p=0.003)

CONCLUSION

Our data suggest that placental and vascular endothelial apoptosis in preeclampsia may further lead to placental and endothelial dysfunction as the possible pathogenesis in HELLP syndrome.