RESEARCH ARTICLE
Prostacyclin, thromboxane and glomerular filtration rate are abnormal in sickle cell pregnancy Opeyemi Abayomi Obilade1,2, Alani Suleimon Akanmu3,4, Fiona Broughton Pipkin5, Bosede Bukola Afolabi1,6*
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1 Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria, 2 Department of Obstetrics and Gynaecology, State House Medical Centre, Aso Rock, Asokoro, Abuja, Nigeria, 3 Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, IdiAraba, Lagos, Nigeria, 4 Department of Haematology and Blood Transfusion, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria, 5 Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom, 6 Department of Obstetrics and Gynaecology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria *
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Abstract OPEN ACCESS Citation: Obilade OA, Akanmu AS, Broughton Pipkin F, Afolabi BB (2017) Prostacyclin, thromboxane and glomerular filtration rate are abnormal in sickle cell pregnancy. PLoS ONE 12 (9): e0184345. https://doi.org/10.1371/journal. pone.0184345 Editor: Markus M. Bachschmid, Boston University, UNITED STATES Received: April 18, 2017
Background Pregnancy increases the risk of morbidity and mortality in sickle cell disease. We previously showed pregnant women with sickle cell disease to have a relatively low plasma renin concentration in late pregnancy, associated with a lack of the expected plasma volume expansion. We hypothesized this to be due to increased systemic vascular resistance through an imbalance between the vasodilator prostacyclin and vasoconstrictor thromboxane, associated with decreased glomerular filtration rate (GFR).
Accepted: August 22, 2017
Objective
Published: September 7, 2017
To compare estimated prostacyclin, thromboxane and GFR in non-pregnant and pregnant women with hemoglobin SS (HbSS) and AA (HbAA).
Copyright: © 2017 Obilade et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: The study was internally funded by OAO as it formed part of the requirements towards the part II Fellowship exam of the Faculty of Obstetrics and Gynaecology of the National Postgraduate Medical College of Nigeria. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Study design Four groups of 20 normotensive, nulliparous women were studied in Lagos, Nigeria: pregnant HbSS or HbAA women at 36–40 weeks gestation; non-pregnant HbSS and HbAA controls. We measured stable metabolites of prostacyclin and thromboxane A2 by enzymelinked immunosorbent assay; GFR using the Cockcroft-Gault equation. Data analysis was by independent (Student’s) t-test or Mann-Whitney U test for comparisons between any two groups of continuous variables, univariate ANOVA for multiple groups and Pearson’s correlation coefficient for degree of association between variables.
Results HbSS women had lower serum 6-keto-PGF1α concentrations than HbAA, whether pregnant or non-pregnant (P
