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Abstract: Objectives: Previously preeclamptic women may express cognitive difficulties, which have largely been unappreciated or attributed to stresses of a complicated pregnancy. This study aimed to explore the scope of perceived neurocognitive and psychosocial problems as well as quality of life following preeclampsia. Study design: Observational study. Through website promotion and e-mail, registrants of the USA-based Preeclampsia Foundation who experienced preeclampsia in the past 20years were invited to complete a web-based survey. Participants were requested to ask an acquaintance that had a normotensive pregnancy to also complete the survey (controls). Main outcome measures: The Cognitive Failures Questionnaire (CFQ), abbreviated WHO Quality Of Life questionnaire (WHOQOL-BREF), Social Functioning Questionnaire (SFQ) and Breslau Short Screening Scale for DSM-IV Posttraumatic Stress Disorder were used in the survey. Analysis was performed using Mann–Whitney U tests and linear regression. Results: 966 cases and 342 controls completed the survey (median age 34, median time since first pregnancy 4 vs. 5years). Cases scored significantly worse on CFQ (median 35 vs. 27), WHOQOL-BREF domains physical health (15 vs. 17), psychological (13 vs. 15), social relationships (13 vs. 15) and environment (15 vs. 16), and SFQ (8 vs. 7). All p <0.001. Multivariable analysis showed an independent significant effect of eclampsia on CFQ and of migraine on all questionnaires and the effect of preeclampsia was still present after adjustment for confounders. Posttraumatic stress symptoms accounted for part of the relationships. Conclusions: Previously preeclamptic women appear to perceive more cognitive and social problems, and report poorer quality of life compared to a group of women with normotensive pregnancies. Research relating to the origin and management of these issues is needed. [Copyright &y& Elsevier]

Abstract: Objective: To assess brain damage using the neuroinflammation marker S100B in a preeclampsia rat model. Methods: Non-pregnant and pregnant rats were infused with saline or low-dose-endotoxin on day 14 of pregnancy. S100B expression in the brain (immunohistochemistry) and S100B plasma concentrations (ELISA) were studied. Results: No differences in S100B expression in brain tissue were observed between the four groups. Pregnant endotoxin treated animals did not show increased levels of plasma S100B levels as compared with control pregnant rats, while significantly higher plasma S100B levels were found in non-pregnant endotoxin versus pregnant endotoxin infused rats. Conclusion: Pregnancy nor experimental preeclampsia, alter S100B in rat brain, or in plasma. Increased plasma S100B in non-pregnant endotoxin-treated rats may indicate brain injury in these rats, whereas pregnancy might be protective. [Copyright &y& Elsevier]

Objectives To ascertain the incidence and demographic data of TOP for hypertensive disorders at the limits of fetal viability. Methods We conducted a retrospective cohort study. All terminations for hypertensive disorders between 2000 and 2009 in the ten Dutch tertiary care centers with a gestational age between 22 and 28 weeks were included. In all cases the fetus was judged to be non-viable, either because of the low gestational age or because of the effects of the maternal condition on the fetus. There was no intention to intervene for fetal indications. Results During the study period TOP for hypertensive disorders occurred in 0.8 promille (131/163.052) of all deliveries in these 10 centers, of which there were 126 singleton and five twin pregnancies. 94 women were nulliparous and 37 multiparous. The main indication for TOP was HELLP syndrome. General history revealed hypertension in 24 women (18.3%). History was unremarkable in 98 cases (75%). The mean gestational age at admission was 166 days ± 9.6 days (GA 23+5), and at delivery this was 173 days ± 9.7 days (GA 24 + 5 weeks). The mean birth weight was 472 ± 123 g (70% < p10). The overall perinatal mortality was 99.3%. There were no maternal deaths. Conclusions In 10 years there we identified 131 cases of TOP for hypertensive disorders prior to fetal viability in The Dutch tertiary care centers. Ninety-eight women (75%) had no preexisting maternal disease. Table 1. Indications for termination of pregnancy. N = number. Indication N (%) HELLP syndrome 80 (61.1) Preeclampsia 40 (30.5) Eclampsia 7 (5.3) Refractory hypertension 4 (3) Disclosures L. van Eerden: None. [ABSTRACT FROM AUTHOR]