Peripartal Temporal Course of Endothelin 1, Angiotensin II, and Atrial Natriuretic Peptide in Pre-Eclampsia and Normotensive Pregnancy

OBJECTIVE: To investigate the temporal peripartal course of plasma endothelin 1 (ET-1), angiotensin II (ANG II), and atrial natriuretic peptide (ANP) in patients with pre-eclampsia as compared to women with normotensive pregnancy. METHODS: Levels of ET-1, ANG II, and ANP were measured by means of radio-immunoassay twice a week in 17 patients with pre-eclampsia and in 17 women with normotensive uncomplicated pregnancy during four different periods: (a) from admission to 1 week before delivery, (b) 1st week before delivery, (c) 1st week after delivery, and (d) 2nd week after delivery. RESULTS: ET-1 levels were not statistically different between the two groups. ANG II concentrations were lower in the pre-eclampsia group than in the control group with statistical significance in period c (2.8 +/- 3.0 vs. 7.1 +/- 5.9 pg/ml, mean +/- SD). ANP levels were higher in pre-eclamptic women than in the control group, the difference being statistically significant in period a (54 +/- 46 vs. 11 +/- 16 pg/ml) and in period c (122 +/- 134 vs. 39 +/- 22 pg/ml). CONCLUSIONS: There are considerable differences in ANP and ANG II concentrations during the peripartal period between patients with pre-eclampsia and normotensive pregnant women. Decreased ANG II and elevated ANP levels in the 1st week postpartum may reflect the clinical observation that some women deteriorate in this period.