ajog.

org Poster Session V

STUDY DESIGN: Pregnant rats were dived into normal pregnant (NP) (Figure A). 5) Time interval from presentation to the diagnosis of
and RUPP groups; RUPP was performed on gestational day (GD) 14, severe PET was inversely related to GA at presentation (Figure B).
and on GD19 conscious mean arterial blood pressure (MAP) was CONCLUSION: GA at the diagnosis of GHTN is inversely related with
measured, placentas were collected and mitochondria were isolated. both the rate of disease progression to PET and to the time interval
Mitochondrial Electron Transport Chain (ETC) complex I and IV to the diagnosis of severe PET.
activities were measured spectrophotometrically. Additionally,
glutamate/malate was used as complex I substrate to measure
respiration. Respiration rates measured included: basal state (no
substrates), state 2 (glutamate/malate), state 3 (ADP), state 4 (oli-
gomycin), and maximal state (FCCP).
RESULTS: MAP was elevated in RUPP (n16) compared to NP rats
(n14) (1192 vs. 1002 mmHg, p<0.05). Complex I mediated
state 3 and maximal state respiration rates were signicantly reduced
in RUPP vs. NP (31316, n7 vs. 42315, n8, pmol/sec/mg,
p<0.01) and (24413, n7 vs. 30011, n8, pmol/sec/mg,
p<0.01) respectively. Respiratory control ratio (state3/state4) was
signicantly reduced in RUPP (n6) vs. NP rats (n8) (71 vs
101, p<0.05). Additionally, ETC complex I (123, n3 vs. 232,
n5 nmol e-/min/mg, P<0.05) and complex IV (50914, n4 vs.
64417, n6 nmol e-/min/mg, P<0.01) activities were drastically
reduced in RUPP compared to NP rats.
CONCLUSION: Impairment of mitochondrial respiration and ETC
activities indicate that mitochondrial dysfunction is associated with
placental ischemia of pregnancy and thereby could contribute to
oxidative stress, hypertension and other pathophysiological features
of PE.

881 Progression from gestational hypertension to

preeclampsia - what is the role of gestational age?
Eyal Krispin1, Liran Hiersch2, Adi Katz1, Omri Riter1,
Amir Aviram2, Eran Hadar1, Arnon Wiznitzer1, Yariv Yogev2,
Eran Ashwal2
1
Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva,
and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, 2Lis
Maternity Hospital, Sourasky Medical Center, Tel Aviv, and Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel
OBJECTIVE: To evaluate the effect of gestational age (GA) at presen-
tation with gestational hypertension (GHTN) on the interval to
progression to preeclampsia (PET).
STUDY DESIGN: A retrospective cohort study of all women presenting
with new onset hypertensive disorders of pregnancy in a single
medical center (2014-2015). Hypertensive disorders were classied
as either gestational hypertension (GHTN) or PET as dened by
ACOG. Severe PET was dened as blood pressure >160/110 or
HELLP syndrome. Women with chronic hypertension, multiple
gestations and chronic renal disease were excluded. Women with
GHTN at presentation were subdivided according to GA at presen-
tation (<34 vs. 34-36 vs. 37 weeks) and the rate of progression to
PET and the time interval from presentation with GHTN to the
diagnosis of PET was explored.
RESULTS: 1) Overall, among 15,564 women delivered during the
study period 359 (2.3%) met inclusion criteria and presented with
hypertensive disorders of pregnancy. 2) Diagnosis at presentation
was GHTN in 222 (61.8%), mild PET in 102 (28.4%) and Severe
PET in 35 (9.7%) women. Among 220 women with GHTN, 22
(9.9%) presented at GA<34 weeks, 47 (21.2%) at 34-36 weeks and
153 (68.9%) at 37 weeks. 3) The characteristics of the study groups
are presented in the Table. No signicant difference was observed
between the groups regarding Blood pressure or laboratory indices at
presentation. 4) The rate of those who progressed to any PET
and severe PET was inversely related to GA at diagnosis of GHTN
882 A role for natural killer cells in the
pathophysiology of preeclampsia
Jamil T. ElFarra, Lorena M. Amaral, Maggie McCalmon,
Ashley Gnam, Mark W. Cunningham Jr., Tarek Ibrahim,
Jeremy D. Scott, Babbette LaMarca, Denise C. Cornelius
University of Mississippi Medical Center, Jackson, MS
OBJECTIVE: Preecalmptic woman exhibit an increase in the number
of total and cytolytic natural killer (NK) cells when compared to
women with normal pregnancies. The exact role of the NK cells
during preeclampsia pathophysiology remains elusive. Using the
Reduced Uterine Perfusion Pressure (RUPP) rat model, which ex-
hibits many of the characteristics of preeclampsia, we hypothesize
that NK cell depletion could improve preeclampsia pathophysiology.
STUDY DESIGN: Three groups were used in this study: normal preg-
nant (NP; n13), RUPP (n11), and RUPP+NK cell depletion
(NKD; n13). NK cells were depleted in a subset of the RUPP rats
by i.p. administration of the Anti-asialo GM1 antibody (AaGM1), an
NK cell specic depleting antibody. Blood pressure and pup
weights were measured in all groups and tissues were collected for
further analysis. Total and cytolytic placental NK cells were quanti-
ed in all groups using ow cytometry. Placental reactive oxidative
stress was measured in all groups using the lucigenin chemilumi-
nescent assay
RESULTS: Placental ischemia caused an increase in both the total
placental NK cells (NP: 7.42% vs RUPP 16.53%, p<0.05) and the
cytolytic activation of placental NK cells (NP: 3.01% vs RUPP
11.73%, p<0.05). NK cell depletion (NKD) signicantly lowered

Supplement to JANUARY 2017 American Journal of Obstetrics & Gynecology S503