A prospective study of urinary prostaglandins E in women with normal and hypertensive pregnancies.

Studies in vitro suggest that pregnancy induced hypertension, or toxemia, is associated with decreased placental prostaglandins E (PGE) levels. To validate this observation in vivo PGE were measured weekly in 24h urine collections, in a prospective cross-sectional study in 9 women from 7 to 40 weeks. In addition, urinary PGE levels were also measured in 28 hospitalized pregnant women with either chronic hypertension or toxemia. Prostaglandins E were measured by radioimmunoassay after organic extraction and silicic acid separation. Urinary PGE levels during pregnancy (normotensive and chronic hypertensive women) were significantly elevated than those of the non-pregnant state. Mean urinary PGE levels in toxemic patients were significantly decreased compared to those of normal pregnancy and patients with chronic hypertension but they were similar to the mean levels of the non-pregnant state. One fetal death attributed to aggravation of chronic hypertension and one eclampsia were associated with undetectable levels of maternal urinary PGE. In conclusion, normal pregnancy is associated with a significant increase of urinary PGE; chronic hypertension and occurrence of toxemia are associated with significant diminution of urinary PGE excretion.