Maternal brain involvement in (pre)eclampsia. Pathophysiology and long-term consequences

PhD ceremony: Ms. M.J. Wiegman, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Maternal brain involvement in (pre)eclampsia. Pathophysiology and long-term consequences

Promotor(s): prof. J.G. Aarnoudse, prof. M.J. Cipolla

Faculty: Medical Sciences

Preeclampsia complicates about 5-7%% of all pregnancies in the Netherlands. It is characterized by high blood pressure and the presence of proteins in the urine. Preeclampsia can be complicated by fluid accumulation in the brain, leading to convulsions in the mother, which is called eclampsia.

How preeclampsia results in eclampsia is largely unknown. Because knowledge on the influence of pregnancy, and preeclampsia in particular, on the brain is scarce, we conducted research with animal models. Blood vessels from brains of non-pregnant and pregnant rats, with or without preeclampsia, were examined for function (ability of the blood vessels to regulate blood flow) and structure. Furthermore, in non-pregnant and pregnant rats, we investigated the permeability of blood vessels to water and the presence of proteins that may influence permeability (aquaporins).

Until recently it was thought that women who experienced preeclampsia could expect complete recovery. However, our research demonstrated that on MRI scans these women more often showed small brain changes that seem to be related to normal aging, so called white matter lesions, compared to women with healthy pregnancies. The exact causes and consequences of these lesions are unclear. To investigate such causes, we compared brain scans of women who formerly had eclampsia, preeclampsia or a healthy pregnancy. The scans were evaluated according to the location of white matter lesions since this may point at specific causes. Because it is known that lesions may influence someone’s vision, the visual fields (the area someone can see while looking straight ahead) of formerly eclamptic women were assessed. These women also completed a questionnaire concerning their visual functioning.