Preeclampsia is a pregnancy-specific condition that originates in the placenta. Despite decades of research, its pathogenesis remains largely unknown. However, several risk factors for preeclampsia... Show morePreeclampsia is a pregnancy-specific condition that originates in the placenta. Despite decades of research, its pathogenesis remains largely unknown. However, several risk factors for preeclampsia have been identified, including a (family) history of preeclampsia, autoimmune disease and conditions associated with endothelial damage, including hypertension, diabetes mellitus and preexistent renal disease. This thesis aims to further investigate through which mechanisms these risk factors increase the risk for preeclampsia. It deals with both the genetic background of preeclampsia, as well as the role of complement activation in its pathogenesis. Finally, it touches upon the role of angiogenic factors in the development of preeclampsia. Show less
Over the last two decades, there has been substantial progress in the area of blood safety in Uganda. In contrast, little attention has been paid to transfusion safety in Uganda and there are gaps... Show moreOver the last two decades, there has been substantial progress in the area of blood safety in Uganda. In contrast, little attention has been paid to transfusion safety in Uganda and there are gaps in laboratory and clinical transfusion practices within hospitals. Assessment of the current practice at Mulago and Mbarara Referral Hospitals showed inadequate documentation of the transfusion process, and poor monitoring of blood recipients. Our findings also indicated that one in every 16 transfused Ugandans and a similar number of RhD negative pregnant women possessed clinically significant red blood cell (RBC) alloantibodies in their plasma. However, RBC alloantibody screening is not performed during pre-transfusion and antenatal testing in the country. Thus, alloimmunized recipients and babies of RhD negative mothers are at high risk of morbidity and mortality due to haemolytic transfusion reactions (HTRs) and haemolytic disease of the fetus and the newborn (HDFN). Furthermore, data on the occurrence of acute and delayed HTRs and HDFN in Uganda are lacking. A cost-effectiveness analysis showed that introduction of RBC alloantibody screening would be cost-effective and improve blood transfusion safety. Therefore, there is need to improve immunohaematological testing in Uganda so that RBC alloimmunization and the consequences thereof may be prevented. Show less
