Clinical aspects of preeclampsia: a retrospective analysis
DOI:
https://doi.org/10.15574/HW.2024.170.65Keywords:
preeclampsia, frequency, clinical characteristics, pregnant womenAbstract
Preeclampsia (PE) is a serious cause of maternal and perinatal mortality. Every year, more than 2 million cases of PE and about 76,000 deaths among women from this pathology are registered in the world. Preeclampsia can cause premature birth and increase the risk of complications. Clinical manifestations of the disease are diverse. Therefore, studying the clinical features of PE is necessary to improve its prevention, diagnosis and treatment.
Purpose - to study the frequency and clinical aspects of the course of PE in pregnant women to improve prevention, diagnosis and treatment of this pathology of pregnancy.
Materials and methods. 21,950 cases of childbirth from 2016 to 2022 were analyzed. The clinical characteristics of 1,209 patients with preeclampsia were analyzed. The obstetric history of women with PE was studied, their somatic status was assessed, and laboratory data were analysed. The results were statistically analysed using the methods of variation and alternative statistics.
Results. In 2016-2020, the frequency of PE was 5.5% of the total number of births. The increase in PE during the observation period was 51.5%, its severe degree was 70.5%. In women with PE, I-III pregnancies prevailed (79.5%) and I or II births in the anamnesis (97.4%). The severity of the disease was correlated with the body mass index, which varied from 22 to 43 kg/m2. Pathological changes in the objective status were revealed, including edema (53.8%) and neurological disorders (71.7%). Almost all pregnant women with PE had proteinuria. Thrombocytopenia was detected in 15.4%, hemoglobin decrease was in 25.6%. The majority of pregnant women had an increase in the prothrombin index (73.6%) and a decrease in fibrinogen (52.7%).
Conclusions. The study of clinical aspects of PE reveals a high frequency of this pathology, a wide range of clinical symptoms, hemostasis disorders and organ dysfunction, which indicates the need to develop effective strategies for its diagnosis and treatment.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
References
ACOG. (2019). Gestational Hypertension and Preeclampsia. ACOG Practice Bulletin No. 202. Obstetrics and gynecology. 133(1): 1. https://doi.org/10.1097/AOG.0000000000003018
Armaly Z, Jadaon JE, Jabbour A, Abassi ZA. (2018). Preeclampsia: Novel Mechanisms and Potential Therapeutic Approaches. Frontiers in physiology. 9: 973. https://doi.org/10.3389/fphys.2018.00973; PMid:30090069 PMCid:PMC6068263
Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S et al. (2018). The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy hypertension. 13: 291-310. https://doi.org/10.1016/j.preghy.2018.05.004; PMid:29803330
Chaemsaithong P, Leung TY, Sahota D, Cheng YKY, Leung WC et al. (2019). Body mass index at 11-13 weeks' gestation and pregnancy complications in a Southern Chinese population: a retrospective cohort study. The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 32(12): 2056-2068. https://doi.org/10.1080/14767058.2018.1424824; PMid:29301455
Chen SN, Cheng CC, Tsui KH, Tang PL, Chern CU et al. (2018). Hypertensive disorders of pregnancy and future heart failure risk: A nationwide population-based retrospective cohort study. Pregnancy hypertension. 13: 110-115. https://doi.org/10.1016/j.preghy.2018.05.010; PMid:30177036
Goel A, Maski MR, Bajracharya S, Wenger JB, Zhang D, Salahuddin S et al. (2015). Epidemiology and Mechanisms of De Novo and Persistent Hypertension in the Postpartum Period. Circulation. 132(18): 1726-1733. https://doi.org/10.1161/CIRCULATIONAHA.115.015721; PMid:26416810 PMCid:PMC4816491
Guida JPS, Andrade BG, Pissinatti LGF, Rodrigues BF, Hartman CA, Costa ML. (2022). Prevalence of Preeclampsia in Brazil: An Integrative Review. Prevalência de pré-eclâmpsia no Brasil: Uma revisão integrativa. Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia. 44(7): 686-691. https://doi.org/10.1055/s-0042-1742680; PMid:35139578 PMCid:PMC9948112
Hernández-Díaz S, Toh S, Cnattingius S. (2009). Risk of pre-eclampsia in first and subsequent pregnancies: prospective cohort study. BMJ (Clinical research ed.). 338: b2255. https://doi.org/10.1136/bmj.b2255; PMid:19541696 PMCid:PMC3269902
Ives CW, Sinkey R, Rajapreyar I, Tita ATN, Oparil S. (2020). Preeclampsia-Pathophysiology and Clinical Presentations: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 76(14): 1690-1702. https://doi.org/10.1016/j.jacc.2020.08.014; PMid:33004135
Jim B, Karumanchi SA. (2017). Preeclampsia: Pathogenesis, Prevention, and Long-Term Complications. Seminars in nephrology. 37(4): 386-397. https://doi.org/10.1016/j.semnephrol.2017.05.011; PMid:28711078
Jung E, Romero R, Yeo L, Gomez-Lopez N, Chaemsaithong P, Jaovisidha A et al. (2022). The etiology of preeclampsia. American journal of obstetrics and gynecology. 226(2S): S844-S866. https://doi.org/10.1016/j.ajog.2021.11.1356; PMid:35177222 PMCid:PMC8988238
Mæland KS, Morken NH, Schytt E, Aasheim V, Nilsen RM. (2023). Risk of Subsequent Preeclampsia by Maternal Country of Birth: A Norwegian Population-Based Study. International journal of environmental research and public health. 20(5): 4109. https://doi.org/10.3390/ijerph20054109; PMid:36901120 PMCid:PMC10001690
Ndwiga C, Odwe G, Pooja S, Ogutu O, Osoti A, Warren CE. (2020). Clinical presentation and outcomes of pre-eclampsia and eclampsia at a national hospital, Kenya: A retrospective cohort study. PloS one. 15(6): e0233323. https://doi.org/10.1371/journal.pone.0233323; PMid:32502144 PMCid:PMC7274433
Olson KN, Redman LM, Sones JL. (2019). Obesity «complements» preeclampsia. Physiological genomics. 51(3): 73-76. https://doi.org/10.1152/physiolgenomics.00102.2018; PMid:30716010 PMCid:PMC6459374
Padhan SC, Pradhan P, Panda B, Pradhan SK, Mishra SK (2023). Risk Factors of Pre-eclampsia: A Hospital-Based Case-Control Study. Cureus. 15(7): e42543. https://doi.org/10.7759/cureus.42543
Pankiewicz K, Szczerba E, Maciejewski T, Fijałkowska A. (2019). Non-obstetric complications in preeclampsia. Przeglad menopauzalny = Menopause review. 18(2): 99-109. https://doi.org/10.5114/pm.2019.85785; PMid:31485207 PMCid:PMC6719635
Phipps E, Prasanna D, Brima W, Jim B. (2016). Preeclampsia: Updates in Pathogenesis, Definitions, and Guidelines. Clinical journal of the American Society of Nephrology: CJASN. 11(6): 1102-1113. https://doi.org/10.2215/CJN.12081115; PMid:27094609 PMCid:PMC4891761
Poniedziałek-Czajkowska E, Mierzyński R, Leszczyńska-Gorzelak B. (2023). Preeclampsia and Obesity-The Preventive Role of Exercise. International journal of environmental research and public health. 20(2): 1267. https://doi.org/10.3390/ijerph20021267; PMid:36674022 PMCid:PMC9859423
Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H et al. (2019). The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 145; Suppl 1: 1-33. https://doi.org/10.1002/ijgo.12802; PMid:31111484 PMCid:PMC6944283
Tassi A, Sala A, Mazzera I, Restaino S, Vizzielli G, Driul L. (2023). Long-term outcomes of patients with preeclampsia, a review of the literature. Hypertension in pregnancy. 42(1): 2217448. https://doi.org/10.1080/10641955.2023.2217448; PMid:37259591
Teka H, Yemane A, Abraha HE, Berhe E, Tadesse H, Gebru F et al. (2023). Clinical presentation, maternal-fetal, and neonatal outcomes of early-onset versus late onset preeclampsia-eclampsia syndrome in a teaching hospital in a low-resource setting: A retrospective cohort study. PloS one. 18(2): e0281952. https://doi.org/10.1371/journal.pone.0281952; PMid:36848332 PMCid:PMC9970097
Tranquilli AL, Brown MA, Zeeman GG, Dekker G, Sibai BM. (2013). The definition of severe and early-onset preeclampsia. Statements from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Pregnancy hypertension. 3(1): 44-47. https://doi.org/10.1016/j.preghy.2012.11.001; PMid:26105740
Wilkerson RG, Ogunbodede AC. (2019). Hypertensive Disorders of Pregnancy. Emergency medicine clinics of North America. 37(2): 301-316. https://doi.org/10.1016/j.emc.2019.01.008; PMid:30940374
Williams D, Stout MJ, Rosenbloom JI, Olsen MA, Joynt Maddox KE, Deych E et al. (2021). Preeclampsia Predicts Risk of Hospitalization for Heart Failure With Preserved Ejection Fraction. Journal of the American College of Cardiology. 78(23): 2281-2290. https://doi.org/10.1016/j.jacc.2021.09.1360; PMid:34857089 PMCid:PMC8647839
Yang Y, Le Ray I, Zhu J, Zhang J, Hua J, Reilly M. (2021). Preeclampsia Prevalence, Risk Factors, and Pregnancy Outcomes in Sweden and China. JAMA network open. 4(5): e218401. https://doi.org/10.1001/jamanetworkopen.2021.8401; PMid:33970258 PMCid:PMC8111481
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Ukrainian Journal Health of Woman
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal UKRAINIAN JOURNAL «HEALTH OF WOMAN» when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
