Are There Differences in the Anthropometric, Hemodynamic, Hematologic, and Biochemical Profiles between Late- and Early-Onset Preeclampsia?

Márcia Aires Rodrigues De Freitas,Mario Da Silva Garrote Filho,Angélica Lemos Debs Diniz,Alice Vieira Da Costa,Luciana Alves De Medeiros,Nilson Penha-Silva

doi:10.1155/2018/9628726

Márcia Aires Rodrigues De Freitas, Mario Da Silva Garrote Filho + Show 4 more

Open Access

https://doi.org/10.1155/2018/9628726

Copy DOI

Abstract

Preeclampsia (PE) is classified as early-onset PE (EOPE) and late-onset PE (LOPE) when present before or after 34 weeks of gestation, respectively. This transversal study aimed to investigate the differences and possible associations existing in the anthropometric, hemodynamic, hematologic, and biochemical profiles of late- and early-onset preeclampsia. The study included 65 volunteers admitted to a tertiary hospital in Brazil: 29 normotensive and 36 with preeclampsia (13 with EOPE and 23 with LOPE). Pregnant women with LOPE presented greater weight gain and borderline increase in body mass index at the end of gestation in relation to the other groups, which is compatible with the metabolic origin, associated with obesity, attributed to this form of the disease. Pregnant women with EOPE presented a borderline reduction in the number of erythrocytes and a significant decrease in the number of platelets, in addition to a significant increase in reticulocytes, serum iron, and ferritin when compared to normotensive pregnant women and pregnant women with LOPE. A significant increase in osmotic stability of erythrocytes was observed in the EOPE group in relation to other groups. Hemodynamic analysis by Doppler ultrasonography of the ophthalmic artery showed that both groups of pregnant women with PE presented alterations compatible with the occurrence of hyperflow in the orbital territory. These hemodynamic changes were associated with changes in hematimetric indices.

Highlights

Preeclampsia (PE) is a complex multifactorial syndrome with etiology not yet established, which affects between 5 and 7% of pregnancies worldwide [1, 2]. e diversity of repercussions in the pregnant woman and in the fetus has been investigated in light of its classification in early-onset PE (EOPE) and lateonset PE (LOPE), when present before and after 34 weeks of gestation, respectively [3]. is classification seems to reflect etiopathogenic mechanisms that begin at different moments of gestation
E parameters H0, H50, and H100 are proportional to the osmotic fragility of the erythrocytes. erefore, their inverse forms, 1/H0, 1/H50, and 1/H100, are those which effectively represent the osmotic stability of those cells. dX is effectively a variable of osmotic stability of erythrocytes, and the dX/H50 and dX/Amin ratios are directly proportional to the erythrocyte membrane stability since Amin and H50 have inverse relationships with the stability of these cells
At each ejection of blood from the left ventricle, a pulse pressure, which is represented by a rapid upward curve, occurs, generating the peak systolic velocity (PSV), which is followed by sudden drop, and a secondary elevation of velocity, generating a second systolic peak (P2) and a notch before the end of the systolic cycle

Summary

Introduction

Preeclampsia (PE) is a complex multifactorial syndrome with etiology not yet established, which affects between 5 and 7% of pregnancies worldwide [1, 2]. e diversity of repercussions in the pregnant woman and in the fetus has been investigated in light of its classification in early-onset PE (EOPE) and lateonset PE (LOPE), when present before and after 34 weeks of gestation, respectively [3]. is classification seems to reflect etiopathogenic mechanisms that begin at different moments of gestation. E diversity of repercussions in the pregnant woman and in the fetus has been investigated in light of its classification in early-onset PE (EOPE) and lateonset PE (LOPE), when present before and after 34 weeks of gestation, respectively [3]. Epidemiological studies have shown that neurologic complications occur more frequently in EOPE than in LOPE [6, 7]. This suggests that EOPE is the most severe form of PE, promoting neurologic complications due to central vascular alterations [8,9,10,11]. The factors that contribute to neurologic involvement during EOPE are not well known [7]

Methods

Results

Conclusion