Year-end Sale % OFF 
Abstract
Pre-eclampsia is a pregnancy-induced hypertensive disorder which affect multiple organ functions, it is one of the main factors increasing the morbidity and mortality of the maternal and neonatal. Furthermore, with the increasing rate of infertility or sub-fertility, more and more couples are conceiving assisted reproductive therapies, especially in vitro fertilization (IVF), which brings high possibility of multiple pregnancy due to its unique process and the patients demands. As is well known that multiple pregnancy may face great challenges of complications such as pre-eclampsia, gestational diabetes, intrahepatic cholestasis of pregnancy etc. If pre-eclampsia is not treated and monitored very well on time the mothers perhaps will have eclampsia, placental abruption or multiple organ dysfunction leading to death, likewise those fetus whose mother suffered from Pre-eclampsia also face the risks of fetus growth restriction, fetal stress or even stillbirth. We represent a patient in our clinic who had done twice in vitro fertilization-embryo transplantation(IVF-ET) with several high risks of pre-eclampsia and followed by recurrent Pre-eclampsia and Intrahepatic Cholestasis of Pregnancy, we fully recognize her risks in her second pregnancy and give a close antenatal surveillance, and she finally have two alive babies, but a large amount of money was spend for the two preterm babies in hospitalization in NICU and also the mother herself became exhausted and almost lost her hope. It reminds us that before conceiving IVF technology for patients, the indication must be clear, the adverse effect must be brought into consideration, cooperation must be obtained from both the reproductive clinicians and obstetrician to fully balance the benefit and adverse effect, attention must be paid to choose the best method during the assisted reproductive therapies and acquire the utmost benefit and avoid the side effect as possible.
Highlights
Pre-eclampsia is clinically defined by hypertension and proteinuria, with or without pathological edema that occurs after 20 weeks’ gestation, but can present up to 4-6 weeks post-partum [1]
Since Intrahepatic Cholestasis Pregnancy (ICP) was suspected on the basis of elevated bile acid and her symptom, S-adenosyl-L-methionine (SAMe) andursodeoxycholic acid (UDCA) were added to her treatment. One week later her serum albumin drop to 26g/l with TBA increasing to 40umol/l (Figure 3), proteinuria remained negative, electrocardiography showed broadening of pulmonary artery, considering the high possibility of recurrent pre-eclampsia, pulmonary hypertension and sudden fetal death, she was admitted at her 30th week gestation to the obstetrics ward, besides all the
Several studies, including a systematic review and a meta-analysis, have reported an increased risk of pre-eclampsia in pregnancies conceived by in vitro fertilization (IVF) [11,12,13,14]. Those patients underwent Assistant Reproductive Technique (ART) always has infertility, such as in our case the patient is suffered from Polycystic Ovarian Syndrome (PCOS), patients with PCOS have a higher risk of pre-eclampsia, because PCOS patients generally have a high ovarian response to FSH, and it has been reported that IVF technology may have certain undesirable side effects, such as OHSS and hypertensive disorders in pregnancy, possibly due to use of drugs and operational intervention [15]
Summary
Pre-eclampsia is clinically defined by hypertension and proteinuria, with or without pathological edema that occurs after 20 weeks’ gestation, but can present up to 4-6 weeks post-partum [1]. Diagnosis and appropriate management is extremely important in patients with pre-eclampsia or those who has high risks of pre-eclampsia. The exact etiology is unknown but some high risks are recognized worldwide, such as prior pre-eclampsia, chronic hypertension, multiple gestation, pre-gestational diabetes, maternal BMI >30kg/m2, anti-phospholipid syndrome/SLE [3]. But the Journal of Gynecology and Obstetrics 2018; 6(4): 80-85 assisted therapy method play an important role in the maternal and neonatal outcome, following the ICSI-ET(intro-cytoplasmic sperm injection and embryo transplantation) process, the invasive procedure can create some unfavorable condition that may impact the implantation of the embryos and change the endometrial microenvironment, which can affect the health of the off springs [7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
