Preeclampsia Complications Research Articles

Ascites in preeclampsia: A case report

Preeclampsia complicates approximately 2-8% of all pregnancies and is an important cause of maternal morbidity and mortality. Ascites in preeclampsia is a rare complication. We here are presenting a case of a 28-year primigravida with 34 weeks of gestation, a known case of preeclampsia, that was referred to our institute from a primary health centre in view of impending eclampsia. Massive ascites is an unusual complication of preeclampsia which may lead to maternal respiratory compromise, which calls for active termination of the pregnancy within 24–48 hours as it cannot be cured by medical treatment. Its rarity may be due to under-reporting. The incorporation into clinical practice of evaluating the amount of ascites in patients with preeclampsia might prompt the obstetrician to more intensive and more frequent maternal and fetal surveillance to avoid maternal and fetal complications.

Platelet mitochondrial membrane depolarization reflects disease severity in patients with preeclampsia

BackgroundThrombocytopenia is a feared complication of preeclampsia (PE) that can additionally complicate the disease course and that carries a poor prognosis. The disease mechanisms of PE on a platelet level are poorly understood and only few platelet-based markers have been investigated. In sepsis, platelet mitochondrial membrane depolarization, a sensitive and early indicator of mitochondrial dysfunction and platelet cell death, correlates with disease severity and outcome as shown in previous studies. The aim of this study was to investigate platelet mitochondrial membrane potential (Mmp-Index) by flow-cytometry in patients with preeclampsia compared to controls and to assess its value in correlation with disease severity of PE and during follow-up after delivery.MethodsIn this prospective translational case–control study, platelet Mmp-Index was measured in PE (n = 16) by flow cytometry in living platelets in simultaneous comparison to healthy pregnant (n = 32) and non-pregnant controls (n = 16) and was individually reassessed after delivery to investigate recovery of platelet mitochondrial function. Subgroup analysis of patients with severe and non-severe PE was performed. Six patients with isolated gestational hypertension were also included for comparative analysis.ResultsPlatelet Mmp-Index in patients with symptomatic preeclampsia (Mmp-Index non-severe PE 0.72 ([0.591; 0.861]; p = 0.002) was significantly reduced compared to healthy pregnant controls (Mmp-Index 0.97 [0.795; 1.117]) and even more pronounced in patients with severe PE (n = 6) (Mmp-Index severe PE 0.542 [0.361; 0.623]; p = 0.03). In the severe PE group, complementary measurements of platelet Annexin V- and CD62 (P-Selectin) surface expression showed apoptosis of platelet populations in the majority of patients. Platelet Mmp normalized after delivery within few days. Patients with isolated gestational hypertension showed normal Mmp-Index values.ConclusionsThis study shows for the first time that platelet Mmp-Index is a quantifiable, easy-to-measure intracellular marker of platelet mitochondrial function in vital cells that reflects disease severity of preeclampsia. For future investigations, platelet Mmp may serve as a prognostic marker that may aid clinical risk stratification and adds novel information on potential mechanisms for thrombocytopenia in preeclampsia.

Topical aspects of laboratory diagnosis of urinary tract infections in pregnancy (literature review)

Numerous scientific studies, as well as practical experience in public health, have determined that proper and timely diagnosis of urinary tract infection (UTI) during pregnancy often determines obstetric and perinatal outcomes, and affects maternal and perinatal mortality rates. Urinary tract infections are common, with a prevalence in pregnancy ranging from 8 to 10%. During pregnancy and delivery, patients with UTIs can develop a number of complications such as anaemia, spontaneous miscarriage, preeclampsia, fetoplacental insufficiency, premature delivery and postpartum septic complications. UTIs also have adverse effects on the fetus, causing fetal hypoxia, delayed intrauterine development and intrauterine infection. Prenatal screening for UTIs is included in the standard of care for pregnant women throughout the world and in some countries, women are screened more than once. Such early diagnosis for asymptomatic bacteriuria is thought to reduce obstetric, perinatal and urological complications by up to a factor of five. However, in some European countries, the socioeconomic feasibility of routine screening of pregnant women for asymptomatic bacteriuria has recently been raised.

Proteomics and Metabolomics Profiling of Platelets and Plasma Mediators of Thrombo-Inflammation in Gestational Hypertension and Preeclampsia.

Platelets may be pivotal mediators of the thrombotic and coagulopathic complications of preeclampsia (PE), linking inflammation and thrombosis with endothelial and vascular dysfunction. Both PE and gestational hypertension (GH) fall within the spectrum of hypertensive complications of pregnancy, with GH being a risk factor for preeclampsia. However, it is unclear what biomarkers distinguish PE from GH. Using a discovery size cohort, we aimed to characterize specific plasma and platelet thrombo-inflammatory drivers indicative of PE and differentiate PE from GH. We performed multiplex immunoassays, platelet and plasma quantitative proteomics and metabolomics of PE patients, comparing with non-pregnant (NP), healthy pregnant controls (PC) and GH participants. The expression pattern of plasma proteins and metabolites in PE/GH platelets was distinct from that of NP and PC. Whilst procoagulation in PC may be fibrinogen driven, inter-alpha-trypsin inhibitors ITIH2 and ITIH3 are likely mediators of thrombo-inflammation in GH and PE, and fibronectin and S100A8/9 may be major procoagulant agonists in PE only. Also enriched in PE were CCL1 and CCL27 plasma cytokines, and the platelet leucine-rich repeat-containing protein 27 and 42 (LRRC27/42), whose effects on platelets were explored using STRING analysis. Through protein-protein interactions analysis, we generated a new hypothesis for platelets’ contribution to the thrombo-inflammatory states of preeclampsia.

Двусторонняя экссудативная отслойка сетчатки, сформировавшаяся на фоне преэклампсии тяжелой степени

Purpose. To present a clinical case of bilateral exudative retinal detachment in a patient with severe preeclampsia. Material and methods. Patient M. 19 years old. Pregnancy 27−28 weeks (III trimester), severe preeclampsia, premature detachment of a normally located placenta. Result. On examination, the pronounced edema of the eyelids and pale chemosis of the conjunctiva attracted attention. Visual acuity was extremely low and amounted to 0.01. Ophthalmoscopy in the upper quadrant of the right eye revealed a high vesicular retinal detachment with the capture of the macular region. In the left eye, a vesicular retinal detachment was determined, localized in the macular region. Conclusion. Thus, the presented clinical case is of great interest, since exudative retinal detachment is a rather rare complication in preeclampsia. This pathology provides for bed rest, normalization of blood pressure, control of proteinuria and, as a rule, does not require surgical treatment. Keywords: exudative retinal detachment, preeclampsia, endothelial dysfunction.

Case Report: Rare Case of NF2 in Pregnancy with Favorable Maternal and Perinatal Outcome, Under General Anesthesia Caesarean Section

Background: Neurofibromatosis type 2 (NF2) is an autosomal dominant disease due to chromosome 22 (22q12.2) mutation with a prevalence of 1:33,000-40,000. As many as 50% of cases are familial, 30-60% are genetic mosaic, de novo mutations. Tumor growth in NF often becomes more rapid in pregnancy. Pregnancy with NF2 has a risk of complications of hypertension, preeclampsia, cardiovascular problems, and IUGR (Intrauterine growth restriction). Case Reports: A 26-year-old woman, 29/30 weeks gestational age complaint of visual impairment, hearing loss, and multiple body masses. The results of MRI examination of the Head and whole Spine with contrast showed bilateral vestibular schwannoma, meningiomatosis, cervical schwannoma (C1-C5), which were features of NF2. Routine clinical evaluation, laboratory tests, fetal growth examination, and multidisciplinary management were performed during the antenatal care. There were no signs of increased intracranial pressure, hydrocephalus, and complications of preeclampsia, fetal abnormalities, or IUGR. A termination at 37 weeks of gestation with Caesarean Section and General Anesthesia was decided to reduce the increase of intracranial pressure during labor. A male infant was born with a birth weight of 2600 grams, without any abnormalities. Conclusion: Pregnancy in NF2 patient has a potential risk of tumor growth progression, preeclampsia, and IUGR, therefore it is necessary to monitor and evaluate the mother and fetus multidisciplinary during the pregnancy process to get good maternal and fetal outcomes. The mode of delivery in neurofibromatosis is determined mainly by obstetric indications.

Role of Salivary Uric Acid Versus Serum Uric Acid in Predicting Maternal Complications of Pre-Eclampsia in a Rural Hospital in Central India: A Two-Year, Cross-Sectional Study.

BackgroundHypertensive disorders during pregnancy are an important topic of concern, specifically in rural and remote areas of India where there is a lack of awareness and it is difficult to maintain proper follow-up of pregnant females to screen them for complications developed during pregnancy. Gestational hypertension and pre-eclampsia result in the abruption of the placenta, hemolysis, elevated liver enzymes, low platelet count syndrome, eclampsia, and disseminated intravascular coagulation, which can be a serious threat to the health of the mother and the fetus. Therefore, it is important to identify biomarkers for diagnosing and predicting the complications of pre-eclampsia that may aid the obstetric high-dependency units based in rural areas to tackle this important health hazard during pregnancy.MethodologyA total of 180 singleton pregnant women of more than 34 weeks of gestational age were enrolled in this study. All women were divided into three groups (control group, severe pre-eclampsia, and non-severe pre-eclampsia) based on the severity of blood pressure and the presence of proteinuria (≥+1 by the dipstick method). Salivary and serum uric acid levels were measured through morning samples, and all patients were monitored for the development of complications and outcomes. Salivary uric acid and serum uric acid levels were correlated with each other and with maternal complications of pre-eclampsia.ResultsMean salivary uric acid (mg/dL) in severe pre-eclampsia was (6.72 ± 0.49) significantly higher compared to non-severe pre-eclampsia (4.75 ± 0.94) and control (3.13 ± 0.43). Mean serum uric acid (mg/dL) in severe pre-eclampsia was (8.13 ± 0.87) significantly higher compared to non-severe pre-eclampsia (6.23 ± 0.76) and control (3.85 ± 0.46).The lowest best cut-off value of maternal salivary uric acid was 5.06 mg/dL, above which one can predict maternal complications with a diagnostic accuracy of 78.33%.ConclusionsSalivary uric acid and serum uric acid levels are significantly raised in cases of pre-eclampsia in comparison to normal pregnancy. Salivary uric acid and serum uric acid are correlated significantly indicating that salivary uric acid can function as a cost-effective, novel marker to provide an idea about serum uric acid levels. The prognostic accuracy of salivary uric acid was good in predicting maternal complications among cases of pre-eclampsia (severe and non-servere) and early-onset maternal complications. Therefore, it may be utilized as a helpful marker to identify high-risk patients.

Cerebral biomarkers in neurologic complications of preeclampsia

There is no tool to accurately predict who is at risk of developing neurologic complications of preeclampsia, and there is no objective method to determine disease severity. We assessed whether plasma concentrations of the cerebral biomarkers neurofilament light, tau, and glial fibrillary acidic protein could reflect disease severity in several phenotypes of preeclampsia. Furthermore, we compared the cerebral biomarkers with the angiogenic biomarkers soluble fms-like tyrosine kinase 1, placental growth factor, and soluble endoglin. In this observational study, we included women from the South African Preeclampsia Obstetric Adverse Events biobank. Plasma samples taken at diagnosis (preeclampsia cases) or admission for delivery (normotensive controls) were analyzed for concentrations of neurofilament light, tau, glial fibrillary acidic protein, placental growth factor, soluble fms-like tyrosine kinase 1, and soluble endoglin. The cerebrospinal fluid concentrations of inflammatory markers and albumin were analyzed in a subgroup of 15 women. Analyses were adjusted for gestational age, time from seizures and delivery to sampling, maternal age, and parity. Compared with 28 women with normotensive pregnancies, 146 women with preeclampsia demonstrated 2.18-fold higher plasma concentrations of neurofilament light (95% confidence interval, 1.64-2.88), 2.17-fold higher tau (95% confidence interval, 1.49-3.16), and 2.77-fold higher glial fibrillary acidic protein (95% confidence interval, 2.06-3.72). Overall, 72 women with neurologic complications (eclampsia, cortical blindness, and stroke) demonstrated increased plasma concentrations of tau (2.99-fold higher; 95% confidence interval, 1.92-4.65) and glial fibrillary acidic protein (3.22-fold higher; 95% confidence interval, 2.06-5.02) compared with women with preeclampsia without pulmonary edema; hemolysis, elevated liver enzymes, and low platelet count; or neurologic complications (n=31). Moreover, angiogenic markers were higher, but to a lesser extent. Women with hemolysis, elevated liver enzymes, and low platelet count (n=20) demonstrated increased plasma concentrations of neurofilament light (1.64-fold higher; 95% confidence interval, 1.06-2.55), tau (4.44-fold higher; 95% confidence interval, 1.85-10.66), and glial fibrillary acidic protein (1.82-fold higher; 95% confidence interval, 1.32-2.50) compared with women with preeclampsia without pulmonary edema; hemolysis, elevated liver enzymes, and low platelet count; or neurologic complications. There was no difference shown in the angiogenic biomarkers. There was no difference between 23 women with preeclampsia complicated by pulmonary edema and women with preeclampsia without pulmonary edema; hemolysis, elevated liver enzymes, and low platelet count; or neurologic complications for any of the biomarkers. Plasma concentrations of tau and glial fibrillary acidic protein were increased in women with several neurologic complications compared with women with eclampsia only. Plasma neurofilament light, glial fibrillary acidic, and tau were candidate biomarkers for the diagnosis and possibly prediction of cerebral complications of preeclampsia.

Abstract No.: ABS2271: A Comparative Study of Optic Nerve Sheath Diameter and Lung Ultrasound Score in Healthy and Preeclampsia Parturients.

Background & Aims:Complications of preeclampsia include cerebral and pulmonary oedema which strongly correlate with optic nerve sheath diameter (ONSD) and lung ultrasound score (LUSS) respectively. This study was conducted to compare ONSD and LUSS in healthy and preeclamptic parturients.Methods:In this prospective observational analytical study, healthy pregnant women and preeclamptic women, 35 each, age >18 years and gestational age >34 weeks up to 24 hours of delivery, were included. Approval from institutional ethical committee was obtained and trial registered with clinical trial registry of India. Ultrasound assessment for ONSD and LUSS (12 region lung technique) was performed. Severity of preeclampsia was noted. Data was analysed using appropriate statistical tests. ROC analysis was performed to obtain a cutoff value for both ONSD and LUSS to predict complications of preeclampsia. A p-value of <0.05 was considered significant.Results:Of the 35 preeclamptic women, 19 had severe preeclampsia. Severe preeclamptics had higher ONSD and LUSS than mild preeclamptics and healthy parturients (p-value < 0.001). No difference was observed in LUSS between mild preeclamptics and healthy parturients. Mean ONSD of >4.65mm and LUSS of >2 predicted preeclampsia complications with a sensitivity of 77.14% and 68.57%, specificity of 91.43% and 85.71% and AUC of 0.907 and 0.806 respectively.Conclusion:ONSD and LUSS assessment is an easy, bedside, noninvasive technique to assess complications, guide fluid therapy and monitor response to treatment in preeclamptic parturients. Thus, early intervention can help in reducing maternal/fetal morbidity and mortality

202 Acute postpartum pulmonary edema – A case report

Introduction and aims of the study: Acute pulmonary edema is a rare complication in pregnancy and postpartum, with an estimated incidence between 0.08 and 0.5%. Acute pulmonary edema is the main cardiovascular complication of preeclampsia and one of the criteria of severe preeclampsia; occurs in 3% of preeclampsia cases, 70% of which take place during postpartum. The main risk factors for acute pulmonary edema in preeclampsia are advanced maternal age, multiparity and chronic hypertension. On the other side, preeclamspia and multiparity are risk factors for peripartum cardiomyopathy, which can also present itself with acute pulmonary edema; a common pathophysiological basis between preeclampsia and peripartum cardiomyopathy is under study.

Cerebral Biomarkers and Blood-Brain Barrier Integrity in Preeclampsia.

Cerebral complications in preeclampsia contribute substantially to maternal mortality and morbidity. There is a lack of reliable and accessible predictors for preeclampsia-related cerebral complications. In this study, plasma from women with preeclampsia (n = 28), women with normal pregnancies (n = 28) and non-pregnant women (n = 16) was analyzed for concentrations of the cerebral biomarkers neurofilament light (NfL), tau, neuron-specific enolase (NSE) and S100B. Then, an in vitro blood–brain barrier (BBB) model, based on the human cerebral microvascular endothelial cell line (hCMEC/D3), was employed to assess the effect of plasma from the three study groups. Transendothelial electrical resistance (TEER) was used as an estimation of BBB integrity. NfL and tau are proteins expressed in axons, NSE in neurons and S100B in glial cells and are used as biomarkers for neurological injury in other diseases such as dementia, traumatic brain injury and hypoxic brain injury. Plasma concentrations of NfL, tau, NSE and S100B were all higher in women with preeclampsia compared with women with normal pregnancies (8.85 vs. 5.25 ng/L, p < 0.001; 2.90 vs. 2.40 ng/L, p < 0.05; 3.50 vs. 2.37 µg/L, p < 0.001 and 0.08 vs. 0.05 µg/L, p < 0.01, respectively). Plasma concentrations of NfL were also higher in women with preeclampsia compared with non-pregnant women (p < 0.001). Higher plasma concentrations of the cerebral biomarker NfL were associated with decreased TEER (p = 0.002) in an in vitro model of the BBB, a finding which indicates that NfL could be a promising biomarker for BBB alterations in preeclampsia.

Pregnancy complications and risk of uterine rupture among women with singleton pregnancies in China

BackgroundThe goal of this study was to investigate whether pregnancy complications are associated with an increased risk of uterine rupture (UR) and how that risk changes with gestational age.MethodsWe obtained all data from China’s National Maternal Near Miss Surveillance System (NMNMSS) between 2012 and 2018. Poisson regression analysis was used to assess the risk of UR with pregnancy complications (preeclampsia, gestational diabetes mellitus, placental abruption, placenta previa and placenta percreta) among 9,454,239 pregnant women. Furthermore, we analysed the risks of UR with pregnancy complications in different gestational age groups.ResultsThe risk of UR was increased 2.0-fold (1.2-fold to 2.7-fold) in women with pregnancy complications (except for preeclampsia). These associations also persisted in women without a previous caesarean delivery. Moreover, an increased risk of UR before term birth was observed among women with gestational diabetes mellitus, placental abruption and placenta percreta. The risk of UR was slightly higher in women with gestational diabetes mellitus who had a large for gestational age (LGA) foetus, especially at 32 to 36 weeks gestation.ConclusionsThe risk of UR is associated with gestational diabetes mellitus, placental abruption, placenta previa and placenta percreta, but varies in different gestational ages.

Factors Associated with Maternal and Perinatal Complications of Preeclampsia at the Central Hospital of Yaound&amp;#233;: A Cross-Sectional Analytical Study

Introduction: Pre-eclampsia (PE) is a public health problem especially in developing countries due to its incidence and severity. It is responsible for high maternal and perinatal morbidity and mortality. Accordingly, the objective of this work was to study the factors associated with the occurrence of maternal and perinatal complications of preeclampsia. Method: This was an analytical cross-sectional study with prospective and retrospective data collection including all patients, pregnant or postpartum, admitted for pre-eclampsia to the maternity ward of the Yaoundé Central Hospital. It took place over a period of seven (07) months. The data collected was analyzed using CS Pro 7.4, SPSS 20.0 and Microsoft Office Excel 2010 software. We compared the group with complications to the group without complications. We calculated the odds ratio to look for associations between variables and their 95% confidence intervals. The threshold for statistical significance was set at p Results: We recruited 214 cases of preeclampsia in our series. There were maternal complications in 44.4% of cases, dominated by eclampsia (31.8%). We recorded 07 maternal deaths, representing a maternal lethality of 3.3%. We had at least one perinatal complication in 105 cases (49.1%). The predominant perinatal complication was prematurity. We recorded 32 cases of intrauterine fetal demise and 13 cases of early neonatal death, giving a perinatal lethality of 21%. After logistic regression, the factors associated with maternal complications were residing in a rural area (OR = 2.217 [1.054 - 3.09]; p - 36.162]; p - 4.029]). Conclusion: Complications of preeclampsia are very common in our setting. Several identified factors are associated with the occurrence of these complications. We suggest building the capacity of providers of PNC and sensitization of women on the use of PNC services.

High serum zinc levels in HELLP syndrome

Aim: HELLP syndrome is a possibly fatal complication of severe preeclampsia that occurs throughout pregnancy. Biochemical abnormalities are one of the hypotheses proposed to explain the disease's physiopathological symptoms. According to studies, different congenital illnesses are caused by a lack of nutrients such as zinc, copper, iron, manganese, and folic acid, the demand for which increases during pregnancy. The objective of this study was to evaluate serum zinc and copper levels in healthy controls and pregnant women with HELLP, as well as to determine the relationship between them. Material and Methods: The serum zinc and copper levels of 20 healthy pregnant women and 20 pregnant women with HELLP were measured using an Atomic Absorption Spectrophotometer. Results: Serum Zn levels in HELLP syndrome patients were significantly higher than in healthy pregnant women (p&lt;0.05). Furthermore, a negative connection was found between Zn levels and PLT, and a positive correlation between LDH (r:-0.322, p&lt;0.05; r:0.384, p&lt;0.05 respectively). Conclusion: In conclusion, high serum zinc levels in HELLP syndrome can be evaluated in the laboratory.

Neonatal Complications of Severe Pre-Eclampsia and Eclampsia in Rural Area in Sénégal

Neonatal Complications of Severe Pre-Eclampsia and Eclampsia in Rural Area in Sénégal

Тромбоэластография в акушерской практике

The study of changes in the hemostatic system in women with a complicated pregnancy is one of the promising tasks aimed at the prevention of thrombotic complications in obstetric practice. Objective. To develop treatment and prevention strategies for thrombotic complications in women staying in maternity units based on the study of hemostatic parameters using thromboelastography (TEG). Patients and methods. The pattern of coagulation disorders in the hemostatic system was examined in 343 pregnant women with obstetric complications (pre-eclampsia, placental abruption, fetal growth restriction, and preterm labor). In 220 women, hemostatic disorders were not corrected; in 123 women, the treatment strategy was determined by the results of laboratory and instrumental monitoring of the hemostatic system. Results. The area under the ROC curve (AUC) for maximum clot firmness (MA) [AUC = 0.9 (CI = 0.83–0.95), p &lt; 0.001] was greater than for any of the blood coagulation parameters considered. The optimal classification threshold for the MA parameter is a cut-off point of 64.4. This threshold is characterized by sensitivity of 80.3% and specificity of 81.8%. Significant thresholds for thrombotic conditions are MA &gt; 75 mm [AUC = 0.83 (95% CI 0.76–0.90)] and R &lt; 2 min [AUC = 0.72 (95% CI 0.63–0.81)]. Conclusion. The introduction of treatment and prevention strategies based on thromboelastography in women staying in maternity units helps to avoid such complications as lower extremity thrombophlebitis, pelvic vein thrombosis, pulmonary embolism, and cerebral ischemia. Key words: pregnancy complications, prevention, thrombosis, thromboelastography

A Cross-Sectional Study on Current Practice of the Management of Pregnancy Induced Hypertension and Its Maternal and Foetal Complications and Outcome in the Western Part of the State of Libya

Background: Maternal and perinatal mortality and morbidity are mainly affected by hypertension during pregnancy (pre-eclampsia). Haemorrhage and cerebral bleeding are the primary and significant complications of pre-eclampsia. Abruption of the placenta and renal failure are among the major complications caused by this disease. The perinatal complications include Intrauterine Growth Restriction (IUGR), Intrauterine Foetal Death (IUFD), neonatal death, and prematurity. Objective: The purpose of the present study was to examine the incidence of Pregnancy-Induced Hypertension (PIH), pre-eclampsia, the management of PIH, including the early diagnosis, the pharmacological drug management used, and the prevalence of maternal and perinatal complications. Methods and Patients: This cross-sectional study took place in Aljalaa maternity hospital, which represented the west of the state of Libya in the period from 1st January 2012 to 31st December 2012, with patients who were diagnosed, managed, and terminated according to protocol management of the hospital. Results: In the present study, from the total deliveries in Aljalaa Maternity hospital, the incidence of PIH is 8.4% and pre-eclampsia is 5.1%. No maternal mortality, CNS haemorrhaged, hepatic failure, or renal failure. The reported maternal complications included: Eclampsia, HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low platelets), abruption placenta, and pulmonary oedema see in eighteen percent, six percent, nine percent, four percent and less than one percent, respectively. The foetal complications were preterm babies and Intrauterine Growth Restriction (IUGR) in nineteen percent, Low Birth Weight (LBW) in twenty-five percent, Intrauterine Foetal Death (IUFD) in five percent, neonatal death in two percent and, perinatal death in six percent. In the PIH patients, the presence of associated symptoms such as headache, blurred vision, irritability, and the presence of signs such as severe hypertension, generalized oedema, exaggerated reflexes, and abnormal investigations (protein urea, high uric acid, abnormal LFT, haemoconcentration, and low pits) increased the risk of maternal and foetal complications. Conclusion: To decrease mother and newborn mortality and morbidity in PIH patients, a rigorous management protocol is required to implement evidence-based guidelines.

Environmental influence on the features of the formation of placental structures in cow

Normal organization of placental structures at different stages of pregnancy is critical for the growth and development of the fetus. The aim of this study is to characterize the localization and ratio of epithelial and mesenchymal cells in the placenta of cows with physiological and complicated preeclampsia pregnancy using the immunohistochemical method. To date, it has been established that adverse environmental factors adversely affect the reproductive potential of animals regardless of their gender. The results of the study demonstrated that in the placenta of cows with the development of preeclampsia in the last stages of pregnancy, there was a significant decrease in the content of keratin filaments both in the trophoblasts of the villous tree of the fetus and in the epithelial cells of the maternal part in comparison with physiological values. In this case, the vimentin filaments also underwent partial degradation. Thus, the ratio of keratin and vimentin intermediate filaments can be used as a histological criterion for changes in the placental structures of cows during the development of preeclampsia.

Platelet Count and Complications in Pre-Eclampsia and Eclampsia Patients in Pregnancy: An Observational Study in a Tertiary Care Hospital in Bangladesh

Objective: To measure the platelet count and complications in pre-eclampsia and eclampsia patients in pregnancy. Methods and Materials: This was a cross sectional observational study and conducted from 1st January 2018 to 30th June 2018 in Sheikh Sayera Khatun Medical College Hospital, Gopalgonj. Total 150 samples were taken from indoor of Sheikh Sayera Khatun Medical College Hospital, Gopalgonj. Purposive sampling technique was followed in this study. Patients who clinically present with features of pre-eclampsia and eclampsia without any chemical evidence of haemorrhegic menifestations were included in this study. Any maternal abnormalities in pregnancies (such as multiple pregnancy, pregnancy with heart diseases, GDM etc.) except pre-eclampsia and eclampsia and patients who were suffering from other coagulation disorder before pregnancy were excluded from the study. Results: average mean maternal age for the eclampsia group was 23.12±4.20 years and mean maternal age for the pre-eclampsia group was 28.24±5.86 years. Average mean gestational age for the eclampsia group was 33.50±2.58 weeks and average mean gestational age for the pre-eclampsia group was 37.50±3.89 weeks. 58 (70.73%) eclamptic patients and 18 (39.13%) pre-eclamptic patients were primigravida. 24 (29.27%) eclamptic patients and 28 (60.89%) pre-eclamptic patients were multigravida. p value of Mean maternal age, gestational age and gravida is &lt; 0.001, which is significant. platelet count in &gt; 200,000 / cu mm in eclampsia is (4.87%) and PET is 02 (4.35%), platelet count between 150,000 – 200,000 / cu mm in eclampsia is (13.41%) and PET is (30.43%). platelet count between 100,000 -150,000 / cu mm in eclampsia is 66 (80.49%) and PET is 30 (65.22%). Platelet count between 50,000 - 100,000/ cu mm in eclampsia is 01 (1.21%). Platelet count &gt; 200,000 / cu mm present in 4 eclampsia is and 2 PET patients, out of which no patient developed any abnormal coagulation or any complications. Platelet count ...........

Effect of diabetes mellitus on pregnancy and birth outcomes in Wolaita Zone, Southern Ethiopia: A retrospective cohort study

Background and aimsPresence of diabetes mellitus (DM) during pregnancy is important cause of maternal and fetal complications. Studies that address the effect of DM on pregnancy and birth outcome are scarce in Ethiopia. The aim of this study was to determine the effect of DM on maternal and birth outcomes in Wolaita Zone, Southern Ethiopia. MethodsA retrospective cohort study was done to compare maternal and birth outcomes of mothers with DM and non-DM who received maternity service in three hospitals and four health centers in Southern Ethiopia. A total of 136 exposed (with DM) and 272 unexposed (non-DM) mothers were included in the study. Data were extracted from medical records of mothers by experienced and trained data collectors. Means were compared for continuous variables. Logistic regression analysis model was used to check the effect of DM on pregnancy and birth outcome. Risk Ratio was calculated and p value less than 0.05 was considered statistically significant. ResultsPregnancy of diabetic mothers was significantly complicated by pre-eclampsia when compared with non-diabetic mothers, (RR = 1.8: 95% CI; 1.2–2.7). The risk of macrosomia was higher for neonates of diabetic mothers than non-diabetic mothers, (RR = 1.9: 95% CI; 1.3–2.7). From multivariate analysis, mothers with DM were 2.9 times more likely to be delivered by caesarean section than non-diabetic mothers (RR = 2.9: 95%CI; 1.3–6.2) and the risk of pre-term delivery was 2.5 times higher among mothers with DM, (RR = 2.5: 95% CI; 1.1–6.2). ConclusionsDiabetes mellitus among pregnant mothers is associated with increased risk of pre-term delivery, macrosomia and maternal complications of pre-eclampsia and caesarian delivery. Early detection and management of DM should be one of the key activities to improve maternal and child mortality and morbidity.