Mild Preeclampsia Research Articles

Revolutionizing Postpartum Hemorrhage Prediction with Insights from Iraq

Background: Postpartum hemorrhage (PPH) is a severe complication affecting women with gestational hypertension or preeclampsia, yet predictive models for PPH in this population remain underdeveloped. Specific Background: Existing studies have not adequately addressed the combined influence of antepartum and intrapartum factors on the predictability of PPH. Knowledge Gap: There is a lack of comprehensive models integrating both antepartum and intrapartum variables to predict PPH risk in women with gestational hypertension or mild preeclampsia. Aims: The study investigates the predictability of preeclampsia (PPH) in women with gestational hypertension or preeclampsia at term using logistic regression models incorporating both antepartum and intrapartum factors. Methods: The study, conducted in Karbala, Iraq, involved 1252 women with hypertension or preeclampsia, developed two logistic regression models, and assessed their predictive efficacy using receiver operating characteristic analysis and calibration techniques. Results: A study found that 168 participants (10.4%) experienced preterm pregnancies, with antepartum predictors including maternal age, pre-pregnancy BMI, and preeclampsia, and intrapartum factors like gestational age and labor duration. Novelty: The study introduces a novel predictive model for Pregnancy-Positive Hypertension (PPH) that integrates antepartum and intrapartum variables for risk assessment in high-risk populations. Implications: The study suggests that combining antepartum and intrapartum variables can improve risk stratification and preventive measures, requiring further refinement for improved maternal care outcomes. Highlights: Antepartum and intrapartum variables enhance PPH prediction accuracy. Model B outperforms antepartum-only model in predicting PPH. Results stress need for improved risk stratification and prevention strategies. Keywords: postpartum hemorrhage, gestational hypertension, preeclampsia, predictive modeling, logistic regression

Self-Management Effect on Preeclampsia in Pregnant Women at RSI Jemursari Surabaya

The leading cause of mortality after infection and hemorrhage is preeclampsia. Preeclampsia can develop in a pregnant woman anywhere from the third trimester onwards, or after the 20th week of gestation. Finding out how self-management affects preeclampsia in pregnant women was the goal of this study at RSI Jemursari Surabaya. This study's pre-experimental design makes use of the One-Group Pre-Test and Post-Test methodology. The study's population consisted of sixty-two pregnant women diagnosed with preeclampsia at RSI Jemursari Surabaya. extracted with the use of a sequential non-random sampling procedure. One variable that may be controlled is preeclampsia, while another is self-management. The device used a preeclampsia observation sheet. In order to analyze the data, the Wilcoxon ranks test statistic was used, with a significance threshold of = 0.05. The results obtained from 53 respondents that before being given intervention there were severe preeclampsia (39.6%), mild preeclampsia (49.1%) of respondents, and superimposed (11.3%). 0%), mild preeclampsia (71.7%) and superimposed preeclampsia (11.3%). Analysis of the Wilcoxon ranks test statistical test obtained a significance value of P=0.001 so that H0 is rejected and H1 is accepted. Self Management has an effect on the incidence of preeclampsia, so pregnant women can do it independently and nurses are expected to be able to provide education in health services.

Changes of coagulation function and platelet parameters in preeclampsia and their correlation with pregnancy outcomes.

Preeclampsia (PE) is a severe pregnancy complication characterized by significant alterations in coagulation function. This study aims to analyze the correlation between coagulation function, platelet parameters, and pregnancy outcomes in PE patients. Clinical data, along with blood and urine samples, were collected from 168 PE patients and 128 healthy pregnant women. General demographic and laboratory testing data were recorded, and maternal and fetal outcomes were followed up. Data were analyzed using Kaplan-Meier and logistic regression analyses. In mild PE patients, thrombin time (p=.000), platelet distribution width (PDW) (p=.000), and clot formation time (p=.000) were increased, while prothrombin time (p=.000) and fibrinogen (p=.045) were reduced. With increasing PE severity, prothrombin time (p=.000), platelet count (PLT) (p=.000), mean platelet volume (MPV) (p=.000), plateletcrit (p=.000), maximum amplitude (MA) (p=.000), and coagulation index (p=.001) decreased, whereas activated partial thromboplastin time (APTT) (p=.000), thrombin time (p=.002), D-dimer (p=.026), and PDW (p=.000) increased. Lower prothrombin time (p=.048), PLT (p=.004), and coagulation index (p=.026) or higher APTT (p=.032), thrombin time (p=.044), D-dimer (p=.023), and PDW (p=.016) were associated with a higher risk of poor pregnancy outcomes. Thrombin time was identified as an independent risk factor (p=.025, OR=2.918, 95% CI: 1.145-7.436), whereas gestational age was an independent protective factor (p=.000, OR=0.244, 95% CI: 0.151-0.395). This study demonstrates that specific coagulation and platelet parameters are significantly associated with PE severity and adverse pregnancy outcomes. These findings highlight the importance of monitoring coagulation function in PE patients to improve clinical management and outcomes.

Correlation of adiponectin and leptin with BMI, blood pressure in patients with preeclampsia

The purpose of our research was to find out how serum levels of leptin and adiponectin are connected with preeclampsia and whether they may be used as biomarkers for the illness. Thirty (30) normal-pregnant patients and sixty (60) preeclamptic patients were included. Additionally, we included thirty (30) age- and BMI-matched healthy controls. Using an enzyme-linked immunosorbent assay, the amounts of leptin and adiponectin in the serum were measured. When compared to healthy controls and normal pregnant women, patients with mild and severe preeclampsia had significantly higher blood pressure, body mass index, serum adiponectin, and leptin levels. According to the individual's correlation analysis, blood pressure and body mass index were positively and statically linked with serum levels of adiponectin and leptin. The study's conclusions suggest that the markedly elevated serum levels of leptin and adiponectin could serve as an indicator of preeclampsia.

Epicardial adipose tissue thickness associated with preeclampsia and birth weight in early pregnancy

ABSTRACT Objective Preeclampsia (PE) increases the risk of many adverse maternal and fetal outcomes. This study was to investigate the correlation between epicardial adipose tissue (EAT) thickness and PE and birth weight. Methods This was a single-center retrospective study, 221 patients with PE were selected, and 81 women without hypertension and proteinuria were selected as a comparison. Echocardiogram was performed in their first prenatal examinations at 11–13 gestational weeks, and the thickness of EAT was measured. At the subsequent follow-up, the birth weight was recorded. Results EAT thickness was significantly elevated (6.60 ± 1.34 vs. 5.71 ± 1.79 mm, p < 0.001) in severe PE compared to mild PE. In the multivariate analysis, EAT thickness (OR 5.671, 95% CI, 1.991–16.150, p = 0.001), and C reactive protein (OR 4.097, 95% CI, 2.323–7.224, p < 0.001) were found as significant independent predictors of severe PE after adjusting for other risk factors. Linear regression analysis showed that hs-CRP, EAT thickness, and severe PE significantly negatively affected birth weight. Conclusion EAT thickness can be used to identify pregnant women with severe PE risks and low birth weight. It is an independent risk factor for severe PE but is not a valuable sign of mild PE.

Association of serum homocysteine with vitamin B12 and folate levels in women with pre-eclampsia in a tertiary health care center in Nepal

BackgroundPre-eclampsia is a syndrome that chiefly includes the development of new-onset hypertension and proteinuria after 20 weeks of pregnancy. Pre-eclampsia is one of the major causes of mortality and morbidity in Nepal. Hyperhomocysteinemia may be a cause of the endothelial dysfunction provoked by oxidative stress in pre-eclampsia. This study was designed to evaluate the association of homocysteine with Vitamin B12 and folate in patients with pre-eclampsia.MethodAn observational cross sectional study was performed in the Gynecology and Obstetrics Department of TUTH involving seventy two subjects with pre-eclampsia. Blood pressure, urinary protein levels, serum homocysteine, Vitamin B12 and folate levels were compared in both mild and severe forms of pre-eclampsia. Concentration of Vitamin B12 and folate were measured using Vitros ECI and homocysteine was measured using CLIA. SPSS 23.0 was used to analyze the data. Tests were performed with Mann Whitney Test and Spearman’s rank correlation test. A p-value < 0.05 was considered statistically significant.ResultsThis study showed no significant difference in age and weeks of gestation in both mild and severe forms of pre-eclampsia. Mean concentration of homocysteine was higher (13.1 ± 6.4 micromol/L) in severe Pre-eclampsia as compared to mild cases (7.6 ± 2.8 micromol/L). Mean concentration of folate was lower in severe cases (35.4 ± 24.1 micromol/L) when compared with mild cases of pre-eclampsia (57 ± 23.4 micromol/L).ConclusionHomocysteine levels were increased in severe Pre-eclampsia when compared with mild pre-eclampsia and this finding can be used to predict and prevent complications in patients with pre-eclampsia.

Pathogenetic role of a number of factors in the development and progression of preeclampsia with varying severity in pregnant women.

Context Preeclampsia is a common pregnancy complication, posing significant risks to both the mother and fetus. Predicting and determining the risks of this disease is crucial. Aims This research aims to understand the pathogenetic role of several factors in the development and progression of preeclampsia, particularly in relation to its severity in pregnant patients. Methods The study included 60 pregnant women diagnosed with either mild or severe preeclampsia and 40 healthy pregnant women for comparison. Blood plasma was analysed using biochemical methods, and blood microcirculation parameters were determined to identify homeostatic abnormalities in early preeclampsia. Key results A molecular genetic study revealed the frequency of the endothelial nitric oxide gene eNOSC774T . Homeostatic abnormalities were statistically correlated with polymorphic genotypes of the eNOSC774T gene. Conclusions The research found a correlation between the T774T eNOS genotype mutation and the severity of preeclampsia, alongside significant homeostasis abnormalities in patients. Implications The T774T mutant genotype of the eNOS gene and higher levels of lipid peroxidation products are strongly linked to the severity and progression of preeclampsia. This highlights a significant connection between genetic predisposition and biochemical abnormalities in the disease's development.

Association of C-reactive Protein in Preeclampsia

Introduction: Preeclampsia is a multisystemic disorder that complicate about 7-10 percent of human pregnancies.Worldwide this syndrome contributes high maternal and perinatal mortality and morbidity. C-reactive protein, a marker of tissue damage and inflammation, is elevated in seurm in overt preeclampsia. It is used as an objective and sensitive index of overall inflammatory activities in the body. Aims and Objectives: To explore the association of C-reactive protein level with the preeclampsia patients. Materials and Methods: The present study was a Case–Control study, conducted in the Department of Obstetrics and Gynaecology in collaboration with the Department of clinical pathology of Sir Salimullah Medical College Hospital, Mitford, Dhaka during the period of January 2013 to December 2013.The study population was pregnant women with preeclampsia and normal term pregnant patients admitted during study period. A total of 66 patients were included in the study. Among them 33 were clinically diagnosed preeclampsia women grouped as Cases and another 33 were age, parity and BMI matched term pregnant women as Controls. Eastmation of serum C-reactive protein was done by Nyco Card Reader-II method (Appendix-11). Statisticians analysis was perform by using SPSS. Results: C-reactive protein concentration (mg/L) was found significantly higher (p&lt;0.001) in case group (17.93±10.5) than control group (7.45±1.80). Creactive protein was _ 6mg/L in 29(87.9%) in case group and 9 (27.3%) in control group and C-reactive protein values showed significant positive correlation with systolic and diastolic blood pressure (p&lt;0.001) in case group. C-reactive protein concentration was found significantly higher (p&lt;0.001) in severe preeclampsia group than mild preeclampsia group. Conclusion: Therefore, it can apparently be concluded from this study that increased maternal serum C-reactive protein level might be a strong risk factor for preeclampsia, although the precise role of C-reactive protein in this regard whether causal or consequential, is yet to be determined. Finding of this study might be helpful for formulating a guideline for management of pregnant women with preeclampsia. Medicine Today 2024, Vol.36 (2): 67-71

PRESCRIPTION PROFILE OF ANTIHYPERTENSIVE DRUGS IN PREECLAMPSIA PATIENTS AT KIRANA HOSPITAL

Preeclampsia is a complication of pregnancy with symptoms of hypertension ≥ 140/90 mmHg and proteinuria ≥ 0.3 grams/24 hours or 30 mg/dl (+1 dipstick) arising after more than 20 weeks of gestation in previously normotensive pregnant women. Maternal deaths in Indonesia in 2021 related to hypertension in pregnancy reached 1077 cases (Source: Directorate General of Public Health, Ministry of Health, 2021). Pharmacological therapy intervention, antihypertensive treatment is also needed in addition to maintaining a healthy lifestyle. The purpose of the study was to determine the description of pharmacological therapy including the pharmacological class of drugs, drug names, drug doses, rules of use, and types of antihypertensive drug therapy (single / combination) in patients with preeclampsia. This type of descriptive observational research is retrospective with total sampling obtained from medical records and patient prescriptions. The results of this study were the incidence of preeclampsia aged 35 years and over by 21 patients (36%) and the most common diagnosis was mild preeclampsia by 38 samples (66%). The use of nifedipine which is included in the CCB (Calcium Channel Blocker) group was 42 respondents (72%). Meanwhile, the use of methyldopa which is included in the central sympatholytic group was 17 respondents (28%). In the single therapy type study, 59 prescriptions (100%) used nifedipine or methyldopa. Pregnant women are encouraged to routinely conduct antenatal care checks at the hospital every month.

Efficacy and safety of 12-hour versus 24-hour magnesium sulfate in management of patients with pre-eclampsia and eclampsia: a systematic review and meta-analysis

IntroductionMagnesium sulfate is the most utilized anticonvulsant for treating patients with eclampsia and pre-eclampsia. The purpose of this study is to determine whether the 12-h regimen of magnesium sulfate outweighs the 24-h regimen in both efficacy and safety in the management of patients with mild or severe pre-eclampsia and eclampsia.MethodsWe searched six electronic databases: PubMed, Scopus, Web of Science, Cochrane Library, Ovid, and Google Scholar. This search was conducted to yield any studies that were published until 15 January 2023. We did the statistical analysis plan by Review Manager Software version 5.4.ResultsWe included 13 randomized control trials with 2813 patients in this systematic review. Our meta-analysis revealed that there were no statistically significant differences between the 12-h regimen of the magnesium sulfate group and the 24-h regimen of the magnesium sulfate group in our outcome of interest: occurrence of seizure (RD: -0.00, 95% CI [-0.01, 0.00], P = 0.56), diminished deep tendon reflexes (RD: -0.00, 95% CI [-0.01, 0.01], P = 0.80), respiratory depression (RD: -0.00, 95% CI [-0.02, 0.01], P = 0.57), and pulmonary edema (RD: -0.00, 95% CI [-0.01, 0.01], P = 0.85).ConclusionOur study showed no statistically significant difference in effectiveness and toxicity risk between the 12-h and 24-h regimens.

Soluble endoglin as a diagnosis glycoprotein in preeclampsia

Background: Angiogenic factor imbalance, such as that caused by soluble endoglin (sEng), is a feature of preeclampsia. However, the connection between sEng and clinical and laboratory indicators, and the severity of preeclampsia is not entirely understood.Methods: Ninety subjects were incorporated in this study, 30 were healthy pregnant with mean age (35.6) years. (32) mild Preeclampsia case with mean age (32.65) years preeclampsia, and (30) sever PE with mean age (32.65) wherever all women were more than 24 weeks of pregnancy. Mean blood pressure and level of proteinuria were used as indicators of the severity of the disease. ELISA was used to measure the levels of sEng in the serum. Serum lipid profile was measured by enzymatic methods. The qualitative dip-stick technique (CYBOWTM DFI Co Ltd, Republic of Korea) was used to assess the amount of urine protein.Results : A substantial difference between the PE group's serum sEng concentration and that of the healthy subjects (p 0.001) could be seen. Serum sEng concentrations of patients with moderate PE and those with severe PE differed significantly. Additionally, there were strong positive relationships between the serum sEng concentration and the SBP and proteinuria. serum sEng levels, biochemical indicators, and other factors, however, did not significantly correlate. The diagnostic accuracy (86.2) in distinguishing mild PE from the healthy patient group was good thanks to the excellent area under the curve (AUC = 0.827, p &lt; 0.0001). Conclusion: Levels of sEng in sera of PE patients were elevated. sEng was significantly correlated with PE patients.Keywords: Soluble Endoglin; Preeclampsia; Proteinuria; Blood Pressure

Anesthesia Type Outcome in Severe Pre-eclampsia with Caesarean Section

Background: Preeclampsia is a hypertensive disorder during pregnancy with fetomaternal mortality. The choice of anesthesia method for cesarean sections among preeclamptic women is still debated. Objective: To compare the outcomes of spinal and general anesthesia in a cesarean section among preeclamptic women. Methods: A prospective study was conducted at Al-Imam Al-Sajjad Hospital/Al-Najaf Health Directorate from February 2021 to September 2023. Women undergoing cesarean sections due to severe preeclampsia were enrolled in the spinal or general anesthesia group. Data on maternal age, gestational age at delivery, parity, Apgar scores, maternal mortality and perinatal mortality were recorded. The background characteristics and outcomes were compared between both groups. We excluded women with mild preeclampsia, multiple pregnancies, other pregnancy medical disorders, gestational age &lt; 32 weeks, cases of eclampsia, and general anesthesia following spinal anesthesia failure. Results: The general anesthesia group had a significantly lower Apgar score at 1 minute than the spinal anesthesia group (27.3% and 57.4%, p=0.006), and at 5 minutes (15.2% and 37.03%, p=0.005). The study groups showed no significant difference regarding maternal and perinatal mortality. Conclusions: Maternal and perinatal mortality were not affected by anesthesia type in severe preeclampsia, but general anesthesia caused a higher proportion of birth asphyxia.

Clinical Analysis of Serum Soluble Tyrosine Kinase Receptor-1 and Placental Growth Factor in Pre-eclampsia

Objective: To study the clinical application effect of using serum soluble tyrosine kinase receptor-1 (sFlt-1) and placental growth factor (PlGF) in pre-eclampsia. Methods: From September 2021 to September 2023, 58 cases of pre-eclampsia patients who underwent physical examination during pregnancy and eventually gave birth in Xinghua People’s Hospital were the observation group of this study and 795 cases of healthy pregnant women who underwent pregnancy examination in this hospital during the same period of time were the control group of this study; 38 cases of mild pre-eclampsia in the observation group were treated as the mild group and 20 cases of severe pre-eclampsia patients were treated as the severe group and the serum sFlt-1 and PlGF were used to compare the results of the observation group and the control group. Compare the serum sFlt-1 and PlGF levels between the observation and control groups; compare the serum sFlt-1 and PlGF levels between the mild and severe groups. Results: The serum PlGF level of the observation group was lower than that of the control group, and the sFlt-1 level was higher than that of the control group, P &lt; 0.05; the serum PlGF level of the mild group was higher than that of the severe group, and the sFlt-1 level was lower than that of the control group, P &lt; 0.05; the results showed that the serum and urine sFlt-1 and PlGF levels of pregnant women of all the three groups were elevated with the aggravation of the condition of pre-eclampsia, and the sFlt-1/PlGF ratio also increased. The differences of sFlt-1/PlGF in serum and urine of the three groups were compared, with P &lt; 0.05; the above ratios of the patients in the mild group were higher than those of the control group and those of the severe group were higher than those of the mild group, with P &lt; 0.05. Conclusion: Serum sFlt-1 level was high in preeclamptic patients, while serum PlGF was low in preeclamptic patients.

Progressive Muscular Relaxation Versus Breathing Excercise Techniques to Control Blood Pressure among Mild Preeclamptic Pregnant Women.

Hypertensive disturbances during pregnancy are the leading cause of maternal and fetal death; unfortunately, no effective treatment exists. Therefore, interventions that reduce the likelihood of developing preeclampsia during pregnancy are required. This study aimed to see how Progressive Muscle Relaxation (PMR) compared to breathing exercise techniques affected Blood Pressure (BP) levels among mildly preeclamptic pregnant women. A convenience sample was used in a quasi-experimental study of 75 mild preeclamptic pregnant women in the Obstetrical Outpatient Clinics at the Suez Canal University Hospital in Ismailia, Egypt. They were divided into three groups: study group [I]: the deep breathing exercise group; study group [II]: the PMR group; and study group [III]: the control group. Data were collected using two methods: an interviewing information collection tool and a physiological measurement tool. There was a statistical significant difference in systolic and diastolic blood pressure after six weeks of training among intervention groups (PMR and breathing excercise technique with p value 0.001 for both groups) compered to contol group. However, there was no statistical difference in BP (systolic or diastolic) after two weeks of intervention among the three groups. PMR and breathing techniques could effectively control BP in pregnancy complicated by mild preeclampsia. Both techniques could be introduced in routine antenatal care for women diagnosed with mild preeclampsia. Health and fitness professionals should focus more on preparing and delivering various sports programs incorporating various muscle relaxations and breathing techniques.

Serum lncRNAs TUG1, H19, and NEAT1 and their target miR-29b/SLC3A1 axis as possible biomarkers of preeclampsia: Potential clinical insights

To date, the epigenetic signature of preeclampsia (PE) is not completely deciphered. Oxidative stress-responsive long non-coding RNAs (lncRNAs) are deregulated in preeclamptic placenta; however, their circulating profiles and diagnostic abilities are still unexplored. We investigated serum redox-sensitive lncRNAs TUG1, H19, and NEAT1, and their target miR-29b/cystine/neutral/dibasic amino acids transporter solute carrier family 3, member 1 (SLC3A1) as potential non-invasive biomarkers of PE risk, onset, and severity. We recruited 82 patients with PE and 78 healthy pregnant women. We classified PE patients into early-onset (EOPE) and late-onset (LOPE) subgroups at a cut-off 34 gestational weeks and into severe and mild PE subgroups by blood pressure and proteinuria criteria. Bioinformatics analysis was employed to select lncRNAs/microRNA/target gene interactions. Serum H19, NEAT1, and SLC3A1 mRNA expression were reduced, meanwhile miR-29b levels were elevated, whereas there was no significant difference in TUG1 levels between PE patients and healthy pregnancies. Serum H19 levels were lower, whereas miR-29b levels were higher in EOPE versus LOPE. Serum miR-29b and H19 levels were higher in severe versus mild PE. ROC analysis identified serum H19, NEAT1, miR-29b, and SLC3A1 as potential diagnostic markers, with H19 (AUC = 0.818, 95%CI = 0.744–0.894) and miR-29b (AUC = 0.82, 95%CI = 0.755–0.885) were superior discriminators. Only H19 and miR-29b discriminated EOPE and severe PE cases. In multivariate logistic analysis, miR-29b and H19 were associated with EOPE, using maternal age and gestational age as covariates, while miR-29b was associated with severe PE, using maternal age as covariate. Studied markers were correlated with clinical and ultrasound data in the overall PE group. Serum H19 and TUG1 were negatively correlated with albuminuria in EOPE and LOPE, respectively. NEAT1 and SLC3A1 were correlated with ultrasound data in EOPE. Likewise, TUG1, miR-29b, and SLC3A1 showed significant correlations with ultrasound data in LOPE. Conclusively, this study configures SLC3A1 expression as a novel potential serum biomarker of PE and advocates serum H19 and miR-29b as biomarkers of EOPE and miR-29b as a biomarker of PE severity.

КЛИНИКО-ПАТОФИЗИОЛОГИЧЕСКИЕ АСПЕКТЫ МИКРОВЕЗИКУЛЯРНОГО СОСТАВА ПЕРИФЕРИЧЕСКОЙ КРОВИ У БЕРЕМЕННЫХ С ПРЕЭКЛАМПСИЕЙ

Abstract. Introduction. Preeclampsia is a pregnancy complication characterized by the development of arterial hypertension after 20 weeks of gestation, proteinuria, and/or oedemas. The pathogenesis of preeclampsia remains unclear to this day. Some studies have shown the importance of microvesicles in the pathogenesis of various pathological conditions. Involvement of microvesicles in the preeclampsia pathogenesis is a relevant issue. Taking into account all of the above, we have made an attempt to consider the pathogenesis of preeclampsia from the perspective of clinical and laboratory data. Aim. To establish the importance of microvesicles circulating in peripheral blood, their quantity and phenotype in the pathogenesis of preeclampsia. Materials and Methods. A one-stage cohort study was conducted, including 105 pregnant women: 30 pregnant women with severe preeclampsia (group 1), 35 pregnant women with mild preeclampsia (group 2), and 40 pregnant women without hypertensive syndrome (group 3), at 29–40 weeks of gestation. All patients were delivered surgically (Joel-Cohen laparotomy, cesarean section in the lower segment). All pregnant women underwent blood sampling to define the number and phenotypes of microvesicles (using flow cytometry) and laser scanning microscopy of the clot to confirm the presence of microvesicles of placental origin containing tissue factor, as well as the lipopolysaccharide of gram-negative microorganisms. Results and Discussion. In the group of patients with severe preeclampsia, a statistically significant increase was found in the number of placental, erythrocyte microvesicles, microvesicles with the tissue factor and lipopolysaccharide, compared to the group of patients with mild preeclampsia and pregnant women without hypertensive syndrome. In the group of patients with mild preeclampsia, a statistically significant increase was found in microvesicles with tissue factor and lipopolysaccharide, compared to pregnant women without hypertensive syndrome. The data obtained from the study confirm the fact that severe preeclampsia is a separate nosological entity, most likely pregnancy-associated thrombotic microangiopathy. Conclusions. The data obtained from the study indicate the need for further research to clarify the importance of microvesicles in the preeclampsia pathogenesis.

#1059 Value of urine transcription factor 21 as a diagnostic tool for preeclampsia

Abstract Background and Aims Prediction of pre-eclampsia early in pregnancy can reduce its incidence and subsequent maternal and fetal morbidity and mortality. The sensitivity of current biomarkers is fair despite being used in clinical settings. Podocyturia was found to be a useful biomarker of preeclampsia with high sensitivity and specificity. UTF21 is highly expressed on podocytes. We investigated the relationship between urine transcription factor 21 as a new biomarker and preeclampsia. Method 160 pregnant women with pre-eclampsia and age and gestational age matched 64 pregnant women with normal pregnancy were recruited. Pre-eclamptic patients were subdivided into mild (92 pregnant patients) and severe (68 pregnant patients). Each group is subdivided into early-onset and late-onset preeclampsia. Urine transcription factor 21 and compared with serum PlGF and sFlts were measured. The sFlt/PlGF ratio was calculated. Results The mean Urine transcription factor 21 was significantly higher in pregnant patients with preeclampsia than in healthy pregnant controls (512.3 ± 281.4 vs. 300 ± 66.8; p&amp;lt;0.001). Urine TCF21 could not differentiate between early- and late-onset preeclampsia with the mean urine TCF21 was higher in early-onset preeclampsia than late-onset preeclampsia (532.63 ± 312.33 vs. 491.41 ± 248.1, p=0.519). Urine TCF21 was statistically significantly higher in mild preeclampsia than severe preeclampsia (572.3 ± 300.9 vs. 361.9 ± 155.8, p&amp;lt;0.001). The sensitivity and specificity of urine TCF21 was 60.62% and 90.62% when using 370 pg/mL as cutoff in the prediction of preeclampsia development. Conclusion Urine transcription factor 21 can be used as a possible and easy diagnostic marker for preeclampsia. It can differentiate between mild and severe preeclampsia but cannot be used to differentiate between early- and late-preeclampsia.

Potential Predictive Value of Platelet Parameters in Preeclampsia.

Preeclampsia is a serious pregnancy complication that jeopardizes the health of both the mother and the fetus. Platelet parameters are closely linked to the severity of preeclampsia. This study aimed to assess the diagnostic potential of platelet parameters in the early second trimester for the detection of preeclampsia. A total of 840 participants from the Affiliated Hospital of Jining Medical College were included in the study, consisting of 327 healthy pregnant women, 209 with mild preeclampsia, and 304 with severe preeclampsia. General clinical data and platelet parameters for these three groups of pregnant women were collected, and differences among them were compared. In addition, univariate analysis and logistic regression were used to identify preeclampsia risk factors, and receiver operating characteristic curve analysis was conducted to assess the predictive value of platelet parameters. Platelet count was not found to significantly differ between the healthy and preeclampsia groups. However, mean platelet volume, platelet distribution width (PDW), and platelet-large cell ratios (P-LCR) were observed to be significantly higher in the preeclampsia group than the healthy group. After adjusting for confounding factors (such as age, gestational week at blood sampling, systolic and diastolic blood pressure, and body mass index during the second trimester), it was determined that PDW and P-LCR could be considered effective predictors of preeclampsia. In clinical practice, P-LCR and PDW hold potential predictive value for preeclampsia.

Raised levels of chemerin in women with preeclampsia: A meta-analysis.

Chemerin is a multifunctional adipokine associated with systemic inflammation, angiogenesis, and oxidative stress. Emerging evidence suggests a potential link between chemerin and the pathogenesis of preeclampsia (PE). In this systematic review and meta-analysis, we aimed to evaluate the serum chemerin levels in women with PE. A systematic search was conducted across Medline, Web of Science, and Embase databases from inception until April 15, 2023, to identify studies comparing serum chemerin levels in pregnant women with and without PE. A random-effects model was employed to pool the results, accounting for heterogeneity. Thirteen datasets from 10 observational studies, encompassing 832 women with PE and 1298 healthy pregnant women, were analyzed. The pooled findings indicated a statistically significant elevation in serum chemerin levels in women with PE compared to controls (mean difference [MD] = 89.56 ng/mL, 95% confidence interval [CI] 62.14 - 116.98; P < 0.001; I2 = 87%). The subgroup analysis revealed consistent findings across studies that measured chemerin levels before or after the diagnosis of PE, studies that did or did not match the body mass index (BMI), and studies with varying quality scores (P values for subgroup differences were all > 0.05). Compared to controls, women with severe PE exhibited a significantly greater increase in serum chemerin levels than those with mild PE (P value for subgroup difference = 0.007). Additionally, meta-regression analysis results suggested that the mean BMI of the included pregnant women might positively modify the difference in circulating chemerin levels between women with and without PE (coefficient = 8.92; P = 0.045). In conclusion, this meta-analysis suggests a positive correlation between elevated serum chemerin levels and PE diagnosis in comparison to pregnant women without the condition.

The Relationship between the Level of Coagulative Function Hypertensive Disorder Complicating Pregnancy.

Preeclampsia, a pregnancy complication associated with significant maternal and perinatal mortality and morbidity, has been found to be closely linked to dysfunction in the blood coagulation-fibrinolysis system. However, the relationship between hematologic data and severity and onset time of preeclampsia remains unclear. This study aimed to identify specific hematologic parameters in both preeclamptic and normotensive pregnant women and determine their potential significance in the pathogenesis of preeclampsia. A total of 112 patients with gestational hypertension disease were divided into two groups: early-onset preeclampsia (32 cases) and late-onset preeclampsia (80 cases). A control group of 82 normotensive pregnant women matched for age and parity was also selected. Blood samples were collected from all participants to test for specific hematologic parameters. Mild and severe preeclampsia were associated with lower hemoglobin level (P = 0.01 and P = 0.03, respectively), higher mean platelet volume (P = 0.01 and P = 0.01, respectively) and fibrinogen (P = 0.01 and P = 0.01, respectively), and shorter prothrombin time (P = 0.02 and P = 0.01, respectively) and activated partial thromboplastin time (P = 0.01 and P = 0.02, respectively). These findings have provided evidence on the hematologic coagulative actors in the pathogenesis and severity of preeclampsia.