Mild Preeclampsia Research Articles

Nursing care in post cesarean section due to preeclampsia

Cesarean section is the surgical procedure that consists of the removal of the fetus in a rapid and timely manner that is given as a treatment to the patient with mild pre-eclampsia, to avoid complications such as maternal fetal morbidity and mortality, seizures, postpartum eclampsia, pulmonary edema, cerebrovascular accident, HELLP syndrome, among others. So a human care with quality and warmth was applied contemplating scientific knowledge. The objective is to administer a process of care intervention for a post-cesarean patient due to preeclampsia in the post-anesthetic recovery unit.The study is qualitative, unique clinical case type, which includes a 35-year-old patient, for which the Nursing Care Process was used in its five stages: assessment, diagnosis, planning. Execution and evaluation of the results was done according to the difference of the final and baseline scores respectively. 8 altered patterns were identified and three were prioritized: pattern VI: cognitive-perceptual, pattern VII: self-perception-self-concept, pattern I: perception-health management, critical analysis allowed the identification of 8 diagnoses; being prioritized: acute pain, anxiety and risk of infection, according to the SSPFR format (signs and symptoms, problem and related factor) the evaluation was made according to the difference in final and baseline scores corresponding to +2, +3, +2 .We conclude that according to the problems identified, the nursing care program was administered in its five stages, however, it should be noted that the success of the nursing treatment depends on the timely identification of the problems and adequate treatment.

Urinary protein and coagulation-fibrinolysis indicators in preeclampsia: Expression and significance.

This study investigates the expression and significance of urinary protein and coagulation-fibrinolysis indicators in preeclampsia, categorized into mild preeclampsia (109 cases) and severe preeclampsia (97 cases) based on disease severity. Additionally, 110 patients with gestational hypertension (gestational hypertension group) were included for comparative analysis. General information, laboratory indicators, urinary protein, and coagulation-fibrinolysis indicator levels were collected for each group. Significant differences were observed in blood pressure among groups (P<.05), while uric acid, serum creatinine, aspartate transaminase, alanine transaminase, and triglycerides showed no significant differences (P>.05). Total cholesterol, triglycerides, and low-density Lipoprotein levels in severe preeclampsia were higher than those in mild preeclampsia and gestational hypertension groups, whereas high-density lipoprotein, albumin, and platelet levels were lower in severe preeclampsia. No significant differences were observed in prothrombin time or D-dimer levels among groups (P>.05). Urinary protein, urinary protein quantification, activated partial thromboplastin time, thrombin time, and fibrinogen were identified as influencing factors for adverse maternal and infant outcomes in severe preeclampsia patients. The study concludes that urinary protein and coagulation-fibrinolysis indicators are elevated in preeclampsia, particularly in severe preeclampsia cases, suggesting their potential use as diagnostic influencing factors for severe preeclampsia.

Maternal Complications of Severe Preeclampsia at Tugurejo Hospital, Semarang, 2016-2020

Preeclampsia is a condition accompanied by hypertension and proteinuria in pregnancy. Preeclampsia is divided into mild preeclampsia, severe preeclampsia, and superimposed preeclampsia on chronic hypertension. Severe preeclampsia is characterized by systolic pressure ≥160 mmHg and/or diastolic ≥110 mmHg, thrombocytopenia (&lt;100,000 µL), and serum creatinine level &gt;1.1 mg/dl or creatinine level increased from normal levels without coexisting kidney disease. Severe preeclampsia can cause several complications for the mother and fetus. Descriptive research with cross sectional design and retrospective approach. Sampling was in the form of medical records; this study used a total sampling method with a population from 1 January 2016 to 31 December 2020. This research was conducted in February 2022 - March 2022 at Tugurejo Hospital, Semarang. Obtained the results of normal delivery as much as 89.5% and severe preeclampsia as much as 588 10.5%, ideal maternal age as much as 73% and risky maternal age as many as 159 cases 27%. In severe preeclampsia with the ideal age, vaginal delivery 51.0%, multigravidas 64.1%, term delivery age 62.5%, no history of hypertension or severe preeclampsia in previous pregnancies 86.7%, and the most complications was pulmonary edema (2.3%). In severe preeclampsia at risk age, vaginal delivery was 52.8%, multigravida was 86.8%, term delivery was 63.5%, had no history of hypertension or severe preeclampsia in previous pregnancies was 64.2%, and complications the most was pulmonary edema (5.7%). The ratio of normal births to severe preeclampsia is 8:1, severe preeclampsia occurs mostly in women of ideal age,At the ideal age and at risk, the majority are abdominal, multigravida, term deliveries, have no history of hypertension and preeclampsia, and the complications found includepulmonary edema, eclampsia, postpartum hemorrhage, placental abruption, HELLP syndrome, heart failure, thrombocytopenia, acute renal failure, hepatic rupture, and maternal death.

The effects of synbiotic supplementation on blood pressure and other maternal outcomes in pregnant mothers with mild preeclampsia: a triple-blinded randomized controlled trial

IntroductionPreeclampsia affects a significant percentage of pregnancies which is a leading cause of premature birth. Probiotics have the potential to affect inflammatory factors, and oxidative stress, which are linked to the development of preeclampsia. The study aimed to compare the effect of synbiotic and placebo on blood pressure and pregnancy duration as primary outcomes, and other pregnancy outcomes.MethodsThis study comprised 128 pregnant women with mild preeclampsia and gestational ages exceeding 24 weeks who were referred to the high-risk pregnancy clinic. It was a randomized, controlled, phase III, triple-blinded clinical experiment. The intervention and control groups were distributed to the participants at random. Intervention group received one oral synbiotic capsule, and control group received placebo daily until delivery. Based on gestational age at the time of diagnosis, preeclampsia was stratificated as early (< 34 weeks) or late (≥ 34 weeks). Data obtained from questionnaires, and biochemical serum factors were analyzed using SPSS software version 23 software.ResultsWith the exception of the history of taking vitamin D3, there were no statistically significant variations in socio-demographic variables between the research groups. After the intervention, the means of systolic blood pressure (adjusted mean difference: -13.54, 95% CI: -5.01 to -22.07), and diastolic blood pressure (adjusted mean difference: -10.30, 95% CI: -4.70 to -15.90) were significantly lower in the synbiotic-supplemented group than in the placebo group. Compared to the placebo group, the incidence of severe PE (p < 0.001), proteinuria (p = 0.044), and mean serum creatinine level (p = 0.005) significantly declined in the synbiotic-supplemented group after the intervention. However, our analysis found no significant association for other outcomes.ConclusionBased on our results, synbiotic had beneficial effects on some pregnancy outcomes. Further studies with larger samples are needed to verify the advantages of synbiotic supplementation for high-risk pregnancies, particularly with regards to higher doses, and longer intervention periods.Trial registrationIRCT20110606006709N20.

Asuhan Kebidanan Komprehensif Pada Ny. K Umur 27 Tahun Dengan Anemia Ringan Di PMB Ny. S Wilayah Kerja Puskesmas Kaliwadas Kabupaten Brebes Tahun 2023

The success of maternal and child health can be seen from the indicators of maternal mortality rate (MMR) and infant mortality rate (IMR). One of the causes of maternal mortality is bleeding that occurs due to anemia during pregnancy. Anemia conditions can be prevented by antenatal care (ANC) checks, and can help make labor run physiologically. Objective To provide comprehensive midwifery care to the patient, family, community or closest friends in order to get appropriate care.This study used a qualitative descriptive method with a case study approach. In the first visit pregnancy care found the incidence of Mild Anemia, at the second visit found the incidence of Mild Preeclampsia. In the care of childbirth, there were cases of premature rupture of membranes and chepalopelvic disporpotion so that delivery was carried out by Sectio Caesarea. And in the care of newborns, postpartum and family planning there are no problems and the condition of the mother and baby is normal. Based on the comprehensive care provided to Mrs. K, there were no gaps in the care of pregnancy, puerperium, newborn, and family planning, but in the care of childbirth there were some gaps between theory and practice.

Studi Penatalaksanaan dan Ketepatan Pengobatan Antihipertensi pada Wanita Hamil di RSUD Toto Kabila

Hypertension is a condition that can affect pregnancy. High blood pressure during pregnancy can hinder fetal and uterine growth, lead to fetal death in the womb, and result in premature birth. These complications can be minimized with appropriate antihypertensive therapy. The objective of this study is to determine the incidence rate, management, and accuracy of antihypertensive treatment according to the reference standards of the 2016 Preeclampsia National Medical Service Guidelines (PNPK). This research was an observational descriptive study where the data obtained were secondary data collected retrospectively from medical records at Regional Public Hospital of Toto Kabila from September 2022 to May 2023. The sample was taken using a saturated sampling technique, so the sample in this study included all pregnant women diagnosed with preeclampsia. The results of the study obtained 65 patients, consisting of 36 severe preeclampsia patients and 29 mild preeclampsia patients. The study showed that hypertension in pregnant women was often found in the age group of 26-35 years, with 25 patients (39%), and in the third trimester of pregnancy, with 23 cases, while 2 experienced hypertension in the first trimester. 12 patients were diagnosed with severe preeclampsia and 13 patients with mild preeclampsia. The treatment of hypertension in pregnant women for mild preeclampsia included methyldopa (34%) and nifedipine (7%). For severe preeclampsia, single therapy included methyldopa (39%), amlodipine (8%), and combination therapy such as nifedipine + methyldopa (36%) and methyldopa + amlodipine (17%). The accuracy of antihypertensive drug use in pregnant women based on the 2016 Preeclampsia PNPK was 86%, including appropriate indications, correct drugs and correct doses.

Association between high-mobility group box 1 levels and preeclampsia: a systematic review and meta-analysis.

Previous studies had demonstrated that high-mobility group box 1 (HMGB1) levels were elevated in preeclampsia (PE). However, the conclusion remains controversial. This study aimed to investigate the association between blood and placenta HMGB1 levels and PE in pregnant women. After a systematic literature search, eligible literature was screened according to inclusion and exclusion criteria. Data extraction and quality assessment were performed independently by two reviewers. The extracted data were analyzed using Review Manager 5.4 and STATA 12.0 software. Subgroup analysis and meta-regression analysis were conducted to find potential sources of heterogeneity. Twelve studies were included, with a total of 1145 participants. Compared with normal pregnancies, pregnant women with PE had significantly higher blood HMGB1 levels (SMD = 1.34, 95% CI: 0.72-1.95, p < 0.0001). Similarly, the expression of placental HMGB1 in PE was higher than that in normal controls by using Western blot (MD = 0.37, 95% CI: 0.27-0.47, p < 0.00001) or immunohistochemistry (OR = 6.36, 95% CI: 1.48-27.25, p = 0.01). In addition, the blood HMGB1 levels were positively correlated with the severity of PE, with higher blood HMGB1 levels in severe PE than those in mild PE (SMD = 3.35, 95% CI: 0.63-6.06, p = 0.02). The subgroup analysis indicated a close association of blood HMGB1 with PE in the Asian group, but not in the European group. Both blood and placental HMGB1 levels in patients with PE were significantly elevated, and higher blood HMGB1 levels indicated a more serious disease condition, suggesting that higher levels of HMGB1 were associated with the risk of PE.

Fetal Outcome in Women of Pre-Eclampsia

Background: Pre-eclampsia, a serious condition characterized by high blood pressure in pregnant women, presents significant health risks for both the mother and fetus. This study aimed to assess the impact of pre-eclampsia on fetal outcomes in the Pakistani population, recognizing the condition's high prevalence and its role in maternal and neonatal morbidity and mortality. Objective: To evaluate the fetal outcome in women with pre-eclampsia in the Pakistani population. Methods: This descriptive case series was conducted at the Department of Obstetrics and Gynaecology, University College of Medicine and Dentistry Lahore, from January to June 2023. A total of 93 patients were enrolled to study the effects of pre-eclampsia on mothers and fetuses. Results: Among the 93 patients, the mean age was 37.59±6.37 years. The age distribution predominantly included women aged 31-35 years, followed by those in the 36-40 and 41-45 age groups. Severe pre-eclampsia was observed in 69.9% of patients, while 30.1% had mild pre-eclampsia. The fetal outcomes were as follows: 65.5% good, 12.9% stillbirth, and 21.5% neonatal death, with an insignificant P-value. Conclusion: The study concluded that the high prevalence of pre-eclampsia in the community is alarming, significantly increasing the risk of adverse outcomes for infant health and well-being. There is a critical need to educate women about the signs and symptoms of pre-eclampsia.

Investigation of serum apelin-13 and apelin-36 concentrations in pregnancies complicated by preeclampsia; a prospective case-control study

Objective We aimed to investigate the relationship between preeclampsia and maternal serum apelin-13 and apelin-36 concentrations. Methods This cross-sectional study was carried out in the Gynecology and Obstetrics Clinic of Umraniye Training and Research Hospital. The preeclampsia group consisted of 40 pregnant women diagnosed with preeclampsia, and the control group consisted of 40 healthy pregnant women matched with the preeclampsia group in terms of age and body mass index. The two groups were compared in terms of maternal serum apelin-13 and apelin-36 concentrations. Results Both groups were similar in terms of demographic characteristics and the gestational week at blood sampling. Maternal serum apelin-13 and apelin-36 concentrations were significantly lower in the preeclampsia group than in the control group (p = 0.005, p = 0.001, respectively). The optimal cutoff value for the prediction of preeclampsia in receiver operator curve analysis for apelin-13 was determined as 1781.67 pg/ml with 60% sensitivity and 60% specificity, and 885.5 pg/ml for apelin-36 with 67% sensitivity and 65% specificity. We divided the preeclampsia group into two groups mild and severe and compared the three groups in terms of maternal serum apelin-13 and apelin-36 concentrations. The lowest apelin-13 concentration was detected in the severe preeclampsia group, while the lowest apelin-36 concentration was detected in the mild preeclampsia group (p = 0.020, p = 0.003, respectively). Considering the onset of the disease, we divided the preeclampsia group into two groups early and late-onset, then compared the three groups in terms of maternal serum apelin-13 and apelin-36 concentrations. The lowest maternal serum apelin-13 and apelin-36 concentrations were detected in the early-onset preeclampsia group (p = 0.016, p = 0.001, respectively). Conclusion It was determined that serum apelin-13 and apelin-36 concentrations were significantly lower in preeclamptic pregnant women, this decrease was more significant in early-onset preeclampsia, and low maternal serum apelin-13 concentration was more associated with the severity of preeclampsia.

THE ROLE OF INTRAUTERINE ANTIGEN EXPOSURE IN THE MORPHOGENESIS OF CEREBRAL BLOOD VESSELS

Introduction. The state of cerebral vessels in children of the first year of life with congenital toxoplasmosis, both active and without signs of activity (as models of antenatal antigenic exposure), was considered. The patients were born to mothers whose pregnancy proceeded with mild preeclampsia and perinatal damage to the nervous system. The features of the morphogenesis of the brain vessels of rats after exposure to antigens in the antenatal period were experimentally investigated. Materials and Methods. 119 children of the first year of life were examined. 43 patients with toxoplasmosis, 25 children from women whose pregnancy was complicated by mild preeclampsia, and 28 children with perinatal lesions of the nervous system of hypoxic-ischemic genesis due to antenatal hypoxia of the fetus. The comparison group consisted of 23 healthy children with an uncomplicated antenatal history. Experimental study of the morphogenesis of brain vessels of Wistar rats after intrauterine administration of antigens according to the method of M.A. Voloshin. Results. At 1–2 and 7–8 months of life, in children with antigenic antenatal exposure and perinatal lesions of the nervous system of hypoxic-ischemic genesis, blood flow disorders in the anterior cerebral arteries, vessels of the nail bed, manifestations of endothelial dysfunction and impaired function of the sympathoadrenal system were detected. In the experiment, after the intrauterine introduction of antigens of various nature, an increase in the proportion of the connective tissue component in blood vessels was established, and a significant decrease in the ratio of muscle and connective tissue components from the 1st to the 60th day of postnatal development. Changes in indicators of carbohydrate metabolism and a decrease in glycogen in the anterior cerebral artery of rats 1–60 days of life with antigenic antenatal exposure indicate long-term changes in metabolic disorders of carbohydrate metabolism in the anterior cerebral arteries. By extrapolating the results obtained in the experiment on rats, it is possible to predict metabolic disorders in the vessels of people of the appropriate age, which to a certain extent explains the ultrasound and biomicroscopic changes in vessels, endothelial dysfunction detected in children with antigenic antenatal stimulation at 1–2 and 7–8 months of life. Conclusions. The identified features indicate a change in the morphogenesis of brain vessels after antenatal antigenic exposure and are the background for the formation of central nervous system pathology in children

The role of ultrasound and mitofusin-2 levels to predict pregnancy outcomes in patients with severe preeclampsia: a case-control study.

The aim of this study was to evaluate mitofusin-2 levels and fetal Doppler ultrasonography effects in patients with severe preeclampsia. This single-center case-control study was conducted in the gynecology service of the university hospital in Van. A total of 90 pregnant women aged 18-40 years were included in the study. Of these, 30 are normal, 30 have mild preeclampsia, and 30 are pregnant with severe preeclampsia. In this study, especially in severe preeclampsia patients, serum mitofusin-2 levels and important fetal Doppler flows such as uterine arterial pressure, umbilical arterial pressure, and 1st and 5th minute Apgar scores, birth weight, and the relationship between postnatal outcomes such as week of birth and the number of patients in the neonatal intensive care unit were investigated. There was a significant difference between the three groups in terms of mitofusin-2 levels, which was the highest in the group (p<0.05). Maternal serum mitofusin-2 levels were positively correlated with uterine arterial pressure (r=0.543, p=0.007), umbilical arterial pressure (r=0.238, p=0.008), diastolic blood pressure, and systolic blood pressure (p<0.001). Receiver operating characteristic curve of mitofusin-2 in predicting preeclampsia is as follows: optimal cutoff 1.6 ng/mL; area under the curve: 0.861; 95%CI: 0.786-0.917; sensitivity: 83.9%; and specificity: 70.0%, (p≤0.001). A one-unit increase in mitofusin-2 resulted in a statistically significant 4.21-fold increase in preeclampsia risk. This study recommends the use of mitofusin-2 together with fetal Doppler ultrasound findings as a reliable indicator of preeclampsia severity.

The early predictive value of maternal serum PAPP-A concentration at 11-14 weeks of pregnancy for preeclampsia.

To determine the expression and clinical significance of maternal serum pregnancy-associated plasma protein A (PAPP-A) in pregnant women with different degrees of preeclampsia at 11-14 weeks of gestation. The clinical data of 65 pregnant women with preeclampsia admitted to our hospital from January 2020 to October 2022 were retrospectively analysed. Another 45 normal pregnant women who came to our hospital for prenatal examination and delivery during the same period were selected as the healthy control group. The serum contents of PAPP-A, a-fetoprotein (AFP) and free estriol (uE3) in each group were compared. The correlation between PAPP-A and AFP as well as uE3 was analysed by Pearson analysis. The clinical value of serological indexes in diagnosing preeclampsia was analysed using ROC curve. The levels of PAPP-A and uE3 in pregnant women in the preeclampsia group were lower, while the contents of AFP were higher than these in the healthy control group ( p < 0.01). The pregnant women with severe preeclampsia had lower levels of PAPP-A and uE3 with higher levels of AFP compared to these with mild preeclampsia ( p < 0.001). Pearson correlation analysis showed that serum PAPP-A was negatively correlated with AFP ( r = -0.246, p < 0.05) and positively correlated with uE3 ( r = 0.398, p < 0.01) in preeclampsia patients. ROC curve analysis demonstrated that the area under the curve (AUC) of PAPP-A, AFP and uE3 to assist in the diagnosis of preeclampsia was 0.740, 0.738 and 0.806, respectively. The AUC of the combination of PAPP-A, AFP and uE3 to assist in the diagnosis was 0.912, with a sensitivity of 90.38% and a specificity of 80.33%. The clinical assisted diagnostic value of combined detection was high. The serum level of PAPP-A in pregnant women with preeclampsia in the early pregnancy was significantly lower and related to the severity of the disease. The combination of routine detection for AFP and uE3 had a good predictive value for preeclampsia, which was helpful to take relevant interventions to reduce the incidence of preeclampsia as early as possible, and had a positive impact on protecting maternal and infant health.

The association of ghrelin rs26311 and rs27647 polymorphisms and mRNA expression with preeclampsia susceptibility and severity-A case-control study.

Ghrelin is an adipokine the placenta generates to control the maternal metabolic adaptation to pregnancy. It causes different pregnancy complications like preeclampsia (PE). Therefore, the aim of this study was to assess the association between ghrelin mRNA expression and rs26311 and rs27647 polymorphisms and PE development. In total, 156 PE women (including 97 patients with mild PE and 59 patients with severe PE) and 152 healthy controls were recruited in this case-control study during 2019-2020. All participants with other diseases have been excluded from both groups. The ghrelin expression was analyzed with real-time PCR, and ghrelin variants were examined using the RFLP-PCR method. The maternal and placental ghrelin rs27647 and rs26311 variants were unrelated to PE susceptibility. Haplotype analyses showed no significant difference between the four haplotypes and PE. No relationship was revealed between rs27647 polymorphism and severe PE. However, the results indicated a relationship between rs27647 and severe PE compared to mild PE and controls. Therefore, the rs27647 variant was associated with severe PE compared to mild PE in codominant, recessive, and log-additive models and controls in codominant, dominant, recessive, and log-additive models. The placental ghrelin mRNA expression declined in PE women compared to controls (0.67-fold), but the difference was insignificant (p=0.263). No significant difference was found between various genotypes of rs27647 and rs26311 polymorphisms concerning ghrelin mRNA expression. The maternal and placental ghrelin polymorphisms, rs27647 and rs26311, showed no effect on PE. However, the rs27647 variant was associated with severe PE.

Exploring the Complex Interplay of Trace Elements and Their Association with the Risk of Development of Pre-eclampsia in Pregnancy: a Case-Control.

Pre-eclampsia, a hypertensive disorder occurring during pregnancy, poses significant risks to maternal and fetal health worldwide. Despite extensive research, the precise cause of pre-eclampsia remains unknown. Recent studies have indicated that trace elements, essential minerals crucial for various biological processes, might be significant factors in the development of pre-eclampsia. This study examines the intricate relationship between trace elements (magnesium, copper, zinc, calcium, phosphorus, and iron) and the severity of pre-eclampsia. The study involves a total of 150 participants, categorized into three distinct groups: 50 individuals with mild pre-eclampsia, 50 with severe pre-eclampsia, and 50 healthy pregnant controls. Specifically, out of the 100 pre-eclampsia cases, 5 were identified as early-onset and 95 as late-onset. Participants were recruited from a tertiary care hospital based on stringent inclusion and exclusion criteria. All the trace elements were quantitatively measured by direct colorimetric method using the Beckman Coulter AU480 analyzer system (Beckman Coulter, USA). Pre-eclampsia cases exhibited a significantly lowered level of magnesium (2.02 mg/dL), zinc (57.62 mg/dL), calcium (8.02 mg/dL), and phosphorus (3.93 mg/dL). These levels were approximately 14.4%, 20.2%, 21.1%, and 22.6% lower when compared to healthy pregnant women. Conversely, copper (151.67 mg/dL) and iron (53 μg/dL) levels were significantly elevated in pre-eclampsia cases. Age emerged as a significant risk factor, correlating with heightened pre-eclampsia susceptibility. Magnesium showed a protective effect, correlating negatively with age and positively with gestational age. The complex relationships between trace elements, age, and pre-eclampsia underline the need for personalized interventions, potentially including magnesium supplementation, in high-risk pregnancies.

The role of first trimester serum inflammatory indexes (NLR, PLR, MLR, SII, SIRI, and PIV) and the β-hCG to PAPP-A ratio in predicting preeclampsia

ObjectiveThe aim of this study was to investigate the predictive value of inflammation parameters and indices measured in the first trimester for the detection of preeclampsia. Materials and methodsIn this retrospective analysis, we examined the medical records of 276 eligible pregnancies at a tertiary referral center from 2022 to 2023. The cases were categorized into the Control group (n = 171), the Mild Preeclampsia group (n = 63), and the Severe Preeclampsia group (n = 42). We examined the demographic characteristics and perinatal outcomes of all participants. Additionally, we analyzed laboratory parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune inflammation index (SII) (neutrophil*platelet/lymphocyte), systemic inflammation response index (SIRI) (neutrophil*monocyte/lymphocyte), pan-immune inflammation value (PIV) (neutrophil*platelet*monocyte/lymphocyte), and the β-hCG to PAPP-A ratio in the first trimester. Receiver operating characteristic curve (ROC) analysis was conducted to identify the optimal cut-off levels for inflammatory markers in predicting preeclampsia. ResultsSIRI and PIV exhibited statistical significance in differentiating between the preeclampsia and control groups for predicting preeclampsia. The determined cut-off value for SIRI was 1.5, providing a sensitivity of 56.2% and a specificity of 55.6% (p = 0.012). Likewise, the cut-off value for PIV was 394.4, with a sensitivity of 55.2% and a specificity of 55% (p = 0.013). NLR, PLR, MLR, SII, and β-hCG to PAPP-A ratio could not predict preeclampsia. ConclusionsThis study suggests that SIRI and PIV hold promise as potential tools for predicting the risk of preeclampsia during the first trimester.

Evaluating the Analgesic Efficacy of Magnesium Sulfate in Quadratus Lumborum Block for Mild Pre-eclampsia during Cesarean Section

Evaluating the Analgesic Efficacy of Magnesium Sulfate in Quadratus Lumborum Block for Mild Pre-eclampsia during Cesarean Section

The Association Of Adiponectin, Homocysteine, B 12 And Folic Acid In Iraqi Women With Preeclampsia And Its Severity

Background: preeclampsia is a common obstetric disorder that remains a leading cause of maternal and perinatal mortality and morbidity. Maternal serum concentrations of adiponectin, folate, homocysteine, and vitamin B12 have been found to be associated with pre-eclampsia. Nevertheless, reported studies involved still not clear with variable reliably. The aim of the present study is to examine the relationship between these biomarkers and pre-eclampsia and its severity in Iraqi population. Aims: The study aims to evaluate the association between maternal serum adiponectin, homocysteine, B12 and Folic acid and preeclampsia and its severity. Study design and setting: A case control study carried out in Al-Zahraa Maternity and Pediatric Teaching Hospital in Najaf city/ Iraq from the 1st of December 2019 to the 1st of December 2020. Patient and Methods: The study included 50 pregnant women with preeclampsia and a comparative control group of 50 normotensive pregnant women. Preeclamptic women were further subdivided into 14 women with severe preeclampsia and 36 women with mild preeclampsia. Serum Adiponectin, Homocysteine, B 12, and Folic acid were measured by using special ELIZA (Enzyme linked immunosorbent assay) technique. Results: There was a significant increment in the level of Adiponectin and Homocysteine while vitamin B12 and Folic acid were significantly decreased in preeclamptic pregnant women in comparison to the control group. On the other hand, there was no significant relation between the severity of preeclampsia and the level of Adiponectin, Homocysteine, Vitamin B 12, and Folic acid. Conclusion: Women with preeclampsia had significantly lower vitamin B12 and folic acid and significantly higher concentrations of adiponectin and homocysteine than normotensive pregnant women, but no relation with its severity.

EVALUATION OF THE ANTIHYPERTENSIVE DRUGS IN PREECLAMPSIA PATIENTS TO CLINICAL OUTCOMES AT RSUD SEKARWANGI ON 2021 PERIOD

Preeclampsia is a pregnancy complication with several symptoms, such as hypertension, proteinuria, and edema. Such symptoms occur in pregnant women after the gestational age reaches 20 weeks. Preeclampsia is divided into mild preeclampsia (PER) and severe preeclampsia (PEB). Antihypertensive drugs are used to lower blood pressure and proteinuria levels in patients with preeclampsia. The purpose of this study was to obtain a profile of antihypertensive drugs and monitor changes in clinical outcomes in patients with preeclampsia. This was a retrospective cross-sectional study using secondary data from the medical records of preeclampsia patients. Of the 54 patients who met the inclusion criteria with the age at which most preeclampsia was 21–35 years old, 33 (61.11%) patients and 32 (59.62%) patients had PEB. The most widely used antihypertensive drug was a combination of methyldopa and nifedipine, with 27 (50%) patients receiving combination therapy. After treatment with antihypersensitive drugs, 50 (92.60%) patients experienced a decrease in blood pressure, 45 (83.33%) patients experienced a decrease in proteinuria levels, and 45 (83.33%) patients had normal birth conditions. Antihypertensive treatment for preeclampsia patients has a relationship with a decrease in the patient’s blood pressure (p-value = 0,007), but there was no relationship with a decrease in proteinuria levels (p-value = 0,660) and condition of baby birth (p-value = 0,446). Keyword: Preeclampsia; Antihypertensive Drugs; Clinical Outcomes

The value of TDI combined with myocardial strain parameters in quantitative evaluation of left heart function in parturient with pregnancy-induced hypertension

This study aimed to investigate the value of tissue doppler imaging (TDI) and 4D myocardial strain parameters in evaluating left heart function of pregnant women with hypertension and the association between these parameters and relevant factors. Forty-five pregnant women with hypertensive disorder, including 20 with hypertension, 15 with mild preeclampsia, and 10 with severe preeclampsia, were recruited, and their cardiac functions were compared with those of 30 healthy pregnant women as controls. High Left ventricular end-systolic volume (LVESV), Left atrial volume index (LAVI), E/e were observed in hypertensive disorder, while Mitral peak diastolic velocity(E), Early diastolic peak velocity(e), E/A, Left ventricularglobal longitudinal strain (LVGLS), Left ventricularglobal area strain (LVGAS), and Left atrialglobal longitudinal strain (LAGLS) were decreased; for pre-eclampsia, Left ventricular end-systolic diameter (LVESD), Left atrial anteroposterior diameter (LAD-ap), LVESV, LAVI were significantly increased, LVGLS, LAGLS were significantly decreased, Left ventricular end-diastolic diameter (LVEDD), Left ventricular end-diastolic volume (LVEDV), A peak, E/e were increased, while E peak, E/A, e, Left ventricle global radial strain (LVGRS), Left ventricle global circumferential strain (LVGCS), LVGAS were decreased but not significantly; for severe preeclampsia, Left ventricular end diastolic diameter (LVEDD), LVESD, LAD-ap, Left ventricular end-diastolic volume (LVEDV), LVESV, LAVI, A, and E/e were significantly increased, while LVGLS, LVGRS, LVGCS, LVGAS, LAGLS, E peak, E/A, and e were significantly reduced. TDI combined with 4D myocardial strain parameters can detect early changes in cardiac function of hypertensive disorders in pregnancy, with LVGLS, LVGAS, and LAGLS being the most sensitive indicators for early changes. Such findings provide a basis for effective clinical treatment of these symptoms.

Significance of maternal serum pentraxin-3 level in assessment of severity of pre-eclampsia and its effect on neonatal outcome

Abstract Background: Preeclampsia is a multisystem, highly variable disorder specific to pregnancy. Pentraxin-3 (PTX3), a recently identified multimeric inflammatory mediator, it can be considered as a promising biomarker of preeclampsia and its severity. Objective: To determine the association between maternal serum PTX3 level and preeclampsia, its severity and its effect on the neonatal outcome. Materials and Methods: This case control study was carried-out at the Department of Obstetrics and Gynecology, Azadi Teaching Hospital, Kirkuk City, Iraq from 1st of February, till 30th of November 2021. The study included 92 pregnant women at term who were divided into three groups (mild preeclampsia, severe preeclampsia, and pregnant without preeclampsia and regarded as control group). The neonatal outcomes were documented. PTX3 was measured in the serum using human PTX3 ELISA KIT. Results: PTX3 cutoff value of ≥120.8 pg/mL was associated with sensitivity of 100% and specificity of 96%. The correlation between PTX3 and urea, body mass index, birth weight, APGAR (A for neonatal appearance, P for heart rate, G for grimace, A for activity, R for respiration) score in 1 and 5 minutes showed that, there was significant positive weak correlation between PTX3 and urea, in which an increase in urea was associated with an increase in PTX3. Also, there was significant negative weak correlation between PTX3 with birth weight and APGAR 1, in which an increase in PTX3 was associated with a decrease in birth weight and APGAR in 1 min. Conclusion: PTX3 is one of the biochemical markers in diagnosing preeclampsia and distinguishing its severity and can be used as a marker for early neonatal outcome in preeclampsia.