Preeclampsia Mothers Research Articles

Existential challenges due to severe pre-eclampsia when becoming parents

ObjectivesTo deepen the understanding of parents’ existential challenges and experiences when having a premature infant due to the mother's pre-eclampsia. DesignTwo empirical studies based on reflective lifeworld research (RLR), were conducted to investigate parents’ experiences of having a premature infant due to mother's pre-eclampsia. A further abstraction was possible. The two essences were synthesised into a general structure. Then, a philosophical examination of the existential issues was done using Karl Jaspers' concept of limit situation and health theory outlined by Dahlberg and Segesten. SettingMaternity ward and neonatal intensive care unit. ParticipantsNine mothers and six fathers. FindingsThe findings revealed the experiences of a vulnerable group of parents in the maternity ward and in the neonatal intensive care unit (NICU). The parents faced a paradoxical experience. They experienced mothers' severe illness and in some cases accompanied by the possibility of death, at the same time they experienced the joy of becoming parents. The premature birth and the mother's severe symptoms revealed the intertwinement of biological and existential features. Pre-eclampsia restricted the mothers from fulfilling the major project in their lives: to become real mothers. These experiences were elucidated by the concept of limit situations as suffering, struggle, death, and paradoxes of life as well as the health theory with its biological and existential dimensions. Key conclusionSome parents experienced closeness to death and the beginning of life as almost intertwined. These two fundamental facets of life are connected to existential features and challenges. The study also underlined the antinomies of life; suffering and facing severe illness that could cost both the mother's and infant's lives, and at the same time feeling the happiness of becoming parents. Implications for practiceHealth professionals should know how these experiences affect parents. They should be sensitive when approaching mothers and fathers in such situations. The families’ vulnerability must be considered within the physical space of health services. If the parents needs to talk, time and staff should be available to meet their needs.

Hubungan Tingkat Stres dengan Kualitas Tidur pada Ibu Preeklamsi di Wilayah Kerja Puskesmas Tempurejo-Jember

Preeclampsia is some of the symptoms that occur in pregnancy, childbirth, and puerperal women, which are characterized by hypertension, edema, and increased proteinuria. Preeclampsia usually occurs when pregnancy enters the age of 20 weeks to 48 hours after the birth process. In that condition, there are undesirable complications during pregnancy that can make mothers more vulnerable to psychological disorders, one of which is stress. Stress experienced during pregnancy can affect the health of the baby and can also improve poor sleep quality. This study aims to analyze the relationship of stress levels with the quality of preeclampsia sleep in the Tempurejo Community Health Center in Jember. This research was conducted on 31 preeclampsia mothers using a correlational research design with a cross-sectional approach and total sampling techniques. Data collection using questionnaires stress and sleep quality. The results showed 19 (61.3)% of respondents experienced mild stress, and 26 (83.9)% experienced poor sleep quality. The results of data analysis using the spearmen statistical test obtained p-value 0.001 and r = 0.894, which means there is a relationship between stress levels and sleep quality or ha is accepted. R-value = 0.396 means that the correlation between stress levels and sleep quality in preeclampsia has a positive correlation with weak correlation strength. Nursing implications for further research can intervene in interventions that can reduce stress levels with the quality of sleep in preeclampsia mothers to reduce the factors of preeclampsia.

Analysis of serum levels L-arginine and 25-hydroxyvitamin D as a predictor of survival of severe preeclampsia mothers

ObjectiveThis study aimed to analyze serum levels of L-arginine and 25-hydroxyvitamin D as predictors of survival in severely preeclamptic women. MethodsThis study is a retrospective descriptive study using medical record data from June to August 2019 and has received a recommendation for ethical approval with the protocol number UH20070290. The study was conducted in 4 hospitals in Makassar: Dr. General Hospital. Wahidin Sudirohusodo, Hasanuddin University Teaching Hospital, Siti Fatimah Regional Mother and Child Health Hospital, and Sitti Khadijah 1 Mother and Child Hospital. The samples of this study were mothers who gave birth with a diagnosis of normal pregnant women, severe preeclampsia, and severe preeclampsia with complications. ResultsSerum l-arginine level did not affect the survival of severe preeclamptic mothers. It was shown at p-value 0.799>0.05. Meanwhile, serum levels of 25-hydroxyvitamin D affect the predictors of maternal preeclampsia where the p-value is 0.024<0.05. In comparing serum levels of L-arginine and 25-hydroxyvitamin D, there was no significant difference in groups of normal pregnant women, severe preeclampsia, and severe preeclampsia with complications. ConclusionSerum level of 25-hydroxyvitamin affects the survival of severe preeclamptic mothers.

PERBEDAAN PENURUNAN TEKANAN DARAH PADA IBU DENGAN PRE EKLAMPSIA YANG DITERMINASI PADA USIA KEHAMILAN KURANG BULAN DAN CUKUP BULAN

Pre-eclampsia is the second leading cause of maternal death worldwide, with the main symptoms of hypertension and proteinuria in pregnant women. Various factors can affect the occurrence of pre-eclampsia and cause serious disease complications and even death. The purpose of this study was to determine the difference in blood pressure reduction in pre-eclampsia mothers who were terminated at the age of less and at term with a comparative analytic study design using a cross sectional approach. The population in this study were all pregnant women with pre-eclampsia who were terminated by caesarean section at preterm and full-term gestation, as many as 56 people. The sampling technique used is stratified proportional random samplingwith as many as 30 people. Through the Independent T-Test statistical test with a significance level of 0.05. The t-count is -3.209 and the significance is 0.003, then Ho is rejected, which means that there is a difference between the decrease in blood pressure in mothers with pre-eclampsia who were terminated at preterm and full-term gestation Keywords: Decrease in Blood Pressure, Pre Eclampsia, Aterm and Preterm

Assessment of angiotensin converting enzyme gene polymorphism in preeclampsia mothers of Bangladesh

The study aimed to assess the association of ACE insertion/deletion (I/D) polymorphisms with the susceptibility for preeclampsia in Bangladesh. It was a case-control study involving 220 subjects (100 preeclamptic and 120 normal pregnant women). The ACE (I/D) genotyping was done using the conventional PCR method. Overall, the frequency of ACE II genotypes was significantly (p<.05) higher in normal pregnant women than the preeclamptic women. The pregnant mother with DD genotype was at 3.43-fold higher risk (OR = 3.43; p<.01) of developing preeclampsia while pregnant mother with ID genotype was at lower risk (OR = 1.32; p>.05). On the other hand, patients having either DD or ID genotypes showed 1.9 fold (OR = 1.90; p>.05) increased risk of developing preeclampsia compared to the control group but not statistically significant. This study suggested that ACE (DD) genotypes may have strong associations with the occurrence of preeclampsia. Impact Statement What is already known on this subject? The study was conducted among 100 preeclamptic and 120 normal pregnant women. The preeclamptic patients were diagnosed by protein in urine and high blood pressure. The normal pregnant women were selected with no known complications. What the results of this study add? Overall, the pregnant mothers with DD genotype were at 3.43-fold higher risk of developing preeclampsia while pregnant mothers with ID or II genotypes were at a lower risk. What the implications are of these findings for clinical practice and/or further research? ACE (I/D) gene would be a biomarker of early diagnosis of preeclampsia and also be helpful to intervene in personalised medicine and gene therapy as a novel treatment of preeclampsia.

Immunohistochemical Expression of the Alpha Nicotinic Acetylcholine Receptor 7 in the Human Normal, Diabetic, and Preeclamptic Placenta and Products of Conception.

Preeclampsia (PE) and gestational diabetes (GD) are complications in advanced pregnancy while miscarriage for early pregnancy. However, the etiological factors are not well understood. Smoking has been associated with these complications as well as the sudden intrauterine deaths, sudden infant death, miscarriages, and still births. However, the immunolocalization of alpha 7 nicotine acetylcholine receptor (α7-nAChR) is not studied.Materials and Methods: α7-nAChR subunit expression was evaluated in 10 paraffin-embedded placental tissues after delivery and 10 tissue samples of products of conception during first trimester by immunohistochemistry. Among the placental tissues, two samples were normal placental tissue, four from PE mother, and four from GD mother. The expression of α7-nAChR was compared between the two groups in general and within the subgroups of placenta as well. Protein expression was evaluated using the nuclear labeling index (%) of villi with positive cells stained, positive cells in the decidua, and intensity of staining in the outer villous trophoblast layer.Results: The expression of α7-nAChR protein was high in all the cases of placenta and products of conception (POCs). α7-nAChR expression showed no notable differences among different cases of miscarriages irrespective of the mother’s age and gestational age at which the event occurred. However, there were some changes among the normal, PE, and GD placental groups in the linings of the blood vessels. Changes were restricted to the villi (as opposed to the decidua) lining cells, both cytotrophoblast and syncytiotrophoblast, and were specific to the α7 subunit. PE blood vessel lining was thicker and showed more expression of this receptor in endothelial cells and myofibroblasts in PE and GD groups. In POCs, the strong expression was observed in the decidua myocytes of maternal blood vessels and in syncytiotrophoblast and cytotrophoblast of chronic villi.Conclusion: Nicotine acetyl choline receptors are found to be expressed highly in the placental tissues and in products of conception. They may be associated with the sudden perinatal deaths and miscarriages or complications of pregnancy.

Association of Maternal Regulatory Single Nucleotide Polymorphic CD99 Genotype with Preeclampsia in Pregnancies Carrying Male Fetuses in Ethiopian Women.

Preeclampsia (PE) is a human specific syndrome with unknown etiology causing maternal and fetal morbidities and mortalities. In PE, maternal inflammatory responses are more exaggerated if the fetus is male than female. Other pregnancy complications such as spontaneous abortions are also more common if the fetus is male. Recent transcriptome findings showed an increased expression of CD99 in erythroid cells from male cord blood in PE. The single nucleotide polymorphism (SNP) rs311103, located in a GATA-binding site in a regulatory region on the X/Y chromosomes, governs a coordinated expression of the Xg blood group members CD99 and Xga in hematopoietic cells in a sex-dependent fashion. The rs311103C disrupts the GATA-binding site, resulting in decreased CD99 expression. We aimed to investigate the association between PE and the allele frequency of rs311103 in pregnancies in a fetal sex-dependent fashion. In a case-controlled study, we included 241 pregnant women, i.e., 105 PE cases and 136 normotensive controls. A SNP allelic discrimination analysis was performed on DNA from maternal venous blood and fetal cord blood by qPCR. A statistically significant association was observed between rs311103 allele frequency and PE in mothers carrying male fetuses. Therefore, the rs311103 genotype may play a role in the pathogenesis of PE in a fetal sex-specific manner.

THE EFFECT OF FOOT SOAK THERAPY USING WARM WATER TOWARD ANXIETY LEVEL OF PREECLAMPSIA MOTHERS IN PUBLIC HEALTH OF TEMPUREJO JEMBER REGENCY

One of psychological error happened on preeclampsia mothers is anxiety disorder. One of the interventions given to preeclamptic women who suffer anxiety is the treatment of warm water foot soak. The research aim to analyze the effect of warm water foot soak therapy on anxiety of preeclampsia women in Puskesmas Tempurejo, Jember Regency. This research used Quasi experimental with a research design of Pretest-posttest with Control Group. The sample was 30 preeclamptic women and used purposive sampling. Data was obtained using an anxiety questionnaire (validity value 0.93 and reliability value 0.97). Data analysis used Wilcoxon. The results of this research showed that there were 15 effects of warm water foot soak therapy (p = 0,003). While in the control group there was no influence (p = 0.317). The mann whitney  showed significant differences between the intervention groups after being given warm water foot soak therapy and the control group (p = 0,000). Warm water foot soak therapy is a non-pharmacological therapy that can stimulate the endorphin hormone so that the body feels relaxed. The effect of relaxation by increasing comfort through sensations on foot surface and lower the level of anxiety. This warm water foot soak therapy is applicable for pregnant women who suffer anxiety.Â

EFEKTIVITAS MASSAGE EFFLEURAGE DAN TERAPI MUSIK TERHADAP PENURUNAN TEKANAN DARAH PADA IBU BERSALIN DENGAN PRE EKLAMSI

ABSTRACTBackground: According to the Indonesian Health Demographic Survey (IDHS) in 2017, the direct cause of the maternal mortality rate (MMR) of 30% was preeclampsia. Preeclampsia can be treated pharmacologically and non pharmacologically. Non-pharmacological treatment is a natural treatment including effluerage massage and music therapy.Objective: To identify and analyze differences in blood pressure reduction in pre-eclampsia mothers before and after massage effleurage and music therapy in the Kragan II Puskesmas maternity room.Methods: The study design used the Two Group Post Test With Control Design. Sampling by accidental sampling. Sampling in this study were 40 women with preeclampsia. Test results using the Mann-Whitney test.Results: With effluarge massage the average blood pressure value was 22.0 while in music therapy 19.00 and obtained ρ was 0.002 (&lt;0.05). So Ho refused Ha accepted, which means there are differences in the effectiveness of massage effleurage and music therapy to reduce blood pressure in mothers giving birth with pre-eclampsia in health center II.Conclusion: Massage effleurage is more effective when compared to music therapy in reducing maternal blood pressure. It is expected that health workers to implement an effleurage massage program in women with preeclampsia. Keywords: Massage effleurage, Music Therapy, Preeclampsia

Short-term Evaluation of Survival Newborns Having Spent a Day in Neonatology at the University Clinics of Kinshasa During Severe Preeclampsia: Prospective Cohort Survey

Background and aims: neonatal mortality in pregnant women with pre-eclampsia remains a concern in our environment and several factors, including those related to complications of pre-eclampsia, contribute to it in our settings where the care is inadequate. The aims of our study is to determine the frequency of transfer to describe the survival of babies born to preeclampsia mothers admitted to the Pediatric Neonatology Department of University Clinics of Kinshasa over a consecutive period of approximately 30 days. Methods: This is a prospective cohort study carried out over a period from January 1, 2006 to December 31, 2015 targeting all babies born to preeclampsia mothers followed in the neonatal service of the University Clinics of Kinshasa. Maternal, perpartal, neonatal and evolutionary characteristics (cure or death) were studied. Survival was described by the Kaplan Meier method at the 5% significance level. Results: the recorded death rate was 26.5%. Gestational age between 28-36 weeks of amenorrhea conferred a risk of death in children 3 times, compared with APGAR <7 at the 1st, 5th and 10th which conferred a risk of 2, 3 and 3 times respectively. The overweight-obese mothers had a risk doubled of causing the death of newborns. Conclusion: The toll of neonatal mortality during preeclampsia is heavy in developing countries where newborns continue to die from often preventable causes. The reduction in neonatal morbidity and mortality requires an improvement in the system of care for newborns in our environment.

The Relationship between Distance of Pregnancy and Parity with The Incidence of Preeclampsia in RSUD dr. M. Yunus Bengkulu

The impact of preeclampsia is low birth weight (LBW) and death in mothers. This study aims to study the relationship between distance of pregnancy and parity with the incidence of preeclampsia in RSUD dr. M. Yunus Bengkulu in 2018. This study uses an Analytical Survey approach with a case control design. The population is all non-primiparous maternity mothers in RSUD Dr. M Yunus Bengkulu In 2018 as many as 342 people consisted of 51 case variables of mothers who had preeclampsia taken in total sampling and 51 control variables of non preeclampsia mothers taken by systematic random sampling with multiples of 6. Data collection is using secondary data by looking at documentation data using cheklis. Data analysis was performed with the Chi-Square (χ2) test, Contingency Coefficient (C) Test and Odd Ratio (OR). The results obtained: Of the 102 ibu, there were 51 mothers preeclampsia and 51 mothers not preeclampsia, 36 pregnancy distances 2 years, 66 people pregnancy distances ≥ 2 years, 63 people (38.9%) primiparous or grandemultiparous parity, 99 people (61.1%) multiparous parity, there is a significant relationship between the distance of pregnancy with the incidence of preeclampsia in RSUD dr. M. Yunus Bengkulu, with a moderate relationship category, and there is a significant relationship between parity and the incidence of preeclampsia in RSUD dr. M. Yunus Bengkulu, with medium relationship category. It is hoped that health workers will further enhance health promotion about the effects of pregnancy spacing and parity on preeclampsia. Keywords: pregnancy distance, parity, preeclampsia

Prevent Mortality Rates of Pregnant Women in Preeclampsia Condition Based on Characteristics Analysis

Background: Preeclampsia is the leading cause of the deaths of pregnant women in Indonesia (30.9%). The cause of preeclampsia until now is not known for sure. The purpose of this study was to determine the characteristics of preeclamptic pregnant women based on age, parity, body mass index and based on a history of hypertension, family history of hypertension, and level of education.Methods: The research method is observasional descriptive. The sampling technique is total sampling. The sample in this study were preeclamptic pregnant women in Dr. Mohammad Soewandhie Hospital in the period of 1 January up to 31 Desember 2017 amounting to 100 samples.Results: The results showed that 55% of preeclampsia pregnant women aged &gt;35 years, 65% of primipaternity preeclampsia mothers, 63% obesity, 67% had no history of hypertension, 78% had no family history of hhypertension, and level of education does not affect the condition.Conclusions and Discussions: The highest risk factors for preeclampsia are age&gt; 35 years, primipaternity and obesity. Therefore, it needs appropriate prevention methods to avoid the emergence of pregnancy problems and their complications include recognizing the signs and symptoms of preeclampsia, be aware of risk factors for the causes of preeclampsia, routine antenatal care, and adopting a healthy lifestyle.

P3441Impact of maternal preeclampsia on left ventricular structure and function in the newborn heart

Abstract Background Maternal preeclampsia (PE) has been associated with an increased risk of a variety of congenital heart defects in the infant. Whether PE also confers an increased risk of subtle structural and functional cardiac deficits is unknown. Purpose We investigated whether left ventricular dimensions and systolic function differed among infants of mothers with PE, compared to infants born after uncomplicated pregnancies. Method Systematic transthoracic echocardiography (TTE) was performed in neonates included in a population-based study in the period 2016–2018 (n=25,000). TTE was preferably performed within 14 days of birth. Left ventricular (LV) posterior wall end-diastolic thickness (LVPWd), interventricular septum end-diastole thickness (IVSd), LV internal diameter in end-diastole and end-systole (LVIDd and LVIDs), LV ejection fraction (LVEF) and fractional shortening (FS) were assessed. Information on maternal PE (ICD-10 codes DO140–142 and DO159) was retrieved from an obstetric database. Using linear regression in a sample of echocardiograms, we compared the LV structure and function adjusted for maternal age; gestational age; sex; weight and length. Results In total, 447 infants were exposed to PE, and 7,178 were born to uncomplicated pregnancies (Table). In infants of PE mothers, we found significantly larger LVPWd and IVSd (0.18 mm, 95% CI [0.14; 0.22], p&lt;0.001 and 0.06 mm, 95% CI [0.02; 0.10], p=0.001, resp.) and LVIDd as LVIDs were significantly smaller (−0.15 mm, 95% CI [−0.29; −0.01], p=0.032 and −0.16 mm 95% CI [−0.28; −0.04], p=0.009, resp.) compared to infants of non-PE mothers. We found no differences in systolic function. LV measures in PE and non-PE infants Parameter Infants of PE mothers, Infants of non-PE mothers, p-value Estimate* [95% CI] p-value mean [± SD] (n=447) mean [± SD] (n=7,178) Left Ventricular Posterior Wall in end-Diastole, LVPWd (mm) 2.20 [±0.58] 2.07 [±0.40] &lt;0.001 0.18 [0.14; 0.22] &lt;0.001 Interventricular Septum in end-Diastole, IVSd (mm) 2.53 [±0.52] 2.55 [±0.41] 0.562 0.06 [0.02; 0.10] 0.001 Left Ventricular Internal Diameter in end-Diastole, LVIDd (mm) 19.35 [±2.00] 20.10 [±1.41] &lt;0.001 −0.15 [−0.29; −0.01] 0.032 Left Ventricular Internal Diameter in end-Diastole, LVIDs (mm) 13.13 [±1.43] 13.65 [±1.79] &lt;0.001 −0.16 [−0.28; −0.04] 0.009 Fractional Shortening, FS (%) 32.10 [±4.07] 32.11 [±3.86] 0.937 0.26 [−0.11; 0.63] 0.168 Left Ventricular Ejection Fraction, LVEF (%) 63.19 [±5.61] 63.09 [±5.30] 0.690 0.34 [−0.17; 0.85] 0.192 *Adjusted for maternal age; gestational age; sex; weight and length. Conclusion In the largest population-based group of neonates to date, we showed that infants born to PE mothers compared to infants of non-PE mothers had significantly thicker left ventricular myocardium, and reduced left ventricular volumes. However, PE was not associated with altered systolic function. Our results might reflect an adaption of the fetal heart to the increased resistance in the placental arteries in PE mothers, and a secondary increased left ventricular afterload. Acknowledgement/Funding Danish Heart Association, Danish Children's Heart Foundation, Candy's Found., Toyota Found., Herlev-Gentofte Hospital Research Found., Lundbeck Found.

The Effect of Warm Footbath With Salt of Edema Under Extremity In Postpartum Pre Eclamsia

Preeclampsia is a complication of pregnancy that is acute and can occur ante, intra postpartum. Ideally during the postpartum blood pressure 120/80 mmHg. However, based on the preliminary there were 73.9% who experienced lower extremity edema in postpartum preeclampsia. The purpose of this study was to analyze the effect of a warm foot bath with salt edema under extremity in postpartum preeclampsia. The research design was a quasi-experimental pre-post test with control group design. The independent variable was soaking the foot using mixed salt warm water mixed. The dependent variable was extremity edema in the postpartum mother pre-eclampsia. The population was 9 respondents. Samples taken were 9 respondents. The results in the treatment group obtained a value of p = 0.04 while the control group p = 0.05. Test results obtained by Whitney p = 0.004. Based on the results of this study, it is expected that patients with extreme edema in postpartum preeclampsia should be advised to soak the foot using mixed salt warm water to improve blood circulation, especially for sufferers of lower extremity edema in postpartum preeclampsia.

Nꭃ-nitro-l-arginine methyl model of pre-eclampsia elicits differential IBA1 and EAAT1 expressions in brain

Pre-eclampsia (PE) is a pregnancy syndrome associated with an increased risk of both the mother and the baby developing cardiovascular disorders later in life. It is widely accepted that women with severe PE develop a neurological impairment however studies have revealed that the mother and baby are at jeopardy for a neurological deficit later in life. The present study examined expression of Ionized calcium binding adaptor molecule 1 (IBA1) and Excitatory amino acid transporter 1 (EAAT1) as neuroinflammatory markers in an Nꭃ-nitro-l-arginine methyl (L-NAME) model of early- and late-onset (EOPE/ LOPE) PE-like syndrome in rat models. Forty-five adult nulliparous pregnant Sprague-Dawley rats were used for this experiment. They were divided into Control, EOPE and LOPE groups. Administration of L-Name was done between gestational days 8–17 for the treated groups. Animals were sacrificed at gestational day (GD) 19, post-natal day (PND) 1 and 60 and the brain excised for further analysis. Our study confirmed L-NAME induced PE-like symptoms in rat models as evidenced by significant increase in systolic blood pressure and urine protein compared with Control. There was upregulation of IBA1 expression and increased microglial activation in the brain of PE rat models assessed at gestational day 19, post-natal day 1 and 60. Also, IBA1 expression is up regulated in the pups at post-natal day 1 and 60. Contrastingly, EAAT1 expression is down-regulated in the brain of PE rat models assessed at gestational day 19, post-natal day 1 and 60, as well as offspring at post-natal day 1 and 60. These results demonstrate likely neuro-inflammation within the brain of PE mothers during pregnancy, that persist into later life, as well as possible neuro-inflammation in brains of offspring of PE mothers.

Estimation of Level of Serum Lactate Dehydrogenase in Pre-eclampsia Patients and its Association with Maternal and Fetal Outcome

Introduction: Pre-eclampsia is a pregnancy-specific syndrome recognised as a leading cause of maternal and perinatal mortality. Etiopathogenesis of preeclampsia is defective placentation and endothelial dysfunction leading to oxidative stress and cellular lysis. Lactate Dehydrogenase (LDH) is an intracellular enzyme of glycolysis. Hypoxia and cellular lysis results in elevated levels of LDH. Early detection and management are important in prevention of Preeclampsia complications and deaths. Hence, the present study was conducted to estimate levels of Sr. LDH in Pre-eclampsia patients to find its association with maternal and fetal outcome was undertaken. Materials and Methods: Present prospective study was conducted in Department of Obstetrics and Gynaecology from August 2016 to December 2018 consisting of 84 cases of preeclampsia of ≥28 weeks gestation divided in 2 groups; Mild and Severe Preeclampsia. Sr. LDH was estimated in all study participants and its association with parameters of maternal and fetal outcome was observed. Results: In the present study, 46 patients had Mild Preeclampsia. and 38 had Severe Preeclampsia. Most cases of Mild preeclampsia. i.e., 78.3% had LDH &lt;600 IU/L whereas 71.1% of Severe Preeclampsia. had LDH &gt;600 IU/L. Complications like eclampsia in 66.7%, HELLP in 33.3%, Abruptio placenta in 55.6%, ARF and DIC in 33.3% cases were noted more in patients with LDH &gt;800 IU/L. Fetal still birth in 55.6%, Lower APGAR score and more NICU admission and Early neonatal death was present in babies of preeclampsia mother with LDH &gt;800 IU/L. There was found statistically significant association (p&lt;0.001) of raised Sr. LDH levels with poor maternal and fetal outcome in preeclampsia patients. Conclusion: Elevated levels of Sr. LDH during hypoxia, indicate the cellular damage and dysfunction occurring in preeclampsia. Detection of patients with increased levels of LDH is of crucial importance to detect and promptly manage the complicated cases and decrease the morbidity and mortality in mother and fetus.

PREEKLAMSIA DAN BAYI BERAT LAHIR RENDAH (BBLR) DI RSU ANUTAPURA PALU

ABSTRACT Preeclampsia is defined as the development of hypertension and proteinuria after 20 weeks of pregnancy. This research aims to determine the relationship between preeclampsia and LBW in Anutapura Hospital Palu. This research is a case-control research. The population was 186 infants and 93 infants LBW as samples, matching at 37, 38, 39, and 40 weeks gestation. The results showed that preeclampsia mothers gave birth to 16 LBW babies (64%) and 9 non LBW babies (36%). While non preeclampsia mothers gave birth to 77 LBW babies (47.8%) and 84 non LBW babies (52.2%). The mean BBL in preeclampsia mothers was 2232,00gr, whereas for non preeclampsia mothers was 2363,04gr. Based on the results of the chi-square test p-value = 0.197 (0.197&gt; 0.05). As conclusion, despite the prevalence of high LBW in preeclampsia mothers, there is no significant effect between preeclampsia and LBW babies. It is recommended that further analysis of other maternal factors be carried out for the incidence of LBW in Anutapura Hospital Palu.Keywords: Preeclampsia and Low Birth Weight

Cord Blood Sex Hormones Concentration: Relation to Birth Weight and Pregnancy Complications

Objectives: Umbilical cord blood can be taken at birth and largely gives indication of fetal and maternal conditions. The aim of the study was to investigate the relation between sex hormones in cord blood and birth weight of newborns and pregnancy complications.&#x0D; Materials and methods: Fifty cord blood samples were collected from newborns at labor room of Baghdad Teaching Hospital between May and October 2018. Blood was withdrawn from their mothers for lead analysis. Five milliliters (ml) of cord blood was taken, 3 ml was used for testosterone and estradiol analysis (using enzyme-linked immunosorbent assay) and 2 ml for lead measurement by lead care analyzer. Newborns weight and head circumference were measured. Delivered women were divided into 4 groups: Women with normal pregnancy, women with preeclampsia, diabetic women and polycystic ovary syndrome (PCOS) women.&#x0D; Results: There was no significant difference in age between women in all groups (p˃0.05). Birth weights, estradiol, and testosterone were significantly different between groups. Estradiol was higher in cord blood of newborns of PCOS women (p˂0.05) than others. Testosterone was higher in cord blood of babies of PCOS and preeclampsia women compared to those of diabetes (p˂0.05). There were no significant differences between male and female neonates regarding cord estradiol (3596.27±1934.69, 3714.57±1581.47 pg/ml respectively), and testosterone (393.18±87.14, 361.43±102.14 ng/ml respectively) (p˃0.05). Maternal lead levels correlated positively with cord lead (r=0.905, p˂0.05), which correlated negatively with head circumference (r=-0.766, p˂0.05). Birth weight correlated negatively with estradiol (r=-0.295), but positively with testosterone (r=0.006) (p˃0.05). &#x0D; Conclusion: Cord blood estradiol and testosterone levels do not differ between males and females. Estradiol was high in cord blood of PCOS mothers. Testosterone was high in cord blood of PCOS and preeclampsia mothers. The increase in cord lead causes decrease in babies head circumference.

A comprehensive home-care program for health promotion of mothers with preeclampsia: protocol for a mixed method study

BackgroundOne of the most common complications of pregnancy and the third cause of maternal death is preeclampsia. Thus this group of mothers should be supported, trained and received efficient health care services. Home-care is one strategy to improvement complications of Pregnancy. In Iran, high-risk pregnancies care provide in health care centers, hospitals and clinics by midwives and obstetricians. In this mixed method study, at first, a qualitative approach will be used to identify preeclampsia mothers’ health needs and home-care strategies for them. Then, the qualitative results will be emerged with literature review and expert ideas to develop a comprehensive home-care program which fits with the needs of these mothers in Iran.MethodsThis study is a qualitative- quantitative mixed exploratory research that consists of three sequential phases. In the first step, in qualitative study, all the women with preeclampsia, obstetricians, midwives, and maternal health policy makers will select purposefully. Health care needs and home-care strategies for mothers with preeclampsia will be determined. Sampling continues until data saturation. In the second step, an expert panel will be formed to prioritization of home-care needs and strategies extracted from result of qualitative study and review of literature. Afterwards, Primary home care program will be designed. In the third step, Delphi method will be used of minimum 10–15 experts including: obstetricians, midwives, and reproductive health professionals about validation of this home-care program by questionnaires in three rounds, then the final program is being developed.DiscussionIt is expected conducting a mixed method study to develop a home care program mothers with preeclamsia to improve their health status and wellbeing while reducing additional health care costs through preventing excessive admissions and interventions. Moreover it wants to follow up properly and timely high risk pregnant women. This study might be helpful in improvement quality of health services and promote health equity.ConclusionDeveloping a home care program for maternal health care especially for high risk pregnancy by considering Iran socio-cultural context.

Analysis of amino acid and acyl carnitine profiles in maternal and fetal serum from preeclampsia patients

Objectives: To analyze and compare concentrations of amino acids (AAs) and acylcarnitine (AC) profiles in maternal–fetal serum from women with preeclampsia (PE) and to assess their use as possible predictors of PE.Methods: This is a retrospective study in which we enrolled a total of 38 pregnant women and their offspring. Pregnant women with PE (n = 14) and healthy pregnant control subjects (n = 24) participated voluntarily in the study. Maternal blood and cord blood were tested using dry blood spot (DBS) specimens, and we detected concentrations of 18 types of AAs and 31 types of AC by using high-performance liquid chromatography tandem mass spectrometry (HPLC-MS), and compared metabolites between the groups. We used logistic regression modeling to estimate the association of each metabolite with development of PE.Results: Concentrations of most AAs and AC in PE mothers were significantly higher than those in the group of control mothers. Cord plasma concentrations of AC in most PE mothers were significantly higher than those in controls; however, in PE, levels of cord plasma concentrations of most AAs were significantly lower, except for Gly, compared with controls. Levels of most AAs and AC were lower in the control and PE groups, with a tendency for lower levels in maternal blood compared to cord blood. Receiver operating characteristics (ROC) and areas under the curves (AUC) analyses using these metabolites did not predict PE individually.Conclusions: Maternal–fetal levels of AAs and AC were associated with PE. But the use of metabolites did not constitute a reliable method for use as a biomarker in the diagnosis of PE. Further prospective studies are needed to clarify the roles of different metabolites involved in the mechanism underlying the development of PE.