Perinatal Outcomes In Preeclampsia Research Articles

PERINATAL AND MATERNAL OUTCOME OF PREECLAMPSIA WITH SEVERITY FEATURE MANAGED EXPECTANTLY AT ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE (SPHMMC), 2021, ADDIS ABABA, ETHIOPIA. A CROSS SECTIONAL STUDY

ABSTRACT Background Preeclampsia refers to the new onset of hypertension and proteinuria after 20 weeks of gestation in a previously normotensive woman. It is labeled as Preeclampsia with severe features when one of the severity signs occurs. Worldwide, Preeclampsia occurs in up to 7.5 percent of pregnancies and 10 - 15 % of direct maternal deaths are associated with preeclampsia and eclampsia. Majority of adverse maternal and perinatal outcome occur in Preeclampsia with severe features and when Preeclampsia occurs remote from term ( ). Objective The main objective of this study was to determine the maternal and perinatal outcome of Preeclampsia with severe features managed expectantly at SPHMMC in one year period. Materials and Methods: Facility based cross-sectional study was conducted. The study participants were selected consecutively by including all mothers admitted during the study period (January 2021 to December 2021 G.C.) with the diagnosis of Preeclampsia with severe features to SPHMMC that fulfill the inclusion criteria. Data taken was, the patients chart and a direct patient interview using pre-tested & structured questionnaire. Collected data was entered in to Epi info version 7 & analysis was made through SPSS version 25. Descriptive statistics, tables & figures was used to describe the study finding. Result –the mean days of prolongation of pregnancy was 11.5 days with slight increment of maternal complication from expected proportion that completely resolved postpartum. The most common maternal complications were HELLP syndrome (15.1%) and abruptio placenta (7.2%). There were 21 perinatal deaths (08 still births and 13 neonatal deaths) that give perinatal mortality rates of 276 per 1000 live births. The rate of NICU admission was 66.7% and the neonatal survival to seventh day was 71.7%. Only 66(90.4%) of the women were a good candidate for expectant management. Magnesium sulphate and steroid (dexamethasone) at admission was given 100% but 8.2% of the mothers didn’t get magnesium sulphate during intra partum and post partum period. Conclusion / Recommendation - Proper selection of pregnant mothers with pre-eclampsia with severity feature and Close and frequent maternal and fetal surveillance during expectant management is associated with a good perinatal outcome without significant difference in maternal complication. Key Words: pre-eclampsia ,Perinatal outcome, maternal complication.

Maternal serum angiopoietins levels in pre-eclampsia and pregnancy outcomes.

Although the understanding of pre-eclampsia (PE) has improved, there is still insufficient knowledge on the exact etiology and pathophysiological mechanisms. Dysregulation of angiogenic factors has emerged as a significant contributing factor. Among these factors, angiopoietins (Ang-1 and Ang-2) have gained considerable attention due to their crucial role in regulating vascular development and endothelial function. This study explored the maternal serum levels of angiopoietins and perinatal outcomes in PE. A case-control study involving women with PE (cases) and normotensive pregnancies (controls) was conducted at the Maternity unit of the Korle-Bu Teaching Hospital. Descriptive analysis was performed and the Mann-Whitney U test (two-sided) was used to compare maternal serum levels of angiopoietins between the cases and controls. We included 188 participants comprising 94 cases (women with PE) and 94 controls (normotensive pregnancies) with an average maternal age of 29.76 ± 5.56 and 28.43 ± 5.57 years, respectively. Maternal serum levels of Ang-2 were significantly lower among the PE cases comparedto the normotensive controls (1.25 [0.90, 2.15] vs. 2.14 [1.18, 5.73] ng/mL, p = 0.001) but no significant difference in Ang-1 levels (92.61 [80.92, 114.92] vs. 99.26 [81.76, 113.12] ng/mL, p = 0.429) was observed between the groups. The Ang-1/Ang-2 ratio was significantly elevated among women with PE compared to normotensive controls (74.47 [37.69, 110.59] vs. 45.98 [16.11, 88.22] ng/mL, p = 0.014). Also, women who delivered vaginally had significantly high maternal serum levels of Ang-1 compared to women who had cesarean section delivery (107.98 ± 27.79 vs. 89.02 ± 32.62 ng/mL). Maternal serum levels of Ang-2 but not Ang-1 were significantly depressed in women with PE compared to the pregnant normotensive controls. No significant associations were observed between Ang-1, Ang-2 levels, or the Ang-1/Ang-2 ratio and pregnancy outcomes such as preterm birth, birth weight, and severity of hypertension.

Is the expression of placental epithelial and lymphoid markers associated with the perinatal outcomes in preeclampsia?

This study aimed to investigate the association of the epithelial and lymphoid immune markers with the adverse perinatal conditions such as early-onset preeclampsia (EOPE), fetal growth restriction (FGR) and intrauterine fetal death (IUFD) in preeclampsia in the placentae of preeclamptic patients. A total of 60 pregnant patients were included in this study. The immunohistochemistry method was used to determine the expression levels of CD4, CD8, CD4 / CD8, CD68, P53, MDM2, CK18, CK19, E-cadherin, and β-catenin. In our study, the increase in E-cadherin expression in the preeclamptic fetal-maternal placental region was associated with EOPE and FGR development preeclampsia and the decrease in the expression of CD4 and CD8, which are involved in the local immunomodulation, was associated with IUFD. Our data reveal that the increase in the expression of CK18, CK19, E-cadherin, and β-catenin and the decrease in CD4 and CD8 play a role in the pathogenesis of preeclampsia.

SFlt-1 to PlGF ratio cut-offs to predict adverse pregnancy outcomes in early-onset FGR and SGA: a prospective observational study

This is a prospective, observational study, conducted in a tertiary referral hospital. We enrolled 175 singleton pregnancies with estimated foetal weight below the 10th centile between 20 + 0 and 31 + 6 weeks. Placental growth factor (PlGF), soluble fms‐like tyrosine kinase‐1 (sFlt-1) and fetoplacental circulation were assessed at the time of diagnosis. Receiver operating characteristic curves were used to assess the performance of sFlt-1/PlGF for predicting adverse perinatal outcomes (APO). The optimal cut-offs to predict each adverse outcome were calculated and the resulting areas under the curve (AUC) were compared to those calculated from the cut-off points of 38, 85 and 110. The need for delivery at <30 and <34 weeks and APO were the main outcome measures. The optimal cut-off points to predict APO, delivery <30 and <34 weeks were 24.9, 116.7 and 97.5, respectively. None of them proved to be superior to 38, 85 or 110 for predicting any adverse pregnancy outcome. Impact Statement What is already known on this subject? Soluble fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) are biomarkers of placental dysfunction. High sFlt‐1/PlGF values predict adverse perinatal outcomes in preeclampsia (PE). What do the results of this study add? No specific thresholds have been described to identify early-onset foetal growth restriction (FGR) and small for gestational age (SGA) foetuses at higher risk of adverse outcomes. This study describes these specific cut-offs and compares their predictive capacity to those described for PE. What are the implications of these findings for clinical practice and/or further research? The sFlt-1/PlGF cut-off points of 38, 85 and 110 might be useful for ruling out the occurrence of APO and the need for elective delivery at <30 and at <34 weeks from the moment of diagnosis in early-onset FGR and SGA. These cut-offs could aid Doppler studies in the distinction between FGR and SGA.

Maternal and perinatal outcome of pre-eclampsia in patients with gestational diabetes mellitus

Background: Pre-eclampsia is a leading cause of maternal mortality in Bangladesh. The most common problem of the gestational diabetic mother is increased incidence of pre-eclampsia. The aim of the study was to compare the maternal and perinatal outcome of diabetic pregnancy complicated with pre-eclampsia and without preeclampsia.&#x0D; Methods: This was a prospective observational study including 70 gestational diabetes mellitus (GDM) cases with pre-eclampsia and 70 patients with GDM without pre-eclampsia admitted in Obstetrics and Gynaecology Department of BIRDEM General Hospital-2. A detailed history was taken, and relevant data were collected through interview in a structured questionnaire and analyses were done according to objectives of the study.&#x0D; Results: In this study, 82% patients were delivered by Caesarean section in the study group (pre-eclampsia) and 72% patients were delivered by Caesarean section in the control group (p value 0.158). Rate of pre-term delivery was 55% in the studygroup and 32% in the control group (p value &lt;0.001). In the study group percentage of intrauterine growth retardation (IUGR) was 11.4% and in control group proportion of percentage of IUGR was 1.4%. There was oligo-hydramnios in 32% subjects of the study group and 22% of control group (p value 3.32). In the study group 44% babies were low birth weight whereas in control group 8% were low birth weight (p value &lt;0.001).&#x0D; Conclusion: The rates of pre-maturity and low birth weight were significantly higher among patients of GDM with pre-eclampsia in comparison to patients with GDM without pre-eclampsia.&#x0D; BIRDEM Med J 2022; 12(2): 106-110

Retrospective Analysis of the Perinatal Outcomes in Preeclampsia and Eclampsia in a Tertiary Care Center

Retrospective Analysis of the Perinatal Outcomes in Preeclampsia and Eclampsia in a Tertiary Care Center

Prediction of adverse maternal and perinatal outcomes in preeclampsia based on B-type natriuretic peptide: a retrospective study.

Elevated B-type natriuretic peptide (BNP) is closely related to preeclampsia. Whether it is a predictor of adverse outcomes in preeclampsia is unclear. This study aimed to investigate the relationship between BNP and adverse outcomes of preeclampsia, and to establish the prediction models and nomograms based on BNP. A retrospective analysis was conducted involving 284 women with preeclampsia admitted to a tertiary hospital from January 2017 to July 2019. Logistic regression and receiver operating characteristic (ROC) curve were used to analyze the relationship between BNP and adverse outcomes. Multivariate logistic regression was used to establish the models for predicting adverse outcomes. Then the nomogram and ROC curve of the models were generated. In preeclampsia, BNP is a risk factor for adverse outcomes, and as the level of BNP increases, the incidence of adverse outcomes increases. Preeclampsia with BNP >118 pg/mL was associated with a significantly increased risk of adverse outcomes. The results showed that BNP has a predictive value for adverse maternal outcomes, and the area under the ROC curve (AUC) was 0.739 [P<0.001, 95% confidence interval (CI): 0.684-0.789]. Then, the prediction models for adverse maternal and perinatal outcomes based on BNP combined with other multi-factors were established. The discriminative ability of the 2 models was found to be good, the AUC was 0.844 (95% CI: 0.796-0.884) and 0.792 (95% CI: 0.740-0.838), respectively. Therefore, BNP was shown to significantly improve the discriminative ability of the prediction models. The BNP is an important risk factor for evaluating the adverse outcomes of preeclampsia. Combined with multi-factors, BNP can be used to predict the adverse outcomes.

Correlation of Brain Derived Neurotrophic Factors (BDNF) With Maternal and Perinatal Outcome in Preeclampsia

Objective: To analyze the correlation between BDNF and maternal and perinatal outcomes in preeclampsia.Methods: This was an observational analytic study with a cross-sectional design on 73 pregnant women with preeclampsia. The study began in January 2020 to June 2020 in the Obstetrics and Gynecology Department of Dr M. Djamil Hospital Padang.Results: The mean BDNF levels of pregnant women with preeclampsia were 519.9± 325.4 pg/ml. The correlation between BDNF and systolic blood pressure, diastolic blood pressure, and Mean Arterial Pressure was negatively correlated (r = -0.145, -0.1, and -0.218), with a weak correlation. There was no statistically significant relationship between BDNF and systolic blood pressure, diastolic blood pressure, and mean arterial pressure (p&gt; 0.05). BDNF correlation with infant birth weight and the birth length was positively correlated (0.196 and 0.205) with a weak correlation. The correlation between BDNF level and Apgar score was negatively correlated (-0.039 and -0.054) with a weak correlation. There was no statistically significant correlation between BDNF with birth weight, birth length, and Apgar score (p&gt; 0.05).Conclusion: The mean BDNF level in preeclampsia was lower than normal pregnancy, there was a negative correlation between BDNF levels and maternal outcomes in preeclampsia with a weak correlation. There was a positive correlation between BDNF levels and perinatal outcomes (birth weight and birth length) in preeclampsia and there was a negative correlation between BDNF levels and Apgar score in preeclampsia with a weak correlation.Keywords: Brain Derived Neurotrophic Factors, Preeclampsia, Maternal Outcome, Perinatal Outcome

Association of Hypoproteinemia in Preeclampsia with Maternal and Perinatal Outcomes : A Prospective Analysis of High-Risk Women

Background: Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks gestation and can present as late as 4-6 weeks post-partum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema.Aim: The aim of the present study is to evaluate and assess the maternal and perinatal outcomes in preeclampsia (PE), according to serum albumin value.Materials and Methods: In this study, 50 preeclamptic patients were divided into two groups according to the serum albumin level. To date, there has been no widely accepted predictive test or therapeutic intervention to prevent or delay preeclampsia. Patients included in the study were divided into two groups : group A preeclampsia with an albumin value of > 25g/l (mild hypoproteinemia). Group b preeclampsia with an albumin value of < 25 g/l (severe hypoproteinemia). All the cases were subjected to full obstetric assessment and routine laboratory investigations including serum albumin value.Results: Severe hypoproteinemia has higher incidence of cesarean section delivery mode than mild hypoprteinemia. Severe hypopreteinemia has a higher percentage and risk of preterm labor than mild hypoprotenimia. Liver function and renal function tests are affected mainly with higher percentage in SHP than MHP. SHP is associated with more percentage of poor maternal and neonatal outcomes than MHP. Fetal growth restriction can be seen more often in SHP than mild hypoprotenimea.Conclusion: Pre-eclampsia is a disease of multisystemic affection, causing liver and renal injuries, hematological abnormalities and abnormal uteroplacental blood flow. Identification of women at high risk for PE could potentially improve pregnancy outcome because intensive maternal and fetal monitoring in such patients would lead to an earlier diagnosis of the clinical signs of the disease and the associated fetal growth restriction and avoid the development of serious complications through such interventions as the administration of antihypertensive medication and early delivery. Estimation of albumin levels in pregnancy is of value in the early prediction of pre-eclampsia. SHP PE is associated with a higher risk of adverse maternal and neonatal outcomes than MHP PE, deserving closer surveillance during pregnancy

Perinatal Outcomes in Preeclampsia Stratified by ABO Blood Group [24L

INTRODUCTION: Preeclampsia is a hypertensive disorder unique to pregnancy of which the exact etiopathogenesis has yet to be elucidated. The condition is characterized by hypertension, third spacing, and the effects of arterial vasospasm induced end organ damage. The purpose of the study was to determine if in our patient population there are statistically significant differences in preeclampsia outcomes stratified by ABO blood group. METHODS: A retrospective cohort analysis was performed on singleton gestations that delivered at our institution between January 2010 and July 2014 and had a diagnosis of preeclampsia, eclampsia, and HELLP syndrome. 127 patients met criteria, and statistical analysis using SPSS was performed. Primary measures were maternal and fetal characteristics, method of delivery, and adverse perinatal outcomes. Demographic data were analyzed and compared. A χ2 and Fischer-Exact analysis was used for discrete variables, ANOVA was used for continuous variables, and a Kaplan-Meier Survival analysis was performed. RESULTS: 127 patients met inclusion criteria. There was no statistically significant difference in maternal age, gestational age at delivery, preterm delivery rate, delivery route, 1 and 5 minute Apgars, or perinatal complications between the ABO blood groups. CONCLUSION: Contrary to published studies, our single site cohort study did not demonstrate a statistically significant difference in perinatal outcomes or EGA at delivery for Rh positive blood groups A, B or O, however, a Type 2 error may exist. Our study adds to the knowledge base in that it highlights the fact that preeclampsia is most likely a multifactorial disease involving molecular, genetic, and epigenetic factors.

Maternal and perinatal outcome of preeclampsia without severe feature among pregnant women managed at a tertiary referral hospital in urban Ethiopia.

BackgroundPreeclampsia refers to the new onset of hypertension and proteinuria after 20 weeks of gestation in a previously normotensive woman. Pregnant women with preeclampsia are at an increased risk of adverse maternal, fetal and neonatal complications. The objective of the study is, therefore, to determine the maternal and perinatal outcome of preeclampsia without severity feature among women managed at a tertiary referral hospital in urban Ethiopia.MethodsA hospital-based prospective observational study was conducted to evaluate the maternal and perinatal outcome of pregnant women who were on expectant management with the diagnosis of preeclampsia without severe feature at a referral hospital in urban Ethiopia from August 2018 to January 2019.ResultsThere were a total of 5400 deliveries during the study period, among which 164 (3%) women were diagnosed with preeclampsia without severe features. Fifty-one (31.1%) patients with preeclampsia without severe features presented at a gestational age between 28 to 33 weeks plus six days, while 113 (68.9%) presented at a gestational age between 34 weeks to 36 weeks. Fifty-two (31.7%) women had maternal complication of which, 32 (19.5%) progressed to preeclampsia with severe feature Those patients with early onset of preeclampsia without severe feature were 5.22 and 25.9 times more likely to develop maternal and perinatal complication respectively compared to late-onset after 34 weeks with P-value of <0.0001, (95% CI 2.01–13.6) and <0.0001(95% CI 5.75–115.6) respectively.ConclusionIn a setting where home-based self-care is poor expectant outpatient management of preeclampsia without severe features with a once per week visit is not adequate. It’s associated with an increased risk of maternal and perinatal morbidity and mortality. Our findings call for special consideration and close surveillance of those women with early-onset diseases.

Evaluation of maternal and perinatal outcomes in preeclampsia and eclampsia in correlation with LDH

Introduction: Preeclampsia and eclampsia complicate 6-8% of pregnancies. It is a serious multisystem disorder specific to pregnancy and is a global problem leading to adverse maternal and perinatal complications. In the recent years monitoring of lactate dehydrogenase (LDH) levels is proposed as prognostic in predicting preeclampsia complications. Materials and Methods: This prospective comparative study was conducted in the Department of Obstetrics and Gynaecology, Mysore Medical College and Research Institute. Total of 210 pregnant women were studied. They were divided into groups of mild preeclampsia (n=60), severe preeclampsia (n=60), eclampsia (n=30) and normotensive pregnant women (n=60) as control group. LDH levels were done in study group and correlated with maternal and perinatal complications. Results: LDH levels were significantly elevated in patients with preeclampsia and eclampsi a (F -statistics value =43.4076, df = 3, P value diastolic blood pressures correlated with high LDH (P were significantly correlated with high LDH (P Conclusion: Serum LDH values significantly correlate with severity and clinical outcome of preeclampsia and eclampsia. Raised LDH levels suggest heightened risk developing maternal and perinatal complications. LDH can be offered as prognostic tool to predict preeclampsia and eclampsia complications. Keywords: Maternal outcome, Perinatal outcome, Preeclampsia, Eclampsia, Lactate dehydrogenase.

Prevalence and Determinants of Maternal and Perinatal Outcome of Preeclampsia at a Tertiary Hospital in Ethiopia

INTRODUCTION: Preeclampsia is a common pregnancy disorder with potential adverse maternal andneonatal outcomes. This study aimed to assess the prevalence and determinants of maternal and perinatal outcomeof preeclampsia at Ayder Comprehensive Specialized Hospital. Ayder Comprehensive Specialized Hospital (ACSH),is a tertiary hospital in northern Ethiopia where most preeclamptic patients are treated.METHODS: We performed a retrospective chart review of preeclamptic patients treated at ACSH betweenSeptember 1, 2015 and August 31, 2018. Descriptive analysis and logistic regression were applied for differentvariables. P value &lt;.05 was taken as statistically significant.RESULTS: Over the study period, the total number of deliveries recorded was 8,502. There were 362 patientswith preeclampsia. The poor maternal outcome was present in 40% of cases while 25% of cases had poor perinataloutcomes. The top three poor maternal outcomes reported in this study were maternal death (2.8%), eclampsia(6.6%), and renal failure (1.1%). Headache (AOR 32.26 95% CI 0.03-32.60 and low hemoglobin value (AOR 15.9495% CI 2.34-108.81) were associated with poor maternal outcome. The poor perinatal outcomes were stillbirths(5.8%), early neonatal deaths (1.1%), and low APGAR score (18.8%). Earlier gestational age at diagnosis (AOR 2.1595% CI 1.22-3.79) was associated with poor perinatal outcome.CONCLUSIONS AND RECOMMENDATIONS: In a resource-limited setting where diagnostictools are scarce, the clinical profile should be taken into consideration for prediction of poor outcome. Owing to theassociation found between maternal outcome and hemoglobin, further prospective research is required to identifyif anemia was the cause or effect of preeclampsia.KEYWORDS: Preeclampsia, maternal, perinatal, outcome, Ayder, Ethiopia

Predictive value of serum uric acid levels for adverse perinatal outcomes in preeclampsia.

Preeclampsia is a multisystem disorder associated with pregnancy and is a common cause of perinatal morbidity. The aim of this study was to determine whether elevated serum uric acid levels, alone or in combination with other laboratory factors could predict preeclampsia in women with adverse perinatal outcomes.We conducted a prospective observational study of women who were admitted to Soonchunhyang University Cheonan Hospital from January 2016 to December 2016. Demographic, clinical and laboratory data were collected for each pregnancy at the time of delivery. Women were grouped according to status (preeclampsia or normotensive), and a logistic regression analysis was used to determine the relationship between serum uric acid levels and adverse outcomes.The mean age of the study participants was 31.3 ± 5.0 years. In patients with preeclampsia, serum uric acid level was associated with the severity of preeclampsia, including blood pressure (R = 0.321, P = .014), serum creatinine levels (R = 0.505, P < .001), and proteinuria (P = .014), as well as adverse fetal outcomes, including preterm labor (P = .027) and low birth weight delivery (P = .001). The optimal maternal serum uric acid threshold that predicted low birth weight at delivery was 6.35 mg/dL (sensitivity, 0.58; specificity, 0.95). The multivariable logistic regression model that was used to predict low birth weight at delivery displayed an area under the receiver-operating characteristic curve of 0.902 (95% confidence interval, 0.817–0.986).In women with preeclampsia, maternal serum uric acid level is an important parameter for predicting low birth weight. Additionally, the combination of uric acid, hemoglobin, and bilirubin levels appear to be optimal for predicting low birth weight in women with preeclampsia.

Prevalence and Determinants of Maternal and Perinatal Outcome of Preeclampsia at a Teaching Hospital in Ethiopia [3T

Prevalence and Determinants of Maternal and Perinatal Outcome of Preeclampsia at a Teaching Hospital in Ethiopia [3T

Lactate dehydrogenase and maternal and perinatal outcome in preeclamptic women

Background: Preeclampsia is a condition that is characterized by hypertension and proteinuria occurring after 28 weeks of gestation. It complicates 5%–8% of all pregnancies. Lactate dehydrogenase (LDH) is an intracellular enzyme and its level is increased in preeclamptic women due to cellular death. Preeclampsia is a multisystem disorder and leads to a lot of cellular death. It carries substantial risks for both fetus and mother with a subsequent increase in the perinatal and maternal morbidity and mortality. Aim: The present study was planned to estimate and compare the serum LDH levels in women with preeclampsia and normal pregnant women and to correlate LDH levels with maternal and perinatal outcome in preeclampsia. Materials and Methods: This observational prospective study was conducted on 200 antenatal women. Women were divided into two groups, namely Group I (n = 100) comprised of women with preeclampsia (study group) and it was further subdivided into three categories on the basis of LDH levels: A (n = 53): 800 IU and Group II (n = 100, control) comprised of normotensive pregnant women. LDH levels of both the groups were compared, and association of maternal and perinatal outcome was assessed in relation to LDH levels. Results: With increased severity of preeclampsia, rise in the LDH levels was observed. Severely preeclamptic women with LDH levels >800 IU/l showed a significant increase in incidence of eclampsia, abruption, hemolysis, elevated liver enzymes, and low platelet count syndrome, disseminated intravascular coagulation, and intensive care unit (ICU)/respiratory ICU transfer as compared to women who had lower levels

OBSTETRIC AND PERINATAL OUTCOMES IN PREGNANCY WITH DIFFERENT SEVERITY AND TIME OF THE MANIFESTATION OF PREECLAMPSIA

The aim of the study – to conduct a retrospective analysis of the course of pregnancy and delivery to determine the nature of obstetric and perinatal complications in preeclampsia.&#x0D; Materials and Methods. The analysis was based on the results of the evaluation of the medical documentation (individual medical records of the pregnant woman, birth histories, developmental histories of the newborn) in 224 pregnant women with preeclampsia and 80 pregnant women without preeclampsia. In addition to the results of the clinical and laboratory examination, the analysis included the severity of preeclampsia and the time of clinical manifestations. The results of the study were statistically processed by methods of mathematical analysis with the determination of the mean values ​​(M ± m), Student's t-test and significance factor (р˂0.050 difference was statistically significant.&#x0D; Results and Discussion. According to the results of the analysis, mild preeclampsia was found in 32.6 % of cases, modera­te PE – in 37.5 %, severe PE – in 29.9 % of cases. The early onset of PE (up to 34 weeks) was observed in 35.7 % of pregnant women, and later onset (after 34 weeks) in 64.7 %. The analysis of the incidence of early and late PE cases at various severity levels showed that, in the case of early PE, severe disease was 2.9 times more frequent, and the moderate disease was 2.7 times more frequent than the mild disease. In the late PE, the mild PE was 1.9 times more frequent than the severe PE and 1.2 times more frequent than the moderate PE. In addition to PE, 31.7 % of women had other complications of pregnancy. The most common complications include asymptomatic bacteriuria (16.9 %), abnormal placental location (14.1 %), placental dysfunction (32.4 %), and fetal growth retardation (21.1 %). Term delivery occurred in 81.6 % of cases, premature births were in 18.3 %. Complications include premature rupture of membranes, anomalies of labor, premature detachment of the normally located placenta, postpartum hemorrhage. Among perinatal complications, fetal growth retardation, hemodynamic disorders, fetal distress, newborn asphyxia have been observed. The adverse outcome for a child in severe PE was 3 times higher than for mild PE.&#x0D; Conclusion. The analysis showed that obstetric and perinatal outcomes in preeclampsia are associated with the time of this pregnancy complication and its severity.

211. Association between laboratory abnormalities and obesity with time of birth and perinatal outcome in pre-eclampsia

Laboratory abnormalities and obesity may be associated with perinatal outcomes in patients with pre-eclampsia. Analysis of these factors may guide damage prevention strategies. To associate laboratory variables and maternal body mass index (BMI) with childbirth outcome before 34 and 37 weeks and perinatal outcomes in cases of pre-eclampsia. Cohort study. Location: Guilherme Álvaro Hospital, Santos/Brazil; (May/2017–April/ 2018). Inclusion: women with pre-eclampsia (NHBPEP; 2000) and preterm delivery. Group 1: delivery < 34 weeks. Group 2: childbirth < 37 weeks. Measured at admission: uric acid (> 6 mg/dl), liver enzymes (AST> 34 U/I and ALT> 35 U/I), obesity (BMI> 30), neonatal ICU admission. Statistical analysis: Fisher’s exact test (significance p < 0.05). The work has ethical approval. Sample size: 90 patients. Group 1: AST elevation in 53.3% of the pacients (p = 0.001); ALT elevation in 46.7% (p = 0.001), uric acid elevation in 28.6% (p = 0.068) and 12.5% were obese (p = 0.044). Group 2: AST elevation in 30.2% of the pacients (p = 0.001); ALT elevation in 23.3% (p = 0.004); uric acid elevation in 20% (p = 0.085) and 24.4% were obese (p = 0.047). Of the total sample, 45.6% of newborns were admitted to the neonatal ICU. In Group 1, with more severe prematurity, hepatic damage and elevated uricemia were more frequent. In Group 2, obesity was more prevalent, corroborating with the literature (Chaemsaithong P, 2018). The neonatal ICU admission of the total sample was significantly elevated. This behavior of the indirectly recognized target organ damage and lipotoxicity, associated with the severity of prematurity, may represent indicators regarding the higher expression of preeclampsia causing preterm delivery, the need to guide prophylaxis strategies and eventually prognostic counseling. Enlarging the sample may add information.

High serum lactate dehydrogenase levels as a prognostic marker for morbid perinatal outcome in pre eclampsia

High serum lactate dehydrogenase levels as a prognostic marker for morbid perinatal outcome in pre eclampsia

A study of maternal and perinatal outcome in pre-eclampsia

A study of maternal and perinatal outcome in pre-eclampsia