Preeclampsia In Previous Pregnancy Research Articles

Evaluation of Antithrombin-III Activity and Platelet Count in Pregnancy-Induced Hypertension among Pregnant Women attending Antenatal care in a Tertiary Health Facility in Southeast, Nigeria

Background: Pregnancy-induced hypertension (PIH) is a significant health issue that affects maternal and fetal outcomes. Antithrombin-III (AT-III) and platelet count alterations could serve as pivotal indicators for the management and prognosis of PIH. Objective: This study aimed to assess AT-III activity and platelet counts in pregnant women with and without PIH at the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria. Methods: A case-control cross-sectional analytical study design was employed, including 135 pregnant women with PIH and 135 age-matched normotensive pregnant women. Exclusion criteria comprised chronic hypertension, known thrombophilic disorders, or anticoagulant therapy before pregnancy. AT-III levels and platelet counts were compared between groups using SPSS version 20.0, with significance set at p ≤ 0.05. Results: AT-III activity was significantly lower in the PIH group (75.45±6.23%) compared to the normotensive group (96.84±9.64%, p=0.028). Similarly, platelet count was significantly reduced in the PIH group (170.90 ±8.78 x109/L) versus the normotensive group (191.56±6.54 x109/L, p=0.032). No significant differences were found in sociodemographic variables except for the trimester of antenatal care registration and history of preeclampsia in previous pregnancies. Conclusion: This study highlights significant reductions in AT-III activity and platelet count among pregnant women with PIH, suggesting these parameters' potential role in PIH management and prognosis. These findings emphasize the importance of monitoring AT-III levels and platelet count as part of the antenatal care protocol in pregnant women, particularly those with or at risk for PIH.

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 (<100,000 µL), and serum creatinine level >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.

Luteal phase support of intramuscular progesterone associated with lower hypertensive disorders of pregnancy as compared to vaginal progesterone: A cohort study.

To compare the hypertensive disorders of pregnancy (HDP) risk between vaginal and intramuscular (IM) progesterone in programmed frozen-thawed embryo transfer (FET) cycles. This was a retrospective cohort study at a tertiary hospital, and only women who achieved ongoing pregnancy after programmed FET between January 2018 and June 2022 were included. Women with chronic hypertension before pregnancy or with history of gestational hypertension or pre-eclampsia in previous pregnancies were excluded. All women were divided into IM progesterone or vaginal progesterone groups according to the route of progesterone supplementation. Follow-up information on obstetric complications and neonatal outcomes were obtained by telephonic interviews. The primary outcome was HDP. Association between routes of progesterone supplementation and HDP was assessed by subgroup analysis and multivariable logistic regression. A total of 5891 programmed FET cycles (3196 IM progesterone cycles and 2695 vaginal progesterone cycles) were included in the analysis. The prevalence of HDP in the IM progesterone group was significantly lower than that of the vaginal progesterone group (6.54% vs 9.17%, P < 0.001). Therein, the prevalence of gestational hypertension (3.57% vs 4.94%, P = 0.009) and pre-eclampsia (2.97% vs 4.23%, P = 0.009) in the IM progesterone group were all significantly lower as compared to the vaginal progesterone group. According to subgroup analysis, IM progesterone was associated with lower HDP risk in all subgroups. The logistic regression analysis showed that the IM progesterone cycles were associated with lower risk of HDP compared to vaginal progesterone cycles (adjusted odds ratio 0.66, 95% CI: 0.54-0.80, P < 0.001). Among women undergoing programmed FET cycles, progesterone supplementation with IM progesterone was associated with reduced HDP risk compared to vaginal progesterone.

The importance of using disease causal models in studies of preventive interventions: Learning from preeclampsia research

ObjectiveInterventions aimed at preventing disease are commonly studied as strategies of primary or secondary prevention. Unfortunately, this dichotomy can be misleading, and studies might unknowingly exclude people at high risk of the disease that could benefit from the intervention. Here I use the example of aspirin for prevention of preeclampsia to illustrate this problem. MethodsI use directed acyclic graphs to represent several causal models of aspirin and preeclampsia, each making different assumptions regarding the causal relation between previous preeclampsia, aspirin, and subsequent preeclampsia. Afterwards, I discuss the implications of each model. ResultsAspirin started being recommended to pregnant women that had presented preeclampsia in previous pregnancies, but not to women at high risk due to other factors. Studies started evaluating aspirin in women at high risk due to these other causes and found it also reduced the risk of preeclampsia in them. Thanks to a shift towards risk-based interventions, guidelines started recommending aspirin to all women considered at high risk of preeclampsia. Furthermore, recent studies have begun using blood markers in women without classic risk factors to identify additional women that might benefit from aspirin. With such advances, performing “secondary prevention” once the first event occurred will increasingly represent a failure to intervene on time. ConclusionsExplicitly illustrating disease causal models helps to identify those individuals that are most likely to benefit from risk reduction, regardless of whether they were previously afflicted by the disease. This is beneficial when designing studies and when implementing preventive interventions.

A Pilot Study of Dietetic, Phenotypic, and Genotypic Features Influencing Hypertensive Disorders of Pregnancy in Women with Pregestational Diabetes Mellitus.

Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and perinatal morbimortality. Dietetic, phenotypic, and genotypic factors influencing HDP were analyzed during a nutrigenetic trial in Rio de Janeiro, Brazil (2016-2020). Pregnant women with pregestational diabetes mellitus (n = 70) were randomly assigned to a traditional or DASH diet group. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured during prenatal visits and HDP were diagnosed using international criteria. Phenotypic data were obtained from medical records and personal interviews. Genotyping for FTO and ADRB2 polymorphisms used RT-PCR. Linear mixed-effect models and time-to-event analyses were performed. The variables with significant effect on the risk for progression to HDP were: black skin color (adjusted hazard ratio [aHR] 8.63, p = 0.01), preeclampsia in previous pregnancy (aHR 11.66, p < 0.01), SBP ≥ 114 mmHg in the third trimester (aHR 5.56, p 0.04), DBP ≥ 70 mmHg in the first trimester (aHR 70.15, p = 0.03), mean blood pressure > 100 mmHg (aHR 18.42, p = 0.03), and HbA1c ≥ 6.41% in the third trimester (aHR 4.76, p = 0.03). Dietetic and genotypic features had no significant effect on the outcome, although there was limited statistical power to test both.

Prediction of pre-eclampsia in diabetic pregnant women.

Gestational or preexisting diabetes is one of the risk factors of pre-eclampsia. Both are responsible for higher maternal and fetal complications. The objective was to study clinical risk factors of pre-eclampsia and biochemical markers in early pregnancy of women with diabetes mellitus (DM)/gestational diabetes mellitus (GDM) for the development of pre-eclampsia. The study group comprised pregnant women diagnosed with GDM before the 20 wk of gestation and DM before pregnancy and the control group had age-, parity- and period of gestation-matched healthy women. Sex hormone-binding globulin (SHBG), insulin-like growth factor-I (IGF-I) and 25-hydroxy vitamin D [25(OH)D] levels and the polymorphism of these genes was evaluated at recruitment. Out of 2050 pregnant women, 316 (15.41%) women (296 had GDM and 20 DM before pregnancy) were included in the study group. Of these, 96 women (30.38%) in the study group and 44 (13.92%) controls developed pre-eclampsia. Multivariate logistic regression analysis indicated those who belonged to the upper middle and upper class of socio-economic status (SES) were likely to be at 4.50 and 6.10 times higher risk of developing pre-eclampsia. The risk of getting pre-eclampsia among those who had DM before pregnancy and pre-eclampsia in their previous pregnancy was about 2.34 and 4.56 times higher compared to those who had no such events, respectively. The serum biomarkers [SHBG, IGF-I and 25(OH)D] were not found to be useful in predicting pre-eclampsia in women with GDM. To predict risk of development of pre-eclampsia, the fitted risk model by backward elimination procedure was used to calculate a risk score for each patient. Receiver operating characteristic (ROC) curve for pre-eclampsia showed that area under the curve was 0.68 (95% confidence interval: 0.63-0.73); P<0.001. The findings of this study suggested that pregnant women with diabetes were at a higher risk for pre-eclampsia. SES, history of pre-eclampsia in previous pregnancy and pre-GDM were found to be the risk factors.

462 Maternal and perinatal outcomes of pregnancies complicated by preeclampsia

Introduction and aim of the study: Preeclampsia occupies a leading place in maternal and perinatal morbidity and mortality. Aim of the study was to analyze the course of pregnancy, perinatal and maternal outcomes in women with pregnancy complicated by preeclampsia. Methods: It was the retrospective evaluation of the pregnancy and labor outcomes, course of early neonatal period of the newborns of 60 women (30 with moderate and 30 with severe preeclampsia). Results: A history of preeclampsia in previous pregnancy has 10 women (16.7%).

Copeptin in Patients with Pregnancy-Induced Hypertension.

Pregnancy-induced hypertension (PIH) occurs in 6–8% of pregnancies, and increases the risk of many severe obstetric complications. The etiology of PIH has not been fully explained, and hence, treatment is only palliative in nature, and prevention is not fully effective. It has been proposed that PIH development is influenced by the arginine vasopressin pathway, whose surrogate biomarker is copeptin. The aim of this study is a prospective assessment of the relationship between the level of copeptin in pregnant women and the occurrence of PIH, and to identify its usefulness in predicting complications. The study involved a group of 21 pregnant women who developed PIH and 37 women with uncomplicated pregnancies as a control group. Blood samples were collected at the three trimesters of gestation (<13 HBD, between 13 and 26 and >26 HBD) and then frozen. Copeptin levels [pg/mL] were measured in serum samples obtained in the first, second and third trimesters of gestation from women in the PIH and control groups. The concentration of copeptin in the second and third trimesters of pregnancy was statistically significantly higher in the PIH group (p < 0.05). For copeptin determined in the first trimester, which could be used to screen for PIH, the area under the ROC curve was 0.650. The highest risk of PIH occurred in patients with high concentrations of copeptin in the first trimester of pregnancy and obesity OR = 5.5 (95% CI 1.0–31.3). The risk of PIH was augmented in patients with high levels of copeptin and an abnormal Doppler result of the uterine arteries OR = 28.4 (95% CI 5.3–152). In conclusion, copeptin levels were found to be elevated in pregnant women before the diagnosis of PIH; however, copeptin should not be used as a stand-alone marker. The combination of copeptin concentration with the other risk factors (diabetes, maternal age and preeclampsia in previous pregnancy) did not improve the diagnostic values of the use of copeptin in the PIH risk assessment, but the combination of copeptin concentration with BMI may be useful in clinical practice. Measurement of copeptin together with a Doppler examination of uterine arteries in the first trimester of pregnancy may be a useful marker in predicting the development of PIH.

The interval between births and the risk of recurrent preeclampsia among predominantly high risk women in urban tertiary care center

Women with a history of preeclampsia have a higher risk of recurrent preeclampsia. This study sought to ascertain the relationship between the interbirth interval and the risk of recurrent preeclampsia and difference in angiogenic markers between the two groups. Data was collected from an ongoing cohort study of women with hypertensive disorders of pregnancy (HDP) enrolled at the admission to the labor and delivery floor. From this dataset, multigravida women with a prior diagnosis of preeclampsia were identified and compared to women with no prior history of preeclampsia. Of the 375 women with HDP who were predominantly African American, 245 were multigravida and 44 (18.0%) had a prior history of preeclampsia. Women with prior preeclampsia had an earlier gestational age of delivery, higher rates of preterm delivery and a higher incidence of preeclampsia with severe features (56.8% vs 29.8%) in the index pregnancy (p-values≤0.001) than those without. The median number of years between history of preeclampsia in previous pregnancy and current pregnancy was 6years (IQR 3, 8). Among patients with a prior history of preeclampsia, the interbirth interval was not associated with severe preeclampsia (p=0.60) and there was no difference in angiogenic factors between patients with a prior history of preeclampsia compared to those without. In this study, the duration of the interbirth interval was not identified as a risk factor of developing severe preeclampsia in a subsequent pregnancy and angiogenic factors are not a reflection of maternal predisposition to recurrent preeclampsia.

Analysis of the results of a retrospective cohort study of the course of pregnancy, childbirth and the postpartum period in high-risk patients to identify factors of unfavorable outcomes and build a predictive model of fetal loss

Prenatal prognosis is an important part of obstetric care, which aims to reduce fetal and neonatal losses. A differentiated approach to the management of different risk groups allows you to optimize existing approaches.The objective: to identify antenatal factors that correlate with perinatal losses, by conducting a retrospective cohort study of women at high perinatal risk, to build a multifactorial prognostic model of adverse pregnancy outcomes.Materials and methods. A retrospective cohort study was conducted from 2014 to 2016 on the basis of the medical center LLC «Uniclinic», Medical Genetics Center «Genome», Clinic of Reproductive Genetics «Victoria», Kyiv City Maternity Hospital №2. 2154 medical cards of pregnant women from the group of high perinatal risk were selected and analyzed. Of these, 782 pregnant women were included in the final protocol after verification of compliance with the criteria.Results. Cesarean delivery occurred in 115 cases (14.7%). In 50 cases (6.4%) the caesarean section was performed in a planned manner, in 65 (8.3%) – in an emergency. In 39 (5%) cases, the indication for surgical delivery was acute fetal distress. Antenatal fetal death occurred in 11 (1.4%) cases: one case in terms of &lt;34 weeks and &lt;37 weeks of gestation, the remaining 9 cases – in terms of&gt; 37 weeks. Intranatal death of two fetuses (0.3%) was due to acute asphyxia on the background of placental insufficiency. In the early neonatal period, 14 (1.8%) newborns died. Hospitalization of the newborn to the intensive care unit for the first 7 days was registered in 64 (8.2%) cases.The need for mechanical ventilation was stated in 3.96% (31/782) of newborns. The method of construction and analysis of multifactor models of logistic regression was used in the analysis of the relationship between the risk of perinatal losses (antenatal death, intranatal death, early neonatal death) and factor characteristics.Conclusion. Signs associated with the risk of perinatal loss: the presence of chronic hypertension, preeclampsia in previous pregnancies, type of fertilization (natural or artificial), the concentration of PAPP-A (MoM), the concentration of free β-HCG (MoM) in the second trimester, average PI in the uterine arteries in 28–30 weeks of pregnancy, PI in the middle cerebral arteries in 28–30 weeks of pregnancy, episodes of low fetal heart rate variability in the third trimester of pregnancy, episodes of high fetal heart rate variability in the third trimester of pregnancy. The model, built on selected features, allows with a sensitivity of 73.1% (95% CI: 52.2% – 88.4%) and a specificity of 72.7% (95% CI: 69.3% – 75.9%) to predict risk perinatal loss.

Maternal age ? 35 years, Nulliparity, High Blood COHb Levels, and Low Serum Nitric Oxide Levels Increased Risk of Preeclampsia

Objective: To find out the risk factors for preeclampsia. Materials and Methods: a case-control study was between March 2018 and December 2018. Pregnant women who with gestational age of at least 22 weeks live in residential areas, exposed to smoke from combustion of tile or brick were divided into two groups. Cases were those diagnosed with preeclampsia. Controls were normotensive pregnant women who had a history of preeclampsia in previous pregnancy. CO (carbon monoxide) exposure in pregnant women was determined by examining COHb levels in the blood. Serum Nitric Oxide levels were measured using the ELISA (Enzyme-Linked Immunosorbent Assay) method. Data were analyzed by Chi-square test or Fisher’s exact test, Independent T-Test and regression analysis. Adjusted odds ratio (ORs) with 95% confidence interval (CI) was calculated. Results: The results of Blood COHb levels were significantly higher in preeclampsia (4.58±1.2) than the case of control group (2.85±0.4). Serum nitric oxide levels in preeclampsia were significantly lower in preeclampsia (18.28±4.1) than the case of control group (35.15±7.2). Maternal age ? 35 years, nulliparity, high blood COHb levels &gt; 3.5%, and low serum Nitric Oxide levels &lt; 25 ?mol/L were significantly associated with increased risk of preeclampsia. Conclusion: Low serum Nitric Oxide levels (&lt; 25 ?mol/L) due to exposure to CO from the smoke of combustion of tiles or brick carried an increased risk of developing preeclampsia (ORs 25.5;95% CI 4.3- 29.7). These results can help health workers in pregnancy care counseling and prevention of preeclampsia in pregnant women located in areas exposed to carbon monoxide from the smoke of combustion of tiles or brick

The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia

Background: Many studies hypothesized a strong relation between vitamin D level during pregnancy and the frequency of recurrent preeclampsia (PE). Objectives: The aim of the current study was to determine the effect of vitamin D supplement on reducing the probability of recurrent preeclampsia in pregnant women with history of preeclampsia. Patients and Methods: The study population included 50 women having a history of preeclampsia in previous pregnancies. They were referred to the obstetrical clinic in Diarb Negm Centeral Hospital in Diarb Negm City, for prenatal care. Women were classified into two groups, the first one (I) received 25-hydroxy vitamin D supplements and the other (II) received placebo. Results: Eight patients had pre-eclampsia in group II (34.8%) while in group I only 4 patients had preeclampsia (16%) (p=0.133). There were no significant statistical differences between the two groups according to pre-eclampsia incidence. The mean vitamin D level was 25.72 ± 7.69 and 28.33 ± 7.40 among patients without and with preeclampsia respectively. (p=0.309) there were no significant relation between the preeclampsia incidence and vitamin D level. Conclusion: vitamin D supplement may not have a role in prevention of preeclampsia recurrence.

Assessment of occurrence of preeclampsia and some clinical and demographic risk factors in Zahedan city in 2017

ABSTRACTBackground: Blood pressure dysfunctions are one of the biggest complications and causes of maternal mortality during pregnancy. The aim of the present study is to evaluate some of the clinical and demographic risk factors in various aspects, both of which can help to better understand the causes and reduce the incidence of preeclampsia.Method: This nested case–control study was carried out on 270 pregnant women with preeclampsia as the case group and 270 pregnant women who did not have symptoms of preeclampsia at the time of referral were interviewed according to inclusion criteria as the control group. The factors studied included age, body mass index, history of hypertension in mother, history of diabetes in mother, history of lupus in mother, number of pregnancies, history of preeclampsia in previous pregnancies, twin or more pregnancies, season of occurrence, maternal educational level, maternal blood group, maternal occupation status, infant’s sex and smoking status which were compared etween the two groups. t test and Chi-square tests were used to compare the variables in both groups. Fisher's exact test or Mann–Whitney U test was used if necessary.Findings: Of the 6929 pregnant women who participated in our study, 541 (7.8%) had preeclampsia. The means of body mass index (BMI) (24.86% versus 23.52%) (P = 0.032), the history of hypertension (19.3% versus 10.7%) (P = 0.006), history of preeclampsia in previous pregnancies (60.2% versus 13.3%) (P < 0.001), low level of education and illiteracy (51.1% versus 39.6%) (P = 0.028), and twin or more pregnancies (5.6% versus 2.2%) (P = 0.045) were significantly higher in the case group when compared to the control group. There was no statistically significant difference between the mean and standard deviation of age and number of pregnancies and the frequency of diabetes and lupus, the frequency of maternal occupation, maternal smoking, maternal blood group, and season of occurrence in the two groups (P > 0.05).Conclusion: Maternal BMI, maternal hypertension, history of preeclampsia in previous pregnancies, low maternal educational status, and twin or multiple pregnancies might be the risk factors for preeclampsia during pregnancy.

An Unusual Case of Eclampsia at 21 Weeks of Gestation with Multiple Risk Factors Except Molar Pregnancy

Preeclampsia/eclampsia is a serious complication of the pregnancy and early-onset disease is mostly associated with molar pregnancy. We present a rare case of eclampsia that occurred at very early weeks of gestation and had multiple risk factors for preeclampsia, but not molar pregnancy. A 35-year-old woman (gravidity 11, parity 1) presented with eclampsia at 21 weeks of gestation. She had history of preeclampsia in previous pregnancy, chronic hypertension, recurrent pregnancy loss (a total of 9 abortions at 6-21 weeks of gestation) and methyltetrahydrofolatereductase (MTHFR) heterozygous mutation. The pregnancy was terminated by hysterotomy. Molar change was not observed in the placenta. No postoperative complication occurred and the patient was discharged with antihypertensive therapy. Eclampsia is a severe form of the preeclampsia and clinicians should keep in mind that it may be occurred at very early weeks of gestation in patients with multiple risk factors for preeclampsia.

Prediction of Preeclampsia by Maternal Factors and Biophysical Markers During the First-trimester

Objectives: In this study, we examined the predictive effect of maternal factors, first-trimester mean arterial pressure (MAP) and uterine artery mean pulsatility index (mUt.A-PI) on the subsequent development of preeclampsia (PE). Methods: Maternal characteristics and medical history were recorded and biophysical markers included uterine artery flow velocity wave forms mUt.A-PI and MAP were measured in 393 single pregnancies who getting antenatal care at 11+0-13+6 weeks. Results: Sixty six (16.8%) cases had preeclampsia and 327 (83.2%) cases were unaffected by preeclampsia. One hundred nineteen (30.3%) of the 393 pregnancies were nulliparous, 274 (69.7%) pregnancies were multiparous. Seventy one (25.9%) women had a history of preeclampsia in previous pregnancy and 203 (74.1%) women had no history of preeclampsia. For MAP as a predictor of PE, the cutoff point for MAP was 89.5 mmHg (sensitivity 71.2%, specificity 75.5%, J0.467, AUC 0.792, P&lt;.001). The cutoff point of mUt.A-PI was 2.34 (sensitivity 33.3%, specificity 77.7%, J0.12, AUC-0.577, P&lt;.001). Logistic regression analysis showed that woman who had PE previously had highest odds ratio (OR=5.81, p&lt;0.001) for developing PE. Conclusion: The strongest predictor of PE was a previous history of PE. The MAP was a more accurate predictor of PE than the mUt.A-PI measurement

Early-Pregnancy Changes in Maternal Lipid Profile in Women with Recurrent Preeclampsia and Women with Normal Pregnancy

Background: “According to the current knowledge, changes in lipid profile in pregnancy is a major contributor in the pathogenesis of preeclampsia. The present study was designed to compare the changes in lipid profile in normal pregnancy and in patients with history of recurrent pre-eclampsia (PE).”Objective: Assessment the relationship between lipid profiles changes in women with history of recurrent preeclampsia in comparison to normal pregnancy in early pregnancy.Patients and Methods: Measurement of lipid profile changes in women with history of recurrent preeclampsia (more than two preeclampsia in previous pregnancies) at 12 to 16 weeks of pregnancy and compared to normal pregnancy as a control group who does not have history of preeclampsia also early in pregnancyResults: The patients with history of recurrent Preeclampsia had significantly higher mean total cholesterol level compared to controls (216.1 ± 25.5 mg/dl) and (195.6 ± 23.2 mg/dl), respectively, (P&lt;0.05).The mean HDL cholesterol (HDL-C) level was significantly lower in PE group (49.3 ± 9.2 mg/dl) than controls (52.2 ± 8.4 mg/dl), (P&lt;0.05). The mean level of LDL cholesterol was (122.3 ± 28.7) mg/dl in PE group and it was significantly higher than the (108.6 ± 26.8 mg/dl) of controls, (P&lt;0.05). Similarly, the mean VLDL cholesterol was also higher in women with history of recurrent preeclampsia than control group, (44.8 ± 12.6) vs. (34.8 ± 7.3) mg/dl, respectively, (P&lt;0.05). The Triglycerides (TG) was also elevated in women with history of recurrent preeclampsia where the mean TG level was (224.2 ± 63.1 mg/dl) compared to (174.6 ± 36.3mg/dl) in controls, (P&lt;0.05).Conclusion: “This study showed that the women who have history of recurrent preeclampsia had disturbed lipid profile (increased levels of total TC, TG, VLDL-C and LDL-C concentration) in addition to decrease the high density lipoprotein cholesterol (HDL-C) level in subsequent pregnancy compared to normal pregnancy.”&#x0D;

Evaluation of Incidence and Risk Factors of Severe Preeclampsia in a Tertiary Hospital Centre

Aims: To evaluate the incidence of severe preeclampsia, eclampsia and HELLP syndrome in a tertiary Hospital Centre of Obstetrics and Gynaecology and to identify the impact of risk factors associated with severe preeclampsia. Study Design: Retrospective cross-sectional study. Place and Duration of Study: University Hospital of Obstetrics and Gynaecology “Koco Gliozheni”, Tirana, Albania between January 2009 and December 2013. Methodology: To collect the data for this study we used the medical records of births of a period of five years. The standard inclusion criteria in the study were pregnant women diagnosed with preeclampsia that had delivered in this hospital after 24 weeks’ gestation despite the number of the babies, fetal presentation and mode of delivery. The exclusion criteria in this study were: pregnancies with confirmed fetal anomalies non-viable, pregnancies with missing data, and pregnancies with unknown gestational age. The maternal variables collected from the medical Original Research Article Ndoni et al.; BJMMR, 13(12): 1-7, 2016; Article no.BJMMR.24143 2 records were: maternal age, parity, gestational age at delivery, multiple pregnancy, pre-existing (chronic) hypertension, pre-existing diabetes mellitus, renal diseases and preeclampsia in previous pregnancy. The data collected for the variables were compared with the statistical data for all the deliveries during the study period. Fisher’s exact test, Chi-squared test and SPSS program were used as statistical methods. Results: The study found differences between the severe preeclampsia group and the general population for the maternal risk factors: severe preeclampsia was evaluated 16.8% vs. 3.5% (P< 0.01), pre-existing hypertension 7.8% vs. 2.3% (P = 0.02), renal diseases 1.9% vs. 1.1%, diabetes mellitus 5.8% vs. 4.6% and multiple pregnancies 7.1% vs. 2.7% respectively. Conclusion: Identification of these risk factors is very important for the calculation of risk for preeclampsia in early pregnancy and early treatment to prevent the maternal and perinatal morbidity and mortality from this disease.

Maternal and perinatal outcome of eclampsia over a decade at a tertiary hospital in Kuwait

Aims: To determine maternal and perinatal outcome of eclampsia patients over a decade.Methods: Analysis of case records of all eclampsia cases from January 2005 to December 2014.Results: There were 30 cases of eclampsia. The most significant risk factors for developing pre-eclampsia are unbooked cases (97%), nulliparity, young age, marriage ≤4 months, history of pre-eclampsia in previous pregnancy, remarriage, preexisting diabetes mellitus, interval between pregnancies ≥10 years, positive family history. The incidence of eclampsia was 0.05%, antepartum eclampsia 15 (50%), intrapartum 6 (20%) and postpartum 9 (30%) with no maternal deaths, and 1 perinatal death. Perinatal mortality was 33.3/1000. 22 (73%) patients received magnesium sulphate (MgSO4) and 8 patients (27%) received Diazepam, of which 1 had recurrence of convulsions. All 15 antepartum cases were delivered by cesarean section as were 2 intrapartum. 13 (43%) of women delivered vaginally. Only 6 (20%) patients were of low socio-economic status and were primary school educated. Severe maternal complications occurred in 8 (27%), with abruptio placentae being the most common 3 (38%).Conclusions: Incidence of eclampsia was low, with no maternal deaths. MgSO4 was found to be highly effective. Lack of antenatal care is a major risk factor.

Association between Uric Acid and Severity of Pre-Eclampsia

The objective of this study was to evaluate the use of uric acid as a marker of severity of pre-eclampsia. Uric acid was measured in 36 pre-eclamptic pregnant women and 26 healthy pregnant women in the control group. Data regarding age, history of pre-eclampsia in previous pregnancies, family history of pre-eclampsia, pregnancy, and abortion were obtained through a questionnaire given to each pregnant woman, after signing the consent form. The route of delivery and weight of the newborns were obtained from medical records of patients. Statistical analyses used were the t-test and Fisher's exact test. Uric acid was significantly higher and weight of neonates was significantly lower in pre-eclamptic women. Significant correlations between uric acid and systolic blood pressure, and uric acid and 24-hour proteinuria were observed. Inverse correlations between uric acid levels and weight of newborns and between systolic blood pressure and the weight of newborns were also observed. The results agree with other previous research, and reinforce the idea that the concentration of serum uric acid in pregnant women with pre-eclampsia is associated with disease severity and contributes to better monitoring of the mother and newborn.

Perinatal outcome of pre-eclampsia in parous women

Women with a second and recurrent pre-eclampsia pregnancy have more adverse pregnancy outcomes compared with women with pre-eclampsia in the first pregnancy. A retrospective cohort study was performed to compare the clinical characteristics and perinatal outcomes of pre-eclampsia in parous women who had complicated pre-eclampsia in previous pregnancies (n = 69) and uncomplicated pre-eclampsia in previous pregnancies (n = 312) from 2006 to 2010, in the Fujian Maternity and Child Health Hospital. No statistical significant differences were observed between the two groups in terms of: maternal age, admission blood pressure and BMI; prenatal care times, hospitalisation time, laboratory results and incident rates of complications. The incident and delivery weeks were earlier and the renal injury, caesarean section and small for gestational age (SGA) incidence rates were higher in recurrent pre-eclampsia women. Women with recurrent pre-eclampsia had adverse perinatal outcomes when compared with parous women with pre-eclampsia who had not had pre-eclampsia in prior pregnancies.