Preeclampsia Pregnancy Research Articles

Sex-Specific Dysregulation of Placental Lipid Metabolism in Preeclampsia.

Preeclampsia (PE) is a hypertensive disorder of pregnancy associated with adverse maternal and fetal outcomes. While placental dysfunction is implicated in PE pathogenesis, the impact of PE on placental lipid metabolism and its potential sexual dimorphism remains poorly understood. We conducted a comprehensive analysis of term placentas from PE and normotensive pregnancies with male and female fetuses. Lipid profiles were quantified using mass spectrometry, and mRNA expression of genes involved in fatty acid oxidation, esterification, and transport was assessed using qPCR. Placentas from PE pregnancies exhibited elevated lipid levels, with male placentas showing a more pronounced increase in triacylglycerols, cholesteryl esters, and free cholesterol compared to female placentas. Gene expression analysis revealed sexually dimorphic alterations, with male PE placentas exhibiting upregulation of genes involved in fatty acid uptake, oxidation, and esterification, while female PE placentas showed a more complex response with both upregulation and downregulation of certain genes. Notably, peroxisomal fatty acid oxidation was upregulated in male PE placentas but suppressed in female PE placentas. Our findings reveal sexually dimorphic alterations in placental lipid metabolism in PE, suggesting that male placentas may be more vulnerable to lipotoxicity. These insights may have implications for understanding the pathogenesis of PE and developing sex-specific interventions to improve maternal and fetal outcomes.

Urinary Nephrin: A Potential Biomarker of Early Glomerular Injury in a Cohort of Pregnant Women Attending Routine Antenatal Care Services.

Introduction: Glomerular injury may occur during pregnancy as a consequence of systemic disease and pregnancy-related medical complications. While urinary nephrin has been shown to provide early identification of preeclampsia (PE) in high-risk pregnancies, the role of urinary nephrin in determining glomerular injury in pregnant women is yet to be explored. This study aimed to investigate the use of urinary nephrin as a predictor for early glomerular injury in a study conducted at the Townville University Hospital. Methods and Materials: A cross-sectional study was conducted. All pregnant women with a full dataset (n = 273) were classified into three categories according to their urinary albumin-to-creatinine ratio (ACR): normoalbuminuria, microalbuminuria and macroalbuminuria. Continuous variables were compared between groups, and the cut-off value for the urinary nephrin-to-creatinine ratio (NCR) was determined to predict albuminuria as an indirect indicator of early glomerular injury. The percentages of pregnant women who had elevated nephrinuria were calculated for each of the ACR categories. Results: Urinary NCR positively correlated with urinary ACR (r = 0.29, p < 0.0001). Urinary NCR increased comparably in women with normoalbuminuria, microalbuminuria and macroalbuminuria. Using a cut-off value of 14 ng/mg, nephrinuria was detected in 65% of women with normoalbuminuria, 95% with microalbuminuria and 100% with macroalbuminuria. Of the normoalbuminuric women who had an elevated urinary NCR (> 14 ng/mg), 78% were diagnosed with a hypertensive disorder and 63% were diagnosed with diabetes in pregnancy. In women with PE, urinary NCR and ACR were significantly higher when compared to women who did not develop PE. The AUC of the ROC for urinary NCR was 0.74 (95% CI: 0.650-0.824), with a sensitivity of 97% and a specificity of 36% to predict glomerular injury and a sensitivity of 93% and specificity of 42% to predict glomerular injury of PE. Conclusion: The study found that urinary NCR were elevated not only in women with micro- and macroalbuminuria but also in pregnant women with normoalbuminuria. Increased urinary NCR without increased urinary albumin may be associated with early glomerular injury. Urinary NCR may be a more sensitive marker than microalbuminuria to detect early glomerular injury in women with systemic disease and adverse pregnancy outcomes.

Communication Needs about Preeclampsia and Other Hypertensive Disorders of Pregnancy: Applying the Theory of Motivated Information Management

Communication Needs about Preeclampsia and Other Hypertensive Disorders of Pregnancy: Applying the Theory of Motivated Information Management

Modeling risk factors in preeclampsia for late pregnancies using fuzzy cognitive maps

As women delay motherhood, concerns arise about the risks associated with pregnancy at advanced ages. Pregnant women aged 35 and older face an increased likelihood of complications, such as spontaneous abortions and preexisting conditions that can complicate pregnancy, such as hypertension and diabetes. The incidence of hypertensive disorders, such as preeclampsia, also significantly increases in this age group, which can lead to a higher use of cesarean sections and instrumental deliveries, as well as an increase in neonatal morbidity and mortality. This study aims to model the risk factors for preeclampsia in late pregnancies using fuzzy cognitive maps, seeking a better understanding of the complexity of this condition and facilitating the early identification of women at risk. Data collection will be conducted through the review of clinical records and structured interviews with participants, which will complement the existing clinical information. The identification of risk factors, such as obesity and a history of hypertension, is crucial for optimizing prenatal care and improving maternal-fetal outcomes. Additionally, prevention strategies are proposed that include education about the risks, promoting healthy lifestyle habits, and ensuring access to adequate prenatal care, in order to reduce the incidence of preeclampsia and its associated complications in pregnant women aged 35 and older

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.

Disaccharide compositional analysis of chondroitin sulphate using WAX HILIC-MS with pre-column procainamide labelling; application to the placenta in pre-eclampsia.

Chondroitin sulphate (CS) and dermatan sulphate are negatively charged linear heteropolysaccharides. These glycosaminoglycans (GAG) are involved in cellular signalling via binding to growth factors. CS is expressed in a range of tissue and biological fluids and is highly expressed in the placenta. There is evidence that decorin; a CS proteoglycan is significantly decreased in pre-eclampsia and fetal growth restriction. It is considered that GAG chain composition may influence cellular processes that are altered in pre-eclampsia. The goal of the present study was to develop an LC-MS method with precolumn procainamide labelling for the disaccharide compositional analysis of CS. The method was used to investigate whether the disaccharide composition of placenta-extracted CS is altered in pre-eclampsia. The study revealed differential disaccharide compositions of placental chondroitin sulphate between pre-eclampsia and other pregnancy conditions. This suggests that the method may have diagnostic potential for pregnancy disorders. Furthermore, the findings suggest that CS sulphation might play a significant role in maternal labour.

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

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

Impact of Severe Preeclampsia on the Incidence of Low-Birth-Weight Babies

Infant birth weight is an important indicator of survival, growth potential, and developmental capacity. Maternal health plays an important role in determining the well-being of newborns. A complicated pregnancy, inclusive of conditions such as preeclampsia, elevates the risk of giving birth to a low birth weight (LBW) baby. This study aimed to compare the impact of severe preeclampsia on the incidence of LBW babies in Dr. Dradjat Prawiranegara General Hospital Serang, Indonesia. This case-control analysis included 148 parturients recruited randomly from June to October 2022. Logistic regression was used as the analytical tool, with P=0.000 considered as demonstrating a significant association. The incidence rates of LBW and severe preeclampsia in 2018 were 19.84% and 14.15%, respectively. The case group recorded LBW within the weight range of 1,000-2,450 g, with 38% of them were Small for Gestation Age (SGA), while 50% and 12% were Appropriate for Gestational Age (AGA), and Large for Gestational Age (LGA), respectively. In contrast, the control group, with birth weights ranging from 2,600-4,500 g, 13.50% were SGA, while 77% and 9.50% were AGA and LGA, respectively. Parity was a confounding factor influencing the incidence of LBW, while maternal age did not present a significant correlation. Pregnancies with severe preeclampsia were found to have a 29-fold increased likelihood of delivering LBW babies compared to the control group when controlling for parity (P=0.000, CI 95%). Hence, women with severe preeclampsia pregnancies have a higher risk for delivering LBW babies of 29 times higher than the control.

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

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

The risk of preeclampsia in pregnancy with a deficit of selenium. A systematic review

The risk of preeclampsia in pregnancy with a deficit of selenium. A systematic review

COMPARISON OF OXIDATIVE STRESS LEVELS DURING THE THIRD TRIMESTER IN NORMAL PREGNANCY AND PREECLAMPSIA

Background: The placenta is a complex transiently formed organ which plays a crucial role in the development of the foetus. As the placenta is responsible for maintaining pregnancy placental defects are mainly responsible for pregnancy-related issues. Preeclampsia is a pregnancy-related disorder due to uteroplacental insufficiency resulting from deficient remodelling of spiral arteries causing ischemic reperfusion injury which is finally responsible for the generation of reactive oxygen species and oxidative stress by the placenta. So, this study was planned to determine and compare serum levels of oxidative stress markers (ischemia-modified albumin and malondialdehyde) in preeclampsia and normal pregnancy in the third trimester. Methods: Study design: Cross-sectional comparative study Settings Gynae/Obs Department and Pathology Laboratory, Lahore General Hospital, Lahore. Study population: 42 Pregnant females at 34–36 weeks of gestation were selected. Group 1 compromised 21 normal healthy pregnant females and group 2 included 21 preeclamptic patients. Sampling technique: non-probability purposive sampling. Blood samples were taken at 34–36 weeks of gestation. Serum was stored for ischemia-modified albumin and malondialdehyde. Data was analyzed using SPSS version 20. An Independent t-test was used to compare values between the groups during the third trimester. A p-value of ≤0.05 was considered significant. Results: Comparison of ischemia-modified albumin and malondialdehyde values between group I and group 2 showed a highly significant difference of p-value of &lt;0.001. Conclusion: Oxidative stress markers were higher in preeclamptic patients as compared to normal pregnant females during the third trimester suggesting the role of the placenta in oxidative stress.

Preeclampsia and diabetes mellitus.

The purpose of this paper is to provide a review of recent research on the relationship between preeclampsia and diabetes mellitus in pregnancy. A structured search for literary sources in PubMed and ScienceDirect databases using keywords, followed by a selection of papers based on solid methodology. Preeclampsia is a serious condition, which complicates 2-7% of pregnancies. It causes maternal complications (organ dysfunction) and fetal complications (pathological haemodynamic parameters of the uteroplacental unit and fetal growth restriction). Pregnant women with pregestational diabetes have a 2- and 4-times higher risk of developing preeclampsia and the ones with gestational diabetes have 1.3-times higher risk. The main identified risk factors are inadequate compensation of diabetes, diabetic nephropathy, retinopathy and the duration of diabetes. To minimalize the risk of developing preeclampsia, a composite screening has been implemented. With a positive result a preventive use of acetylsalicylic acid from at the latest 16 and up until the 36th week is advised. Preeclampsia is also a risk factor for developing diabetes mellitus and other cardiovascular diseases later in life. For that reason, a long-term dispensary of women who had preeclampsia in pregnancy is recommended.

Care in pregnancy after stillbirth

Pregnancy after stillbirth is associated with increased risk of stillbirth and other adverse pregnancy outcomes including fetal growth restriction, preeclampsia, and preterm birth in subsequent pregnancies. In addition, pregnancy after stillbirth is associated with emotional and psychological challenges for women and their families. This manuscript summarizes information available to guide clinicians for how to manage a pregnancy after stillbirth by appreciating the nature of the increased risk in future pregnancies, and that these are not affected by interpregnancy interval. Qualitative studies have identified clinician behaviors that women find helpful during subsequent pregnancies after loss which can be implemented into practice. The role of peer support and need for professional input from the antenatal period through to after the birth of a live baby is discussed. Finally, areas for research are highlighted to develop care further for this group of women at increased risk of medical and psychological complications.

The role of microRNAs in preeclampsia

AIM: The aim of this study was to review current sources of scientific literature covering the role of miRNAs in preeclampsia.&#x0D; BASIC PROVISIONS: MicroRNAs are a class of short RNA nucleotide sequences that are not involved in protein synthesis, but are capable of controlling complex processes such as cell growth, differentiation, stress response, and tissue remodeling, which under certain conditions play a key role in a variety of pathological processes, including preeclampsia. MicroRNAs regulate up to 60% of the human genome. There are three types of placental miRNAs: placenta-specific, placenta-associated and circulating ones. Three miRNA gene clusters, namely chromosome 19 cluster (C19MC), chromosome 14 cluster (C14MC), and miR-371 ~ 373 cluster, encode most placenta-specific miRNAs. C19MC encodes 58 mature miRNAs and is expressed in trophoblast cells in early pregnancy and then, in placental differentiated cells. C14MC encodes 63 mature microRNAs, which are also expressed in trophoblasts. The miR-371~373 cluster only encodes six mature microRNAs expressed in placental differentiated cells and embryonic stem cells. The functions of placenta-specific miRNAs are being actively studied now. It has been established that the action of these microRNAs is associated with proliferation, apoptosis, migration, angiogenesis of trophoblast cells and placentation in early pregnancy. Recently, special attention has been paid to identifying microRNAs as possible predictors of preeclampsia in early pregnancy.&#x0D; CONCLUSIONS: Literature data indicate that miRNAs are associated with the pathogenesis of preeclampsia. It has been proven that more than a hundred types of miRNAs are expressed in placental tissues, and some of them can be isolated and detected in peripheral blood and urine in patients with preeclampsia. Studying the miRNA types will allow for determining the most significant prognostic markers for early detection of preeclampsia and developing non-invasive tests.

Proteomic analysis of N-glycosylation of the human placenta between preeclampsia and normal pregnancies

Protein N-glycosylation plays critical roles in modulating placental function, but little is known about N-glycoproteins in the human placenta and modifications in preeclampsia (PE). Here, we show a large, site-specific N-glycoproteome profiling study of PE and normal placenta using quantitative N-glycoproteomics based on mass spectrometry. The study identified disease signatures of altered N-glycoproteins and N-glycosylation site occupancy in PE and provided a system-level view of human placental N-glycoproteins and in vivo N-glycosylation sites. The study led to the discovery of a roster of glycoproteins with aberrant N-glycosylation levels associated with PE, including CD34, ENPP1 (ectonucleotide pyrophosphatase/phosphodiesterase family member 1), insulin-like growth factor binding protein (IGFBP3), and HYOU1 (hypoxia up-regulated 1). An emerging phenomenon that N-glycosylation is involved in several PE pathways, including cell adhesion molecules, PI3K-Akt signaling, pyrimidine metabolism, and metabolic pathways was revealed by pathway analysis of PE-associated aberrant glycoproteins. After enzymolysis, the proteins in each group were enriched with N-glycosylated peptides by lectin, the glycochain was excised by peptide N-glycosidase F (PNGase F) in H218O, and the glycosylated sites were analyzed by LC-MS/MS to achieve large-scale qualitative and quantitative analysis of N-glycosylated proteins. Our findings highlight the role of N-glycosylation in the pathogenesis of PE and provide new molecular and system-level insights for understanding and treating this disease.

BLOOD BIOMARKERS TO PREDICT OF THE ONSET AND ADVERSE OUTCOMES OF PREECLAMPSIA : A SYSTEMATIC REVIEW

Background: Pre-eclampsia is one of the most common pregnancy complications, and a major cause of fetal and maternal morbidity and mortality globally. Diagnosis currently takes place in the third trimester based on clinical symptoms. This systematic review sought to determine the blood biomarkers that are associated with pre-eclampsia, and in particular, the biomarkers that could predict pre-eclampsia in early pregnancy. Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2013 and 2023 were taken into account. Several different online reference sources, like Pubmed and SagePub, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 257 articles, whereas the results of our search on SagePub brought up 78 articles. The results of the search conducted for the last year of 2013 yielded a total 198 articles for PubMed and 54 articles for SagePub. In the end, we compiled a total of 5 papers, 4 of which came from PubMed and 1 of which came from SagePub. We included five research that met the criteria. Conclusion: PlGF and sFlt-1 are the most used in clinical practice, even if their specificity and sensitivity do not justify a default implementation into guidelines to screen all pregnant women. Their role is limited to rule-out a diagnosis of pre-eclampsia in women presenting with symptoms highly suggestive of the disease. Therefore, their current application is not useful for an early prediction of pre-eclampsia. Novel lines of research are needed to identify molecules able to detect pre-eclampsia in a timely manner and which have a predictive value high enough to justify the costs associated with routine measurements in the general pregnant population.

Experience of mothers with a history of preeclampsia in pregnancy

Pre-eclampsia is a disease that can occur in pregnancy, and is one of the causes of death in large numbers in childbirth. One indicator of a country's health status is the low maternal mortality rate, where preeclampsia is one of the main causes of maternal death. Objective this Scoping Review is to review and map research on mother's life experience with a history of preeclampsia in pregnancy. Scoping Review it uses framework PRISMA-ScR with search of articles through relevant databases Pubmed, ScienceDirect, and Willey then do Critical Appraisal use The Joanna Briggs Institute (JBI). Based on the search results of the selected 921 articles, there were 10 articles that met the inclusion criteria, and then the review process was continued to identify keywords that resulted in 3 themes, namely Mother's Experience with a history of preeclampsia in pregnancy Impacts related to preeclampsia in pregnant women and Outlook Society believes that preeclampsia is a disorder of evil spirits. History of preeclampsia in pregnancy still really need attention from families and health workers, especially from the aspect of vigilance for the symptoms that are felt and the importance of information about preeclampsia in pregnancy.

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.

Pregnancy-induced hypertension: risk factors and current treatment strategies

Hypertensive disorders during pregnancy are a major public health concern in both developed and developing countries. Early detection and treatment of maternal health issues reduce the severity of these issues. This study set out to identify possible risk factors of these conditions and evaluate current methods of treatment. Throughout the research (6 months), 80 PIH women who met the inclusion criteria were studied in an observational study. Women in their twenties and thirties are more likely to have pregnancy-induced hypertension. Preeclampsia and gestational hypertension in pregnancy are the most common types. Hypertension issues are more common among pregnant women who are more likely to be obese, have had previous pregnancies, and reside in rural areas. Medication for the treatment of pregnancy-induced hypertension is prescribed and administered regarding drugs used for primary hypertension. Methyldopa and labetalol are examples of first-line treatments. Patients with PIH who are about to give birth are given hydralazine intravenously (IV) or nifedipine orally (P.O.) as a second-line treatment. When providing antihypertensive medicines or any other medications, the well-being of both maternal and fetal is taken into consideration. The risks to both mother and child may be reduced with prompt treatment with additional, safe medications.

Effect of Third Interstitial Fluid on Adverse Outcomes in Patients with Severe Pre-eclampsia and Twin Pregnancy: A 5-year Single-center Retrospective Study.

This study aims to identify the effect of third interstitial fluid on adverse outcomes in twin pregnancies with severe pre-eclampsia, and explore the differences in bad ending between twins and singletons. The present retrospective cohort study was conducted on patients with severe pre-eclampsia, who delivered in Tongji Hospital, Wuhan, China, between 2017 and 2022. The adverse outcomes in singleton and twin pregnancies with severe pre-eclampsia were initially investigated. Then, the diverse maternal and fetal consequences between singleton and twin pregnancies in patients with severe pre-eclampsia were compared after merging with the third interstitial fluid. A total of 709 patients were included for the present study. Among these patients, 68 patients had twin pregnancies, and 641 patients had singleton pregnancies. The rate of postpartum hemorrhage (2.81% vs. 13.24%, P<0.001), and admission rate to the Neonatal Intensive Care Unit (NICU) after birth (30.73% vs. 63.24%, P=0.011) were significantly higher in twin pregnancies. The neonatal weight of twins was statistically lower than singletons (1964.73±510.61 g vs. 2142.92±731.25 g, P=0.008). For the groups with the third interstitial fluid, the delivery week (P=0.001) and rate of admission to the NICU after birth were significantly advanced in twin pregnancy group, when compared to singleton pregnancy group (P=0.032), and the length of hospital stay was shorter (P=0.044). Furthermore, there was no statistically significant difference between the twin pregnancy group and the singletony pregnancy group without the third interstitial fluid. The maternal and fetal adverse outcomes of patients with severe pre-eclampsia increased in twin pregnancies, when compared to singleton pregnancies. Thus, when patients develop the third interstitial fluid, twin pregnancies would more likely lead to adverse fetal outcomes, when compared to singleton pregnancies, and there would be no significant difference in maternal adverse outcomes. More attention should be given to patients who merge with the third interstitial fluid.