M et al in his nested case-control study
that involved pre-eclampsia
screening project. After some exlusions from total 5367 pregnant women with no
specific symptoms had routine trans-vaginal uterine artery (UtA) Doppler at 11
+ 0 to 13 + 6 weeks, of these women later diagnosed with preeclampsia were 70,
with 53 late-onset (delivery ? 34
weeks) pre-eclampsia and 17 pregnancies having early-onset (delivery < 34 weeks) pre-eclampsia. The study concludes that early or late pre-eclampsia was characterized by an anti-angiogenic state and impaired placentation during the first trimester of pregnancy. Regression models including maternal characteristics, UtA Doppler and Placental growth factor (PlGF) that can probably predict approximately half of pregnancies that will develop early-onset pre-eclampsia. There is need for study to aid in designing a better and more population-specific screening test for pre-eclampsia during the first trimester of pregnancy. 11) Erez O et al in his case-control longitudinal study, including 90 normal pregnant women and 76 patients with late-onset preeclampsia (diagnosed at ?34 week). In early pregnancy (8-22 weeks) elevated matrix metalloproteinase 7 (MMP-7) and later in pregnancy (after 22 weeks) low PlGF are the strongest predictors for the sequential development of late-onset preeclampsia. Thus the study suggests that the optimal prediction of patients at risk may include a two-step diagnostic process. 12) Saxena N et al in her prospective study on 150 pregnant patients diagnosed with severe pre-eclampsia and eclampsia (>20 weeks of gestation) with the aim to study the maternal
and fetal outcome for the period of one year in a tertiary center. Results
reveal that out of 150 patients 47% were Primi and 69% were 20-30 years of age.
Of 75 preeclampsia patients, 11 suffered convulsions and 75 experienced
convulsions on admission and four patients died. Most common complaint being headache.
Caesarean section was the prevailing
mode of delivery in about 72 (48%) women, due to failed induction. From the
total, 59% complications were related to placental abruption, renal dysfunction
and failure, postpartum hemorrhage, DIC, pulmonary edema and embolism. It
concludes that eclampsia was shown to have higher complications in both mother
and child. Early diagnosis, better antenatal care, and proper management of
severe pre-eclampsia can minimize the incidence of eclampsia.
13) Torjusen H in a prospective cohort study in
Norway, for time period of years 2002–2008 including 28?192 pregnant women. The prevalence of pre-eclampsia was
5.3% (n=1491). Lower risk of pre-eclampsia was seen in women who proclaimed to
have eaten ‘mostly’ or ‘often’ organic vegetables (n=2493, 8.8%) compared to
those who ‘sometimes’ or ‘never/rarely’ had them. High intake of organic fruit,
milk, eggs, cereals or a combined index reflecting organic consumption reported
to have no relation with pre-eclampsia. Results suggest that during pregnancy opting
for organic vegetables was related with minimized risk of pre-eclampsia.
Possible reason for this association may be that organic vegetables minimize
the exposure to pesticides.
T in A retrospective cohort
study involving singleton pregnancies, patients diagnosed with preeclampsia and
without prior cesarean at ? 34 weeks’ gestation was carried out. Among 5,506 cases
of preeclampsia (? 34 weeks’ gestation) 5,104 (92.7%) women were subjected to
inductions. Outcomes were compared using adjusted odds ratios (aORs) with 95% confidence intervals (CIs). It
concludes that induction was not attributed with higher risk of the primary
outcome, but was related to a maximum risk of ICU admissions and reduced risks
of neonatal outcomes.
S et al in this population-based cross-sectional study, relates the effects on risk
of stillbirth by pregnancy history, in Finland during 2000 and 2010, including
604047 women (?20 years
of age) with singleton pregnancies. Per 1000 deliveries the prevalence of
stillbirth was found to be 3.17. For multiparous women with no prior fetal loss
in pregnancy after adjusting for major pregnancy complications related with stillbirth
such as pre-eclampsia, placental abruption, placenta previa. Comparatively in
multiparous women with prior pregnancy loss, nulliparous women with and prior
spontaneous abortion, prevalence of consecutive stillbirth was higher.
of the number of previous deliveries, prior pregnancy loss was reported to be
an independent risk factor for abortion or stillbirth.
A et al in this prospective cohort study to describe the early postpartum blood
pressure (BP) profile following preeclampsia. In Total 115 preeclampsia patients
and 41 normal pregnant women were included. Prevalence of various hypertensive
phenotypes by applying 24-hour ambulatory BP monitoring (ABPM), 6 to 12 week following
childbirth, was assessed along with the risk of salt sensitivity and the
variability of BP derived from ABPM parameters. Study concludes
that, ABPM 6 to 12 weeks postpartum uncovers a high rate of masked and nocturnal
hypertension, sustained ambulatory after preeclampsia. This report may assist diagnose
women who shall be involved in a management program of postpartum
Timofeeva AV et al in this study intended to evaluate miRNA expression
levels in the blood plasma and placenta of pregnant women with early and late
onset preeclampsia comparing it with control group to design prerequisites for
its early non-invasive diagnosis.
Methods like miRNA deep sequencing after which
real-time quantitative RT-PCR were included, logistic regression
analysis of data was done.
the patient’s blood plasma with PE, miR-423-5p, 519a-3p, and -629-5p and
let-7c-5p were higher than 2-fold increase compared to those in placenta. The
above-mentioned miRNAs are related with PE diagnosis. Conclusion implies that for the early diagnosis of PE the miRNA -miR-423-5p may be treated as a potential candidate at the time
of targeted management of pregnancies at
18. McKinney D et al in this retrospective cohort study
including, live-born, without anomalies singleton, deliveries that took place at
the University of Cincinnati Medical Center over the duration of 2008 to 2013. Inclusion
criteria were patients with preeclampsia onset before 34 weeks are completed
and on its management. On the basis of presence /absence of fetal growth
restriction 2 study groups were defined. Its presence was reported to be related
with a reduced time interval to delivery in women subjected to expectant
management of preeclampsia (<34 weeks). These data may aid in counseling patients concerning the expected duration of pregnancy, analyze the necessity for maternal transport and guiding decision making regarding steroids therapy. 19) Rabinovich A et al in this retrospective matched case-control study that compares 81 preterm pregnant women (28 0/7 and 36 6/7 weeks) diagnosed with pre-eclampsia and oligohydramnios low amniotic fluid index (AFI) in contrast to 81 patients with preterm pre-eclampsia and without oligohydramnios( control group ). Around 4.8% of all pre-eclampsia preterm parturients resulted with oligohydramnios. study group underwent more cesarean sections. AFI <5?cm was related with a serious neonatal morbidity such as fetal distress during labor, and majority were presented with lower fetal weight and small for gestational age (SGA). Study concludes that Oligohydramnios is an independent risk factor for perinatal morbidity in preterm pre-eclamptic parturients and its presence can guide in decision making for patients delivery and also help decide for / against conservative management. 20. Elmugabil A et al in this case-control study carried out in Omdurman Maternity Hospital in Sudan, over the period of 4 months in 2014. The preeclampsia patients were cases while healthy parturients were the control group. Atomic absorption spectrophotometer was utilized to analyze serum calcium, magnesium, zinc and copper levels. In contrast with the controls, preeclampsia patients showed increased serum magnesium 1.9 (1.4?2.5) vs. 1.4 (1.0?1.9) mg/dl and decreased median (inter-quartile) calcium 7.6 (4.0?9.6) vs. 8.1 (10.6?14.2), mg/dl. In binary logistic regression, increased magnesium and decreased calcium levels were related with preeclampsia. Study concludes significant relations between serum levels of calcium and magnesium and preeclampsia exists.