- The course of pregnancy and childbirth in women with preeclampsia
The course of pregnancy and childbirth in women with preeclampsia
Ukrainian Journal Health of Woman. 2023. 1(164): 39-44; doi 10.15574/HW.2023.164.39
Lemish N. Y.
SHEI «Uzhhorod National University», Ukraine
For citation: Lemish N.Y. (2023). The course of pregnancy and childbirth in women with preeclampsia. Ukrainian Journal Health of Woman. 1(164): 39-44; doi 10.15574/HW.2023.164.39.
Article received: Dec 07, 2022. Accepted for publication: Feb 27, 2023.
Purpose – to determine the features of pregnancy and childbirth in women who had complications from the group of major obstetric syndromes (MOS), which were clinically manifested by pre-eclampsia.
Materials and methods. A retrospective clinical and statistical analysis of the course of pregnancy and childbirth in 103 pregnant women with pre-eclampsia (main group – MG) was performed. The control group (CG) included 56 practically healthy pregnant women with a favorable reproductive history and uncomplicated pregnancy. Statistical processing of the study results was performed using standard software Microsoft Excel 5.0 and Statistica 6.0.
Results. Moderate pre-eclampsia prevailed in pregnant women of MG – 71 (69.6%) cases versus 2 (3.5%) cases in CG (p<0.05). Severe pre-eclampsia was observed in almost every third pregnant woman of MG – 31 (30.4%) cases. One of the main complications of the third trimester of gestation, as well as in the first and second trimesters, was gestational anemia – 38 (37.2%) cases in MG versus 14 (25.0%) cases in CG (p<0.05). Placental insufficiency was significantly more common in pregnant women of MG – 33 (32.1%) cases versus 2 (3.5%) cases in CG (p<0.05); which led to the development of fetal growth retardation syndrome in 10 (9.7%) cases in MG. The threat of preterm birth was noted in 16 (15.6%) cases in MG versus 4 (7.1%) cases in CG (p<0.05), preterm birth was noted – in 12 (11.7%) cases, and the incidence of cesarean section was 32 (31.1%) cases versus 5 (8.9%) cases (p<0.05).
Conclusions. The features of the course of pregnancy and childbirth in women with MOS, which is clinically manifested by the development of pre-eclampsia, are characterized by a significantly high frequency of threatened abortion, gestational anemia, bacterial vaginosis, placental insufficiency, fetal growth retardation syndrome, premature rupture of membranes, premature birth, premature detachment of a normally located placenta, fetal distress and, as a result of these complications, an increase in the incidence of caesarean section to 31.1%.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. Informed consent of women was obtained for the study.
No conflict of interest was declared by the author.
Keywords: women, pregnancy, major obstetric syndromes, pre-eclampsia, pregnancy complications, obstetric complications.
REFERENСЕS
1. Abalos E, Cuesta C, Carroli G, Qureshi Z, Widmer M, Vogel J, Souza J. (2014). Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization multicountry survey on maternal and newborn health. BJOG : an international journal of obstetrics and gynecology. 121: 14-24. https://doi.org/10.1111/1471-0528.12629; PMid:24641531
2. Boutin A, Demers S, Gasse C, Giguère Y, Tétu A, Laforest G, Bujold E. (2019). First-trimester placental growth factor for the prediction of preeclampsia in nulliparous women: the great obstetrical syndromes cohort study. Fetal Diagnosis and Therapy. 45(2): 69-75. https://doi.org/10.1159/000487301; PMid:30304731
3. Boutin A, Gasse C, Demers S, Giguère Y, Tétu A, Bujold E. (2018). Maternal characteristics for the prediction of preeclampsia in nulliparous women: the great obstetrical syndromes (GOS) study. Journal of Obstetrics and Gynaecology Canada. 40(5): 572-578. https://doi.org/10.1016/j.jogc.2017.07.025; PMid:29079078
4. Boutin A, Gasse C, Guerby P, Giguère Y, Tétu A, Bujold E. (2021). First-trimester preterm preeclampsia screening in nulliparous women: the great obstetrical syndrome (GOS) study. Journal of Obstetrics and Gynaecology Canada. 43(1): 43-49. https://doi.org/10.1016/j.jogc.2020.06.011; PMid:32917539
5. Boutin A, Guerby P, Gasse C, Tapp S, Bujold E. (2021). Pregnancy outcomes in nulliparous women with positive first-trimester preterm preeclampsia screening test: the Great Obstetrical Syndromes cohort study. American journal of obstetrics and gynecology. 224(2): 204-e1. https://doi.org/10.1016/j.ajog.2020.08.008; PMid:32777265
6. Brosens I, Pijnenborg R, Vercruysse L, Romero R. (2011). The «Great Obstetrical Syndromes» are associated with disorders of deep placentation. Am J Obstet Gynec. 204(3): 193-201. https://doi.org/10.1016/j.ajog.2010.08.009; PMid:21094932 PMCid:PMC3369813
7. Burgess A, McDowell W, Ebersold S. (2019). Association between lactation and postpartum blood pressure in women with preeclampsia. MCN: The American Journal of Maternal/Child Nursing. 44; 2: 86-93. https://doi.org/10.1097/NMC.0000000000000502 ;PMid:30688668
8. Cordero L et al. (2021). Breastfeeding initiation among women with preeclampsia with and without severe features. Journal of Neonatal-Perinatal Medicine. 14; 3: 419-426. https://doi.org/10.3233/NPM-200508; PMid:33337389
9. Demers S, Boutin A, Gasse C, Drouin O, Girard M, Bujold E. (2019). First-trimester uterine artery Doppler for the prediction of preeclampsia in nulliparous women: the great obstetrical syndrome study. American journal of perinatology, 36(09), 930-935. https://doi.org/10.1055/s-0038-1675209; PMid:30414599
10. Di Renzo GC. (2009). The great obstetrical syndromes. The Journal of Maternal-Fetal & Neonatal Medicine. 22; 8: 633-635. https://doi.org/10.1080/14767050902866804; PMid:19736613
11. Di Renzo GC, Cabero RL, Facchinetti F, Helmer H, Hubinont C, Jacobsson B et al. (2017). Preterm labor and birth management: recommendations from the European Association of Perinatal Medicine. The Journal of Maternal-Fetal & Neonatal Medicine. 30(17): 2011-2030.
https://doi.org/10.1080/14767058.2017.1323860; PMid:28482713
12.Di Renzo GC, Tosto V, Giardina I. (2018). The biological basis and prevention of preterm birth. Best Practice & Research Clinical Obstetrics & Gynaecology. 52: 13-22. https://doi.org/10.1016/j.bpobgyn.2018.01.022; PMid:29703554
13. Docheva N, Romero R, Chaemsaithong P, Tarca AL, Bhatti G, Pacora P et al. (2019). The profiles of soluble adhesion molecules in the "great obstetrical syndromes". The Journal of Maternal-Fetal & Neonatal Medicine. 32(13): 2113-2136. https://doi.org/10.1080/14767058.2018.1427058; PMid:29320948 PMCid:PMC6070437
14. Erez O, Romero R, Jung E, Chaemsaithong P, Bosco M, Suksai M, Gotsch F. (2022). Preeclampsia and eclampsia: the conceptual evolution of a syndrome. American journal of obstetrics and gynecology. 226(2): S786-S803. https://doi.org/10.1016/j.ajog.2021.12.001; PMid:35177220 PMCid:PMC8941666
15. Frolova NA, Tezikov YV, Lipatov IS. (2021). Justification of the choice of diosmin vasoprotective as a preventive agent of pre-eclampsia. Reproductive health of woman. 1(46): 40-43. https://doi.org/10.30841/2708-8731.1.2021.229710
16. Ivo B, Puttemans P, Benagiano G. (2019). Placental bed research: I. The placental bed: from spiral arteries remodeling to the great obstetrical syndromes. American journal of obstetrics and gynecology. 221; 5: 437-456. https://doi.org/10.1016/j.ajog.2019.05.044; PMid:31163132
17. Jung E, Romero R, Yeo L, Gomez-Lopez N, Chaemsaithong P, Jaovisidha A et al. (2022). The etiology of preeclampsia. American journal of obstetrics and gynecology. 226(2): S844-S866. https://doi.org/10.1016/j.ajog.2021.11.1356; PMid:35177222 PMCid:PMC8988238
18. Miller D et al. (2022). Cellular immune responses in the pathophysiology of preeclampsia. Journal of Leukocyte Biology. 111; 1: 237-260. https://doi.org/10.1002/JLB.5RU1120-787RR; PMid:33847419 PMCid:PMC8511357
19. Mintser AP. (2018). Statisticheskie metodyi issledovaniya v klinicheskoy meditsine. Prakticheskaya meditsina. 3: 41-45.
20. Poon LC et al. (2019). The International Federation of Gynecology and Obstetrics (FIGO) initiative on preeclampsia (PE): a pragmatic guide for first trimester screening and prevention. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 145; Suppl 1: 1.
21. Poon LC, Magee LA, Verlohren S, Nicolaides KH, Shennan A, Dadelszen PV et al. (2021). A literature review and best practice advice for second and third trimester risk stratification, monitoring, and management of pre-eclampsia. Int. J. Gynecol. Obstet. 154(S1): 3-31. https://doi.org/10.1002/ijgo.13763; PMid:34327714 PMCid:PMC9290930
22. Romero R et al. (2022). Toward a new taxonomy of obstetrical disease: improved performance of maternal blood biomarkers for the great obstetrical syndromes when classified according to placental pathology. American Journal of Obstetrics and Gynecology. 227; 4: 615-e1. https://doi.org/10.1016/j.ajog.2022.04.015; PMid:36180175
23. Romero R, Kusanovic JP, Kim ChJ. (2010). Placental bed disorders in the genesis of the great obstetrical syndromes. Cambridge University Press: 271-289. https://doi.org/10.1017/CBO9780511750847.025; PMid:20036322
24. Scott H, Danel I. (2016). Accountability for improving maternal and newborn health. Best Practice & Research Clinical Obstetrics & Gynaecology. 36: 45-56. https://doi.org/10.1016/j.bpobgyn.2016.05.009; PMid:27473405
25. Simcha Y, Cohen SM, Goldman-Wohl D. (2022). An integrated model of preeclampsia: a multifaceted syndrome of the maternal cardiovascular-placental-fetal array. American journal of obstetrics and gynecology. 226; 2: S963-S972. https://doi.org/10.1016/j.ajog.2020.10.023; PMid:33712272
26. Staff AC et al. (2022). Failure of physiological transformation and spiral artery atherosis: their roles in preeclampsia. American journal of obstetrics and gynecology. 226; 2: S895-S906. https://doi.org/10.1016/j.ajog.2020.09.026; PMid:32971013
27. Stevens DU, de Nobrega Teixeira JA, Spaanderman MEA, Bulten J, van Vugt JMG, Al-Nasiry S. (2020). Understanding decidual vasculopathy and the link to preeclampsia: a review. Placenta. 97: 95-100. https://doi.org/10.1016/j.placenta.2020.06.020; PMid:32792071
