scholarly journals Are There Differences in the Anthropometric, Hemodynamic, Hematologic, and Biochemical Profiles between Late- and Early-Onset Preeclampsia?

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Márcia Aires Rodrigues de Freitas ◽  
Alice Vieira da Costa ◽  
Luciana Alves de Medeiros ◽  
Mario da Silva Garrote Filho ◽  
Angélica Lemos Debs Diniz ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Early Onset ◽  
Doppler Ultrasonography ◽  
Late Onset ◽  
Tertiary Hospital ◽  
Hemodynamic Changes ◽  
Osmotic Stability ◽  
Biochemical Profiles ◽  
Early Onset Preeclampsia ◽  
Transversal Study

Preeclampsia (PE) is classified as early-onset PE (EOPE) and late-onset PE (LOPE) when present before or after 34 weeks of gestation, respectively. This transversal study aimed to investigate the differences and possible associations existing in the anthropometric, hemodynamic, hematologic, and biochemical profiles of late- and early-onset preeclampsia. The study included 65 volunteers admitted to a tertiary hospital in Brazil: 29 normotensive and 36 with preeclampsia (13 with EOPE and 23 with LOPE). Pregnant women with LOPE presented greater weight gain and borderline increase in body mass index at the end of gestation in relation to the other groups, which is compatible with the metabolic origin, associated with obesity, attributed to this form of the disease. Pregnant women with EOPE presented a borderline reduction in the number of erythrocytes and a significant decrease in the number of platelets, in addition to a significant increase in reticulocytes, serum iron, and ferritin when compared to normotensive pregnant women and pregnant women with LOPE. A significant increase in osmotic stability of erythrocytes was observed in the EOPE group in relation to other groups. Hemodynamic analysis by Doppler ultrasonography of the ophthalmic artery showed that both groups of pregnant women with PE presented alterations compatible with the occurrence of hyperflow in the orbital territory. These hemodynamic changes were associated with changes in hematimetric indices.

scholarly journals Altered Maternal Serum Matrix Metalloproteinases MMP-2, MMP-3, MMP-9, and MMP-13 in Severe Early- and Late-Onset Preeclampsia

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Marzena Laskowska
Keyword(s):  
Matrix Metalloproteinases ◽  
Pregnant Women ◽  
Immunosorbent Assay ◽  
Early Onset ◽  
Late Onset ◽  
Maternal Serum ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Control Subjects ◽  
Early Onset Preeclampsia

Objective. The aim of this study was to determine whether maternal serum matrix metalloproteinases 2, 3, 9, and 13 levels differ in early- and late-onset preeclampsia and uncomplicated pregnancies. Patients and Methods. The study was carried out in 125 pregnant women (29 with early-onset preeclampsia; 31 preeclamptic patients with late-onset preeclampsia; and 65 healthy pregnant controls). Levels of MMP-2, MMP-3, MMP-9, and MMP-13 were measured in the maternal serum using an enzyme-linked immunosorbent assay. Results. Maternal serum MMP-2 levels in both the groups of preeclamptic women were significantly higher than those in the controls. Levels of MMP-3 were significantly higher in preeclamptic patients with early-onset disease; however, the MMP-3 levels in patients with late-onset preeclampsia were similar to those observed in the control subjects. MMP-9 levels were lower whereas the levels of MMP-13 were higher in both preeclamptic groups of pregnant women than in the healthy controls, but these differences were statistically insignificant. Conclusions. One important finding of the present study was that MMP-3 appears to be involved solely in early-onset preeclampsia, but not in late-onset preeclampsia. Higher levels of MMP-2 and MMP-13 and lower levels of MMP-9 seem to be related to both early- and late-onset severe preeclampsia.

scholarly journals Role of pregravid body mass and its gestational increase in development of various variants of preeclampsia

2020 ◽  
pp. 11-15
Author(s):  
K. B. Pokusaeva ◽  
A. S. Krivenko ◽  
N. Yu. Katkova ◽  
V. N. Pokusaeva ◽  
A. S. Vakhrushin
Keyword(s):  
Body Weight ◽  
Pregnant Women ◽  
Fat Mass ◽  
Early Onset ◽  
Late Onset ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Increased Risk ◽  
Negative Effect ◽  
Early Onset Preeclampsia

Aim. To evaluate the effects of maternal pre-pregnancy body weight and excessive gestational weight gain (GWG) on the risk of different subtypes of preeclampsia (PE).Methods. A cohort study of 289 pregnant women: 41 with early-onset (less than 34 weeks) preeclampsia (EPE), 76 with late-onset (more than 34 weeks) preeclampsia (LPE) and 172 normotensive women (control). Associations between anthropometric indicators (pre-pregnancy BMI, GWG, fat mass in the 1st, 2nd, 3rd trimesters, on the 2–3rd day after birth) and risk of PE and its subtypes were evaluated.Results. Pre-pregnancy body weight (r = 0.36; р = 0.000) and BMI (r = 0.38; р = 0.000) moderately increased risk of PE. GWG had independent risk of developing PE (r = 0.46; р = 0.000). Women with excessive GWG had an increased risk of PE in normal BMI (RR = 2.2; р = 0.019), in overweigh (RR = 2.7; р = 0.028), in obese (ОР = 5.2; р = 0.000). The risk of developing preeclampsia increased in normal weight with GWG more than 500 g per week in the 2nd trimester (р = 0.000) and more than 400 g per week in the 3d trimester (р = 0.000), total GWG more than 16.5 kg increased risk of preeclampsia in 3.4-fold (ОР = 3.4; р = 0.001). Overweight and obesity had an increased risk of late-onset preeclampsia (RR = 4.9; р = 0.000). No association was found for early-onset preeclampsia (p > 0.050). Gestational metabolic disorders were independent risk of LPE: weekly GWG and the per cent of fat mass in normal weight pregnant women with LPE were significantly higher compared to the women with EPE and control. The per cent of fat mass in the 1st trimester in PPE (23.90 ± 4.40 %) exceeded control (20.50 ± 4.30 %; р = 0.003) and EPE (21.20 ± 3.65 %; р = 0.008) groups. Differences were aggravated during pregnancy (р < 0.050).Conclusions. Pre-pregnancy overweight and obesity, excessive GWG and gain of fatty mass were an independent risk of developing PE with synergistic negative effect. Pre-pregnancy and gestational lipid dismetabolism were associated with LPE. Our results suggested that no correlation between pre-pregnancy BMI, GWG, fatty mass and risk of EPE.

scholarly journals Elecsys® and Kryptor immunoassays for the measurement of sFlt-1 and PlGF to aid preeclampsia diagnosis: are they comparable?

2019 ◽  
Vol 57 (9) ◽  
pp. 1339-1348 ◽  
Author(s):  
Holger Stepan ◽  
Martin Hund ◽  
Peter Dilba ◽  
Johanna Sillman ◽  
Dietmar Schlembach
Keyword(s):  
Pregnant Women ◽  
Early Onset ◽  
Late Onset ◽  
Correlation Coefficients ◽  
Serum Samples ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count ◽  
Early Onset Preeclampsia ◽  
Plgf Ratio ◽  
Control Study

Abstract Background For pregnant women with suspected preeclampsia, the soluble fms-like tyrosine-kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio is a biomarker to aid diagnosis. We performed method comparisons between Elecsys® and Kryptor sFlt-1 and PlGF immunoassays and assessed the diagnostic performance for preeclampsia. Methods Serum samples from a case-control study involving 113 pregnant women with preeclampsia/elevated liver enzymes and low platelet count (HELLP) and 270 controls were analyzed. sFlt-1 and PlGF were measured using Roche Elecsys® and BRAHMS Kryptor sFlt-1/PlGF immunoassays. The sFlt-1/PlGF ratios were calculated, and Passing-Bablok regression/Bland-Altman plots were performed. Gestation-specific cut-offs, ≤33 and ≥85/≥110, were assessed. Results Mean (±2 standard deviation [SD]) differences between the Elecsys® and Kryptor values were: sFlt-1, 173.13 pg/mL (6237.66, −5891.40); PlGF, −102.71 pg/mL (186.06, −391.48); and sFlt-1/PlGF, 151.74 (1085.11, −781.63). The Elecsys® and Kryptor immunoassays showed high correlation: Pearson’s correlation coefficients were 0.913 (sFlt-1) and 0.945 (PlGF). Slopes were 1.06 (sFlt-1) and 0.79 (PlGF), resulting in ~20% lower values for Kryptor PlGF. Sensitivities and specificities using the sFlt-1/PlGF ≥85 cut-off for early-onset preeclampsia (20 + 0 to 33 + 6 weeks) were 88.1%/100.0% (Elecsys®) and 90.5%/96.2% (Kryptor), respectively, and using the ≥110 cut-off for late-onset preeclampsia (≥34 + 0 weeks) were 51.3%/96.5% (Elecsys®) and 78.9%/90.1% (Kryptor), respectively. Using Elecsys® and Kryptor sFlt-1/PlGF, 0% and 3.8% of women, respectively, were falsely ruled-in for early-onset, and 3.5% and 9.9%, respectively, for late-onset preeclampsia. Conclusions Despite high correlation between the Elecsys® and Kryptor immunoassays, we observed significant differences between sFlt-1/PlGF and PlGF results. Therefore, sFlt-1/PlGF cut-offs validated for Elecsys® immunoassays are not transferable to Kryptor immunoassays.

scholarly journals Early- and Late-Onset Preeclampsia at a Tertiary Hospital in 2016

2022 ◽  
Vol 13 (1) ◽  
pp. 6
Author(s):  
Hapsari Kinanti ◽  
Muhammad Ilham Aldika Akbar ◽  
Pudji Lestari
Keyword(s):  
General Hospital ◽  
Early Onset ◽  
Late Onset ◽  
Tertiary Hospital ◽  
Obstetric History ◽  
Significant Difference ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
The Difference ◽  
Early Onset Preeclampsia

Introduction: Preeclampsia is still one of the major causes of maternal morbidity and mortality worldwide. Preeclampsia nowadays has another classification, early-onset preeclampsia and late-onset preeclampsia. This study aimed to evaluate the differences between early-onset and late-onset preeclampsia in Dr. Soetomo General Hospital, Surabaya in 2016.Methods: This was an analytic observational study, evaluating the difference between early- and late-onset preeclampsia in terms of maternal data, medical history, and obstetric history. The samples were taken from the medical record of Dr. Soetomo General Hospital, Surabaya from January until December 2016.Results: In maternal data, early- and late-onset preeclampsia mostly happened in productive age, consisted of 34 patients of early-onset preeclampsia (77.3%) and 31 patients of late-onset preeclampsia (73.8%). Early-onset preeclampsia tended to happen in nullipara (42.2%) and primigravida (35.6%) women, and late-onset preeclampsia usually happened in multipara (43.9%) and multigravida (85.4%) women. In medical and obstetric history, early-onset preeclampsia mostly had a history of hypertension (61.7%), rather than late-onset preeclampsia (32.7%). Moreover, there were no significant differences in other variables.Conclusion: Early-onset and late-onset preeclampsia had a significant difference in parity, gravidity, and hypertension disease.

scholarly journals Mean arterial blood pressure: potential predictive tool for preeclampsia in a cohort of healthy nulliparous pregnant women

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jussara Mayrink ◽  
◽  
Renato T. Souza ◽  
Francisco E. Feitosa ◽  
Edilberto A. Rocha Filho ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Early Onset ◽  
Late Onset ◽  
Roc Curves ◽  
Predictive Tool ◽  
Arterial Blood ◽  
Early Onset Preeclampsia

Abstract Background Prediction of preeclampsia is a challenge to overcome. The vast majority of prospective studies in large general obstetric populations have failed in the purpose of obtain a useful and effective model of prediction, sometimes based on complex tools unavaible in areas where the incidence of preeclampsia is the highest. The goal of this study was to assess mean arterial blood pressure (MAP) levels at 19–21, 27–29 and 37–39 weeks of gestation and performance of screening by MAP for the prediction of preeclampsia in a Brazilian cohort of healthy nulliparous pregnant women. Methods This was a cohort approach to a secondary analysis of the Preterm SAMBA study. Mean arterial blood pressure was evaluated at three different time periods during pregnancy. Groups with early-onset preeclampsia, late-onset preeclampsia and normotension were compared. Increments in mean arterial blood pressure between 20 and 27 weeks and 20 and 37 weeks of gestation were also calculated for the three groups studied. The accuracy of mean arterial blood pressure in the prediction of preeclampsia was determined by ROC curves. Results Of the 1373 participants enrolled, complete data were available for 1165. The incidence of preeclampsia was 7.5%. Women with early-onset preeclampsia had higher mean arterial blood pressure levels at 20 weeks of gestation, compared to the normotensive group. Women with late-onset preeclampsia had higher mean arterial blood pressure levels at 37 weeks of gestation, than the normotensive groups and higher increases in this marker between 20 and 37 weeks of gestation. Based on ROC curves, the predictive performance of mean arterial blood pressure was higher at 37 weeks of gestation, with an area under the curve of 0.771. Conclusion As an isolated marker for the prediction of preeclampsia, the performance of mean arterial blood pressure was low in a healthy nulliparous pregnant women group. Considering that early-onset preeclampsia cases had higher mean arterial blood pressure levels at 20 weeks of gestation, future studies with larger cohorts that combine multiple markers are needed for the development of a preeclampsia prediction model.

scholarly journals Prediction of preeclampsia using a combination of serum micro RNA-210 and uterine artery Doppler ultrasound

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110368
Author(s):  
Ananya Trongpisutsak ◽  
Vorapong Phupong
Keyword(s):  
Pregnant Women ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Early Onset ◽  
Uterine Artery ◽  
Micro Rna ◽  
Predictive Values ◽  
Uterine Artery Doppler ◽  
Early Onset Preeclampsia ◽  
Sensitivity Specificity

The objective was to determine whether a combination of serum micro RNA-210 level and uterine artery Doppler can predict preeclampsia in pregnant women at 16–24 weeks gestation. A prospective observational study conducted in singleton pregnant women at 16–24 weeks of gestation who had prenatal care at the King Chulalongkorn Memorial Hospital, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand between 2017 and 2018. Uterine artery Doppler ultrasound and blood testing for serum micro RNA-210 were performed. Pregnancy outcomes were recorded. Optimal cut-off for uterine artery pulsatility index (PI) and serum micro RNA-210 were obtained to calculate the predictive values for preeclampsia. Data from 443 participants were analyzed. Twenty-two cases developed preeclampsia (5.0%) and seven of these preeclamptic cases had early-onset preeclampsia (1.6%). Pregnant women with preeclampsia had higher mean PI of the uterine artery (1.34 ± 0.52 vs 0.98 ± 0.28, p = 0.004), higher detection rates of diastolic notching (45.5% vs 11.2%, p < 0.001), and lower median serum micro RNA-210 level (22.86 vs 795.78, p < 0.001) than pregnant women without preeclampsia. Using abnormal serum micro RNA-210 level, abnormal mean PI or uterine artery diastolic notches to predict for preeclampsia, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 95.5%, 54.9%, 10.0%, and 99.6%, respectively. For early-onset preeclampsia prediction, the sensitivity, specificity, PPV, and NPV were 100.0%, 53.2%, 3.3%, and 100.0%, respectively. This study demonstrated that a combination of serum micro RNA-210 and uterine artery Doppler is effective in predicting preeclampsia in the second trimester.

scholarly journals Maternofetal outcomes in early versus late onset pre-eclampsia: a comparative study

2019 ◽  
Vol 8 (2) ◽  
pp. 548
Author(s):  
Poornima Shankar ◽  
Kavitha Karthikeyan ◽  
Amrita Priscilla Nalini ◽  
Sindhura M. ◽  
Gowtham Kim
Keyword(s):  
Risk Factors ◽  
Gestational Age ◽  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
Fetal Outcomes ◽  
Chi Square ◽  
Onset Type ◽  
Significant Difference ◽  
Early Onset Preeclampsia

Background: Preeclampsia is being increasingly recognized as two different entities: early-onset preeclampsia occurring at less than 34 weeks of gestation, and late-onset disease occurring at 34 or more weeks of gestation. Early-onset and late-onset pre-eclampsia are found to have different implications for the mother and neonate. The aim of this study is to compare the risk factors, maternal and fetal outcomes in early (<34 weeks) versus late (≥34weeks) onset preeclampsia.Methods: 208 patients diagnosed with pre-eclampsia in Chettinad Academy of Research and Education over a period of three years (From January 2014 to December 2016) were retrospectively studied. Patients were classified as early onset and late onset pre-eclampsia based on the gestational age of onset. Data on risk factors, maternal and fetal outcomes were collected and analyzed using Chi Square and Fisher’s test and compared.Results: The overall preeclampsia rate was 6.3%. Early onset and late onset were 34.6% and 65.3% respectively and the rate increased with increasing gestational age.35.3% of patients with late onset preeclampsia and 55.6% patients of early onset type required more than one drug which is a statistically significant difference. Proteinuria more than 3gm/l/day was significantly more in late onset preeclampsia than in early onset preeclampsia. 55.5% of patients with early onset pre-eclampsia required MgSO4 when compared to 17.4%. There was no statistically significant difference in the rate of caesarean section (61.1% vs 73.5%). Altered coagulation profile was significantly more in early onset preeclampsia (11.1%). The incidence of oligohydramnios, SGA and low APGAR at 5 minutes of birth were significantly high in early onset pre-eclampsia when compared to late onset type.Conclusions: Patients with early onset pre-eclampsia are found to have significantly higher rates of specific maternal and fetal morbidity when compared to the late onset type.

Maternal ABO Blood Type and Factors Associated With Preeclampsia Subtype

2019 ◽  
Vol 21 (3) ◽  
pp. 264-271 ◽  
Author(s):  
Adriane Burgess ◽  
Teresa S. Johnson ◽  
Amanda Simanek ◽  
Theodore Bell ◽  
Sandra Founds
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Risk Identification ◽  
Blood Type ◽  
Tertiary Referral Center ◽  
South Central ◽  
Central Pennsylvania ◽  
Subtype Identification ◽  
Abo Blood Type ◽  
Early Onset Preeclampsia

Background: The pathophysiology of preeclampsia remains unclear. The disorder is heterogeneous, and the pathophysiology may vary by subtype. Identification of relevant biomarkers will help to better elucidate the pathophysiologic basis of each preeclampsia subtype. Blood type may be a biomarker that allows risk identification for preeclampsia. Objective: The purpose of this study was to investigate the associations among maternal ABO blood type and preeclampsia subtype and fetal growth restriction (FGR). Method: Medical records of 126 women with early-onset preeclampsia (≤33 6/7 weeks’ gestation), 126 women with late-onset preeclampsia (≥34 0/7 weeks’ gestation), and 259 controls who gave birth between January 2012 and June 2016 were retrospectively abstracted from a large suburban tertiary referral center in South Central Pennsylvania for this hospital-based case–control study. Results: Women with AB blood type had >3 times the odds of late-onset preeclampsia (odds ratio [ OR] = 3.35, 95% confidence interval (CI) = [1.02, 11.05]) compared to those with O blood type. Among women with early-onset preeclampsia, those with B blood type had 5 times the odds of having a growth-restricted fetus than did women with O blood type ( OR = 5.44, 95% CI [1.65, 17.94]). Discussion: Our findings suggest that AB blood type may be an important risk factor for late-onset preeclampsia and that among women with early-onset preeclampsia, those with B blood type have increased odds of FGR. These findings warrant further study in women and their offspring to identify the pathophysiologic processes that may link ABO blood type, preeclampsia subtype, and FGR.

HtrA3 Isoform–Specific ELISAs for Early Detection of Preeclampsia

2016 ◽  
Vol 23 (10) ◽  
pp. 1092-1099 ◽  
Author(s):  
Yao Wang ◽  
Ying Li ◽  
Jonathan Hyett ◽  
Fabricio da Silva Costa ◽  
Guiying Nie
Keyword(s):  
Early Detection ◽  
Early Onset ◽  
Late Onset ◽  
Pdz Domain ◽  
First Trimester ◽  
Potential Utility ◽  
Third Trimester ◽  
The Third ◽  
Early Onset Preeclampsia ◽  
Singleton Pregnancies

Preeclampsia is a serious disorder of human pregnancy occurring after 20 weeks of gestation. It can be divided into subtypes of early onset (<34 weeks of gestation) and late onset (>34 weeks). Presymptomatic detection to identify those at high risk is important for managing this disease. HtrA3, a serine protease with high expression in the developing placenta, exists in long (HtrA3-L) and short (HtrA3-S) isoforms. They are identical, except HtrA3-S lacks the C-terminal PDZ domain. We have previously shown by Western blot analysis that serum HtrA3 levels at the end of the first trimester are significantly higher in women who later develop preeclampsia than in controls. In this study, using highly specific HtrA3 monoclonal antibodies, we established and fully validated two enzyme-linked immunosorbent assays to detect both HtrA3 isoforms together (HtrA3-T) and HtrA3-L alone in the human serum. We then determined serum HtrA3 at 11 to 13 weeks of gestation in a cohort of singleton pregnancies that proceeded without complications or developed preeclampsia in the third trimester. Compared with controls, those who developed late-onset preeclampsia had significantly higher levels of HtrA3-L, whereas those who developed early-onset preeclampsia had significantly lower ratios of HtrA3-L/HtrA3-T. These data support a potential utility of these HtrA3 ELISAs for early detection of preeclampsia.

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