Formational features of the vascular component of the chorion in miscarriage in the first trimester of gestation

2016 ◽  
pp. 72-74
Author(s):  
E.V. Kravchenko ◽  
Keyword(s):  
Pregnant Women ◽  
Vascular System ◽  
Three Dimensional ◽  
Local Therapy ◽  
First Trimester ◽  
Study Groups ◽  
Flow Index ◽  
Control Group ◽  
Symptomatic Therapy ◽  
Micronized Progesterone

In women with miscarriage in early pregnancy by ultrasound was studied the volume of the ovum, the volume of the cavity of the amnion and their relationship. Using special three-dimensional VOCAL program performed the calculation of the volume of the chorion, the evaluation of his vascular system based on the definition of the vascularization index (VI) and flow index (FI). The aim of the study: to study the stages of growth and vascularization of the chorion with the threat of miscarriage in the first trimester of gestation. Materials and methods. There were examined 50 pregnant women with threat of miscarriage at early terms of gestation: 30 - burdened obstetric history (BOH), receiving the drug micronized progesterone 50 mg 3-4 times per day (the main group) and 20 pregnant women, the history of which was not encumbered, who were on symptomatic therapy (control group). Results. Analysis of the frequency of occurrence of extragenital pathology in the study groups showed that in women with recurrent pregnancy loss and BOH somatic diseases were almost 2 times more often than in the control group (respectively 60% and 30%). The frequency of infectious complications in the first trimester of pregnancy in women with threatened abortion and BOH compared to the control group of patients, significantly more frequently noted violations of vaginal microbiocenosis, in the form of gardnerellosis (20% and 10%), Candida vaginitis (30% and 5.5%) and urogenital infections – chlamydia, ureaplasmosis, mycoplasmosis (15% and 0%). All pregnant women was carried out sanitation of the source of infection in the first trimester of gestation – local therapy, systemic treatment after completion of the processes of placentation. Conclusion. The study found that use of micronized progesterone in miscarriage in the first trimester of gestation contributes to the growth of the volume of the chorion, the intensity of the flow in the parenchyma and a complete restructuring of the spiral arteries resulting in inadequate formation of the placental-uterine blood flow, which certainly improves the prediction of the further course of pregnancy. Key words: miscarriage, the I trimester of gestation, the vessels of the chorion.

scholarly journals THREE-DIMENSIONAL ECHOGRAPHIC EVALUATION OF CHORION VASCULARIZATION IN 1st TRIMESTER OF GESTATION IN WOMEN WITN THROMBOFILIA

2018 ◽  
Vol 25 (6) ◽  
pp. 19-25
Author(s):  
M. A. Asriyants ◽  
O. V. Astafieva ◽  
V. G. Shcherbina
Keyword(s):  
Pregnant Women ◽  
Anticoagulant Therapy ◽  
High Reliability ◽  
Three Dimensional ◽  
High Specificity ◽  
First Trimester ◽  
Flow Index ◽  
Control Group ◽  
Quantitative Indices ◽  
Before And After

Aim.Determine the threshold values of quantitative indices of chorionic volume flow in pregnant women with thrombophilia in the first trimester of pregnancy for the prediction of miscarriage and evaluate the effectiveness of anticoagulant therapy.Materials and methods.Ultrasound examination of the embryo and extraembryonic structures with volume reconstruction of the chorion and determination of quantitative indices using VOCAL program − vascularization index (VI), flow index (FI), vascularization flow index (VFI) in women with thrombophilia from 7th to 10th of the week of gestation.Results.The analysis of the quantitative parameters VI, FI and VFI in pregnant women in the first trimester showed high reliability (p<0.001) in the value of VI and VFI in pregnant women with thrombophilia without treatment and in the pregnant control group, as well as in pregnant women with thrombophilia before and after anticoagulant therapy. Among the most informative parameters for assessing the chorion vascularization in predicting miscarriage VFI≤7,80 has highest value for negative outcome. Index VI due to the very high specificity (SP = 82.6%) better more informative for predicting a favorable outcome.Conclusion.The use of the proposed method allows us to identify a risk group for predicting miscarriage in the first trimester in pregnant women with thrombophilia and promptly prescribe anticoagulant therapy and evaluate its efficiency. 

scholarly journals Kisspeptin and Hematologic Parameters as Predictive Biomarkers for First-Trimester Abortions

2021 ◽  
Author(s):  
Ümit Görkem ◽  
Özgür Kan ◽  
Mehmet Ömer Bostancı ◽  
Deniz Taşkıran ◽  
Hasan Ali İnal
Keyword(s):  
Pregnant Women ◽  
Spontaneous Abortion ◽  
Pregnancy Outcomes ◽  
Significant Relationship ◽  
Blood Count ◽  
Complete Blood Count ◽  
First Trimester ◽  
Study Groups ◽  
Control Group ◽  
Gestational Stage

Objective: Spontaneous abortion is the most common complication of early pregnancy, affecting up to 20% of recognized pregnancies. Kisspeptin is predominantly released by placental syncytiotrophoblasts, and regulates their placental invasion into the uterine matrices. We aimed to establish an association of serum kisspeptin levels with pregnancy outcomes during the early gestational stage of the first trimester. Method: In this prospective study, 90 pregnant women in their 7 to 8 6/7 gestational weeks were classified into three groups: (i) The control group, consisting of healthy pregnant women (n=30), (ii) the threatened abortion group (n=30), and (iii) the spontaneous abortion group (n=30). The maternal serum samples were analyzed for complete blood count parameters and kisspeptin levels. Results: There was no statistical difference regarding body mass index (BMI) and gestational age (p=0.370). Regarding detailed obstetric notations, including gravida, parity, abortion, and living children, socioeconomic levels, and employment rates, all study groups were comparable (p>0.05, for all). No significant association was found regarding the biochemical parameters of complete blood count, including neutrophil, lymphocyte, and platelet concentrations, as well as neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) (p>0.05, for all). The median serum kisspeptin levels of the study groups did not differ between the groups (p=0.153). Correlation analysis revealed no significant relationship between serum kisspeptin levels and other study parameters in any study groups (p>0.05, for all) Conclusions: We found no statistically significant relationship between serum kisspeptin concentrations and pregnancy outcomes in the early gestational stage of the first trimester, and serum kisspeptin concentrations did not seem to be a reliable marker to distinguish abortion status from viable pregnancy

Two- and three-dimensional sonography of anomalies of orofacial area in the first trimester of gestation

2020 ◽  
Author(s):  
N.A. Venchikova, À.À. Ershova-Pavlova, I.V. Novikova et all
Keyword(s):  
Pregnant Women ◽  
Three Dimensional ◽  
First Trimester ◽  
Population Based ◽  
Control Group ◽  
Axial Section ◽  
Mother And Child ◽  
Trimester Screening ◽  
2D Ultrasound ◽  
3D Sonography

As part of the population-based prenatal screening of 900 pregnant women, who underwent 1st trimester screening at the RPMC “Mother and Child” in 2018–2019, an ultrasound scan of the fetal palate was performed to evaluate the effectiveness of new ultrasound markers in detecting orofacial clefts (OFC). Fetal palatal defects were screened at a 2D assessment of bone markers of the palate – the image of the palatal line in the sagittal section, the retronasal triangle in the coronary section, the alveolar arch of the upper jaw in the axial section. If a palate abnormality was detected or suspected in the 2D study, the fetal palate was evaluated using the 3D mode. In 50 pregnant women of the control group, 3D sonography of the fetal palate was performed in the norm. In total, during the gestation period of 10+5–12+5 weeks, 10 cases of OFC were detected, of which 1 case was a median lip/palate cleft (LPC), 6 — bilateral LPC, 1 — left-sided LPC, 1 — unspecified LPC, 1 — PC. Visualization of 2D ultrasound markers was possible in 9 cases of palate anomalies, 3D assessment worked out in all 10 cases. In all identified OFC cases, cytogenetic and/or pathomorphological studies were performed.

scholarly journals Efficiency evaluation of the improved treatment and prevention complex in pregnant women after assisted reproductive technologies

2021 ◽  
pp. 26-31
Author(s):  
V.O. Beniuk ◽  
L.M. Vygivska ◽  
I.V. Maidannyk ◽  
T.V. Kovaliuk ◽  
O.O. Chorna ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Control Group ◽  
Significant Difference ◽  
Β Hcg ◽  
Arginine Aspartate ◽  
Micronized Progesterone

Study objective: to determine the role and effectiveness of the proposed therapeutic and preventive complex and psychoemotional correction of hormonal disorders in the pregnancy dynamics after assisted reproductive technologies (ART) to improve the antenatal observation and prevention of obstetric and perinatal complications.Materials and methods. The study included 299 pregnant women: the main group included 249 women whose pregnancy occurred as an ART result; the control group included 50 pregnant women with spontaneous pregnancy. Therapeutic and prophylactic complex for pregnant women after ART included: micronized progesterone, magnesium oxide, folic acid, L-arginine aspartate, ω3-polyunsaturated fatty acids and long-term psychological correction on the eve of the ART program, at 8–10, 16–18 and 28–30 weeks of pregnancy. Results. There was a significant increase in the β-chorionic gonadotropin (β-hCG) level in women of the study groups in the first trimester of pregnancy against the background of the proposed treatment. Mean β-HCG value at 7–8 weeks of gestation in the subgroup IA exceeded the subgroup IB by 37% (p <0.05), in subgroup IIA it exceeded the subgroup IIB by 33% (p <0.05). The mean β-hCG value in subgroups IIIA and IIIB did not have a significant difference in the dynamics of the first trimester compared with the control group and among themselves (p >0.05).Mean progesterone value at 7–8 weeks of gestation in subgroup IA increased by 38% in comparison with pregnant women who received the conventional treatment complex (p <0.05), in subgroup IIA it was 73% higher than in subgroup IIB (p <0.05). There was no significant difference in the progesterone level in subgroups IIIA and IIIB in the dynamics of the first trimester.The average cortisol value at 23–24 weeks of pregnancy in subgroup IA decreased by 42% (p <0.05), in pregnant women with endocrine infertility against the background of the proposed treatment complex it was 62% less than in subgroup IIB (p <0.05). The average cortisol level in women with a male factor of infertility was 63% lower than in subgroup IIIB against the background of the proposed complex (p <0.05).Conclusion. Advanced therapy with micronized progesterone in combination with magnesium saturation, L-arginine aspartate, folic acid, ω-3 polyunsaturated fatty acids, as well as long-term psychoemotional correction is appropriate and effective compared to conventional therapy for pregnant women.

scholarly journals Difference between Vascularization Indexes of the Placenta in Severe Pre-eclampsia and Normal Pregnancy by Three-dimensional Power Doppler Ultrasound

2014 ◽  
Vol 8 (4) ◽  
pp. 329-335 ◽  
Author(s):  
Wiku Andonotopo ◽  
Herman Kristanto ◽  
Julian Dewantiningrum ◽  
Besari Adi Pramono
Keyword(s):  
Pregnant Women ◽  
Doppler Ultrasound ◽  
Gestational Age ◽  
Power Doppler ◽  
Three Dimensional ◽  
Normal Pregnancy ◽  
Flow Index ◽  
Control Group ◽  
Power Doppler Ultrasound ◽  
3D Power Doppler

ABSTRACT Aim The object of this study was to analyze the vascularization index of three-dimensional (3D) power Doppler ultrasound (PDUS) of the placenta in severe pre-eclampsia compared with normal pregnancy conditions by vascular biopsy sampling sphere. Subjects and methods This study is a prospective longitudinal observational study on 80 pregnant women which divided into 2 groups: Group I (study group) were 40 pregnant women with severe pre-eclampsia, group II (control group) were 40 pregnant women without disorder. Variables examined in this study were vascular index (VI), flow index (FI) and vascular flow index (VFI) of the 3D-PD placental perfusion. Its correlation to gestational age in normal pregnancy compared with the condition of preeclampsia were obtained by taking multiple biopsy sampling vascular sphere. All pregnant women underwent 3D PD-US examination (single examination only), data volume recorded of the placenta allows for off-line analysis without the presence of the patient, thus allowing the data analysis done anywhere and anytime by observers for the comparative analysis of interobserver reliability. Results The placenta can be visualized perfectly in both of the study group and also the control group. Average Kappa value for the acquisition of placental vascularization index measurements with 3D PD-US was 0.72 (0.61-0.82), 0.73 (0.65-0.82) and 0.71 (0.61-0.81) for VI, FI and VFI in the range of 20 to 38 weeks showed good interobserver reliability. All 3D power Doppler indices had a significant association with gestational age, with VI showed a less significant relationship (r = 0.207, p = 0.0139) and FI has the most significant relationship (r = 0.582, p < 0.001). FI index increased progressively with gestational age, while the VI index values indicate dispersion pattern and reached a plateau from week 30 onwards. Entering week 37th, there was a decrease in the value of the index VI until the end of pregnancy. Meanwhile, VFI index appears to resemble the pattern of a combination of both VI and FI index (r = 0.692, p <0.001). Conclusion All parameters of 3D power Doppler index was lower in the severe pre-eclampsia compared with normal pregnancy. 3D PD-US can be used to assess the vascularization of the placenta and the intensity of intra-placental blood flow. Placental vascular biopsy method is fairly efficient way to perform routine evaluations evolution of placental vascular branch during pregnancy. How to cite this article Andonotopo W, Kristanto H, Dewantiningrum J, Pramono BA. Difference between Vascularization Indexes of the Placenta in Severe Pre-eclampsia and Normal Pregnancy by Three-dimensional Power Doppler Ultrasound. Donald School J Ultrasound Obstet Gynecol 2014;8(4):329-335.

Clinical and microbiological aspects of vaginal microbiota at pregnant with threat of late miscarriages during treatment with vaginal gestagens forms

2017 ◽  
pp. 68-73
Author(s):  
I.P. Polishchuk ◽  
Keyword(s):  
Pregnant Women ◽  
Therapeutic Effect ◽  
Local Treatment ◽  
Vaginal Microbiota ◽  
Control Group ◽  
Before And After ◽  
Low Efficiency ◽  
Late Miscarriage ◽  
Microbiological Aspects ◽  
Micronized Progesterone

The objective: was to examine the effectiveness of treatment of late miscarriage threat by micronized form of progesterone for 100 mg – 3 times a day in the form of gelatin pills and vaginal tablets with lactose. Patients and methods. Under our supervision there were 70 pregnant women with normocenosis of vagina (NCV) without extragenital pathology, which were not performed systemic or local treatment with antibacterial drugs in the last 4 weeks. Among them 25 pregnant women with TLSM treated by gelatin tablets of micronized progesterone (GTP) (group 1); 25 pregnant women with TLSM, treated by vaginal micronized progesterone tablets (VPT) (2nd group) and 20 healthy women with physiological pregnancy – PV (control group). The distribution of women in the group adhered to the principles of randomization. The age of examined women ranged from 19 to 32 years, most pregnant women were aged under 30 years (89.02%). General clinical examination was carried out according to the standard scheme according to the Order MH of Ukraine № 620. Results. During the research we have determined the colpocytologcal dynamics and state of vaginal microbiota in pregnant women with threatened late miscarriage with initial vaginal normocenosis before and after treatment whit vaginal forms of progesterone. Conclusion. The received results showed low efficiency of micronized progesterone gelatin dragee at threat of the late miscarriage that at small therapeutic effect has led to the development of vaginal dysbiosis in all surveyed. In contrast, the use of micronized progesterone vaginal tablets – the maximally rapid therapeutic effect without disturbance of vaginal normocenosis. Key words: the threat of a late miscarriage, vaginal micronized forms of progesterone.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

scholarly journals Modern view on the problem of optimization of therapy in pregnant women with functional cervical insufficiency

2018 ◽  
Vol 22 (1) ◽  
pp. 173-177
Author(s):  
V. F. Oleshko
Keyword(s):  
Blood Serum ◽  
Pregnant Women ◽  
Main Group ◽  
Control Group ◽  
Cervical Insufficiency ◽  
Progesterone Concentration ◽  
Therapeutic Dosage ◽  
Hormonal Balance ◽  
Magnesium Orotate ◽  
Micronized Progesterone

A functional cervical insufficiency plays an important role in the etiology of miscarriage and premature birth. The aim of research was to estimate the hormonal balance indexes during the course of pregnancy in pregnant women with functional cervical insufficiency and to correct the revealed violations in order to prevent obstetric complications. 101 pregnant women with confirmed diagnosis of a functional cervical insufficiency in term of gestation 22–32 weeks of pregnancy (the main group) and 34 pregnant women and women in labor with physiological condition of the cervix (the control group) were examined. The content of estradiol, progesterone, cortisol and prolactin was examined in the blood serum. On the second stage of examination 63 pregnant women obtained general basic therapy (I main group) and 38 pregnant women (II main group) received a developed treatment complex which included progesterone support by the micronized progesterone 200–400 mg twice a day up to 34–35 weeks of pregnancy, magnesium support by the magnesium orotate dehydrate in the therapeutic dosage and arginine glutamate in the therapeutic dosage. The correction of cervical insufficiency was performed with the help of a cervical pessary (according to indications). The examination of hormonal balance revealed an accurate decease of progesterone concentration on the background of high concentration of estradiol and increased levels of stress-associated hormones. Propitious influence of the developed therapy is proved by increase of progesterone concentration in the blood serum, normalization in stress-associated hormones balance according to gestational age. All this provideded the decrease of specific weight of threatened preterm labors, placental dysfunction, vaginitis, bacterial vaginosis and delay the labors up to 38–39 weeks of gestation in 97,4% of pregnant women (82,5% in the I main group). Prescription of micronized progesterone, magnesium orotate dehydrate, arginine glutamate to pregnant women with a cervical insufficiency is reasonable and effective one comparing with general and traditional therapy.

scholarly journals The Effect of Red Seaweed (Kappaphycus alvarezii) Biscuits on Hemoglobin Levels and Body Weight among the First Trimester Pregnant Women

2021 ◽  
Vol 9 (A) ◽  
pp. 1019-1023
Author(s):  
Salma Salma ◽  
Veni Hadju ◽  
Jamaluddin Jompa ◽  
Stang Stang ◽  
Sundari Sundari ◽  
...  
Keyword(s):  
Body Weight ◽  
Pregnant Women ◽  
Kappaphycus Alvarezii ◽  
Community Health Center ◽  
Intervention Group ◽  
First Trimester ◽  
Control Group ◽  
P Value ◽  
Red Seaweed ◽  
Chi Square

BACKGROUND: The prevalence of anemic pregnant women is still reasonably high, especially in low-middleincome countries. AIM: This study was aimed to assess the effect of giving red seaweed (Kappaphycus alvarezii) biscuits on changes in hemoglobin (Hb) levels and body weight of pregnant women in the first trimester. METHODS: The study used a quasi-experiment pretest-posttest study design. The study was conducted from April to June 2021 involving pregnant women in the first trimester who living in the working area of the Wapunto Community Health Center, Muna Regency, Indonesia. A total of 45 pregnant women were selected purposively and assigned to three different groups. The first group was given two pieces of red seaweed biscuits per day. The second group was given two pieces of red seaweed biscuits plus Fe tablets (60 mg/day), and the last group was given Fe tablet only (60 mg/day). Chi-square, paired sample t-test, Wilcoxon, and Kruskal–Wallis tests were performed using SPSS. RESULTS: The intervention group of red seaweed biscuits plus Fe tablets had the highest increase in Hb levels after 8 weeks of intervention, followed by the red seaweed biscuit group and the control group (0.97, 0.78, and 0.60 g/dL, respectively, p-value < 0.05). The red seaweed biscuit intervention group had the highest changes for body weight compared to the red seaweed biscuit plus Fe tablet group and the control group (1.07, 0.43, and 0.04 kg, respectively). CONCLUSION: The provision of red seaweed biscuits could increase maternal Hb level and weight during the first trimester of their pregnancy.

scholarly journals Hematological Changes, Serum Interferon Gamma and Interleukin-4 Alterations in Normal Pregnancy and Preeclampsia

2020 ◽  
Vol 9 (1) ◽  
pp. 44-51
Author(s):  
Shilan Anwar Mawlood ◽  
Bakhtiar Mohamed Mahmoud
Keyword(s):  
Pregnant Women ◽  
Antiphospholipid Antibodies ◽  
Study Groups ◽  
Normal Pregnancy ◽  
Anticardiolipin Antibodies ◽  
Interleukin 4 ◽  
Control Group ◽  
Immunological Parameters ◽  
Immunological Changes ◽  
Hematological Changes

Background: Various hematological and immunological changes can occur in pregnancy which could be beneficial for the growth of the fetus and the maintenance of the pregnancy although some of these changes could be hazardous to the fetus and can cause complications during pregnancy. Thus, this study was conducted to investigate the hematological and immunological changes in normal pregnancy and preeclampsia (PE). Materials and Methods: To this end, hematological and immunological changes were evaluated in 62 normal pregnant women and 56 pregnant women with PE. Moreover, 58 healthy non-pregnant women were studied as the control group. The study was done between December 1, 2018 to May 1, 2019 in Chwarbakh Private Clinic and Shorsh Teaching Hospital. The venous peripheral blood from the antecubital vein was used in this study. Results: The results revealed a significant increase in the number of granulocytes, monocytes, and mean platelet (PLT) volume in both normal pregnant women and PE patients in comparison to normal (non-pregnant) controls (P<0.01). In addition, there was a significant correlation between a reduction in their hematocrit (HCT), PLT, and lymphocytes (P<0.01). With regard to immunological changes, a significant increase was also observed in the serum interleukin-4 (IL-4) levels in both normal pregnancy and preeclamptic patients when compared to non-pregnant controls (P<0.01), but gamma interferon was not significantly different. Conversely, there were no significant associations between the serum level of antiphospholipid antibodies and anticardiolipin antibodies in the study groups except for antiphospholipid antibodies which were significantly lower in the third trimester of pregnancy in the preeclamptic patients (P<0.05). Conclusion: In general, significant changes in hematological and immunological parameters were observed in both normal pregnant and PE patients although further studies are required to include more immunological parameters.

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