Maternal Preeclampsia and Neonatal Outcomes (original) (raw)
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Early Preeclampsia Effect on Preterm Newborns Outcome
Journan of Clinical Medicine, 2022
Background: An early form of preeclampsia is rare. Abnormal placentation, placental perfusion disorders, and inflammatory cytokine release will have an effect on the fetus and newborn. Material and methods: The study group consisted of preterm newborns whose mothers had a history of preeclampsia and a gestational age of between 30 weeks and 34 weeks + 6 days. The control group consists of neonates matched for gestational age with the case group, whose mothers had normal blood pressure. The incidence and severity of respiratory distress syndrome (RDS), intraventricular hemorrhage, hypoglycemia, pH gas changes, and hematological parameters were analyzed in the two groups. Results: The study group of preterm neonates had a lower birth weight than the control group (p < 0.001). Most of the deliveries in the group of newborns exposed to preeclampsia were performed by cesarean section. Severe forms of RDS were two times more frequent in the group of newborns exposed to preeclampsia compared to those in the control group. Even though we expected to see a lower incidence, owing to the high number of deliveries by cesarean section, we still observed a higher rate of intraventricular hemorrhage in the preeclampsia group (16 cases in the study group vs. 7 in the control, p = 0.085). Neutropenia and thrombocytopenia were more frequent in preterm newborns exposed to preeclampsia. Conclusions: The study shows that early preeclampsia increases the risk of complications in preterm neonates. RDS was more frequent in the exposed group than in the control group. The severity of preeclampsia correlates with hematological changes.
756: Mode of delivery and neonatal outcomes in patients with severe preeclampsia
American Journal of Obstetrics and Gynecology, 2011
The aim of this study was to compare neonatal outcome of patients with severe preeclampsia delivered via vaginal delivery (VD) vs. those delivered via cesarean section (CS). STUDY DESIGN: Patients who developed severe preeclampsia before delivery were included in this study. Data were gathered from our obstetrical database on deliveries in our hospital from 1990 to 2005. Severe preeclampsia cases were selected from the group of obstetrical complications. Patients without severe preeclampsia served as the control group. Neonatal outcome included an Apgar score of Ͻ7 at 5 minutes and/or admission to the neonatal intensive care unit (NICU). We controlled for gestational age (GA). Binary logistic regression was used in the statistical analysis. A p Ͻ .05 was used to indicate statistical significance. RESULTS: 1377 patients were identified. The patients were divided into three groups: Group A, patients who underwent labor followed by CS (nϭ 414); Group B, patients who had an indicated CS (nϭ 475) and Group C patients who delivered vaginally (nϭ 488). GA at delivery ranged from 26.4 to 42.0 weeks (median: 36.0 weeks) for patients in Group A. It was between 24.0 to 40.5 weeks (median: 31.1 weeks) in the patients of Group B, and between 24.6 and 41.6 weeks (median: 37.6 weeks) for the patients in Group C. The neonates with an Apgar Ͻ 7 at 5 minutes were 58 in Group A, 106 in Group B, and 25 in Group C. There were 125 neonates who were admitted to the NICU in Group A, 275 in Group B and 41 in Group C. A statistically significant increase in the number of patients with an Apgar score Ͻ7 at 5 min was noted in Group A (p Ͻ .05) Number of admissions to the NICU was significantly increased in groups A and B (p Ͻ .05). CONCLUSIONS: These data indicate that in patients who develop severe preeclampsia, VD decreases the risk of 5 min Apgar score of Ͻ7 and admission to the NICU. VD should be strongly considered in patients who develop severe preeclampsia.
Early Human Development, 2004
Background and objective: In the literature, there are conflicting data on the neonatal outcome in preterm infants who were delivered for maternal pre-eclampsia. The purpose of this study is to investigate the effect of maternal pre-eclampsia on neonatal morbidity and 2-year developmental outcome in a population of preterm infants delivered before 32 weeks of gestation. Methods: The hospital records of all 89 surviving VLBW infants with GA below 32 weeks born from January 1997 to December 1999 were reviewed retrospectively. Data on respiratory outcome, sepsis and intraventricular hemorrhage (IVH) were compiled and analyzed for their association to maternal preeclampsia. Seventy-eight infants were assessed employing the Bayley Scales of Infant Development for developmental outcome at 2 years of corrected age. Results: There was no difference in neonatal morbidity between groups. More infants born to pre-eclamptic mothers had lower MDI scores at 24 months of age ( P = 0.04) as compared to infants without maternal pre-eclampsia. After multiple logistic regression analysis, pre-eclampsia ( P = 0.007, OR = 10.8) remained a significant risk factor of mildly delayed MDI at 24 months of age. Conclusion: Delivery before 32 weeks because of pre-eclampsia was associated with an increased risk of poor cognitive outcome. There was no significant difference in the postnatal course in comparison with infants born after pregnancies not complicated by pre-eclampsia.
Maternal and Neonatal Outcomes in Women with Preeclampsia
Background: Preeclampsia is a pregnancy-specific hypertensive syndrome associated with significant morbidity and mortality in mother and neonate. It is the 3 rd leading cause of maternal mortality and is responsible for 15-20% of maternal mortality and is a major cause of neonatal morbidity and mortality. Objective: The objective of this study was the effects of pre-eclampsia associated with maternal complications, pregnancy outcome and neonatal complications. Materials and Methods: A hospital based descriptive observational study was conducted from July to December 2017.All pre-eclampsia associated with complications were included. Data obtained that included maternal age, systolic and diastolic blood pressures, gestational age at diagnosis, gestational age at delivery, associated maternal complications, pregnancy outcome, mortality, birth-weight and neonatal complications. Results: The mean parity was higher in the normotensive group than in the preeclamptic patients (2.3+0.65 vs 3.6+0.74;p =<0.05).cesarian section rates were significantly higher in the group with preeclampsia than in the control group, in the preeclamptic women undergoing vaginal delivery,31% of them underwent induction of labour. The most common complication associated with preeclampsia is eclampsia (21%). The most common indication for induction of labour was severity of pre eclampsia among the patients 9% of them were admitted with intra uterine demise, while 91 neonates survived. The most common causes of neonatal mortality were congenital abnormalities and respiratory distress syndrome. Conclusion: Gestational age, parity, cesarean section rate, the rate of induced labor, and low birth weight neonates were more frequent in pre-eclamptic women than in healthy pregnant women
Early Preterm Preeclampsia Outcomes by Intended Mode of Delivery
American journal of obstetrics and gynecology, 2018
The optimal route of delivery in early onset preeclampsia before 34 weeks is debated, as many clinicians are reluctant to proceed with induction for perceived high risk of failure. Our objective was to investigate labor induction success rates and compare maternal and neonatal outcomes, by intended mode of delivery in women with early preterm preeclampsia. We identified 914 singleton pregnancies with preeclampsia in the Consortium on Safe Labor study for analysis who delivered between 24 0/7 and 33 6/7 weeks. We excluded fetal anomalies, antepartum stillbirth or spontaneous preterm labor. Maternal and neonatal outcomes were compared between women undergoing induction of labor (n=460) and planned cesarean delivery (n=454) and women with successful induction of labor (n=214) and unsuccessful induction of labor (n=246). We calculated relative risks (RRs) and 95% confidence intervals (CIs) to determine outcomes by Poisson regression model with propensity score adjustment. The calculatio...
Bjog: An International Journal Of Obstetrics And Gynaecology, 2017
Objective To describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre-eclampsia before 26 weeks of gestation. Design Nationwide case series. Setting All Dutch tertiary perinatal care centres. Population All women diagnosed with severe pre-eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014. Methods Women were identified through computerised hospital databases. Data were collected from medical records. Main outcome measures Maternal complications [HELLP (haemolysis, elevated liver enzyme levels, and low platelet levels) syndrome, eclampsia, pulmonary oedema, cerebrovascular incidents, hepatic capsular rupture, placenta abruption, renal failure, and maternal death], neonatal survival and complications (intraventricular haemorrhage, retinopathy of prematurity, necrotising enterocolitis, bronchopulmonary dysplasia, and sepsis), and outcome of subsequent pregnancies (recurrent pre-eclampsia, premature delivery, and neonatal survival). Results We studied 133 women, delivering 140 children. Maternal complications occurred frequently (54%). Deterioration of HELLP syndrome during expectant care occurred in 48%, after 4 days. Median prolongation was 5 days (range: 0-25 days). Neonatal survival was poor (19%), and was worse (6.6%) if the mother was admitted before 24 weeks of gestation. Complications occurred frequently among survivors (84%). After active support, neonatal survival was comparable with the survival of spontaneous premature neonates (54%). Pre-eclampsia recurred in 31%, at a mean gestational age of 32 weeks and 6 days. Conclusions Considering the limits of prolongation, women need to be counselled carefully, weighing the high risk for maternal complications versus limited neonatal survival and/or extreme prematurity and its sequelae. The positive prospects regarding maternal and neonatal outcome in future pregnancies can supplement counselling.
Neonatal outcomes of early- and late-onset preeclampsia
The Turkish Journal of Pediatrics, 2020
Background. The aim of the current study was to demonstrate the neonatal outcomes of infants born to mothers with early-onset preeclampsia (EP) and late-onset preeclampsia (LP), and compare the neonatal outcomes before and after 34 weeks of gestation in EP group. Methods. In this retrospective study, we evaluated preeclamptic mother and child pairs who were followedup at Hacettepe University Hospital between the years 2010 and 2017. The pregnant women were classified as having EP if diagnosed before 34 weeks of gestation (n=91) and LP if diagnosed after 34 weeks of gestation (n=34). The women in the EP group were further divided into subgroups according to the gestational week at birth, including those who gave birth before 34 weeks of gestation (early birth; n=57) and after 34 weeks of gestation (late birth; n=34). Necessary clinical and demographic data were withdrawn from the electronic registry and patient files. Results. Neonates in the EP/late birth subgroup had significantly lower gestational age and birthweight. Small for gestational age (SGA) frequency was higher in the early-onset subgroup born after 34 weeks' gestation compared to the late-onset preeclampsia group (p= 0,016). The incidence of neutropenia was significantly higher in the EP/late birth subgroup than in the LP group (p= 0.002). After correcting for gestational week and birth weight, neutrophil count was still significantly lower in the EP/late birth subgroup (p= 0.002). EP/late birth subgroup and LP group had comparable outcomes regardless of neutrophil count and SGA rate. Conclusions. Close follow up and postponing delivery in stable and appropriate pregnant women with preeclampsia would be beneficial for neonates.
Maternal, fetal and new born outcomes in pre-eclampsia and eclampsia: a hospital based study
Health Renaissance, 2015
Background: Pre-eclampsia /Eclampsia are becoming a leading cause of maternal and neonatal morbidity and mortality in developed and developing countries. Developing countries are at higher risk of facing this problem. Objective: To assess the maternal, fetal / newborn outcome of pre-eclampsia and eclampsia among mothers admitted in maternity ward of BPKIHS. Methods: This is a hospital based cross sectional study carried out in maternity ward at BPKIHS. A total 150 pregnant women (diagnosed of preeclampsia/eclampsia cases-75 and controls-75) included using purposive sampling technique. Data was collected using self-developed pretested, semi structured performa by the interview. Detailed physical examination and observations were also done. Results: Preterm delivery, early rupture of membrane, need for an assisted vaginal delivery (vacuum and forceps) and caesarean delivery, were significantly higher in cases than controls (P < 0.001). Abnormal range of fetal heart rate, still birth, intrauterine fetal death, birth asphyxia ,need for resuscitation, low birth weight and intrauterine growth retardation were significantly higher in cases than controls (P <0.001). Conclusion: Maternal, fetal and newborn outcome such as preterm delivery, caesarean section, birth asphyxia, low birth weight and intrauterine fetal death are more common seen among women who were diagnosed with preeclampsia /eclampsia than normal pregnancy. It is very important of early identification and prompt management to prevent complication of both mother and fetus.
Pregnancy Hypertension, 2021
This secondary analysis of the PHOENIX trial (evaluating planned delivery against expectant management in late preterm preeclampsia) demonstrates that in women who started induction of labour, 63% of women delivered vaginally (56% at 34 weeks' gestation). Compared to expectant management, planned delivery was associated with higher rates of neonatal unit admission for prematurity (but lower proportions of small-for-gestational age infants); length of neonatal unit stay and neonatal morbidity (including respiratory support) were similar across both intervention groups at all gestational windows. Neonatal unit admission was increased by earlier gestation at delivery, development of severe preeclampsia, and being small-for-gestational age.