Pre-eclampsia is known to cause considerable maternal morbidity and mortality. Thus, many studies have examined the etiopathogenesis of pre-eclampsia. While many pathophysiological factors related to pre-eclampsia have been identified, the precise etiopathogenesis of pre-eclampsia remains unclear. Numerous studies have identified factors for the early prediction for pre-eclampsia to lead to preparation and closer observation on pre-eclampsia when it occurs. This article reviews on current studies of biomarkers and genetic factors related to pre-eclampsia, which may be important for developing strategies for early prediction of pre-eclampsia.
Biomarkers* ; Early Diagnosis ; Mortality ; Pre-Eclampsia*

Female ; Pregnancy ; Humans ; Pre-Eclampsia/diagnosis*

The diagnosis of HELLP syndrome associated with preeclampsia-eclampsia during pregnancy uses three test results, including hemolysis, elevated liver enzyme, low platelets and their related clinical symptoms. Liver rupture is a life-threatening and rare complication related to HELLP syndrome. Early diagnosis and rapid treatment are very important for protecting the life of the patient and the fetus. We are reporting an anesthetic experience a sudden-onset suspicious HELLP syndrome with an intraperitoneal hemorrhage caused by a rapidly progressed liver rupture in a severe preeclampsia patient without any abnormalities during gestation.
Diagnosis ; Early Diagnosis ; Eclampsia ; Female ; Fetus ; HELLP Syndrome* ; Hemolysis ; Hemorrhage* ; Humans ; Liver* ; Pre-Eclampsia* ; Pregnancy ; Rupture*

Although the technique of antenatal care is developed, the incidence of late postpartum eclampsia has been increased and its prevention is difficult. In addition, the diagnosis is more difficult if the patient did not show any symptoms of preeclampsia before delivery. We described one case of late postpartum eclampsia that occurred on 7th day after preterm delivery and has not been diagnosed before delivery including a review of this literature.
Diagnosis ; Eclampsia* ; Female ; Humans ; Incidence ; Obstetric Labor, Premature ; Postpartum Period* ; Pre-Eclampsia ; Pregnancy

Objective: To explore the association between coagulation function indicators and placental abruption (PA) in different trimesters of pregnancy among preeclampsia-eclampsia pregnant women. Methods: From February 2018 to December 2020, pregnant women who participated in the China birth cohort study and were diagnosed with preeclampsia, eclampsia and chronic hypertension with superimposed preeclampsia in Beijing Obstetrics and Gynecology Hospital were enrolled in this study. The baseline and follow-up information were collected by questionnaire survey, and the coagulation function indicators in the first and third trimesters were obtained through medical records. The Cox proportional hazards model was used to analyze the association between the coagulation function indicators and PA. A restrictive cubic spline curve was used to draw the dose-response curve between the relevant coagulation function indicators and PA. Results: A total of 1 340 participants were included in this study. The age was (32.50±4.24) and the incidence of PA was 4.4% (59/1 340). After adjusting for relevant factors, Cox proportional hazards model showed that compared with the high-level classification of fibrinogen (FIB), participants within the middle-(HR=3.28, 95%CI: 1.27-8.48) and low-level (HR=3.84, 95%CI: 1.40-10.53) classification during the first trimester and within the low-level classification (HR=4.18, 95%CI: 1.68-10.39) during the third trimester were more likely to experience PA. Compared with the middle-level classification of pro-thrombin time (PT), the risk of PA in the participants within the low-level classification (HR=2.67, 95%CI: 1.48-4.82) was significantly higher in the third trimester. The restrictive cubic spline analysis showed a linear negative association between FIB and PA in the first and third trimesters, while PT and PA showed an approximately L-shaped association . Conclusion: Among pregnant women diagnosed with preeclampsia-eclampsia, the middle-and low-level classification of FIB in the first and third trimesters and the low-level classification of PT in the third trimester could increase the risk of PA.
Pregnancy ; Female ; Humans ; Pre-Eclampsia/diagnosis* ; Abruptio Placentae/epidemiology* ; Pregnant Women ; Eclampsia ; Cohort Studies ; Placenta

Cerebrovascular disorders (infarction and intracranial hemorrhage), otherwise collectively referred to as stroke, are an uncommon and feared complication of pregnancy. Collectively, these disorders contribute up to 12% of all maternal deaths. Because of the common presentation with seizures, hypertension, proteinuria, and visual disturbance there has been diagnostic confusion with eclampsia, especially when cerebrovascular disorders occur antepartum or intrapartum. This case is intended to assist the clinician with clues for prompt diagnosis and therapy for this uncommon and unpreventable medical complication of pregnancy.
Cerebral Hemorrhage* ; Cerebrovascular Disorders ; Diagnosis ; Eclampsia ; Female ; Hypertension ; Intracranial Hemorrhages ; Maternal Death ; Pre-Eclampsia* ; Pregnancy ; Proteinuria ; Seizures ; Stroke

Clinical observation was performed on 1412 cases of neonates which was seen at S.N.U.H. during the past 2years from Jan. 1975 to Dec. 1976. The results ware as following: 1. The incidence of prematurity (below 38wks) was 12.1% and the incidence of S.B.W. was 9.8% 2. The mortality rate of prematurity and L.B.W. was 7.35%. 3. The average sex ration of male to female was: Total neonates: 1.14:1 Prematurity: 1.06:1 : 0.88:1 4. High incidence of prematurity and L.B.W. was peaked on Dec. and Feb. 5. The mortaity rate was: under 1000gm: 100% under 1500gm: 50% under 24wks:100% under 30wks: 63% So liability was increased after 30wks and 1500gm. 6. The aberage duration of admission date was: 1000~1500gm: 30days 1500~2000gm: 20days 2000~2500gm: 5~8days 7. The relating factors to prematurity and L.B.W. was C-section, preeclampsia and eclampsia, twin, breech delivery and congenital syhpilis. 8. Autopsy was done only one cases, and the diagnosis ws primary atelecasis. 9. High mortality was seen from Dec. to Feb. and nearly within 24 hours. 10. Low incidence was seen 20~24 maternal age group. 11. High incidence rate in primipars (49.5%). 12. The physiologic weight loss was seen about 4~% days, aerage 9% (167.0gm). 13. Weight gain was: under 1250gm: 14.2gm/d over 1250gm: 27.5gm/d 14. Average discharge weight was (over 5 days admission): 2150gm.
Autopsy ; Diagnosis ; Eclampsia ; Female ; Humans ; Incidence ; Infant, Newborn ; Male ; Maternal Age ; Mortality ; Pre-Eclampsia ; Pregnancy ; Twins ; Weight Gain ; Weight Loss

Of 119 full-term pregnant subjects studied from October, 1995 to March, 1996, 79 hadpreeclampsia(severe; 43, mild; 36) and 40 were normotensive controls. The plasma fibronectinlevels of each subject were assayed by turbidometric immunoassy(Boehringer Mannheim).The objective of this study was to evaluate the relationship of plasma fibronectin withpreeclampsia as a marker for vascular injury.The results were as follows:1. There were significant differences of plasma fibronectin values among the normotensivepregnancy, mild preeclampsia and severe preeclampsia. Within each group of patients,plasm a fibronectin values were 101.7 +/- 59.4 ng/ml and 249.7 +/- 96.3 ng/ml and 329.2 +/- 169.5 ng/ml, respectively (p < 0.001).2. Plasma fibronectin values had positive correlations with severity of preeclampsia,proteinuria, diastlic blood pressure and systolic blood pressure, but negative correlationswith birth weight and platelet count(p < 0.001).3. When the severity of proteinuria on preeclampsia were +1, +2, and +3 or more,plasma fibr onectin values revealed 246.0 +/- 93.3 ng/ml, 342.3 +/- 185.1 ng/ml and 345.0 +/- 168.1ng/ml, respectively and there were significant differences among three groups.4. To verify the variables correlated with plasma fibronectin by using mutiple regressionanalysis, the only variable which was selected significantly was the severity of preeclampsia(r(2) : 0.529).5. With receiver operating characteristic(ROC) curve analysis of the relationship betweenplasma fibronectin values and preeclampsia, if cut off value was selected at the levelof 175ng/ml or more, the sensitivity for diagnosis of preeclampsia was 87.3%, specificity90.0%, positive predictive value 94.5%, and negative predictive value 78.3%, respectively.
Birth Weight ; Blood Platelets ; Blood Pressure ; Diagnosis ; Fibronectins* ; Plasma* ; Pre-Eclampsia* ; Proteinuria

Pheochromocytoma is an extremely rare tumor in pregnant women with potentially fatal consequences. We report a case of pregnant woman at 22 weeks of gestation with pheochromocytoma. A correct diagnosis on the basis of differential clues from severe preeclampsia was obtained and laparoscopic adrenalectomy was performed.
Adrenalectomy* ; Diagnosis ; Female ; Humans ; Laparoscopy ; Pheochromocytoma* ; Pre-Eclampsia ; Pregnancy* ; Pregnant Women

Objective: To explore the associations between blood pressure trajectories during pregnancy and risk of future pre-eclampsia in a large cohort enrolling pregnant women at gestational age of ~12 weeks from community hospitals in Tianjin. Latent class growth modeling (LCGM) was used to model the blood pressure trajectories. Methods: This was a large prospective cohort study. The study enrolled pregnant women of ~12 weeks of gestation in 19 community hospitals in Tianjin from November 1, 2016 to May 30, 2018. We obtained related information during 5 antepartum examinations before gestational week 28, i.e., week 12, week 16, week 20, week 24 and week 28. LCGM was used to model longitudinal systolic (SBP) and diastolic blood pressure (DBP) trajectories. For the association study, the predictors were set as SBP and DBP trajectory membership (built separately), the outcome was defined as the occurrence of preeclampsia after 28 weeks of gestation. Results: A total of 5 809 cases with known pregnant outcomes were documented. After excluding 249 cases per exclusion criteria, 5 560 cases with singleton pregnancy were included for final analysis. There were 128 cases preeclampsia and 106 cases gestational hypertension in this cohort. Univariate logistic regression and multivariate logistic regression showed the higher baseline SBP level and DBP level were related with increased risk of preeclampsia. Four distinctive SBP trajectories and DBP trajectories from 12 weeks to 28 weeks of gestation were identified by LCGM. After controlling for potential confounders (baseline BMI, being primipara or not, white blood cell counts, hemoglobin level, platelet counts and alanine aminotransferase level), the OR for SBP latent classification trajectory_ 4 was 4.023 (95%CI: 2.368 to 6.835, P<0.001), and the OR for SBP latent classification trajectory_3 was 1.854 (95%CI: 1.223 to 2.811, P=0.004). Logistic regression showed that: using the DBP latent classification trajectory_1 as the reference group, the OR for DBP latent classification trajectory_4 was 4.100 (95%CI: 2.571 to 6.538, P<0.001), and 2.632 (95%CI: 1.570 to 4.414, P<0.001) for DBP latent classification trajectory_2. After controlling for potential confounders (baseline BMI, being primipara or not, white blood cell counts, hemoglobin level, platelet counts and alanine aminotransferase level), the OR for DBP_traj_4 was 2.527 (95%CI: 1.534 to 4.162, P<0.001), and the OR for DBP_traj_3 was 1.297 (95%CI: 0.790 to 2.128, P=0.303), and 2.238 (95%CI: 1.328 to 3.772, P=0.002) for DBP_traj_2. Therefore, BP trajectories from 12 weeks to 28 weeks identified by LCGM served as novel risk factors that independently associated with the occurrence of preeclampsia. Receiver operating characteristic (ROC) curve analysis showed incremental diagnostic performance by combing baseline blood pressure levels with blood pressure trajectories. Conclusion: By applying LCGM, we for the first time identified distinctive BP trajectories from gestational week 12 to 28, which can independently predict the development of preeclampsia after 28 weeks of gestation.
Female ; Humans ; Pregnancy ; Infant ; Blood Pressure ; Pre-Eclampsia/diagnosis* ; Prospective Studies ; Gestational Age ; Alanine Transaminase ; Hemoglobins