Search citation statements
Paper Sections
Citation Types
Year Published
Publication Types
Relationship
Authors
Journals
Introduction. In obstetrics, hypertensive disorders of pregnancy (HDP) including preeclampsia (РЕ) are one of the primary causes resulting in critical cases and maternal mortality. HDP prediction is a milestone that allows preventing complications as well as reducing the number of most common relevant complications of pregnancy. Existing algorithms that predict PE risk distribute the risks in such a way that a considerable number of patients fall into the category of false negative results, and, consequently, receive no timely prevention and proper follow-up. In particular, this cohort usually consists of patients with borderline high risks, who may be designated as a medium risk group or located in a “gray” zone. Aim: to develop a prognostic model for risk stratification in female patients with borderline to high developing PE risk based on combined first-trimester screening. Materials and Methods. A prospective comparative study included 1089 female patients who underwent a combined screening at 11–14 weeks of gestation. Group 1 consisted of female patients at high РЕ risk (1:100 and greater), while female patients at moderate risk (1:101–1:250) and low risk (below 1:250) were included into Group 2 and Group 3, respectively. All pregnant women underwent examination including assessed anamnestic, general clinical and laboratory data, mean blood pressure (BP), uterine artery pulsatility index, serum level of human chorionic gonadotropin beta-subunits (β-hCG), placental growth factor (PlGF), pregnancy-associated plasma protein-A (PAPP-A). Results. An impact of various factors on risk of developing hypertensive disorders in pregnancy was assessed by binary logistic regression by identifying most significant among them and generating a statistical prediction model – the prognostic index of hypertensive disorders in pregnancy. The latter included: obstetric history, body mass index, PlGF, mean ВР, and alanine aminotransferase level. The sensitivity and specificity comprised 91.2 and 53.6 %, respectively, and the method effectivenesswas 81.8 %. Conclusion. The method proposed for HDP prediction is a second-line approach that may be used in clinical practice to stratify patients with borderline high risk of developing PE.
Introduction. In obstetrics, hypertensive disorders of pregnancy (HDP) including preeclampsia (РЕ) are one of the primary causes resulting in critical cases and maternal mortality. HDP prediction is a milestone that allows preventing complications as well as reducing the number of most common relevant complications of pregnancy. Existing algorithms that predict PE risk distribute the risks in such a way that a considerable number of patients fall into the category of false negative results, and, consequently, receive no timely prevention and proper follow-up. In particular, this cohort usually consists of patients with borderline high risks, who may be designated as a medium risk group or located in a “gray” zone. Aim: to develop a prognostic model for risk stratification in female patients with borderline to high developing PE risk based on combined first-trimester screening. Materials and Methods. A prospective comparative study included 1089 female patients who underwent a combined screening at 11–14 weeks of gestation. Group 1 consisted of female patients at high РЕ risk (1:100 and greater), while female patients at moderate risk (1:101–1:250) and low risk (below 1:250) were included into Group 2 and Group 3, respectively. All pregnant women underwent examination including assessed anamnestic, general clinical and laboratory data, mean blood pressure (BP), uterine artery pulsatility index, serum level of human chorionic gonadotropin beta-subunits (β-hCG), placental growth factor (PlGF), pregnancy-associated plasma protein-A (PAPP-A). Results. An impact of various factors on risk of developing hypertensive disorders in pregnancy was assessed by binary logistic regression by identifying most significant among them and generating a statistical prediction model – the prognostic index of hypertensive disorders in pregnancy. The latter included: obstetric history, body mass index, PlGF, mean ВР, and alanine aminotransferase level. The sensitivity and specificity comprised 91.2 and 53.6 %, respectively, and the method effectivenesswas 81.8 %. Conclusion. The method proposed for HDP prediction is a second-line approach that may be used in clinical practice to stratify patients with borderline high risk of developing PE.
Aim: to assess the molecular mechanisms in developing various clinical phenotypes of preeclampsia (PE) by analyzing specific placental tissue transcriptome patterns.Materials and Methods. The prospective observational comparative study in parallel groups enrolled 43 pregnant women divided into 2 groups: main group – 23 pregnant women with diagnosed PE and control group – 20 apparently healthy women with uncomplicated pregnancy course, delivery and the postpartum period. To examine PE phenotypic features, the main group of pregnant women with PE was subsequently divided into 2 subgroups according to the date of pathology onset: early (n = 10) and late (n = 13) PE. Using the whole-genome next-generation sequencing (NGS), a comparative analysis of altered 18 microRNA level in placental tissue was carried out.Results. Pregnant women with early PE compared to the control group were characterized by significantly low expression level for hsa-miR-656-3p (p < 0.001), hsa-miR-323a-5p (p = 0.017), hsa-miR-519c-3p (p = 0.019), hsa-let-7i-5p (p = 0.019), hsa-miR-433-3p (p = 0.019), hsa-let-7g-5p (p = 0.030), hsa-miR-214-5p (p = 0.030), hsa-miR-27a-5p (p = 0.031), hsa-miR-339-5p (p = 0.041), hsa-miR-524-5p (p = 0.045), hsa-miR-1283 (p = 0.049) and high expression for hsa-miR-151a-5p (p = 0.007), hsa-miR-4521 (p = 0.018), hsa-miR-30d-5p (p = 0.026), hsa-miR-548l (p = 0.027), hsa-miR-133b (p = 0.034), hsa-miR-424-5p (p = 0.042), hsa-miR-211-5p (p = 0.049). Patients with late PE had significantly decreased expression for hsa-miR-656-3p (p = 0.050) and hsa-miR-574-3p (p = 0.017) as well as a significantly higher for hsa-miR-211-5p (p = 0.001) compared to the control group. Subgroup of women with early vs. late onset PE was characterized by significantly decreased expression level for hsa-miR-323-5p (p = 0.007) and overexpressed hsa-miR-30d-5p (p = 0.002), hsa-miR-5481 (p = 0.027).Conclusion. The noted multidirectional expression for some microRNAs in subgroups of PE patients confirms the validity for stratification of such pathology based on two distinct phenotypic manifestations (early and late forms) and indicates the existence of different pathophysiological vectors in PE formation.
Objective. To study the features of hypertensive disorders formation in pregnancy depending on the period and clinical form on the example of the population of Sverdlovsk region. Materials and methods. The outcomes of 217 pregnant women with moderate and severe preeclampsia and gestational hypertension were analyzed (41, 74, and 102 cases, respectively). Results. The severe preeclampsia group had the highest rate of fetal growth restriction (14.6 %), low birth weight -2045 g (1640–2650), preterm delivery (63.4 %), and cesarean delivery (87.8 %). A detailed analysis of 28 cases of gestational hypertension lasting up to 34 weeks was performed. The analysis revealed significant challenges in the differential diagnosis of this pregnancy complication, not only in terms of clinical manifestations, but also in terms of timely diagnosis in general. Conclusions. The findings of this study spark a debate over the use of severity-based classification in clinical practice, which lessens the doctor's vigilance in milder forms that, however, result in equally serious complications. This raises the question of whether unified tactical approaches should be used in this pathology.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.