Massive Urinary Protein Excretion Associated with Greater Neonatal Risk in Preeclampsia

Mateus, Julio; Newman, Roger B.; Sibai, Baha M.; Li, Qing; Combs, C. Andrew; Guzman, Edwin R.; Boggess, Kim; Gyamfi, Cynthia; Dadelszen, Peter von; Woelkers, Doug

doi:10.1055/s-0037-1601866

Cited by 35 publications

(38 citation statements)

References 33 publications

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“…The current results were similar to those of previous reports of worsening perinatal outcomes with increasing levels of proteinuria; however, in the present study, maternal adverse outcomes were also influenced by proteinuria severity. The mean gestational age at diagnosis of pre‐eclampsia was also similar to that reported in a prior study …”

Section: Discussionsupporting

confidence: 92%

“…The current results were similar to those of previous reports of worsening perinatal outcomes with increasing levels of proteinuria 6,8,10,11 ;…”

Section: Discussionsupporting

confidence: 92%

“…Some studies have shown that high levels of proteinuria are related to poor perinatal outcomes, probably owing to early onset of pre‐eclampsia; however, evidence regarding the influence of urinary protein levels on maternal health is lacking …”

Section: Introductionmentioning

confidence: 99%

“…7 Some studies have shown that high levels of proteinuria are related to poor perinatal outcomes, probably owing to early onset of pre-eclampsia; however, evidence regarding the influence of urinary protein levels on maternal health is lacking. 6,8 The aim of the present study was to assess the impact of proteinuria severity on maternal and perinatal outcomes among women with pre-eclampsia.…”

Section: Introductionmentioning

confidence: 99%

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The impact of proteinuria on maternal and perinatal outcomes among women with pre‐eclampsia

Guida

Parpinelli

Surita

et al. 2018

Intl J Gynecology & Obste

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Section: Discussionsupporting

confidence: 92%

“…The current results were similar to those of previous reports of worsening perinatal outcomes with increasing levels of proteinuria 6,8,10,11 ;…”

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The impact of proteinuria on maternal and perinatal outcomes among women with pre‐eclampsia

Guida

Parpinelli

Surita

et al. 2018

Intl J Gynecology & Obste

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“…In the presence of fetal growth restriction, a recommended schedule for serial fetal surveillance with ultrasound is detailed within these recommendations. 22. Maternal monitoring in pre-eclampsia should include: blood pressure monitoring, repeated assessments for proteinuria if it is not already present, clinical assessment including clonus, and a minimum of twice-weekly blood tests for hemoglobin, platelet count, and tests of liver and renal function, including uric acid, the latter being associated with worse maternal and fetal outcomes.…”

mentioning

confidence: 99%

Hypertensive Disorders of Pregnancy

et al. 2018

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These recommendations from the ISSHP are based upon available literature and expert opinion. It is intended that this be a 'living' document, to be updated when needed as more research becomes available to influence good clinical practice. Unfortunately there is a relative lack of high quality randomised trials in the field of Hypertension in Pregnancy compared with studies in essential hypertension outside of pregnancy and ISSHP encourages greater funding and uptake of collaborative research in this field. Accordingly, the quality of evidence for the recommendations in this document has not been graded, though relevant references and explanations are provided for each recommendation. The document will be a 'living' guideline and we hope to be able to grade recommendations in the future.Guidelines and recommendations for management of hypertension in pregnancy are typically written for implementation in an ideal setting. It is acknowledged that in many parts of the world, it will not be possible to adopt all of these recommendations; for this reason, options for management in less-resourced settings are discussed separately in relation to diagnosis, evaluation, and treatment. This document has been endorsed by the International Society of Obstetric Medicine (ISOM) and the Japanese Society for the Study of Hypertension in Pregnancy (JSSHP). 5 KEY POINTS: All units managing hypertensive pregnant women should maintain and review uniform departmental management protocols and conduct regular audits of maternal & fetal outcomes.The cause(s) of pre-eclampsia and the optimal clinical management of the hypertensive disorders of pregnancy remain uncertain; therefore, we recommend that every hypertensive pregnant woman be offered an opportunity to participate in research, clinical trials and follow-up studies. Classification1. Hypertension in pregnancy may be chronic (pre-dating pregnancy or diagnosed before 20 weeks of pregnancy) or de novo (either pre-eclampsia or gestational hypertension).2. Chronic hypertension is associated with adverse maternal and fetal outcomes and is best managed by tightly controlling maternal blood pressure (BP 110-140/85 mmHg), monitoring fetal growth and repeatedly assessing for the development of pre-eclampsia and maternal complications. This can be done in an outpatient setting.3. White-coat hypertension refers to elevated office/ clinic (≥140/90mmHg) blood pressure but normal blood pressure measured at home or work (<135/85mmHg); it is not an entirely benign condition and conveys an increased risk for pre-eclampsia. 6 4. Masked hypertension is another form of hypertension, more difficult to diagnose, characterised by blood pressure that is normal at a clinic or office visit but elevated at other times, most typically diagnosed by 24 hour ambulatory BP monitoring (ABPM) or automated home blood pressure monitoring (HBPM). 5.Gestational hypertension is hypertension arising de novo after 20 weeks' gestation in the absence of proteinuria and without biochemical or haematological abnormalities. It...

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Evaluation of Fetal Cardiac Functions in Preeclampsia: Does the Severity or Proteinuria Affect Fetal Cardiac Functions?

Hendem

Oluklu

Beşer

et al. 2023

J of Ultrasound Medicine

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ObjectiveTo compare the fetal cardiac functions in preeclampsia and control group, and determine whether the severity or amount of proteinuria affects fetal cardiac functions.MethodsThis prospective case–control study involves 48 pregnant women with preeclampsia and 48 healthy women. Pulsed wave Doppler, M‐mode, and tissue Doppler imaging were used to measure the cardiac function between the 32 and 34 gestational weeks in each group. All Doppler indices and cardiac function parameters were also compared in subgroups with mild and severe preeclampsia and between subgroups with proteinuria >3 g/24 hours and <3 g/24 hours.ResultsDecreased diastolic function (decreased E, A, E′, and A′ values in mitral/tricuspid valves and increased isovolumetric relaxation time) and decreased systolic functions (decreased mitral and tricuspid annular plane systolic excursion and S′ value in mitral/tricuspid valves) were detected in the preeclampsia group. Decreased tricuspid E value in severe preeclampsia compared with mild preeclampsia was shown in the present study.ConclusionPreeclampsia may cause changes in systolic and diastolic functions in the fetal heart. Subclinical functional changes of these fetuses can be detected earlier and more sensitively with the help of tissue Doppler imaging. Biventricular diastolic functional changes are more prominent in preeclamptic cases with proteinuria >3 g/24 hours.

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Massive Urinary Protein Excretion Associated with Greater Neonatal Risk in Preeclampsia

Cited by 35 publications

References 33 publications

The impact of proteinuria on maternal and perinatal outcomes among women with pre‐eclampsia

The impact of proteinuria on maternal and perinatal outcomes among women with pre‐eclampsia

Hypertensive Disorders of Pregnancy

Evaluation of Fetal Cardiac Functions in Preeclampsia: Does the Severity or Proteinuria Affect Fetal Cardiac Functions?

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