OBSTETRIC AND PERINATAL OUTCOMES IN PREGNANCY WITH DIFFERENT SEVERITY AND TIME OF THE MANIFESTATION OF PREECLAMPSIA
DOI:
https://doi.org/10.11603/24116-4944.2018.2.9572Keywords:
pregnancy, preeclampsia, obstetriс, perinatal outcomesAbstract
The aim of the study – to conduct a retrospective analysis of the course of pregnancy and delivery to determine the nature of obstetric and perinatal complications in preeclampsia.
Materials and Methods. The analysis was based on the results of the evaluation of the medical documentation (individual medical records of the pregnant woman, birth histories, developmental histories of the newborn) in 224 pregnant women with preeclampsia and 80 pregnant women without preeclampsia. In addition to the results of the clinical and laboratory examination, the analysis included the severity of preeclampsia and the time of clinical manifestations. The results of the study were statistically processed by methods of mathematical analysis with the determination of the mean values (M ± m), Student's t-test and significance factor (р˂0.050 difference was statistically significant.
Results and Discussion. According to the results of the analysis, mild preeclampsia was found in 32.6 % of cases, moderate PE – in 37.5 %, severe PE – in 29.9 % of cases. The early onset of PE (up to 34 weeks) was observed in 35.7 % of pregnant women, and later onset (after 34 weeks) in 64.7 %. The analysis of the incidence of early and late PE cases at various severity levels showed that, in the case of early PE, severe disease was 2.9 times more frequent, and the moderate disease was 2.7 times more frequent than the mild disease. In the late PE, the mild PE was 1.9 times more frequent than the severe PE and 1.2 times more frequent than the moderate PE. In addition to PE, 31.7 % of women had other complications of pregnancy. The most common complications include asymptomatic bacteriuria (16.9 %), abnormal placental location (14.1 %), placental dysfunction (32.4 %), and fetal growth retardation (21.1 %). Term delivery occurred in 81.6 % of cases, premature births were in 18.3 %. Complications include premature rupture of membranes, anomalies of labor, premature detachment of the normally located placenta, postpartum hemorrhage. Among perinatal complications, fetal growth retardation, hemodynamic disorders, fetal distress, newborn asphyxia have been observed. The adverse outcome for a child in severe PE was 3 times higher than for mild PE.
Conclusion. The analysis showed that obstetric and perinatal outcomes in preeclampsia are associated with the time of this pregnancy complication and its severity.
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