Clinical realization for different types of preeclampsia (results of a double-centre retrospective study)
Aim of study. To determine specific clinical and diagnostic predictors and symptoms of different preeclampsia phenotypes. Material and methods. A double-centre retrospective case-control study was performed including analysis of somatic status data, obstetric and gynaecological history and peculiarities in pregnancy progression and delivery of 373 female patients. The control group was constituted by 200 female subjects whose physiological pregnancy concluded with term delivery. The main group enrolled 173 patients, the course of pregnancy of which was complicated by development of severe preeclampsia (PE) including placental PE (early) - 44 cases (25%) and severe maternal PE (late) - 129 cases (75%). Over 100 potential clinical and anamnestic risk factors for PE, peculiarities in pregnancy progression and delivery outcomes have been analysed. Results. Despite of the similarity between clinical parameters of different PE phenotypes, placental PE (pPE) is characterised by a more significant arterial hypertension (p=0.0311) and proteinuria (p=0.0005) growing over the course of a day. Therewith, a reliable correlation has been established between the level of diastolic blood pressure and proteinuria (OR=0.87; 95% CI 0.77-0.93; p<0.0001). Maternal PE (mPE) is characterised by growth of symptoms within the period of 1-3 weeks. Significantly more frequently, maternal PE is developed against the background of pathological BMI growth (OR=4.1, p=0.105) and gestational diabetes mellitus (OR=3.6; p=0.0432). Perinatal outcomes in pPE are characterised by high rates of stillbirth (22.7%) and fetal growth retardation (82.6%). Conclusion. Placental (early) PE is characterised by a more severe progression with specific clinical and ultrasound predictors, which makes it possible to outline a cohort of females for closer monitoring and preventive procedures.