Severe preeclampsia and HELLP syndrome at 18 weeks gestation
- Authors: Belokrinitskaya T.E.1, Frolova N.I.1, Kargina D.S.2, Zolotukhina A.O.3, Agarkova M.A.1
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Affiliations:
- Chita State Medical Academy, Ministry of Health of Russia
- Transbaikal Regional Hospital, Chita
- Transbaikal Regional Pathoanatomical Bureau
- Issue: No 7 (2024)
- Pages: 136-144
- Section: Guidelines for the Practitioner
- URL: https://journals.eco-vector.com/0300-9092/article/view/635303
- DOI: https://doi.org/10.18565/aig.2024.58
- ID: 635303
Cite item
Abstract
Background: According to the current Russian and international clinical guidelines, preeclampsia is a complication of pregnancy, childbirth and postpartum period characterized by an increase in systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg after 20 weeks gestation, regardless of the BP level in the patient’s history, combined with proteinuria or at least another parameter indicating the onset of multi-organ failure. However, preeclampsia is generally known to occur before 20 weeks gestation in patients with molar pregnancy.
Case report: The article presents a clinical observation of a case of severe preeclampsia complicated by HELLP syndrome at 18 weeks gestation in a healthy patient at high risk of developing preeclampsia who did not receive acetylsalicylic acid prophylaxis. The clinical case has a favorable outcome for the mother but it resulted in the fetal loss.
Conclusion: It is recommended to determine biochemical markers (PlGF or PlGF/sFlt-1 ratio) in order to improve the efficiency of prenatal screening and to identify the risk group for the development of preeclampsia before 20 weeks gestation. The effects of acetylsalicylic acid on the prevention of preeclampsia before 20 weeks gestation have not been studied yet due to the rare incidence of atypical course of this complication. It is necessary to conduct international registry studies to establish new criteria for the prognosis of early-onset preeclampsia and to reconsider the current definition.
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About the authors
Tatiana E. Belokrinitskaya
Chita State Medical Academy, Ministry of Health of Russia
Author for correspondence.
Email: tanbell24@mail.ru
ORCID iD: 0000-0002-5447-4223
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology of Pediatric Faculty and Faculty of Professional Retraining
Russian Federation, ChitaNataly I. Frolova
Chita State Medical Academy, Ministry of Health of Russia
Email: taasyaa@mail.ru
ORCID iD: 0000-0002-7433-6012
Dr. Med. Sci., Associate Professor at the Department of Obstetrics and Gynecology of Pediatric Faculty and Faculty of Professional Retraining
Russian Federation, ChitaDaria S. Kargina
Transbaikal Regional Hospital, Chita
Email: gven2007@yandex.ru
ORCID iD: 0000-0003-0130-5861
obstetrician-gynaecologist at the Gynecology Department
Russian Federation, ChitaAnastasiya O. Zolotukhina
Transbaikal Regional Pathoanatomical Bureau
Email: zolot-anastasiya@mail.ru
ORCID iD: 0000-0002-1136-1798
Head of the Department of Pediatric and Prenatal Pathology
Russian Federation, ChitaMaria A. Agarkova
Chita State Medical Academy, Ministry of Health of Russia
Email: rinary_19@mail.ru
ORCID iD: 0009-0005-4924-1475
Resident at the Department of Obstetrics and Gynecology of Pediatric Faculty and Faculty of Professional Retraining
Russian Federation, ChitaReferences
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