The clinical and morphological features of earlyand late-onset preeclampsia

Objective. To study the specif ic features of labor and placental changes in early- and late-onset preeclampsia in pregnant women with sleep apnea syndrome. Subject and methods. The study enrolled 36 patients aged 20 to 41 years who were divided into 2 groups according to the onset of preeclampsia. Polysomnography and placental morphological examinations were performed. The f indings were processed using a Statistica 6.0 program. Results. Early-onset preeclampsia differs significantly from late-onset one with regard to the time of pregnancy prolongation. Sleep apnea is much more common in late-onset preeclampsia (88.9%) than in its early onset (5.5%). The placentas obtained from the women with early-onset preeclampsia display lower VEGF and VEGFR-2 expressions while the VEGF expression in late-onset preeclampsia is not distinct from that in the control group. Conclusion. The findings may suggest that the main cause of early-onset preeclampsia is impaired trophoblast invasion processes; late-onset preeclampsia may be linked to pathogenetic mechanisms, such as nocturnal intermittent hypoxia in sleep apnea, which leads to endothelial dysfunction, systemic inflammatory response, and oxidative stress.

early-onset preeclampsia, late-onset preeclampsia, vascular endothelial growth factor, sleep apnea