scholarly journals Early Onset Preeclampsia Diagnosis Prior to the 20th Week of Gestation in a Twin Pregnancy Managed via Selective Reduction of an Intrauterine Growth Restriction Fetus: A Case Report and Literature Review

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 531
Author(s):  
Anastasios Konstantopoulos ◽  
Konstantinos Sfakianoudis ◽  
Mara Simopoulou ◽  
Adamantia Kontogeorgi ◽  
Anna Rapani ◽  
...  
Keyword(s):  
Live Birth ◽  
Early Onset ◽  
Intrauterine Growth Restriction ◽  
Twin Pregnancy ◽  
Pregnancy Termination ◽  
Selective Reduction ◽  
Intrauterine Growth ◽  
Protein Levels ◽  
Selective Embryo Reduction ◽  
Early Onset Preeclampsia

A single, healthy, 44-year-old perimenopausal woman pursuing a pregnancy, employed donor embryos, resulting to a dichorionic diamniotic twin pregnancy. In the 18th week of gestation severe symptoms indicated early onset preeclampsia reporting severe hypertension (BP 180/90 mmHg), intense headaches and nausea as well as elevated 24-h urine protein levels (1.5 g/day). Concurrently diagnosis of an IUGR fetus was concluded. Standard pharmaceutical administration for treating preeclampsia was ordered. Persistence of symptoms indicated recommendation for pregnancy termination, however the patient opted against this. Selective embryo reduction was performed as the last resort prior to pregnancy termination. Following selective reduction the headaches and nausea were successfully subdued and the patient’s blood pressure was adjusted (mean BP 130/80 mmHg). This enabled further progression of pregnancy for an impressive 11 week-period, and a live birth on the 30th week. To conclude, only a few rare cases have been reported with diagnosis of early onset preeclampsia prior to the 20th week mark and none report live births. Albeit termination of pregnancy was recommended, the management of selective reduction of the IUGR fetus enabled successful treatment of preeclampsia coupled by a live birth of a healthy infant without any perinatal or postnatal complications reported.

NT-proBNP levels in preeclampsia, intrauterine growth restriction as well as in the prediction on an imminent delivery

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Paula Lafuente-Ganuza ◽  
Fran Carretero ◽  
Paloma Lequerica-Fernández ◽  
Ana Fernandez-Bernardo ◽  
Ana I. Escudero ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Early Onset ◽  
Intrauterine Growth Restriction ◽  
Left Atrial ◽  
Late Onset ◽  
Growth Restriction ◽  
Low Cardiac Output ◽  
Intrauterine Growth ◽  
High Positive Predictive Value ◽  
Early Onset Preeclampsia

Abstract Objectives Studies of cardiovascular function in pregnancy have shown inconsistent and, in some cases, contradictory results, particularly regarding cardiac output. While some studies report preeclampsia associated with high cardiac output, other studies suggest that preeclampsia should be further subdivided into women with high or low cardiac output. This study was conducted to examine the NT-proBNP levels in preeclampsia, intrauterine growth restriction, and hypertensive pregnancies without preeclampsia. We also examined N-terminal pro-B natriuretic peptide (NT-proBNP) levels three to four months after delivery, in preeclamptic women as well as the prediction of delivery within 10 days. In a reduced number of preeclamptic women and controls we performed echocardiograms to study their diastolic function. Methods We investigated the NT-proBNP levels in 213 subjects with preeclampsia only, 73 with intrauterine growth restriction, 44 with preeclampsia and intrauterine growth restriction, 211 who were hypertensive and 662 unaffected pregnancies (controls). We also performed echocardiograms on 36 preeclampsia and 19 controls before delivery and three to five months after delivery. Results NT-proBNP levels are higher in early onset preeclampsia than in late onset preeclampsia. Intrauterine growth restriction pregnancies showed a NT-proBNP levels similar to hypertensive and unaffected pregnancies. Compared with healthy pregnancies, women with preterm preeclampsia (<37 gestational weeks) had altered left atrial segments. Conclusions We observed that NT-proBNP levels are higher in early onset preeclampsia than in late onset. Moreover, diastolic dysfunction is higher in early onset than in late-onset term preeclampsia. An NT-proBNP value >136 pg/mL has a high positive predictive value for an imminent delivery within 10 days.

Dysregulation of oxygen sensing/responsive pathways in pregnancies complicated by idiopathic intrauterine growth restriction and early onset preeclampsia

Placenta ◽  
2015 ◽  
Vol 36 (9) ◽  
pp. A50-A51
Author(s):  
Sean K.M. Seeho ◽  
Jenny H. Park ◽  
Sharon A. McCracken ◽  
Eileen D.M. Gallery ◽  
Jonathan M. Morris
Keyword(s):  
Early Onset ◽  
Intrauterine Growth Restriction ◽  
Oxygen Sensing ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Early Onset Preeclampsia

scholarly journals The usefulness of fetal Doppler evaluation in early versus late onset intrauterine growth restriction. Review of the literature.

2016 ◽  
Vol 18 (1) ◽  
pp. 103 ◽  
Author(s):  
Daniel Mureșan ◽  
Ioana Cristina Rotar ◽  
Florin Stamatian
Keyword(s):  
Early Onset ◽  
Intrauterine Growth Restriction ◽  
Pulsatility Index ◽  
Late Onset ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Intrauterine Growth ◽  
Fetal Doppler ◽  
Doppler Evaluation ◽  
Early Onset Preeclampsia

Intrauterine growth restriction (IUGR) represents a serious condition that can lead to increased perinatal morbidity, mortality and postnatal impaired neurodevelopment. There are two distinct phenotypes of IUGR: early onset and late onset IUGR with different onset, patterns of evolution and fetal Doppler profile. In early onset preeclampsia the main Doppler modifications are at the level of umbilical artery, with progressive augmentation of the pulsatility index to absent or reverse end diastolic flow. The modifications of the cerebral, cardiac and ductus venosus circulation are generally present, but with different sequences. The late onset IUGR is determined by third trimester placental insufficiency that entails fetal hypoxia. The cerebro-placental ratio (CPR) and the pulsatility index of the middle cerebral artery (PI MCA) seems to be the main markers for both diagnosis and obstetrical management while umbilical Doppler PI is frequently normal. Also the sequence of Doppler alterations is neither specific nor complete. New protocols for the diagnosis and management of late onset IUGR need to be implemented.

Risk of Perinatal Death in Early-Onset Intrauterine Growth Restriction according to Gestational Age and Cardiovascular Doppler Indices: A Multicenter Study

2012 ◽  
Vol 32 (1-2) ◽  
pp. 116-122 ◽  
Author(s):  
Mónica Cruz-Lemini ◽  
Fàtima Crispi ◽  
Tim Van Mieghem ◽  
Daniel Pedraza ◽  
Rogelio Cruz-Martínez ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Gestational Age ◽  
Early Onset ◽  
Intrauterine Growth Restriction ◽  
Perinatal Death ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Doppler Indices

Outcome of monochorionic twin pregnancy complicated by Type‐III selective intrauterine growth restriction

2021 ◽  
Vol 57 (1) ◽  
pp. 126-133
Author(s):  
S. Shinar ◽  
W. Xing ◽  
V. Pruthi ◽  
C. Jianping ◽  
F. Slaghekke ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Twin Pregnancy ◽  
Growth Restriction ◽  
Monochorionic Twin ◽  
Intrauterine Growth ◽  
Type Iii
Sign in / Sign up

Export Citation Format

Share Document