Med Bull Sisli Etfal Hosp. 2021; 55(3): 426-431 | DOI: 10.14744/SEMB.2020.56650

Adverse Outcomes of Preeclampsia in Previous and Subsequent Pregnancies and the Risk of Recurrence

Ulas Coban¹, Taha Takmaz², Ozge Deniz Unyeli³, Savas Ozdemir^1
1Department of Obstetrics and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
²Department of Obstetrics and Gynecology, Bezmialem University Faculty of Medicine, Istanbul, Turkey
³Department of Obstetrics and Gynecology, Samsun Training and Research Hospital, Samsun, Turkey

Objectives: We evaluated the fetal and maternal outcomes of pregnant women with preeclampsia who gave birth in our hospital; we also evaluated preeclampsia recurrence rates in these patients and their fetal and maternal outcomes in their subsequent pregnancy.
Methods: In this retrospective cohort study, 126 patients whose medical records were accessed completely and who got pregnant again and gave birth in our hospital were analyzed. The primary aim was to show the recurrence rate of preeclampsia, while the secondary aim was to evaluate the maternal and fetal results of the first pregnancy in which preeclampsia developed and the subsequent pregnancy.
Results: The incidence of preeclampsia was found to be 2.1% in our clinic. The first pregnancy in which preeclampsia developed; 111 (80.2%) pregnancies resulted in a live birth, 7 (5.6%) resulted in termination, and 8 (6.3%) resulted in stillbirth. Neonatal death occurred in 10 (7.9%) pregnancies. While 105 of the subsequent pregnancies resulted in a live birth, 10 (7.9%) resulted in abortion, 9 (7.1%) resulted in stillbirth, and 2 (1.6%) resulted in termination due to preeclampsia. Neonatal death developed in 3 (2.6%) pregnancies. In the subsequent pregnancy, preeclampsia developed in 70 (55.5%) patients and 39 (55.7%) of these had preeclampsia with severe features.
Conclusion: The present study guides us on the risk factors related to preeclampsia and the rate of fetomaternal adverse outcomes and emphasizes the need for strict and regular antenatal follow-up in the subsequent pregnancies of women who have a history preeclampsia. Improvement of maternal and fetal morbidity and mortality in this way is the utmost goal.

Keywords: Preeclampsia, pregnancy outcomes; pregnancy; recurrence risk.

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Önceki ve sonraki gebeliklerde preeklampsinin olumsuz sonuçlarý ve rekürrens riski

Ulas Coban¹, Taha Takmaz², Ozge Deniz Unyeli³, Savas Ozdemir^1
1Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Kadýn Hastalýklarý ve Doðum Kliniði, Ýstanbul
²Bezmialem Üniversitesi Týp Fakültesi, Kadýn Hastalýklarý ve Doðum Anabilim Dalý, Ýstanbul
³Samsun Eðitim ve Araþtýrma Hastanesi Kadýn Hastalýklarý ve Doðum Kliniði, Samsun

Amaç: Bu çalýþmada hastanemizde doðum yapmýþ preeklamptik gebelerin fetal ve maternal sonuçlarýný deðerlendirdik ayrýca bu hastalarda preeklampsi rekürrens oranlarýný ve takip eden gebelikteki fetal ve maternal sonuçlarý deðerlendirdik.
Yöntemler: Bu retrospektif kohort çalýþmada medikal kayýtlarýna eksiksiz ulaþýlabilen, tekrar gebe kalýp hastanemizde gebeliði sonuçlanan 126 hasta analiz edildi. Birincil amaç preeklampsinin rekürrens oranýný ortaya koymak ikincil amaç ise preeklampsi geliþen ilk gebelik ve bunu takip eden gebeliðin maternal ve fetal sonuçlarýný deðerlendirmekti.
Bulgular: Kliniðimizde preeklampsi görülme oraný %2.1 olarak tespit edildi. Preeklampsi geliþen ilk gebelikte 111 (%80.2) gebelik canlý doðum ile sonuçlanýrken, 7 (%5.6) gebelik terminasyon, 8 (%6.3) gebelik de ölü doðum ile sonuçlanmýþtýr. Neonatal ölüm 10 (%7.9) gebelikte izlendi. Takip eden gebeliklerin 105 tanesi canlý doðum ile sonuçlanýrken, 10 (%7.9) tanesi abortus, 9 (%7.1) tanesi ölü doðum ve 2 (%1.6) tanesi preeklampsi nedeniyle terminasyon ile sonuçlandý. Neonatal ölüm 3 (%2.6) gebelikte izlendi. Takip eden gebelikte hastalardan 70 (%55.5)'inde preeklampsi geliþti ve bunlardan 39 (%55.7) tanesi þiddetli preeklampsi kriterlerine sahipti.
Sonuç: Bu çalýþma preeklampsi ile ilgili risk faktörleri ve fetomaternal advers sonuçlarýn oranlarý konusunda bize yol gösterici olup geçirilmiþ preeklampsi öyküsü olan hastalarýn takip eden gebeliklerinde de antenatal takibin sýký ve düzenli olarak yürütülmesi konusuna dikkat çekmektedir. Bu þekilde maternal ve fetal morbidite ve mortalitenin iyileþtirilmesi en büyük hedeftir. (SETB-2020-07-135)

Anahtar Kelimeler: gebelik, preeklampsi, gebelik sonuçlarý, preeklampsi, rekürrens riski

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