Preeclampsia and eclampsia: new approaches in diagnosis and evaluation of severity

• Savelyeva G.M.
• Shalina R.I.
• Alexander G. Konoplyannikov
• Simukhina M.A.

Abstract

Aim. To determine the features of the clinical course of severe preeclampsia (PE) and eclampsia (Е) in modern conditions, as well as possible ways to reduce maternal morbidity and mortality using modern technologies.

Material and methods. Complex analysis of 152 delivery cases of patients with severe PE and E divided into 3 groups: 1^st - 130 patients with severe PE, 2^nd - 12 patients with E (survived), 3^rd - 10 deaths from severe PE and E. 36 delivery cases of patients with PE who had undergone brain MRIa.

Results. When analyzing the initial figures of blood pressure, of 33 patients with moderate hypertension or normotension, У₃ of the patients had a SBP increase of 60 mm Hg and more. Swelling is significantly more frequent in patients of groups 2 and 3. In the structure of complaints, the first place is headache (64-42.1%, p<0.01). 46% of the PE was atypical. All patients have a combination of various additional symptoms, complaints, laboratory changes, indicating the dysfunction of vital organs. In patients with PE and complaints of headache and/or visual impairment in 47.2% of the MRI data, changes in the GM were detected, 88% of which are due to AH: PRES (13.9%), acute disturbance of cerebral circulation (5.6%), vascular focal lesions in the brain (22.2%). PRES and acute disturbance of cerebral circulation developed at an atypical form of the disease.

Conclusion. In order to reduce the incidence of complications of PE, it is necessary to take into account the normal BP figures for evaluating the degree of arterial hypertension, any quantitative determination of the protein in the urine, to isolate the atypical form and the critical stage of PE, and to use an MRI of the brain for an objective assessment of the CNS condition.

Keywords:preeclampsia, atypical preeclampsia, eclampsia, PRES

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