Clinical and laboratory changes in preeclampsia

The aim of the study: to study the features of clinical and laboratory parameters in pregnant women with preeclampsia. Materials and methods. A case-control study (continuous blind sampling method) was conducted among pregnant women who were delivered in the obstetric hospital of the Clinic of the SouthUrals State Medical University in Chelyabinsk (sample size 95 people). Control group 1 included 29 women whose pregnancy was not complicated by preeclampsia (they did not receive acetylsalicylic acid at 12– 16 weeks); group 2 consisted of 32 pregnant women with moderate preeclampsia; and group 3 consisted of 34 patients with severe preeclampsia. The outcomes of pregnancy and childbirth were studied (the results were obtained by means of questionnaires, analysis of medical documentation: a pregnant woman's medical record, birth history), a clinical and laboratory examination was performed, peripheral blood parameters, biochemical and hemostatic parameters were studied, and the leukocyte intoxication index was calculated. Results and conclusions. In severe preeclampsia, there was a significant decrease in hematocrit, the number of reticulocytes, relative microcytosis and hyperchromia of red blood cells, and an increase in the number of schizocytes. Changes in the leukocyte formula have been registered: a decrease in the percentage of lymphocytes and monocytes, an increase in the Kalf-Kalif leukocyte intoxication index. In addition, there was a significant increase in the number of cases of thrombocytopenia. In severe preeclampsia, a significant increase (within the normal range during pregnancy) in ALT, AST, gamma-GTP, LDH, serum potassium and glucose levels was recorded against the background of a decrease in serum alkaline phosphatase, total protein and sodium levels. With increasing severity of preeclampsia, an increase in proteinuria and a decrease in tubular reabsorption were noted. In patients with preeclampsia, it was found to be reduced (within the normal range during pregnancy) antithrombin activity, increased induced platelet aggregation with ADP5. Additionally, in severe preeclampsia, a relative decrease in fibrinogen with an increase in the prothrombin index was revealed.

1. Сюндюкова Е. Г., Чулков В. С., Рябикина М. Г. Преэклампсия: современное состояние проблемы // Доктор.Ру. – 2021. – Т. 20, № 1. – С. 11–16.

2. Robillard P. Y., Dekker G., Scioscia M., и др. Preeclampsia in 2023: Time for preventing early onset- and term preeclampsia: The paramount role of gestational weight gain // Journal of reproductive immunology. – 2023. – Т. 158. – С. 103968.

3. Jung E., Romero R., Yeo L., и др. The etiology of preeclampsia // American journal of obstetrics & gynecology. – 2022. – Т. 226, № 2. – С. 844–866.

4. Сюндюкова Е. Г., Медведев Б. И., Сашенков С. Л. Роль гематологических показателей в ранней предикции преэклампсии // Вопросы гинекологии, акушерства и перинатологии. – 2019. – Т. 18, № 6. – С. 51–58.

5. de Las Cuevas Allende R., Díaz de Entresotos L., Conde Díez S. Anaemia of chronic diseases: Pathophysiology, diagnosis and treatment // Medicina Clinica (Barc.). – 2021. – Т. 156, № 5. – С. 235–242.

6. Сюндюкова Е. Г., Медведев Б. И., Сашенков С. Л. Преэклампсия : монография. – Челябинск, 2020. – 290 с.

7. Al-Nuaimi A. M. A. Role of hematological indices in predicting preeclampsia and its severity: retrospective case-control study // Medicine (Baltimore). – 2024. – Т. 103, № 25. – С. e38557.

8. De Mendonça E. L. S. S., da Silva J. V. F., Mello C. S., и др. Serum uric acid levels associated with biochemical parameters linked to preeclampsia severity and to adverse perinatal outcomes // Archives of Gynecology and Obstetrics. – 2022. – Т. 305, № 6. – С. 1453–1463.

9. Najeeb M. N., Munir U., Sattar N., и др. Biochemical and Oxidative Biomarkers in Preeclampsia // Journal of College Physicians and Surgeons Pakistan. – 2024. – Т. 34, № 7. – С. 780–784.

10. Преэклампсия. Эклампсия. Отеки, протеинурия и гипертензивные расстройства во время беременности, в родах и послеродовом периоде : клинические рекомендации. – 2024.