Severe preeclampsia and HELLP syndrome at 18 weeks gestation
Belokrinitskaya T.E., Frolova N.I., Kargina D.S., Zolotukhina А.О., Agarkova М.А.
Background: According to the current Russian and international clinical guidelines, preeclampsia is a complication of pregnancy, childbirth and postpartum period characterized by an increase in systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg after 20 weeks gestation, regardless of the BP level in the patient’s history, combined with proteinuria or at least another parameter indicating the onset of multi-organ failure. However, preeclampsia is generally known to occur before 20 weeks gestation in patients with molar pregnancy.
Case report: The article presents a clinical observation of a case of severe preeclampsia complicated by HELLP syndrome at 18 weeks gestation in a healthy patient at high risk of developing preeclampsia who did not receive acetylsalicylic acid prophylaxis. The clinical case has a favorable outcome for the mother but it resulted in the fetal loss.
Conclusion: It is recommended to determine biochemical markers (PlGF or PlGF/sFlt-1 ratio) in order to improve the efficiency of prenatal screening and to identify the risk group for the development of preeclampsia before 20 weeks gestation. The effects of acetylsalicylic acid on the prevention of preeclampsia before 20 weeks gestation have not been studied yet due to the rare incidence of atypical course of this complication. It is necessary to conduct international registry studies to establish new criteria for the prognosis of early-onset preeclampsia and to reconsider the current definition.
Authors’ contributions: Belokrinitskaya T.E. – developing the concept and design of the study, general supervision, editing the text; Frolova N.I. – collection and analysis of publications on the issue of the article; Kargina D.S., Agarkova M.A. – collecting and processing clinical material; Zolotukhina A.O. – pathomorphological studies, preparation of slides of placenta, their description; Belokrinitskaya T.E., Frolova N.I. – writing the text.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
Patient Consent for Publication: The patient provided an informed consent for the publication of her data.
For citation: Belokrinitskaya T.E., Frolova N.I., Kargina D.S., Zolotukhina А.О., Agarkova М.А.
Severe preeclampsia and HELLP syndrome at 18 weeks gestation.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (7): 136-144 (in Russian)
https://dx.doi.org/10.18565/aig.2024.58
Keywords
preeclampsia
HELLP syndrome
early-onset preeclampsia
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Received 18.03.2024
Accepted 27.06.2024
About the Authors
Tatiana E. Belokrinitskaya, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology of Pediatric Faculty and Faculty of Professional Retraining,Chita State Medical Academy, Ministry of Health of Russia, 672000, Russia, Chita, Gorky str., 39a, +7(3022)32-30-58,
tanbell24@mail.ru, https://orcid.org/0000-0002-5447-4223
Nataly I. Frolova, Dr. Med. Sci., Associate Professor at the Department of Obstetrics and Gynecology of Pediatric Faculty and Faculty of Professional Retraining,
Chita State Medical Academy, Ministry of Health of Russia, 672000, Russia, Chita, Gorky str., 39a, taasyaa@mail.ru, https://orcid.org/0000-0002-7433-6012
Daria S. Kargina, obstetrician-gynaecologist at the Gynecology Department, Transbaikal Regional Hospital, 672090, Russia, Chita, Kohansky str., 7,
gven2007@yandex.ru, https://orcid.org/0000-0003-0130-5861
Anastasiya O. Zolotukhina, Head of the Department of Pediatric and Prenatal Pathology, Transbaikal Regional Pathoanatomical Bureau, 672038, Russia, Chita,
Matveeva str., 64, zolot-anastasiya@mail.ru, https://orcid.org/0000-0002-1136-1798
Maria А. Agarkova, Resident at the Department of Obstetrics and Gynecology of Pediatric Faculty and Faculty of Professional Retraining, Chita State Medical Academy, Ministry of Health of Russia, 672000, Russia, Chita, Gorky str., 39а, rinary_19@mail.ru, https://orcid.org/0009-0005-4924-1475
Corresponding author: Tatiana E. Belokrinitskaya, tanbell24@mail.ru
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