Pre-Eclampsia
Conditions
Brief summary
Preeclampsia (hypertension during pregnancy) is a common problem affecting 2-8% of pregnancies worldwide and is typically diagnosed by increased blood pressure and proteinuria. The rate of preeclampsia has increased since the 1980s with higher rates at extreme maternal ages as well as during the first pregnancy. Pre-eclampsia is a serious hypertensive disorder of pregnancy affecting outcomes for both mother and infants. These infants not only have increased risk of neonatal complications including preterm birth, intrauterine growth restriction, abnormal Doppler parameters, feed intolerance, intestinal problem, poor growth, and long term lung condition but also have increased risk of cerebral palsy, abnormal neurodevelopmental outcomes, cardiovascular disease, stroke, and mental disorders during childhood and adulthood.
Detailed description
Preeclampsia is diagnosed according to the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria: BP \> 140/90 on two occasions in previous normotensive mother after 20 weeks of gestation and one of the following; proteinuria in urine \> 0.3 gram/kg/day or acute kidney or liver dysfunction or signs of uterine dysfunction. The onset of preeclampsia can be early before 34 weeks of pregnancy (Early-onset preeclampsia) or late after 34 weeks of pregnancy (Late-onset preeclampsia). Early-onset preeclampsia, especially between 28-32 weeks gestation, is characterized by a high prevalence of microvascular changes in the placenta that makes mothers and their infants are more liable to complication. The pathogenesis of preeclampsia is unclear. Preeclampsia affects hematopoiesis and the fetal myeloid lineage leading to thrombocytopenia, neutropenia, decrease phagocytic function, decrease T regulatory cells, and an increase in cytotoxic natural killer cells in neonates. Innate and adaptive immunity are regulated by myeloid cells and the immune changes in infants of preeclampsia mothers could lead to increased incidence of neonatal sepsis and the development of chronic inflammatory conditions.
Interventions
OTHERCardiovascular and immunological changes
performing cardiac ultrasound, vascular doppler, and immunological study on cord blood sample
Sponsors
Assiut University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Intervention model description
enrollment of infants born from preeclampsia mother and control from infants born from normal pregnancies
Eligibility
Sex/Gender
ALL
Age
1 Minutes to 3 Days
Healthy volunteers
No
Inclusion criteria
* Infants born from Pregnant women with preeclampsia, their mother willing to give consent.
Exclusion criteria
* 1-Infant with a major heart problem. * Infants with major congenital and genetic anomalies.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cardiac changes | within 72 hours after birth | cardiac output will be presented by ml/minute |
| Cardiac function changes | within 72 hours after birth | Fractional shortening and ejection fraction will be presented by percentage |
| Vascular changes in superior mesenteric and anterior cerebral arteries | 72 hours after birth | Doppler parameters( peak-systolic velocity, end-diastolic velocity, and mean velocity. All will be measured in meter/second |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Feeding problem | 3 months after birth | rate of necrotizing enterocolitis and feeding intolerance |
| oval all outcomes | 3 months | Rate of long term lung condition, sepsis, intraventricular hemorrhage and overall mortality |
| immunological changes | cord blood at birth | interleukins level |
Contacts
Primary ContactAhmed S Ali
Outcome results
None listed