Maternal Medicine

Abstract

Introduction: In 2014, the International Society for the Study of Hypertension in Pregnancy (ISSHP) revised the definition of preeclampsia(PE). However, there is no report on the incidence of PE superimposed on chronic hypertension without proteinuria, which is not mentioned in the conventional diagnostic criteria, as well as pregnancy outcomes. Objective: We aimed to evaluate the validity of the diagnostic criteria for PE superimposed on chronic hypertension without requiring proteinuria. Methodology: This retrospective study included 142 women with essential hypertension diagnosed at ≤20 weeks of gestation, managed at a tertiary center. They were divided into three groups (non-PE group; PE with proteinuria group; and PE without proteinuria group) to compare pregnancy outcomes. The non-PE group was further divided into two subgroups (controlled and uncontrolled hypertension subgroups) Results: There were 87 women in the non-PE group, 47 in the PE with proteinuria group, and 8 in the PE without proteinuria group. Median gestational age at delivery was 38.7 weeks in the non-PE group, 30.4 in the PE with proteinuria group, and 28.4 in the PE without proteinuria group. In three of the eight women in the PE without proteinuria group, the condition fulfilling the diagnostic criteria was liver involvement (complicated by thrombocytopenia in one woman). Although the remaining five women had uteroplacental dysfunction, the validity of their PE diagnosis was questionable because their blood pressure was well controlled throughout pregnancy. The 87 women in the non-PE group were divided into a controlled hypertension subgroup of 75 women and uncontrolled hypertension subgroup of 12. In the uncontrolled HT subgroup, the pregnancy outcomes were significantly poorer than those in the controlled HT subgroup. Conclusion: Although exclusion of proteinuria from the essential diagnostic criteria for PE superimposed on chronic hypertension is valid, the criteria might need to include uncontrolled hypertension instead of uteroplacental dysfunction. 0020Maternal magnesium sulfate treatment and infant outcomes Ting-Chun Lai, Chi-Yuan Liao Mennonite Christian Hospital, Hualien, Taiwan Introduction: To prevent risk of the sometimes fatal complications of preeclampsia, magnesium sulfate is the recommended drug of choice for both prevention and treatment of eclampsia. Risk to infants from maternal magnesium sulfate exposure remains unclear, however, as earlier studies found an association with increased admission to neonatal intensive care and special care units, while more recent studies have found no associated risk of intensive resuscitation and other adverse neonatal outcomes. Objectives: Our study aims to elucidate the association between maternal magnesium sulfate exposure and neonatal risk. Methodology: This 12-year retrospective cohort included women diagnosed with preeclampsia who delivered at >=37 weeks' gestation. Women who received treatment with magnesium sulfate were categorized into the exposure group and all others into t...