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Aim: This study aimed to examine how the number of patients diagnosed with pre‐eclampsia increased according to the Japanese classification of hypertensive disorders of pregnancy (HDP) that was revised in 2018. The effect of new classification on perinatal outcomes was also analyzed. Methods: We enrolled 181 women with HDP who delivered at Hokkaido University Hospital between February 2011 and December 2017. All women were reclassified on the basis of the new classification, in which proteinuria was not required to diagnose pre‐eclampsia in patients with maternal organ damage. The number and reasons of reclassification and the admission rate to the neonatal intensive care unit (NICU) and gestational age (GA) at the onset of HDP and at delivery were analyzed. Results: In this cohort, 17 (9.4%) of 181 women with HDP were reclassified. Low platelet count (41.2%) and uteroplacental dysfunction (41.2%) were the two main causes for reclassification. GA at the onset of HDP (33.6 [29.9–36.1] weeks vs 37.4 [35.7–38.4] weeks; P < 0.001) and at delivery (35.9 [32.4–37.3] weeks vs 38.1 [37.3–39.6] weeks; P < 0.001) were significantly earlier in women with reclassification than women without reclassification. The NICU admission rate was higher in women with reclassification than women without reclassification (70.6% vs 20.4%; P < 0.001). Conclusion: Almost 10% of pregnant women were newly diagnosed with pre‐eclampsia as per the new Japanese classification of HDP. Women with reclassification as pre‐eclampsia had a greater risk of preterm delivery and NICU admission than those who were not reclassified. [ABSTRACT FROM AUTHOR]

Introduction: The differences in the d-dimer rise between women with singleton and multifetal pregnancies have not been studied extensively. Materials and Methods: d-Dimer levels were determined in 1089 blood specimens from 1089 women in various stages of pregnancy, including 977 and 112 women with singleton and multifetal pregnancies, respectively. None of the 1089 women developed hypertension or clinical venous thromboembolism during pregnancy or in the postpartum period. Results: The d-dimer levels were significantly and positively correlated with gestational week at examination in women with singleton or multifetal pregnancies. The d-dimer levels (μg/ml, mean±SD [number of specimens]) determined at the 1st trimester did not differ significantly (0.81±0.82 [102] for singleton vs. 1.20±0.77 [7] for multifetal), but those at the 2nd (1.61±1.45 [216] vs. 2.62±2.26 [59]) and 3rd (2.37±2.22 [659] vs. 4.02±2.14 [46]) trimesters were significantly higher in women with multifetal than singleton pregnancies. The 90th percentile value was 4.31μg/ml for 1089 specimens. A significantly greater number of women exceeded 4.31μg/ml during the 2nd (16.9% vs. 5.6%, P =0.0043) and 3rd (34.8% vs. 10.6%, P <0.0001) trimesters among those with multifetal than with singleton pregnancies. Conclusions: The degree of d-dimer rise in pregnancy was greater in women with multifetal than with singleton pregnancies. [ABSTRACT FROM AUTHOR]

Objective: To examine whether laboratory parameters can predict the onset of recurrent hypertensive disorders of pregnancy (HDP).Methods: A retrospective study of 257 women with consecutive deliveries at a hospital in Sapporo, Japan, between 2009 and 2017. Women were divided into four groups according to whether or not they had HDP in the first and second peripartum periods (HDP-HPD, HDP-Non, Non-HDP, Non-Non). HDP was defined as gestational hypertension and/or proteinuria. Laboratory parameters measured on the day of or 1 day before delivery were compared between peripartum-1 and peripartum-2.Results: Frequency of HDP in peripartum-2 was higher among the 24 (9.3%) women with HPD in peripartum-1 (6/24, 25.0%) than among the 233 (90.7%) women without (3/233, 1.3%) (P<0.001). In peripartum-1, women with HDP had lower median antithrombin activity than those without (74% vs 89%, P=0.021). Antithrombin activity in peripartum-1 was also lower in the HDP-HDP (67%) than in the HDP-Non (79%) group (P=0.021). Antithrombin activities of 77% or less at the first delivery predicted HDP in peripartum-1 (P<0.001) and 70% or less predicted HDP in peripartum-2 (P=0.018).Conclusion: Women with HDP in peripartum-1 had a higher incidence of HDP recurrence. Low antithrombin before a first delivery might predict recurrent HDP in a second pregnancy. [ABSTRACT FROM AUTHOR]