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1. Maternal and neonatal outcomes in women with severe early onset pre-eclampsia before 26 weeks of gestation, a case series

Author

van Oostwaard, M F, van Eerden, L, de Laat, M W, Duvekot, J J, Erwich, Jjhm, Bloemenkamp, Kwm, Bolte, A C, Bosma, Jpf, Koenen, S V, Kornelisse, R F, Rethans, B, van Runnard Heimel, P, Scheepers, Hcj, Ganzevoort, W, Mol, Bwj, de Groot, C J, Gaugler-Senden, Ipm, van Oostwaard, M F, van Eerden, L, de Laat, M W, Duvekot, J J, Erwich, Jjhm, Bloemenkamp, Kwm, Bolte, A C, Bosma, Jpf, Koenen, S V, Kornelisse, R F, Rethans, B, van Runnard Heimel, P, Scheepers, Hcj, Ganzevoort, W, Mol, Bwj, de Groot, C J, and Gaugler-Senden, Ipm

Published
2017

2. Maternal and neonatal outcomes in women with severe early onset pre-eclampsia before 26 weeks of gestation, a case series

Author

Unit Opleiding Aios, Geboortecentrum voorzitterschap, MS Verloskunde, Circulatory Health, van Oostwaard, M F, van Eerden, L, de Laat, M W, Duvekot, J J, Erwich, Jjhm, Bloemenkamp, Kwm, Bolte, A C, Bosma, Jpf, Koenen, S V, Kornelisse, R F, Rethans, B, van Runnard Heimel, P, Scheepers, Hcj, Ganzevoort, W, Mol, Bwj, de Groot, C J, Gaugler-Senden, Ipm, Unit Opleiding Aios, Geboortecentrum voorzitterschap, MS Verloskunde, Circulatory Health, van Oostwaard, M F, van Eerden, L, de Laat, M W, Duvekot, J J, Erwich, Jjhm, Bloemenkamp, Kwm, Bolte, A C, Bosma, Jpf, Koenen, S V, Kornelisse, R F, Rethans, B, van Runnard Heimel, P, Scheepers, Hcj, Ganzevoort, W, Mol, Bwj, de Groot, C J, and Gaugler-Senden, Ipm

Published
2017

3. Maternal and neonatal outcomes in women with severe early onset pre-eclampsia before 26 weeks of gestation, a case series

Author

van Oostwaard, MF, primary, van Eerden, L, additional, de Laat, MW, additional, Duvekot, JJ, additional, Erwich, JJHM, additional, Bloemenkamp, KWM, additional, Bolte, AC, additional, Bosma, JPF, additional, Koenen, SV, additional, Kornelisse, RF, additional, Rethans, B, additional, van Runnard Heimel, P, additional, Scheepers, HCJ, additional, Ganzevoort, W, additional, Mol, BWJ, additional, de Groot, CJ, additional, and Gaugler-Senden, IPM, additional

Published
2017
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4. Recurrence of hypertensive disorders of pregnancy: an individual patient data metaanalysis

Author

van Oostwaard, Mf, Langenveld, J, Schuit, E, Papatsonis, Dnm, Brown, Ma, Byaruhanga, Rn, Bhattacharya, S, Campbell, Dm, Chappell, Lc, Chiaffarino, F, Crippa, I, Facchinetti, F, Ferrazzani, Sergio, Ferrazzi, E, Figueiró-Filho, Ea, Gaugler-Senden, Ipm, Haavaldsen, C, Lykke, Ja, Mbah, Ak, Oliveira, Vm, Poston, L, Redman, Cwg, Salim, R, Thilaganathan, B, Vergani, P, Zhang, J, Steegers, Eap, Mol, Bwj, Ganzevoort, W, Ferrazzani, S (ORCID:0000-0001-7382-2951), van Oostwaard, Mf, Langenveld, J, Schuit, E, Papatsonis, Dnm, Brown, Ma, Byaruhanga, Rn, Bhattacharya, S, Campbell, Dm, Chappell, Lc, Chiaffarino, F, Crippa, I, Facchinetti, F, Ferrazzani, Sergio, Ferrazzi, E, Figueiró-Filho, Ea, Gaugler-Senden, Ipm, Haavaldsen, C, Lykke, Ja, Mbah, Ak, Oliveira, Vm, Poston, L, Redman, Cwg, Salim, R, Thilaganathan, B, Vergani, P, Zhang, J, Steegers, Eap, Mol, Bwj, Ganzevoort, W, and Ferrazzani, S (ORCID:0000-0001-7382-2951)

Abstract

OBJECTIVE: We performed an individual participant data (IPD) metaanalysis to calculate the recurrence risk of hypertensive disorders of pregnancy (HDP) and recurrence of individual hypertensive syndromes. STUDY DESIGN: We performed an electronic literature search for cohort studies that reported on women experiencing HDP and who had a subsequent pregnancy. The principal investigators were contacted and informed of our study; we requested their original study data. The data were merged to form one combined database. The results will be presented as percentages with 95% confidence interval (CI) and odds ratios with 95% CI. RESULTS: Of 94 eligible cohort studies, we obtained IPD of 22 studies, including a total of 99,415 women. Pooled data of 64 studies that used published data (IPD where available) showed a recurrence rate of 18.1% (n=152,213; 95% CI, 17.9-18.3%). In the 22 studies that are included in our IPD, the recurrence rate of a HDP was 20.7% (95% CI, 20.4-20.9%). Recurrence manifested as preeclampsia in 13.8% of the studies (95% CI,13.6-14.1%), gestational hypertension in 8.6% of the studies (95% CI, 8.4-8.8%) and hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome in 0.2% of the studies (95% CI, 0.16-0.25%). The delivery of a small-for-gestational-age child accompanied the recurrent HDP in 3.4% of the studies (95% CI, 3.2-3.6%). Concomitant HELLP syndrome or delivery of a small-for-gestational-age child increased the risk of recurrence of HDP. Recurrence increased with decreasing gestational age at delivery in the index pregnancy. If the HDP recurred, in general it was milder, regarding maximum diastolic blood pressure, proteinuria, the use of oral antihypertensive and anticonvulsive medication, the delivery of a small-for-gestational-age child, premature delivery, and perinatal death. Normotensive women experienced chronic hypertension after pregnancy more often after experiencing recurrence (odds ratio, 3.7; 95% CI, 2.3-6.1). CONCLUSION: Am

Published
2015

5. Maternal and neonatal outcomes in women with severe early onset pre-eclampsia before 26 weeks of gestation, a case series.

Author

Oostwaard, MF, Eerden, L, Laat, MW, Duvekot, JJ, Erwich, JJHM, Bloemenkamp, KWM, Bolte, AC, Bosma, JPF, Koenen, SV, Kornelisse, RF, Rethans, B, Runnard Heimel, P, Scheepers, HCJ, Ganzevoort, W, Mol, BWJ, Groot, CJ, Gaugler‐Senden, IPM, van Oostwaard, M F, van Eerden, L, and de Laat, M W

Subjects
PREGNANCY, EDEMA, PLACENTA, RETROLENTAL fibroplasia, KIDNEY failure
Abstract

Objective: To describe the maternal and neonatal outcomes and prolongation of pregnancies with severe early onset pre-eclampsia before 26 weeks of gestation.Design: Nationwide case series.Setting: All Dutch tertiary perinatal care centres.Population: All women diagnosed with severe pre-eclampsia who delivered between 22 and 26 weeks of gestation in a tertiary perinatal care centre in the Netherlands, between 2008 and 2014.Methods: Women were identified through computerised hospital databases. Data were collected from medical records.Main Outcome Measures: Maternal complications [HELLP (haemolysis, elevated liver enzyme levels, and low platelet levels) syndrome, eclampsia, pulmonary oedema, cerebrovascular incidents, hepatic capsular rupture, placenta abruption, renal failure, and maternal death], neonatal survival and complications (intraventricular haemorrhage, retinopathy of prematurity, necrotising enterocolitis, bronchopulmonary dysplasia, and sepsis), and outcome of subsequent pregnancies (recurrent pre-eclampsia, premature delivery, and neonatal survival).Results: We studied 133 women, delivering 140 children. Maternal complications occurred frequently (54%). Deterioration of HELLP syndrome during expectant care occurred in 48%, after 4 days. Median prolongation was 5 days (range: 0-25 days). Neonatal survival was poor (19%), and was worse (6.6%) if the mother was admitted before 24 weeks of gestation. Complications occurred frequently among survivors (84%). After active support, neonatal survival was comparable with the survival of spontaneous premature neonates (54%). Pre-eclampsia recurred in 31%, at a mean gestational age of 32 weeks and 6 days.Conclusions: Considering the limits of prolongation, women need to be counselled carefully, weighing the high risk for maternal complications versus limited neonatal survival and/or extreme prematurity and its sequelae. The positive prospects regarding maternal and neonatal outcome in future pregnancies can supplement counselling.Tweetable Abstract: Severe early onset pre-eclampsia comes with high maternal complication rates and poor neonatal survival. [ABSTRACT FROM AUTHOR]

Published
2017
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