Early Onset Preeclampsia Diagnosis Prior to the 20th Week of Gestation in a Twin Pregnancy Managed via Selective Reduction of an Intrauterine Growth Restriction Fetus: A Case Report and Literature Review
Abstract
:1. Introduction
2. Case Report Description
3. Discussion
4. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Case | Tanaka et al. [14] | Schena et al. [24] | Maya [23] | Stillman et al. [22] | Imasawa et al. [21] | Hazra et al. [20] |
---|---|---|---|---|---|---|
Patient Age (years) | 30 | 44 | 17 | 30 | 35 | 41 |
Gravidity (number) | NP | 7 | 0 | 1 | 0 | NP |
Parity (number) | 0 | 2 | 0 | 0 | 0 | 3 |
Risk Factor for PE | Nulliparity | AMA, familiar hypertension history, chronic hypertension, previous PE | Nulliparity | Nulliparity, Twin pregnancy | Nulliparity, Twin pregnancy | Previous PE |
Gestational age at PE onset (week) | 18 | 16 | 19 | 15 | 15 | 18 |
Renal Biopsy | Consistent with PE | Consistent with PE | Consistent with PE | Consistent with PE | Consistent with PE | Not performed |
PE Management | Methyldopa and steroids | Labetalol, nifedipine, methyldopa, low-molecular-weight heparin, aspirin, medical termination of pregnancy | Methyldopa, medical termination of pregnancy, hydralazine and magnesium sulfate, nifedipine | Labetalol, nifedipine, Aldomet, medical termination of pregnancy | Methyldopa, nifedipine, heparin, medical termination of pregnancy | Methyldopa, heparin, medical termination of pregnancy, labetol |
Maternal outcome | BP normal few weeks following delivery, urinary protein levels normal 6 month postpartum | Normal BP and protein/creatinine ratio 26 weeks postpartum | BP improved | Normal renal function few weeks following pregnancy termination | BP normalized and proteinuria decreased three weeks following pregnancy termination | Normal BP with labetol, normal urine analysis |
Perinatal outcome | In utero death, SGA | IUGR, medical termination at 22 week of gestation | Nonviable fetus with no gross congenital abnormalities | Cytogenetic analysis revealed normal fetuses | Female fetuses without gross congenital abnormalities | In utero death, no gross congenital abnormalities |
Case | Weg et al. [49] | Yu et al. [38] | Heyborne et al. [37] | Heyborne et al. [37] | Heyborne et al. [37] | Audibert et al. [36] |
---|---|---|---|---|---|---|
Patient Age (years) | NP | NP | 46 | 37 | 45 | 32 |
Parity (number) | NP | NP | 0 | 0 | 1 | 0 |
Type of twin pregnancy | Dichorionic triamniotic | NP | Dichorionic | Trichorionic triplet | Dichorionic | Dichorionic diamniotic |
Gestational age at PE onset (week) | 16 | NP | 26 | 24 | 16 | 28 |
Gestational age at SER (week) | 16 (reduction of monocorionic twin) | 27 | 26 (reduction of IUGR twin fetus) | 24 (reduction of IUGR twin fetus) | 16 | 32 (reduction of IUGR twin fetus) |
Time of delivery (week) | 32 | 29 | At term | 34 | At term | 38 |
Maternal outcome | No symptoms of preeclampsia following SER | No symptoms of preeclampsia following SER | No symptoms of preeclampsia following SER | No symptoms of preeclampsia following SER and labetalol administration | No symptoms of preeclampsia following SER | No symptoms of preeclampsia following SER |
Perinatal outcome | Live Birth | Live Birth (pre-term) | Live Birth | Live Birth (pre-term) | Live Birth | Live Birth |
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Konstantopoulos, A.; Sfakianoudis, K.; Simopoulou, M.; Kontogeorgi, A.; Rapani, A.; Grigoriadis, S.; Pantou, A.; Bathrellos, N.; Grammatis, A.; Pantos, K. Early Onset Preeclampsia Diagnosis Prior to the 20th Week of Gestation in a Twin Pregnancy Managed via Selective Reduction of an Intrauterine Growth Restriction Fetus: A Case Report and Literature Review. Diagnostics 2020, 10, 531. https://doi.org/10.3390/diagnostics10080531
Konstantopoulos A, Sfakianoudis K, Simopoulou M, Kontogeorgi A, Rapani A, Grigoriadis S, Pantou A, Bathrellos N, Grammatis A, Pantos K. Early Onset Preeclampsia Diagnosis Prior to the 20th Week of Gestation in a Twin Pregnancy Managed via Selective Reduction of an Intrauterine Growth Restriction Fetus: A Case Report and Literature Review. Diagnostics. 2020; 10(8):531. https://doi.org/10.3390/diagnostics10080531
Chicago/Turabian StyleKonstantopoulos, Anastasios, Konstantinos Sfakianoudis, Mara Simopoulou, Adamantia Kontogeorgi, Anna Rapani, Sokratis Grigoriadis, Agni Pantou, Nikolaos Bathrellos, Alexandros Grammatis, and Konstantinos Pantos. 2020. "Early Onset Preeclampsia Diagnosis Prior to the 20th Week of Gestation in a Twin Pregnancy Managed via Selective Reduction of an Intrauterine Growth Restriction Fetus: A Case Report and Literature Review" Diagnostics 10, no. 8: 531. https://doi.org/10.3390/diagnostics10080531