Related Experiment Video
Updated: Aug 7, 2026
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
[Study on different onset patterns and perinatal outcomes in severe preeclampsia]
Zi Yang1, Jia-lüe Wang, Ping Huang
1Department of Obstetric and Gynaecology, Peking University Third Hospital, Beijing 100083, China.
Insights
Severe preeclampsia with abrupt onset affects 16% of cases, leading to serious complications. Early onset severe preeclampsia before 32 weeks is linked to poorer maternal and perinatal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatology
Context:
- Severe preeclampsia is a significant cause of maternal and perinatal morbidity and mortality.
- Understanding the clinical onset patterns of severe preeclampsia is crucial for timely intervention and improved outcomes.
- This study investigates the distinct clinical presentations and their associations with maternal and fetal health in severe preeclampsia.
Purpose:
- To investigate the clinical onset patterns of severe preeclampsia.
- To compare maternal and perinatal outcomes between early- (< or = 34 weeks) and late-onset (> 34 weeks) severe preeclampsia.
- To analyze the impact of abrupt versus gradual onset on complications and mortality.
Summary:
- A prospective study of 173 severe preeclampsia cases identified abrupt onset in 16.2%.
- Abrupt onset, regardless of gestational age, was associated with significantly higher rates of serious maternal complications (100%) and perinatal mortality compared to gradual onset.
- Early onset severe preeclampsia (before 32 weeks) was significantly linked to poorer maternal and perinatal outcomes.
Impact:
- The findings highlight that abrupt onset of severe preeclampsia is a critical indicator of high risk for severe maternal complications and perinatal death.
- Establishing an early onset clinical delimitation at 32 weeks gestation can help identify high-risk pregnancies requiring closer monitoring and management.
- This research provides valuable insights for clinical decision-making and risk stratification in the management of severe preeclampsia.
Objective:
To explore the different clinical onset patterns in severe preeclampsia.
Methods:
A prospective observational study was conducted in 173 cases of severe preeclampsia. They were divided into two groups according to the onset of gestational age of severe preeclampsia, early onset of severe preeclampsia (S-PE) (onset < or = 34 weeks) and late onset of S-PE (onset > 34 weeks). Then according to the onset pattern they were subdivided into 4 subgroups: early abrupt onset (10) and early onset with gradual progress of severe preeclampsia (87), late abrupt onset (18) and late onset with gradual progress of severe preeclampsia (58). Clinical characteristics in each subgroup were evaluated.
Results:
Cases with abrupt onset accounted for 16.2% out of 173 cases of severe preeclampsia (28/173). The incidence of abrupt onset or onset with gradual progress between early and late onset groups was not significantly different (P > 0.05). Whether in early onset group or late onset group, the incidence of serious maternal complications was much higher in abrupt onset subgroups than that in gradual progress subgroups [100.0% (10/10) vs 34.5% (30/87) and 100.0% (18/18) vs 29.3% (17/58); P < 0.001]. The incidence of serious maternal complications was not significantly different between early onset and late onset groups (P > 0.05). The perinatal mortality rate was higher in abrupt onset subgroups compared to gradual progress subgroups both in early onset groups and in late onset ones (72.7% vs 24.3%, P < 0.01; 22.2% vs 4.9%, P < 0.05). The perinatal mortality rate was higher in each subgroups in early onset groups than that in late onset ones respectively (P < 0.01, P < 0.05). The gestational age at delivery was closely associated with perinatal outcomes. When a delimitation of early onset of severe preeclampsia was set at 32-week gestation, perinatal outcome was associated with both gestational age at birth and the onset time of severe preeclampsia. If the cut-off point was set at 34-week gestation, perinatal outcome was associated only with gestational age at birth.
Conclusions:
Approximately 16% pregnant women with severe preeclampsia were attacked abruptly and complicated by serious complications. The clinical delimitation of early onset of severe preeclampsia set at 32-week gestation is significantly associated with poor maternal and perinatal outcomes.