Do Case Reports and Case Series Generate Clinical Discoveries About Preeclampsia? A Systematic Review

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Research Methodology

Background:

• Preeclampsia is a major cause of maternal and perinatal mortality.
• Current management strategies for preeclampsia have seen limited advancement.
• The etiology of preeclampsia remains incompletely understood.

Purpose of the Study:

• To evaluate if recent case reports and case series have contributed novel knowledge or clinical insights into preeclampsia.
• To assess the quality and impact of case-based literature on preeclampsia research.

Main Methods:

• Systematic search of Embase and MEDLINE databases for case reports/series on hypertensive disorders in pregnancy (2015-2020).
• Independent screening and data extraction by two reviewers.
• Quality appraisal using Joanna Briggs Institute (JBI) critical appraisal checklists.

Main Results:

• 104 case reports and 3 case series (118 pregnancies) were included.
• 81% of pregnancies reported severe presentations or complications; 84% had positive maternal outcomes.
• Only 24.3% of publications presented a novel clinical discovery; most reports were of low to moderate quality.

Conclusions:

• A significant majority of recent preeclampsia case reports and series do not present new knowledge.
• The overall quality of published case-based literature on preeclampsia is low.
• There is a need for higher quality case reporting to advance preeclampsia understanding.