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Fetal growth retardation and pre-eclampsia
Insights
Early-onset pre-eclampsia significantly increases fetal growth retardation risk. This condition may precede clinical signs, leading to higher rates of placental abruption and perinatal deaths.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Pre-eclampsia is a serious pregnancy complication.
- Fetal growth retardation (FGR) is a known adverse pregnancy outcome.
- The relationship between pre-eclampsia subtypes and FGR requires further elucidation.
Purpose of the Study:
- To investigate the prevalence of fetal growth retardation (FGR) in patients with pre-eclampsia.
- To compare FGR rates in early-onset versus late-onset pre-eclampsia.
- To explore potential preceding factors and associated complications in pre-eclampsia with FGR.
Main Methods:
- Retrospective analysis of 2434 patients with pre-eclampsia.
- Comparison of FGR prevalence between pre-eclamptic patients and the general hospital population.
- Analysis of subnormal oestriol excretion and hypoglycemia in relation to FGR and pre-eclampsia onset.
- Assessment of placental abruption and perinatal death rates in specific pre-eclampsia subgroups.
Main Results:
- Fetal growth retardation (FGR) prevalence was 8.7% in pre-eclampsia patients, similar to the general population (8.6%).
- Early-onset pre-eclampsia showed a significantly higher FGR prevalence (18.2%) compared to late-onset (5.6%).
- Subnormal oestriol excretion (79.5%) and hypoglycemia (33.3%) were more common in early-onset pre-eclampsia with FGR, suggesting FGR preceded clinical signs.
- Pregnancies with early-onset pre-eclampsia and FGR had significantly higher rates of placental abruption (8.3%) and perinatal deaths (28.7%).
Conclusions:
- Fetal growth retardation is significantly more prevalent in early-onset pre-eclampsia.
- Biochemical markers and hypoglycemia may indicate FGR preceding clinical pre-eclampsia diagnosis.
- Early-onset pre-eclampsia with FGR is associated with severe adverse outcomes, including placental abruption and perinatal mortality.
Abstract:
In a series of 2434 patients with pre-eclampsia, the prevalence of fetal growth retardation was 8.7 per cent compared with 8.6 per cent in the total hospital population. The prevalence was increased in early-onset pre-eclampsia (18.2 per cent) (P less than 0.001) and reduced in late-onset pre-eclampsia (5.6 per cent) (P less than 0.001). In patients who later developed early-onset pre-eclampsia with fetal growth retardation, the prevalence of subnormal oestriol excretion was significantly increased (79.5 per cent) (P less than 0.001) as was the prevalence of hypoglycaemia (33.3 per cent) (P less than 0.001) suggesting that fetal growth retardation in these pregnancies preceded the clinical signs of pre-eclampsia. The prevalence of placental abruption (8.3 per cent) and the prevalence of perinatal deaths (28.7 per cent) were both significantly higher in pregnancies with early-onset pre-eclampsia and fetal growth retardation (P less than 0.001).