PERINATAL OUTCOMES IN PATIENTS WITH EARLY AND LATE SEVERE PREECLAMPSIA

F.Z. OLIMOVA, M.F. DODKHOEVA, Z.D. SALIMOVA

Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To study perinatal outcomes in patients with early and late severe preeclampsia (PE).

Methods: A prospective study was conducted with 140 patients with severe PE admitted to the intensive care unit at the City Maternity Hospital No. 1 in Dushanbe, Republic of Tajikistan. The patients were divided into two groups: 1st group (n=47) included pregnant women with severe PE and a gestation period of up to 34 weeks, referred to as the early PE group. The 2nd group (n=93) included pregnant women with PE and a gestation period of 36 to 42 weeks, classified as the late PE group. The analysis examined various parameters, including age, parity, comorbidities, obstetric history, complications during the current pregnancy, complications during childbirth, prior pregnancy outcomes for both the mother and fetus, and complications during the postpartum period.

Results: The average gestational age in the pregnant women in the early PE group was 31.7±0.4 weeks, while in the late PE group, it was 38.7±0.1 weeks. A high incidence of premature birth was observed among patients in the early PE group. Placental abruption (PA) or abruptio placentae which refers to a premature separation of the normally implanted placenta that occurred in one out of every eight patients in this group (p=0.017). The incidence of intrapartum fetal death and disseminated intravascular coagulation (DIC) was also notably high, at 4% in the early PE group. The median birth weight of newborns born to mothers with severe PE in the early PE group was 1,840.0 g; in the late PE group, it was 3,160.0 g (p<0.001). Perinatal encephalopathy was diagnosed at the same frequency in both groups (p>0.05). Low birth weight and respiratory distress syndrome (RDS) were predominantly found among newborns born from mothers in the early PE group (p<0.001). Additionally, the frequency of pneumonia and intrauterine infections among newborns was statistically significantly higher in the early PE group (p=0.013 and p=0.037, respectively).

Conclusion: Early PE is almost always associated with the induction of labor and the birth of premature infants, often occurring alongside intrauterine growth restriction (IUGR) syndrome. This condition is linked to a high frequency of perinatal morbidity and mortality. Neonatal mortality in 11 out of 44 (25%) newborns born to mothers with early-onset preeclampsia was attributed to complications such as prematurity, IUGR, and pneumonia. These findings underscore the importance of postpartum observation and medical counseling for both mothers and their newborns who are at high risk for perinatal complications.

Keywords: Preeclampsia, pregnancy, perinatal outcomes, premature birth, intrauterine growth retardation..

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