Monitoring hypertensive disorders in pregnancy to prevent preeclampsia in pregnant women of advanced maternal age: Trial mimicking with retrospective data

Deng Yali; She Lifei; Li Xiaoye; Lai Weisi; Yu Ling; Zhang Wen; Nie Yanting; Xiao Songyuan; Liu Hongyu; Zhou Yang; Luo Ting; Deng Wen; Liu Jinyu; Zhou Xihong; Wen Ying; Zhong Yanhong; Xiao Lingyi; Ding Yiling; Peng Mei

doi:10.1515/med-2022-0560

Open Medicine (Nov 2022)

Monitoring hypertensive disorders in pregnancy to prevent preeclampsia in pregnant women of advanced maternal age: Trial mimicking with retrospective data

Deng Yali,
She Lifei,
Li Xiaoye,
Lai Weisi,
Yu Ling,
Zhang Wen,
Nie Yanting,
Xiao Songyuan,
Liu Hongyu,
Zhou Yang,
Luo Ting,
Deng Wen,
Liu Jinyu,
Zhou Xihong,
Wen Ying,
Zhong Yanhong,
Xiao Lingyi,
Ding Yiling,
Peng Mei

Affiliations

Deng Yali: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
She Lifei: Department of Pharmacy, The Maternal and Child Health Hospital of Hunan Province, Changsha 410000, P.R. China
Li Xiaoye: Department of Gynaecology and Obstetrics, Sanya Central Hospital (Hainan Third People’s Hospital), Sanya 572000, P.R. China
Lai Weisi: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Yu Ling: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Zhang Wen: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Nie Yanting: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Xiao Songyuan: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Liu Hongyu: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Zhou Yang: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Luo Ting: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Deng Wen: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Liu Jinyu: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Zhou Xihong: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Wen Ying: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Zhong Yanhong: Department of Gynaecology and Obstetrics, Maternal and Child Health Hospital in Yuanjiang City, Yuanjiang 413111, P.R. China
Xiao Lingyi: Department of Gynaecology and Obstetrics, Affiliated Hospital of Xiangnan University, Chenzhou 423000, P.R. China
Ding Yiling: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, Changsha 410011, P.R. China
Peng Mei: Department of Gynaecology and Obstetrics, The Second Xiangya Hospital of Central South University, No. 139 People’s Middle Road, Changsha 410011, P.R. China

DOI: https://doi.org/10.1515/med-2022-0560
Journal volume & issue: Vol. 17, no. 1
pp. 1840 – 1848

Abstract

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This study investigated the implication of monitoring hypertensive disorders in pregnancy (HDP) to prevent preeclampsia (PE) in pregnant women of advanced maternal age. Between January 2016 and April 2021, 262 consecutive pregnant women aged ≥40 years were recruited. Extensive monitoring of hypertensive disorders in pregnancy, including blood hypercoagulability screening and subsequent interventions, was performed in 129 pregnant women in our university hospital. The remaining 133 patients from other centres, who did not receive antenatal maternal pregnancy screening and preventive intervention during the same period, constituted the non-intervention group enabling comparison to mimic a trial. The incidences of hypertensive disorders, mild and severe PE, eclampsia, and chronic hypertension complicated by PE in the intervention group were significantly lower than in the non-intervention group (10.08 versus 20.30%, 8.52 versus 18.80%, 7.75 versus 21.05%, 0 versus 3.01%, and 3.86 versus 15.04%, respectively; P < 0.05). Premature birth, low birth weight, and foetal loss were significantly rarer in the intervention group than in the non-intervention group (6.98 versus 24.81%, 7.75 versus 21.80%, and 0.78 versus 14.29% respectively; P < 0.001). The comparison of MP with routine blood coagulation biochemical examination found that the MP detection system of Beijing Yes Medical Devices Co., Ltd., had similar sensitivity as thromboelastogram. Still, it was significantly better than the routine biochemical indicators (P < 0.01). Based on MP parameters, early anticoagulant treatment with low-molecular-weight heparin or low-dose aspirin in pregnant women with hypercoagulability can effectively prevent the occurrence of PE and significantly improve the prognosis of both mothers and infants.

Published in Open Medicine

ISSN: 2391-5463 (Online)
Publisher: De Gruyter
Country of publisher: Poland
LCC subjects: Medicine
Website: https://www.degruyter.com/journal/key/med/html

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