Early Onset Preeclampsia Diagnosis Prior to the 20th Week of Gestation in a Twin Pregnancy Managed via Selective Reduction of an Intrauterine Growth Restriction Fetus: A Case Report and Literature Review

Diagnostics

Konstantinos Pantos¹  Anastasios Konstantopoulos¹  Alexandros Grammatis¹  Konstantinos Sfakianoudis¹  Nikolaos Bathrellos¹  Agni Pantou¹  Adamantia Kontogeorgi²  Anna Rapani²  Sokratis Grigoriadis²  Mara Simopoulou² 

[1] Centre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, Greece;Laboratory of Experimental Physiology, Department of Physiology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece;

关键词: early onset preeclampsia;    twin pregnancy;    selective embryo reduction;    live birth;   

DOI  :  10.3390/diagnostics10080531

来源: DOAJ

【 摘 要 】

A single, healthy, 44-year-old perimenopausal woman pursuing a pregnancy, employed donor embryos, resulting to a dichorionic diamniotic twin pregnancy. In the 18th week of gestation severe symptoms indicated early onset preeclampsia reporting severe hypertension (BP 180/90 mmHg), intense headaches and nausea as well as elevated 24-h urine protein levels (1.5 g/day). Concurrently diagnosis of an IUGR fetus was concluded. Standard pharmaceutical administration for treating preeclampsia was ordered. Persistence of symptoms indicated recommendation for pregnancy termination, however the patient opted against this. Selective embryo reduction was performed as the last resort prior to pregnancy termination. Following selective reduction the headaches and nausea were successfully subdued and the patient’s blood pressure was adjusted (mean BP 130/80 mmHg). This enabled further progression of pregnancy for an impressive 11 week-period, and a live birth on the 30th week. To conclude, only a few rare cases have been reported with diagnosis of early onset preeclampsia prior to the 20th week mark and none report live births. Albeit termination of pregnancy was recommended, the management of selective reduction of the IUGR fetus enabled successful treatment of preeclampsia coupled by a live birth of a healthy infant without any perinatal or postnatal complications reported.

【 授权许可】

Unknown