To investigate the effects of maternal and neonatal outcomes of preeclampsia and levels of markers

ABSTRACT INTRODUCTION: Hypertensive diseases are the most frequently seen medical complications during pregnancy and they make up %5-10 of all pregnancies. These diseases are most important causes of maternal and perinatal mortality and morbidity. Hypertensive diseases, seen in pregnancy are 4: Chronic hypertension, preeclampsia superimposed by chronic hypertension, gestational hypertension and preeclampsia-eclampsia. The preeclampsia cases represents a challenge for the clinician faced with their antepartum or postpartum care. Early detection of high-risk individuals by well- trained medical personnel and timely referral to advanced tertiary centers will bring to improved perinatal and maternal outcomes in this critical group of patients. AIM: In the year 2013 it was proposed by ACOG (American College of Obstetricians and Gynecologists) to remove proteinuria as an indicator of preeclampsia severity. This research aims to study the relationship between preeclampsia indicators –mainly proteinuria- and perinatal or neonatal results. MATERIALS AND METHODS: The diagnosis and classification of preeclampsia is based on „ACOG Task force on hypertension in pregnancy 2013‟ criteria. Düzce University Ethics Board approved the study. 200 women with 25 to 42 weeks of pregnancy were enrolled in the study. Of 200 women enrolled in the study who referred to Obstetrics and Gynecology ward between January 2012 and September 2015; 100 had preeclampsia and 100 became the control group with no conditions of medical or obstetric complications. The pregnant women enrolled to the study are asked for age, gravida, parity, abortus history. Blood pressure is measured. Time of hospitalization, hematologic and biochemistry parameters, type of delivery, caesarean indication if done, ablatio placentae, DIC, acute renal failure, pulmonary embolia, intracranial hemorrhagia, the need for transfusion of fresh frozen plasma, platelet suspension, need for dialysis, plasmapheresis, liver subcapsular hematoma were inquired then recorded. The features of the newborn; measurements of height, weight, FGR(fetal growth restriction), ARDS (acute respiratory distress syndrome), NEC (necrotizing enterocollitis), sepsis, need for intensive care were inquired then recorded. The (HGB)haemoglobin, (HTC)hematocrit, platelet, alanine transaminase(ALT), vii aspartate transaminase (AST) lactate dehydrogenase (LDH), INR, BUN, creatinine, aPTT, PT parameters were tested and recorded. Descriptive statistics are presented as frequency, percentage, mean, median, minimum and maximum values. Comparisons were made for the continuous variables between patient and control groups. For the continuous variables correlated with normal distribution Independent samples t-test was used and for the continuous variables not correlated with normal distribution Mann-Whitney U test was used. In the correlation analysis for continuous variables; Pearson Correlation coefficient was calculated for normal distribution variables and Spearman rho correlation coefficient was calculated for the variables not in normal distribution. SPSS v22 program was used for analyses and the values which are less than 0.05 were accepted as significant. RESULTS: In pregnant women with preeclampsia, as proteinuria amount increases; the cesarean rates(p=451), ablatio placentae rates(p=0.312), the need for antihypertensive therapy (p=0.323), transfusion of blood and blood products(p=0.319) increases as well but they are not statistically significant. Neonatal intensive care need (p=0.015) increases with proteinuria and is statistically significant. For neonatal intensive care patients with FGR (p=0.033), RDS (p=0.613), sepsis (p=0.065); the rates increase with proteinuria amount but they are not statistically significant. Eclampsia was seen only in patients with +3 proteinuria and found to be statistically significant (p=0.018). According to this study results, maternal and neonatal complications increases as the proteinuria amount increases but it is not statistically significant. According to the article they published in 2013, ACOG removes massive proteinuria as diagnostic criteria of severe preeclampsia and states that proteinuria amount has minimal relation to neonatal and maternal results. In this study, we reach ed the conclusion that as the amount of proteinuria increases maternal and neonatal complications increases as well but they are not statistically significant. Key words:( Preeclampsia, Proteinuria, Maternal-Perinatal outcomes)