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Abstract
Pre-eclampsia is best described as a pregnancy specific syndrome of reduced organ perfusion secondary to vasospasm and endothelial activation. It is also defined as a multisystemic pregnancy-specific disorder that is diagnosed by new onset hypertension and proteinuria after 20 weeks gestation. It is a leading cause of maternal and fetal morbidity and mortality worldwide. That affects 2-5% of pregnancies.
Faulty placentation is an early event in the development of pre-eclampsia in which deficient replacement of the wall of the spiral arteries at the placental bed by trophoblast occurs, causing placental ischemic changes which produce variety of factors causing hematological disturbance including fragmentation haemolysis and elevated NRBCs count in peripheral circulation.
The current study was designed to correlate feto-placental blood flow in pre-eclamptic patients to nucleated red blood cell count in maternal and cord blood and to examine which parameter yields better diagnostic performance in the prediction of uteroplacental hypoperfusion.
Sixty pregnant women > 34 weeks gestation were recruited from El Shatby Maternity University Hospital, and were allocated into three groups,each (n=20). Group A with severe pre- eclampsia, Group B with mild pre-eclampsia and Group C healthy normotensive pregnant women as a control group.
All the cases were subjected to a full history taking, general examination including measurement of blood pressure, laboratory investigation including; complete blood picture, random blood sugar, prothrombin time, activity, blood urea, creatinine, uric acid, liver enzymes; ALT, AST and measurement of protein in 24 hours collected urine. Also, they were subjected to fetal assessment including ultrasonography, Doppler study of umbilical artery and non-stress cardiotocographic test. Their babies were subjected also to cord blood sampling for pH value and complete blood picture for NRBC count per 100 WBC.
The results of the present study were tabulated and statistically analyzed revealing that, there was positive significant association between fetoplacental blood flow – represented by S/D ratio of umbilical artery blood flow – and cord blood NRBCs count .Also, our study revealed that S/D ratio of U.A. blood flow confirmed better diagnostic performance as a predictor of uteroplacental hypoperfusion.