RECURRENT PREECLAMPSIA IN THE SAME PATIENT

Abstract

Introduction: Preeclampsia is a complex disease that occurs in 5-7% of the entire population. Preeclampsia is an important cause of maternal and perinatal mortality. The etiology of preeclampsia is unknown, but recent research suggests that these disorders originate in the placenta and are characterized by extensive maternal endothelial dysfunction. This leads to inadequate blood supplementation and oxidative stress. Placental factors such as soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble receptor for vascular endothelial growth factor (VEGF), are released into the maternal circulation, where they stimulate the inflammatory response and endothelial dysfunction. Objective: To demonstrate the possibility of preventing severe preeclampsia in the same patient by determining the ratio of angiogenic factors sFlt-1/ PLGF. With early detection of angiogenic factors, the patient is monitored more closely when the growth of angiogenic factors begins without clinical manifest symptoms and timely termination of pregnancy in the interest of the patient’s health. Case Report: Monitor the clinical form of preeclampsia in a patient in her two pregnancies. In the first pregnancy, the patient develops the most severe form of preeclampsia (Eclampsia and HELLP Syndrome) at 29.1 weeks gestation. The postpartum patient is in serious condition with a stay in the Intensive Care Unit. During the first pregnancy, in 2014, angiogenic factors were not examined. In the second pregnancy, 2020/ 2021, in the second trimester (in the 24th week of gestation), the angiogenic factors are started to be examined. Along with the ultrasound examination and measurement of the mean arterial pressure, the danger of developing severe preeclampsia is detected early in pregnancy and with careful monitoring of the patient it ends in time before the patient’s health is seriously endangered. Conclusion: Preeclampsia is a unique health condition that occurs only in pregnancy and that can seriously endanger the health of both mother and fetus. With the development of medicine, many tests are being developed that try to diagnose the occurrence of preeclampsia very early. Recent studies of angiogenic factors and the correlation between sFlt-1/ PLGF have been shown to be sensitive in predicting preeclampsia, as well as in patient’s case studies.