الفهرس 
PREECLAMPSIAOnly 14 pages are availabe for public view
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Abstract
Eclampsia was firstly reported 2200 BC in papyri of ancient Egypt. Eclampsia is originally a Greek word ´eklampsis
and means ―bright light‖. For 2000 years, eclampsia was known as a disease of convulsions in late gestation that resolves by termination of pregnancy. Scientists of late 19th century recognized the similarity in the swollen appearance of pregnant women who had seizures and explained all by the onset of glomerulonephritis with proteinuria. With the advanced noninvasive blood pressure measurement, it was observed that those women had increased blood pressure and not a long time before understanding that proteinuria and arterial hypertension occurrence before seizures. Thus, it was defined as ―pre- eclampsia‖ that now it is a life-threatening condition for both the mother and the fetus.
Nowadays, hypertensive disorders during pregnancy, with an incidence that varies according to different measures, can exceed 10% in some population. Between multiple causes of maternal mortality and morbidity Pre-eclampsia and eclampsia are the second or third.
Pre-eclampsia (PE), a complex, multisystem, pregnancy- associated hypertensive disorder, typically developing after the 20th week of gestation, that complicates 2–8% of pregnancies, is a leading cause of neonatal and maternal mortality and morbidity.
This Prospective Cohort study was conducted at tertiary care hospital at Ain Shams University hospitals from June 2021 till January 2022 and performed on total of 100 patients who diagnosed as non-severe pre-eclampsia after exclusion of severity features.
In this study, we aimed to identify different factors predicting transformation of non-severe pre-eclampsia in to pre-eclampsia with severe features.
Most of the previous literature used combinations of biomarkers with clinical factors in diagnostic performance in predicting pre-eclampsia while our study used clinical factors only for prediction of transformation of non-severe pre- eclampsia into preeclampsia with severe features.
The current study revealed that transformation to severe pre-eclampsia occurred in 33% of the studied cases and BMI, past and family histories of preeclampsia statistically were significantly higher in cases transformed into preeclampsia with severe features.
Our study results revealed that Admission blood pressure, albumin by dipstick, Oligohydramnios and IUGR statistically were significantly higher in cases with transformation of non severe pre-eclampsia into pre-eclampsia with severe features. Platelet count statistically was
significantly lower in cases with transformation of non severe pre-eclampsia into pre-eclampsia with severe features.
Our study results revealed that only BMI, Admission GA, Admission SBP, Admission DBP and Platelet count statistically had low significant diagnostic performance in predicting transformation of non severe pre-eclampsia into pre- eclampsia with severe features and the reported performance of clinical risk factors to predict pre-eclampsia is modest, with an AUC (area under the curve) in the order of 0.642 to 0.669. Other parameters had no significant predictive value.
We concluded that our study results identified the most important clinical risk factors for transformation to severe features of pre-eclampsia from non-severe features and provided new information on the level of risk associated with specific combinations of risk factors (BMI ≥35.4, Admission GA, Admission SBP, Admission DBP, albumin dipstick 4+ and Platelet count) with low significant diagnostic performance in predicting transformation of non severe pre-eclampsia into pre- eclampsia with severe features.
We recommend future prospective studies with larger sample sizes demonstrating the long-term outcomes of biomarkers and uterine artery Doppler studies for prediction of severe features of preeclampsia.