Monitoring of Pregnancy-Induced Hypertension Syndrome Combined with Ultrasound Monitoring in Early Pregnancy to Prevent Chronic Hypertension with Preeclampsia

Songyuan Xiao¹, Jinyu Liu¹, Bo Liu¹, Ling Yu¹, Yali Deng¹, Wen Zhang¹, Yanting Nie¹, Weisi Lai¹, Hongyu Liu¹, Yang Zhou¹, Li Yu², Ying Wen¹, Bo Zhou³, Yanhong Zhong⁴, Lingyi Xiao⁵, Yiling Ding¹, Mei Peng^1,*

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¹ Department of Gynecology and Obstetrics, The Second Xiangya Hospital, Central South University, 410011 Changsha, Hunan, China

² Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, 410011 Changsha, Hunan, China

³ Department of Gynecology and Obstetrics, Ningxiang Hospital Affiliated to Hunan University of Traditional Chinese Medicine, 410600 Ningxiang, Hunan, China

⁴ Department of Gynecology and Obstetrics, Yuanjiang Maternal and Child Health Care Hospital, 413100 Yuanjiang, Hunan, China

⁵ Department of Gynecology and Obstetrics, Affiliated Hospital of Xiangnan University, 423000 Chenzhou, Hunan, China

^*Correspondence: pm3971@csu.edu.cn (Mei Peng)
Academic Editor: Paolo Ivo Cavoretto

Clin. Exp. Obstet. Gynecol. 2023, 50(1), 16; https://doi.org/10.31083/j.ceog5001016

Submitted: 3 September 2022 | Revised: 11 November 2022 | Accepted: 15 November 2022 | Published: 13 January 2023

This is an open access article under the CC BY 4.0 license.

Abstract

Background: This study explored the guiding value of monitoring pregnancy-induced hypertension syndrome (MP) for blood hypercoagulability in combination with ultrasound monitoring of uterine artery blood flow in early pregnancy and fetal growth and development in the second and third trimesters, with the goal of preventing chronic hypertension with preeclampsia (PE) and its clinical effects. Methods: The medical records of 189 pregnant patients with chronic hypertension between June 2016 and June 2021 were retrospectively analyzed; among them, 98 constituted the intervention group. The intervention group received MP screening for blood hypercoagulability in combination with ultrasound monitoring of uterine artery blood flow in early pregnancy and fetal growth and development in the second and third trimesters of pregnancy. Those with abnormalities were given timely symptomatic (low-molecular-weight heparin with or without aspirin) and supportive treatment. The remaining 91 patients who did not receive timely monitoring and intervention constituted the control group. Fetal outcomes and PE rates were compared between groups. Results: The PE incidence in the intervention group was significantly lower than that in the control group (p $<$ 0.01), and the premature delivery of low-birth-weight neonates, fetal loss and neonatal asphyxia incidences were also significantly lower in the intervention group than the control group (p $<$ 0.05). Conclusions: MP screening for blood hypercoagulability combined with ultrasound monitoring of uterine artery blood flow can effectively prevent PE occurrence in pregnant patients with chronic hypertension and significantly improve fetal outcomes. Additionally, MP screening is noninvasive and easy to use at a low cost.

Keywords

ultrasound

uterine artery blood flow

chronic hypertension

low-molecular-weight heparin

preeclampsia

Funding

2021JGB149/Research Project on Degree and Graduate Education and Teaching Reform of Nanjing University

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Fig. 1.

Intervention flow chart for the intervention group ( $\leq$ 12 gestational weeks). MP and uterine artery blood flow (UABF) notch monitoring were performed. The intervention mainly involved low-molecular-weight heparin (LMWH), assisted with aspirin.

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Clin. Exp. Obstet. Gynecol. Print ISSN 0390-6663 Electronic ISSN 2709-0094