Study on unparalleled damage of end organs in severe preeclampsia and perinatal outcomes

Objective To analyze the clinical characteristics of end target organ damage of severe preeclampsia （S-PE） and the relationship of different patterns of end organ damage and perinatal outcomes. Methods A prospective study was conducted in 191 pregnant women with S-PE. Early onset of S-PE was defined as those occurred at ≤34 weeks and late onset of S-PE as those at ≤34 weeks. The clinical data were evaluated. The relations between the pattern of end organ damage and maternal outcomes and perinatal mortality and morbidities were analyzed. Results 71.70% of all 191 S-PE cases were involved in single organ systemic damage, and the rate was higher than those involved in two or more end organ damage. In those women with single end organ damage, placenta （55.26%） and liver（15.79%） were the two main organs concerned in early onset group; while in late onset group they were placental（18. 42%, compared with the early onset group P〈0. 05）, cardiopul monary（10. 53%） and encephalic damage（10.53%）. In those women with two organs involved, placental and hepatic damage were the dominate damages in the early onset group and cardiopulmonary and nephric damage in late onset ones. In patient with multiple organ damage, no difference was found among different patterns of end organ damage. Perinatal mortality was much higher in patients with end organ damage than those without and those in the early onset group was higher than those of the late onset ones in single organ involved（P〈0.05）. However, no difference in the perinatal mortality was shown among those of two and multiple end organ involved, the same results was obtained in those in the early onset group with different patterns of end organ damage. In late onset group, perinatal mortality was much higher in two and multiple end organ damage patterns than those involved in single organ damage. Conclusions There is remarkable unparallel patterns in end organ damage involved in S-PE. Perinatal outcomes are strictly associated with the onset of S-PE, gestation at birth and the severity of disease as well as the status of end organ damage. Genetic heterogeneity may play a role in different trigger mechanism. Key words: Pre-eclampsia;  Pregnancy outcome