Objective To investigate the relation of Human Leukocyte Antigen-DRs to Pre-eclampsia/eclampsia （PE/E） by reviewing the observational studies on PE/E. Methods We searched the MEDLINE/PubMed, EMBASE, The Cochrane Library and CBMdisc to July 2005, by combining free text with MeSH words. We assessed the quality of included studies, extracted and analyzed data. Results The odds ratio of fetal-maternal HLA-DR4 antigen frequency in case group versus control group was 2. 60 （95% CI 1.87 to 3.60） with statistical significance. The antigen frequencies of＇other fetal-maternal HLA-DRs in case and control groups were not statistically significant. The antigen frequencies of the couple HLA DRs were not statistically significant between case and control groups. We found that neither the HLA-DR sharing between the couples nor between fetus and mothers in case and control groups were statistically significant. Conclusions The antigen frequencies of HLA-DRs between the couples may have no association with the development of PE/E. The fetal gene types may be related to the development of PE/E. The HLA-DR sharing in mothers and fetus and the couples may have no association with the development of PE/E.
Objective To compare the central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) in healthy pregnant women and patients with pre-eclampsia. Methods A prospective control study. Twenty normal subjects, 20 healthy pregnant women and 20 patients with pre-eclampsia were included. The difference of gestational weeks between healthy pregnant women and patients with pre-eclampsia was not significant (χ2=0.012, P=0.913). The differences of age and spherical equivalent among normal subjects, healthy pregnant women and patients with pre-eclampsia were not significant (χ2=1.760, 0.087; P=0.413, 0.957). All eyes underwent optical coherence tomography examination to measure the CFT and SFCT. Results The mean CFT of normal subjects, healthy pregnant women and patients with pre-eclampsia were (194.40±16.17), (201.2±17.33), (199.00±15.46) μm, there was no significant difference among the three groups (χ2=0.888, P=0.641). The mean SFCT of normal subjects, healthy pregnant women and patients with pre-eclampsia were (263.45±69.66), (330.00±49.20), (373.40±52.00) μm, there was significant difference among the three groups (χ2=22.818, P=0.000). The mean SFCT of healthy pregnant women was increased than that of normal subjects (Z=−2.991, P=0.002). The mean SFCT of patients with pre-eclampsia was increased than that of healthy pregnant women (Z=−2.638, P=0.007). Conclusion The mean SFCT of patients with pre-eclampsia is increased than healthy pregnant women.
ObjectiveTo observe and preliminary investigate the influencing factors of exudative retinal detachment in patients with severe preeclampsia (S-PE) and its influence on pregnancy outcome.MethodsA total of 89 patients of S-PE patients diagnosed in Department of Obstetrics in The Third Central Hospital of Tianjin from July 2018 to June 2020 were included in this study. According to whether the patients were complicated with exudative retinal detachment, they were divided into retinal detachment group (43 cases) and non retinal detachment group (46 cases). All patients underwent direct ophthalmoscopy, and those with suspected or definite retinal detachment underwent optical coherence tomography or B-mode ultrasonography. The age, course of disease, body mass index, systolic blood pressure, diastolic blood pressure, laboratory serum albumin level, 24 h urinary protein, platelet count, mean platelet volume, platelet distribution width and serum uric acid content were collected. The average age (t=−1.01), body mass index (t=−1.799), course of disease (t=−1.657) and constituent ratio of primipara and multipara in the two groups were compared (χ2=1.411), the difference was not statistically significant (P＞0.05). The end of pregnancy time, systemic complications, fetal outcomes and neonatal Apgar scores were analyzed, retrospectively. Independent sample t test was used to compare the quantitative data between the two groups; Chi square test was used to compare qualitative data. Binary logistic regression analysis to screen the influencing factors of exudative retinal detachment in S-PE.ResultsSystolic blood pressure and diastolic blood pressure were higher in the retinal detachment group than in the non retinal detachment group, and the difference was statistically significant (t=2.087, 2.810; P=0.040, 0.006). Serum albumin (t=−10.404), 24-hour urinary protein quantification (t=6.401), blood uric acid (t=3.910), platelet count (t=−6.124) and platelet distribution width (t=2.992) were compared between the two groups, and the differences were statistically significant (P＜0.05). There were 30 (69.77%, 30/43) cases in retinal detachment group and 14 (30.43%, 14/46) cases in non retinal detachment group with severe systemic complications; The average time of ending pregnancy was 34.66±3.29 and 38.25±1.62 weeks; The average Apgar scores at birth were 7.28±3.40 and 9.46±1.59. The incidence of severe systemic complications in two groups (χ2=13.755), the end of pregnancy time (t=−6.448), Apgar score at birth (t=−3.824), the differences were statistically significant (P=0.000、0.000、0.000). Fetal distress and death were 8 (18.60%, 8/43), 7 (16.28%, 7/43) and 7 (15.22%, 7/46), 1 (2.17%, 1/46) in retinal detachment group and non retinal detachment group respectively. There was no significant difference in the incidence of fetal distress between the two groups (χ2=0.182, P=0.670). The difference of fetal mortality was statistically significant (P= 0.027). Logistic regression analysis showed that serum albumin and uric acid were associated with exudative retinal detachment in patients with S-PE (P＜0.05).ConclusionsSerum albumin and uric acid are the influencing factors of exudative retinal detachment in patients with S-PE. Patients with exudative retinal detachment are prone to adverse pregnancy outcomes.