Clinico-laboratorial blood indices as possible predictors of preeclampsia with early and late manifistation

Aim. To reveal the characteristics of clinico-laboratorial indices in early (to 34 gestation weeks) and late preeclampsia onset. Material and methods. We performed the investigation (combination of prospective and case-control study) of 105 women with late preeclampsia (the onset after 34 weeks) and of 76 women with early one; we also studied pregnancy outcomes and dynamics of hematological and immune-biochemical blood indices. Results. We did not reveal any associations of late preeclampsia with “maternal contribution” (obesity, chronic arterial hypertension, or kidney disease). In case of early preeclampsia the pregnancy was often induced upon ART-programme, was multiple and accompanied by severe form of preeclampsia and placental disturbances, it was also conjugated with high perinatal morbidity and mortality. Anemia with relative iron deficiency and inadequate erythropoietin production developed in early preeclampsia. We also observed proinflammatory restructuring of differential blood cell count and lipid profile with increase of system inflammation markers (Kalf-Kalifa index, hs C-reactive protein), considerable reduction of initially relatively increased platelet levels, growth of liver function test indicators, decrease of total blood protein level accompanied by increase of nitrogen metabolism (creatinine, urea), and changes in electrolyte status (relative hypernatremia and hyperkalemia, hypocalcemia). Conclusion. Effective clinico-laboratorial predictors of early preeclampsia in the first trimester appeared to be erythropoietin (EPO) production less than 10.75 mmol/L (specificity 86.2%, sensibility 71.4%, accuracy 78.8%); OEPO/PEPO ratio (observed EPO value to predicted EPO value ratio) less than 0.770 (specificity 72.4%, sensibility 71.4%, accuracy 71.9%), which suggests possible erythropoietin participation in pathogenesis of early preeclampsia.