Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review

Bersaoui Marianne; Halimeh Rawad; Msallem Mark; Chedid Julien; Feghali Joe

doi:doi:10.11648/j.jgo.20210901.16

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Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review

Bersaoui Marianne, Halimeh Rawad, Msallem Mark, Chedid Julien, Feghali Joe

Published in Journal of Gynecology and Obstetrics (Volume 9, Issue 1)

Received: 10 February 2021 Accepted: 20 February 2021 Published: 27 February 2021

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Abstract

Preeclampsia is one of the most common causes of maternal mortality in the developed world. Until today, it is still one of the most researched entities in obstetrics mainly because it increases the risk of gestational complications, life-long sequalae and increased maternal and neonatal morbidity. Therefore, all causes of hypertension and /or proteinuria need to be ruled out of our differential diagnosis to get a clear definition of preeclampsia and manage it appropriately. Our case describes a patient with hypertension and proteinuria that presented after the 20^th week of gestation. In hospital management and close follow up was done with patient’s symptoms, blood pressure, laboratory values and proteinuria resolving during her gestation leading to a good obstetrical and neonatal outcome. It has never been reported in literature to have a resolving case of hypertension and proteinuria in a singleton gestation resulting in a healthy living neonate. Our findings raise a lot of questions about the pathophysiology of the disease and whether preeclampsia can normalize before the delivery of the placenta. Therefore, is it time we start thinking about the maternal cardiovascular origin of preeclampsia instead of the placental vascular origin. We definitely need bigger studies to ascertain these clinical findings.

Published in	Journal of Gynecology and Obstetrics (Volume 9, Issue 1)
DOI	10.11648/j.jgo.20210901.16
Page(s)	26-30
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Preeclampsia, Hypertension, Gestation, Pregnancy, Proteinuria

References

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[2]	American College of Obstetricians and Gynecologists. 2013. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and Gynecology 122: 1122–1131.
[3]	Creanga A. A., Berg C. J., Syverson C., et al: Pregnancy-related mortality in the United States, 2006-2010. Obstet Gynecol 2015; 125: pp. 5-12.
[4]	Peter von Dadelszen, Laura A. Magee & James M. Roberts (2003) Subclassification of Preeclampsia, Hypertension in Pregnancy, 22: 2, 143-148, DOI: 10.1081/PRG-120021060.
[5]	Rana, S., Lemoine, E., Granger, J. P., & Karumanchi, S. A. (2019). Preeclampsia. Circulation Research, 124 (7), 1094–1112. doi: 10.1161/circresaha.118.313276.
[6]	Pham, A., Rosenthal, E., Roman, A., Makhamreh, M., Berghella, V., Farhi, F., & Al-Kouatly, H. B. (2020). Preeclampsia resolution after fetal death in multifetal gestation: A systematic literature review. American Journal of Obstetrics and Gynecology, 222 (4), 385-389. doi: 10.1016/j.ajog.2019.10.097.
[7]	(2013). Hypertension in Pregnancy. Obstetrics & Gynecology, 122 (5), 1122–1131. doi: 10.1097/01.AOG.0000437382.03963.88.
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[9]	English, F. A., Kenny, L. C., & McCarthy, F. P. (2015). Risk factors and effective management of preeclampsia. Integrated blood pressure control, 8, 7–12. doi: 10.2147/IBPC.S50641
[10]	Lopez-Jaramillo, P., Barajas, J., Rueda-Quijano, S. M., Lopez-Lopez, C., & Felix, C. (2018). Obesity and Preeclampsia: Common Pathophysiological Mechanisms. Frontiers in Physiology, 9. doi: 10.3389/fphys.2018.01838.
[11]	Rolnik D. L., Wright D., Poon L. C., et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. The New England Journal of Medicine. 2017; 377 (7): 613–622. doi: 10.1056/NEJMoa1704559.
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[13]	Uzan, J., Carbonnel, M., Piconne, O., Asmar, R., & Ayoubi, J. M. (2011). Pre-eclampsia: pathophysiology, diagnosis, and management. Vascular health and risk management, 7, 467–474. doi: 10.2147/VHRM.S20181.
[14]	Airoldi, J. & Weinstein, L. (2007). Clinical Significance of Proteinuria in Pregnancy. Obstetrical & Gynecological Survey, 62 (2), 117-124. doi: 10.1097/01.ogx.0000253301.55009.ac.
[15]	Sibai, B. (2021). Preeclampsia and Hypertensive Disorders. In M. Landon (Author), Gabbe's Obstetrics: Normal and Problem Pregnancies (7th ed., Vol. 38, pp. 708-750). Elsevier.
[16]	Ekiz A, Kaya B, Polat I, et al. The outcome of pregnancy with new onset proteinuria without hypertension: retrospective observational study. J Matern Fetal Neonatal Med 2016; 29: 1765.
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APA Style

Bersaoui Marianne, Halimeh Rawad, Msallem Mark, Chedid Julien, Feghali Joe. (2021). Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review. Journal of Gynecology and Obstetrics, 9(1), 26-30. https://doi.org/10.11648/j.jgo.20210901.16

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ACS Style

Bersaoui Marianne; Halimeh Rawad; Msallem Mark; Chedid Julien; Feghali Joe. Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review. J. Gynecol. Obstet. 2021, 9(1), 26-30. doi: 10.11648/j.jgo.20210901.16

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AMA Style

Bersaoui Marianne, Halimeh Rawad, Msallem Mark, Chedid Julien, Feghali Joe. Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review. J Gynecol Obstet. 2021;9(1):26-30. doi: 10.11648/j.jgo.20210901.16

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@article{10.11648/j.jgo.20210901.16,
  author = {Bersaoui Marianne and Halimeh Rawad and Msallem Mark and Chedid Julien and Feghali Joe},
  title = {Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {9},
  number = {1},
  pages = {26-30},
  doi = {10.11648/j.jgo.20210901.16},
  url = {https://doi.org/10.11648/j.jgo.20210901.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210901.16},
  abstract = {Preeclampsia is one of the most common causes of maternal mortality in the developed world. Until today, it is still one of the most researched entities in obstetrics mainly because it increases the risk of gestational complications, life-long sequalae and increased maternal and neonatal morbidity. Therefore, all causes of hypertension and /or proteinuria need to be ruled out of our differential diagnosis to get a clear definition of preeclampsia and manage it appropriately. Our case describes a patient with hypertension and proteinuria that presented after the 20th week of gestation. In hospital management and close follow up was done with patient’s symptoms, blood pressure, laboratory values and proteinuria resolving during her gestation leading to a good obstetrical and neonatal outcome. It has never been reported in literature to have a resolving case of hypertension and proteinuria in a singleton gestation resulting in a healthy living neonate. Our findings raise a lot of questions about the pathophysiology of the disease and whether preeclampsia can normalize before the delivery of the placenta. Therefore, is it time we start thinking about the maternal cardiovascular origin of preeclampsia instead of the placental vascular origin. We definitely need bigger studies to ascertain these clinical findings.},
 year = {2021}
}

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TY  - JOUR
T1  - Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review
AU  - Bersaoui Marianne
AU  - Halimeh Rawad
AU  - Msallem Mark
AU  - Chedid Julien
AU  - Feghali Joe
Y1  - 2021/02/27
PY  - 2021
N1  - https://doi.org/10.11648/j.jgo.20210901.16
DO  - 10.11648/j.jgo.20210901.16
T2  - Journal of Gynecology and Obstetrics
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JO  - Journal of Gynecology and Obstetrics
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PB  - Science Publishing Group
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UR  - https://doi.org/10.11648/j.jgo.20210901.16
AB  - Preeclampsia is one of the most common causes of maternal mortality in the developed world. Until today, it is still one of the most researched entities in obstetrics mainly because it increases the risk of gestational complications, life-long sequalae and increased maternal and neonatal morbidity. Therefore, all causes of hypertension and /or proteinuria need to be ruled out of our differential diagnosis to get a clear definition of preeclampsia and manage it appropriately. Our case describes a patient with hypertension and proteinuria that presented after the 20th week of gestation. In hospital management and close follow up was done with patient’s symptoms, blood pressure, laboratory values and proteinuria resolving during her gestation leading to a good obstetrical and neonatal outcome. It has never been reported in literature to have a resolving case of hypertension and proteinuria in a singleton gestation resulting in a healthy living neonate. Our findings raise a lot of questions about the pathophysiology of the disease and whether preeclampsia can normalize before the delivery of the placenta. Therefore, is it time we start thinking about the maternal cardiovascular origin of preeclampsia instead of the placental vascular origin. We definitely need bigger studies to ascertain these clinical findings.
VL  - 9
IS  - 1
ER  -

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Author Information

Bersaoui Marianne

Department of Obstetrics and Gynecology, Saint George Hospital University Medical Center, Beirut, Lebanon
Halimeh Rawad

Department of Obstetrics and Gynecology, Saint George Hospital University Medical Center, Beirut, Lebanon
Msallem Mark

Faculty of Medicine, University of Balamand, Beirut, Lebanon Email address:
Chedid Julien

Department of Obstetrics and Gynecology, Saint George Hospital University Medical Center, Beirut, Lebanon
Feghali Joe

Department of Obstetrics and Gynecology, Saint George Hospital University Medical Center, Beirut, Lebanon

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APA Style

Bersaoui Marianne, Halimeh Rawad, Msallem Mark, Chedid Julien, Feghali Joe. (2021). Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review. Journal of Gynecology and Obstetrics, 9(1), 26-30. https://doi.org/10.11648/j.jgo.20210901.16

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ACS Style

Bersaoui Marianne; Halimeh Rawad; Msallem Mark; Chedid Julien; Feghali Joe. Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review. J. Gynecol. Obstet. 2021, 9(1), 26-30. doi: 10.11648/j.jgo.20210901.16

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AMA Style

Bersaoui Marianne, Halimeh Rawad, Msallem Mark, Chedid Julien, Feghali Joe. Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review. J Gynecol Obstet. 2021;9(1):26-30. doi: 10.11648/j.jgo.20210901.16

Copy | Download

@article{10.11648/j.jgo.20210901.16,
  author = {Bersaoui Marianne and Halimeh Rawad and Msallem Mark and Chedid Julien and Feghali Joe},
  title = {Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review},
  journal = {Journal of Gynecology and Obstetrics},
  volume = {9},
  number = {1},
  pages = {26-30},
  doi = {10.11648/j.jgo.20210901.16},
  url = {https://doi.org/10.11648/j.jgo.20210901.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210901.16},
  abstract = {Preeclampsia is one of the most common causes of maternal mortality in the developed world. Until today, it is still one of the most researched entities in obstetrics mainly because it increases the risk of gestational complications, life-long sequalae and increased maternal and neonatal morbidity. Therefore, all causes of hypertension and /or proteinuria need to be ruled out of our differential diagnosis to get a clear definition of preeclampsia and manage it appropriately. Our case describes a patient with hypertension and proteinuria that presented after the 20th week of gestation. In hospital management and close follow up was done with patient’s symptoms, blood pressure, laboratory values and proteinuria resolving during her gestation leading to a good obstetrical and neonatal outcome. It has never been reported in literature to have a resolving case of hypertension and proteinuria in a singleton gestation resulting in a healthy living neonate. Our findings raise a lot of questions about the pathophysiology of the disease and whether preeclampsia can normalize before the delivery of the placenta. Therefore, is it time we start thinking about the maternal cardiovascular origin of preeclampsia instead of the placental vascular origin. We definitely need bigger studies to ascertain these clinical findings.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Normalization of Hypertension and Proteinuria in a Singleton Gestation; a Case Report and Literature Review
AU  - Bersaoui Marianne
AU  - Halimeh Rawad
AU  - Msallem Mark
AU  - Chedid Julien
AU  - Feghali Joe
Y1  - 2021/02/27
PY  - 2021
N1  - https://doi.org/10.11648/j.jgo.20210901.16
DO  - 10.11648/j.jgo.20210901.16
T2  - Journal of Gynecology and Obstetrics
JF  - Journal of Gynecology and Obstetrics
JO  - Journal of Gynecology and Obstetrics
SP  - 26
EP  - 30
PB  - Science Publishing Group
SN  - 2376-7820
UR  - https://doi.org/10.11648/j.jgo.20210901.16
AB  - Preeclampsia is one of the most common causes of maternal mortality in the developed world. Until today, it is still one of the most researched entities in obstetrics mainly because it increases the risk of gestational complications, life-long sequalae and increased maternal and neonatal morbidity. Therefore, all causes of hypertension and /or proteinuria need to be ruled out of our differential diagnosis to get a clear definition of preeclampsia and manage it appropriately. Our case describes a patient with hypertension and proteinuria that presented after the 20th week of gestation. In hospital management and close follow up was done with patient’s symptoms, blood pressure, laboratory values and proteinuria resolving during her gestation leading to a good obstetrical and neonatal outcome. It has never been reported in literature to have a resolving case of hypertension and proteinuria in a singleton gestation resulting in a healthy living neonate. Our findings raise a lot of questions about the pathophysiology of the disease and whether preeclampsia can normalize before the delivery of the placenta. Therefore, is it time we start thinking about the maternal cardiovascular origin of preeclampsia instead of the placental vascular origin. We definitely need bigger studies to ascertain these clinical findings.
VL  - 9
IS  - 1
ER  -

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