Effect Of Hypoproteinemia On Clinical Outcomes In Patients With Severe Preeclampsia

Objective1.To explore the effect of hypoproteinemia on clinical outcomes of severe preeclampsia patients.2.To investigate the plasma albumin level and therapeutic significance of severe preeclampsia patients after termination of pregnancy.MethodPart ?:A retrospective analysis of 677 patients hospitalized in the Second Hospital of Shandong University from April 2013 to April 2019 and diagnosed as severe preeclampsia was conducted.According to the plasma albumin value in liver function examination at admission,the patients were divided into severe preeclampsia combined with hypoalbuminemia group based on the plasma albumin value of 30g/L(no human albumin was used before termination of pregnancy in all patients).Plasma albumin<25g was group A,plasma albumin 25-<30g was group B)and severe preeclampsia albumin normal group(group C).The differences in conditions,complications,mode of delivery,pregnancy outcome and birth weight of newborns between the two groups were compared.Part ?:297 cases of severe preeclampsia(non-chronic hypertension)with singleton pregnancy were reviewed for plasma albumin after termination of pregnancy,of which 147 cases were treated with human albumin and 150 cases were not treated with human albumin.Group a was the 24-hour review group,group B was the 48-hour review group,and group C was the 72-hour review group.Statistical methods:t-test,t'test,2 test,non-parametric test and linear correlation analysis were used for data comparison.ResultPart ?:1.The number of pleural,peritoneal and pericardial effusion in severe preeclampsia patients with hypoalbuminemia was significantly higher than that in patients with normal albumin(P?0.05),but the degree of plasma albumin reduction did not affect the incidence of serous effusion.2.The number of weeks of termination of pregnancy and the incidence of premature delivery in severe preeclampsia patients with hypoalbuminemia were significantly higher than those in patients with normal plasma albumin(P?0.05),and the lower the plasma albumin level,the shorter the weeks of termination of pregnancy and the higher the incidence of premature delivery.3.The number of low birth weight neonates delivered in severe preeclampsia combined with hypoalbuminemia group was significantly higher than that in normal plasma albumin group,and the weight of neonates delivered in severe preeclampsia combined with hypoalbuminemia group was significantly lower than that in normal plasma albumin group(P?0.05).The lower the level of plasma albumin,the higher the incidence of low birth weight neonates and the newbornThe lower the birth weight of the baby.Part ?:1.There were differences in plasma albumin levels between patients who used human albumin before termination of pregnancy and those who did not(P?0.05).There were also differences in plasma albumin levels between patients who used human albumin 48 hours and 72 hours after termination of pregnancy and those who did not(P?0.05),while there were differences in plasma albumin levels between patients who used human albumin 24 hours after termination of pregnancy and those who did not(P?0.05).There was no significant difference in plasma albumin level between patients with serum albumin(P?0.05).2.The decrease of plasma albumin level is more obvious in patients without human albumin after termination of pregnancy.The difference ratio of plasma albumin level between severe preeclampsia patients treated with human albumin and severe preeclampsia patients not treated with plasma albumin was different at 48 hours and 72 hours after termination of pregnancy(P?0.05),but not at 24 hours after termination of pregnancy(P?0.05).Conclusion1.Most patients with severe preeclampsia have a tendency to decrease the plasma albumin level,and the plasma albumin level is related to the severity of the disease to some extent.2.Severe preeclampsia combined with hypoalbuminemia is associated with adverse pregnancy outcomes.Severe preeclampsia patients with hypoalbuminemia are more likely to have complications such as serosal effusion,and patients often choose to terminate pregnancy earlier because of their more serious conditions.3.The plasma albumin level in severe preeclampsia patients is related to the birth weight of perinatal infants,and the newborns delivered by patients with hypoalbuminemia tend to have lower birth weight,which indicates that the growth and development of fetuses and newborns are adversely affected by maternal hypoalbuminemia.4.The trend of further decrease of plasma albumin in severe preeclampsia patients after termination of pregnancy can be effectively alleviated,and this effect is more obvious at 48 hours and 72 hours after termination of pregnancy.5.Monitoring the plasma albumin level of severe preeclampsia patients is conducive to early identification of the disease progression of severe preeclampsia patients,and strive for a favorable opportunity for clinical treatment.