One of the leading causes of maternal and neonatal morbidity and mortality is preeclampsia (Pregnancy-related hypertensive illnesses). Over two decades have passed, yet the cause of preeclampsia is still mostly unknown. The management of this condition has not altered significantly.
Historically, case reports and case series have communicated new knowledge about current conditions. It is unknown if this holds with preeclampsia. An international magazine on women’s health released a recent study.
The authors ascertain whether recent case reports or case series have produced new information and clinical findings on preeclampsia. Clinical observations have played a significant role in accumulating knowledge about illnesses, treatments, and the human body. Clinical research relies heavily on meticulous observation, like scientific research.
The conventional approach to disseminating these initial clinical observations and findings has been through case reports and case series. Case reports or case series have been the first to document many medical findings in the literature.
Toxic shock syndrome and its link to tampon use, malignant hyperthermia treated with dantrolene, the psychopharmacological characteristics of lithium and chlorpromazine, and the description of uncommon infections and cancers that led to the identification of HIV infection are a few examples. Recently, we have seen the utilization of unique clinical findings that are transmitted in different ways in identifying and treating COVID-19.Â
Pregnancy-related hypertension disorders are a major global cause of maternal mortality and morbidity; they account for roughly 18% of all maternal deaths worldwide and impact between 5% and 10% of pregnancies. One such hypertensive pregnancy problem is preeclampsia, characterized by resistant hypertension, proteinuria, or other unfavorable circumstances or consequences.
Untreated preeclampsia can progress to eclampsia; severe versions of the condition can present as hemolysis, high liver enzymes, and low platelet count (HELLP) syndrome. High rates of morbidity and mortality are linked to both HELLP and eclampsia. Â
Pregnancy-related hypertensive illnesses and their sequelae are among the oldest medical conditions ever documented; Hippocrates wrote one of the earliest accounts of eclampsia in the fifth century BCE. The past 20 years have seen significant advancements in our understanding of the pathophysiology of hypertensive diseases of pregnancy, but nothing has changed in the therapeutic management of preeclampsia.Â
Authors conclude that, To the best of our knowledge, a systematic analysis of case reports and case studies, including individuals with hypertensive disorders of pregnancy, including preeclampsia, has not been published before. Between 2015 and 2020, 104 case reports and three case series were found, covering 118 pregnant individuals diagnosed with pregnancy-related hypertension problems.
Notably, a trend emerged in the collected publications to report on favorable maternal outcomes (84%) and patients with severe presentation or complication (81%). 96 of the 118 patients included in these articles (81%) had a severe presentation or complication and a successful pregnancy.Â
Case studies and series, which present new clinical data in an organized and thorough way, can play a significant role in scientific discovery. Our research shows fewer than 25% of these preeclampsia trials had a clinical discovery element. According to the authors, our investigation indicates that most case reports and case series of hypertensive problems during pregnancy are of low quality and do not provide new information.
From 2015 to 2020, only 25% of published case reports and case series focused on a novel clinical observation or discovery; most of these cases dealt with preeclampsia management. The utility of these reports as valid sources of information for understanding and controlling hypertensive disorders of pregnancy was restricted due to a lack of complete reporting and an overall medium-to-low quality of the included research.Â
Reference Â
Janoudi G, Uzun Rada M, Boyd ST, Fell DB, Ray JG, Foster AM, Giffen R, Clifford TJ, Walker MC. Do Case Reports and Case Series Generate Clinical Discoveries About Preeclampsia? A Systematic Review. Int J Womens Health. 2023 Mar 21;15:411-425. doi: 10.2147/IJWH.S397680. Â
