CONICET | Buscador de Institutos y Recursos Humanos

Gestational hypertensive disorders (GHD) constitute a group of pathologies whose etiology has not yet been elucidated. They could be different pathologies with similar clinical signs. Multiple pregnancies (MPs) with GHD are possible candidates to be studied as a separate group. Our hypothesis is that an insufficient relationship between the placenta and the baby in gestation could give rise to the clinical symptoms even though the placentation mechanism has not been inadequately developed. Objective: To characterize the GHD in MPs. Methodology: We conducted a retrospective approach in which all patients with MPs attended in the Hospital Posadas during 2010, 2012 and 2014 were studied. We focused on their obstetric history, birth weight and gestational age. Results: We studied 247 MPs. The incidence of MPs was between 1 and 2%, similar to previous reports described in the literature. Primiparous women with MPs have a 3.1-fold increase relative risk (1.31-7.30) of developing preeclampsia compared to those with a simple pregnancy (p=0.08). However, women with previous pregnancies and current MP have the same relative risk of developing preeclampsia compared to women with previous pregnancies and current single pregnancies (2.54 vs 2.34 p>0.05). We found no significant differences between the gestational ages, birth weights, intrauterine growth retardation incidence, and neonatal mortality rate between preeclamptic women with MP and normotensive women with single pregnancy. In addition, no significant differences were found in uric acid levels after the 20th week of gestation in both groups, which could rule out endothelial dysfunction (3.89±1.01 mg/dl vs 4.50±1.73 mg/dl, p>0.05). Conclusion: Our results support the hypothesis that preeclampsia in women with MPs may be due to a pathophysiological mechanism different from that proposed for women with simple pregnancy, perhaps related to a placental system that does not meet the fetal requirements.