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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; 15:411-425. [PMID: 36974131 PMCID: PMC10039711 DOI: 10.2147/ijwh.s397680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Background Preeclampsia is a leading cause of maternal and perinatal mortality and morbidity. The management of preeclampsia has not changed much in more than two decades, and its aetiology is still not fully understood. Case reports and case series have traditionally been used to communicate new knowledge about existing conditions. Whether this is true for preeclampsia is not known. Objective To determine whether recent case reports or case series have generated new knowledge and clinical discoveries about preeclampsia. Methods A detailed search strategy was developed in consultation with a medical librarian. Two bibliographic databases were searched through Ovid: Embase and MEDLINE. We selected case reports or case series published between 2015 and 2020, comprising pregnant persons diagnosed with hypertensive disorders of pregnancy, including preeclampsia. Two reviewers independently screened all publications. One reviewer extracted data from included studies, while another conducted a quality check of extracted data. We developed a codebook to guide our data extraction and outcomes assessment. The quality of each report was determined based on Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series. Results We included 104 case reports and three case series, together comprising 118 pregnancies. A severe presentation or complication of preeclampsia was reported in 81% of pregnancies, and 84% had a positive maternal outcome, free of death or persistent complications. Only 8% of the case reports were deemed to be of high quality, and 53.8% of moderate quality; none of the case series were of high quality. A total of 26 of the 107 publications (24.3%) included a novel clinical discovery as a central theme. Conclusion Over two-thirds of recent case reports and case series about preeclampsia do not appear to present new knowledge or discoveries about preeclampsia, and most are of low quality.
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Affiliation(s)
- Ghayath Janoudi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Stephanie T Boyd
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Deshayne B Fell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Joel G Ray
- Departments of Medicine, Health Policy Management and Evaluation, and Obstetrics and Gynecology, St Michael’s Hospital, University of Toronto, Toronto, ON, Canada
| | - Angel M Foster
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | - Tammy J Clifford
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Canadian Institute of Health Research, Government of Canada, Ottawa, ON, Canada
| | - Mark C Walker
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- International and Global Health Office, University of Ottawa, Ottawa, ON, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
- Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada
- BORN Ontario, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- Correspondence: Mark C Walker, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice Changing Research, Box 241, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada, Tel +1 613-798-5555 x76655, Email
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Marinho M, Nogueira R, Soares C, Melo M, Godinho C, Brito C. Placental spectrum features between mesenchymal dysplasia and partial hydatidiform mole coexisting with a live fetus. JOURNAL OF CLINICAL ULTRASOUND : JCU 2021; 49:841-846. [PMID: 34416021 DOI: 10.1002/jcu.23055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 06/24/2021] [Accepted: 08/06/2021] [Indexed: 06/13/2023]
Abstract
We report a case of a singleton hydrops pregnancy with placental gross and microscopic features between partial hydatidiform mole (PHM) and placental mesenchymal dysplasia (PMD) in a diploid live fetus. Pregnancy was complicated by early onset of growth restriction and pre-eclampsia. A female newborn was born at 29 weeks with no congenital malformations. Histology of the placenta revealed mixed phenotype of PMD and PHM, and genetic test results were normal.
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Affiliation(s)
- Márcia Marinho
- Department of Obstetrics and Gynecology, Centro Hospitalar Vila Nova Gaia/Espinho, Porto, Portugal
| | - Rosete Nogueira
- Embrio & Fetal Pathology Laboratory, CGC Unilabs/Centro de Genética Clínica, Porto, Portugal
- IVCS/3B's-PT Government Associate Laboratory, University of Minho, Braga/Guimarães, Portugal
| | - Célia Soares
- Department of Obstetrics and Gynecology, Centro Hospitalar Vila Nova Gaia/Espinho, Porto, Portugal
| | - Mónica Melo
- Department of Obstetrics and Gynecology, Centro Hospitalar Vila Nova Gaia/Espinho, Porto, Portugal
| | - Cristina Godinho
- Department of Obstetrics and Gynecology, Centro Hospitalar Vila Nova Gaia/Espinho, Porto, Portugal
| | - Conceição Brito
- Department of Obstetrics and Gynecology, Centro Hospitalar Vila Nova Gaia/Espinho, Porto, Portugal
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Sebire NJ. Recurrent GTD and GTD coexisting with normal twin pregnancy. Best Pract Res Clin Obstet Gynaecol 2020; 74:122-130. [PMID: 33451920 DOI: 10.1016/j.bpobgyn.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/04/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
Hydatidiform mole (HM) affects around 1/1000 pregnancies, and in such cases the recurrence risk is around 1%, being greater for those with complete HM (CHM). Whilst most cases appear sporadic with unknown mechanisms, there is a distinct subgroup of patients who suffer recurrent pregnancy loss, including multiple recurrent CHM (familial recurrent biparental HM syndrome). The majority of these cases are related to maternal genetic mutations in genes related to the control of imprinting, specifically NALP7 and KHDC3L. Oocyte donation is an effective treatment allowing these patients to have successful pregnancies. Approximately 1 in 50,000 pregnancies are complicated by twin pregnancy comprising normal foetus and HM, the majority of reported cases being CHM. Such pregnancies are at significantly increased risk of complications, including pregnancy loss, early-onset preeclampsia and severe preterm delivery, but when managed conservatively the delivery of a liveborn healthy infant occurs in around one-third of cases. Regardless of management, the risk of persistent GTD in such cases appears similar to that following singleton CHM. Rarely, other conditions mimic prenatal ultrasound appearances of twin pregnancy with HM, CHM mosaicism and placental mesenchymal dysplasia, both of which have distinctive histological and genetic features.
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Affiliation(s)
- Neil J Sebire
- Trophoblastic Disease Unit, Department of Histopathology, Charing Cross Hospital Imperial Nhs Trust, London, UK.
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