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421954 occurrences (No.40 in the rank) during 5 years in the PubMed. [no cache] 500 found

367) Although mean 2nd trimester hemoglobin concentration are higher in patients with subsequent development of severe preeclampsia, due to the low sensitivity and specificity of this parameter clinical use for identifying women at risk is of limited value.

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PMID:23089882 DOI:10.3233/CH-2012-1625

2015 Clinical hemorheology and microcirculation

* Rheologic results and their correlation to hemostatic changes in patients with moderate and severe preeclampsia: an observational cross-sectional study.

- Previous study have shown an association between failure of physiological hemodilution during 2nd trimester and an increased risk for the development of subsequent pregnancy complications such as early birth, birth of a growth retarded newborn (IUGR), low fetal birth weight and preeclampsia. The latter complication in particular goes along with dramatic changes in the placental perfusion as well as systemic maternal blood flow. Severity of preeclampsia may be preceded by distinct impaired hemodilution and reflected by the results of rheological parameters. A subgroup analysis was performed in a community based retrospective study of 4,985 consecutively recorded singleton pregnant women of whom 423 had preeclampsia. Mean 2nd trimester hemoglobin levels and blood rheological results at the time of delivery were assessed and compared in women with moderate and severe preeclampsia. Mean 2nd trimester hemoglobin levels were calculated from the maternal records. Rheological variables included plasma viscosity (KSPV 1 Fresenius) and Red blood cell aggregation in stasis and under low shear conditions (MA1-Aggregometer; Myrenne). According to the definition of the German Society of Gynecology and Obstetrics (DGGG) 314 women had moderate preeclampsia (74.2%), while 109 had severe preeclampsia due to the presence of a blood pressure>170/110 mmHg (n=41; 9.7%), and/or IUGR<5th percentile (n=28; 6.6%), and/or HELLP-Syndrome (n=10; 2.4%), and/or proteinuria≥5 g/24 h (n=30; 7.1%). Age, BMI, smoking, and maternal weight were comparable in the groups, while gestational age at delivery as well as fetal outcome parameter were statistically significant unfavourable in patients with severe preeclampsia. Mean 2nd trimester hemoglobin level were statistically significantly higher in women who developed severe vs. moderate preeclampsia (m=12.75±0.99 g/dL vs. m=12.50±1.05 g/dL; p=0.033). However, in the ROC calculations a hemoglobin value of 12.05 g/dL revealed best sensitivity (78%) and specificity (33.8%) in women with subsequent diagnosis of severe preeclampsia, whereas sensitivity was 100% for a value>10.95 g/dL. There were no statistically significant differences for none of the rheological parameters at the time of delivery between groups of patient with moderate v.s severe preeclampsia. Severe preeclampsia and IUGR, however, was associated with statistically significantly higher RBC aggregation as compared to patients with moderate preeclampsia. Plasma viscosity was statistically significantly (p<0.05) correlated with Fibrinogen values (r=0.16), leukocyte-(r=0.11) and platelets-count (r=0.127), and hemoglobin/hematocrit values in particular (r=0.23/0.26). Although mean 2nd trimester hemoglobin concentration are higher in patients with subsequent development of severe preeclampsia, due to the low sensitivity and specificity of this parameter clinical use for identifying women at risk is of limited value. On the other hand, a hemoglobin value below 11.0 g/dL excluded the risk for severe preeclampsia to 100%. Blood rheological parameters at the time of delivery in the absence of IUGR are not markedly influenced by severity of preeclampsia.

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(1)138 of	(9)9 in	(17)4 factors,	(25)2 managers
(2)72 factors	(10)7 group	(18)4 stratification	(26)2 mortality
(3)40 for	(11)6 ratio	(19)4 was	(27)2 perception
(4)24 factor	(12)5 behavior	(20)3 groups	(28)2 rates
(5)23 and	(13)5 is	(21)3 infants	(29)2 the
(6)16 null	(14)5 patients	(22)2 among
(7)13 assessment	(15)5 to	(23)2 during
(8)10 score	(16)4 areas	(24)2 estimators

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--- WordNet output for risk --- =>1.損害の恐れ, 危険, 冒険, リスク, 2.危険にさらす, 3.敢えてする, 被保険者, 被保険物, 危険にさらす, 賭けてみる Overview of noun risk The noun risk has 4 senses (first 2 from tagged texts) 1. (4) hazard, jeopardy, peril, risk, endangerment -- (a source of danger; a possibility of incurring loss or misfortune; "drinking alcohol is a health hazard") 2. (2) risk, peril, danger -- (a venture undertaken without regard to possible loss or injury; "he saw the rewards but not the risks of crime"; "there was a danger he would do the wrong thing") 3. risk, risk of infection -- (the probability of becoming infected given that exposure to an infectious agent has occurred) 4. risk, risk of exposure -- (the probability of being exposed to an infectious agent) Overview of verb risk The verb risk has 2 senses (first 2 from tagged texts) 1. (8) risk, put on the line, lay on the line -- (expose to a chance of loss or damage; "We risked losing a lot of money in this venture"; "Why risk your life?"; "She laid her job on the line when she told the boss that he was wrong") 2. (2) gamble, chance, risk, hazard, take chances, adventure, run a risk, take a chance -- (take a risk in the hope of a favorable outcome; "When you buy these stocks you are gambling") --- WordNet end ---