Therapeutic Plasma Exchange in Early-Onset Preeclampsia: A 7-Year Monocentric Experience

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Jul 14

PMID 37445324

Authors

Antonella Iannaccone

Beatrix Reisch

Rainer Kimmig

Borge Schmidt

Laven Mavarani

Marvin Darkwah Oppong

Bartosz Tyczynski

Mark Dzietko

Michael Jahn

Alexandra Gellhaus

Angela Koninger

Affiliations

Soon will be listed here.

Abstract

Different therapeutic apheresis techniques have been clinically tested to delay preterm delivery in the case of eoPE (early-onset preeclampsia). Our study evaluated the feasibility of TPE (therapeutic plasma exchange) compared to standard-of-care treatment. Twenty patients treated with 95 TPE sessions were included in the final analysis and retrospectively matched with 21 patients with comparable placental dysfunction. Gestational age at admission was 23.75 ± 2.26 versus 27.57 ± 2.68 weeks of gestation (WoG) in the control group ( = < 0.001), mean sFlt-1/PlGF ratio was 1946.26 ± 2301.63 versus 2146.70 ± 3273.63 ( = 0.821) and mean sEng was 87.63 ± 108.2 ng/mL versus 114.48 ± 88.78 ng/mL ( = 0.445). Pregnancy was prolonged for 8.25 ± 5.97 days when TPE was started, compared to 3.14 ± 4.57 days ( = 0.004). The median sFlt-1/PlGF Ratio was 1430 before and 1153 after TPE (-18.02%). Median sEng fell from 55.96 ng/mL to 47.62 mg/mL (-27.73%). The fetal survival rate was higher in TPE-treated cases. NICU (Neonatal Intensive Center Unit) stay was in the median of 63 days in the TPE group versus 48 days in the standard-of-care group ( = 0.248). To date, this monocentric retrospective study, reports the largest experience with extracorporeal treatments in eoPE worldwide. TPE could improve pregnancy duration and reduce sFlt-1 and sEng in maternal serum without impairing neonatal outcomes.

Citing Articles

Alteration in sB7-H4 Serum Levels and Placental Biomarker Expression after Therapeutic Plasma Exchange in Early-Onset Preeclampsia Patients.

Duan L, Ma Y, Reisch B, Hadrovic E, Mach P, Kimmig R Int J Mol Sci. 2024; 25(20).

PMID: 39456867 PMC: 11507903. DOI: 10.3390/ijms252011082.

Impact of the Immunomodulatory Factor Soluble B7-H4 in the Progress of Preeclampsia by Inhibiting Essential Functions of Extravillous Trophoblast Cells.

Ma Y, Duan L, Reisch B, Kimmig R, Iannaccone A, Gellhaus A Cells. 2024; 13(16).

PMID: 39195262 PMC: 11352994. DOI: 10.3390/cells13161372.

CCN1-Mediated Signaling in Placental Villous Tissues after SARS-CoV-2 Infection in Term Pregnant Women: Implications for Dysregulated Angiogenesis.

Ma Y, Duan L, Reisch B, Kimmig R, Iannaccone A, Gellhaus A Curr Issues Mol Biol. 2024; 46(4):3533-3550.

PMID: 38666951 PMC: 11049059. DOI: 10.3390/cimb46040221.

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