At High-risk for Pre-eclampsia After Assisted Reproductive Technology

Prior treatment

• Thyroid dysfunction not under control with medication:
  • Hyperthyroidism, the diagnoses is made when:
• History of prior pre-eclampsia

Other illness

• Known essential hypertension or development of a new-onset hypertension before 20 weeks' gestation
  • Hypertension is defined as a systolic blood pressure ≥ 140 or a diastolic blood pressure ≥ 90 on two separate measurements with at least 20 minutes in between, taken when the patients is in a seated position Or
  • The patient is known with hypertension, diagnosed by a certified doctor
• Other endocrinological disorder (including Cushing syndrome, Adrenal insufficiency, acromegaly): for diagnosis we will trust the opinion of the certified endocrinologist
• Cardiovascular diseases (including coronary artery disease, arrhythmia, heart valve disease and heart failure): for diagnosis we will trust the opinion of the certified cardiologist
• Renal disease/insufficiency: for diagnosis we will trust the opinion of the certified nephrologist
• Antiphospholipid syndrome: for diagnosis we will trust the opinion of the certified internal medicine doctor
• Liver dysfunction/disease: for diagnosis we will trust the opinion of the certified gastroenterologist
• Women pregnant with a fetus with known abnormalities such chromosomal anomalies, structural deformities of limbs or organs or any other prebirth diagnosed syndromes or defects

Lab values

• Known diabetes type 1 or 2 before pregnancy
  • Diagnosis of diabetes is confirmed when one of the following is present:
  • Fasting glucose ≥ 126 mg/dl
  • A 2-hour plasma glucose level ≥ 200 mg/dL during a 75-g oral glucose tolerance test Or
  • The patient is known with diabetes (type 1 or 2), diagnosed by a certified doctor

Other

• Peripheral blood TSH \<0,5 mIU/L and fT4 \>1,9 ng/dl Or
• When the patient is known with hyperthyroidism diagnosed by a certified physician
  • Hypothyroidism, the diagnosis is made when:
  • Peripheral blood TSH \>5 mIU/L and fT4 \<0,7 ng/dl Or
  • When the patient is known with hypothyroidism diagnosed by a certified physician
• Systemic lupus erythematosus: for diagnosis we will trust the opinion of the certified internal medicine doctor
• Multiple pregnancy

• First time oocyte acceptors Or Nulliparous PCOS patients undergoing ART (IVF/ICSI)
• Criteria for PCOS: two out of the three following criteria must be present:
  • Oligo-or anovulation: a menstrual cycle \>35 days
  • Hyperandrogenism:
  • Clinically: the presence of hirsutism and/ or severe acne in combination with alopecia confirmed hyperandrogenism Or
  • Biochemically: serum total testosterone \>52 ng/dl or calculated free testosterone \>0,64 ng/dl
  • Polycystic ovaries:
  • Follicle number per ovary (FNPO) ≥ 12 on both ovaries Or
  • Ovarian volume ≥ 10 ml in both ovaries Or
  • One ovary with ≥ 20 follicles (Using endovaginal US transducers with a frequency bandwidth that includes 8 MHz) Or
  • AMH ≥ 4,9 ng/ml