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.
Keywords: hypertensive disorders of pregnancy, eclampsia, HELLP syndrome, study design
FAQs
What is the purpose of case reports and case series in medical research?
Case reports and case series are traditionally used to communicate new knowledge about existing medical conditions. They often highlight unique cases, rare presentations, or novel treatments that can provide valuable insights for clinical practice.
How effective are case reports and case series in generating clinical discoveries about preeclampsia?
According to the systematic review, only about 24.3% of the recent case reports and case series on preeclampsia included a novel clinical discovery as a central theme. This suggests that while some reports contribute new knowledge, the majority do not significantly advance understanding of the condition.
What were the findings regarding the quality of the case reports and case series reviewed?
The review found that only 8% of the case reports were of high quality, with 53.8% deemed moderate quality. None of the case series were considered high quality. This indicates a need for improved rigor and reporting standards in case-based research on preeclampsia.
What is the significance of the findings related to preeclampsia in the reviewed publications?
The findings indicate that most of the recent case reports and case series on preeclampsia do not present new discoveries or knowledge. This could imply a gap in the potential of case-based research to contribute meaningfully to the understanding and management of preeclampsia.
Why is preeclampsia an important focus of clinical research?
Preeclampsia is a leading cause of maternal and perinatal mortality and morbidity. Despite its significance, the management of preeclampsia has not changed much over the past two decades, and its underlying causes are still not fully understood. Research in this area is critical to improving outcomes for affected women and their babies.
What was the scope of the systematic review conducted?
The systematic review included 104 case reports and three case series published between 2015 and 2020, focusing on pregnant individuals diagnosed with hypertensive disorders of pregnancy, including preeclampsia. The review assessed the quality and novelty of these reports to determine their contribution to clinical knowledge.