title: Use of a gestational carrier for a patient with recurrent adverse pregnancy outcomes from early onset severe pre-eclampsia.
abstract: OBJECTIVE
  To describe the first reported case of gestational carrier treatment to prevent severe early onset pre-eclampsia.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A university-based reproductive endocrinology and infertility clinic and a tertiary care hospital.
  
  
  METHODS
  A 29-year-old woman and her husband with three consecutive pregnancies complicated by early onset severe pre-eclampsia causing fetal demises at 22 and 24 weeks gestation; a neonatal death at 25 weeks gestation; and life-threatening maternal hemolysis, elevated liver enzymes, and low platelets.
  
  
  METHODS
  An IVF procedure in the patient using her husband's sperm with the transfer of two embryos to a friend who offered to be a gestational carrier.
  
  
  METHODS
  Successful IVF cycle in the patient and uncomplicated pregnancy and delivery in the gestational carrier.
  
  
  RESULTS
  The gestational carrier achieved a pregnancy and progressed without complications to delivery of a healthy, 3.2-kg infant at 39 weeks gestation.
  
  
  CONCLUSIONS
  The use of a gestational carrier deserves consideration as a treatment option in patients with poor reproductive histories because of early onset severe pre-eclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. This experience also suggests that development of pre-eclampsia may be in large part maternally rather than embryologically or paternally driven.
authors.affiliation: Department of Obstetrics and Gynecology, University of Kansas School of Medicine-Wichita, Wichita, Kansas 67226, USA.
authors.forename: Darren M
authors.initials: DM
authors.lastname: Farley
authors.forename: David A
authors.initials: DA
authors.lastname: Grainger
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Tjaden
authors.forename: Linda M
authors.initials: LM
authors.lastname: Frazier
authors.forename: Janey E
authors.initials: JE
authors.lastname: Maki
mesh_terms: D000026:Abortion, Habitual / Q000517:prevention & control*; D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D050498:Live Birth; D011225:Pre-Eclampsia / Q000517:prevention & control*; D011247:Pregnancy; D013533:Gestational Carriers