Current diagnostic criteria for pre-eclampsia include organic dysfunctions. Recognizing predictive signs of complications in the initial clinical evaluation could optimize resources guiding care ...strategies.
To describe the status of pre-eclampsia patients in the initial evaluation by clinical and laboratorial parameters.
Retrospective study approved by Ethics Committee. Location: Guilherme Álvaro Hospital, Santos, São Paulo/Brazil; (May 2017 - April 2018). Inclusion: 85 patients. with pre-ecampsia, according to NHBPEP (2000) criteria. Analized Variables: Gestational age and severe admission complications, pressure values, symptomatology (visual, headache, epigastralgia) and medication use. For the sample’s information, numerical means and descriptive measures were used.
The means of gestational age was 31.7 weeks, systolic and diastolic blood pressures 137.51 and 83.34 mmHg respectively and weight 91.67 kg. 18,8% of urine dipsticks tests were negative or trace. The symptomathic evaluation, 11.8% was visuals (scotoma), 21.2% headache and 12.9% epigastric pain. For medication, 23.5% used Acetylsalicylic acid (ASA), 89.4% methyldopa and 28.2% corticosteroid. About 1.2% of the patients presented placental abruption, 1.2% eclampsia and 5.9% thrombocytopenia as severe complications at admission. No fetal or maternal death occurred in the current analyzed population.
Early clinical evaluation may demonstrate the potential risk of prematurity associated with pre-eclampsia, once the mean of gestacional week was 31 weeks. A considerable fraction of the analyzed women presented obesity and serious clinicals expressions of pre-eclampsia, although approximately 20% was not recognized by the initial proteinuria test screening. An expressive amount of the patients used ASA, without a characterization about the use. Most patients used at least one hypotensive agent, which could be an exaggerated expectation for these drugs. Although just a few patients presented serious complications these risks should not be neglected, mainly the thrombocytopenia. We also observed that some clinical-laboratory data can guide actions since the admission of the pregnant woman.
Preeclampsia (PE) causes morbidity and mortality in several women in the productive phase, including definitive sequels. Recognizing the socio-demographic profile of pregnant women may justify the ...allocation of resources to promote an effective care for this population.
To describe the socio-demographic profile of pregnant women diagnosed with preeclampsia.
Retrospective study of medical records of 98 patients. Place: Hospital Guilherme Álvaro Santos/ Brazil, (from May 2017 to April 2018). Variables analyzed: Previous history of systemic arterial hypertension (SAH) and preeclampsia, first-degree relative with SAH, recreational drug use, cohabitation with the partner, pre-eclampsia, employment status, years of schooling, average number of pregnancies and body mass index (BMI). For all the information in the sample, a description of the data was made through numerical means and descriptive measures of variables with the intention of searching for clues about the behavior of the phenomena studied. The study has ethical approval.
We identified that 53.1% had previous SAH; 29% reported a history of preeclampsia; 83% had first-degree relative with SAH; 19% used recreational drugs; 32% lived with partner; 38% were unemployed. How many means: the time of schooling was of 10,23 years; that of pregnancies of 2.27 previous; and the BMI of 31.93 (obesity).
These data suggest that it is necessary to create strategies for reproductive planning access for this population because several women were in the third gestation and advised of the risks identified in their own history as relatives with SAH. Avoiding additional complications due to drug use, especially among obese women, hypertensive and with a history of pre-eclampsia and that these guidelines need to be reinforced also by low education. These aspects can be recognized by the anamnesis itself, which can optimize resources and optimize financial resources.
Systematic delivery term in preeclampsia can reduce risks, identify maternal and neonatal outcomes contributing to the adoption of this strategy worldwide.
Evaluate maternal and perinatal outcomes at ...37 – 39 weeks with systematic delivery in preeclampsia with no signs of severity, comparing pregnancies with no comorbidities.
A retrospective study of 1471 women who gave birth at the Guilherme Álvaro Hospital (Santos / Brazil), from January/2014 to January/2015. Data were collected from records of all deliveries. The inclusion criteria for the study group were: pregnancies with a single live fetus, gestational age 37–39 weeks in patients with “pure” or superimposed preeclampsia with no signs of severity (NHBPEP, 2000). Exclusion criteria were multiple births, gestational age less than 37 or more than 39 weeks, with severe preeclampsia and incomplete records. The control group included: pregnancies with a single live fetus, gestational age 38 – 40 weeks with no hypertension or other comorbidities, after normal deliveries of spontaneous onset. Exclusion criteria were twin pregnancies, gestational age less than 38 or more than 40 weeks, cesarean sections, forceps deliveries, induced vaginal deliveries, incomplete records, presence of collagen, clinical or gestational diabetes, smoking, fetal malformations, alloimmunization and infections. For the numerical variables of the research the Student’s t test was used and for the statistical analysis the Fisher’s exact test. The significance level was p <0.05.
88 records were selected (44 in the study group/44 in the control group). Both differed regarding the variables: maternal age and gestational age at delivery, previous cesarean, type of delivery, days of hospitalization and maternal complications in the postpartum period. 50% of the women in the study group were induced at the beginning of labor but only ten pregnancies evolved to normal delivery. The following neonatal complications weren’t present: sepsis, periventricular hemorrhage, meconium aspiration syndrome, bronchopulmonary dysplasia, and any need for intubation or cardiac massage. There was just one case of pathological jaundice in each group.
Introduction Systematic delivery term in preeclampsia can reduce risks, identify maternal and neonatal outcomes contributing to the adoption of this strategy worldwide. Objective Evaluate maternal ...and perinatal outcomes at 37 – 39 weeks with systematic delivery in preeclampsia with no signs of severity, comparing pregnancies with no comorbidities. Method A retrospective study of 1471 women who gave birth at the Guilherme Álvaro Hospital (Santos / Brazil), from January/2014 to January/2015. Data were collected from records of all deliveries. The inclusion criteria for the study group were: pregnancies with a single live fetus, gestational age 37–39 weeks in patients with “pure” or superimposed preeclampsia with no signs of severity (NHBPEP, 2000). Exclusion criteria were multiple births, gestational age less than 37 or more than 39 weeks, with severe preeclampsia and incomplete records. The control group included: pregnancies with a single live fetus, gestational age 38 – 40 weeks with no hypertension or other comorbidities, after normal deliveries of spontaneous onset. Exclusion criteria were twin pregnancies, gestational age less than 38 or more than 40 weeks, cesarean sections, forceps deliveries, induced vaginal deliveries, incomplete records, presence of collagen, clinical or gestational diabetes, smoking, fetal malformations, alloimmunization and infections. For the numerical variables of the research the Student’s t test was used and for the statistical analysis the Fisher’s exact test. The significance level was p <0.05. Results 88 records were selected (44 in the study group/44 in the control group). Both differed regarding the variables: maternal age and gestational age at delivery, previous cesarean, type of delivery, days of hospitalization and maternal complications in the postpartum period. 50% of the women in the study group were induced at the beginning of labor but only ten pregnancies evolved to normal delivery. The following neonatal complications weren’t present: sepsis, periventricular hemorrhage, meconium aspiration syndrome, bronchopulmonary dysplasia, and any need for intubation or cardiac massage. There was just one case of pathological jaundice in each group.
Introduction Preeclampsia is an expressive cause of maternal and neonatal morbidity and mortality, studying it contributes to guide approach strategies. Objectives Compare epidemiological ...characteristics, maternal and neonatal outcomes between preeclampsia and normal pregnancies with spontaneous vaginal delivery after 38 weeks. Methods Retrospective study with 124 women, through medical records review, was developed in Guilherme Álvaro Hospital- Santos/São Paulo/Brazil (July/2015–May/2016). Study group: 71 women with preeclampsia according to NHBPEP- National High Blood Pressure Education Program (2000) criteria, with single and live fetus, regardless of gestational age. Control group: 53 pregnant women with single and live fetus, after 38 weeks of gestation, without comorbidities. Exclusion criteria for study group: twin pregnancy and fetal anomalies. Exclusion criteria for control group: twin pregnancy, gestational age < 38 weeks, cesarean/forceps/induced vaginal delivery, fetal anomalies and presence of comorbidities. Maternal variables: age, gestational age at admission, previous pregnancy history, body mass index and length of hospital stay. Neonatal variables: weight and adequacy weight for gestational age, height, Apgar score, intensive care unit admission, length of hospital stay and respiratory and non-respiratory complications. The study was approved by Guilherme Álvaro Hospital’s ethics and research committee. Statistical comparisons for categorical variables were made using Fisher’s exact test, and t -Student test for numerical variables. Data analysis was performed by calculating odds ratio adoption hypothesis and the rejection level of 0,05. Results Comparions between preeclampsia group and control group in maternal and neonatal outcomes (* = p < 0,05): Conclusions Preeclampsia is more often associated with maternal and neonatal adverse outcomes if compared to the normal pregnancies. Women diagnosed with preeclampsia appear to be older, have higher body mass index and longer hospital stay. The results show that newborns from the study group present lower weight and smaller height at birth, longer hospital stay (including in intensive care unit) and acute respiratory distress syndrome development.
Introduction The use of such markers in predicting preeclampsia, such as PlGF, can serve in predicting the syndrome, and precocious identification can anticipate management and decrease the risks. ...Objective To evaluate among pregnant women, both those who developed pre-eclampsia as those who did not developed hypertensive disorder complications, the role of placental growth factor (PlGF) as predictor of the syndrome in question, pre-eclampsia. Methods From the MEDLINE database, articles were extracted using the following keywords: (placental growth factor OR PLGF) AND pre-eclampsia/diagnosis by selecting, from a total of 193 retrieved in the search, papers published from 2014 to produce a systematic review. Were excluded narrative and systematic reviews, and in addition, the selected study models included cohort and case-control, which analyzed PlGF alone, sFlt-1/PlGF ratio, PlGF associated with other biomarkers of PE, Doppler Velocimetry uterine artery added to the PlGF and other biomarkers, getting a total of 25 articles after three independent reviewers to analyze the search results and confront their findings. Results Although there is no agreement in all literature about the PlGF levels during pregnancy, the studies evaluated showed a standardization of variations in the marker values during gestation, which are reduced in the preeclampsia group compared to controls, and further reduced in early and severe preeclampsia. On average, pregnancies that resulted in the disease did not show values above 208 pg/ml, unlike the pregnancies in the control group who always obtained values above 300 pg/ml, usually in the second quarter. Recalling that, in the latter group, it kept growing with the evolution of pregnancy. The association of PlGF to Doppler velocimetry of the uterine artery, or other biomarkers or both leads to an increase in the accuracy of the tests. But we can see that the evaluation of sFlt-1 ratio/PlGF is the parameter that brings greater sensitivity and specificity in predicting preeclampsia. Conclusion According to gestational age, PlGF levels have a pattern of variability that differs in healthy women compared to that present the syndrome in question. The latter has lower PlGF values than the control group, and the difference is even greater when you have early or severe PE. Disclosure of interest None declared.
Preeclampsia is an expressive cause of maternal and neonatal morbidity and mortality, studying it contributes to guide approach strategies.
Compare epidemiological characteristics, maternal and ...neonatal outcomes between preeclampsia and normal pregnancies with spontaneous vaginal delivery after 38weeks.
Retrospective study with 124 women, through medical records review, was developed in Guilherme Álvaro Hospital- Santos/São Paulo/Brazil (July/2015–May/2016). Study group: 71 women with preeclampsia according to NHBPEP- National High Blood Pressure Education Program (2000) criteria, with single and live fetus, regardless of gestational age. Control group: 53 pregnant women with single and live fetus, after 38 weeks of gestation, without comorbidities. Exclusion criteria for study group: twin pregnancy and fetal anomalies. Exclusion criteria for control group: twin pregnancy, gestational age <38weeks, cesarean/forceps/induced vaginal delivery, fetal anomalies and presence of comorbidities. Maternal variables: age, gestational age at admission, previous pregnancy history, body mass index and length of hospital stay. Neonatal variables: weight and adequacy weight for gestational age, height, Apgar score, intensive care unit admission, length of hospital stay and respiratory and non-respiratory complications. The study was approved by Guilherme Álvaro Hospital’s ethics and research committee. Statistical comparisons for categorical variables were made using Fisher’s exact test, and t-Student test for numerical variables. Data analysis was performed by calculating odds ratio adoption hypothesis and the rejection level of 0,05.
Comparions between preeclampsia group and control group in maternal and neonatal outcomes (*=p<0,05): Display omitted
Preeclampsia is more often associated with maternal and neonatal adverse outcomes if compared to the normal pregnancies. Women diagnosed with preeclampsia appear to be older, have higher body mass index and longer hospital stay. The results show that newborns from the study group present lower weight and smaller height at birth, longer hospital stay (including in intensive care unit) and acute respiratory distress syndrome development.
The use of such markers in predicting preeclampsia, such as PlGF, can serve in predicting the syndrome, and precocious identification can anticipate management and decrease the risks.
To evaluate ...among pregnant women, both those who developed pre-eclampsia as those who did not developed hypertensive disorder complications, the role of placental growth factor (PlGF) as predictor of the syndrome in question, pre-eclampsia.
From the MEDLINE database, articles were extracted using the following keywords: (placental growth factor OR PLGF) AND pre-eclampsia/diagnosis by selecting, from a total of 193 retrieved in the search, papers published from 2014 to produce a systematic review. Were excluded narrative and systematic reviews, and in addition, the selected study models included cohort and case-control, which analyzed PlGF alone, sFlt-1/PlGF ratio, PlGF associated with other biomarkers of PE, Doppler Velocimetry uterine artery added to the PlGF and other biomarkers, getting a total of 25 articles after three independent reviewers to analyze the search results and confront their findings.
Although there is no agreement in all literature about the PlGF levels during pregnancy, the studies evaluated showed a standardization of variations in the marker values during gestation, which are reduced in the preeclampsia group compared to controls, and further reduced in early and severe preeclampsia. On average, pregnancies that resulted in the disease did not show values above 208pg/ml, unlike the pregnancies in the control group who always obtained values above 300pg/ml, usually in the second quarter. Recalling that, in the latter group, it kept growing with the evolution of pregnancy. The association of PlGF to Doppler velocimetry of the uterine artery, or other biomarkers or both leads to an increase in the accuracy of the tests. But we can see that the evaluation of sFlt-1 ratio/PlGF is the parameter that brings greater sensitivity and specificity in predicting preeclampsia.
According to gestational age, PlGF levels have a pattern of variability that differs in healthy women compared to that present the syndrome in question. The latter has lower PlGF values than the control group, and the difference is even greater when you have early or severe PE.
None declared.
Analyze epidemiological data of postpartum women who had or not preeclampsia in a reference hospital to evaluate possible differences between these two groups.
It is a descriptive and retrospective ...study of medical records of 287 pregnant women with and without preeclampsia admitted at the Guilherme Álvaro Hospital Santos/SP – Brazil (January–February 2013). Patients with preeclampsia were included in the study group according to the criteria of National High Blood Pressure Education Program – 2000: systolic blood pressure (⩾140mmHg) and/or diastolic blood pressure (⩾90mmHg) two times, associated to proteinuria/24h ⩾2g/dL or tape reagent ⩾1 cross. The control group consisted of healthy women admitted during the same period. The data analyzed was: maternal age, mode of delivery, maternal presence of comorbidities (such as diabetes, collagen diseases, anemia, lung and heart diseases), gestational age, birth weight, Apgar score 1′5′ and admission to the neonatal intensive care unit (ICU). For categorical variables we used the Person’s Chi-square test and Fisher’s exact and for numerical variables from the research, we used the Student t test. The data analysis was performed by calculating odds ratio hypothesis rejection level of adoption of 0.05.
Of the total of 246 women evaluated, 22 women had preeclampsia (8.9%). comparison of epidemiology profile and outcomes of pregnant woman with preeclampsia compared to healthy women (*=p<0.05):
VariableControl groupStudy groupMaternal age average (years)25*30*Cesarean section42.6%77.3%*Comorbidities19.6%77.3%*Gestation age4035*Weight newborn average3150g2500g*Neonatal ICU admission4%9.1%*
Considering the identified prevalence of preeclampsia, the age group most affected, and the most unfavorable outcome for complicated pregnancies with the preeclampsia group compared with normal pregnant women, the adoption of qualified programs of family planning and effective antenatal care, particularly for the most vulnerable groups, is justified.
A. Bergamo: None. B. Zeiger: None. D. Vidal: None. V. Marçal: None. M. David: None. A. Ribeiro: None. B. Pontes: None. K. Dom Bosco: None. O. de Moura: None. J. Garcia: None. L. Bordinoski: None. S. de Toledo: None. F. Sousa: None.
Objectives Analyze epidemiological data of postpartum women who had or not preeclampsia in a reference hospital to evaluate possible differences between these two groups. Methods It is a descriptive ...and retrospective study of medical records of 287 pregnant women with and without preeclampsia admitted at the Guilherme Álvaro Hospital Santos/SP – Brazil (January–February 2013). Patients with preeclampsia were included in the study group according to the criteria of National High Blood Pressure Education Program – 2000: systolic blood pressure (⩾140 mmHg) and/or diastolic blood pressure (⩾90 mmHg) two times, associated to proteinuria/24 h ⩾ 2 g/dL or tape reagent ⩾1 cross. The control group consisted of healthy women admitted during the same period. The data analyzed was: maternal age, mode of delivery, maternal presence of comorbidities (such as diabetes, collagen diseases, anemia, lung and heart diseases), gestational age, birth weight, Apgar score 1′5′ and admission to the neonatal intensive care unit (ICU). For categorical variables we used the Person’s Chi-square test and Fisher’s exact and for numerical variables from the research, we used the Student t test. The data analysis was performed by calculating odds ratio hypothesis rejection level of adoption of 0.05. Results Of the total of 246 women evaluated, 22 women had preeclampsia (8.9%). comparison of epidemiology profile and outcomes of pregnant woman with preeclampsia compared to healthy women (* = p < 0.05): Variable Control group Study group Maternal age average (years) 25* 30* Cesarean section 42.6% 77.3%* Comorbidities 19.6% 77.3%* Gestation age 40 35* Weight newborn average 3150 g 2500 g* Neonatal ICU admission 4% 9.1%* Conclusions Considering the identified prevalence of preeclampsia, the age group most affected, and the most unfavorable outcome for complicated pregnancies with the preeclampsia group compared with normal pregnant women, the adoption of qualified programs of family planning and effective antenatal care, particularly for the most vulnerable groups, is justified. Disclosures A. Bergamo: None. B. Zeiger: None. D. Vidal: None. V. Marçal: None. M. David: None. A. Ribeiro: None. B. Pontes: None. K. Dom Bosco: None. O. de Moura: None. J. Garcia: None. L. Bordinoski: None. S. de Toledo: None. F. Sousa: None.
