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Vasquez DN, Das Neves AV, Aphalo VM, Vidal L, Moseinco M, Lapadula J, Santa-Maria A, Zakalik G, Gomez RA, Capalbo M, Fernandez C, Agüero-Villareal E, Vommaro S, Moretti M, Soli SB, Ballestero F, Sottile JP, Chapier V, Lovesio C, Santos J, Bertoletti F, Mos FA, Risso-Vazquez A, Esteban-Chacon M, Illutovich S, Chapela S, Loudet CI, Scapellato JL, Intile AD, Estenssoro E. Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study. Hypertens Pregnancy 2021; 40:279-287. [PMID: 34587828 DOI: 10.1080/10641955.2021.1981373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To explore variables associated with adverse maternal/fetal/neonatal outcomes among pregnant/postpartum patients admitted to ICU for hypertensive disorders of pregnancy (HDP). METHODS Multicenter, prospective, national cohort study. RESULTS Variables independently associated with maternal/fetal/neonatal mortality among 172 patients were as follows: Acute Physiology and Chronic Health Evaluation-II (APACHE-II)(OR1.20[1.06-1.35]), gestational age (OR0.698[0.59-0.82]) and aspartate aminotransferase (AST)(OR1.004[1.001-1.006]). Positive likelihood ratio for headache, epigastric pain, and visual disturbances to predict composite adverse outcomes were 1.23(1.16-1.30), 0.76(0.59-1.02), and 1.1(0.98-1.2), respectively. CONCLUSIONS Maternal/fetal mortality due to HDP was independently associated with severity of illness on admission, gestational age, and elevated AST. Accuracy of clinical symptoms to predict composite adverse outcomes was low.
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Affiliation(s)
- Daniela N Vasquez
- ICU, Sanatorio Anchorena, City of Buenos Aires, Argentina.,ICU, Hospital Interzonal De Agudos Gral. San Martín, La Plata, Bs As, Argentina
| | - Andrea V Das Neves
- ICU, Hospital Interzonal De Agudos Gral. San Martín, La Plata, Bs As, Argentina
| | | | - Laura Vidal
- ICU, Hospital Pablo Soria, San Salvador De Jujuy, Jujuy, Argentina
| | | | - Jorge Lapadula
- ICU, Hospital Nacional Prof. Alejandro Posadas, Villa Sarmiento, Bs As, Argentina
| | | | - Graciela Zakalik
- ICU, Hospital Luis Lagomaggiore, City of Mendoza, Mendoza, Argentina
| | - Raúl A Gomez
- ICU, Sanatorio De Los Arcos, City of Buenos Aires, Argentina
| | - Mónica Capalbo
- ICU, Hospital Gral De Agudos José M.Penna, City of Buenos Aires, Argentina
| | - Claudia Fernandez
- ICU, Hospital De Agudos Ramón Madariaga, Posadas, Misiones, Argentina
| | - Enrique Agüero-Villareal
- ICU, Hospital Policlínico Regional Dr. Ramón Carrillo, City of Santiago Del Estero, Santiago Del Estero, Argentina
| | | | | | - Silvana B Soli
- ICU, Sanatorio Julio Corzo, Rosario, Santa Fé, Argentina
| | | | - Juan P Sottile
- ICU, Hospital Zonal Bariloche, Bariloche, Río Negro, Argentina
| | - Viviana Chapier
- ICU, Hospital Español De Mendoza, Godoy Cruz, Mendoza, Argentina
| | | | - José Santos
- ICU, Clínica Colón, Mar Del Plata, Bs As, Argentina
| | | | - Fernando A Mos
- ICU, Sanatorio Anchorena, City of Buenos Aires, Argentina
| | | | | | | | | | - Cecilia I Loudet
- ICU, Hospital Interzonal De Agudos Gral. San Martín, La Plata, Bs As, Argentina
| | | | | | - Elisa Estenssoro
- ICU, Hospital Interzonal De Agudos Gral. San Martín, La Plata, Bs As, Argentina
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Chaemsaithong P, Ting YH, Cheng KYY, Poon CYL, Leung TY, Sahota DS. Uterine artery pulsatility index in the first trimester: assessment of intersonographer and intersampling site measurement differences. J Matern Fetal Neonatal Med 2017; 31:2276-2283. [DOI: 10.1080/14767058.2017.1341481] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Piya Chaemsaithong
- Department of Obstetrics and Gynecology, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuen Ha Ting
- Department of Obstetrics and Gynecology, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kwun Yue Yvonne Cheng
- Department of Obstetrics and Gynecology, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chiu Yee Liona Poon
- Department of Obstetrics and Gynecology, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Tak Yeung Leung
- Department of Obstetrics and Gynecology, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Daljit Singh Sahota
- Department of Obstetrics and Gynecology, the Chinese University of Hong Kong, Hong Kong SAR, China
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Phoa KYN, Chedraui P, Pérez-López FR, Wendte JF, Ghiabi S, Vrijkotte T, Pinto P. Perinatal outcome in singleton pregnancies complicated with preeclampsia and eclampsia in Ecuador. J OBSTET GYNAECOL 2016; 36:581-4. [PMID: 26790539 DOI: 10.3109/01443615.2015.1107532] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Preeclampsia in Ecuador is an understudied subject since available epidemiological data are scarce. The aim of this study was to describe perinatal outcomes among singleton pregnancies complicated with preeclampsia and eclampsia in a sample of low-income Ecuadorian women. Pregnant women complicated with preeclampsia (mild and severe) and eclampsia (defined according to criteria of the ACOG) delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador were surveyed with a structured questionnaire containing maternal (socio-demographic) and neonatal data. Perinatal outcomes were compared according to severity of clinical presentation. A total of 163 women with preeclampsia [mild (23.9%), severe (68.7%) and eclampsia (7.4%)] were surveyed. Perinatal mortality and stillbirth rate was similar among studied groups (mild vs. severe preeclampsia/eclampsia cases). However, severe cases displayed higher rates of adverse perinatal outcomes: lower birth Apgar scores, more preterm births, and more low birth weight and small for gestational age infants. Caesarean-section rate and the number of admissions to intensive or intermediate neonatal care were higher in severe cases. A similar trend was found when analysis excluded preterm gestations. In conclusion, in this specific low-income Ecuadorian population perinatal outcome was adverse in pregnancies complicated with severe preeclampsia/eclampsia.
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Affiliation(s)
- K Y N Phoa
- a Academic Medical Centre Amsterdam , University of Amsterdam , Amsterdam , the Netherlands
| | - P Chedraui
- b High Risk Pregnancy Labor and Delivery Unit , Enrique C. Sotomayor Obstetrics and Gynecology Hospital , Guayaquil , Ecuador .,c Institute of Biomedicine, Research Area for Women's Health, Facultad De Ciencias Médicas, Universidad Católica De Guayaquil , Guayaquil , Ecuador
| | - F R Pérez-López
- d Department of Obstetrics and Gynecology, Facultad De Medicina , Lozano Blesa University Hospital, Universidad De Zaragoza , Zaragoza , Spain
| | - J F Wendte
- e Department of Social Medicine , Academic Medical Centre Amsterdam , Amsterdam , the Netherlands , and
| | - S Ghiabi
- a Academic Medical Centre Amsterdam , University of Amsterdam , Amsterdam , the Netherlands
| | - T Vrijkotte
- e Department of Social Medicine , Academic Medical Centre Amsterdam , Amsterdam , the Netherlands , and
| | - P Pinto
- f Neonatal Department , Enrique C. Sotomayor Obstetrics and Gynecology Hospital , Guayaquil , Ecuador
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