Prediction of Adverse Maternal Outcomes in Preecla

Authors: Shruti Agrawal Nandita Maitra

Publish Date: 2015/11/11

Volume: 66, Issue: 1, Pages: 104-111

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Abstract

A prospective cohort study on 323 women who fulfilled definite inclusion and exclusion criteria was conducted Subjects were monitored for clinical symptoms of preeclampsia biochemical parameters and adverse maternal and neonatal outcomes A risk prediction score was calculated using the fullPIERS calculator Statistical analysis of rates and ratios was carried out by assessing χ 2 test and odds ratio183  n = 60 had adverse maternal outcome and 428  n = 138 had adverse fetal outcome and 43 1335  had combined adverse maternal and perinatal outcome Dyspnea visual disturbances epigastric pain and textSp textO 2 appeared to be highly significant risk factors In the biochemical variables studied serum creatinine and serum uric acid were found to have a significant association The association between adverse perinatal outcome and vaginal delivery was highly significant OR 035 95  CI 019 063 and the P value was 00005 The likelihood ratio associated with the highest risk group predicted probability of the outcome ≥30  showed excellent performance ie 175 of fullPIERS model as a rule in testThe fullPIERS model performed well in the prediction of adverse maternal outcomes in women with preeclampsia It is easy to use The model is based on the use of few important clinical and biochemical parameters and does not require extensive laboratory testing Although it might be of limited use in a wellequipped tertiary care facility this model can be utilized in the setting of district or subdistrict level hospitals to identify patients who are at risk of complications due to preeclampsia Timely referral to a higher center will help in reducing the morbidity and mortality associated with this condition

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