Estudio comparativo de la morbimortalidad del producto gestacional en mujeres embarazadas con preeclampsia modera o severa / Comparative study of morbimortality of gestational product in pregnant women with mild or severe preeclampsia

INTRODUCCION: La preeclampsia es una enfermedad exclusiva de la gestación humana, que afecta a la embarazada produciendo una disfunción vascular. OBJETIVO: Comparar la morbimortalidad del producto gestacional en mujeres embarazadas con preeclampsia (PE) moderada o severa. PACIENTES Y METODO: Estudio de tipo no experimental, descriptivo, por causa-efecto, de carácter retrospectivo. La población estudiada correspondió a toda paciente que sufrió PE, subclasificada en dos grupos; pacientes con PE moderada y pacientes con PE severa. El estudio se realizó en la Clínica Hospital del Profesor en el período comprendido entre junio del año 2007 y junio del año 2008. Se analizaron variables clínicas del recién nacido y de la embarazada. Los resultados obtenidos fueron analizados por medio de las pruebas de comparación de medias poblacionales y comparación de proporciones poblacionales. RESULTADOS: De un total de 1680 embarazos registrados en la Clínica Hospital del Profesor, 42 fueron diagnosticados con síndrome hipertensivo del embarazo (SHE), correspondiendo a un 2,5 por ciento. 28 (66 por ciento) correspondieron a PE moderada, 13 (32 por ciento) correspondieron a PE severa. El retardo del crecimiento intrauterino (RCIU) presentó diferencia significativa con un p< 0,05. El sufrimiento fetal agudo (SFA) y la mortalidad fetal, no presentaron diferencia significativa con un p> 0,05. CONCLUSION: Si bien las diferencias clínicas para el diagnóstico de preeclampsia moderada y severa son claras, las complicaciones que pueden traer al producto de la gestación no presentan diferencia, salvo al analizar el RCIU.

INTRODUCTION: Preeclampsia is an exclusive disease of human gestation, that affects pregnant women producing vascular dysfunction. AIM: Compare the morbid-mortality of the gestational product in pregnant women with mild or severe preeclampsia (PE). PATIENT AND METHODS: Retrospective, descriptive, non experimental, cause-effect study. The studied subjects were women that suffered with PE, sub-classified in two groups, mild PE patients and severe PE patients. The study was made in the “Clínica Hospital del Profesor” from June 2007 to June 2008. Different clinical parameters from the newborn and the pregnant were analyzed. The results were analyzed by the comparison of population and population ratio tests. RESULTS: From a total of 1680 pregnant women registred in the “Clínica Hospital del Profesor”, 42 were diagnosed pregnancy-induced hypertension / gestational hypertension, which represents 2.5 percent of all pregnancies. 28 (66 percent) represents to a moderate PE, 13(32 percent) represents to a severe PE. Intrauterine growth restriction presented a significant difference with an p< 0,05. The acute fetal suffering and fetal mortality didn’t have a significant difference with an p> 0,05. CONCLUSION: Although the clinical differences for the diagnose of mild and severe PE are clear, the complications that may ocurre to the product of the pregnancy don’t present a significant difference, except for the intrauterine growth restriction, that presented a significant difference with an alpha = 0,05.

Systematic Evaluation in Hospitalization in Mildly Preeclamptic Women whose Placental Dysfunction was Exacerbated / 대한주산의학회잡지

OBJECTIVES: To compare the systematic evaluations in hospitalization of mildly preeclamptic women whose placental dysfunction was exacerbated with those whose placental dysfunction was not exacerbated. METHODS: There were seventy six mildly preeclamptic women after systematic evaluations in hospitalization, in which twenty eight women showed exacerbated placental dysfunction. Outcome markers considered suggestive of exacerbation of placental dysfunction included oligohydramnios (amniotic fluid index less than 5 cm), clinical diagnosis of intrapartum fetal distress and progression to severe preeclampsia. A clinical diagnosis of fetal distress was made when the monitoring revealed recurrent late, persistent tachycardia with loss of variability or prolonged decelerations. RESULTS: There were no significant differences in the amount of 24 hours urine protein, the concentrations in serum protein, creatinine, aspartate transaminase and alanine transaminase and hematocrit. But in exacerbated group, the concentrations of serum albumin and urine creatinine and creatinine clearance were significantly lower and the concentrations of serum uric acid and lactate dehydrogenase were significantly higher than not exacerbated group. CONCLUSION: In mildly preeclamptic women diagnosed after systematic evaluation in hospitalization, we must give attention to those whose concentrations of serum albumin and urine creatinine and creatinine clearance are low and concentrations of serum uric acid and lactate dehydrogenase are high.