Utilidad para establecer diagnóstico y severidad de los síntomas y signos más frecuentes en la paciente preeclámptica / Usefulness of Establishing Diagnosis and Severity of the Most Frequent Signs and Synptoms in Preeclamptic Patients
Gac. méd. Méx
; 140(5): 513-517, sep.-oct. 2004. ilus, tab
Artigo
em Espanhol
| LILACS
| ID: lil-632177
Biblioteca responsável:
MX1.1
RESUMEN
Objetivo:
determinar qué síntomas y signos son más útiles para establecer el diagnóstico y la gravedad de la preeclampsia. Material ymétodos:
estudio analítico, transversal comparativo prolectivo para evaluar una prueba diagnóstica. Muestreo no probabilístico. Tamaño de muestra 408 pacientes. Se usaron los criterios de clasificación del American College of Obstetricians and Gynecologists. Un médico familiar en forma ciega e independiente interrogó y exploró a cada paciente. Se incluyeron pacientes de reciente diagnóstico y sin tratamiento. Se excluyeron pacientes con síndrome Hellp, eclampsia y de terapia intensiva. Se evaluó cefalea, acúfenos, fosfenos, tinnitus, vómito, dolor epigástrico, dolor en hipocondrio derecho, disuria, polaquiuria y tenesmo vesical, equimosis, hematomas e hiperreflexiaResultados:
192 pacientes sin preeclampsia, 63 con preeclampsia leve y 153 con preeclampsia severa. Fueron asintomáticas 60, 21 y 8% respectivamente. La presencia de 3 ó más síntomas o signos tiene sensibilidad de 60% (IC95% 53-67) especificidad de 84% (IC95% 79-89) cociente de probabilidad positivo de 3.8 y negativo de 0.48. Para evaluar gravedad son útiles hiperreflexia, fosfenos, acúfenos, dolor en hipocondrio derecho o epigastrioConclusiones:
existe una proporción de pacientes preeclámpticas sin manifestaciones clínicas (29%); los síntomas y signos descritos son útiles para evaluar gravedad pero no para diagnóstico de preeclampsia.ABSTRACT
Objective:
Our aim was to determine that signs and symptoms are tools in establishing diagnosis and severity of preeclampsia. Materials andMethods:
Our study design was prolective, comparative, cross-sectional for evaluation of diagnosis. Our sample included 408 patients. The study employed classification criteria of the American College of Obstetricians and Gynecologists. One blinded family physician interrogatedandexaminedeach patient. The sample included patients with recent diagnosis and without treatment. Patients with HELLP syndrome, eclampsia, and those in Intensive Care were excluded. Clinical signs evaluated included headache, Phosphenes, acuphenes, tinnitus, vomiting, epigastric pain, right hypochondrium pain, ecchymosis, hematomas, and hyperreactive reflexes.Results:
A total of 192 patients without preeclampsia, 63 with mild, and 153 with severe preeclampsia were included. Clinical manifestations were absent in 60,21 and 8% respectively of patients in each group. Presence of three or more signs or symptoms had sensitivity of 60% (CL95% 53-67), specificity of 84% (CL95% 79-89), and positive likelihood ratio of 3.8 and negative, 0.48. Most usefulness data for diagnosis of preeclampsia are hyperreactive reflexes, phosphenes, acuphenes, right hypochondrium pain, and epigastric pain.Conclusions:
The symptoms and signs taken alone are tools for evaluation of severity but not for detection of preeclampsia. There is necessary to develop new way for it's diagnosis during prenatal care.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Pré-Eclâmpsia
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Gravidez
Idioma:
Espanhol
Revista:
Gac. méd. Méx
Assunto da revista:
Medicina
Ano de publicação:
2004
Tipo de documento:
Artigo
País de afiliação:
México