Expectant management in non-severe pre-eclampsia, obstetric and
DOI:
https://doi.org/10.18597/rcog.3075Keywords:
Pregnancy complications, preeclampsia, disease management, perinatal careAbstract
Objective: To determine the incidence of non-severe preeclampsia and identify maternal and perinatal outcomes in patients managed initially just with observation.
Materials and methods: Historical cohort of pregnant women with non-severe preeclampsia seen in a public high-complexity referral institution between June 2015 and May 2016. Convenience sampling was used. Sociodemographic, clinical and paraclinical characteristics were measured as well as maternal and perinatal outcomes; the incidence of non-severe preeclampsia is determined and a descriptive analysis is performed.
Results: The incidence rate ratio of non-severe preeclampsia was 3%. Overall, 86 pregnant women with a mean age of 28 years (SD ± 8.1) were included in the cohort. Mean gestational age at the time of diagnosis was 20 weeks (SD ± 3.1). Of the women with an initial diagnosis of preeclampsia and no severity characteristics, 47.7% converted to severe preeclampsia and 27 neonates had at least one complication, the most frequent being admission to the Neonatal Intensive Care Unit (27.9%).
Conclusion: The major maternal complication in patients with non-severe preeclampsia was transition to severe preeclampsia identified in around half of the patients, and perinatal complications in around one third of the pregnant mothers. Therefore, a strict control of the patients with non-severe preeclampsia and expectant management is required.
Author Biographies
Yuly Natalia Guzmán-Yara
Médica residente de Ginecología y Obstetricia, Universidad
Surcolombiana, Neiva (Colombia). yunagu1223@gmail.com
Edgardo Parra-Amaya
Médico residente de Ginecología y Obstetricia, Universidad
Surcolombiana, Neiva (Colombia). edpaam80@gmail.com
Julian David Javela-Rugeles
Médico investigador en Servicio Social Obligatorio, Universidad
Surcolombiana, Neiva (Colombia). julianjavela@hotmail.com
Juan Camilo Barrios-Torres
Médico investigador en Servicio Social Obligatorio, Universidad
Surcolombiana, Neiva (Colombia). juancabarto@gmail.com
Carlos Montalvo-Arce
Médico epidemiólogo y salubrista, profesor auxiliar, programa de medicina, Universidad Surcolombiana, Neiva (Colombia). carlos.montalvo@usco.edu.co
Hector Leonardo Perdomo-Sandoval
Médico ginecoobstetra, con entrenamiento en medicina crítica y cuidado intensivo. Profesor vinculado al programa de posgrado de Ginecología y Obstetricia, Universidad Surcolombiana, Neiva (Colombia). hlperdomo@hotmail.com
References
Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376:631-44. https://doi.org/10.1016/S0140-6736(10)60279-6
Gabbe SG, Niebyl JR, Simpson JL, Landon MB, Galan HL, Jauniaux ER, et al. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia: Elsevier; 2012. p. 779.
Roberts J, Druzin M, August P, Gaiser R, Bakris G, Granger J, et al. Hypertension in Pregnancy. Washington: The American College of Obstetricians and Gynecologists; 2013. p. 13
Pauli JM, Repke JT. Preeclampsia Short-term and Long-term Implications. Obstet Gynecol Clin North Am. 2015;42:299-313. https://doi.org/10.1016/j.ogc.2015.01.007
Ministerio de Salud y Protección Social, Universidad Nacional de Colombia. Guía de Práctica Clínica para el abordaje de las Complicaciones Hipertensivas Asociadas al Embarazo. Rev Colomb Obstet Ginecol. 2013;64:289-326 [visitado 2017 Sept 21]. Disponible en: http://www.scielo.org.co/pdf/rcog/v64n3/v64n3a06.pdf
Koopmans CM, Bijlenga D, Groen H, Vijgen SMC, Aarnoudse JG, Bekedam DJ, et al. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks’ gestation (HYPITAT): A multicentre, open-label randomized controlled trial. Lancet. 2009;36:979-88. https://doi.org/10.1016/S0140-6736(09)60736-4.
Broekhuijsen K, van Baaren GJ, van Pampus MG, Ganzevoort W, Sikkema JM, Woiski MD et al. Immediate delivery versus expectant monitoring for hypertensive disorders of pregnancy between 34 and 37 weeks of gestation (HYPITAT-II): an open-label, randomized controlled trial. Lancet. 2015;385:2492-501. https://doi.org/10.1016/S0140-6736(14)61998-X.
Sibai BM. Management of late preterm and early-term pregnancies complicated by mild gestational hypertension/pre-eclampsia. Semin Perinatol. 2011;35:292-6. https://doi.org/10.1053/j.semperi. 2011.05.010.
Briones C, Meneses J, Moreno A, González J, Díaz M, Briones J. Preeclampsia: una nueva teoría para un viejo problema. Rev la Asoc Mex Med. 2008;22:99-104.
Muñoz M, Rojas F, Fonseca J. Resultado materno en pacientes con hipertensión en el embarazo entre las 20 y 41 semanas en el Hospital Universitario Hernando Moncaleano Perdomo durante los años 2006 a 2009 [tesis en internet]. Neiva: Universidad Surcolombiana; 2010 [visitado 2017 Sept 21]. Disponible en: https://contenidos.usco.edu.co/images/documentos/grados/T.G.Ginecologia-y-Obstetricia/12.T.G-Merly-Muoz-Espinosa-2010.pdf
Helou A, Walker S, Stewart K, George J. Management of pregnancies complicated by hypertensive disorders of pregnancy: ¿Could we do better? Aust New Zeal J Obstet Gynaecol. 2017;57:253-9. https://doi.org/10.1111/ajo.12499
World Health Organization, United Nations International Children’s Emergency Fund and the World Bank. Tasa de mortalidad materna (estimado mediante modelo, por cada 100.000 nacidos vivos). Banco Mundial. 2016 [Visitado 2017 Mar 30]. Disponible en: https://datos.bancomundial.org/indicador/SH.STA.MMRT.
How to Cite
Downloads
Downloads
Published
Issue
Section
License
Copyright (c) 2018 Revista Colombiana de Obstetricia y Ginecología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Article metrics | |
---|---|
Abstract views | |
Galley vies | |
PDF Views | |
HTML views | |
Other views |