Eclâmpsia e pré-eclâmpsia: estudo comparativo e experiência no Hospital São Lucas da PUCRS

• Ano de defesa: 2010
• Autor(a) principal: Paula, Letícia Germany
• Orientador(a): Figueiredo, Carlos Eduardo Poli de
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre
• Palavras-chave em Português: MEDICINA; ECLAMPSIA; PRÉ-ECLÂMPSIA; HIPERTENSÃO ARTERIAL
• Link de acesso: http://hdl.handle.net/10923/4579

Objective: To characterize a group of women who developed eclampsia and to compare them with a group that had preeclampsia syndrome. Methods: The records of patients delivered at Hospital São Lucas from PUCRS were reviewed retrospectively and the charts of 733 pregnant women with hypertension were selected; 424 had a diagnosis of preeclampsia syndrome and 52, of eclampsia. Results: Patients with eclampsia and preeclampsia were different in several clinical, laboratorial and demographic aspects. Those with eclampsia were younger, had fewer pregnancies and lower weights. Mean values of systolic and diastolic blood pressure were markedly higher in the eclampsia group. The occurrence of HELLP syndrome was significantly different between groups, with a higher risk in the eclampsia group. Mean urinary protein excretion was also above severity thresholds in hypertensive pregnancies. Patients with eclampsia had higher serum uric acid levels, were more likely to have cesarean section, and had worst perinatal outcomes. The combination of uric acid equal or above 6 mg/dL and proteinuria/creatininuria ratio (PCR) equal or above 5 had a striking association with eclampsia according to logistic regression. Maternal age below 16 years was also a risk. Conclusion: Our data strongly suggest that the combination of maternal serum uric acid above 5. 9 mg/dL and proteinuria-to-creatininuria ratio equal or above 5 pose special risk to mothers and may be an indication that pregnancy interruption should be considered.