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ISSN 2448-8909 (Print)

2007, Number 4

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Med Crit 2007; 21 (4)

Clinical development of severe preeclampsia-eclampsia: prognosis and development comparison of treatment protocols between two 3rd mexican institutions

Hernández-Pacheco JA, Estrada-Altamirano A, Brito BB, Vila HS, Juárez AS

Language: Spanish
References: 23
Page: 170-178
PDF size: 141.02 Kb.


ABSTRACT

Objective: To compare the development and prognosis of two different treatment protocols for the preeclampsia-eclampsia management of two obstetric intensive care units of Mexico.
Material and methods: 300 patients of the intensive care units from two institutions were studied; Hospital A (108 patients), Hospital B (192 patients), with preeclampsia-eclampsia diagnosis. The treatment protocols of both institutions differ in the prenatal approach, antihypertensive therapy and hydric management. Demographic characterics, clinical and laboratory variables were compared at the moment to be entered, after birth, and 24 and 72 hours, as well as the complications that were presented in both groups of patients in different time of measurement.
Results: There was statistic difference between the demographic variables at the moment of comparing both groups of patients. Hospital A mean age 23.8 years old, gestational age 35 weeks, weight at birth 2,334 grams. Hospital B, mean age 28.8 years old, mean gestation weeks 32.8 and weight at birth 1,815 grams. There was no difference in severity degree at the moment to be entered, when comparing means of clinical variables and laboratory.
There was significant difference in the complications incidence at Hospital A compared to Hospital B; renal failure 14.8% versus 9.4%, recurrence of hypertensive urgency or emergency was 9.3% versus 3.6% there was more recurrence of convulsive crisis in eclamptic patient at the Hospital A than B (15 versus 3). The best explanatory pattern of multiple logistic regression showed that those women who are attended at Hospital A have RR = 3.19 (95 percent confidence interval 1.3 to 7.59) to develop any complication associated with severe preeclampsia, compared to those women attended at Hospital B, p = 0.008.
Comment: The present work shows difference in the prognosis between two obstetric intensive care units with different therapeutic approach.


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