Leticia G Paula1, Bartira E Pinheiro da Costa2, Marta R Hentschke3, Ivan C Antonello4, Jorge H Luz5, Edson V da Cunha Filho6, Carlos E Poli-de-Figueiredo7. 1. Programa de Pós-Graduação em Medicina e Ciências da Saúde, São Lucas Hospital, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: leticiagpaula@terra.com.br. 2. Programa de Pós-Graduação em Medicina e Ciências da Saúde, São Lucas Hospital, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: bart@pucrs.br. 3. Programa de Pós-Graduação em Medicina e Ciências da Saúde, São Lucas Hospital, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: marta.hentschke@pucrs.br. 4. Programa de Pós-Graduação em Medicina e Ciências da Saúde, São Lucas Hospital, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: ivan.antonello@pucrs.br. 5. Programa de Pós-Graduação em Medicina e Ciências da Saúde, São Lucas Hospital, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: jorgeluz@terra.com.br. 6. Programa de Pós-Graduação em Medicina e Ciências da Saúde, São Lucas Hospital, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil. 7. Programa de Pós-Graduação em Medicina e Ciências da Saúde, São Lucas Hospital, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil. Electronic address: cepolif@pucrs.br.
Abstract
OBJECTIVES: Eclampsia results in high morbidity and mortality, so it is important to identify clinical and laboratorial aspects that may be useful as potential markers to differentiate women at higher risk. Thus, we aim to identify, among women with preeclampsia, aspects that may increase the risk to develop eclampsia. STUDY DESIGN: Retrospective cohort study. The records of patients delivered at Hospital São Lucas/PUCRS were reviewed retrospectively; 733 pregnant women with hypertension were analyzed; 329 had preeclampsia, and 45 eclampsia. MAIN OUTCOME MEASURES: Serum uric acid levels and protein excretion in women that develop eclampsia. RESULTS: Patients with eclampsia had higher serum uric acid levels and protein excretion, systolic and diastolic blood pressure; were more likely to have cesarean section and had worst perinatal outcomes. The combination of uric acid above 5.9 mg/dL and protein/creatinine ratio over 4.9 had a striking association with eclampsia (p ≤ 0.001). The occurrence of HELLP syndrome was significantly different between groups, with a higher incidence among women who developed eclampsia (OR 6.5; 95%CI, 3.2-13.2; p < 0.001). CONCLUSION: Our data suggest that the combination of high levels of maternal serum uric acid and proteinuria are strongly associated with the development of eclamptic crises.
OBJECTIVES:Eclampsia results in high morbidity and mortality, so it is important to identify clinical and laboratorial aspects that may be useful as potential markers to differentiate women at higher risk. Thus, we aim to identify, among women with preeclampsia, aspects that may increase the risk to develop eclampsia. STUDY DESIGN: Retrospective cohort study. The records of patients delivered at Hospital São Lucas/PUCRS were reviewed retrospectively; 733 pregnant women with hypertension were analyzed; 329 had preeclampsia, and 45 eclampsia. MAIN OUTCOME MEASURES: Serum uric acid levels and protein excretion in women that develop eclampsia. RESULTS:Patients with eclampsia had higher serum uric acid levels and protein excretion, systolic and diastolic blood pressure; were more likely to have cesarean section and had worst perinatal outcomes. The combination of uric acid above 5.9 mg/dL and protein/creatinine ratio over 4.9 had a striking association with eclampsia (p ≤ 0.001). The occurrence of HELLP syndrome was significantly different between groups, with a higher incidence among women who developed eclampsia (OR 6.5; 95%CI, 3.2-13.2; p < 0.001). CONCLUSION: Our data suggest that the combination of high levels of maternal serum uric acid and proteinuria are strongly associated with the development of eclamptic crises.