C L Chang1, J M Yang, K G Wang. 1. Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Abstract
BACKGROUND: Umbilical artery Doppler velocimetry has been used as an important perinatal tool to identify fetal compromise. However, the fact that it is both expensive and time-consuming makes it not always available. This study was a search for any maternal serum laboratory test which might be much simpler and easier than Doppler velocimetry, and still determining the perinatal outcome in severe preeclampsia. METHODS: Forty-seven patients with severe preeclampsia were enrolled in this study. Doppler velocimetry of umbilical artery, maternal serum biochemistry and hematological tests were all performed within two days prior to delivery or fetal death. RESULTS: By choosing a maternal hematocrit (Hct) of greater than 44% as the cutoff value, a significantly higher incidence of adverse perinatal events was noted in patients with abnormal value than those with normal value. Abnormal Hct level as a predictor of adverse perinatal outcome had a sensitivity of 50.0%, a specificity of 84.2%, a positive predictive value of 53.3% and a negative predictive value of 63.8%. CONCLUSIONS: This study found that elevated maternal Hct (> 44%) levels might indicate a condition of hemoconcentration with reduced placental perfusion in severely preeclamptic patients. Hct level can serve as a clinically useful predictor of adverse perinatal outcome.
BACKGROUND: Umbilical artery Doppler velocimetry has been used as an important perinatal tool to identify fetal compromise. However, the fact that it is both expensive and time-consuming makes it not always available. This study was a search for any maternal serum laboratory test which might be much simpler and easier than Doppler velocimetry, and still determining the perinatal outcome in severe preeclampsia. METHODS: Forty-seven patients with severe preeclampsia were enrolled in this study. Doppler velocimetry of umbilical artery, maternal serum biochemistry and hematological tests were all performed within two days prior to delivery or fetal death. RESULTS: By choosing a maternal hematocrit (Hct) of greater than 44% as the cutoff value, a significantly higher incidence of adverse perinatal events was noted in patients with abnormal value than those with normal value. Abnormal Hct level as a predictor of adverse perinatal outcome had a sensitivity of 50.0%, a specificity of 84.2%, a positive predictive value of 53.3% and a negative predictive value of 63.8%. CONCLUSIONS: This study found that elevated maternal Hct (> 44%) levels might indicate a condition of hemoconcentration with reduced placental perfusion in severely preeclamptic patients. Hct level can serve as a clinically useful predictor of adverse perinatal outcome.