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Urinary protein excretion and expectant management of early onset, severe pre-eclampsia
D R Hall1, H J Odendaal, D W Steyn
1Department of Obstetrics and Gynecology, Tygerberg Hospital and Stellenbosch University, MRC Perinatal Mortality Research Unit, Tygerberg, South Africa. drh@sun.ac.za
Objective:
To evaluate the importance of proteinuria in the expectant management of early onset, severe pre-eclampsia.
Methods:
In this prospective series of 340 women, 24-h urine collections were performed and monitored twice weekly in a high-care ward.
Results:
Seventy-four women with at least two 24-h urine collections were grouped into women with a proteinuria increase of > or =2 g (n=29) and with women whose proteinuria decreased, or increased by <2 g (n=45). Major maternal complications, prolongation of gestation, and perinatal outcomes were comparable. Fifty-six (75%) women experienced an increase in proteinuria. When patients with heavy proteinuria (n=83) were compared to those with moderate proteinuria (n=257), maternal and perinatal outcomes were comparable. More days were gained before delivery in the heavy proteinuria group than in the moderate (12 vs. 9; P<0.001).
Conclusion:
Most patients experienced increased proteinuria. Neither the rate of increase nor the amount of proteinuria affected maternal and perinatal outcomes.