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Predictability of adverse outcomes in hypertensive disorders of pregnancy: a multicenter prospective cohort study
Daniela N Vasquez1,2, Andrea V Das Neves2, Vanina M Aphalo1
1ICU, Sanatorio Anchorena, City of Buenos Aires, Argentina.
Objectives:
To explore variables associated with adverse maternal/fetal/neonatal outcomes among pregnant/postpartum patients admitted to ICU for hypertensive disorders of pregnancy (HDP).
Methods:
Multicenter, prospective, national cohort study.
Results:
Variables independently associated with maternal/fetal/neonatal mortality among 172 patients were as follows: Acute Physiology and Chronic Health Evaluation-II (APACHE-II)(OR1.20[1.06-1.35]), gestational age (OR0.698[0.59-0.82]) and aspartate aminotransferase (AST)(OR1.004[1.001-1.006]). Positive likelihood ratio for headache, epigastric pain, and visual disturbances to predict composite adverse outcomes were 1.23(1.16-1.30), 0.76(0.59-1.02), and 1.1(0.98-1.2), respectively.
Conclusions:
Maternal/fetal mortality due to HDP was independently associated with severity of illness on admission, gestational age, and elevated AST. Accuracy of clinical symptoms to predict composite adverse outcomes was low.
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