Risk factors for abruptio placentae and eclampsia

Analysis of 445 consecutively managed women with severe preeclampsia and eclampsia

A. G. Witlin, George Saade, F. Mattar, B. M. Sibai, V. R. Lupo, C. C. Lin, J. N. Martin, H. Sandmire, V. Suarez

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

OBJECTIVE: Our purpose was to characterize the clinical presentation or laboratory variables predictive of either abruptio placentae or eclampsia in women with severe preeclampsia. STUDY DESIGN: Prospective collection of perinatal data from 445 consecutively managed women with severe preeclampsia and eclampsia. Univariate analysis was used to determine which of the independent variables were significantly different between the groups (abruptio placentae vs no abruptio placentae; eclampsia vs no eclampsia). Those with significant differences were then entered into multiple logistic regression analysis to determine those characteristics that were independently related to the outcome variable (abruptio placentae or eclampsia). Before multivariate analysis, the independent variables with an interval scale of measurement were converted to a dichotomous scale, with the receiver-operator characteristic curve used to determine a cutoff level. RESULTS: Univariate analysis revealed statistical significance for the following variables associated with eclampsia: uric acid concentration, > 8.1 mg/dL; proteinuria (>3+); headache; visual symptoms; deep tendon reflexes >3+; serum albumin concentration, <3 mg/dL; and serum creatinine concentration, >1.3 mg/dL. However, with subsequent multivariate analysis, only headache and deep tendon reflexes >3+ remained significant. Univariate analysis for variables associated with abruptio placentae revealed an association between bleeding and platelet count <60,000/mm3. There was no association between abruptio placentae and eclampsia and systolic, diastolic, or mean arterial pressure, quantitative proteinuria, epigastric pain, bleeding, gestational age at delivery, history of preeclampsia, or chronic hypertension. CONCLUSION: Quantitative proteinuria and degree of blood pressure elevation were not predictive of either abruptio placentae or eclampsia, as has previously been suggested. The greatest morbidity associated with eclampsia occurred in women with preterm gestations not receiving medical attention.

Original languageEnglish (US)
Pages (from-to)1322-1329
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume180
Issue number6 I
DOIs
StatePublished - 1999

Fingerprint

Abruptio Placentae
Eclampsia
Pre-Eclampsia
Proteinuria
Stretch Reflex
Headache
Multivariate Analysis
Hemorrhage
Uric Acid
Platelet Count
Serum Albumin
Gestational Age
Arterial Pressure
Logistic Models
Regression Analysis
Blood Pressure
Hypertension
Morbidity
Pain
Pregnancy

Keywords

  • Abruptio placentae
  • Eclampsia
  • Preeclampsia

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Risk factors for abruptio placentae and eclampsia : Analysis of 445 consecutively managed women with severe preeclampsia and eclampsia. / Witlin, A. G.; Saade, George; Mattar, F.; Sibai, B. M.; Lupo, V. R.; Lin, C. C.; Martin, J. N.; Sandmire, H.; Suarez, V.

In: American Journal of Obstetrics and Gynecology, Vol. 180, No. 6 I, 1999, p. 1322-1329.

Research output: Contribution to journalArticle

Witlin, A. G. ; Saade, George ; Mattar, F. ; Sibai, B. M. ; Lupo, V. R. ; Lin, C. C. ; Martin, J. N. ; Sandmire, H. ; Suarez, V. / Risk factors for abruptio placentae and eclampsia : Analysis of 445 consecutively managed women with severe preeclampsia and eclampsia. In: American Journal of Obstetrics and Gynecology. 1999 ; Vol. 180, No. 6 I. pp. 1322-1329.
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T1 - Risk factors for abruptio placentae and eclampsia

T2 - Analysis of 445 consecutively managed women with severe preeclampsia and eclampsia

AU - Witlin, A. G.

AU - Saade, George

AU - Mattar, F.

AU - Sibai, B. M.

AU - Lupo, V. R.

AU - Lin, C. C.

AU - Martin, J. N.

AU - Sandmire, H.

AU - Suarez, V.

PY - 1999

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N2 - OBJECTIVE: Our purpose was to characterize the clinical presentation or laboratory variables predictive of either abruptio placentae or eclampsia in women with severe preeclampsia. STUDY DESIGN: Prospective collection of perinatal data from 445 consecutively managed women with severe preeclampsia and eclampsia. Univariate analysis was used to determine which of the independent variables were significantly different between the groups (abruptio placentae vs no abruptio placentae; eclampsia vs no eclampsia). Those with significant differences were then entered into multiple logistic regression analysis to determine those characteristics that were independently related to the outcome variable (abruptio placentae or eclampsia). Before multivariate analysis, the independent variables with an interval scale of measurement were converted to a dichotomous scale, with the receiver-operator characteristic curve used to determine a cutoff level. RESULTS: Univariate analysis revealed statistical significance for the following variables associated with eclampsia: uric acid concentration, > 8.1 mg/dL; proteinuria (>3+); headache; visual symptoms; deep tendon reflexes >3+; serum albumin concentration, <3 mg/dL; and serum creatinine concentration, >1.3 mg/dL. However, with subsequent multivariate analysis, only headache and deep tendon reflexes >3+ remained significant. Univariate analysis for variables associated with abruptio placentae revealed an association between bleeding and platelet count <60,000/mm3. There was no association between abruptio placentae and eclampsia and systolic, diastolic, or mean arterial pressure, quantitative proteinuria, epigastric pain, bleeding, gestational age at delivery, history of preeclampsia, or chronic hypertension. CONCLUSION: Quantitative proteinuria and degree of blood pressure elevation were not predictive of either abruptio placentae or eclampsia, as has previously been suggested. The greatest morbidity associated with eclampsia occurred in women with preterm gestations not receiving medical attention.

AB - OBJECTIVE: Our purpose was to characterize the clinical presentation or laboratory variables predictive of either abruptio placentae or eclampsia in women with severe preeclampsia. STUDY DESIGN: Prospective collection of perinatal data from 445 consecutively managed women with severe preeclampsia and eclampsia. Univariate analysis was used to determine which of the independent variables were significantly different between the groups (abruptio placentae vs no abruptio placentae; eclampsia vs no eclampsia). Those with significant differences were then entered into multiple logistic regression analysis to determine those characteristics that were independently related to the outcome variable (abruptio placentae or eclampsia). Before multivariate analysis, the independent variables with an interval scale of measurement were converted to a dichotomous scale, with the receiver-operator characteristic curve used to determine a cutoff level. RESULTS: Univariate analysis revealed statistical significance for the following variables associated with eclampsia: uric acid concentration, > 8.1 mg/dL; proteinuria (>3+); headache; visual symptoms; deep tendon reflexes >3+; serum albumin concentration, <3 mg/dL; and serum creatinine concentration, >1.3 mg/dL. However, with subsequent multivariate analysis, only headache and deep tendon reflexes >3+ remained significant. Univariate analysis for variables associated with abruptio placentae revealed an association between bleeding and platelet count <60,000/mm3. There was no association between abruptio placentae and eclampsia and systolic, diastolic, or mean arterial pressure, quantitative proteinuria, epigastric pain, bleeding, gestational age at delivery, history of preeclampsia, or chronic hypertension. CONCLUSION: Quantitative proteinuria and degree of blood pressure elevation were not predictive of either abruptio placentae or eclampsia, as has previously been suggested. The greatest morbidity associated with eclampsia occurred in women with preterm gestations not receiving medical attention.

KW - Abruptio placentae

KW - Eclampsia

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