ABSTRACT
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.
Abbreviations
HDP, hypertensive disorders of pregnancy; ICU, intensive care unit; APACHE II, Acute Physiology and Chronic Health Evaluation II; SOFA24, Sequential Organ Failure Assessment during the first 24 h; ARDS, acute respiratory distress syndrome; MODS, multiple-organ dysfunction syndrome; SBP, systolic blood pressure; DBP, diastolic blood pressure; GH, gestational hypertension; CH, chronic hypertension; HELLP, hemolysis, elevated liver enzymes and low platelets; CFR, case fatality rates; ICH, intracranial hemorrhage.
Acknowledgments
We are indebted to all patients who participated in this study with the aim of helping other women at risk and to Maria-Teresa Pérez who co-edited this manuscript.
Disclosure statement
The author(s) report no conflict of interest.