Clinical Presentation of Women Readmitted With Postpartum Severe Preeclampsia or Eclampsia

Atterbury, Jana L.; Groome, Lynn J.; Hoff, Charles; Yarnell, Joni A.

doi:10.1111/j.1552-6909.1998.tb02603.x

Cited by 11 publications

(11 citation statements)

References 16 publications

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“…These readmissions are often not preventable, as most do not have identifiable risk factors for preeclampsia and usually warrant magnesium sulfate treatment in the setting of a new diagnosis. 2,10–13 However, no studies have focused on the worsening or persistence of hypertensive disease postpartum among women diagnosed with pregnancy-related hypertension before delivery. Given the nationwide push to improve transitions of care, elucidating predictors of persistent postpartum hypertensive disease may help guide management and reduce preventable readmissions in this population.…”

Section: Discussionmentioning

confidence: 99%

Clinical factors associated with readmission for postpartum hypertension in women with pregnancy-related hypertension: a nested case control study

2016

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Objective To evaluate the association between mode of delivery and length of labor on readmission for postpartum hypertension in women with pregnancy-related hypertension. Study Design Nested case control study within a cohort of 99 women with pregnancy-related hypertension who delivered at our institution between 2005 and 2009. Data were abstracted for clinical and labor information. Mode of delivery and length of labor were compared between women with previously diagnosed pregnancy-related hypertension readmitted within 4 weeks post partum (25 cases) and those not readmitted (74 controls). Categorical and continuous variables were compared using χ2 and T-tests, respectively. Multivariable logistic regression controlled for confounders. Result Hypertension readmission was not associated with mode of delivery (cases: 10(40%) spontaneous vaginal delivery, 15(60%) cesarean delivery; controls: 38(51%) spontaneous vaginal delivery, 36(49%) cesarean delivery, P=0.33). Length of labor appeared longer in cases, with a trend toward significance (median: 15.5 [7,28] h vs 10.75 [5.8,15.9] h, P=0.12) and was significantly associated with readmission after controlling for delivery mode, induction and parity (adjusted odds ratio = 1.06 [1 to 1.12], P = 0.048). Readmitted patients were less likely to have initially been started on antihypertensive medications after controlling for age, race and chronic hypertension (adjusted odds ratio = 0.23 [0.06 to 0.88], P=0.03). Conclusion Postpartum readmission for hypertension in women with known pregnancy-related hypertension is not associated with mode of delivery, appears increased in those with longer length of labor and decreased in those initially started on antihypertensive medications. This provides targets for future research to continue to improve transitions of care and reduce preventable readmissions.

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Section: Discussionmentioning

confidence: 99%

Clinical factors associated with readmission for postpartum hypertension in women with pregnancy-related hypertension: a nested case control study

2016

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“…Two studies by Atterbury et al address additional facets of preeclampsia: blood pressure variations and symptoms (6,7). The first study found that women with an increase of mean arterial pressure of 10 mm Hg or more between the antepartum and postpartum periods have a three-fold higher risk of readmission.…”

Section: Discussionmentioning

confidence: 97%

“…Women with postpartum preeclampsia complain of headache, malaise, and nausea and vomiting more often than women with antepartum preeclampsia. These symptoms are associated with a more severe disease course (7).…”

Section: Discussionmentioning

confidence: 99%

Postpartum Preeclampsia Occurring After Resolution of Antepartum Preeclampsia

Andrus

Wolfson

2010

The Journal of Emergency Medicine

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“…Previous authors described that postpartum preeclampsia presents more frequently with headache [511141920], nausea/vomiting [1920] and higher blood pressures [1920] than antepartum preeclampsia. Other studies found little to no clinical differences between study groups [5].…”

Section: Discussionmentioning

confidence: 99%

Differences in clinical presentation and pregnancy outcomes in antepartum preeclampsia and new-onset postpartum preeclampsia: Are these the same disorder?

et al. 2016

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ObjectiveNew-onset postpartum preeclampsia is a poorly defined condition that accounts for a significant percentage of eclampsia cases. It is unclear whether new-onset postpartum preeclampsia is a different disorder from or belongs to the same spectrum of classic antepartum preeclampsia. The objective of this study was to compare the clinical presentation and pregnancy outcomes of antepartum preeclampsia and new-onset postpartum preeclampsia.MethodsA retrospective study including 92 patients with antepartum preeclampsia and 92 patients with new-onset postpartum preeclampsia was performed. Clinical presentation and pregnancy outcomes were compared. Chi-square test was used to analyze categorical variables, and independent t-test and Mann-Whitney U-test for numerical variables. P-values of <0.05 were used to indicate statistical signifi cance.ResultsPatients with antepartum preeclampsia and new-onset postpartum preeclampsia differ significantly in profile, symptoms at presentation, laboratory markers and pregnancy outcomes.ConclusionNew-onset postpartum preeclampsia has a distinct patient profile and clinical presentation than antepartum preeclampsia, suggesting they may represent different disorders. Characterization of a patient profile with increased risk of developing this condition will help clinicians to identify patients at risk and provide early and targeted interventions to decrease the morbidity associated with this condition.

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Clinical Presentation of Women Readmitted With Postpartum Severe Preeclampsia or Eclampsia

Cited by 11 publications

References 16 publications

Clinical factors associated with readmission for postpartum hypertension in women with pregnancy-related hypertension: a nested case control study

Clinical factors associated with readmission for postpartum hypertension in women with pregnancy-related hypertension: a nested case control study

Postpartum Preeclampsia Occurring After Resolution of Antepartum Preeclampsia

Differences in clinical presentation and pregnancy outcomes in antepartum preeclampsia and new-onset postpartum preeclampsia: Are these the same disorder?

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