Fetal Losses in Hypertension and Preeclampsia Part I. An Analysis of 4432 Cases

Taylor, Howard C.; Tillman, Alvin J.B.; Blanchard, Joseph

doi:10.1097/00006254-195410000-00004

Cited by 5 publications

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“…There were 16 primary articles that met the selection criteria including a total of 6749 women (Figure 1 ) [ 1 , 19 - 34 ]. Eight articles reported estimation of proteinuria by laboratory method only [ 20 , 21 , 23 , 26 , 28 , 29 , 33 , 34 ], five by bedside dipstick urinalysis only [ 22 , 24 , 25 , 30 , 32 ], two by either of the above methods [ 27 , 31 ] and one by spot urine protein:creatinine ratio [ 1 ]. The salient features (population subgroups, test characteristics and reference standards) of each individual study can be obtained from the authors.…”

Section: Resultsmentioning

confidence: 99%

“…Thirteen studies reported prediction of fetal, neonatal and perinatal mortality using both laboratory and bedside testing for proteinuria [ 1 , 20 , 21 , 23 , 26 , 28 - 30 , 34 ]. The pooled LRs for positive and negative test for a cut-off of 5 g/24 h as reported in three studies [ 20 , 21 , 23 ] were 2 (95% CI 1.5, 2.7) and 0.53 (95% CI 0.27, 1) respectively (Figure 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…For prediction of adverse fetal outcomes, the only statistically significant results were observed for positive test result with LR+ ranging from 1.3 to 2.3 for cut-off levels of 5 g/24 h, 1+ and 3+ proteinuria in the prediction of stillbirths [ 20 , 21 , 23 , 30 ]. Furthermore, we need to take into account that three of these five test accuracy studies were conducted more than 30 years ago [ 21 , 30 ]. The test was found to be a poor predictor of neonatal and perinatal deaths with no significant LRs for positive or negative test.…”

Section: Discussionmentioning

confidence: 99%

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Estimation of proteinuria as a predictor of complications of pre-eclampsia: a systematic review

Thangaratinam

Coomarasamy

O’Mahony

et al. 2009

BMC Med

144

103

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Background: Proteinuria is one of the essential criteria for the clinical diagnosis of pre-eclampsia. Increasing levels of proteinuria is considered to be associated with adverse maternal and fetal outcomes. We aim to determine the accuracy with which the amount of proteinuria predicts maternal and fetal complications in women with pre-eclampsia by systematic quantitative review of test accuracy studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Estimation of proteinuria as a predictor of complications of pre-eclampsia: a systematic review

Thangaratinam

Coomarasamy

O’Mahony

et al. 2009

BMC Med

144

103

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“…6 From a number of small, heterogeneous studies, heavy proteinuria (5 g/d, 10 g/d, or an increase by 2 g/d) may be somewhat useful or useful as test for predicting eclampsia, stillbirth, perinatal death, SGA infants, or NICU admission. [7][8][9][10][11][12][13][14][15] Within a cohort of women admitted to hospital with preeclampsia, we examined whether the amount of antenatal proteinuria assessed by urinary dipstick, spot urinary Pr/Cr, or 24-hour urine collection is predictive of adverse maternal or perinatal outcomes. PIERS was conducted as a continuous quality improvement project in three sites using predetermined guidelines for the initial assessment and ongoing surveillance of women admitted to hospital with suspected or con rmed preeclampsia.…”

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confidence: 99%

PIERS Proteinuria: Relationship With Adverse Maternal and Perinatal Outcome

Payne¹,

Côté²,

Hutcheon³

et al. 2011

Journal of Obstetrics and Gynaecology Canada

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Objective: To examine the ability of three different proteinuria assessment methods (urinary dipstick, spot urine protein:creatinine ratio [Pr/Cr], and 24-hour urine collection) to predict adverse pregnancy outcomes Methods:We performed a prospective multicentre cohort study, PIERS (Preeclampsia Integrated Estimate of RiSk), in seven academic tertiary maternity centres practising expectant management of preeclampsia remote from term in Canada, New Zealand, and Australia Eligible women were those admitted with preeclampsia who had at least one antenatal proteinuria assessment by urinary dipstick, spot urine Pr/Cr ratio, and/or 24-hour urine collection Proteinuria assessment was done either visually at the bedside (by dipstick) or by hospital clinical laboratories for spot urine Pr/Cr and 24-hour urine collection We calculated receiver operating characteristic area under the curve (95% CI) for each proteinuria method and each of the combined adverse maternal outcomes (within 48 hours) or adverse perinatal outcomes (at any time) Models with AUC ≥ 070 were considered of interest Analyses were run for all women who had each type of proteinuria assessment and for a cohort of women ("ALL measures") who had all three proteinuria assessmentsResults: More women were proteinuric by urinary dipstick (≥ 2+, 614%) than by spot urine Pr/Cr (≥ 30g/mol, 504%) or 24-hour urine collection (≥ 03g/d, 347%) Each proteinuria measure evaluated had some discriminative power, and dipstick proteinuria (categorical) performed as well as other methods No single method was predictive of adverse perinatal outcome Conclusion:The measured amount of proteinuria should not be used in isolation for decision-making in women with preeclampsia Dipstick proteinuria performs as well as other methods of assessing proteinuria for prediction of adverse events

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“…Retrospective studies have described pregnancy outcome in women with severe hypertension with perinatal survival ranging from 19% to 50% during 1931-1953, before modern advances in obstetrics and neonatal care (14,16,17). Neonatal outcome also depends upon the neonatal care facilities which have improved over time.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Complicated by Severe Chronic Hypertension: A 10-Year Analysis from a Developing Country

Bagga

Aggarwal

Chopra

et al. 2007

Hypertension in Pregnancy

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The small number of cases reflects the lack of antenatal supervision in developing countries. A much larger number of women are referred in the third trimester with eclampsia or severe preeclampsia, at which time it is not possible to identify whether or not they had underlying hypertension. Adverse events were found to occur more often in patients with severe chronic hypertension compared with those with mild hypertension.

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Fetal Losses in Hypertension and Preeclampsia Part I. An Analysis of 4432 Cases

Cited by 5 publications

References 0 publications

Estimation of proteinuria as a predictor of complications of pre-eclampsia: a systematic review

Estimation of proteinuria as a predictor of complications of pre-eclampsia: a systematic review

PIERS Proteinuria: Relationship With Adverse Maternal and Perinatal Outcome

Pregnancy Complicated by Severe Chronic Hypertension: A 10-Year Analysis from a Developing Country

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