Ma. Brown et Ml. Buddle, HYPERTENSION IN PREGNANCY - MATERNAL AND FETAL OUTCOMES ACCORDING TO LABORATORY AND CLINICAL-FEATURES, Medical journal of Australia, 165(7), 1996, pp. 360-365
Objectives: To determine the predictive value of clinical and laborato
ry parameters for maternal and fetal complications in pregnant women w
ith hypertension. Design: Prospective data collection. Setting: Two pr
imary referral hospitals in the southern suburbs of Sydney between Mar
ch 1987 and July 1994. Subjects: 1183 pregnant women with hypertension
managed conjointly by a physician and obstetrician. Intervention: Uni
form management protocol, plus antihypertensive medications if systoli
c blood pressure was persistently greater than or equal to 160 mmHg an
d/or diastolic blood pressure greater than or equal to 90 mmHg. Main o
utcome measures: Maternal and fetal complications, as defined by the A
ustralasian Society for the Study of Hypertension in Pregnancy Consens
us Statement. Results: Of 825 women with pre-eclampsia (502 mild; 323
severe), univariate analysis showed that hyperuricaemia, proteinuria a
nd severe hypertension were significantly associated with a higher rat
e of maternal and fetal complications. In multivariate analyses withou
t confounders, only primiparity, low serum albumin levels and absence
of diabetes were significantly associated with severe pre-eclampsia. S
evere pre-eclampsia, high haemoglobin levels and low platelet count we
re associated with higher rates of small-for-gestational-age babies, b
ut only low serum albumin levels were associated with increased perina
tal mortality rates. Low birthweight was associated with severe hypert
ension and severe pre-eclampsia. Conclusions: Simple clinical and labo
ratory parameters are useful predictors for maternal and fetal outcome
s in pregnancies complicated by hypertension.