Natine Fuzihara Rosa

347. Study of maternal and perinatal variables in preeclampsia according to its clinical expression

Introduction The severity of the clinical expression of preeclampsia determines maternal-fetal repercussions. Recognize indicators of severity may guide the adoption of behaviors in a timely manner. Objective To relate maternal characteristics and perinatal outcomes in patients with severe preeclampsia and without signs of severity. Method Cross-sectional study. Location: Hospital Guilherme Alvaro-Santos/Brazil, January/2015-May/2016. Patients with preeclampsia (NHBPEP/2000) were divided into two groups: no signs of severity (control) and severe (study). Maternal variables: age, body mass index (BMI), parity, prenatal care, gestational age at birth, serum creatinine, aspartate aminotransferase (AST) and alanine (ALT); and neonatal: weight and admission to the Intensive Care Unit (ICU). Statistical analysis: Fisher’s exact test (p significant Results The preeclampsia group presented more commonly than women without signs of severity: age ⩾40 years (6%), obesity (56.5%) and nulliparity (38%) against 0%, 61.5%, 6.7%, respectively. Absence of prenatal care 24% against 6.7%. The childbirth occurred between 29–346/7weeks in 36% in the group with severe preeclampsia, whereas in the preeclampsia without signs of severity: 6.7%. Average weight of newborns of 3205 g and 02 (13.3%) ICU admissions, against 2528 g and 21 (42.9%). The average creatinine level was similar; AST and ALT was 18.67 and 12.53 in the control group compared to 22.63 and 15.65. Discussion Similar rates of severe preeclampsia were found in the literature. (Batista, 2009). The severe expression of preeclampsia was associated with women in the extremes of age, with previous gestation, obesity and with worse perinatal performance. Noting that these women lack counseling and qualified care. Inadequate follow-up of prenatal care may be explained by the greater number of hospital admissions in severity. It is proposed a reflection on strategies to increase vaginal parturition in this group. The variations of AST-ALT indicate hepatic involvement anterior to the renal, which will be clearer with the continuation of the study.