Asunto(s)
Lesión Renal Aguda/epidemiología , Maternidades/estadística & datos numéricos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Complicaciones del Embarazo/epidemiología , Lesión Renal Aguda/etiología , Adolescente , Adulto , Enfermedad Crítica , Progresión de la Enfermedad , Eclampsia/epidemiología , Femenino , Hospitales Urbanos/estadística & datos numéricos , Humanos , México/epidemiología , Preeclampsia/epidemiología , Embarazo , Prevalencia , Estudios Retrospectivos , Sepsis/epidemiología , Choque/epidemiología , Adulto JovenRESUMEN
BACKGROUND: Hyperuricemia is a factor related to a higher frequency of complications in patients with preeclampsia. OBJECTIVES: To determine maternal complications in preeclamptic patients with hyperuricemia managed in the intensive care unit of a high-specialty hospital. MATERIAL AND METHODS: Cross-sectional study. Clinical files of 127 preeclamptic patients with criteria of severe disease were reviewed. Maternal complications were studied only in patients with hyperuricemia defined as a serum uric acid (UA) level > 4 mg/dL upon admission. Descriptive statistics were used. RESULTS: Frequency of patients with hyperuricemia was 88.1% (112 cases). Median value of UA was 6.6 ± 1.5 mg/dL (range 4.6-12.4), maternal age 28.1 ± 5.98 years, parity 2 and gestational age 32.9 ± 3.7 weeks. Cesarean section was performed in 98.21%. Frequency of maternal complications was 50% (56 cases): HELLP syndrome 40.1% (45 cases), acute renal injury 6.2% (7 cases), abruptio placentae 1 .7% (2 cases), hemorrhage due to uterine atony 0.8% (1 case) and acute pulmonary edema 0.8% (1 case). There were no cases of multiorgan failure syndrome and maternal mortality was 0%. None of the patients experienced worsening of their condition. CONCLUSIONS: There was an elevated frequency of patients with hyperuricemia and maternal complications. Reported complications were different from those reported in previous studies. All patients were successfully intervened with the administered medical treatment and may be a reflection of the beneficial effect of intensive care treatment.
Asunto(s)
Hiperuricemia/terapia , Preeclampsia/terapia , Adulto , Estudios Transversales , Femenino , Humanos , Unidades de Cuidados Intensivos , Embarazo , Complicaciones del Embarazo/terapia , Estudios RetrospectivosRESUMEN
BACKGROUND: HELLP syndrome is an aggressive form of preeclampsia related with hemolysis and its complications. OBJECTIVE: To determine the frequency of the appearance of criteria of hemolysis and maternal complications in preeclamptic patients with HELLP syndrome treated in an intensive care unit. MATERIAL AND METHODS: We carried out a cross-sectional study in 50 preeclamptic women with HELLP syndrome admitted to intensive care unit to determine the presence of the following criteria of hemolysis: peripheral blood schistocytes, anemia (hemoglobin ≤ 10 g/dL), lactate dehydrogenase ≥ 600 U/L, indirect bilirubin ≥ 0.6 mg/dL and hemoglobinuria. We also studied maternal complications in patients with lactate dehydrogenase ≥ 600 U/L and positive for schistocytes. Descriptive (mean, median, range, standard deviation) and inferential (Student t test) statistics were used. RESULTS: Lactate dehydrogenase ≥ 600 U/L was found in 36%, indirect bilirubin 0.6 mg/dL in 20%, positive schistocytes in 16%, hemoglobinuria in 4% and anemia in 0%. Patients with lactate dehydrogenase ≥ 600 U/L had more clinical and laboratory deterioration as well as prolonged intensive care unit stay (p = 0.0025). Patients positive for schistocytes did not demonstrate adverse effects. CONCLUSION: Biochemical criteria of hemolysis were more frequent than schistocytes, hemoglobinuria and anemia. Patients with lactate dehydrogenase ≥ 600 U/L was alterations more serious than patients with positive schistocytes so its usefulness as a biomarker may be higher.