Desfechos maternos e perinatais em pacientes com pré-eclâmpsia grave atendidas em uma maternidade pública no Município de Campina Grande-PB.

Abstract

Preeclampsia is a multisystem disorder characterized by hypertension and proteinuria, or end-organ dysfunction, after twenty weeks of gestation. It is a frequent condition, with complications that are considered important causes of maternal morbidity and mortality. Objective: to evaluate the main clinical outcomes and perinatal data of women affected by severe pre-eclampsia, determining its association with the gestational age of development of the hypertensive disorder. Methods: We carried out a cross-sectional, analytical and observational study, based on the secondary analysis of a database pre-existing data containing 565 patients with severe maternal morbidity, being included 376 pregnant women with severe preeclampsia. Variable data were pre-coded in forms and stored in Excel/Office 2010 software spreadsheet, with statistical analysis carried out in the Epi-Info program, version 7.1. For the comparison of maternal complications, fetal and neonatal conditions present in pregnant women with early and late preeclampsia, the association chi-square test and Fisher's exact test, when applicable, calculating the Prevalence ratio (PR) and its 95% Confidence Interval (95% CI). Results: found in women with early-onset severe preeclampsia frequency significantly greater risk of developing acute kidney injury (PR: 17.60; 95% CI: 2.19- 141.4), placental abruption (PR: 3.6; 95% CI: 1.40-9.19) and hospitalization prolonged (PR: 3.44; 95% CI: 2.42-4.90). Comparing the neonatal outcomes of women with early and late preeclampsia, the former had a prevalence ratio significantly more likely to have children with low birth weight (PR: 3.14; 95% CI: 2.57- 3.81), Apgar at the fifth minute of life less than seven (PR: 3.27; 95% CI: 1.45-7.38) stillbirths (PR: 7.37; 95% CI: 3.14-17.29) and early neonatal deaths (PR: 9.77; 95% CI: 1.94-49.2). In addition, newborns of women with severe preeclampsia at onset were more frequently admitted to a neonatal intensive care unit (PR: 4.04; 95% CI: 2.53-6.43). Conclusion: the heterogeneity of pre-eclampsia is confirmed, showing that the time of disease onset is an important indicator of severity and, possibly the etiology of the disease. There is a clear need for better adherence by medical professionals to pre-eclampsia diagnosis and prevention guidelines complications.