Risk factors for maternal death in patients with severe preeclampsia and eclampsia

• Autor(a) principal: Amorim,Melania Maria Ramos de
• Data de Publicação: 2001
• Outros Autores: Santos,Luiz Carlos, Porto,Ana Maria Feitosa, Martins,Leila Katz Dias
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista Brasileira de Saúde Materno Infantil (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1519-38292001000300004
• topic: Eclampsia; Hypertension; Death; Risk factors

OBJECTIVES: to determine the principal death causes in patients with severe preeclampsia/eclampsia and identify related risk factors. METHODS: a case-control study was performed comprising all cases of maternal death (n = 20) in patients with severe preeclampsia or eclampsia (n = 2.541). 80 controls (survivors) were randomly selected. The odds ratio and an estimate of maternal death relative risk were determined, and a multiple logistic regression analysis performed to determine the adjusted odds ratio. RESULTS: the basic causes for death were: acute pulmonary edema, disseminated intravascular coagulopathy, hemorrhagic shock, pulmonary embolism, acute renal failure, sepsis and three cases of undetermined causes of death. The principal risk factors were: age &gt; 25 years old, multiparity, gestational age < 32 weeks, lack of prenatal care, diastolic pressure &gt; 110mmHg, convulsions, chronic systemic arterial hypertension, HELLP syndrome, pulmonary edema, normally inserted abruptio placenta, disseminated intravascular coagulation, acute renal failure. Variables persistently related to maternal death were: HELLP syndrome, eclampsia, acute pulmonary edema, eclampsia, chronic hypertension and lack of prenatal care. CONCLUSIONS: the principal risk factors for death in women with preeclampsia/eclampsia are the lack of prenatal care, associated to chronic hypertension, HELLP syndrome, eclampsia and acute pulmonary edema.