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Agrega??o familiar e resultados maternos e perinatais da pr?-ecl?mpsia severa em popula??o do Rio Grande do NorteBezerra, Patr?cia Costa Fonseca Meirelles 28 November 2007 (has links)
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Previous issue date: 2007-11-28 / To determine whether there is familiar aggregation of severe
preeclampsia in a Brazilian population from Rio Grande do Norte and to characterize the maternal and perinatal outcomes in the studied population. Methods: A case control study was performed with 412 participants who were
admitted at Maternidade Escola Janu?rio Cicco (MEJC) for medical care. Of these, 264 subjects presented normal blood pressure and 148 were cases. Cases were composed of eclampsia (n=47), HELLP Syndrome (n=85) and
Eclampsia associated with HELLP syndrome (n=16). The diagnosis of these illness were based on the citeria developed by National High Blood Pressure Education Program Working (2000). An interview was performed with each subject and questions related to personal and familiar history of hypertension, preeclampsia, HELLP syndrome and eclampsia. Statistical analysis was performed and comparison of median and mean between cases and controls were performed, with the level of significance of 5%. The Odds-Ratio was
determined to estimate the risk of preeclampsia within the families. Results: There were no difference in the demographic data between cases and controls. Previous history of chronic hypertension and preeclampsia was more frequent in the case group. Headaches were more frequent in eclampsia and
epigastric pain in the HELLP syndrome cases. Bleeding and oliguria were more frequently found in the eclampsia associated with HELLP syndrome cases. Acute Renal insufficiency was a common complication in the case group, but these cases did not evolve to chronic renal insufficiency. The maternal mortality was 0.4% and the perinatal mortality was high, 223 per 1,000 live births. The 111 risk of a woman to develop preeclampsia whose mother has hypertension or
had preeclampsia was respectively 2.5 and 3.5. This risk was increased 5 times, when a sibling has hypertension and 6 times when both sibling and mother had previous history of preeclampsia. Conclusions: This study confirms that there is familiar aggregation of preeclampsia in this Brazilian population. The potential for cardiovascular complications due to development of chronic hypertension indicates the need of closely follow up of women who develop preeclampsia / Determinar a agrega??o familiar na pr?-ecl?mpsia severa em
popula??o brasileira do Rio Grande do Norte e caracterizar os resultados maternos e perinatais desta popula??o. M?todos: Estudo de caso controle, no qual foram arroladas 412 pacientes internadas na Maternidade Escola Janu?rio Cicco (MEJC). Dessas, 264 pacientes normotensas, grupo controle, e 148 com pr?-ecl?mpsia severa, grupo dos casos. Os casos foram compostos por ecl?mpsia (n=47), s?ndrome HELLP (n=85) e por ambas, ecl?mpsia e s?ndrome HELLP (n=16). O
diagn?stico, destas doen?as, foram baseados nos crit?rios adotados pelo National High Blood Pressure Education Program Working (2000). Foi realizado inqu?rito familiar quanto ? agrega??o familiar, sendo questionadas informa??es a respeito de antecedentes de hipertens?o cr?nica, pr?-ecl?mpsia, ecl?mpsia e s?ndrome HELLP. An?lise estat?stica foi realizada para avaliar associa??es e correla??es entre vari?veis, bem como compara??o de m?dias ou medianas,
adotando-se um n?vel de signific?ncia de 5%. O Odds-Ratio foi calculado para estimar o risco da pr?-ecl?mpsia severa nas fam?lias. Resultados: N?o houve diferen?a nos par?metros demogr?ficos entre casos e controles. A hist?ria pr?via de hipertens?o cr?nica e pr?-ecl?mpsia foram mais frequentes nas pacientes com pr?-ecl?mpsia severa. A cefal?ia foi o sintoma mais freq?ente na ecl?mpsia e a epigastralgia na s?ndrome HELLP. A hemorragia e a olig?ria foram mais presentes quando associado ecl?mpsia e s?ndrome HELLP. A insufici?ncia renal aguda foi uma complica??o freq?ente,
sem, no entanto, evoluir para a insufici?ncia renal cr?nica. A mortalidade xii materna foi baixa 0,4% e a mortalidade perinatal alta de 223 por 1000 nascidos vivos. O risco de uma mulher, cuja m?e teve hipertens?o ou pr?-ecl?mpsia, vir
a ter pr?-ecl?mpsia ?, respectivamente, 2,5 e 3,5 vezes. Esse risco aumenta para cinco vezes, quando a irm? tem antecedente de hipertens?o e seis vezes quando, tanto a m?e quanto a irm? t?m antecedentes de pr?-ecl?mpsia.
Conclus?es: Este estudo confirma a agrega??o familiar da pr?-ecl?mpsia em popula??o brasileira. O risco aumentado para doen?as cardiovasculares e hipertens?o cr?nica nestas mulheres, indica a necessidade de seguimento das pacientes que desenvolvem pr?-ecl?mpsia
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