Nonproteinuric Preeclampsia among Women with Hypertensive Disorders of Pregnancy at a Referral Hospital in Southwestern Uganda.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2021-08-30 eCollection Date: 2021-01-01 DOI:10.1155/2021/9751775
Asiphas Owaraganise, Richard Migisha, Wasswa G M Ssalongo, Leevan Tibaijuka, Musa Kayondo, Godfrey Twesigomwe, Joseph Ngonzi, Henry Mark Lugobe
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引用次数: 0

Abstract

Background: Preeclampsia is a priority obstetric emergency requiring urgent diagnosis and treatment to avert poor pregnancy outcomes. Nonproteinuric preeclampsia poses even greater diagnostic challenges due to contested diagnostic criteria by the clinical practice guidelines and variable clinical presentation. Previously, preeclampsia was only diagnosed if high blood pressure and proteinuria were present. This study determined the prevalence of nonproteinuric preeclampsia and associated factors among women admitted with hypertensive disorders of pregnancy at a referral hospital in southwestern Uganda.

Methods: Women with hypertensive disorders of pregnancy were consecutively enrolled in a cross-sectional study at Mbarara Regional Referral Hospital between November 2019 and May 2020. We interviewed all pregnant women ≥20 gestation weeks presenting with hypertension and obtained their sociodemographic, medical, and obstetric characteristics. We excluded women with chronic hypertension. We measured bedside dipstick proteinuria in clean-catch urine. Preeclampsia was defined as hypertension plus any feature of severity including <100,000 platelets/ul, creatinine >1.1 g/dl, and liver transaminases ≥twice upper normal limit with or without proteinuria. We defined nonproteinuric preeclampsia in participants with <+2 urine dipstick cut-off and determined the factors associated with nonproteinuric preeclampsia using logistic regression.

Results: We enrolled 134 participants. The mean age was 26.9 (SD ± 7.1) years and 51.5% were primigravid. The prevalence of nonproteinuric preeclampsia was 24.6% (95% CI: 17.9-32.7). Primigravidity (aOR 2.70 95% CI: 1.09-6.72, p = 0.032) was the factor independently associated with nonproteinuric preeclampsia.

Conclusion: Nonproteinuric preeclampsia was common, especially among primigravidae. We recommend increased surveillance for nonproteinuric preeclampsia, especially among first-time pregnant women, who may not be detected by the traditional criteria. Obstetrics care providers should emphasize laboratory testing beyond proteinuria, among all women with hypertensive disorders of pregnancy to optimally diagnose and manage nonproteinuric preeclampsia.

乌干达西南部一家转诊医院妊娠期高血压疾病患者的非蛋白尿性先兆子痫
背景:先兆子痫是一种需要紧急诊断和治疗以避免不良妊娠结局的产科急症。由于临床实践指南和临床表现的不同,诊断标准存在争议,因此非蛋白尿性子痫前期的诊断面临更大的挑战。以前,子痫前期只有在高血压和蛋白尿的情况下才会被诊断出来。本研究确定了乌干达西南部一家转诊医院收治的妊娠期高血压疾病妇女中非蛋白尿性先兆子痫的患病率及相关因素。方法:2019年11月至2020年5月,在姆巴拉拉地区转诊医院连续招募妊娠期高血压疾病妇女进行横断面研究。我们采访了所有妊娠≥20周出现高血压的孕妇,并获得了她们的社会人口学、医学和产科特征。我们排除了患有慢性高血压的女性。我们测量了床边试纸在清洁尿液中的蛋白尿。子痫前期定义为高血压加上任何严重特征,包括1.1 g/dl,肝转氨酶≥正常上限的两倍,伴或不伴蛋白尿。我们在参与者中定义了非蛋白尿性先兆子痫,结果:我们招募了134名参与者。平均年龄26.9 (SD±7.1)岁,51.5%为初移症。非蛋白尿性子痫前期患病率为24.6% (95% CI: 17.9-32.7)。原发性(aOR 2.70, 95% CI: 1.09-6.72, p = 0.032)是与非蛋白尿性子痫前期独立相关的因素。结论:非蛋白尿性先兆子痫是常见的,尤其是在原始人中。我们建议加强对非蛋白尿性先兆子痫的监测,特别是首次怀孕的妇女,她们可能无法通过传统标准检测到。产科护理提供者应强调在所有妊娠高血压疾病的妇女中,除了蛋白尿之外的实验室检查,以最佳地诊断和管理非蛋白尿性先兆子痫。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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