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Licensed Unlicensed Requires Authentication Published by De Gruyter July 24, 2015

The utility of clinical findings to predict laboratory values in hypertensive disorders of pregnancy

  • Jane So , Elizabeth Young , Natalie Crnosija and Joseph Chappelle EMAIL logo

Abstract

Objective: Preeclampsia is the 2nd leading cause of maternal mortality in the United States. Women with new-onset or worsening hypertension are commonly evaluated for laboratory abnormalities. We aim to investigate whether demographic and/or clinical findings correlate with abnormal laboratory values.

Study design: A retrospective chart review of women who presented for evaluation of hypertension in pregnancy during 2010. Demographic information, medical history, symptoms, vital signs, and laboratory results were collected. Bivariate analysis was used to investigate associations between predictors and the outcome.

Result: Of the 481 women in the sample, 22 were identified as having abnormal laboratory test results (4.6%). Women who reported right upper quadrant pain or tenderness had significantly increased likelihood of having laboratory abnormalities compared to those without the complaint.

Conclusion: Only a small percentage of women evaluated were determined to have abnormal laboratory findings, predominantly among women with severe preeclampsia. Right upper quadrant pain or tenderness was positively correlated with laboratory abnormalities. The restriction of laboratory analysis in women with clinical evidence of severe disease may be warranted – a broader study should, however, first be used to confirm our findings.

References

[1] Bulletins – Obstetrics ACoP. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. Obstet Gynecol. 2002;99:159–67.10.1097/00006250-200201000-00028Search in Google Scholar

[2] Kramer RL, Izquierdo LA, Gilson GJ, Curet LB, Qualls CR. “Preeclamptic labs” for evaluating hypertension in pregnancy. J Reprod Med. 1997;42:223–8.Search in Google Scholar

[3] Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365:785–99.10.1002/9781444312904.ch68Search in Google Scholar

[4] Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol. 2003;102:181–92.Search in Google Scholar

[5] Audibert F, Friedman SA, Frangieh AY, Sibai BM. Clinical utility of strict diagnostic criteria for the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. Am J Obstet Gynecol. 1996;175:460–4.10.1016/S0002-9378(96)70162-XSearch in Google Scholar

[6] Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management. A review. BMC Pregnancy Childbirth. 2009;9:8.10.1186/1471-2393-9-8Search in Google Scholar

[7] Cavkaytar S, Ugurlu EN, Karaer A, Tapisiz OL, Danisman N. Are clinical symptoms more predictive than laboratory parameters for adverse maternal outcome in HELLP syndrome? Acta Obstet Gynecol Scand. 2007;86:648–51.10.1080/00016340601185384Search in Google Scholar

[8] Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103:981–91.10.1097/01.AOG.0000126245.35811.2aSearch in Google Scholar

[9] Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet Gynecol. 1993;169:1000–6.10.1016/0002-9378(93)90043-ISearch in Google Scholar

[10] Bailey DJ, Walton SM. Routine investigations might be useful in pre-eclampsia, but not in gestational hypertension. Aust NZ J Obstet Gynaecol. 2005;45:144–7.10.1111/j.1479-828X.2005.00382.xSearch in Google Scholar PubMed

[11] Ries A, Kopelman JN, Macri C. Laboratory testing for preeclampsia: result trends and screening recommendations. Mil Med. 2000;165:546–8.10.1093/milmed/165.7.546Search in Google Scholar

[12] Cantu J, Clifton RG, Roberts JM, Leveno KJ, Myatt L, Reddy UM, et al. Laboratory abnormalities in pregnancy-associated hypertension: frequency and association with pregnancy outcomes Obstet Gynecol. 2014;124:933–40.10.1097/AOG.0000000000000509Search in Google Scholar PubMed PubMed Central

[13] Haddad B, Barton JR, Livingston JC, Chahine R, Sibai BM. Risk factors for adverse maternal outcomes among women with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. Am J Obstet Gynecol. 2000;183:444–8.10.1067/mob.2000.105915Search in Google Scholar PubMed

[14] Goodwin AA, Mercer BM. Does maternal race or ethnicity affect the expression of severe preeclampsia? Am J Obstet Gynecol. 2005;193:973–8.10.1016/j.ajog.2005.05.047Search in Google Scholar PubMed

[15] Singh AG, Chowdhary VR. Pregnancy-related issues in women with systemic lupus erythematosus. Int J Rheum Dis. 2015;18:172–81.10.1111/1756-185X.12524Search in Google Scholar PubMed

[16] American College of Obstetricians, Gynecologists, Task Force on Hypertension in P. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologist’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122:1122–31.Search in Google Scholar

The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-3-9
Accepted: 2015-6-17
Published Online: 2015-7-24
Published in Print: 2016-4-1

©2016 by De Gruyter

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