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Federación Mexicana de Ginecología y Obstetricia, A.C.

2006, Number 04

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Ginecol Obstet Mex 2006; 74 (04)

Elaboration and validation of an index for pre-eclampsia diagnosis

Peralta PML, Guzmán IMA, Basavilvazo RMA, Sánchez AS, Cruz AA, Lemus RR, Martínez GMC

Language: Spanish
References: 22
Page: 205-214
PDF size: 376.36 Kb.


ABSTRACT

Objective: To build a consistent and valid preeclampsia diagnosis index (IDP) for its Spanish acronyms. Patients and method: The study was done in a Gyneco-Obstetrics Hospital and a Family Medicine Unit from March 2000 to February 2001. Fifty items were chosen from the literature, with a design to validate diagnostic tests, which were assessed by family doctors and gyneco-obstetricians in regard to their appearance and content validity. Concurrent criterion validity. Golden standard: Two gyneco-obstetricians diagnosed pre-eclampsia (hypertension and proteinuria). Simultaneously a family doctor (in an independent and blinded way) questioned, examined and recorded laboratory data of 219 preeclamptic patients and 251 non preeclamptic patients.
Results: Preeclampsia diagnosis index is an additive index with 21 clinical and paraclinical parameters weighted according to their individual diagnostic capacity. It has two parts: The first one with 82% (95%CI 80-84) sensitivity; 93% (95%CI 91-95) specificity; the second one with 86% (95%CI 83-89) sensitivity; 75% (95%CI 65-85) specificity.
Conclusions: Preeclampsia diagnosis index is easily applied and has immediate results, which makes easier the physician’s decisions.


REFERENCES

  1. MacKay AP, Berg CJ, Atrash HK. Pregnancy-related mortality from preeclampsia and eclampsia. Obstet Gynecol 2001;97:533-8.

  2. Estadísticas de mortalidad relacionada con la salud reproductiva. Salud Publica Mex 1999;41:138-46.

  3. ACOG Technical Bulletin. Hypertension in pregnancy. No. 219-January 1996. Committee on Technical Bulletins of the American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 1996;53:175-83.

  4. Sibai B. Pitfalls in diagnosis and management of preeclampsia. Am J Obstet Gynecol 1988;159:1-5.

  5. Higgins JR, Swiet M. Blood pressure measurement and classification in pregnancy. Lancet 2001;357:131-5.

  6. Meyer NL, Mercer BM, Friedman SA, Sibai BM. Urinary dipstick protein: A poor predictor of absent or severe proteinuria. Am J Obstet Gynecol 1994;170:137-41.

  7. Helewa ME, Burrows RF, Smith J, Williams K, et al. Report of the Canadian Hypertension Society Consensus Conference:1. Definitions, evaluation and classification of hypertensive disorders in pregnancy. Can Med Assoc J 1997;157:715-25.

  8. Report of the National High Blood Pressure Education Program Working Group on High Blood Presure in Pregnancy. Am J Obstet Gynecol 2000;183(1):S1-122.

  9. Martin JN, May WL, Magann EF, et al. Early risk assessment of severe preeclampsia: Admission battery of symptoms and laboratory test to predict likelihood of subsequent significant maternal morbidity. Am J Obstet Gynecol 1999;180:1407-14.

  10. Streiner DL, Norman GR. Health measurement scales. A practical guide to their development and use. Oxford: University Press, 1989.

  11. Jenicek M. Epidemiología. La lógica de la medicina moderna. Barcelona: Masson, 1996.

  12. Feinstein AR. Clinimetrics. New Haven: Yale University Press, 1987.

  13. Barry C, Fox R, Stirrat G. Upper abdominal pain in pregnancy may indicate preeclampsia. BMJ 1994;308:1562-3.

  14. Schieve LA, Handler A, Hershow R, Perky V, Davis F. Urinary tract infection during pregnancy: Its association with maternal morbidity and perinatal outcome. Am J Public Health 1994;84:405-10.

  15. Chavarría ME, González G, Lara GA, et al. Concentración plasmática de indicadores bioquímicos en la preeclampsia-eclampsia y su asociación con la severidad de la patología. Ginecol Obstet Mex 2000;68:385-93.

  16. Neilson JP. Symphysis-fundal height measurement in pregnancy. Review. Cochrane Database of Systematic Reviews. (2):CD000944, 2000.

  17. Barron W, Heckerling P, Hibbard JU, Fisher S. Reducing unnecessary coagulation testing in hypertensive disorders of pregnancy. Obstet Gynecol 1999;94:364-70.

  18. Kramer RL, Izquierdo LA, Glison GJ, Curet LB, Qualls CR. “Preeclamptic Labs” for evaluating hypertension in pregnancy. J Reprod Med 1997;42:223-8.

  19. Dekker GA, Sibai BM. Primary, secondary and tertiary prevention of pre-eclampsia. Lancet 2001;20:209-12.

  20. Hsu Ch, Chung YK, LeeI S, Cou K, Copel JA. Maternal serum uric acid levels in preeclamptic women with multiple gestations. Am J Perinatol 1997;14:613-7.

  21. Thurnau GR, Dyer A, Depp R, Martin A. The development of a profile scoring system for early identification and severity assessment of pregnancy-induced hypertension. Am J Obstet Gynecol 1983;146:406.

  22. U.S. Preventive Services Task Force. Guide to clinical preventive services. 2nd ed. Washington: Department of Health and Human Services, Office of Disease Prevention and Health Promotion, 1996.




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