280. Aspects of initial clinical evaluation of the pregnant woman with pre-eclampsia

Abstract

Current diagnostic criteria for pre-eclampsia include organic dysfunctions. Recognizing predictive signs of complications in the initial clinical evaluation could optimize resources guiding care strategies. To describe the status of pre-eclampsia patients in the initial evaluation by clinical and laboratorial parameters. Retrospective study approved by Ethics Committee. Location: Guilherme Álvaro Hospital, Santos, São Paulo/Brazil; (May 2017 - April 2018). Inclusion: 85 patients. with pre-ecampsia, according to NHBPEP (2000) criteria. Analized Variables: Gestational age and severe admission complications, pressure values, symptomatology (visual, headache, epigastralgia) and medication use. For the sample’s information, numerical means and descriptive measures were used. The means of gestational age was 31.7 weeks, systolic and diastolic blood pressures 137.51 and 83.34 mmHg respectively and weight 91.67 kg. 18,8% of urine dipsticks tests were negative or trace. The symptomathic evaluation, 11.8% was visuals (scotoma), 21.2% headache and 12.9% epigastric pain. For medication, 23.5% used Acetylsalicylic acid (ASA), 89.4% methyldopa and 28.2% corticosteroid. About 1.2% of the patients presented placental abruption, 1.2% eclampsia and 5.9% thrombocytopenia as severe complications at admission. No fetal or maternal death occurred in the current analyzed population. Early clinical evaluation may demonstrate the potential risk of prematurity associated with pre-eclampsia, once the mean of gestacional week was 31 weeks. A considerable fraction of the analyzed women presented obesity and serious clinicals expressions of pre-eclampsia, although approximately 20% was not recognized by the initial proteinuria test screening. An expressive amount of the patients used ASA, without a characterization about the use. Most patients used at least one hypotensive agent, which could be an exaggerated expectation for these drugs. Although just a few patients presented serious complications these risks should not be neglected, mainly the thrombocytopenia. We also observed that some clinical-laboratory data can guide actions since the admission of the pregnant woman.