Características clínicas de las gestantes nativas de la gran altitud con preeclampsia grave. Estudio transversal

Abstract

IntroductionHypertensive diseases of pregnancy cause between 62,000-77,000 deaths per year worldwide. Severe preeclampsia varies from 0.4% to 1.3% of all deliveries. The aim of this article is to determine the incidence of severe preeclampsia in high-altitude indigenous pregnant women, and describe clinical characteristics related to altitude, such as decreased oxygen saturation, and elevated haemoglobin. Materials and methodsEpidemiological, observational, descriptive, cross-sectional and retrospective study, in Cerro de Pasco, Peru (4,380metres above sea level). Data were collected upon entry to the intensive care unit, by checking prenatal control cards and medical records. Indigenous high-altitude pregnant women with severe preeclampsia were studied over a 10-year period (January 2009 to December 2018) with non-probabilistic sampling of consecutive cases. ResultsOf 8,221 births and 8,284born, 141 were in severe preeclampsia, an incidence of 1.70 to 1.72%. Our sample was 37 pregnant women who carried their pregnancy in high altitude. A mean haemoglobin of 15.02g% was observed in the first prenatal check-up. On admission to the intensive care unit a haemoglobin of 14.7g% and oxygen saturation: 94% was found. The ratio of haemoglobin and blood pressure was significant (P>.05. Conclusions(i)The incidence of severe preeclampsia at high altitudes is higher than that at sea level. (ii)Elevated haemoglobin is common in high-altitude indigenous pregnant women with severe preeclampsia. (iii)No causal association was found between elevated haemoglobin and increased blood pressure.