Preeclampsia and diuresis criteria: our experience at the University of Iowa Hospitals and Clinics

Kim Naruko-Stewart

doi:10.17077/2154-4751.1097

Abstract

Preeclampsia is a multisystem disorder that complicates approximately 5-8% of pregnancies. It is known that the clinical manifestations of preeclampsia are a result of widespread vasoconstriction. It is therefore thought that the onset of diuresis may signal a reversal of this vasoconstriction, and thus resolution of the disease. This retrospective cohort study was conducted at the University of Iowa Hospitals and Clinics (UIHC) to validate our diuresis criteria and determine if there was a trend for diuresis that was dependent on the type of preeclampsia. This study suggests that the diuresis curves for those women with mild preeclampsia and severe preeclampsia do not vary significantly after the first 5 hours We were able to separate the women with severe preeclampsia into two groups, one of which would have met our diuresis criteria prior to 24 hours and the other of which would not have met diuresis criteria at 24 hours post-delivery.

Highlights

Preeclampsia is a multisystem disorder that complicates approximately 5-8% of pregnancies. outcomes are generally good, preeclampsia is a major cause of morbidity and mortality for a woman and her unborn child.Preeclampsia and eclampsia probably account for more than50,000 maternal deaths a year.2
Rates of re-administration of magnesium sulfate were compared between the patients with mild preeclampsia, the patients with severe preeclampsia that did not diuresis and the patients with severe preeclampsia that would have met our diuresis criteria
This study suggests that the diuresis curves for those women with mild preeclampsia and severe preeclampsia do not vary significantly after the first 5 hours

Summary

Introduction

Preeclampsia is a multisystem disorder that complicates approximately 5-8% of pregnancies. outcomes are generally good, preeclampsia is a major cause of morbidity and mortality for a woman and her unborn child.Preeclampsia and eclampsia probably account for more than50,000 maternal deaths a year.2. Preeclampsia is a multisystem disorder that complicates approximately 5-8% of pregnancies. Outcomes are generally good, preeclampsia is a major cause of morbidity and mortality for a woman and her unborn child. Preeclampsia and eclampsia probably account for more than. For those women with severe preeclampsia, using the above diuresis criteria to allow cessation of magnesium sulfate prior to 24 hours postdelivery would not put them at any increased risk of having to re-start magnesium sulfate therapy. The use of magnesium sulfate for seizure prophylaxis in women with preeclampsia was well established by the Magpie Trial in 2002.1. It is known that the clinical manifestations of preeclampsia are a result of widespread vasoconstriction. At the University of Iowa Hospitals and Clinics (UIHC), women with mild preeclampsia are treated with post-

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Conclusion