Perinatal outcomes in preeclampsia that is complicated by massive proteinuria.
OBJECTIVE
Current treatment of preeclampsia no longer mandates delivery for proteinuria of >5 g per 24 hours. We sought to determine whether delayed delivery of preeclampsia with massive proteinuria (>10 g/24 h) increased maternal or neonatal morbidity.


METHODS
Records of all women with preeclampsia who were delivered at <37 weeks of gestation between January 1, 1997, and June 30, 2001, were reviewed. Patients with underlying renal disease or multiple gestation were excluded. Patients were characterized as having mild (<5 g/24 h), severe (5-9.9 g/24 h), or massive (>10 g/24 h) proteinuria. Outcomes were compared using the chi(2) test, one-way analysis of variance, or Fisher exact test.


RESULTS
Two hundred nine patients met the inclusion criteria: 125 patients had mild proteinuria, 43 patients had severe proteinuria, and 41 patients had massive proteinuria. No significant differences in maternal morbidity were seen. Massive proteinuria was associated with earlier onset of preeclampsia, earlier gestational age at delivery, and higher rates of prematurity complications. After correction for prematurity, massive proteinuria has no significant effect on neonatal outcomes.


CONCLUSIONS
Women with preeclampsia and massive proteinuria did not have increased maternal morbidity compared with women with severe or mild proteinuria. Massive proteinuria appears to be a marker for early-onset disease and progression to severe preeclampsia. Neonatal morbidity appears to be a function of prematurity rather than of massive proteinuria itself.
Newman
Mark G
MG
Maternal Fetal Medicine Center, Woman's Hospital, Baton Rouge, LA 70815, USA.
Robichaux
Alfred G
AG
Stedman
Charles M
CM
Jaekle
Ronald K
RK
Fontenot
M Todd
MT
Dotson
Tony
T
Lewis
David F
DF
D000037:Abruptio Placentae / Q000150:complications; D000328:Adult; D001724:Birth Weight; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D004461:Eclampsia / Q000150:complications; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005865:Gestational Age; D017359:HELLP Syndrome / Q000150:complications; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D007752:Obstetric Labor, Premature / Q000150:complications; D010976:Platelet Count; D011225:Pre-Eclampsia / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011507:Proteinuria / Q000150:complications*
D003404:Creatinine