[Proteinuria in hypertensive syndrome of pregnancy: maternal and perinatal outcome].
OBJECTIVE
The purpose of this study was to determine the role of proteinuria on pregnancy outcome in hypertensive syndrome with singleon pregnancies.


METHODS
Transversal study with retrospective data of 334 pregnancies complicated by hypertensive syndromes who were delivered in the Department of Obstetrics of UNIFESP/EPM from January 1, 1999 to December 31, 2002.


RESULTS
The patients were divided into four groups: (I) without proteinuria (n-203); (II) with proteinuria of 0.3 to 1.0g (n-39); (III) 1.0 to 2.0g (n-45); and (IV) 2.0g or more. Without proteinuria there was one case of placental abruption. The presence of proteinuria predicted adverse maternal outcome with increase of complications proportional to his elevation; among them, HELLP syndrome was the most frequent with 30.5% (40/131) followed by eclampsia with 3.8% (5/131), DPP 3.1% (4/131) and renal insufficiency with 0.7% (1/131). It was confirmed one maternal death in that group, when Maternal Mortality of 763/100.000nv was added up. As to the perinatal effects there was not increase of adverse effects without proteinuria. In the presence of proteinuria and its levels was observed the worst perinatal outcome with the elevation of the following indicatives: increase prematurely (62.2% vs 11.5%), newborn with weight < 2500g (6.5% vs 1.5%), newborn with Apgar < 7 in the 5th minute (30.4% vs 3.5%), concepts with growing restriction of intrauterine (41.9% vs 6.5%), newborn interned in the neonatal undid, (59.8% vs 15.5%) stillborn (14.4% vs 1.4%), neonatal deaths (6.1% vs 0.98%). The Perinatal Mortality was greater with proteinúria (175 vs 19,7) and, when = 2.0g (297.8 vs 19.6).


CONCLUSIONS
The presence of proteinuria in the hipertensives syndromes during gestation and the elevation of their levels increase the risks of maternal complications, especially HELLP syndromes and eclampsia. Besides, it was observed a significative incidence of premature birth, newborn with Apgar < 7, weight < 2500g, IUGR, stillborn and neonatal deaths.
Coelho
Tarcísio Mota
TM
Programa de Pós-Graduação em Obstetrícia, Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP. tm.coelho@uol.com.br
Martins
Marília Glória
MG
Viana
Eder
E
Mesquita
Maria Rita  Sousa
MR
Camano
Luiz
L
Sass
Nelson
N
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D004461:Eclampsia / Q000150:complications; D004812:Epidemiologic Methods; D005260:Female; D017359:HELLP Syndrome / Q000150:complications; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011507:Proteinuria / Q000150:complications* / Q000652:urine