[Usefulness of establishing diagnosis and severity of the most frequent signs and symptoms in preeclamptic patients].
OBJECTIVE
Our aim was to determine that signs and symptoms are tools in establishing diagnosis and severity of preeclampsia.


METHODS
Our study design was prolective, comparative, cross-sectional for evaluation of diagnosis. Our sample included 408 patients. The study employed classification criteria of the American College of Obstetricians and Gynecologists. One blinded family physician interrogated and examined each patient. The sample included patients with recent diagnosis and without treatment. Patients with HELLP syndrome, eclampsia, and those in Intensive Care were excluded. Clinical signs evaluated included headache, Phosphenes, acuphenes, tinnitus, vomiting, epigastric pain, right hypochondrium pain, ecchymosis, hematomas,and hyperreactive reflexes.


RESULTS
A total of 192 patients without preeclampsia, 63 with mild, and 153 with severe preeclampsia were included. Clinical manifestations were absent in 60, 21 and 8% respectively of patients in each group. Presence of three or more signs or symptoms had sensitivity of 60% (CI95% 53-67), specificity of 84% (CI95% 79-89), and positive likelihood ratio of 3.8 and negative, 0.48. Most usefulness data for diagnosis of preeclampsia are hyperreactive reflexes, phosphenes, acuphenes, right hypochondrium pain, and epigastric pain.


CONCLUSIONS
The symptoms and signs taken alone are tools for evaluation of severity but not for detection of preeclampsia. There is necessary to develop new way for it's diagnosis during prenatal care.
Peralta-Pedrero
María Luisa
ML
Ciencias Unidad de Medicina Familiar 93, IMSS. luisaperalta@netscape.net
Guzmán-Ibarra
María de los Angeles
Mde L
Cruz-Avelar
Agles
A
Basavilvazo-Rodríguez
Ma Antonia
MA
Sánchez-Ambríz
Silvia
S
Martínez-García
Ma del Carmen
Mdel C
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index