[Predictive index for preeclampsia before conception and primary prevention].
OBJECTIVE
To derive a prediction index based on the most salient history, laboratory and clinical parameters for identifying women at high risk of developing preeclampsia (PE) and to suggest a primary prevention.


METHODS
Non-pregnant women with a history of PE (n=101) were compared to non-pregnant parous women with a history of one or more successful normotensive pregnancies (n=50) but with comparable age, gestation and parity profiles. The parameters included history and clinical examination; laboratory studies (hemostasis, coagulation, vitamins); and morphological and functional tests (cardiovascular and renal functions). Stepwise logistic regression analysis was applied to develop a three step PE prediction index based on the most discriminant parameters. Strategies to prevent PE in the high-risk group are described.


RESULTS
Identification of women at high risk of PE can be done efficiently (88% sensitivity and specificity) using a predictive index based on a simple history, laboratory, clinical and functional information. Strategies to prevent PE in our high-risk group have given encouraging results during next pregnancy.


CONCLUSIONS
Our study gives a predictive index of PE outside of pregnancy and possibilities to do a primary prevention.
Emonts
P
P
Département de gynécologie-obstétrique, CHR de la Citadelle, université de Liège, boulevard 12e Ligne 1, 4000 Liège, Belgique. patrick.emonts@chrcitadelle.be
Seaksan
S
S
Seidel
L
L
Thoumsin
H
H
Brichant
J-F
JF
Albert
A
A
Foidart
J-M
JM
D000328:Adult; D001777:Blood Coagulation; D001795:Blood Pressure Determination / Q000379:methods; D005260:Female; D006334:Heart Function Tests / Q000379:methods; D006403:Hematologic Tests / Q000379:methods; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods; D008487:Medical History Taking; D010808:Physical Examination / Q000379:methods; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011322:Primary Prevention / Q000379:methods*; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014815:Vitamins / Q000097:blood
D014815:Vitamins