title: Hypertensive disease of pregnancy in the ICU: a multicenter study.
abstract: OBJECTIVE
  To describe characteristics, outcomes and clinical presentations for hypertensive disease of pregnancy (HDP) in patients admitted to three ICUs in Argentina.
  
  
  METHODS
  Case-series multicenter study.
  
  
  RESULTS
  There were 184 patients with HDP. Mean age 26 ± 8; 90% did not present comorbidity; APACHEII 9[6-14]; SOFA24 2[1-4]; ICU-LOS 3[2-6] days and hospital-LOS 8[5-12] days. Gestational age 34 ± 5 weeks; 46% (85) nulliparous and 71% received routine prenatal care. Maternal mortality 3.3% (6) - 50% attributed to intracranial hemorrhage (ICH). Neonatal mortality 13.6%. Diagnostic categories: eclampsia (64; 35%), severe preeclampsia (60; 32.6%), HELLP (33; 17.9%), eclampsia-HELLP (18; 9.8%) and other (chronic/gestational-hypertension) (9: 4.7%). Severe hypertension in 46%, multiple organ dysfunction in 23%, acute respiratory distress in 8.7% and acute renal failure in 8%. Variables independently associated with eclampsia: maternal age (OR 1.07 [1.02-1.13], gestational age (OR 1.14 [1.04-1.24]) and nulliparity (OR 2.40 [1.19-4.85]).
  
  
  CONCLUSIONS
  Although patients were young and the majority received appropriate prenatal care, they spent considerable time in hospital and presented severe morbidity. Maternal mortality was 3.3% and in half of these cases it was attributed to ICH. Eclampsia and severe preeclampsia represented two thirds of the diagnostic categories. Variables independently associated with eclampsia were maternal and gestational ages and nulliparity.
authors.affiliation: a Intensive Care Unit , Sanatorio Anchorena, Capital Federal , Ciudad de Buenos Aires , Argentina .|b Intensive Care Unit , HIGA Gral. San Martín , La Plata, provincia de Buenos Aires , Argentina , and.
authors.forename: Daniela N
authors.initials: DN
authors.lastname: Vasquez
authors.affiliation: b Intensive Care Unit , HIGA Gral. San Martín , La Plata, provincia de Buenos Aires , Argentina , and.
authors.forename: Andrea V
authors.initials: AV
authors.lastname: Das Neves
authors.affiliation: c Intensive Care Unit , Hospital L. Lagomaggiore , Mendoza , Argentina.
authors.forename: Graciela
authors.initials: G
authors.lastname: Zakalik
authors.affiliation: a Intensive Care Unit , Sanatorio Anchorena, Capital Federal , Ciudad de Buenos Aires , Argentina .
authors.forename: Vanina B
authors.initials: VB
authors.lastname: Aphalo
authors.affiliation: c Intensive Care Unit , Hospital L. Lagomaggiore , Mendoza , Argentina.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Sanchez
authors.affiliation: b Intensive Care Unit , HIGA Gral. San Martín , La Plata, provincia de Buenos Aires , Argentina , and.
authors.forename: Elisa
authors.initials: E
authors.lastname: Estenssoro
authors.affiliation: a Intensive Care Unit , Sanatorio Anchorena, Capital Federal , Ciudad de Buenos Aires , Argentina .
authors.forename: Alfredo D
authors.initials: AD
authors.lastname: Intile
authors.affiliation: b Intensive Care Unit , HIGA Gral. San Martín , La Plata, provincia de Buenos Aires , Argentina , and.
authors.forename: Héctor S
authors.initials: HS
authors.lastname: Canales
authors.affiliation: b Intensive Care Unit , HIGA Gral. San Martín , La Plata, provincia de Buenos Aires , Argentina , and.
authors.forename: Cecilia I
authors.initials: CI
authors.lastname: Loudet
authors.affiliation: a Intensive Care Unit , Sanatorio Anchorena, Capital Federal , Ciudad de Buenos Aires , Argentina .
authors.forename: José L
authors.initials: JL
authors.lastname: Scapellato
authors.affiliation: a Intensive Care Unit , Sanatorio Anchorena, Capital Federal , Ciudad de Buenos Aires , Argentina .
authors.forename: Pablo M
authors.initials: PM
authors.lastname: Desmery
mesh_terms: D000328:Adult; D001118:Argentina; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Critical care; HELLP; eclampsia; hypertensive disease of pregnancy; intracranial hemorrhage; preeclampsia