Clinical correlates of laboratory abnormalities in patients with severe preeclampsia at the University of Benin Teaching Hospital

Abstract

Preeclampsia is adiseaseunique tohumanpregnancy.Severeproteinuria, thrombocytopenia and elevated creatinine levels arewell documented complications of the disease. We aimed to detect the frequency of these abnormalities in severe preeclamptics in Benin City, and to determine their clinical correlates. Aretrospective study was conducted with 100 subjects presenting with severe pre eclampsia to the Obstetric Unit of the UBTH,Benin City.Their management included urinalysis, plate let count,serum creatinine and liver enzymes levels. The subjects were managed according to our departmental protocol which included stabilization and delivery. The sociodemographic, clinical and laboratory information retrieved were used to generate a database for analysis.Main outcomemeasure: Frequency and severity of laboratory abnormalities. Proteinuriawas 4+in 32%, thrombocytopeniawas in 35%and creatinine resultswere abnormal in 8%of the patients.No abnormality of liver  enzymes was found.Severe proteinuria, low platelet count and elevated creatinine were 47.8% (87.5 vs 39.7%: P=0.0001), 7.7% (60.0 vs 52.3%: P=0.531) and 8.2% (62.5 vs 54.3%: P=0.727) respectively more likely to be associated with mean arterial blood pressure (MABP).120mmHg. Elevated creatinine was 68.5% more likely to be associated with birth asphyxia (75.0 vs 6.5%, P=0.0001). Maternal mortality was 1% and associated with severe proteinuria, platelet count of 64,000cells/ƒÊl and serum creatinine level of 1.6mg/dl. This study showed that severe  proteinuria, lowplatelet count and elevated serum creatinine in  preeclampsia serve as predictors of adverse clinical outcome. Early  assessment of these parameters and appropriate intervention might improve outcome.