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Delayed postpartum preeclampsia: an experience of 151 cases

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Abstract

Objective

Preeclampsia affects 6% to 8% of pregnancies. There are few data regarding hypertensive disorders that are diagnosed in the postpartum period. Our purpose was to determine the demographics, outcomes, and treatment of this complication.

Study design

This was a multicenter retrospective study of women who had received a diagnosis of hypertension/preeclampsia in the postpartum period. Inclusion criteria were readmission of a patient with this diagnosis (≤6 weeks after the delivery).

Results

Data from 151 women were studied. Complications included 24 cases (15.9%) of eclampsia, 9 cases (5.9%) of pulmonary edema, 6 cases (3.9%) of endomyometritis, 2 cases (1.3%) of thromboembolism, and 1 case of maternal death. Seventy-eight patients required antihypertensive medications on discharge. Subanalysis performed between the eclamptic and non-eclamptic women showed no difference among groups.

Conclusion

Delivery does not eliminate the risk for preeclampsia and its complications. Efforts should be directed at the continued monitoring, reporting, and evaluating of the symptoms of preeclampsia during the postpartum period.

Section snippets

Material and methods

This was a multicenter retrospective analysis of patients who were delivered from January 1992 through December 2002. Participating hospitals included The University of Cincinnati, Good Samaritan Hospital (Cincinnati, Ohio), and Central Baptist Hospital (Lexington, Ky). Patients were identified through a perinatal database and ICD-9 codes. Inclusion criteria were women who were readmitted with a diagnosis of hypertension/preeclampsia (up to 6 weeks after delivery). Records were reviewed for

Results

During the study period, 3988 diagnoses of preeclampsia/eclampsia were made. Two hundred twenty-nine women (5.7%) were diagnosed during the postpartum period. Seventy-eight patients (34%) were diagnosed while still in the hospital, and 151 patients (66%) were readmitted to the hospital after the delivery with a diagnosis of hypertension/preeclampsia. The data analysis was confined to the patients who were readmitted with the diagnosis of hypertension/preeclampsia.

The mean maternal age at

Comment

Hypertensive disorders during pregnancy are the second leading cause, after embolism, of maternal death in the United States.2 During the past decades, there has been extensive research regarding the incidence, risk factors, antepartum treatment, and outcome of these women. Although the medical literature primarily focuses on antenatal and intrapartum treatment, hypertension in the postpartum period is a common phenomenon and often poses a treatment dilemma. It is recognized that the immediate

Acknowledgements

We thank Dr Mark Chames for help with the statistical portion of the paper.

References (7)

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