[Analysis of maternal morbidity and mortality among patients admitted to Obstetric Intensive Care with severe preeclampsia, eclampsia or HELLP syndrome]. / Análisis de la morbimortalidad materna de las pacientes con preeclampsia grave, eclampsia y síndrome HELLP que ingresan en una Unidad de Cuidados Intensivos gineco-obstétrica.

OBJECTIVE: To describe the incidence and clinical and epidemiological profile of patients with severe preeclampsia admitted to Intensive Care. DESIGN: A prospective, observational case series. SETTING: A specific obstetric 8-bed ICU belonging to a university hospital with a total of 55 ICU beds. PATIENTS: A total of 262 patients admitted due to severe preeclampsia, eclampsia or HELLP syndrome. INTERVENTION: Descriptive analysis of the population and complications in the ICU and hospital mortality. RESULTS: The mean patient age was 30.47±5.7 years, with the following diagnóstico at admission: A total of 78% of the patients with severe preeclampsia, 16% with HELLP syndrome, and 6% with eclampsia, occurring in gestational week 31.85±4.45. In turn, 63% of the patients were nulliparous and had a low prevalence of previous diseases. The global complications rate was 14% (9% heart failure, 5% acute renal failure and 2% coagulopathy). Maternal mortality was 1.5% (4 patients), and was associated with non-nulliparous status, the presence of complications, and toast > 71mg/dl. CONCLUSIONS: Severe preeclampsia has a low mortality rate (1.5%), though the complications rate is considerable (14%). The condition develops more often in nulliparous women during the third trimester of pregnancy.

Successful thrombolysis on a mechanical tricuspid prosthesis.

Recombinant tissue-type plasminogen activator (rt-PA) is presently used for the treatment of different clinical entities, mostly myocardial infarction. Its use for treatment of thrombotic dysfunction of prosthetic cardiac valves is more recent and has been only rarely reported. A 33-year-old woman with a St Jude Medical prosthesis in the tricuspid position, had suffered from thrombotic dysfunction of her prosthesis for more than 2 months. She was treated with rt-PA, and after infusion of 70 mg, the prosthesis functioned normally. She showed a moderate systemic fibrinolytic state associated with mild bleeding complications.