[Presence of equinocyte in the preeclampsia-eclampsia syndrome. Is this a subclinical manifestation of the syndrome?]. / Presencia del equinocito en el síndrome de preeclampsia-eclampsia ¿Manifestación subclínica del síndrome?

OBJECTIVE: To determine the relationship between erythrocyte deformations and preeclampsia-eclampsia syndrome before presentation of the triad high blood pressure-edema-proteinuria. MATERIAL AND METHODS: Aleatory study. A total of 308 patients were studied without evidence of preeclampsia, with negative erythrocyte deformation smear, between 12 and 18 weeks of pregnancy. Monthly laboratory samples were performed including arterial blood pressure monitorization, weight, and periphery blood smear considered as positive with presence of 50% of morphologic changes of erythrocyte (equinocyte) deem in 10 fields, with light microscopic and oil immersion at 100X. Statistical studies were performed to determine relative risk (RR), sensitivity (S), and specificity (E), and positive and negative predictive values. RESULTS: A total of 308 patients were studied; 36 patients (100%) had a positive smear, nine (25%) had preeclampsia. Erythrocyte deformation was seen at between 22 and 26 weeks of pregnancy in all patients before onset of high blood pressure, edema, and proteinuria; of 27 patients with positive smear who did not present preeclampsia (75%), five had thrombocytopenia, of five had edema and increased weight, and 17 were normal with normal vaginal delivery. A total of 267 patients who had negative smear until the end of pregnancy (98%), five (2%) had preeclampsia (sensitivity = 64%, specificity = 90%, VP+ = 25%, VP- = 98%, RR = 13.6%). CONCLUSIONS: There is a close relationship between erythrocyte deformations with onset of preeclampsia-eclampsia syndrome prior to presentation of the triad high blood pressure-edema-proteinuria.