RESUMO
OBJECTIVE: To determine the risk of preeclampsia in a population with respect to maternal and sister histories of chronic hypertension, preeclampsia and eclampsia. DESIGN: A case-control study of severe preeclampsia. SETTING: Maternity hospital in Natal, Brazil. PARTICIPANTS: A total of 412 subjects were enrolled, 148 cases and 264 controls. MAIN OUTCOME MEASURES: Personal and familial histories of hypertensive disorders. Odds ratio estimates of preeclampsia with respect to family history of hypertensive diseases. RESULTS: Women with a history of hypertensive disorders were more frequent in the case group (p = 0.001). Women whose mothers had a history of hypertension (p = 0.003), preeclampsia (p = 0.007) or eclampsia (p = 0.038) were at increased risk of severe preeclampsia. The risk of preeclampsia was greater when the woman had a sister with a history of hypertension (OR 2.60, 95% CI 1.60-4.21, p < 0.001), preeclampsia (OR 2.33, 95% CI 1.58-3.45, p < 0.001), or eclampsia (OR 2.57, 95% CI 1.28-5.16, p = 0.008). The risk of preeclampsia was also higher for women who had both a mother and sister with a history of hypertension (OR 3.65, 95% CI 1.65-8.09, p = 0.001). CONCLUSIONS: A family history of hypertensive disorders increased the risk of eclampsia and hemolysis elevated liver enzymes and low platelet (HELLP) syndrome in a Brazilian population.
Assuntos
Predisposição Genética para Doença/epidemiologia , Hipertensão/genética , Pré-Eclâmpsia/genética , Resultado da Gravidez , Adulto , Brasil/epidemiologia , Estudos de Casos e Controles , Causalidade , Comorbidade , Intervalos de Confiança , Saúde da Família , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Incidência , Razão de Chances , Pré-Eclâmpsia/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/genética , Probabilidade , Valores de Referência , Fatores de Risco , Índice de Gravidade de Doença , Adulto JovemRESUMO
OBJECTIVE: The purpose of this study was to review the management of hepatic rupture caused by HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome and to assess maternal and perinatal outcomes of these cases. STUDY DESIGN: A retrospective study of HELLP syndrome cases that were complicated by hepatic rupture was conducted. RESULTS: Ten cases of hepatic rupture were identified. The median maternal age was 42.5 +/- 5.9 years (median +/- SD), and the median gestational age at delivery was 35.5 +/- 4.9 weeks. The most frequent signs and symptoms of hepatic rupture were the sudden onset of abdominal pain, acute anemia, and hypotension. Laboratory findings included low platelet count and increased hepatic enzymes. Surgery was performed in 9 cases. One case was treated nonsurgically. The maternal mortality rate was 10%, and the perinatal mortality rate was 80%. CONCLUSION: A combination of surgical treatment with hepatic artery ligation and omental patching with supportive measures was effective in decreasing the mortality rate in hepatic rupture caused by HELLP syndrome.
