Outcomes of pregnancy with proteinuric and non-proteinuric pre-eclampsia

Volume : VII, Issue : VII, July - 2018

Rakesh Kumar Gupta, Sanjeev Sharma, Dhananjai Agarwal, Vinay Rathore, Reema Gupta

Background: Recent American College of Obstetrics and Gynecology (ACOG) guidelines suggests that pre–eclampsia can be

diagnosed even in the absence of proteinuria. The objective of this study was to compare the outcomes of pregnancy in women

with pre–eclampsia according to the presence or absence of proteinuria.

Design: This prospective study included all pregnant women enrolled for antenatal care in Mahila chikitshalay, a tertiary care

academic hospital in Jaipur, who developed pre–eclampsia during the study period from June 2016 to May 2017. Pre–eclampsia

was diagnosed according to ACOG diagnostic criteria for pre–eclampsia. Patients were divided into two groups namely

proteinuric and non–proteinuric depending upon presence or absence of proteinuria on urine dipstick test. Patients were followed

prospectively to determine the outcome of pregnancy. Epidemiological, clinical and laboratory data were collected in a standard

proforma.

Results: Out of 3926 patients enrolled for antenatal care, 181 (4.6%) developed eclampsia. Forty–nine (27.1%) patients had nonproteinuric

pre–eclampsia. Women with proteinuric pre–eclampsia had higher systolic (167.19±17.10 vs156.24±9.53, p<0.001)

and diastolic blood pressure (108.18±13.3 1vs 103.27±7.43, p= .015) and were more likely to have cereal symptoms (18.9% vs

6.1%, p=0.034) as compared to non–proteinuric patients. Proteinuric patients were more likely to deliver at earlier gestation

(35.7±1.9 vs. 36.7±0.9, p=0.002). , have an infant with small for gestation age (41.7% vs. 20.41%,p=0.008) and had higher

perinatal mortality (12.9% vs. 2.0%, p=0.03).

Conclusion: Proteinuric is associated with increased maternal morbidity and perinatal mortality as compared non–proteinuric

pre–eclampsia.