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Multiple-parameter screening and prevention of preeclampsia: Evaluation of a protocol implemented at Hospital Universitario Puerta de Hierro

Publicado en:Progresos en Obstetricia y Ginecologia. 62 (2): 122-129-129 - 2019-03-01 62(2), DOI: 10.20960/j.pog.00179

Autores: de la Serna Gamboa, Álvaro; Ríos Vallejo, María del Mar; Vargas, Juana; Ruiz de Azúa Ballesteros, M; Gómez Manrique, Ana; García Benasach, Fátima; Nieto Espinar, Yolanda; Martínez Payo, C; Pérez Medina, Tirso

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© 2019, Sociedad Espanola de Ginecologia y Obstetricia. All rights reserved. Objective: To evaluate the implementation in our center of a preeclampsia risk screening protocol in a low-risk population combined with preventive treatment (aspirin, 100 mg/d) by evaluating the variation in the incidence of preeclampsia. To validate the analysis tool and its predictive strength. Material and methods: We studied 310 patients divided into 2 groups: 138 controls (TR) and 172 patients who had undergone screening and received preventive treatment (CI). We collected demographic data, gestational age at consultation, obstetric history, reproductive method, risk factors for preeclampsia (hypertension, diabetes, BMI, kidney disease, and coagulopathy), use of aspirin as preventive therapy, and data on the outcome of pregnancy (hypertension, proteinuria, diagnosis of preeclampsia, and complications). In the CI group, we also recorded the risk of preeclampsia. This was calculated retrospectively in the TR group. Results: The protocol had 80% sensitivity and 98.4% specificity. The incidence of preeclampsia was 3.62% in the TR group and 0.58% in the CI group (p=0.053), with an OR of 0.155 (0.017-1.34). Among patients with a high risk, 66.7% developed preeclampsia in the TR group and 9.1% in the CI group (p=0.027), with an OR of 0.05 (0.04-0.57) and a number needed to treat of 1.74. Conclusions: The high sensitivity and specificity of the analytical tool make it adequate for screening. The protocol reduces the incidence of preeclampsia in high-risk patients, even if that difference was not significant at the level of the study population.

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