Prediction of Adverse Outcome in Preeclampsia Using fullPIERS Model

Introduction: Preeclampsia is a proteinuric state with gestational hypertension occuring in mid or late pregnancy leading to adverse maternal outcome which can be controlled by standardized assessment of pregnant women. The preeclampsia integrated estimate of risk model is a recently developed tool for prediction of adverse maternal outcomes up to 7 days after eligibility when predictor variables are collected following the diagnosis of preeclampsia within 48 hours after hospital admission. Aims and Objectives: To study the performance of full PIERS model in prediction of adverse maternal outcome in preeclampsia. Materials and Methods: A prospective observational study was carried out in the department of obstetrics and gynecology of Umaid hospital, Dr SN Medical College, Jodhpur. All women admitted for delivery in labor ward, having signs and symptoms of preeclampsia were included in the study. Discussion: A total of 410 women were studied, out of which 72 had adverse outcome. Eclampsia was the most common adverse outcome ( in 27 women i.e., 37.5%) followed by abruption. Mean gestational age of women with adverse outcome was 37 weeks. Out of 72 women presenting with adverse outcomes, 37 presented with symptoms. Swelling was the most common symptom of patients (69%). Out of 37 women who presented with symptoms, 21 (56%) had adverse outcomes. In women with adverse outcomes, mean systolic and diastolic BP on admission was 162 mm Hg and 102 mmHg, sPO2 less than 96% had significant association, platelet count was less than 1.19 lacs/ microliter, AST & ALT values more than 82 & 71 mg/dl respectively. Conclusion: The fullPIERS risk prediction model for pre-eclampsia which is supported by our study will help prevent severe materal complications through early identification and if universally implemented could guide clinical decision making, improve understanding of the disease process and to define at risk groups based on prognosis, thus, reducing the global burden of deaths due to HDOP.