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Is massive proteinuria associated with maternal and fetal morbidities in preeclampsia?

대한산부인과학회지 2017년 60권 3호 p.260 ~ 265
 ( Kim Mi-Jung ) - Inje University College of Medicine Busan Paik Hospital Department of Obstetrics and Gynecology

 ( Kim Young-Nam ) - Inje University College of Medicine Busan Paik Hospital Department of Obstetrics and Gynecology
 ( Jung Eun-Jung ) - Inje University College of Medicine Busan Paik Hospital Department of Obstetrics and Gynecology
 ( Jang Hye-Ree ) - Inje University College of Medicine Busan Paik Hospital Department of Obstetrics and Gynecology
 ( Byun Jung-Mi ) - Inje University College of Medicine Busan Paik Hospital Department of Obstetrics and Gynecology
 ( Jeong Dae-Hoon ) - Inje University College of Medicine Busan Paik Hospital Department of Obstetrics and Gynecology
 ( Sung Moon-Su ) - Inje University College of Medicine Busan Paik Hospital Department of Obstetrics and Gynecology
 ( Lee Kyung-Bok ) - Inje University College of Medicine Busan Paik Hospital Department of Obstetrics and Gynecology
 ( Kim Ki-Tae ) - Inje University College of Medicine Busan Paik Hospital Department of Obstetrics and Gynecology

Abstract


Objective: The aim of this study was to investigate whether massive proteinuria in preeclampsia is associated with maternal and fetal complications.

Methods: We retrospectively analyzed the clinical records of 233 patients who were diagnosed with preeclampsia. We divided the preeclamptic patients into three groups based on the amount of proteinuria: massive (≥5 g/24 hr), moderate (2 to 5 g/24 hr) and mild (<2 g/24 hr) proteinuria group. We analyzed the clinical characteristics and maternal and neonatal complications among three groups.

Results: Gestational age at diagnosis and delivery were lower in women with massive and moderate proteinuria group than women with mild proteinuria group (31.5±3.1 vs. 32.3±3.6 vs. 34.0±3.5 weeks, P<0.001 for gestational weeks at diagnosis; 34.6±3.6 vs. 35.1±4.1 vs. 36.9±4.0 weeks, P=0.001 for gestational age at delivery). In maternal complications, the incidences of pleural effusion and retinal detachment were significantly different among three groups (29.9% vs. 22.4% vs. 9.0%, P=0.004 for pleural effusion; 11.5% vs. 3.0% vs. 1.3%, P=0.009 for retinal detachment). Creatinine levels were higher and albumin levels were lower in the massive proteinuria group than in the moderate and mild groups. However, other maternal and neonatal complications were not significantly different among three groups.

Conclusion: Massive proteinuria might be associated with renal albumin excretion-related morbidity, such as pleural effusion, retinal detachment, and low serum albumin levels. Furthermore, it was associated with early-onset preeclampsia and early delivery.

키워드

Morbidity; Pre-eclampsia; Pregnancy complications; Proteinuria
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