Wardhana Manggala Pasca, Dachlan Erry Gumilar, Dekker Gustaaf
a Maternal Fetal Medicine Division, Department of Obstetrics & Gynecology , Fakultas Kedokteran Universitas Airlangga , Surabaya , Indonesia.
b Department of Obstetrics & Gynaecology , University of Adelaide , Elizabeth Vale , SA , Australia.
J Matern Fetal Neonatal Med. 2018 Mar;31(6):689-695. doi: 10.1080/14767058.2017.1295442. Epub 2017 Mar 1.
To analyze risk factors, obstetric outcome and the need for mechanical ventilation in preeclampsia complicated by pulmonary edema.
Case-control study using medical record on preeclampsia complicated by pulmonary edema patients in East Java tertiary referral hospital over 2 years. A simple scoring system was developed to predict the need for mechanical ventilation, using logistic regression.
1106 cases of preeclampsia were admitted, with 62 cases (5.6%) had pulmonary edema. Postpartum (p < .001) and cesarean delivery (p = .001) proportions were higher in the preeclampsia with pulmonary edema group. Of the 62 cases with pulmonary edema, 81% required intensive care admission and 60% needed mechanical ventilation support. Mechanical ventilation used was associated with eclampsia (p = .04), hypertensive crisis (p = .02), lower serum albumin (p = .05) and higher creatinine (p = .01). A simple scoring model developed could predict a 46%-99% probability of need for mechanical ventilation (AUC (ROC): 0.856, 95%CI 0.763-0.95).
Pulmonary edema is a common complication of preeclampsia in Indonesian referral hospitals. This severe complication increased maternal and perinatal morbidity and mortality. The developed scoring model in this study can be used as a triage tool to predict the probability of mechanical ventilation use due to this complication.
分析子痫前期合并肺水肿的危险因素、产科结局及机械通气需求。
采用病例对照研究，收集东爪哇三级转诊医院2年多来子痫前期合并肺水肿患者的病历。使用逻辑回归建立了一个简单的评分系统来预测机械通气需求。
共收治1106例子痫前期患者，其中62例（5.6%）发生肺水肿。子痫前期合并肺水肿组产后（p＜0.001）和剖宫产（p = 0.001）比例更高。在62例肺水肿患者中，81%需要入住重症监护病房，60%需要机械通气支持。使用机械通气与子痫（p = 0.04）、高血压危象（p = 0.02）、血清白蛋白降低（p = 0.05）和肌酐升高（p = 0.01）有关。所建立的简单评分模型可预测机械通气需求的概率为46% - 99%（AUC（ROC）：0.856，95%CI 0.763 - 0.95）。
在印度尼西亚转诊医院中，肺水肿是子痫前期的常见并发症。这种严重并发症增加了孕产妇和围产儿的发病率及死亡率。本研究中建立的评分模型可作为一种分诊工具，用于预测因该并发症而使用机械通气的概率。
