Abstracts – 2008 - Obstetricia Crítica

J Reprod Med. 2007 Nov;52(11):1046-51.Pregnancy outcomes in women with chronic hypertension: a populationbasedstudy.Gilbert WM, Young AL, Danielsen B.Department of Obstetrics and Gynecology, University of California, Davis, USA.gilberw@sutterhealth.orgOBJECTIVE: To determine the pregnancy outcomes associated with maternalchronic hypertension. STUDY DESIGN: Retrospective, population-based cohortstudy of maternal and infant discharge records linked to birth records in Californiafrom 1991 to 2001 were examined for demographics and pregnancy outcomes,and comparisons were made between those with and without chronichypertension. One randomly selected pregnancy per subject was included.RESULTS: The number of women who delivered with chronic hypertension(0.69% incidence) was 29,842. As compared to non-chronic hypertensivepatients, fetal and neonatal mortality and in-hospital maternal mortality wereincreased (ORs and 95% CIs 2.3, (2.1, 2.6); 2.3, (2.0, 2.7); and 4.8, (3.1, 7.6)respectively). Major maternal morbidity was increased: stroke, OR 5.3, (3.7, 7.5);renal failure, OR 6.0, (4.4, 8.1); pulmonary edema, OR 5.2, (3.9, 6.7); severepreeclampsia, OR 2.7, (2.5, 2.9); and placental abruption OR 2.1, (2.0, 2.3).Neonatal morbidity was increased as well: fetal growth restriction, OR 4.9, (4.7,5.2); prematurity, OR 3.2, (3.1, 3.3); low birth weight, OR 5.4, (5.2, 5.5); very lowbirth weight, OR 6.5, (6.2, 6.8); and respiratory distress syndrome, OR 4.0, (3.8,4.2). CONCLUSION: Pregnant women with chronic hypertension havesignificantly increased risks of maternal and perinatal morbidity and mortality.Women with this condition should be treated as high risk with appropriatematernal and fetal surveillance.Am J Obstet Gynecol. 2008 Jan;198(1):56.e1-4.Hyperemesis in pregnancy: an evaluation of treatment strategies withmaternal and neonatal outcomes.Holmgren C, Aagaard-Tillery KM, Silver RM, Porter TF, Varner M.Department of Obstetrics and Gynecology, University of Utah Health SciencesCenter, Salt Lake City, UT, USA. cholmgren73@yahoo.comOBJECTIVE: The objective of the study was to evaluate the use of interventionssuch as a peripherally inserted central catheters (PICC) line or nasogastric(NG)/nasoduodenal (ND) tube with the use of medications alone in themanagement of pregnancies with hyperemesis. STUDY DESIGN: Subjects wereidentified with confirmed intrauterine pregnancy, admitted with hyperemesisgravidarum (HEG) between 1998 and 2004. Medical records were thenabstracted for information with regard to therapy. Subjects were assigned on thebasis of the management plan: medication alone, PICC line, or NG/ND tube.Outcomes were compared between groups. RESULTS: Ninety-four patients metstudy criteria and had complete outcome data available. Of those, 33 had a PICCline placed (35.1%), 19 had a NG/ND placed (20.2%), and 42 were managedwith medication alone (44.7%). These groups were similar with respect to