Evaluation of the clinical and biologic means of assessing fetal prognosis in pregnancy toxemias. Apropos of 223 cases
Valentin, B.; Laffargue, F.; Daures, J.P.; Hedon, B.; Denjean, R.; Dujols, P.; Loubatières, Y.; Viala, J.L.
Journal de Gynecologie Obstetrique et Biologie de la Reproduction 14(4): 499-505
1985
ISSN/ISBN: 0368-2315 PMID: 4031430 Document Number: 259076
Two hundred and twenty-three cases notes of patients with toxaemia of pregnancy were analysed in order to try to establish the ability to predict through clinical and biological assessments of the mother the prognosis for the fetus. Statistical analysis methods were chosen to work out the classification of the parameters and to lead to an index of severity that could be established by a multifactorial discriminating analysis. This study confirms that there is an inversion in the circadian rhythm of arterial blood pressure, with an increase in the evening and at night. It shows how bad prognostically blood pressure instability is. On the other hand oedema of the legs is of no significance. Contrary to the view that has been held for a long time, an increase in weight is directly proportional to fetal parameters. As far as parameters are concerned as a whole (both clinical and biological) a rise in blood urea is more discriminating at every stage of the illness and precedes an increase in the platelet count, the changes in creatinine clearance and night blood pressure. Maternal changes are better correlated with fetal variability before the 35th week of the pregnancy whereas after that date the prognostic value of these readings is of little importance.