Masters Degrees (Obstetrics and Gynaecology)
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Browsing Masters Degrees (Obstetrics and Gynaecology) by Author "Budhram, Samantha"
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- ItemA prospective study evaluating the association of specific risk factors with the development of preeclampsia(Stellenbosch : Stellenbosch University, 2015-12) Budhram, Samantha; Steyn, D. W.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology.ENGLISH ABSTRACT: OBJECTIVE: To determine the association, if any, between certain risk factors for preeclampsia (PE) and the subsequent development of PE in a local cohort of South African women. DESIGN: A prospective study of women with any risk factor for PE for the duration of their pregnancy. METHOD: A prospective study was performed on selected women referred to Tygerberg Hospital, High-risk antenatal clinic, with specific risk factors for the development of PE. A history-based questionnaire was completed by participants at enrolment and biophysical parameters were recorded at each subsequent antenatal visit, admission and at confinement. All data was captured according to the attached data sheet. All information was kept confidential and was strictly for the purposes of this study. STATISTICS: Statistics were performed using the SPSS statistics software version 17.0. Pearson Chi-square test of independence was used for correlating maternal historical factors, mean arterial pressures (MAP) and cardio-metabolic risk with the development of PE in the index pregnancy. p values were considered significant at values < 0.05. RESULTS: The incidence of PE in the cohort was 11.4%. The age of the patient, parity, history of diabetes mellitus, MAP at booking and MAP at 24 weeks showed no significant association with the development of PE at any gestational age. There was a significant association between a history of PE in a previous pregnancy and the development of PE at any gestational age in the index pregnancy (p < 0.05). There were a significantly higher number of women with a history of chronic hypertension that developed PE in the index pregnancy (p < 0.0001). There were also a significantly greater number of obese women that developed PE at any gestational age in the index pregnancy (p < 0.05). The presence of any one or, a combination of cardio-metabolic risk factors was significantly associated with the development of PE at any gestational age (p < 0.005). CONCLUSION: The changing cardio-metabolic milieu, paralleling the pandemic in obesity, may be impacting on the development of PE. Screening for PE in South Africa may mean; validation of historical factors and MAP in prediction of PE in the local population, and if validated, incorporating it with the cardio-metabolic risk profile to triage women to appropriate levels of care. The pre-pregnancy, antenatal, postpartum and inter-pregnancy intervals can be used to optimise cardio-metabolic risk factors and these women, at the end of their reproductive careers, may benefit from life-long surveillance for cardiovascular disease.