Page 28 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

26 | Part 2 Cardiovascular Health
questions. (1) How long can it take for hypertension and proteinuria to resolve after a preeclamptic pregnancy and (2) how do prolongation of pregnancy after the development of preeclampsia and the levels of blood pressure and proteinuria during preeclampsia correlate with postpartum time to resolution and to what extent?
METHODS
This historical prospective cohort study was carried out on preeclamptic women who were admitted to the Department of Obstetrics and Gynecology of the Erasmus University Medical Center and delivered between January 1, 1990 and December 31, 1992. Preeclampsia was defined as the occurrence after 20 weeks’ gestation of a blood pressure of 140/90 mmHg or more and proteinuria of 0.3 g/day or more. The HELLP syndrome was defined as the simultaneous occurrence of a platelet count of < 100 x 109/l, serum aspartate aminotransferase (ASAT) and serum alanine aminotransferase (ALAT) concentrations > 30 U/l (2 S.D. above the mean in our hospital). Women with a record of chronic hypertension or kidney disease prior to pregnancy or before 20th week of gestation were excluded. Severity of the disease was retrospectively defined according to ACOG-criteria83.
During the study period, a consultant of internal and obstetric medicine used a protocol for the follow-up. All women who were admitted with preeclampsia were offered visits at 1.5, three, six, 12, 18 and 24 months after delivery. If a woman did not present for the check-up, she was sent a reminder once. However, not every woman attended every visit. The hospital files were searched to collect data on blood pressure, use of anti-hypertensive drugs, urinary protein excretion and serum-creatinine levels at every attended visit.