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Biomedical subjects

E García-Cáceres

Publications and source records attributed to E García-Cáceres.

5 recordsLinked to original sources
PubMed1998

Thrombocytopenia, hypertension and seizures in eclampsia.

OBJECTIVE: Mortality by eclampsia most likely relies on factors that are associated with seizures, but not directly related to them. The objective of the current study is to analyze these probable factors. METHOD: This study evaluates patients with eclampsia only. Age, parity, weeks of gestation, blood pressure, platelet counts and cause of death were analysed. The groups of survivors and fatalities were compared using relative risk (RR) with 95% confidence intervals (CI), chi2 and Student's t-test. RESULTS: A total of 446 cases of eclampsia were studied, of which there were 371 survivors and 75 deaths. The incidence was 14.2/10000 births with mortality of 14.4%. Mortality was more frequent in patients over 25 years of age (P < 0.005). The diastolic blood pressure showed significant difference between the survivor and fatality group (P < 0.05). Before convulsion, thrombocytopenia was present in 148 patients (33.2%) of which 95 survived and 53 died (RR = 2.76; 95% CI 2.20-3.46; P < 0.0000001). CONCLUSIONS: Mortality by eclampsia is directly related to age, diastolic blood pressure > or = 110 mmHg, seizure and thrombocytopenia. Our findings suggest poor maternal prognosis if seizures occur associated with thrombocytopenia.

Adolescent↗
PubMed1997

Dexamethasone in the post-partum treatment of HELLP syndrome.

OBJECTIVE: To determine if the routine initiation of dexamethasone in patients with post-partum HELLP syndrome produces therapeutic benefits. METHOD: The puerperal courses of 17 mothers who initially received dexamethasone after delivery were compared to 17 other mothers with HELLP syndrome who received no corticosteroids during the puerperium course. Treated patients immediately received 10 mg of dexamethasone post-partum (intravenously) followed 12 h later by 10 mg and 10 mg at 24 h post-partum, to a total of 30 mg. RESULTS: The steroid treated group had significant changes over time in platelet count. Relative to the control group the platelet count increased significantly by 30 h post-partum (P < 0.01). The blood pressure, urinary output, lactic dehydrogenase, aspartato aminotransferase and alanine aminotransferase values were not significantly different between the dexamethasone and control group at any time by 72 h post-partum. CONCLUSION: Parturients with HELLP syndrome who received a short course of post-partum dexamethasone therapy had an accelerated recovery from their platelet count, but not from their liver enzymes and blood pressure.

Adult↗
PubMed1996

[Difference between preeclampsia, HELLP syndrome and eclampsia, maternal evaluation].

120 cases of severe preeclampsia without HELLP Syndrome (hemolysis, elevated liver enzymes and low platelets), 120 cases of HELLP Syndrome without eclampsia and 119 eclamptic patients without HELLP were analyzed. The objective was to found differences in the maternal morbidity and mortality. Eclampsia was found in those patients 20 years or less, nulliparous and with 37 o more weeks of gestation. This difference was statistically significant. In the group with severe preeclampsia there was one death and 18 complications. In the group with eclampsia there was 5 deaths and 21 complications. In the group of patients with HELLP Syndrome there was 9 death and 63 complications. HELLP syndrome presented various causes of death. Cerebral hemorrhage was the principal one in eclamptic patients. The main complication in the three groups was acute renal insufficiency and this was presented mainly in HELLP Syndrome patients. In summary, HELLP Syndrome have different pathophysiologic characteristics than severe eclampsia and eclampsia. This fact was showed by the great difference in the maternal morbidity and mortality. We suggest a more aggressive and intensive care of HELLP Syndrome patients.

Adult↗
PubMed1996

[HELLP syndrome. Analysis of 102 cases].

One hundred and two cases of HELLP Syndrome admitted at the Adults Intensive Care Unit since January 1992, to June 1994; 63 with severe preeclampsia, 26 eclamptics and 13 with chronic hypertension more preeclampsia-eclampsia were analysed. The mean age was 24 year (range, 15 to 42). All 102 of the patients had one or more symptoms, those more often were: headache (85), right upper-quadrant tenderness (61), nausea and/or vomiting (31). The diastolic blood pressure maximum before the admission was 100 mm Hg or less in patients and 46 had more than 110 mm Hg. The mean platelets count was 58000 (range, 17000 to 100000). The median of laboratory test were: lactic dehydrogenase (830 u/l), glutamic oxaloacetic transaminase (278 u/l), glutamic pyruvic transaminase (263 u/l), total bilirubin (3.3 mg/dl). There were complications in 37 patients; acute renal failure 20, disseminated intravascular coagulopathy in 11, cerebral hemorrhage in 10 and abruption placentae in 6 patients. During the study period there were 20 death due to preeclampsia-eclampsia and 14 were in patients with HELLP syndrome, cerebral hemorrhage was the main cause (70%). In the group study 11 intrauterine deaths were diagnosed.

Adolescent↗