Background
Methods
Question formulation
Question Components | Tests for predicting complications of pre eclampsia |
---|---|
Population
| Pregnant women with pre eclampsia |
Tests
| |
History
| Parity; Race; Maternal age; Previous severe pre eclampsia/Eclampsia; Family history of pre eclampsia/eclampsia; Obesity; Weight gain; Pre existing hypertension, renal disease, diabetes, lupus, thrombophilia, other auto immune diseases; Multiple pregnancy; Symptoms-headache, epigastric pain, nausea, visual disturbance or combination of symptoms |
Examination
| Blood pressure; Peripheral oedema; Exaggerated tendon reflexes; Clonus; Papilloedema; Retinal changes; Oliguria; Symphysio fundal height; Oxygen saturation |
Investigations
|
Biochemical: Serum uric acid, urine dipstick (Bedside Urinalyses) 24 hour urine protein, urinary calcium excretion, hypoalbuminaemia, microalbuminuria, fibronectin, protinuria, renal and liver function tests; Ultrasound: Growth, liquor volume, Doppler (uterine, umbilical artery, Middle cerebral artery, venous, uteroplacental) Bio Physical Profile; Haematological: Anti thrombin III, platelet count, haemoglobin, fibrinogen, thrombophilia screen, Maternal serum Alpha feto protein(MSAFP), Serum Human Chorionic Gonadotropin (HCG); Computerised Tomography; Magnetic Resonance Imaging |
Outcome
|
Maternal
Eclampsia; Pulmonary oedema; Cerebral Haemorrhage; Hepatic, renal, haematological complications; Cardiac arrest; Abruption; Thromboembolism; stroke; psychiatric problems; Complications of labour and delivery; Maternal death; Need for hospitalisation, Day care unit visits, Use of intensive care, ventilation and dialysis |
Fetal
Intra uterine growth restriction; Pre maturity; Abnormal p H at birth or antenatal; Abnormal Apgar; Hypoxic Ischemic Encephalopathy; Perinatal death; Long term effect, learning disabilities, Developmental and special needs after discharge; Need for neonatal intensive care admission, mechanical ventilation and duration of hospital stay | |
Study design
|
Systematic review of test accuracy studies
|
Study identification and selection
Population | Test | Outcome | |||
---|---|---|---|---|---|
History | Examination | Investigation | Final Refinement | ||
1. pre adj eclampsia 2. preeclampsia 3. hypertens $ 4. pregnan $ 5. pre-eclampsia #.DE. 6. hypertension #.DE. 7. pregnancy #.DE. 8. 3 or 6 (hypertension) 9. 4 OR 7 (pregnancy) 10. 8 and 9 (pregnancy and hypertension) | 12. history 13. parity 14. multiparity or nulliparity 15. matern$ near age 16. (previous or prior) near eclampsia 17. (previous or prior) near preeclampsia 18. (previous or prior) near pre adj eclampsia 19. multiple near pregnan$* 20. twin$ or triplet$ or quadruplet$ 21. symptom$ 22. headache 23. epigastric near pain 24. naus$ or vomit$ 25. race 26. diabet$ 27. stress 28. lupus 29. thrombophilia 30. medical-history-taking#.DE. 31. maternal-age#.DE. 32. pregnancy-multiple#.DE. 33. headache#.DE. 34. signs-and-symptoms-digestive#.DE. 35. vision-disorders#.DE. 36. weight gain#.DE. 37. population-groups#.DE. 38. diabetes-mellitus#.DE. 39. stress-psychological#.DE. 40. autoimmune-diseases#.DE. 41. thrombophilia#.DE. | 43. blood adj pressure 44. oedema or edema 45. tendon$ near reflex$ 46. hyperreflexia 47. clonus 48. papilledema or papilloedema 49. retina$ near change$ 50. oliguria 51. symphys$ near fundal 52. symphys$ near height 53. cardiotocogra$ 54. oxygen near saturat$ 55. blood-pressure-determination#.DE. 56. edema#.DE. 57. reflex-abnormal#.DE. 58. retinal-diseases#.DE. 59.oliguria#.DE. 60. cardiotocography#.DE. 61.oximetry#.DE. | 63. serum near uric adj acid 64. urin near analys $ 65. urin$ 66. maternal near (feto adj protein$ or fetoprotein$ or alphafetoprotein$) 67. urin$ near calcium 68. hypoalbuminemia or hypoalbuminaemia 69. microalbuminuria 70. fibronectin$ 71. proteinuria 72. renal adj function near test$ 73. liver adj function near test$ 74. liquor near volume 75. biophysical near profile 76. ultraso$ 77. antithrombin$ 78. platelet adj count 79. anti adj thrombin$ 80. fibrinogen 81. antiphospholipid $ 82. haemoglobin 83. uric-acid-QN.DE 84. alpha-fetoproteins #.DE 85. calcium-ur. DE 86. hypoalbuminemi a#.DE. 87. fibronectins .DE. 88. proteinuria #.DE. 89. kidney-function-test s#.DE. 90. liver-function-tests #.DE. 91. ultrasonography #.DE. 92. haematologic-test s#.DE. 93. antithrombin-III. DE. 94. fibrinogen #.DE. 95. antibodies-antiphospholipid #.DE. 96. diagnostic-imaging #.DE. | 99. complicat$ 100. (renal or kidney$) near (disease$ or complicat$) 101. (hepatic or liver$) near (disease$ or complicat$) 102. death or mortality 103. morbidity 104. eclampsia 105. (pulmonary or lung) near (complicat$ or disease$) 106. thromboembolism 107. pulmonary near(oedema or edema) 108. ventilat$ 109. stroke 110. uter$5 near haemorrhage 111. abruption 112. (heart or cardiac) near arrest$ 113. (psychiatric or mental) near (illness$ or complication$1 or disorder) 114. hospitali$ 115. hypox$ near isch$ 116. (development$ or learning) near (disorder$ or difficult$) 117. pregnancy-complications#.DE. 118. kidney-diseases#.DE. 119. renal-dialysis# 120. liver-diseases#.DE. 121. death# 122. eclampsia# 123. pulmonary-embolism.DE. 124. respiration-artificial# 125. cerebrovascular-disorders#.DE. 126. brain-edema.DE. 127. intracranial-hypertension#.DE. 128. uterine-haemorrhage.DE. 129. abruption-placentae#.DE. 130. heart-diseases# 131. mood-disorders#.DE. 132. hospitalization# 133. infant-newborn-diseases# 134. respiratory-distress-syndrome-newborn.DE. 135. mental-disorders-diagnosed-in-childhood#.DE. | 137. 11 and 98 and 136 (Captures Population and Test and Outcome) 138. animal = yes 139. human = yes 140. 138 not 139 141. 137 not 140 142. PT = comment or PT = letter |
11. 1 OR 2 OR 5 OR 10
(Captures Population) |
42. OR/12–41
(Captures history)
|
62. or/43–61
(Captures examination)
|
97. or/63–96
(Captures investigation)
|
136. or/99–135
(Captures Outcome) |
143. 141 not 142
Final citation set (animal only studies, comments and letters excluded)
|
98. 42 or 62 or 97 (Captures Test) |