Efficacy of full piers calculator in predicting adverse maternal outcomes in preeclampsia

Title : Efficacy of full piers calculator in predicting adverse maternal outcomes in preeclampsia

Abstract:

Preeclampsia and other hypertensive disorders of pregnancy (HDPs) remain the leading causes of maternal and perinatal morbidity and mortality. The World Health Organization estimates that at least one woman dies every seven minutes from the complications of HDPs. The Preeclampsia Integrated Estimate of Risk (full PIERS) model is a tool for predicting adverse maternal outcomes following the diagnosis of preeclampsia within 48 hours after admission to the hospital

Aims and objectives: The primary aim of the study was to evaluate the efficacy of the pre- eclampsia integrated estimation of risk (PIERS) calculator in predicting adverse maternal outcomes in women with preeclampsia. The secondary objectives   were   to   determine the incidence of adverse maternal outcomes in preeclampsia and to study  the symptoms associated with preeclampsia.

Materials and methods: This study is a prospective observational study with a sample size of 300; carried out at  two tertiary care centres  in Telangana, a South Indian state . The study subjects included pregnant women  who were diagnosed as  preeclampsia  based on ACOG criteria and were admitted  in hospital.. Data from medical records and direct patient interviews  were  collected  and certain demographic details, clinical parameters  and laboratory parameters along with adverse maternal outcomes were recorded. The PIERS calculator was used   to   calculate each patient's risk   score.

Statistical Analysis: Data was analyzed using SPSS software ver .30.0.0.  The sensitivity, specificity, positive predictive value, and negative predictive value of the PIERS  calculator  was calculated. Receiver operating characteristic (ROC) curves  were visualized to determine the AUC.

Results: The study found that the PIERS calculator demonstrated  a  sensitivity of 86.6%,  specificity of 74%, a positive predictive value of 55.1%, a negative predictive value of 93.6% and a diagnostic accuracy of 77.3%. ROC was visualized to get an  AUC of 0.886 which shows that  Full PIERS calculator is an excellent predictor of adverse maternal outcome.

Conclusion: The findings suggest that the PIERS calculator is a valuable tool for predicting adverse maternal outcomes in women with preeclampsia  and  helps  to decide on triage, transport , management  and timing of delivery particularly in low resourse settings.

Biography:

Dr. Sangeeta Shah an accomplished academic and clinical professional with over 32 years of experience in teaching medical students and clinical practice in Obstetrics and Gynecology (OBG). She is currently serving as Additional Director of Medical Education and  Medical Superintendent , after an illustrious tenure as Professor & Hod of OBG at the prestigious government tertiary care centre namely, Gandhi Medical College and Hospital at Hyderabad- in the Southern Indian state of Telangana. 

Dr. Shah began her career as an Assistant Professor at Deccan Medical College, Hyderabad, in 1992, and subsequently worked at Osmania Medical College and Gandhi Medical College in various academic roles. In addition to her teaching roles, Dr. Shah has been an examiner for both postgraduate and undergraduate programs for over 25 years and has guided numerous post-graduate dissertations. She holds an MBBS from the prestigious and one of the oldest medical colleges of India, Osmania Medical College (1987) and an MD in Obstetrics and Gynecology (1992) from the same institution. Dr. Shah has published 40 articles in national and international indexed journals and is trained in laparoscopic surgery. She was honored for her exemplary services during the Covid pandemic by a Senior Judge of the City Civil Court. Dr. Shah is also a former state-level basketball player and an academic topper during her medical education as a postgraduate sttudent.