Efficacy of full piers calculator in predicting adverse maternal outcomes in preeclampsia at a tertiary care hospital in South India

Title : Efficacy of full piers calculator in predicting adverse maternal outcomes in preeclampsia at a tertiary care hospital in South India

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 study the incidence of adverse maternal outcomes in preeclampsia using the PIERS calculator and to determine the factors associated with adverse maternal outcomes in preeclampsia.

Materials and methods: This study is a prospective observational study with a sample size of 200, carried out at Gandhi Hospital ; a tertiary care centre at Hyderabad in South India. The study subjects included pregnant women with a singleton pregnancy and gestational age >20 weeks, who were diagnosed as preeclampsia based on ACOG criteria. 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. The sensitivity, specificity, positive predictive value, and negative predictive value of the PIERS calculator was calculated. Receiver operating characteristic (ROC) curves were used to assess the predictive performance of the PIERS calculator.

Results: The study found that the PIERS calculator demonstrated a sensitivity of 80%, and specificity of 85%, a positive predictive value of 70% and a negative predictive value of 90%.

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.

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 the Professor and Head of the Department of OBG at Government Medical College, Mahbubnagar, Telangana, India 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 20 years and has guided numerous post-graduate dissertations. She holds an MBBS from Osmania Medical College (1987) and an MD in Obstetrics and Gynecology (1992) from the same institution. Dr. Shah has published 36 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.