Détermination d'un index prédictif de la preeclampsie en préconceptionnel et propositions thérapeutiques de prévention primaire

Objective
To derive a prediction index based on the most salient history, laboratory and clinical parameters for identifying women at high risk of developing preeclampsia (PE) and to suggest a primary prevention.
Material and method
Non-pregnant women with a history of PE (n =101) were compared to non-pregnant parous women with a history of one or more successful normotensive pregnancies (n =50) but with comparable age, gestation and parity profiles. The parameters included history and clinical examination; laboratory studies (hemostasis, coagulation, vitamins); and morphological and functional tests (cardiovascular and renal functions). Stepwise logistic regression analysis was applied to develop a three step PE prediction index based on the most discriminant parameters. Strategies to prevent PE in the high-risk group are described.

Results
Identification of women at high risk of PE can be done efficiently (88% sensitivity and specificity) using a predictive index based on a simple history, laboratory, clinical and functional information.

Stategies to prevent PE in our high-risk group have given encouraging results during next pregnancy.

Conclusion
Our study gives a predictive index of PE outside of pregnancy and possibilities to do a primary prevention.