A prospective post-partum evaluation of renal function in preeclampsia

Akarsh Cheroth Asokan, Seena Kakkanat Babu


Background: Hypertensive disorder comprises one of the leading causes of maternal and perinatal morbidity and mortality across the globe. Because women with preeclampsia are at risk of cardiovascular disease and end-stage renal disease, proper follow-up after delivery for resolution of proteinuria and hypertension is required and investigations should be conducted to find out and adequately treat any underlying cardiovascular or renal disease.

Methods: This was a prospective study and included as participants pregnant women with preeclampsia who met the inclusion and exclusion criteria and who subsequently delivered at Government Medical College Hospital, Thrissur, Kerala, India. For each eligible participant, clinical and laboratory data were collected from third trimester of antenatal period, and six weeks and three months after delivery.

Results: In this study, it is found that 26.2% and 4.23% patients had persistence of systolic blood pressure at 6 weeks and 3 months postpartum where as 19.4% and 3.38% had persistence of diastolic blood pressure at 6 weeks and 3 months post-partum. Serum creatinine was persistently high in 14.4% and 6.77% after 6 weeks and 3 months postpartum respectively. Proteinuria resolved completely in non-severe preeclampsia by 6 weeks postpartum itself. In severe preeclampsia group, 65% and 25% of patients had persisting proteinuria after 6 weeks and 3 months postpartum.

Conclusions: Hypertension that persists more than 6 weeks postpartum usually represents a pathology not directly associated with pregnancy such as essential hypertension or underlying endocrine, neurological, or renal disease. Proteinuria that persists beyond 6-12 weeks postpartum may also warrant further investigation, particularly in early onset preeclampsia, the group of women most likely to have underlying renal disease.


Hypertension, Postpartum renal status, Preeclampsia, Proteinuria, Urine protein creatinine ratio

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