Payne et al reported the miniPIERS model for evaluating a woman with a hypertensive disorder of pregnancy. This can help to identify a woman who may need to be managed more aggressively. The authors are from multiple institutions from around the world participating in the miniPIERS Study Working Group.
Patient selection: hypertensive disorder of pregnancy
Adverse outcome: mortality or serious morbidity (CNS, cardiorespiratory, renal, hepatic, hematologic, other)
Parameters:
(1) multiparity
(2) gestational age on admission in weeks
(3) systolic blood pressure in mm Hg
(4) proteinuria on dipstick
(5) vaginal bleeding with abdominal pain
(6) headache and/or visual changes
(7) chest pain or dyspnea
|
Parameter
|
Finding
|
Points
|
|
multiparity
|
no
|
0
|
|
|
yes
|
-0.298
|
|
gestational age
|
|
-1.07 * LN(GA)
|
|
systolic blood pressure
|
|
1.34 * LN(SBP)
|
|
proteinuria
|
none or 1+
|
0
|
|
|
2+
|
-0.218
|
|
|
3+
|
0.424
|
|
|
4+
|
0.512
|
|
vaginal bleeding with abdominal pain
|
no
|
0
|
|
|
yes
|
1.18
|
|
headache and/or visual changes
|
no
|
0
|
|
|
yes
|
0.422
|
|
chest pain or dyspnea
|
no
|
0
|
|
|
yes
|
0.847
|
X =
= SUM(points for all of the parameters) - 5.77
probability of adverse outcome within 48 hours of admission =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.768.
