PIERS calculator- predicting adverse maternal outcome in preeclampsia

Background: Preeclampsia is a multisystem, highly variable disorder unique to pregnancy. For preeclampsia arising remote from term, supportive and temporizing measures are used to improve perinatal outcome. However, the magnitude of the maternal risks associated with expectant management is unclear. The PIER (preeclampsia integrated estimate of risk) score is a recently designed tool which assesses maternal signs, symptoms, and laboratory findings to generate a valid and reliable algorithm for predicting maternal and perinatal outcome in patients with preeclampsia.Methods: The present study was a prospective hospital based observational study carried out in Department of Obstetrics and Gynecology, Sultania Zanana Hospital, Gandhi Medical College, Bhopal. A total of 125 women with preeclampsia who fulfilled the inclusion criteria were included in the study. Along with history and examination, all relevant and required investigations were done. The fullPIERS calculator was used to calculate the risk of adverse maternal outcome.Results: In the present study, 82(65.6%) women were in the low risk category and only 4 (4.87%) had adverse maternal outcome. High risk patients were 6 (4.8%) and amongst them 5 (83.33%) women had adverse maternal outcome (p-value <0.00001). The result was statistically significant in identifying high risk cases in our study.Conclusions: The fullPIERS calculator gave good results in prediction of adverse maternal outcome according to risk score in women with preeclampsia in our study. It will help the clinicians better manage the patients with preeclampsia specially remote from term and also help health workers in primary and secondary care centres to identify women who are or may become severely ill and who need specialist care and prevent delays in transporting these women to facilities where they can receive appropriate care