Critical care management of eclampsia patients - one year study

Abstract

Background: Critically ill eclampsia patients present a unique challenge to the obstetrician, anesthesiologist and intensivists. In developing countries, maternal mortality is still high due to lack of good maternal antenatal services and obstetric intensive care. This study aims to provide a comprehensive review for the management and outcome of critically ill eclampsia patients admitted in the obstetric intensive care unit (ICU), GMC, Bhopal.Methods: This study was a hospital based cross sectional study. The study included 145 eclampsia patients who were admitted in obstetric ICU for critical care management. For each eligible patient, sociodemograhic profile, indications of ICU admission, data on ICU interventions and maternal outcome were documented.Results: During study period, total obstetric admission were 19,815 and 14,731 live births. Out of 348 eclampsia patients, 145 patients were admitted to the obstetric ICU, giving an ICU admission rate of 9.8/1000 live births. 98.03% patients were unbooked referred obstetric emergencies.The average duration of stay in obstetric ICU was 5.4+3.1 days. 72.9% patients had antepartum eclampsia, 17.2% patients had postpartum eclampsia and 10.8% patients had intrapartum eclampsia. 41% patients received mechanical ventilation, 90% patients received oxygen and advanced monitoring, 48.6% patients received vasoactive drugs and 53.7% patients received blood transfusions. There were 26 maternal deaths giving a case fatality rate of 17.93%.Conclusions: Early referral of eclampsia patients or at risk patients to a tertiary care centre may help to reduce maternal morbidity and mortality. Early diagnosis and prompt treatment through a multidisciplinary team in an ICU setting can prevent complications and reduce morbidity and mortality.

Comparative study of neuroimaging features and clinical symptoms in patients with eclampsia

“…When timing of eclampsia is considered, our study is in accordance with all the previous studies by Khandaker et al, Gurjar et al and Parihar et al this correlates with the fact that incidence of postpartum eclampsia is less than that of antepartum eclampsia, however the percentage of cases differ and this may be due to small number of sample size taken in studies. 18,25,27 In the present study majority of patients with 56% (28/50) presented in the group where period of gestation was between 29-36 weeks. 20% (10/50) cases presented at term pregnancy (37-40 weeks) while 6% (3/50) cases had eclamptic convulsions in early preterm pregnancy in 20-28 weeks gestation.…”

“…Parihar et al observed in their study that 41% patients received mechanical ventilation while 90% patients received oxygen and advance monitoring, the average duration of stay in obstetric ICU was 5.4±3.1 days. 18 17.93% mortality rate was noted. While in study by Brouh et al the time of care spent in the ICU was 07.13±4.18 hours (range, 03-20 hours).…”

Intensive Care Management of Eclampsia Complicated with Acute Kidney Injury: A Case Report

“…The use of drugs must be following existing kidney function. 11,13 Signs and symptoms of eclampsia include seizures, extreme restlessness, and impaired consciousness.…”

Intensive Care Management of Preeclampsia: A Case Report

“…It can cause severe complications and even death in the mother and fetus if not adequately managed. 1,2 Preeclampsia occurs in 2-5% of all pregnancies.…”