Fetomaternal outcome in severe preeclampsia and eclampsia: a retrospective study in a tertiary care centre

Abstract

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. In India, they account for the third most important cause of maternal mortality. The objectives of this study were to evaluate maternal and perinatal outcome and complications in cases with severe preeclampsia and eclampsia. Methods: A retrospective study was carried out on 110 women with severe preeclampsia and eclampsia in a tertiary care referral centre over a period of 15 months. Only those cases with initial B.P reading of ≥160/110 mm Hg or presenting with eclampsia were included in the study. Investigations and management were carried out as per standardized department protocol and maternal and fetal outcomes were analyzed. Results: 42% of the cases were in the age group of 26-30 years, nearly 61% were primigravidae and the majority (64) were referred from peripheral hospitals. Liver function tests were deranged in 19% of the patients and 17% had abnormal renal function. Nifedipine was the most commonly used antihypertensive and magnesium sulphate was the anticonvulsant used in all the cases. Lower segment caesarean section was the mode of delivery in 64.5% of the cases. Commonest maternal complication was atonic PPH. There was no maternal mortality but there were 3 maternal near-miss cases due to DIC. 65% of the cases had a preterm delivery and 39% of the babies needed NICU admission. There were 10 neonatal deaths. Conclusions: Accessible health care and health education and awareness regarding antenatal check-ups for all women will lead to early detection of severe preeclampsia. Prompt treatment and management of its complications will certainly improve the maternal and fetal outcome.

Epidemiology and fetomaternal outcomes in cases of imminent eclampsia and eclampsia- retrospective study

“…The findings of our study are consistent with the findings of the study done by Pillai SS et alwho ndings are similardocumented 42.72% patients in the age group of 26-30 years. 4 These findings are related to the fact that most women conceive first time in this age group. 2 Two third of the subjects (69.11%) were primigravidas and approximately one third of them (30.89%) were multigravidas.…”

“…3 Maternal mortality worldwide is systematically reviewed by World Health Organisation (WHO) and it was reported that 16% of maternal deaths were due to hypertensive disorders in developed countries. 4 According to WHO report 2008, eclampsia constitutes for 12% of all maternal deaths in developing countries. 5 In Asia and Africa, hypertensive disorders constituted for 9% of maternal mortality.…”

“…In India, hypertensive disorders constitute 3 r d most important cause of maternal mortality after hemorrhage and infection. 4 International Society for the Study of Hypertension in Pregnancy (ISSHP) 6 revised the classification for hypertensive disorders in pregnancy in 2014. Accordingly these disorders are classified as:…”

“…5 Maternal and perinatal mortality and morbidity due to preeclampsia can be prevented by providing a good access to quality antenatal care, early diagnosis and identification of risk factors, careful monitoring and timely interventions. 4 The perinatal mortality due to eclampsia is high upto the extent of about 30-50%. 5 Poor fetal outcome is attributed to iatrogenic prematurity, respiratory distress syndrome (RDS), intrauterine asphyxia, intrauterine growth restriction (IUGR) and intrauterine death (IUD).…”

Maternal and perinatal morbidity and mortality in severe pre-eclampsia and eclampsia in a tertiary care hospital: a prospective study

“…(Table 1) Similar findings were seen by Pillai et al in where 19% had deranged LFT, 15% had deranged KFT and 7% had hemolysis on peripheral smear. 9 Authors found that 92% of cases presented at gestational age of >32 weeks (Figure 3).…”