DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20174039

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

Shobha Sreedharan Pillai

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.

 


Keywords


Eclampsia, Maternal morbidity, Maternal mortality, Perinatal morbidity, Perinatal mortality, Preeclampsia

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References


Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Catherine YS. Williams Obstetrics. 24th Ed. New York, NY: McGraw Hill Companies;2014.

Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367:1066-74.

Govt. of India (Sample Registration System) Maternal mortality in India, 1997-2003. Trends, causes and risk factors. Registrar General of India, New Delhi in collaboration with Centre for Global Health Research, Toronto.

Hypertension in pregnancy report of the American College of Obstetricians and Gynecologists' task force on hypertension in pregnancy. [Executive Summary]. ACOG. 2013;122(5):1122-31.

Conde-Agudelo A, Villar J, Lindeheimer M. World Health Organization systematic review of screening tests for preeclampsia. Obstet Gynecol. 2004;104(6):1367-91.

Meler E, Figueras F, Bennasar M, Gomez O, Crispi F, Gratacos E. The prognostic role of uterine artery Doppler investigation in patients with severe early onset preeclampsia. Am J Obstet Gynecol. 2010;202(6):559.e1-e4.

Sibai BM, Cunningham FG. Prevention of preeclampsia and eclampsia. In: Lindheimer MD, Roberts JM, Cunningham FG, editors. Chesley’s Hypertensive Disorders of Pregnancy. 3rd Ed. New York: Elsevier; 2009:215.

Saxena S, Srivastava PC, Thimmaraju KV, Mallick AK, Dalmia K, Das B. Socio-demographic profile of pregnancy induced hypertension in a tertiary care centre. Sch J Appl Med Sci. 2014;2:3081-6.

Conde-Agudelo A, Belizán JM. Risk factors for preeclampsia in a large cohort of Latin American and Caribbean women. BJOG. 2000;107:75-83.

Singhal S, Deepika, Anshu, Nanda S. Maternal and perinatal outcome in severe pre-eclampsia and eclampsia. South Asian Federation Obstet Gynecol. 2009;1(3):25-8.

Gandhi MR, Jani PS, Patel UM, Kakani CR, Thakor NC, Gupta N. Perinatal outcome in pregnancy induced hypertension cases at GMERS Medical College, Dharpur-Patan, North Gujarat region, India: a prospective study. Int J Adv Med. 2015;2:152-5.

Tufnell DJ, Jankowicz D, Lindow SW, Lyons G, Mason GC, Russell IF, et al. Outcome of severe preeclampsia/eclampsia. Yorkshire 1999/2003. Br J Obstet Gynecol. 2005;112:875-80.

Miguil M, Chekairi A. Eclampsia, study of 342 cases. Hypertens Pregnancy. 2008;27(2):103-11.

Dissanayake VH, Samarasinghe HD, Morgan L, Jayasekara RW, Seneviratne HR, Pipkin FB. Morbidity and mortality associated with preeclampsia at two tertiary care hospitals in Sri Lanka. J Obstet Gynaecol Res. 2007;33(1):56-62.

Ajah LO, Ozonu NC, Ezeonu PO, Lawani LO, Obuna JA, Onwe EO. The feto-maternal outcome of preeclampsia with severe features and eclampsia in Abakaliki, South-East Nigeria. J Clin Diagn Res. 2016;10(9):QC1-QC21.

Shaheen B, Hassan L, Obaid M. Eclampsia, a major cause of maternal and perinatal mortality: a prospective analysis at a tertiary care hospital of Peshawar. J Pak Med Assoc. 2003;53(8):346-50.

Mattar F, Sibai BM. Risk factors for maternal morbidity. Am J Obstet Gynecol. 2000;182:307-12.

Igberase GO, Ebeigbe PN. Eclampsia: ten-years of experience in a rural tertiary hospital in the Niger delta, Nigeria. J Obstet Gynecol. 2006; 26(5):414-7.