Maternal and perinatal outcome in pregnancies complicated by preeclampsia: a hospital based prospective study
Keywords:Preeclampsia, Eclampsia, MgSO4, Maternal outcome and fetal outcome
Background: The aim was to study maternal and fetal outcomes in pre-eclamptic mothers and to study sociodemographic distribution, severity of preeclampsia.
Methods: This was a prospective observational study conducted in the department of obstetrics and gynaecology at Government head quarters hospital, Cuddalore, Tamil Nadu, for 12 months (October 2019 to September 2020). 108 preeclamptic mothers between 32-39 weeks of gestational age who met the inclusion and exclusion criteria were studied consecutively.
Results: Among 108 participants, 52.7% were primi, 69.4% belonged to SE class-IV, 45.4% were between 21-25 years, 44.4% were referral cases, 60.1% had BMI >25 kg/m2, 79.6% had late onset preeclampsia, 11.1% had preterm delivery. LSCS rate was 81.5% with most common indication fetal distress 22.7% then oligohydraminos 18.2%. Recurrent preeclampsia among patients with previous childbirth was 48.6%. Maternal complications were 17.6% severe preeclampsia, 13% PPH, 3.7% abruption, 3.7% antepartum eclampsia, 1.9% postpartum eclampsia. 25.9% patients got admitted in maternal ICU. 68.4% of the severe preeclamptic patients were treated with MgSO4 regimen. 6.48% of patients had imminent symptoms. 11.1% neonates had APGAR score 4-6. Neonatal complications 30.5% LBW, 33.3% SGA, 14.8% FGR, 1.9% still birth and 0.9% IUFD. 48.6% neonates were admitted in NICU. There was no maternal mortality in this study.
Conclusions: Fetomaternal morbidities of preeclampsia is reduced by emphasising early registration and admission, providing adequate nutrition through existing government schemes, educating women on significance of routine antenatal check up at PHCs with BP monitoring, albuminuria evaluation and clinical evaluation of fundal height at each visit. Screening Doppler and growth scan done for timely intervention.
Wolde Z. Hypertensive disorders of pregnancy in Jimma university specialised hospital. Ethiop J Health Sci. 2011;21(3):147-54.
Williams J. Williams Obstetrics 25 ed. In: Gary CF, eds. New York: McGraw Hill; 2018: 710-54.
Joshi P, Kathaley M, Borade S, Dashrathi R. Maternal and perinatal outcome in hypertensive disorders of pregnancy-A retrospective study. MVP J Med Sci. 2018;5(1):87-91.
Melese MF, Badi MB, Aymalem GL. Perinatal outcomes of severe preeclampsia/eclampsia and associated facors among mothers admitted in Amhara region referral hospitals, North West Ethiopia, 2018. BMC Pregn Childbirth. 2019;12:147.
Ukah UV, De Silva DA, Payne B, Magee LA, Hutcheon JA, Brown H, et al. Prediction of adverse maternal outcomes from pre-eclampsia and other hypertensive disorders of pregnancy: a systematic review. Pregnancy Hypertens. 2018;11:115-23.
Berhe AK, Ilesanmi AO, Aimakhu CO, Mulugeta A. Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective COHORT study. BMC Pregnancy Childbirth. 2019;20(1):7.
Madazli R, Yuksel MA, Imamoglu M, Tuten A, Oncul M, Aydin B, et al. Comparison of clinical and perinatal outcomes in early and late onset preeclampsia. Arch Gynecol Obstet. 2014;290(1):53-7.
Hnat MD, Sibai BM, Caritis S, Hauth J, Lindheimer MD, MacPherson C, et al. Perinatal outcome in women with recurrent preeclampsia compared with women who develop preeclampsia as nulliparas. Am J Obstet Gynecol. 2002;186(3):422-6.
Bramham K, Briley AL, Seed P, Poston L, Shennan AH, Chappell LC. Adverse maternal and perinatal outcomes in women with preeclampsia: a prospective study. Am J Obstet Gynecol. 2011;204(6):512.
Abalos E, Cuesta C, Carroli G, Qureshi Z, Widmer M, Vogel JP, et al. Preeclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the WHO multicountry survey on maternal and newborn health. BJOG. 2014;121(1):14-24.
Tolu LB, Yigezu E, Urgie T, Feyissa GT. Maternal and perinatal outcome of preeclampsia without severe feature among pregnant women managed at a tertiary referral hospital in urban Ethiopia. PLoS One. 2020;15(4):0230638.
Gawde A, Bhosale UT. A study of maternal and perinatal outcome in Preeclampsia. Ind J Recent Trend Sci Technol. 2014;10(2):267-70.
Singh A, Chawla S, Pandey D, Jahan N, Anwar A. Fetomaternal outcome in cases of pre-eclampsia in a tertiary care referral hospital in Delhi, India: a retrospective analysis. Int J Scientif Stud. 2016;4(2):100-3.
Ahmed M. Study of feto-maternal outcome in pregnancy induced hypertension. Glob J Med Res Gynecol Obstetr. 2014;14(1):20-5.
Aabidha PM, Cherian AG, Paul E, Helan J. Materna and fetal outcome in pre-eclampsia in a secondary care hospital in South India. J Fam Med Prim Care. 2015;4(2):257-60.
Patel J, Desai N, Mehta ST. Study of fetomaternal outcome in cases of preeclampsia. Int J Scientif Res. 2015;4(7):503-5.
Vats K, Paul M. Study of fetal outcome in hypertensive disorders of pregnancy in a tertiary care maternity hospital of Delhi. Int J Reproduct Contracept Obstetr Gynecol. 2016;5(11):3773-7.