Predictors of eclampsia among preeclamptic patients: a case control study in Yaounde, Cameroon

Authors

  • Jeanne Hortence Fouedjio Unit of Obstetrics and Gynaecology of the Yaounde Central Hospital, Cameroon; Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, BO Box: 1364 Cameroon
  • Pascal Foumane Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, BO Box: 1364 Cameroon
  • Jovanny Tsuala Fouogue Douala Gynaeco Obstetric and Pediatric Hospital, PO Box: 7270 Douala-Cameroon
  • Veronique Jordane Mboua Ndenga Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, BO Box: 1364 Cameroon
  • Florent Ymele Fouelifack Unit of Obstetrics and Gynaecology of the Yaounde Central Hospital, Cameroon; Research, Education and Health Development Group, Gares falaise, Dschang, Cameroon; Department of Obstetrics and Gynecology, Higher Institute of Medical Technology of Nkolondom, Yaoundé, Cameroon
  • Agnès Esiene à Bissene Unit of Obstetrics and Gynaecology of the Yaounde Central Hospital, Cameroon; Department of surgery and specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, BO Box: 1364 Cameroon
  • Philip Njotang Nana Unit of Obstetrics and Gynaecology of the Yaounde Central Hospital, Cameroon; Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, BO Box: 1364 Cameroon
  • Loïc Dongmo Fouelifa Faculty of Medicine, University of Lomé, Togo, School of Armies Health Services of Lomé, Togo
  • Robinson Enow Mbu Unit of Obstetrics and Gynaecology of the Yaounde Central Hospital, Cameroon; Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, BO Box: 1364 Cameroon
  • Emile Télesphore Mboudou Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, BO Box: 1364 Cameroon; Department of Obstetrics and Gynecology, Higher Institute of Medical Technology of Nkolondom, Yaoundé, Cameroon

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20162094

Keywords:

Pre-eclampsia, Eclampsia, Predictors, Hypertension, Pregnancy, Cameroon

Abstract

Background: Preeclampsia is a major cause of maternal mortality. Eclampsia is a dramatic complication of preeclampsia. This study aimed at identifying clinical predictors of eclampsia among preeclamptic patients.

Methods: We carried out a case-control study from November 1, 2014 to April 30, 2015 in six health facilities in Yaounde. Cases were women who have had eclamptic seizures antepartum, perpartum or within 48 hours of delivery. Controls were preeclamptic women who did not convulse till 48 hours after delivery. Unadjusted and adjusted Odds Ratios were calculated.

Results: After univariable analysis the following parameters were associated with eclampsia: headache (uOR: 2.9; 95% CI: 1.4-6.2) and absence of stable income (uOR: 17.6; 95% CI: 6.2-49.8). After multivariate analysis predictors of eclampsia among pre-eclamptic patients were: age <20 years (aOR: 2.5; 95% CI: 1.0-5.9), family history of high blood pressure in the mother (aOR: 4.8; 95% CI: 1.2-19.3), antenatal care by a nurse auxiliary (aOR: 9.3; 95% CI: 2.4-35.9), right upper abdominal quadrant pain (aOR: 9.9; 95% CI:1.2-77.9) visual disturbances (aOR:7.9; 95% CI: 2.3-26.9).

Conclusions: These predictors of eclampsia can be used for early initiation of aggressive preventive therapy in pre-eclamptic patients.

References

Sprunck A, Collange O, Pottecher T. Prééclampsie, éclampsie, HELLP syndrome : définitions, éléments de diagnostic et de prise en charge. 51 e Congrès national d’anesthésie et de réanimation. Médecins. Urgences vitals. 2009:1-9.

OMS Mortalité maternelle. WHO 2014. Available at http://www.who.int/mediacentre/factsheets/fs348/fr/. Accessed 26 March 2015.

Mboudou E, Foumane P, Belley Priso E, Dohbit J, Ze Minkande J, Nkengafac WM. l'Hypertension au cours de La Grossesse: Aspects cliniques et épidémiologiques à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé, Cameroun. Clin Mother Child Health. 2009;6(2):1087-93.

Leke RJI. Outcome of delivery at the central maternity. Ann Univ Sc Santé. 1987;4(1):332-0.

Kyebyene MA. Evaluation de la prise en charge des complications de la pré-éclampsie à l’Hôpital Central de Yaoundé mémoire de diplôme de spécialiste en sciences cliniques. Yaoundé Cameroun. Faculté de Médecine et des Sciences Biomédicales. Université de Yaoundé I; 2013.

Belley Priso E, Njamen TN, Coulibaly A, Mboudou E, Doh A. L’éclampsie A L’Hôpital General De Douala : Aspects Épidémiologiques Et Pronostiques. Health Sci Dis. 2013;10(4).

Tebeu PM, Ngassa P, Kouam L, Major AL, Fomulu JN. Maternal mortality in maroua provincial hospital, Cameroon (2003-2005). West Indian Med J. 2007;56(6):502-7.

Abdoulaye N. Mortalité maternelle à l’Hôpital Général de Yaoundé: Etude rétrospective 1996-2005. Yaoundé: Faculté de Médecine et des Sciences Biomédicales. Université de Yaoundé I; 2006.

Moj HN, Randriambololona DMA, Rasolonjatovo T, Ranoaritiana DB, Fidison A, Rakotoambinina B. De la pré-éclampsie à l’éclampsie: quels sont les facteurs de risque? Rev Trop Chir. 2010;4:30-2.

Tebeu PM, Halle G, Lemogoum D, Simo WAG, Kengne FG, Fomulu JN. Risk factors for eclampsia among patients with pregnancy-related hypertension at Maroua Regional Hospital, Cameroon. Int J Gynaecol Obstet. 2012;118(3):254-6.

Coghill AE, Hansen S, Littman AJ. Risk factors for eclampsia: a population-based study in Washington State, 1987-2007. Am J Obstet Gynecol. 2011;205(6):553e1-553e7.

Mayi-Tsonga S, Akouo L, Ngou-Mve-Ngou JP, Meye JF. Facteurs de risque de l’éclampsie à Libreville (Gabon): étude cas-témoins. Cah D’études Rech Francoph. 2006;16(3):197-200.

Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005;330(7491):565.

National institute of statistics-Cameroon. Demographic, health and multiple indicators cluster survey 2011. Yaounde: institut national de statistique; 2012. Available at http://www.statistics-cameroon.org/manager.php?id=6.

Kullberg G, Lindeberg S, Hanson U. Eclampsia in Sweden. Hypertens Pregnancy. 2002;21(1):13-21.

Robillard P, Hulsey T, Pénanin J, Janky E, Miri E, Papiernik E. Association of pregnancy-induced hypertension with duration of sexual cohabitation before conception. Lancet. 1994;344:973-5.

Ben Salem F, Ben Salem K, Grati L, Arfaoui C, Faleh R, Jamel A, et al. Facteurs de risque d’éclampsie: étude cas-témoins. Ann Fr Anesth Réanimation. 2003;22(10):865-9.

Hypertensive Disorders in Pregnancy. In: Cunningham FG, Levenno KJ, Bloom SL, Hauth JC, Gilstrap III LC, Wenstrom KD, eds. Williams Obstetrics. 22nd edition. New York. McGraw-Hill Companies; 2005:34.

Downloads

Published

2017-02-23

Issue

Section

Original Research Articles