Descriptive study of clinical profile of severe preeclampsia

Authors

  • Nisha Gusain Department of Obstetrics and Gynecology, B. J. Medical College and Sassoon General Hospital, Pune, Maharashtra, India
  • Vidya Dinkar Mule Department of Obstetrics and Gynecology, Government Medical College, Miraj, Maharashtra, India
  • Swetha Sekar Lalgudi Department of Obstetrics and Gynecology, Zynova Shalby Multispeciality Hospital, Ghatkopar, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20240473

Keywords:

Eclampsia, Magnesium sulfate, Severe preeclampsia

Abstract

Background: The study was conducted to find out the frequency, risk factors, maternal complications, fetal outcome, the early intervention and treatment in cases of severe preeclampsia in a tertiary care centre.

Methods: It was a descriptive observational study conducted at department of obstetrics and gynecology for the duration of 18 months. Severe preeclampsia diagnosed by clinical features, risk factors identified by history taking, treatment given according to institutional protocol, maternal and neonatal outcome was analysed.

Results: Frequency of severe preeclampsia was 1.3%. Majority of the patients belong to the age group of 20-30 years. Risk factors recorded- raised BMI, primiparity, previous preeclampsia history 56.7% patients underwent LSCS. Complications noted- eclampsia, abruption, PPH, renal failure and HELLP syndrome. 60.5% neonates were having low birth weight (<2.5 kg). Perinatal mortality was found in 14.9% of neonates. Most common reason for maternal ICU admission- ARF followed by DIC, eclampsia. There was no maternal mortality in our study.

Conclusions: Adequate antenatal visits, good antenatal care and NICU care can reduce the morbidity and mortality. For early detection of cases, regular blood pressure monitoring by family physician is essential in predisposed individuals. Early reporting to the institute on development of symptoms, timed termination of pregnancy, wider use of magnesium sulfate, availability and implementation of emergency obstetric care reduces the morbidity and mortality. Although the number of patients undergoing LSCS is more, a fair amount of induction trial can be given with proper monitoring services.

References

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Catherine YS. Williams Obstetrics. 24th edn. 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.

Government 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. Available from: https://ideas.repec.org/p/ess/wpaper/id753.html. Accessed on 12 July 2023.

Oyston CJ, Stanley JL, Baker PN. Potential targets for the treatment of preeclampsia. Expert Opin Therap Targets. 2015;19(11):1517-30.

Gathiram P, Moodley J. Pre-eclampsia: its pathogenesis and pathophysiolgy. Cardiovasc J Africa. 2016;27(2):71-8.

Ngwenya S. Postpartum haemorrhage: incidence, risk factors, and outcomes in a low resource setting. Int J Women’s Health. 2016;8:647-50.

Multidisciplinary management of severe preeclampsia (PE) experts’ guidelines 2008. French society of anesthesia and intensive care. National College of French gynecologists and obstetricians. French Society of Perinatal Medicine. French Society of Neonatology. Ann Fr Anesth Reanim. 2009;28:275-81.

Pottecher T, Luton D. Prise en charge multidisciplinaire de la prééclampsie. French. Issy Les Moulineaux, France: Elsevier; Masson SAS; 2009.

Minire A, Mirton M, Imri V, Lauren M, Aferdita M. Maternal complications of preeclampsia. Med Arch. 2013;67(5):339-41.

American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122:1122.

Kuklina EV, Ayala C, Callaghan WM. Hypertensive disorders and severe obstetric morbidity in the United States. Obstet Gynecol. 2009;113(6):1299-306.

Pannu D, Das B, Hazari P, Shilpa. Maternal and perinatal outcome in eclampsia and factors affecting the outcome: a study in North Indian population. Int J Reprod Contracep Obstet Gynecol. 2010;3:347-51

Ngwenya S. Severe preeclampsia and eclampsia: incidence, complications, and perinatal outcomes at a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe. Int J Women's Health. 2017;9:353-7.

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):QC18.

Pillai SS. Fetomaternal outcome in severe preeclampsia and eclampsia: a retrospective study in a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2017;6:3937-41.

Shaikh S, Ruby AJ, Piotrowski M. Pre eclampsia related chorioretinopathy with Purtscher’s like findings and macular ischaemia. Retina. 2003;23:247-50.

Saxena N, Bava AM, Nandanwar Y. Maternal and perinatal outcome in severe preeclampsia and eclampsia. Int J Reprod Contracept Obstet Gynecol. 2016;5:2171-6.

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

Zhang Y, Li W, Xiao J, Chen S. The complication and mode of delivery in Chinese women with severe preeclampsia: a retrospective study. Hypertens Pregnancy. 2014 Aug;33(3):283-90.

National Guideline Alliance (UK) Hypertension in Pregnancy: Diagnosis and Management (NG133); 2019. Available from: https://www.nice.org.uk/ guidance/ng133. Accessed on 3 October 2019.

Bartsch E, Medcalf KE, Park AL, Ray JG. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ. 2016;353.

Thapa K, Jha R. Magnesium sulfate: a life saving drug. JNMA J Nepal Med Assoc. 2008;47(171):104-8.

Ries A, Kopelman JN, Macri C. Laboratory testing for preeclampsia: result trends and screening recommendations. Milit Med. 2000;165(7):546-8.

Nankali A, Malek-KhosraviSh, Zangeneh M, Rezaei M, Hemati Z, Kohzadi M. Maternal complications associated with severe preeclampsia. J Obstet Gynaecol India. 2013;63(2):112-5.

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.

Tlaye KG, Endalfer ML, Kassaw MW, Gebremedhin MM, Aynalem YA. Preeclampsia management modalities and perinatal death: a retrospective study in Woldia general hospital. BMC Pregnancy Childbirth. 2020;20(1):1-9.

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Published

2024-02-27

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Original Research Articles