The study of maternal and perinatal outcome in preeclampsia in tertiary care hospital
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20185440Keywords:
Maternal mortality, Preeclampsia, Perinatal mortalityAbstract
Background: Preeclampsia accounts for majority of causes for maternal and perinatal morbidity and mortality.
Methods: All patients beyond 20 weeks with pre-eclampsia admitted to Gandhi Hospital during two-year study period were enrolled in the study. The objective of this study was to analyze the type and rate of maternal and perinatal complications in preeclampsia. Women with preexisting renal disease, chronic hypertension, anemia, heart disease, epilepsy, thrombophilias, hemolytic disease, preexisting liver disease were excluded from the study. Obstetrics management was done as per existing protocol in the department. Magnesium sulphate was the drug of choice to control convulsions. Blood pressure was controlled by either tablet alpha methyl dopa or nifedipine or both.
Results: Preeclampsia cases accounted for 460 (4.9%) of total deliveries. Majority (86.52%) were unbooked cases between 20 -25 years of age (63.48%) and were primigravida (60.44%) belonging to low socioeconomic status (73.91%). Commonest maternal complication in present study was eclampsia (34.56%) Total maternal deaths accounted for 14. Most common cause for maternal mortality was eclampsia with HELLP (9,64.28%). Total perinatal deaths accounted for164 and most common cause for perinatal death was prematurity (47,28.65%).
Conclusions: Preeclampsia is major leading cause for poor maternal and fetal outcome. Regular antenatal checkup , early diagnosis , early interventions , early referral to tertiary centers, optimum timing and mode of delivery and awareness among patients will reduce both maternal and perinatal morbidity and mortality.
References
Cunningham FG, MacDonald PC, Gant NF. Williams obstetrics. New York, NY: McGraw-Hill Professional; 2005 Mar 31.
Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S. Births final data for 2004. Natl Vital Stat Rep. 2009;55(1):1-101
Chang J, Elam-Evans LD, Berg CJ, Herndon J, Flowers L, Seed KA et al. Pregnancy related mortality in the United States , 1991-1997 Obstet Gynecol. 2003;101(2):289-96.
National High Blood Pressure Education Programme :Working Group Report on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22
Taylor RN,Davidge ST, Roberts JM : Endothelial cell dysfunction and oxidative stress. In Lindheimer MD,Roberts JM , Cunningham FG (eds) : Chesley's Hypertensive Disorders in Pregnancy, 3rd ed. Elseveir , In press 2009
Alvarez Navascues R , Marin R. Severe meternal complications associated with pre-eclampsia : an almost forgotten pathology? Nefrologia.2001;21 (6):565-73
Kenni L, Baker P, Cunningham FG: Platelets coagulation and the lever, In Lidheimer MD, Roberts JM, Cunningham FG (eds): Chesley's Hypertensive disorders of pregnancy , 3rd Ed . New York , Elseveir , in Press 2009 . & associates.
Singhal S , Deepika , Anshu , Nanda S. Maternal and perinatal outcome in severe pre- eclampsia and eclampsia. South Asian Fed Obstet Gynecol.2009;1(3):25-8
French Society of Anesthesia and Resuscitation, National College of Gynecologists and Obstetricians French. Multidisciplinary management of severe pre-eclampsia (PE). Experts' guidelines 2008. French Society of Anesthesia and Resuscitation. National College of French Gynecologists and Obstetricians. French Society of Perinatal Medicine. French Society of Neonatology. In Annales de Anesthesie et Reanimat. 2009;28(3)275.
Katz VL, Farmer R, Kuller JA. Preeclampsia into eclampsia: toward a new paradigm. Am J Obstet Gynecol. 2000;182(6):1389-96.
Berhe Hailemariam Woldeselassie Pre-eclampsia and its outcome (Maternal and Neonatal Morbidity and Mortality ) in the two Referral Hospitals (Windhoek Central and Katutura ) , Namibia.
J.R. Patnaik , B.B. Pradhan , U. K. Satpathy , Arati mohanty. Platelet Estimation : Prognostic Value in Pregnancy Induced Hypertension indian J Physiol Pharacol. 2007;51(2):160-4.
Hauth JC, Ewell MG, Levine RL, Esterlitz JR, Sibai BM, Curet LB. Pregnancy outcomes in healthy nulliparous women who subsequently developed hypertension . Obstet Gynecol. 2000;95(1):24-8
PN Ebeigbe , ME Aziken Early onset Pregnancy induced hypertension / eclampsia in benin city nigeria Nig J Clinical Practice dec 2001.13(4):388-93.
Ching Ming Liu, Po-Jen Cheng , Shuenn - Dyh Chang Maternal Complications and Perinatal Outcomes Associated with Gestational Hypertension and Severe Preeclampsia in Taiwanese Women J Formos Med Assoc. 2008;107(2):129-38.
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(7):875-80.
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
Fatemeh T, Marziyeh G, Nayereh G, Anahita G, Samira T. Maternal and perinatal outcome in nulliparous women complicated with pregnancy hypertension. JPMA. 2010;60(9):707.
