Maternal and perinatal morbidity and mortality in severe pre-eclampsia and eclampsia in a tertiary care hospital: a prospective study

Authors

  • Neeta Chaudhary Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
  • Natasha Tyagi Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
  • Smita Tyagi Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
  • Shivani Singhal Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20191191

Keywords:

Eclampsia, Maternal morbidity, Maternal mortality, Perinatal morbidity, Pre-eclampsia, Perinatal mortality

Abstract

Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal morbidity and mortality worldwide. In India, they account for the third most important cause of maternal mortality. The objective of this study was to evaluate maternal and perinatal outcome and complications in cases with severe pre-eclampsia and eclampsia and measures to prevent them.

Methods: A prospective study was carried out on 100 patients with severe pre-eclampsia and eclampsia in tertiary care referral hospital over a period of one year i.e. from November 2017 to October 2018. Only those cases with initial blood pressure reading of ≥160/110mmHg or presenting with eclampsia were in included in the study. Detailed history and examination was carried out. Investigations and management were carried out as per standardized department protocol and maternal and fetal outcomes were analyzed.

Results: 48% of women were between 21-25 years age, 82% were from rural area, and 86% cases were unbooked, 68% cases were primigravida. Liver Function Tests were deranged in 18% of the patients and 19% had abnormal Renal Function Tests. Labetalol was the most commonly used antihypertensive. Lower segment cesarean section was the mode of delivery in 59% of the cases. Most common maternal complication was Eclampsia. There were 5 maternal deaths i.e. maternal death rate was 5%. 54.3% of live births needed NICU admission and out of these 50% were preterm deliveries.

Conclusions: Accessible healthcare and health education and awareness regarding antenatal checkup for all women will lead to early detection of severe pre-eclampsia. Hence, early treatment and management of patient’s complications will certainly improve the maternal and perinatal outcome.

References

Cunningham FG, Leveno KG, Bloom SL, Hauth JC, Rouse DJ, Catherine YS. Williams Obstetrics. 25th ed. New York, NY: McGraw Hill Companies;2018.

Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. The lancet. 2006;367(9516):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.

Onuh So, Aisien AO. Maternal and fetal outcome in eclamptic patients in Benin City, Nigeria. J Obstet Gynaecol. 2004;24(7):765-8.

Gandhi MR, Jani PS, Patel UM, Kakani CR, Thakar 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(2): 152-5.

Mahalakshmi G, Krishnaveni A, Nimma W, Vinusha K. The study of maternal and perinatal outcome of eclampsia in a tertiary hospital. IOSR J Dental Med Sci. 2016;15(4):123-8.

Sibai BM, Cunningham FG; Prevention of preeclampsia and eclampsia. In Lindheimer MD, Roberts JM, Cunningham FG editors; Chesley’s Hypertensive Disorders of Pregnancy. 3rd edition, Elsevier, New York, 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; 67(2):3081-6.

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(9):3937-3941

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.

Tufnell DJ, Jankowicz D, Lindow SW, Lyons G, Mason GC, Russell IF et al. Outcome of severe pre-eclampsia/eclampsia. Yorkshire 1999/2003. BrJ Obstet Gynecol. 2005;112(7):875-80.

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

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Published

2019-03-26

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Original Research Articles