Critical care management of eclampsia patients - one year study

Authors

  • Bharti C. Parihar Department of Obstetrics and Gynecology, Sultania Zanana Hospital, Gandhi Medical College Bhopal, Madhya Pradesh, India
  • Babli Yadav Department of Obstetrics and Gynecology, Sultania Zanana Hospital, Gandhi Medical College Bhopal, Madhya Pradesh, India
  • Jaya Patel Department of Obstetrics and Gynecology, Sultania Zanana Hospital, Gandhi Medical College Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20204945

Keywords:

Eclampsia, Critical care, Maternal mortality

Abstract

Background: Critically ill eclampsia patients present a unique challenge to the obstetrician, anesthesiologist and intensivists. In developing countries, maternal mortality is still high due to lack of good maternal antenatal services and obstetric intensive care. This study aims to provide a comprehensive review for the management and outcome of critically ill eclampsia patients admitted in the obstetric intensive care unit (ICU), GMC, Bhopal.

Methods: This study was a hospital based cross sectional study. The study included 145 eclampsia patients who were admitted in obstetric ICU for critical care management. For each eligible patient, sociodemograhic profile, indications of ICU admission, data on ICU interventions and maternal outcome were documented.

Results: During study period, total obstetric admission were 19,815 and 14,731 live births. Out of 348 eclampsia patients, 145 patients were admitted to the obstetric ICU, giving an ICU admission rate of 9.8/1000 live births. 98.03% patients were unbooked referred obstetric emergencies.The average duration of stay in obstetric ICU was 5.4+3.1 days. 72.9% patients had antepartum eclampsia, 17.2% patients had postpartum eclampsia and 10.8% patients had intrapartum eclampsia. 41% patients received mechanical ventilation, 90% patients received oxygen and advanced monitoring, 48.6% patients received vasoactive drugs and 53.7% patients received blood transfusions. There were 26 maternal deaths giving a case fatality rate of 17.93%.

Conclusions: Early referral of eclampsia patients or at risk patients to a tertiary care centre may help to reduce maternal morbidity and mortality. Early diagnosis and prompt treatment through a multidisciplinary team in an ICU setting can prevent complications and reduce morbidity and mortality.

Author Biography

Bharti C. Parihar, Department of Obstetrics and Gynecology, Sultania Zanana Hospital, Gandhi Medical College Bhopal, Madhya Pradesh, India

Professor,

Department of Obstetrics & Gynaecology

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Published

2020-11-26

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Original Research Articles