Adverse Maternal and Fetal Outcome in Patients with Eclampsia

Pradhan, Tarun; Rijal, Pappu; Rai, Rubina; Bhatta, R; Thapa, Bhola; Regmi, Mohan Chandra

doi:10.33314/jnhrc.v16i41.1159

Cited by 8 publications

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“…There were 3(13.63%) perinatal death and all were stillbirth cases. Similar finding was noted in study done by Jadav et al 18 where 15% of babies born were stillbirth and 11% in a study done by Pradhan et al 22 Most of the baby's i.e. 72.72% were delivered preterm and 59.09% were of low birth weight.…”

Section: Discussionsupporting

confidence: 87%

“…Similar finding was reported by Kamrun N et al16 where 40% patient received ICU care and 51.42% were treated in eclampsia ward. In a study done by Dalal et al,13 24.77% patient required ICU care and Pradhan et al22 reported that 31 patient out of 52 required ventilator support for respiration. These findings warrant urgent need of referral of all cases of eclampsia to tertiary care center.…”

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confidence: 98%

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Fetomaternal outcome of eclamptic parturient in a tertiary care center: A descriptive cross-sectional study

Shrestha¹,

Shrestha²,

Gurung³

et al. 2021

Asian J Med Sci

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Background: Eclampsia is still a leading cause of maternal death second to postpartum hemorrhage in developing countries. It is also associated with poor perinatal outcome. Aims and Objective: The objective of this study was to find the incidence, maternal and perinatal outcome of patients admitted in a tertiary hospital, Pokhara with diagnosis of eclampsia. Materials and Methods: A descriptive cross sectional study was conducted in department of obstetrics and gynecology, MTH, Pokhara for duration of 1 year from 1st January 2020 to 30th December 2020. A total of 22 patients were enrolled in the study irrespective of timing of occurrence of fits, age, parity, gestational age and status of booking on admission. Results: During the study period the incidence of eclampsia at our center was 0.85% .Majority of the patients 17(77.27%) were primigravida and 16(72.68%) delivered at less than 37 weeks of gestation. Only 4 patients had her antenatal checkup done in MTH. According to timing of occurrence of fits Antepartum and postpartum eclampsia comprise 50% each with no cases of intrapartum eclampsia. Caesarean section was done in 17(77%) cases. Among the cases 10, (45.45%) patients required ICU admission and 6(27.27%) required ventilator support. HELLP, acute renal failures, PRES, PPH were causes of maternal morbidity. Three (13.63%) babieswere born stillbirth. Sixteen (72.72%) babies were born preterm and 13(59.09%) had birth weight less than 2.5kg. Six (27.27%) babies needed NICU admission. Conclusion: Eclampsia continues to be one of the prime etiological factors for maternal and perinatal morbidity and mortality in developing countries like ours. This is mostly due to the delay in seeking and reaching the care. Regular antenatal checkup, early recognition, its prevention and proper management of eclamptic cases are vital to tackle this challenge.

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Section: Discussionsupporting

confidence: 87%

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confidence: 98%

Fetomaternal outcome of eclamptic parturient in a tertiary care center: A descriptive cross-sectional study

Shrestha¹,

Shrestha²,

Gurung³

et al. 2021

Asian J Med Sci

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“…Tertiary level of education, eclampsia, gestational diabetes, delayed ANC initiation, number of ANC visits, being multiparous and home delivery were found to be signi cantly associated with adverse birth outcomes in this study. Eclampsia has been found to cause deterioration of maternal conditions which result into adverse foetal outcomes such as low birthweight and still births (37). In Ethiopia, adverse neonatal outcomes such as macrosomia, preterm births and large for gestational age was found to be signi cantly higher among newborns from mothers with gestational diabetes (38), which is similar to ndings in this study.…”

Section: Discussionsupporting

confidence: 86%

Quantifying Factors Associated With Birth Outcomes and Their Implications on Evaluating the Success of a Maternal Respiratory Syncytial Virus (RSV) Vaccine Program in Kenya

Nyiro

Bukusi

Mwaengo

et al. 2021

Preprint

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BackgroundMaternal immunisation to prevent respiratory syncytial virus (RSV) associated disease among infants is in focus. However, little is known about adverse birth outcomes and associated factors occurring in a setting with high morbidities of malaria, HIV infection and undernutrition. Quantifying these ahead of introduction of a maternal vaccine would assist in assessing an association between RSV vaccination and adverse birth outcomes. MethodsA cross-sectional survey was conducted to collect data on birth outcomes from women residents of the health and demographic surveillance systems (HDSS) of Siaya and Kilifi, Kenya and from the maternity wards of Siaya County referral hospital and Bondo sub-county hospital. Participants of the HDSS sites had pregnancies registered in the years 2017 to 2020 through census rounds and were traced at home for interview. All women had a birth outcome by the time of data collection. Multiple logistic regression was used to determine independent predictors of adverse birth outcomes. Results A total of 2219 women were interviewed. Median age during pregnancy was 27.7yrs (range: 22.7-32.4), 1857 (83.7%) attended antenatal care clinic (ANC), 1,979 (89.2%) delivered at a health facility and 2204 (99.3%) reported they would take up a new maternal vaccine. Adverse birth outcomes occurred in 781 (35%) of pregnancies; 490 (62.7%) were preterm, 247 (31.6%) low birth weight, 189 (24.2%) macrosomia and 42 (5.4%) still births. Predictors of adverse birth outcomes were, eclampsia (AOR 6.86 (1.40-33.60); p=0.017), gestational diabetes (AOR 3.01 (1.24-7.30; p=0.015), and home delivery (AOR 2.48 (1.20-5.13); p=0.014). Being multiparous (AOR 0.52 (0.33-0.81); p=0.004) was protective. Home delivery was significantly associated with older maternal age 40-49 years (p=0.001), multiparous >5 (p=0.001), level of formal education below primary (p=0.001) and Islamic religion (p=0.001). ConclusionsIn this maternal population, about a third of pregnancies have adverse birth outcomes. Recognizing this baseline prevalence will be important in validating safety of a new maternal vaccine. Monitoring of the actual safety outcomes of the maternal RSV vaccine, will require integrated initiatives to mitigate against factors affecting utilization of maternal healthcare services and individual factors associated with adverse birth outcomes.

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“…A systemic analysis showed that the incidence of eclampsia ranges from 0 to 0.1% in Europe, 4% in Nigeria, 0.6% in Brazil. Majority of the cases of eclampsia are seen in young 6 primigravidas and those with no prior antenatal care. 4,6 The case fatality rate of eclampsia is 1.8% in developed 7 countries, 17.7% in India and 13% in Nepal.…”

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confidence: 99%

“…Majority of the cases of eclampsia are seen in young 6 primigravidas and those with no prior antenatal care. 4,6 The case fatality rate of eclampsia is 1.8% in developed 7 countries, 17.7% in India and 13% in Nepal. The common causes of maternal deaths in eclampsia are coagulopathy, cerebrovascular haemorrhage, HELLP syndrome, Acute Renal Failure (ARF), aspira on pneumonia, pulmonary oedema, AntePartum Haemorrhage (APH), Postpartum haemorrhage (PPH) whereas perinatal mortality is due to preterm delivery, low birth weight, birth 2,8 asphyxia and intrauterine growth restric on.…”

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confidence: 99%

Maternal and Perinatal outcome in eclampsia at a teaching hospital of Eastern Nepal

Mishra¹,

Pradhan

Pokharel

et al. 2020

Birat J. Health Sci.

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Introduction: Eclampsia is a multisystem disorder with potential life-threatening complications that can result in significant maternal and fetal morbidity and mortality. The case fatality rate of eclampsia is 1.8% in developed countries, 17.7% in India and 13% in Nepal. The incidence of pre-eclampsia and eclampsia is high in developing countries due to hypoproteinemia, malnutrition and poor obstetric facilities. Objective: To assess the maternal and perinatal outcome in patients of eclampsia Methodology: This was a hospital based cross-sectional study where all the patients presenting with eclampsia from June 2019 to November 2020 in the department of Obstetrics & Gynecology, Birat Medical College and Teaching Hospital were enrolled for the study. Data analyzed included various maternal parameters and fetal parameters along with the mode of delivery, outcome of baby, postpartum maternal condition and maternal mortality were noted. Results: Among 6631 deliveries, 50 patients had eclampsia with the incidence of 7.54/1000 deliveries. Thirty four (68%) patients were of 20-30 years of age, 37 (74%) were primigravidas, 36 (72%) from rural areas, 34 (68%) were illiterate, 49 (98%) were low to middle socioeconomic status, 41 (82%) were unbooked and 33 (66%) patients had antepartum eclampsia. Eleven (22%) women developed eclampsia related complications. There were 02 (4%) maternal deaths and the common causes were HELLP Syndrome and pulmonary oedema. Neonatal outcome consisted of live births in 39 (78%) newborns, 03 (6%) were still births, 08 (16%) were birth asphyxia and 15 (30%) were low birth weight. Conclusion: Majority of the patients were young, illiterate, unbooked primi gravidas with poor to average socioeconomic status from rural areas. Majority of the eclamptic women nearly 39 (78%) cases delivered via caesarean section for better neonatal outcome. Two (4%) eclamptic women died as a result of eclamptic complications and three (6%) newborns had neonatal deaths because of low birth weight and prematurity. Adequate antenatal screening, early detection of hypertension, timely referral, and early initiation of treatment and termination of eclamptic patients can help to improve the maternal and perinatal outcomes.

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Adverse Maternal and Fetal Outcome in Patients with Eclampsia

Cited by 8 publications

References 0 publications

Fetomaternal outcome of eclamptic parturient in a tertiary care center: A descriptive cross-sectional study

Fetomaternal outcome of eclamptic parturient in a tertiary care center: A descriptive cross-sectional study

Quantifying Factors Associated With Birth Outcomes and Their Implications on Evaluating the Success of a Maternal Respiratory Syncytial Virus (RSV) Vaccine Program in Kenya

Maternal and Perinatal outcome in eclampsia at a teaching hospital of Eastern Nepal

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