Analysis of maternal morbidity and mortality among patients admitted to Obstetric Intensive Care with severe preeclampsia, eclampsia or HELLP syndrome

Balsera, Emilio Curiel; Prieto-Palomino, Miguel Angel; Muñoz-Bono, J.; Elvira, Mariza; Galeas, J.L.; García, G. Quesada

doi:10.1016/j.medine.2011.11.005

Cited by 18 publications

(17 citation statements)

References 20 publications

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“…About 154(49%) have 2++ proteinuria on admission this proteinuria has also association with the maternal out comes (P=0.000361) this is similar to the study finding from Spain reported protein urea and null parity associated with maternal outcomes (15).…”

Section: Discussionsupporting

confidence: 86%

Causes of Admission and out Comes Among Preeclampsia and Eclampsia Mothers Admitted to Jimma University Specialized Hospital Intensive Care Unit

Nega¹

2015

CMR

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Background: Preeclampsia is a multisystem hypertensive disorder of pregnancy with new onset after 20 weeks gestation which is a leading cause of worldwide maternal and fetal morbidity-mortality. Objective: To assess causes of ICU admission and outcomes among pre-eclampsia and eclampsia mothers admitted to Jimma University Specialized Hospital. Methods: A retrospective cross sectional study was conducted at JUSH from May 3 to 8, 2015, all ICU admitted preeclampsia and eclampsia mother's records from January 1, 2010 to December 31, 2014 were included by consecutive sampling with inclusion and exclusion criteria. Causes of admission, complications and outcomes were obtained from patient records and analyzed by SPSS version 16.0, finally the results presented using simple frequency tables and figures. Chi square (x2) test calculated to analyze the statistical association between patients outcome and other variables, p-value less than 0.05 was considered statistically significant. Result: A total of 1981 patients admitted to Jimma University specialized hospital ICU over the last five years (January 1, 2010 to December 31, 2014) from this 326 of them were preeclampsia and eclampsia mothers and this gives admission rate of 16.5%. For this study only total of 314 preeclampsia and eclampsia mothers records were used and 12mothers cards were excluded by exclusion criteria. The main causes of admission to ICU were eclampsia 106 (33.8%), General condition need close observation 77(24.5%), pulmonary edema 63 (20.1%), postoperative bleeding 31(9.9%) While the main complications were pulmonary edema 82(26.1%), acute renal injury 76(24.2), HELLP syndrome 57(18.2%) and mortality rate of 7.3%.There is association level of blood pressure with maternal outcomes. Conclusion: Rate of maternal admission, complications and mortality is found to be high at JUSH ICU, Jimma University with other stakeholders has to work in improving high quality of cares provided to reduce maternal complications and mortality.

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Section: Discussionsupporting

confidence: 86%

Causes of Admission and out Comes Among Preeclampsia and Eclampsia Mothers Admitted to Jimma University Specialized Hospital Intensive Care Unit

Nega¹

2015

CMR

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“…Renal failure was seen among 5% of our patients; similar to the 5% of the patients in Spain 17 . In another report eclampsia and pre-eclampsia accounted for 67.2% of obstetrics patients requiring dialysis 9 .…”

Section: Discussionsupporting

confidence: 85%

Ecalmpsia: maternal and fetal outcome

Jido¹

2012

Af Hlth Sci

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Objective: To determine the incidence of eclampsia and examine the maternal and fetal outcome. Methods: A hundred and twenty consecutive admissions with eclampsia managed in Aminu Kano Teaching Hospital, Kano, Nigeria, were prospectively collated and analysed. Maternal and fetal morbidity and mortality were recorded. Results: The incidence of eclampsia was 1.2% of deliveries. Most (69.2%) of the patients had no antenatal care. In 93 (77.5%), the convulsions were controlled with diazepam, and 22.5% magnesium sulphate. Maternal complications rate was 39.2%, and use of Diazepam for control of convulsions increases complications (RR 3.12, 95% CI = 1.23-7.92, p= 0.02). Case fatality rate was 11.7%, diazepam use failed to achieve significant association with maternal death (RR 8.64, 95% CI = 0.53-140.29, p= 0.13). Stillbirth rate was 22.5% with significant association with diazepam use (RR 7.55, 95% CI= 1.07-53.09, p=0.04). Birth asphyxia was recorded in 39.1% and low birth weight in 25.8%. Conclusion:The incidence of eclampsia in our hospital was very high, with corresponding high maternal and perinatal morbidity and mortality. Increased antenatal screening and use of magnesium sulphate to control convulsions will reduce the incidence and associated morbidity and mortality for both mother and fetus.

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“…[8] Serious and untreated cases may result in maternal death. [9] In the fetus intrauterine growth retardation, preterm delivery, birth asphyxia and cerebral palsy are commonly associated with eclampsia. Pregnancy related complications associated with eclampsia like status, DIC and abruptio placenta put both mother and fetes at risk.…”

Section: Introductionmentioning

confidence: 99%

Maternal and Fetal Outcome in Eclampsia

Praveenkumar¹,

Patil²,

Pachpande³

2017

AIMDR

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Background: (1)To study maternal outcome in eclampsia in relation to respiratory complications, fever, DIC, renal system affection and electrolyte imbalance. (2) To study the fetal outcome in eclampsia in relation to small for gestational age, intrauterine death, neonatal mortality, perinatal mortality and need for NICU admission.Study Design: It was a crosssectional prospective study conducted at Government Medical College Nagpur over a period of 3 months (14 May to 14 July). Methods: The study was approved by the Institutional ethical committee. All patients admitted in the department of obstetrics and gynaecology at government medical college Nagpur with eclampsia was enrolled for the study as per the criteria given. It was a a cross-sectional prospective study conducted from 14 May to 14 July (3 months) on women admitted with eclampsia after the gestational age of 20 weeks and presented with convulsions. The outcome in relation to maternal and neonatal morbidity and mortality was studied on the basis of various complications and defined parameters. Result: A total of 43 patients were enrolled in the study. The most common age group of patients who had eclampsia after 20 weeks of gestation belonged to age group of 21-25 years followed by more than 25 years and the least common age group was between 18-20 years of age. The mean age was found to be 24.23 years. Out of the studied cases 21 (48.83%) were primigravida and 22 (51.16%) were multigravidae. 16 (37.20%) patients visited doctor for ANC visits once or twice while 8 (18.60%) patients visited the doctor thrice, 9 patients made 4 ANC visits while 10 patients were such that they didn't made even a single ANC visit before getting admitted in our hospital with seizures. Patients with term pregnancies made up 34.88% of the total patients while 65.11% patients were preterm. The most common signs and symptoms seen in these patients were Headache (92%), Nausea and vomiting (90%), Epigastric pain (32%), anasarca (23%) and sudden blindness (6%). Out of 43 patients normal vaginal delivery took place in 22 (51.16%) and LSCS was done in 21 (48.83%) of the patients. The most common indication of LSCS in patients with eclampsia was fetal distress (47.61%) followed by unfavourable cervix (28.57%), failure of induction (14.28%) and contracted pelvis (9.52%). The most common complications seen in patients with eclampsia included Respiratory complications like aspiration pneumonia, pleural effusion and pulmonary oedema, which were seen in 11 (25.58%) patients followed by fever (23.25%) and haematuria (23.25%). The least common complications encountered were cardiomyopathy and cerebrovascular accidents which were seen in 2 patients (4.65%) each. Serious complications like disseminated intravascular coagulopathy, renal failure and deranged hepatic functions were seen in 16.27%, 6.97% and 13.95% respectively. convulsions to delivery interval was found to be a significant determinant of outcome and complications were found to be more common if this period exceeded more t...

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Analysis of maternal morbidity and mortality among patients admitted to Obstetric Intensive Care with severe preeclampsia, eclampsia or HELLP syndrome

Cited by 18 publications

References 20 publications

Causes of Admission and out Comes Among Preeclampsia and Eclampsia Mothers Admitted to Jimma University Specialized Hospital Intensive Care Unit

Causes of Admission and out Comes Among Preeclampsia and Eclampsia Mothers Admitted to Jimma University Specialized Hospital Intensive Care Unit

Ecalmpsia: maternal and fetal outcome

Maternal and Fetal Outcome in Eclampsia

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