Risk factors and outcome of patients with eclampsia at a tertiary hospital in Egypt

Abstract

BackgroundEclampsia is a major cause of maternal and neonatal morbidity and mortality in low and middle income countries. The aim of this study was to assess the risk factors and maternal and perinatal outcome in patients with eclampsia in order to get reliable data that helps in reducing the incidence and improving the outcome in an area with high incidence of eclampsia.MethodsRetrospective study including 250 patients diagnosed with eclampsia at Minia Maternity University Hopsital, Minia, Egypt in the period between January 2013 and December 2014.We analyzed the data obtained from medical records of these patients including patient characteristics, medical, obstetric, current pregnancy history, data on hospital admission, treatment given at hospital and maternal and perinatal outcome. Statistical analysis was done using SPSS version 21.ResultsDuring the study period, 21690 women gave birth in the hospital; of which 250 cases of eclampsia were diagnosed (1.2%).Four women died (case fatality rate 1.6%). The main risk factors identified were young age, nulliparity, low level of education, poor ante-natal attendance and pre-existing medical problems. The most common complication was HELLP syndrome (15.6%). Magnesium sulphate therapy was given to all patients but there was lack of parenteral anti-hypertensive therapy. Forty six cases delivered vaginally (18.4%). Assisted delivery was performed in 22 (8.8%) cases and caesarean section in 177 (70.8%) cases; 151(60.4%) primary caesarean sections and 26 (10.4%) intra-partum. Perinatal deaths occurred in 11.9% on cases. Prematurity and poor neonatal services were the main cause.ConclusionMorbidity and mortality from eclampsia are high in our setting. Improving ante-natal and emergency obstetric and neonatal care is mandatory to improve the outcome.

Maternal and Perinatal Outcome of Hypertensive Disorders of Pregnancy: A Prospective Study, Al-Hasaa, KSA.

“…12 Among types, our cases were only significant in PE (7.9%, RR= 3.0, table 2). Lower 17 and higher 19 rates in PE/eclampsia were observed by other authors. However, due to the differences in diagnostic criteria, the true incidence of this syndrome is unknown.…”

“…Consistent low rates were observed by others. 12,14,19 While higher figures of abruption were reported in PE/eclampsia inside 16 and outside KSA 17 , abruption was only encountered in chronic hypertension in our analysis (8.7%, RR=7.3), table 2. This may be an effect of chronicity.…”

“…Lower figures were previously obtained in Eastern KSA 16 as in other countries 12,17,18 , whereas higher rates were observed in larger studies. 14,19 An extremely high rate of CS (98.5%) was seen among hypertensive mothers whose neonates were admitted to NICU. 20 The great variations in the rate of CS may be attributed to the nature of the cases, differences in evaluation technology or differences in considering HDP an indication for CS.…”

“…12 A lower rate (30.8%) was observed among eclampsia. 19 A strong association between placental abruption and hypertension in pregnancy was documented. 21 In contrast, the incidence of placental abruption in this work was low (1.5%) and insignificant.…”

Active surveillance of incidence and risk factors of hemolysis, elevated liver enzymes and low platelets syndrome in Slovakia

“…The most common complication was HELLP syndrome (15.6 %). The main risk factors identifi ed were young age, nulliparity, low level of education, poor ante-natal attendance and pre-existing medical problem (17).…”