Trend in admissions, clinical features and outcome of preeclampsia and eclampsia as seen from the intensive care unit of the Douala General Hospital, Cameroon

Abstract

IntroductionHypertensive disorders in pregnancy (HDP) are a major cause of maternal morbidity and mortality. We aimed at determining the trends in admission, profiles and outcomes of women admitted for preeclampsia and eclampsia to an intensive care unit (ICU) in Cameroon.MethodsA retrospective study involving 74 women admitted to the ICU of the Douala General Hospital for severe preeclampsia and eclampsia from January 2007 to December 2014. Clinical profiles and outcome data were obtained from patient records. Statistical analysis was performed using SPSS version 20.ResultsOf the 74 women admitted to ICU (72.5% for eclampsia), mean age was 30.2years and the majority (90.5%) were aged 20-39 years. While overall trend in admission for HDP increased over the years, mortality remained stable. Mean gestational age (GA) on admission was 34.0 weeks (33.5 for preeclampsia vs 35.4 for eclampsia). Most patients presented with complications of which acute kidney injury was most frequent (66.7%). Visual problems were more common in patients with eclampsia compared to preeclampsia (p = 0.01). HELLP syndrome and acute pulmonary oedema (APO) were predominant in patients with preeclampsia, while cerebrovascular accidents (CVA) occurred more in patients with eclampsia. Overall mortality was 24.3%. Presence of APO was associated with mortality in multivariable analysis (O.R.= 0.03, p = 0,01).ConclusionTrends in admission for HDP were increasing with high but stable mortality rate. Patients presented late most of whom with complications. Interventions improving antenatal care services and multidisciplinary management approach may improve maternal outcome in patients with HDP.

Incidence and predictors of acute kidney injury among women with severe pre-eclampsia at Mbarara Regional Referral Hospital

“…We found a high cumulative incidence of AKI of 42.86% and eclampsia as the main independent predictor of AKI, within 48 h after admission.Our findings were lower than what was reported among severe pre-eclampsia/eclampsia patients in Cameroon among whom 66.7% developed acute kidney injury. This could be because a majority ( 72.5% ) of the enrolled participants in the study done in Cameroon had eclampsia [9] compared to our study which had only 21.4% patients with eclampsia. Furthermore, the Cameroon study was conducted in an intensive care unit and also had 7 years of follow-up.…”

Factors associated with severe maternal outcomes in patients with eclampsia in an obstetric intensive care unit

“…In that tertiary hospital too, patients usually arrive transferred from other healthcare centers, since most women initially seek healthcare facilities of lower complexity, the most accessible care, when symptoms begin. [ 30 ]…”

Incidence and Predictors of Acute Kidney Injury Among Women With Severe Pre-eclampsia at Mbarara Regional Referral Hospital

“…Data from developed countries suggests lower rates of AKI, with estimates as low as 1-2.8% (7). However, in developing countries, the incidence of AKI is high ranging from 36% to 66.7% (8,9), Cameroon (66.7% ) (10), Morocco (66.7%) (11). The high incidence of AKI in developing countries may be attributed to the late presentation of patients to hospitals for care.…”