Abstract
Background: Pre-eclampsia is hypertension in pregnancy after 20weeks of gestation characterized blood pressure greater than 140/90 mm Hg, using the Korotkoff phase V sound for the diastolic value, on two occasions 4 hours apart. It is one of a spectrum of pregnancy disorders which result in different complications including maternal death. Methodology: Retrospective cross-sectional study design was employed. A total of 295 samples were recruited and systematic sampling technique was used to select study subjects who were admitted with preeclampsia from January1, 2016 and December 31, 2018 at Dilla University Referral Hospital. Medical records review was done using pretested data abstraction tool. Data was entered in EpiData version 4.4.2.1and exported into SPSS (statistical package of social science) version 25.0 for analysis. Binary and multiple logistic regressions were used to identify association between variables. Adjusted odds ratio along with 95% confidence interval was estimated to assess the strength of the association, and a p-value ≤ 0.05 was used to declare the level of statistical significance. Results: In this study 295 medical charts of pre-eclamptic women were reviewed. The most 210 (72.2%) of the participants were between the age of 20-34years. Severe type of preeclampsia was 174 (58.0%). HELLP syndrome was the most common complication of severe preeclampsia 81 (66.6%) followed by DIC, renal failure and liver failure, 25 (20.5%), 9 (7.4%) and 1 (0.8%) respectively. Maternal deaths due to preeclampsia were 6 this gives case fatality of 2%. In multivariable logistic regression, rural residence has 5.038 times more risk of unfavorable maternal outcome [AOR=5.038, 95%CI 1.971-12.879], gestational age ≤33 weeks has 3.67 times higher risk of unfavorable maternal outcome [AOR=3.67, 95%CI 1.829-7.364] and admission of women with diagnosis of sever preeclampsia has 6.42 times higher risk of unfavorable maternal outcome [AOR=6.42, 95%CI 2.017-21.103]. Conclusion and recommendation: Although there was current envisaged on maternal health improvement, this study has shown that maternal complications were common among pre-eclamptic women. The most common maternal complications due to preeclampsia were HELLP syndrome, DIC and renal failure. Health care professionals specially who work at PHC center should take appropriate trainings on immediate management and counseling a women coming for ANC and prompt referral for preeclampsia women with severity sign.
Highlights
The distribution of co-morbidities among pre-eclamptic women who admitted to Dilla university referral hospital, Dilla, Ethiopia 2019
There were current envisaged on maternal health improvement, this study has shown maternal complications were common among pre-eclamptic women who admitted to Dilla university referral hospital
The maternal morbidity was common with previous history of preeclampsia, co-morbidity or previous history of medical condition early onset of preeclampsia and severity sign of preeclampsia
Summary
Pre-eclampsia is HDP after 20 weeks of gestation usually diagnosed as mild preeclampsia when blood pressure measured at least 140 mm Hg (systolic) or at least 90 mm Hg (diastolic) on at least two occasions and at least 4–6 h apart and excretion of 300mg of protein in a 24-hour urine collection, alternative to a urine protein (mg/dL)/creatinine ratio (mg/dL) ≥ 0.3 has good sensitivity (98.2%) and specificity (98.8%) in women known to be normotensive before 20 weeks of gestation and regarded as severe if there are sustained rises in blood pressure to at least 160 mm Hg (systolic), at least 110 mm Hg (diastolic) and proteinuria (≥5 g/24 hours or ≥3+ on two random samples 4 hours apart) with manifestations of end-organ disease: oliguria (< 500 mLZerihun Figa et al.: Assessment of Maternal Outcome Among Preeclamptic Women at DillaUniversity Referral Hospital, Dilla Ethiopia in hours), cerebral or visual disturbances, pulmonary edema, cyanosis, epigastric or right-upper quadrant pain, impaired liver function, thrombocytopenia [1, 2].Globally, the MMR fell by nearly 44% over the past years, to an estimated 216 maternal deaths per 100,000 live births in 2015, from an MMR of 385 in 1990 with annual decrease of maternal deaths by 43% from 532 000 in 1990 to an estimated 303 000 in 2015. Pre-eclampsia is hypertension in pregnancy after 20weeks of gestation characterized blood pressure greater than 140/90 mm Hg, using the Korotkoff phase V sound for the diastolic value, on two occasions 4 hours apart. It is one of a spectrum of pregnancy disorders which result in different complications including maternal death. HELLP syndrome was the most common complication of severe preeclampsia 81 (66.6%) followed by DIC, renal failure and liver failure, 25 (20.5%), 9 (7.4%) and 1 (0.8%) respectively. Conclusion and recommendation: there was current envisaged on maternal health improvement, this study has shown that maternal complications were common among pre-eclamptic women. Health care professionals specially who work at PHC center should take appropriate trainings on immediate management and counseling a women coming for ANC and prompt referral for preeclampsia women with severity sign
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