Incidence of Severe Acute Maternal Morbidity in Severe Preeclampsia

Abstract

Background: Hypertensive disorders of pregnancy are among the most common complications, with an incidence ranging from 5 to 10%. It is the third leading cause of maternal mortality in India, contributing to 7% of all maternal deaths. Aims: This study aims to determine the incidence of severe acute maternal morbidity in women with severe preeclampsia. The most affected organ and perinatal outcomes in women with severe preeclampsia were evaluated as secondary objectives. The association between severe preeclampsia and severe acute maternal morbidity which is indicated by dysfunction of cardiovascular, respiratory, renal, coagulation and neurological systems was observed. The perinatal outcomes such as fetal growth restriction, preterm birth, fetal distress, neonatal encephalopathy, still birth, NICU admission and neonatal death were assessed. Methodology: This was a prospective observational study done at a tertiary care centre in India between May 2022 and July 2023. All antenatal and postnatal women i.e. up to 42 days from the day of delivery, diagnosed with severe preeclampsia were included in the study. Women without severe preeclampsia and those who were referred with Multiple Organ Dysfunction Syndrome (MODS) were excluded from the study. Results: A total of 12,359 women delivered during the study period. Out of these, 360 women were diagnosed with severe preeclampsia with an incidence of 2.91%. Amongst 360 women who were diagnosed with severe preeclampsia severe acute maternal morbidity was seen in 68 women with an incidence of 19%. Women with severe preeclampsia had eclampsia as the most common serious complication followed by thrombocytopenia. Most of the women had preterm delivery by caesarean section and more than half of the babies required NICU admission. A considerable number of babies were low birth weight and stillborn. Conclusion: This study has shown the adverse effects of severe preeclampsia on the mother and the fetus leading to morbid condition. Early diagnosis and referral to higher centre for early intervention can prevent the morbid condition.