Abstract
Severe preeclampsia (SPE) is associated with fetal complications including intrauterine growth retardation (IUGR), prematurity and in utero fetal death. Its treatment remains child birth that often is planned before term. However, this attitude can lead to fetal complications related to prematurity. Several studies on preeclampsia have already been studied in the DRC and several aspects have already been realized, but to date, the neonatal outcome has not yet been addressed. Methods: This is cross-sectional study performed in four public hospitals in Kinshasa (Democratic Republic of Congo). We included 400 cases of induced prematurity (IP) for SPE; the analysis compared pregnant women who gave birth before 34 weeks of amenorrhea (WA) and those after 34 WA. The comparison of the proportions was made by the Chi-square test and the calculation of Means by the Student’s test. The significance level was set at P Objective: To determine the frequency of induced prematurity for severe preeclampsia (SPE), to identify the indications and to evaluate neonatal outcome. Results: The IP frequency for SPE was 46.2%. The retro placental hematoma was the most indication in pregnancies before 34 WA 24.9%, while high blood pressure 54.5% in the after 34 WA group. In utero death was more common in pregnant women who gave birth before 34 weeks 25.4%; chronic fetal distress was elevated in the after 34 WA group 19.5%. Neonatal infection was more common in the group after 34 WA 49.4%, while respiratory distress 39.6%, intra and periventricular hemorrhage 19.5% and neonatal death 39.6% were more in group before 34 WA. Conclusion: Prematurity induced for SPE is related to a poor neonatal prognosis.
Highlights
Severe preeclampsia (SPE) is associated with fetal complications including intrauterine growth retardation (IUGR), prematurity and in utero fetal death [1]
Neonatal infection was more common in the group after 34 weeks of amenorrhea (WA) 49.4%, while respiratory distress 39.6%, intra and periventricular hemorrhage 19.5% and neonatal death 39.6% were more in group before 34 WA
We noted 400 cases of induced prematurity for severe preeclampsia, which represents a frequency of 1.7% of all deliveries, 18.3% of cases of preeclampsia and 39.5% of cases of preterm delivery
Summary
Severe preeclampsia (SPE) is associated with fetal complications including intrauterine growth retardation (IUGR), prematurity and in utero fetal death [1]. Its treatment remains childbirth that often is planned before term [2]. This attitude can lead to fetal complications related to prematurity [3]. According to WHO, preterm birth is defined as any childbirth occurring between 22 and 37 weeks of age [4]. In Low-income countries like the DRC, childbirth is premature when it occurs between 28 and 37 weeks of age [5]. In Europe, it is 8% and in the USA it represents 12% [6] This last high rate is essentially represented by induced prematurity. In Africa, the situation is complicated, in Low-income countries like those in sub-Saharan Africa, which alone account for 22% of premature births [3]. In the DRC, prematurity accounts for 15% [5] and University Hospital of Kinshasa is 40% [7]
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