Perinatal Outcome In Eclampsia Research Articles

PREGNANCY OUTCOME IN ECLAMPSIA INFLUENCED BY THE MODE OF DELIVERY

BACKGROUND: To study the association between mode of delivery and maternal and perinatal outcome in eclampsia. METHODS: This was a tertiary care based prospective observational study conducted in the Department of Obstetrics and Gynecology, between the study period October 2018-September 2020.Atotal 165 cases of eclampsia, with >32 weeks gestation, reassuring foetal heart and no other complications were included in the study. They were divided into two groups; Group I undergoing planned vaginal delivery, Group II undergoing early caesarean delivery, maternal and perinatal outcome was analysed and compared between the two groups. RESULT: Maximum number 75 (45.45%) of the study participants were in between 37.1-40 weeks of gestation at the time of admission, Majority of the study participants 125 (75.76%) had an unfavorable cervix i.e., Bishop's score ≤5 on initial assessment at the time of admission. There was no maternal mortality in our study. There was no statistically signicant difference in maternal morbidity. The still births and perinatal deaths were seen to be higher in the planned vaginal delivery group (1 still birth and 3 perinatal deaths). Perinatal morbidity was affected by mode of delivery of delivery, gestational age, BISHOP's score, number of convulsions at time of induction and convulsion delivery interval. CONCLUSIONS:The maternal outcome was seen to be comparable between both the groups and there was no statistically signicant difference between them, the perinatal outcome was better in the early caesarean delivery group as compared to the planned vaginal delivery group, specically in those with an unfavorable cervix and away from term. Early caesarean section to expedite delivery cannot be recommended for all cases of ante partum eclampsia.

Maternal and Perinatal outcome in eclampsia at a teaching hospital of Eastern Nepal

Introduction: Eclampsia is a multisystem disorder with potential life-threatening complications that can result in significant maternal and fetal morbidity and mortality. The case fatality rate of eclampsia is 1.8% in developed countries, 17.7% in India and 13% in Nepal. The incidence of pre-eclampsia and eclampsia is high in developing countries due to hypoproteinemia, malnutrition and poor obstetric facilities.
 Objective: To assess the maternal and perinatal outcome in patients of eclampsia
 Methodology: This was a hospital based cross-sectional study where all the patients presenting with eclampsia from June 2019 to November 2020 in the department of Obstetrics & Gynecology, Birat Medical College and Teaching Hospital were enrolled for the study. Data analyzed included various maternal parameters and fetal parameters along with the mode of delivery, outcome of baby, postpartum maternal condition and maternal mortality were noted.
 Results: Among 6631 deliveries, 50 patients had eclampsia with the incidence of 7.54/1000 deliveries. Thirty four (68%) patients were of 20-30 years of age, 37 (74%) were primigravidas, 36 (72%) from rural areas, 34 (68%) were illiterate, 49 (98%) were low to middle socioeconomic status, 41 (82%) were unbooked and 33 (66%) patients had antepartum eclampsia. Eleven (22%) women developed eclampsia related complications. There were 02 (4%) maternal deaths and the common causes were HELLP Syndrome and pulmonary oedema. Neonatal outcome consisted of live births in 39 (78%) newborns, 03 (6%) were still births, 08 (16%) were birth asphyxia and 15 (30%) were low birth weight.
 Conclusion: Majority of the patients were young, illiterate, unbooked primi gravidas with poor to average socioeconomic status from rural areas. Majority of the eclamptic women nearly 39 (78%) cases delivered via caesarean section for better neonatal outcome. Two (4%) eclamptic women died as a result of eclamptic complications and three (6%) newborns had neonatal deaths because of low birth weight and prematurity. Adequate antenatal screening, early detection of hypertension, timely referral, and early initiation of treatment and termination of eclamptic patients can help to improve the maternal and perinatal outcomes.

Maternal And Perinatal Outcome in Eclampsia in Siddhartha Medical College, Govt. General Hospital, Vijayawada, Andhra Pradesh

Maternal And Perinatal Outcome in Eclampsia in Siddhartha Medical College, Govt. General Hospital, Vijayawada, Andhra Pradesh

Management of Eclampsia and Imminent Eclampsia, Maternal and Perinatal Outcome in 666 Cases—2003-2007 at Government Maternity Hospital in Hyderabad

Objective: This is an audit to evaluate the maternal and perinatal outcome in eclampsia and imminent eclampsia with the management adopted at a tertiary hospital. Methods: During a period of 34 months, from 2003-2007 at Government maternity hospital, Osmania medical college, Hyderabad, 666 women with eclampsia and imminent eclampsia were managed. The number of eclampsia and imminent eclampsia (IE) was 532 and 134, respectively. We have analyzed the clinical profile, parity, age, degree of proteinuria, the period of gestation in weeks, the antenatal care, the number of antenatal visits, referrals from other hospitals, the diastolic B.P. at the time of admission, the recurrence of convulsions and the complications. 1) All the cases of eclampsia and IE were managed with magnesium sulphate as an anticonvulsant. 2) Oral nifedipine, IV labetalol, sublingual nifedipine and nitroglycerine infusion were used to control severe hypertension. 3) Prostaglandin E1 (PGE1) was used for induction of labour (IOL), 25 mcg × 4th hrly, vaginal route and 50 mcg for less than 28 weeks gestation, in 290/424 cases of IOL. Other methods of IOL were employed in 134 cases. Results: Eclampsia (n = 532) occurred antepartum in 407 (75.56%), intrapartum in 76 (14.28%), post partum in 46 (8.64%) and intercurrent in 3 (0.5%) patients. The period of gestation was 34 weeks in 340 patients. Induction of labour with misoprostol was done in 290 with vaginal delivery in 235 (81%) and lower segment caesarean section (LSCS) for failed IOL in 55 (19%) and other methods of IOL were used in 134. The total number of deliveries was 656, with vaginal deliveries in 336 (66.46%) patients, ceasarean deliveries in 220 (33.54%) patients. Ten patients died undelivered. Maternal mortality was 17/666—2.55%. Cerebrovascular events were responsible in 13/17 (76.46%) patients, pulmonary embolisim in 2, aspiration pneumonia in one and sepsis in one. The perinatal mortality was 167/582 (28.69%), PNM when birth weight was >1.5 kg was 59/426 (13.84%), intrauterine fetal deaths at admission were 54 (8.5%), there were four sets of twins. Conclusions: 1) More effective measures to control hypertension and routine administration of anticonvulsant, magnesium sulphate to women with eclampsia should be practised from the first referral unit itself. 2) Our caesarean delivery rate of 33.54% in the very high risk cases of eclampsia and imminent eclampsia is very low compared to others. 3) Induction of labour with misoprostol was successful in 81% with consequent reduction in caesarean section rate and morbidity and mortality associated with caesarean deliveries. Misoprostol has proved to be a safe and effective inducing agent in eclampsia. 4) The maternal mortality in our series is 2.55%.

Maternal and Perinatal outcome in Eclampsia

Maternal and Perinatal outcome in Eclampsia

Maternal and perinatal outcome of eclampsia over a decade at a tertiary hospital in Kuwait

Aims: To determine maternal and perinatal outcome of eclampsia patients over a decade.Methods: Analysis of case records of all eclampsia cases from January 2005 to December 2014.Results: There were 30 cases of eclampsia. The most significant risk factors for developing pre-eclampsia are unbooked cases (97%), nulliparity, young age, marriage ≤4 months, history of pre-eclampsia in previous pregnancy, remarriage, preexisting diabetes mellitus, interval between pregnancies ≥10 years, positive family history. The incidence of eclampsia was 0.05%, antepartum eclampsia 15 (50%), intrapartum 6 (20%) and postpartum 9 (30%) with no maternal deaths, and 1 perinatal death. Perinatal mortality was 33.3/1000. 22 (73%) patients received magnesium sulphate (MgSO4) and 8 patients (27%) received Diazepam, of which 1 had recurrence of convulsions. All 15 antepartum cases were delivered by cesarean section as were 2 intrapartum. 13 (43%) of women delivered vaginally. Only 6 (20%) patients were of low socio-economic status and were primary school educated. Severe maternal complications occurred in 8 (27%), with abruptio placentae being the most common 3 (38%).Conclusions: Incidence of eclampsia was low, with no maternal deaths. MgSO4 was found to be highly effective. Lack of antenatal care is a major risk factor.

O545 MATERNAL AND PERINATAL OUTCOME OF ECLAMPSIA, A CLINICAL STUDY

International Journal of Gynecology & ObstetricsVolume 119, Issue S3 p. S453-S453 Free communication (oral) presentations O545 MATERNAL AND PERINATAL OUTCOME OF ECLAMPSIA, A CLINICAL STUDY P. Phukan, P. PhukanSearch for more papers by this authorM. Rabha, M. RabhaSearch for more papers by this author P. Phukan, P. PhukanSearch for more papers by this authorM. Rabha, M. RabhaSearch for more papers by this author First published: 22 October 2012 https://doi.org/10.1016/S0020-7292(12)60975-8AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume119, IssueS3Abstracts of XX FIGO World Congress of Gynecology and ObstetricsOctober 2012Pages S453-S453 RelatedInformation

Maternal and perinatal outcome of eclampsia in tertiary health institution in Southeast Nigeria

Objective: To evaluate the maternal and perinatal outcome in patients with eclampsia at Nnamdi-Azikiwe-University-Teaching-Hospital (NAUTH), Nnewi, Nigeria. Methods: A retrospective study of cases of eclampsia managed at NAUTH over a 10 year period – 1st January, 2000 to 31st December, 2009. Maternal outcome was measured in terms of complications and maternal death. Foetal outcome was assessed in terms of low birth weight, pre-term births, low apgar score, and perinatal deaths. Results: There were 57 cases of eclampsia out of a total of 6,262 deliveries within the study period, giving a prevalence of 0.91%. Majority, 71.7%, had caesarean section. There were 17.4% maternal deaths mainly from pulmonary oedema, 6 (13.0%), acute renal failure, 4 (8.7%), and coagulopathy, 3 (6.5%). Perinatal deaths were 25.5% as a result of prematurity, 42 (82.4%), and low birth weight, 36 (70.6%). Twenty-one (41.2%) of the new born had Apgar score of less than seven at 5 min while 13.0% were severely asphyxiated. Conclusion: Eclampsia was associated with high maternal and perinatal morbidity and mortality in this study. There is need to review existing protocol on eclampsia management with emphasis on appropriate health education of pregnant mothers, good antenatal care, early diagnosis of pre-eclampsia with prompt treatment.

Maternal and perinatal outcome of eclampsia in a tertiary health institution in south-east Nigeria

Objective: To evaluate the maternal and perinatal outcome in patients with Eclampsia at Nnamdi-Azikiwe-University-Teaching-Hospital (NAUTH), Nnewi, Nigeria.                                                                                    Method: A retrospective study of cases of Eclampsia managed at NAUTH over a ten year period — 1st January, 2000 to 31st December, 2009. Maternal outcome was measured in terms of complications and maternal death. Foetal outcome was assessed in terms of low birth weight, pre-term births, low apgar score, and perinatal deaths.Results: There were 57 cases of Eclampsia out of a total of 6,262 deliveries within the study period, giving a prevalence of 0.91%. Majority, 71.7%, had Caesarean-section. There were 17.4% maternal deaths mainly from pulmonary oedema, 6 (13.0%), acute renal failure, 4 (8.7%), and coagulopathy, 3 (6.5%). Perinatal deaths were 25.5% as a result of prematurity, 42 (82.4%), and low birth weight, 36 (70.6%). Twenty one (41.2%) of the new born had Apgar score of less than seven at five minutes while 13.0% were severely asphyxiated.Conclusion: Eclampsia was associated with high maternal and perinatal morbidity and mortality in this study. There is need to review existing protocol on Eclampsia management with emphasis on appropriate health education of pregnant mothers, good antenatal care, early diagnosis of preeclampsia with prompt treatment.Key Words: Eclampsia, Maternal and perinatal outcome, Tertiary health institution, Southeastern Nigeria.

Management of eclampsia: A review of 50 cases

SummaryEclampsia remains a problem worldwide in obstetric practice. Among 29 450 deliveries at the King Faisal University Teaching Hospital, Al-Khobar, Saudi Arabia, between June 1982 and May 1993, there were 50 singleton pregnancies with eclampsia, giving an incidence of 1 in 589 deliveries (0.17 per cent). Twenty-four patients had antepartum eclampsia; 19 had intrapartum and seven had postpartum fits. The efficacy of two treatment regimens used to control eclamptic fits, diazepam and magnesium sulphate, was studied. None of the mothers with eclampsia died but 10 of the 50 babies were lost, giving a perinatal mortality rate of 200/1000. The perinatal deaths were mainly associated with prematurity and intra-uterine growth retardation. There was no difference in maternal morbidity and perinatal mortality between the two treatment groups. Active obstetric intervention as opposed to conservative management improves both the maternal and perinatal outcome in eclampsia.

Perinatal Outcome of Eclampsia in Dhaka Medical College Hospital

Objectives: The study was done with the objective to find the perinatal outcome in eclampsia patients and also to find out preventable causes of perinatal mortality and morbidity which are related to eclampsia. Materials & methods: This was a cross sectional observational study carried out in the Eclampsia unit in the Department of Obstetrics and Gynaecology in Dhaka Medical College Hospital during the period from February 2001 to July 2001. Results: Three hundred patients were selected for study. Three hundred mother's delivered 311 babies (11 sets of twins). Perinatal death(PND) which included stillbirth (SB) and early neonatal death (END) was 29%; stillbirth rate was 158/1000 live birth and early neonatal death rate was 132/1000 live births; 71% babies were born healthy. Maternal and fetal conditions were assessed and its relation with perinatal outcome was analyzed. Convulsion delivery interval > 12 hours, diastolic BP > 110mm Hg and Proteinuria > 3+ had significant higher perinatal death. (P<0.001, <0.01 and <0.001, respectively). Seventy percent babies had low birth weight. Among the live born neonates (n=262) 27.5% had jaundice, 34.7% had no complication and 15.6% had early neonatal death. Pre-maturity was common cause of early perinatal death (54%) and 39% death was due to asphyxia. Conclusion: Still birth, prematurity and birth asphyxia are important causes of perinatal loss in eclampsia, so early referral of eclampsia patients, early resuscitative measures and good neonatal care can improve perinatal outcome. doi: 10.3329/bjog.v23i1.3053 Bangladesh J Obstet Gynaecol, 2008; Vol. 23(1) : 20-24