Title: Pregnancy outcome in severe preeclampsia and eclampsia patients: A study from North Indian tertiary health care institution

Authors: Rohit Dogra, Anu Bala Chandel

 DOI: https://dx.doi.org/10.18535/jmscr/v8i6.59

Abstract

Introduction: Hypertensive disorders of pregnancy comprising of pre-eclampsia and eclampsia are a major cause of adverse pregnancy outcomes. Neurological manifestations of pregnancy induced hypertension are the most common cause of maternal and foetal morbidity and mortality. Cranial neuro-imaging reveals focal regions of symmetric hemispheric oedema; with parietal and occipital regions getting most commonly affected.

Methods: The study was conducted among 65 antenatal women diagnosed with pre-eclampsia and eclampsia at gestational age >20 weeks in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and child IGMC Shimla.

Results: The maternal age range in majority (77%) of subjects with preeclampsia and eclampsia in the present study was 20-29 years. Most of the subjects in our study were primigravidae (58.46%). In our study 17.18% of the mothers presented with IUD at the time of admission  and 14.51% had still births

Conclusion: The timely intervention may lower the morbidity and mortality among mothers with severe preeclampsia and eclampsia, which accounts for one tenth of all maternal deaths.

Keywords: Antenatal women, Pregnancy induced hypertension, Neuro-imaging.

References

  1. Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. Am J Obstet Gynecol 2000;183:S1–22
  2. World Health Organization. WHO Recommendations for Prevention and Treatment of Pre-Eclampsia and Eclampsia. Geneva, Switzerland: World Health Organization; 2011
  3. Gabbe SG, Niebyl JR, Simpson JL, Landon MB, Galan HL, Jauniaux ERM et al. Obstetrics: Normal and problem pregnancies: Hypertension. 6th edition Philadelphia. Saundars An imprint of Elsevier Publications; 2013, 779-824
  4. Cunnighum FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL. Williams obstetrics: Hypertensive disorders in pregnancy. 24th Newyork: McGraw-Hill Education; 2014. Chapter no. 10 : 1508-6135
  5. Patil Mithil M. Role of Neuroimaging in Patients with Atypical Eclampsia. J of Obstet & Gynecol of India 2012; 62 (5): 526-30
  6. Roybart M, Seidman DS, Serr DM, Mashiach S. Review. Neurological Involvement in Hypertensive Disease of Pregnancy. Obstet & gynaecol Survey 1991; 46(13): 656-64.
  7. Diwan AG, Agrawal PH, Panchanadikar TM, Yadav SV, Joshi P. Late post-partum eclampsia with reversible encephalopathy syndrome: an interesting case. Indian J of Medical Specialities 2012
  8. Demirtas O, Gelal F, Vidinli BD, Demirtas LO, Uluc E, Baloglu A. Cranial MR Imaging with clinical correlation in preeclampsia and eclampsia. Diagn Interv Radiol 2005; 11: 189-94.
  9. Chiou YH, Chen PH, Reversible Posterior Encephalopathy Syndrome as the Presentation of Late Post Partam Eclampsia: A case Report. Acta Neurologica Taiwanica 2007; 16 (3):158-62.
  10. Census of India. Literacy Estimates of mortality indicators 2010. http://www.censusindia.gov.in/vital_statistics/srs/Chap_4_2010. pdf (accessed June 2013).
  11. Sibai BM, Cunningham FG. Prevention of preeclampsia and eclampsia. In: Lindheimer MD, Roberts JM, Cunningham FG, editors. Chesley’s Hypertensive Disorders of Pregnancy. 3rd New York: Elsevier; 2009:215.
  12. Singhal S, Deepika, Anshu, Nanda S. Maternal and perinatal outcome in severe pre-eclampsia and eclampsia. South Asian Federation Obstet Gynecol. 2009;1(3):25-8.
  13. Pillai SS. Fetomaternal outcome in severe preeclampsia and eclampsia: a retrospective study in a tertiary care centre. Int J Reprod Contracept Obstet Gynecol 2017;6:3937-41.

Corresponding Author

Dr Anu Bala Chandel

Department of Obstetrics and Gynaecology, Regional Hospital, Bilaspur, Himachal Pradesh, India