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

• 作者: Bhavana Kasu Harita Reddy Mahita Reddy Addula Malati Ponnur Pratibha Devabhaktuni Shobha Ramakoti
• 来源期刊: 妇产科期刊(英文)
• 学科: 医学
• 关键词: ECLAMPSIA MISOPROSTOL MATERNAL MORTALITY C. Section
• 年，卷（期）: 2017,（2）
• 页码范围: 193-207
• 页数: 15页
• 分类号: R73

摘要

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 d