viernes, 3 de julio de 2015

Eclampsia-Preeclampsia


Evolución perinatal en eclampsia
Perinatal outcome in eclampsia.
Khuman V, Singh RL, Singh RM, Devi UA, Kom T.
J Med Soc 2015;29:12-5
Abstract
Introduction: Eclampsia is a major cause for perinatal morbidity and mortality worldwide and perinatal outcome is much worse in developing countries even today. The reasons are multi-fold and may be because eclampsia is poorly managed and not up to the prescribed standards as in industrialized countries. Also prematurity usually iatrogenic one is a major cause for high perinatal morbidity and mortality in eclampsia due to non-availability and of neonatal intensive care unit (NICU) facilities. Materials and Methods: All eclampsia patients admitted to the antenatal ward in JIPMER from October 2009 to May 2011 were followedup. The pregnancy outcome was duly recorded and analyzed. Results: Majority of the patients were unbooked, young and primigravida. Majority (65%) of women required labor induction in one or more forms. In the study 20% of cases required cesarean section for delivery. Sixty percent of the cases were preterm deliveries and 44% required NICU admissions. There were 52 (17.2%) stillbirths. There were a total of 16 neonatal deaths; mostly due to prematurity (62.5%). The perinatal mortality rate is 231 per 1000 births. Hundred babies had birth weights <1.5kg; and 212 babies less than 2.5 kg. Average birth weight was 1.825kg, which is much lesser than the institutional Average birth weight. of 2.88 kg during the same period. Prematurity was the most common cause for NICU admissions as well as neonatal deaths. Conclusions: Majority (65%) of the cases required induction of labor and only 23% went into spontaneous labor. Twenty percent of eclamptic women required cesarean delivery. Major indication for caesarean section as anticipated was fetal distress. Most common cause for neonatal death was prematurity and its attendant complications.
Keywords: Eclampsia, Neonatal deaths, Perinatal morbidity, Prematurity
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Evolución materna y fetal en pre-eclampsia en un hospital de segundo nivel en el sur de India
Maternal and fetal outcome in pre-eclampsia in a secondary care hospital in South India.
Aabidha PM, Cherian AG, Paul E, Helan J.
J Family Med Prim Care. 2015 Apr-Jun;4(2):257-60. doi: 10.4103/2249-4863.154669.
Abstract
BACKGROUND: Hypertensive disorders in pregnancy are one of the common causes for perinatal and maternal morbidity and mortality in developing countries. Pre-eclampsia is a condition which typically occurs after 20 weeks of gestation and has high blood pressure as the main contributing factor. The aim was to study the effects of pre-eclampsia on the mother and the fetus in rural South Indian population. MATERIALS AND METHODS: This was a descriptive study conducted in a secondary level hospital in rural South India. A total of 1900 antenatal women were screened for pre-eclampsia during the period August 2010 to July 2011 to study the effects on the mother and fetus. RESULTS: Of the 1900 women screened 93 were detected with pre-eclampsia in the study. Among these, 46.23% were primigravida, 30.1% belonged to socio-economic class 4 and 48.8% were among those with BMI 26-30. The incidence of severe pre-eclampsia was higher in the unregistered women. The most common maternal complication was antepartum hemorrhage (13.9%) and the most common neonatal complication was prematurity (23.65%). CONCLUSIONS: Treating anemia and improving socioeconomic status will improve maternal and neonatal outcome in pre-eclampsia. Antenatal care and educating women on significance of symptoms will markedly improve perinatal morbidity and mortality. Prematurity, growth restriction and low birth weight are neonatal complications to be anticipated and dealt with when the mother has pre-eclampsia. A good neonatal intensive care unit will help improve neonatal outcomes.
KEYWORDS: Fetal outcome; maternal outcome; pre-eclampsia
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