Trend in pre eclampsia

Abstract

Introduction: Pre eclampsia is a progressive disorder, in some circumstances; delivery is needed to halt the progression to the benefit of the mother and fetus. Aim: This study is designed to evaluate the incidence and effect of current interventional strategy for severe pre-eclampsia on maternal and perinatal outcome. Materials and methods: This is a cross-sectional study in Obstetrical and Gynecological department at Modern Govt. maternity
hospital Hyderabad from January to August over a period of 8 months with sample size 285 cases in among 14085 deliveries. Cases were studied in relation to age, parity, level of antenatal care, gestational age, BP at the time of admission, investigations, complications, mode of delivery, mode of induction and perinatal outcome in all these cases. Results: Among 14085 deliveries in 8 months we had 285 pre-eclampsia cases, incidence percentage being 2.03%. Majority of women were in the age group of 20-25 yrs and majority of women gestational age >34 weeks Almost half of the twin preeclampsia cases were unbooked cases. Majority of cases are in Primigravidae. Among 285cases, vaginal delivery occurred in 64% cases and LSCS in 37% cases. Severe pre-eclampsia is seen in all blood pressures. BP is controlled by giving oral Nifedepine, IV labetol and magnesium sulphate in all cases. Perinatal mortality is high with birth weight <1 kg in both vaginal and LSCS. In LSCS Total PNMR is 15.12%, while in induced vaginal delivery and non induced vaginal delivery PNMR is 42.2%, 37% respectively. According to gestational age total PNMR LSCS is12.26%, where as PNMR in induced vaginal delivery is 42.2% and in non induced cases PNMR is 37%. Maternal mortality rate observed is 2.1%, causes being pulmonary embolism, acute LVF, ARDS and DIC. Conclusion: Incidence of severe pre-eclampsia is 2.03% in deliveries, seen commonly in young women below 25 yrs of age, nulliparous, with no antenatal care and was seen maximum after 34 weeks of pregnancy. Many patients came with various complications which were efficiently managed by stabilizing and delivering them early. The BP was well controlled with Nifedepine or Labetalol and Magnesium sulphate in all cases.