Pradhan Tarun, Rijal Pappu, Rai Rubina, Bhatta Rabindra Dev, Thapa Baburam Dixit, Regmi Mohan Chandra
Department of Obstetrics and Gynecology, BPKIHS, Dharan, Sunsari, Nepal.
J Nepal Health Res Counc. 2019 Jan 28;16(41):425-427.
Eclampsia is a multisystem disorder that may lead to deterioration of maternal condition, hypoxia and acidosis of fetus. Objective was to evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia.
All patients with eclampsia were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to the patients and attendants about antenatal visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate, then the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition and mortality were then noted.
Fifty-two patients with eclampsia were admitted in the study period. Thirty-one patients required mechanical ventilator support. Twenty-five (48.07%) patients were delivered by emergency cesarean section and 30(57.6%) babies were low birth weight and there were 11(21.1%) stillbirths. There was one maternal mortality and 45(86.5%) patients were discharged with improvement but 6(11.5%) patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate.
Early detection of hypertension and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.
子痫是一种多系统疾病,可导致母体状况恶化、胎儿缺氧和酸中毒。目的是评估子痫患者母婴不良结局的相关危险因素。
2013年2月至2014年2月,所有子痫患者在签署知情同意书后入组。按照表格向患者及家属询问产前检查、产次、癫痫发作次数、从癫痫发作开始至使用硫酸镁的时长,然后按照医院方案对患者进行随访,记录分娩方式、婴儿结局、产后母体状况及死亡率。
研究期间收治了52例子痫患者。31例患者需要机械通气支持。25例(48.07%)患者行急诊剖宫产,30例(57.6%)婴儿出生体重低,11例(21.1%)死产。有1例孕产妇死亡,45例(86.5%)患者出院时病情好转,但6例(11.5%)患者有神经功能损害。死亡率与癫痫发作次数以及癫痫发作开始至使用硫酸镁的时间间隔显著相关。
子痫患者早期发现高血压并使用硫酸镁治疗有助于将母婴不良结局降至最低。