Bhattacharya Rumi, Chaudhary Milankumar, Bhattacharjee Shibashish, Kukadiya Romil, Shahu Sheetal, Shah Dipal, Patel Mamta R
Obstetrics and Gynecology, Pramukhswami Medical College, Bhaikaka University, Karamsad, IND.
Neurological Surgery, Pramukhswami Medical College, Bhaikaka University, Karamsad, IND.
Cureus. 2024 Jul 29;16(7):e65651. doi: 10.7759/cureus.65651. eCollection 2024 Jul.
Introduction Pregnancies complicated by hypertensive disorders contribute to enormous burden on economy and health-care facilities. Eclampsia is one of the clinical markers of near-miss mortality. To achieve optimal outcomes, efforts should be directed at both periphery and tertiary care levels. This study aimed to compare the feto-maternal outcome in patients presenting with eclampsia and a matched control population. Methodology A comparative observational study was conducted among 70 cases and 70 controls. Detailed history and general and obstetrical examinations were carried out. Data was extracted from case files, labor room, and ICU records. Maternal and fetal outcomes were noted from January 2023 to January 2024. Statistical software STATA 14.2 (StataCorp LLC, College Station, Texas, USA) was used for data analysis. Observational descriptive statistics and chi-square and Fisher extract tests were applied. Results In our study, the incidence of eclampsia was 0.7% (70 per 1000 live births). The maternal mortality rate was 102.8/100000 live births and the perinatal mortality rate was 10.2/ 1000 live births in our study. The study observed a relatively young aged population and a significant bulk of cases belonged to late gestation or post-partum. Events like HELLP syndrome, abruption, liver, and renal failure were found to be frequently linked to eclampsia. Neonatal asphyxia (P-0.005), NICU requirement 41.43% vs 29% (P<0.01) preterm delivery 45.7% vs 14% (P=<0.001), and low birth weight were more commonly observed among the cases than the controls. Conclusions Eclampsia was found to be a significant contributor to elevated rates of morbidity and mortality in mothers and newborns. Poor antenatal care, severe anemia, and late referrals were some of the modifiable risk factors. Health care and economic burden on society is immense due to the significant utilization of intensive care and high dependency units.
妊娠期并发高血压疾病给经济和医疗保健设施带来了巨大负担。子痫是孕产妇险些死亡的临床标志之一。为了实现最佳结局,应在基层医疗和三级医疗层面共同努力。本研究旨在比较子痫患者与匹配的对照人群的母婴结局。
对70例病例和70例对照进行了一项比较观察性研究。进行了详细的病史采集以及全身和产科检查。数据从病例档案、产房和重症监护病房记录中提取。记录了2023年1月至2024年1月的母婴结局。使用统计软件STATA 14.2(美国德克萨斯州大学城StataCorp有限责任公司)进行数据分析。应用了观察性描述性统计以及卡方检验和费舍尔精确检验。
在我们的研究中,子痫的发病率为0.7%(每1000例活产中有70例)。本研究中的孕产妇死亡率为每10万例活产102.8例,围产儿死亡率为每1000例活产10.2例。研究观察到相对年轻的人群,且大部分病例属于妊娠晚期或产后。发现诸如HELLP综合征、胎盘早剥、肝肾功能衰竭等事件与子痫频繁相关。病例组新生儿窒息(P = 0.005)、入住新生儿重症监护病房的需求为41.43% 对比29%(P < 0.01)、早产率为45.7% 对比14%(P = 0.001)以及低出生体重的发生率均高于对照组。
子痫被发现是导致母亲和新生儿发病率和死亡率升高的重要因素。产前护理不佳、严重贫血和转诊延迟是一些可改变的风险因素。由于重症监护和高依赖病房的大量使用,给社会带来了巨大的医疗保健和经济负担。