Evaluation of Maternal Complications in Severe Preeclampsia in a University Hospital in Tirana
BACKGROUND: Preeclampsia is a hypertensive multisystem disorder of pregnancy that complicates up to 10% of pregnancies worldwide and is one of the leading causes of maternal and perinatal morbidity and mortality.
AIM: To evaluate maternal complications associated with severe preeclampsia.
METHODS: This is a retrospective cross-sectional study conducted in the UHOG â€œKoÃ§o Gliozheniâ€, in Tirana. Primary outcomes evaluated: maternal death, eclampsia, stroke, HELLP syndrome, and pulmonary edema. Secondary outcomes: renal failure, admission in ICU, caesarean section, placental abruption, and postpartum hemorrhage. Fisherâ€™s exact test and Chi-squared test were used as statistical methods.
RESULTS: In women with severe preeclampsia we found higher rates of complications comparing to the group with preeclampsia. Eclampsia (1.5% vs. 7.1%, P < 0.001), HELLP syndrome (2.4% vs. 11.0%; P < 0.001), stroke (0.5% vs 1.9%, P = 0.105) pulmonary edema (0.25% vs. 1.3%, P = 0.0035), renal failure (0.9% vs. 2.6%, P = 0.107), admission in ICU (19.5% vs. 71.4%, P = 0.007), caesarean section rates (55.5% vs. 77%, P = 0.508), placental abruption (4.3% vs. 7.8%, P = 0.103) and severe postpartum hemorrhage (3.2% vs. 3.9%, P = 0.628).CONCLUSION: Severe preeclampsia is associated with high rates of maternal severe morbidity and early diagnosis and timely intervention can prevent life treating complications.
Plum Analytics Artifact Widget Block
Roberts JM, August PA, Bakris G, Barton JR, Bernstin IM. The American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Hypertension in Pregnancy. Obstetrics & Gynaecology. 2013;122(5):1122-1131.
Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P, et al. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Can. 2014;36(5):416â€“438.
Davey DA1, MacGillivray I. The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol. 1988;158(4):892-8.
Brown MA, Lindheimer MD, de Swiet M, Van Assche A, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy. Hypertens Pregnancy. 2001;20(1):9-14.
American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122:1122.
Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33:130â€“137.
Turner JA. Diagnosis and management of preeclampsia: an update. Int J Women's Health. 2010;2:327â€“337.
Sibai BM, Ramamdan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with HELLP syndrome. Am J Obstet Gynecol. 1993;169:1000-6.
Rath W, Faridi A, Dudenhausen JW. HELLP syndrome. J Perinat Med. 2000;28:249.
Sibai B.M. Diagnosis, controversies, and management of the sindrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103:981â€“991.
Rattray DD, O'Connell CM, Baskett TF. Acute disseminated intravascular coagulation in obstetrics: a tertiary centre population review (1980 to 2009). J Obstet Gynaecol Can. 2012;34:341.
Liu Ching-ming, Cheng Po-Jen, Chang Shuenn-Dyh. Maternal complications and perinatal outcomes associated with gestational hypertension and severe preeclampsia in Taiwanese women. J Formos Med Assoc. 2008;107(2):129â€“138.
Murphy DJ, Stirrat GM. Mortality and morbidity associated with early-onset preeclampsia. Hypertens Pregnancy. 2000;19(2):221â€“231.
Yen TW, Payne B, Qu Z, Hutcheon JA, Lee T, Magee LA, et al. Using clinical symptoms to predict adverse maternal and perinatal outcomes in women with preeclampsia: data from the PIERS (Pre-eclampsia Integrated Estimate of RiSk) study. J Obstet Gynaecol Can. 2011;33:803â€“9.
YÄ±ldÄ±rÄ±m G, GÃ¼ngÃ¶rdÃ¼k K, Aslan H, GÃ¼l A, Bayraktar M, Ceylan Y. Comparison of perinatal and maternal outcomes of severe preeclampsia, eclampsia, and HELLP syndrome. J Turkish-German Gynecol Assoc. 2011;12(2):90-96.
Tuffnell DJ, Jankowicz D, Lindow SW, Lyons G, Mason GC, Russell IF, Walker JJ, and On behalf of the Yorkshire Obstetric Critical Care Group. Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003. BJOG: An International Journal of Obstetrics & Gynaecology. 2005;112: 875â€“880.
All rights reserved.