Evaluation of Maternal Complications in Severe Preeclampsia in a University Hospital in Tirana

  • Eriseida Ndoni University Hospital of Obstetrics and Gynecology “Koço Gliozheni”, Tirana
  • Redi Hoxhallari Italian Clinic “San Antonio”, Tirana
  • Astrit Bimbashi University Hospital of Obstetrics and Gynecology “Koço Gliozheni”, Tirana
Keywords: severe preeclampsia, eclampsia, HELLP syndrome, stroke, pulmonary edema, maternal outcome

Abstract

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 “Koço 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. Fisher’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.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

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.

http://dx.doi.org/10.1097/01.AOG.0000437382.03963.88

PMid:24150027

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):416–438.

http://dx.doi.org/10.1016/S1701-2163(15)30588-0

Davey DA1, MacGillivray I. The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol. 1988;158(4):892-8.

http://dx.doi.org/10.1016/0002-9378(88)90090-7

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.

http://dx.doi.org/10.1081/PRG-100104165

PMid:12044323

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.

PMid:24150027

Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33:130–137.

http://dx.doi.org/10.1053/j.semperi.2009.02.010

PMid:19464502

Turner JA. Diagnosis and management of preeclampsia: an update. Int J Women's Health. 2010;2:327–337.

http://dx.doi.org/10.2147/IJWH.S8550

PMid:21151680 PMCid:PMC2990902

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.

http://dx.doi.org/10.1016/0002-9378(93)90043-I

Rath W, Faridi A, Dudenhausen JW. HELLP syndrome. J Perinat Med. 2000;28:249.

http://dx.doi.org/10.1515/JPM.2000.033

PMid:11031696

Sibai B.M. Diagnosis, controversies, and management of the sindrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103:981–991.

http://dx.doi.org/10.1097/01.AOG.0000126245.35811.2a

PMid:15121574

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.

PMid:22472333

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):129–138.

http://dx.doi.org/10.1016/S0929-6646(08)60126-6

Murphy DJ, Stirrat GM. Mortality and morbidity associated with early-onset preeclampsia. Hypertens Pregnancy. 2000;19(2):221–231.

http://dx.doi.org/10.1081/PRG-100100138

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;33:803–9.

PMid:21846435

Yıldırım G, Güngördük K, Aslan H, Gül 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.

http://dx.doi.org/10.5152/jtgga.2011.22

PMid:24591969 PMCid:PMC3939113

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: 875–880.

http://dx.doi.org/10.1111/j.1471-0528.2005.00565.x

PMid:15957986

Published
2016-02-24
How to Cite
1.
Ndoni E, Hoxhallari R, Bimbashi A. Evaluation of Maternal Complications in Severe Preeclampsia in a University Hospital in Tirana. Open Access Maced J Med Sci [Internet]. 2016Feb.24 [cited 2020Nov.29];4(1):102-6. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2016.025
Section
B - Clinical Sciences