Preeclampsa: Maternal and Fetal outcomes according to symptomatology and proteinuria at University Teaching Hospital, Lusaka
Chisoko, Ernest Chipampe
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Introduction: Hypertension is one of the common complications in pregnancy and contributes significantly to maternal and perinatal morbidity. Preeclampsia and eclampsia are common problems in pregnant women with a reported incidence of 2-8%. Both account for more than 50,000 maternal deaths worldwide each year. Proteinuria is one of the essential criteria for the clinical diagnosis of preeclampsia. Increasing levels of proteinuria is considered to be associated with adverse maternal and fetal Outcomes. The incidence of preeclampsia and eclampsia is 12% at UTH. Objectives: To determine the predictive value of symptomatology and proteinuria for maternal and fetal outcome in preeclamptic patients. Design: Prospective cohort study.Setting: The study was done within the department of obstetrics and gynecology at the University Teaching Hospital (UTH) Lusaka Zambia, from February 2012 to April 2012.Subjects: 162 patients were managed in the high dependant ward of the labour ward. Uniform management protocol, plus antihypertensive medications, were given to those with moderate preeclampsia and magnesium sulphate was added to those with severe preeclampsia and eclampsia. Main outcome measures: Poor maternal and fetal outcome. Results: Of 162 women with preeclampsia 37 (22.8%) had mild preeclampsia, 13 (8.0%) had moderate preeclampsia, 112 (69.1%) severe preeclampsia according to severity of blood pressure on admission. Univariate analysis showed that severe proteinuria, severe hypertension, fits with one or more central nervous system symptoms and a combination of epigastric pain and vomiting were significantly associated with a higher rate of maternal and fetal complication. Neurological complaints, epigastric pain and vomiting were found to be more common. Conclusions: Simple clinical symptomatology and proteinuria may be useful predictor for maternal and fetal outcomes in pregnancies complicated by preeclampsia.
- Medicine