29 A 4 year review of eclampsia managed in the intensive care unit; Lesson learnt

Autor: Olusola Idowu, Ajibola Otegbeye
Rok vydání: 2016
Předmět:
Zdroj: Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health. 6:191
ISSN: 2210-7789
DOI: 10.1016/j.preghy.2016.08.111
Popis: Introduction Eclampsia is a clinical condition seen in obstetrics. It is diagnosed when women with pre-eclampsia develop fits. Its an obstetric emergency seen in 1.7/1000 births in our part of the world. Mortality is quite high accounting for 25% of maternal mortality. This is a retrospective criteria based clinical audit which evaluated women admitted into the ICU with eclampsia. The objective is to identify causes of mortality and evaluate the outcome of the ICU interventions. Method Patients admitted into the ICU over April 2011–April 2014 were evaluated using their case notes and treatment charts. Variables studied include bio-data, type of eclampsia, antenatal booking status, glasgow coma scale on admission. Interventions like use of mannitol, transfusion, mechanical ventilation were also analysed. Outcome is either death or discharged. The variables were analysed to see if they have a relationship with outcome. SPSS version 20 was used for analysis. Chi-square was used to determine prognosis and pvalue less than 0.05 was significant. Result A total of 83 patients were admitted. Mean age is 31.5 years. 59 (71.1%) had antepartum eclaampsia, 24 (28.9%) had postpartum eclampsia. 53 (63.9%) were dischaged to the ward while 30 (36.1%) died. It was commoner in the unbooked patients (79.5%) and in the age group 26–35 (51.8%). Admitting GCS was 3–7 in 20 (26.7%), 8–12 in 28 (37.3%) and 13–15 in 37 (22.5%). They all had magnessium sulphate. The use ofmannitol, mechanical ventilation, blood transfusion were all found to have an influence on the outcome. Autopsy showed intra-cerebral hemorrhage as a leading cause of death. Conclusion This study shows the trend of Eclampsia in Nigerian women. It shows there’s high mortality despite specialized care. Mortality was higher in the unbooked population. Centers are advised to draw a protocol to determine ICU admission and optimise care. Research should continue into reducing mortality. Reference 1. B.C. Ozumbia, A.I. Ibe, Eclampsia in Enugu, Eastern Nigeria, Acta Obstetric Gynecol. Scand., 72 (3) (1993) 189–192.
Databáze: OpenAIRE
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