MAGNITUDE OF PREECLAMPSIA AND ITS MATERNAL AND PERINATAL OUTCOMES

Abstract

Abstract BACKGROUND: Preeclampsia is a form of hypertension that is unique to human pregnancy. Preeclampsia refers to the new onset of hypertension and proteinuria after 20 weeks of gestation. It is a leading cause of maternal and perinatal morbidity and mortality worldwide. It affects 10% of pregnancies worldwide. Perinatal complications of severe preeclampsia include prematurity and its complication related to preterm labor or iatrogenic intervention, intrauterine growth restriction and perinatal death. Hence, this study is focused on determining the overall prevalence of preeclampsia and its maternal and perinatal outcomes. OBJECTIVES: To study the overall prevalence of preeclampsia and assess the relation between the study variables and determine the maternal and perinatal outcomes of preeclampsia in SPHMMC, Addis Ababa. METHOD: A hospital based descriptive cross-sectional study was conducted based on the medical records of the study population. Systematic random sampling method was used and data was collected to a prepared data collection template and then fed to SPSS version 20.0 for windows and frequencies numbers and percentages and cross-tab were done. RESULTS: There were a total of 1042 cases of preeclampsia from all 13,500 deliveries attended in the hospital which makes the overall prevalence rate to be 7.71%. 25% (261) cases were selected for further investigation of the maternal and perinatal complications. The mean age of mothers who was preeclamptic is 27.5 years (SD=4.99).59.8% of the mothers were found to be primigravid. The mean gestational age at diagnosis of PE was 32.7 weeks. Whereas the mean age of termination is 32.01 weeks. Cesarean delivery accounts for 52.9% of all the deliveries and operative vaginal deliveries account only for 2.3% of deliveries. Majority of the pregnancies were complicated by HELLP syndrome (44%) followed by eclampsia (30.2%). Other complications account for <10%. The mean gestational age of the neonates at delivery is 32 weeks and the mean birth weight is 2363±784 grams. Majority of the neonates were discharged along with their mothers while 10.6% of pregnancies end up in unsuccessful pregnancy outcomes. The study was done in St. Paul’s Hospital Millennium Medical College, Addis Ababa, from December – May of 2008EC. Conclusion: Prevalence of severe preeclampsia is progressively increasing among deliveries attended with increasing poor maternal and perinatal outcome; therefore it needs close monitoring and follow-up of high risk mothers in order to improve the quality of care given to our patients. Preeclampsia by itself and obstetric complications are major indications for cesarean deliveries among mothers who are having preeclampsia. Pregnancies complicated by hypertensive disorders of have poor maternal and perinatal outcomes and women from outside of Addis Ababa were more affected. Recommendation: Quality antenatal care services with good obstetric and neonatal care at delivery are essential for early recognition and management of preeclampsia. Key words: Retrospective Study, preeclampsia, Prevalence, ANC follow up.