A Prospective study of Fetomaternal Outcome in Severe Pre-Eclampsia

BACKGROUND: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. In India, they account for the third most important cause of maternal mortality. The objective of this study was to evaluate maternal and perinatal outcome and complications in cases with severe preeclampsia. METHODS: A prospective study was carried out on 300 women with severe preeclampsia in Government Raja Mirasudhar Hospital, Thanjavur Medical College, Thanjavur over a period of 18 months. Only those cases with initial B.P reading of ≥160/110 mm Hg and presenting with features of severe pre eclampsia were included in the study. Investigations and management were carried out as per standardized department protocol and maternal and fetal outcomes were analyzed. RESULTS: 66.4% of the cases were in the age group of 21-30 years, nearly 60% were primigravidae and the majority were referred from peripheral hospitals. Liver function tests were deranged in 24.6% of the patients, 22% had abnormal renal function and 12.3% had altered coagulation profile. Labetalol was the most commonly used antihypertensive and magnesium sulphate was the anticonvulsant used in all the cases. Lower segment caesarean section was the mode of delivery in 51.3% of the cases. Commonest maternal complication was atonic PPH. There were 3 maternal mortality cases. 43% of the cases had a preterm delivery and 61% of the babies needed NICU admission. There were 12 % neonatal deaths. CONCLUSIONS: Accessible health care and health education and awareness regarding antenatal check-ups for all women will lead to early detection of severe preeclampsia. Prompt treatment and management of its complications will certainly improve the maternal and fetal outcome