A prospective review of eclampsia at a regional hospital, eastern Ethiopia: incidence, clinical correlates, management and pregnancy outcome

Objective: The aims of the study were to determine the incidence of eclampsia and describe its clinical correlates and pregnancy outcomes.Patients and Methods: A one-year prospective study of 93 cases of eclampsia using a structured questionnaire which included socio-demographic data, clinical presentation, work-up, management and feto-maternal outcomes was done at Karamara Regional Hospital, Eastern Ethiopia.Results: The incidence of eclampsia was 2.7% (93 in 3500 deliveries). Most of the cases were young (45%), nulliparous (70%) women who had not received any antenatal care (63%). Almost two thirds of the women (n=57, 61%) presented with eclampsia in antepartum, whereas 26 cases (28%) occurred in intrapartum, and there were 10 cases (11%) with eclampsia postpartum. Preceding symptoms were reported in 78.5 % of patients with severe hypertension recorded in 66%. The average gestational age at presentation was 32 weeks. Hydralazine was used for emergency control of hypertension in 91% of the cases. Magnesium was administered to 92 (99%) of the patients. Delay greater than 12h from admission to delivery occurred in 45% of the women with eclampsia. Cesarean section (CS) was performed in 14 (17%) and instrumental delivery in 15 (18%). The maternal and perinatal case fatality rates of eclampsia were 34.7% and 11% respectively.Conclusion: The incidence of eclampsia was very high with corresponding high maternal and perinatal deaths. The presentation of patients was late and the work up and management of cases substandard. Hence capacity building of health facilities, implementation of standard guidelines and criteria based auditing are recommended

Anestesia para pacientes de alto riesgo obstétrico Instituto Materno Infantil IMI

La mortalidad materna en el mundo es de 250/100.000 nacidos vivos (25). Ocupando los trastornos hipertensivos del embarazo un lugar preferencial como factor causante. Se puede inferir que esto es un reflejo de la falta de control prenatal y cuidados adecuados de las mujeres embarazadas en los países en vía de desarrollo. En este artículo se revisa la etiología, fisiopatología, clasificación y manejo anestésico aplicado en estas pacientes, en el Insitituto Materno Infantil (IMI) de la ciudad de Santa Fé de Bogotá, Colombia

Anestesia en preeclampsia severa-eclampsia / Anestethic management in pregnancy induced hypertencion

Se describe el tratamiento anestésico, sus complicaciones y la influencia sobre el bienestar materno y neonatal de pacientes con preeclampsia severa o eclampsia, en un estudio retrospectivo de 283 registros anestésicos de 6 meses de atención obstétrica. Se clasificaron de acuerdo a gravedad y respuesta al tratamiento médico en: toxemia severa no compensada (TSNC); toxemia severa compensada (TSC); inminenciaa de eclampsia (IE) y eclampsia (E) . En la selección de anestesia predominó la técnica regional en los grupos TSNC, TSC e IE con 83 por ciento, 88 por ciento y 52 por ciento respectivamente. En E más del 92 por ciento recibió anestecia general. Las complicaciones observadas fueron: descensos tensionales, anestesia regional insuficiente, intubación arotraqueal traumática, broncoespasmo y crisis convulsivas preanestésicas usadas. El bienestar materno ( Aldrete de 8 o más), la TSNC logró promediar 77 por ciento, la TSC 80 por ciento y la E 50 por ciento siendo mejor bajo anestesia general. La IE con 80 por ciento pero mejor bajo anestesia regional.