[Post-partum eclampsia: epidemiology and prognosis]. / L'éclampsie du post-partum: épidémiologie et pronostic.

INTRODUCTION: The post-partum eclampsia occurs usually in the first 48 hours, its incidence is between 13 and 37% of all eclampsia. The goal of this prospective study was to analyse the epidemiologic data and the prognosis of this complication in the post-partum stage. MATERIALS AND METHODS: We enrolled between January 1st 2000 to December 31st 2003 all eclampsia admitted to the intensive care unit of the maternity of the university hospital centre Ibn Rochd of Casablanca, Morocco. We noted for each patient epidemiologic, clinical, biological and radiologic data. We releaved outcomoe also. Two groups are individualized: 1) group 1 (N=247): when eclampsia diagnosed in the prepartum stage; 2) group 2 (N=58): when crisis diagnosed in the post-partum stage. We compared the groups (student test), p<0.05 was significative. RESULTS: The incidence of eclampsia in the post-partum in this study was 19% (58 over 305). Eighty-two percent had the crisis in the first 24 hours; we noted a crisis in the sixth, seventh and lately in the sixtieth day. The major proportion of patients are nulliparous (64%), young (mean age: 24 years), without prenatal care, and has high blood pressure (48%), low GCS (mean: 12) and massive proteinuria>3 g/24 hours (37%). The post-partum eclampsia has best out come than these occurring in prepartum, with significantly (p<0.05) less high blood pressure, hellp syndrome and less placental abruption. CONCLUSION: Eclampsia is still frequent in our service; it seems less bad when occurring in the post-partum stage. We must give more attention for severe preeclamptic patient in this period.

[Liver rupture in peripartum: about 8 cases]. / Rupture du foie en péripartum: à propos de huit cas.

OBJECTIVES: Subcapsular liver hematoma (SLH) is a serious complication of the preeclampsia and HELLP syndrom. We report eight cases, and we'll precise circumstances of occurrence of this complication, its management and its prognosis. MATERIALS AND METHODS: Between January 2000 and December 2005, we enrolled eight patients with SLH cases in the intensive care unit of maternity's Ibn Rochd university hospital in Casablanca, Morocco. RESULTS: The patients are 22 to 41-years-old; six are multiparous, without prenatal care. All are preeclamptic. We diagnosed the SLH in prepartum stage in one case, in operating room in five cases and in post partum stage in two cases. We established blood pressure and homeostasis disturbances, the surgeon made packing for six patients with hepatic artery ligature in two cases. In two other patients, we did only medical care. We noted five deaths, four after hematoma rupture. CONCLUSION: These results were compared with literature, we need to look for this complication in all-severe preeclampsia with HELLP syndrome, and treat all haemostatic disorders.