Determinants of eclampsia in women with severe preeclampsia at Mpilo Central Hospital, Bulawayo, Zimbabwe.

From PubMed via Jisc Publications RouterHistory: received 2020-12-04, accepted 2021-07-15Publication status: aheadofprintGlobally, preeclampsia is a significant contributor to adverse maternal outcomes. Once women develop eclampsia, they face considerable risks especially in countries with limited resources to deal with such a life-threatening complication. This study was carried out to investigate determinants of eclampsia in pregnant mothers with severe preeclampsia. This institutional based study was completed at Mpilo Central Hospital, a quaternary referral unit from 1st January 2016 - 31st December 2018. In this study, pregnant women with severe preeclampsia/eclampsia were the study participants. The independent variables included socio-demographic and clinical characteristics, and maternal outcomes. Multivariable logistic regression analyses were used to determine independent association with p < 0.05 taken as statistically significant with 95% Confidence Interval (CI). Eclampsia. Development of eclampsia was more frequent in women aged 14-19 years compared to women aged ≥ 35 years (adjusted odds ratio (AOR) 6.64, 95% CI 1.20-22.06, p = 0.02) and in primiparous women compared to women with parity ≥ 3 (AOR 2.76, 95% CI 1.48-5.15, p = 0.001). Eclampsia was more frequent in women with diastolic blood pressure of 131-150 mmHg (AOR 5.48, 95% CI 1.05-28.75, p = 0.04), and ≥ 150 mmHg (AOR 5.78, 95% CI 1.05-31.78, p = 0.04) compared with those with diastolic blood pressure of ≤ 110 mmHg. Symptoms of visual disturbances were also associated with eclampsia (AOR 2.13, 95% CI 1.08-4.18, p = 0.03). This study has identified independent determinants of eclampsia which can be used to identify which women should receive magnesium sulphate prophlyaxis or more intensive monitoring to prevent deterioration in maternal condition. [Abstract copyright: Copyright © 2021 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.

Early onset preeclampsia and eclampsia in low-resource settings

This was a retrospective cross-sectional study carried out at Mpilo Central Hospital a government teaching and tertiary referral centre. It covered the period from February 1, 2016 to July 30, 2018. The aim of the study was to assess the incidence of early-onset severe preeclampsia and eclampsia in a low-resource setting and associated factors. Early-onset severe preeclampsia was diagnosed in those patients with high blood pressure(SBP ≥160, DBP ≥110mmHg) and either severe headaches, epigastric pain and deranged biochemical/haematological blood indices. Eclampsia was diagnosed in women who had a grand mal seizure with features of preeclampsia and no previous history of a seizure disorder such as epilepsy. Women with such history were excluded from the study. All women who were between 20-33+6weeks' of gestation and met the above criteria were included in the study. Early neonatal death was recorded within 7 days of birth. A paper data collection tool was used to collect information from the labour ward delivery registers, perinatal registers and mortality registers. Data were also collected from neonatal intensive care unit and special care baby unit. Hospital case notes were retrieved and data collected from there as well. The data tool collected maternal, fetal and neonatal demographic, clinical and out-come information. Data were entered into Microsoft Excel Inc., then exported to SPSS 20 for analysis. Data cleaning and coding were done in SPSS Version 20 before final analysis. Simple descriptive statistics were performed and presented as frequencies and percentages for categorical variables. Continuous variables were checked for normality using Shapiro Wilk test. Mean and standard deviation(SD) were reported for normal data. Tests of association between variables were performed using Pearson chi-square and Fisher’s exact tests. A p value o