1887
Volume 2019, Issue 1
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426

Abstract

Preeclampsia and eclampsia are two hypertensive disorders of pregnancy that significantly contribute to higher morbidity and mortality rates. Eclampsia is the occurrence of seizures in patients with preeclampsia without any previous history of seizure disorders. The incidence and prevalence of eclampsia varies, and there is scarce literature about the prevalence and trends of eclampsia in the Arabian Gulf countries. This study aimed to identify the incidence and changing trends of eclampsia in Qatar. This retrospective study was conducted at Hamad Medical Corporation, the only tertiary heathcare center in Qatar, and included all patients admitted with eclampsia from 1979 to 2017. The demographic data, maternal age, parity, gestational age, antenatal visits, timing of seizures, mode of delivery, treatment, maternal morbidity, and mortality were recorded. The study period was divided into the initial period of 1979–1988, 1991–2009, and the recent period of 2010–2017. Data analysis was performed using chi-square tests to identify trends among the three different periods. A value of ≤ 0.05 (two-tailed) was considered statistically significant. A total of 151 patients with eclampsia were admitted with an increasing incidence of eclampsia over time. There was a statistically significant improvement in antenatal follow-up and an increase in the maternal age of patients with eclampsia ( = 0.001). The incidence of eclampsia without proteinuria increased significantly over time ( = 0.03). Postpartum eclampsia was more common ( = 0.002). Labetalol was the most frequently used antihypertensive agent ( = 0.001), and magnesium sulfate has been increasingly used as an anticonvulsant agent ( = 0.001). The rate of maternal morbidity was decreasing, and in the recent period, posterior reversible encephalopathy syndrome was becoming a common comorbidity in patients with eclampsia. Maternal mortality displayed significant improvement, reaching 0% in the recent study period ( = 0.02). Perinatal mortality likewise displayed a decreasing trend and reached 3.17% in the recent period. The incidence of eclampsia is increasing in Qatar. The antenatal care of patients with eclampsia has improved significantly. The medical management of patients with eclampsia has also drastically improved, leading to a significant decrease in maternal mortality and improvement in perinatal outcomes.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2019.10
2019-09-20
2019-11-17
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2019/1/qmj.2019.10.html?itemId=/content/journals/10.5339/qmj.2019.10&mimeType=html&fmt=ahah

References

  1. Phipps E, Prasanna D, Brima W, Jim B. Preeclampsia: updates in pathogenesis, definitions, and guidelines. Clin J Am Soc Nephrol. 2016 Jun 6; 11:6:11021113.
    [Google Scholar]
  2. American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013 Nov; 122:5:11221131.
    [Google Scholar]
  3. Liu S, Joseph KS, Liston RM, Bartholomew S, Walker M, León JA, et al.  Incidence, risk factors, and associated complications of eclampsia. Obstet Gynecol. 2011 Nov; 118:5:987994.
    [Google Scholar]
  4. Miguil M, Chekairi A. Eclampsia, study of 342 cases. Hypertens Pregnancy. 2008; 27:2:103111.
    [Google Scholar]
  5. Ngwenya S. Severe preeclampsia and eclampsia: incidence, complications, and perinatal outcomes at a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe. Int J Womens Health. 2017 May 17; 9::353357.
    [Google Scholar]
  6. Sobande AA, Eskandar M, Bahar A, Abusham A. Severe pre-eclampsia and eclampsia in Abha, the south west region of Saudi Arabia. J Obstet Gynaecol. 2007 Feb; 27:2:150154.
    [Google Scholar]
  7. Mahran A, Fares H, El khateeb R, Ibrahim M, Bahaa H, Sanad A, et al.  Risk factors and outcome of patients with eclampsia at a tertiary hospital in Egypt. BMC Pregnancy Childbirth. 2017 Dec 22; 17:1:435.
    [Google Scholar]
  8. Fingar KR, Mabry-Hernandez I, Ngo-Metzger Q, Wolff T, Steiner CA, Elixhauser A, Delivery Hospitalizations Involving Preeclampsia and Eclampsia, 2005–2014: Statistical Brief #222. [Internet] Statistical Briefs. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006–2017 Apr. [updated 2019 May 20 and cited 2019 May 20]. Available from: www.ncbi.nlm.nih.gov/pubmed/28722848 .
  9. Babbar K, Armo M, Murthy M. Burden of Eclampsia: a persisting problem in the Developing countries. Int J Reprod Contracept Obstet Gynecol. 2015; 4:4:10291033.
    [Google Scholar]
  10. Chibber R, Al-Hijji J, Amen A, Fouda M, Kaleemullah ZM, El-Saleh E, et al.  Maternal and perinatal outcome of eclampsia over a decade at a tertiary hospital in Kuwait. J Matern Fetal Neonatal Med. 2016 Oct; 29:19:31323137.
    [Google Scholar]
  11. Al-Safi Z, Imudia AN, Filetti LC, Hobson DT, Bahado-Singh RO, Awonuga AO. Delayed postpartum preeclampsia and eclampsia: demographics, clinical course and complications. Obstet Gynecol. 2011 Nov; 118:5:11021107.
    [Google Scholar]
  12. Sibai BM, Stella CL. Diagnosis and management of atypical preeclampsia-eclampsia. Am J Obstet Gynecol. 2009 May; 200:5:481.e1-7.
    [Google Scholar]
  13. Douglas KA, Redman CW. Eclampsia in the United Kingdom. BMJ. 1994; 309::1395.
    [Google Scholar]
  14. Lamminpaa R, Vehuilinen-Julkumen K, Gissler M, Heinonen S. Preeclampsia complicated by advanced age: a registry- based study on primiparous women from Finland 1997–2008. BMC Pregnancy Childbirth. 2012 Jun 11; 12::47.
    [Google Scholar]
  15. Singh A, Shrivastava C. Changing trends in eclampsia and increasing cesarean delivery – an interesting retrospective study from a tertiary care hospital of Raipur, Chhattisgarh, India. Int J Reprod Contracept Obstet Gynecol. 2016; 5:4:10311035.
    [Google Scholar]
  16. Seal SL, Ghosh D, Kamilya G, Mukherji J, Hazra A, Garain P. Does route of delivery affects maternal and perinatal outcome in women with eclampsia? A randamoised controlled pilot study. Am J Obstet Gynecol. 2012; 206:6:484-e1.
    [Google Scholar]
  17. Duley L, Henderson-Smart DJ, Walker GJ, Chou D. Magnesium sulphate verses diazepam for eclampsia. Cochrane Database Syst Rev. 2010 Dec 8; 12:CD000127.
    [Google Scholar]
  18. Sibai BM. Magnesium sulfate prophylaxis in preeclampsia: lesson learned from recent trails. Am J Obstet Gynecol. 2004 Jun; 190:6:15201526.
    [Google Scholar]
  19. Magee LA, Cham C, Waterman EJ, Ohlsson A, von Dadelszen P. Hydralazine for treatment of severe hypertension in pregnancy. meta-analysis. BMJ. 2003 Oct 25; 327:7421:955960.
    [Google Scholar]
  20. Jido TA. Eclampsia: maternal and fetal outcome. Afr Health Sci. 2012 Jun; 12:2:148152.
    [Google Scholar]
  21. Pannu D, Das B, Hazari P, Shilpa . Maternal and perinatal outcome in eclampsia and factors affecting the outcome: a study in North Indian population. Int J Reprod Contracept Obstet Gynecol. 2014 Jun; 3:2:347351.
    [Google Scholar]
  22. Sibai BM, Sarinoglu C, Mercer BM. Eclampsia VII. Pregnancy outcome after eclampsia and long term prognosis. Am J Obstet Gynecol. 1992 Jun; 166:6 Pt 1:17571761 discussion 1761-3.
    [Google Scholar]
  23. Sibai BM. Diagnosis, prevention and management of eclampsia. Obstet Gynecol. 2005 Feb; 105:2:402410.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2019.10
Loading
/content/journals/10.5339/qmj.2019.10
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error