Severe Preeclampsia: Effect of Timing of Termination of Pregnancy on Maternal and Perinatal Outcome

Asfaw, Mariamawit (2014) Severe Preeclampsia: Effect of Timing of Termination of Pregnancy on Maternal and Perinatal Outcome. Masters thesis, Addis Ababa University.

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Introduction Maternal death as a result of preeclampsia/eclampsia is progressively increasing in Ethiopia; specifically Addis Ababa; contributing to the challage faced in meeting millennium development goal (MDG) 5.Preterm birth is amajor contributor for poor perinatal outcome in pregnancies complicated by severe preeclampsia and every effort should be made to prolong the pregnancy till a favorable gestational age is reached. In doing so, one needs to give due emphasis to decrease maternal mortality and morbidity. This makes management of pregnancies complicated by severe preeclampsia challanging. Objective The main objective of this study is to describe management option selected for pregnancies complicated by severe preeclampsia in the three teaching hospitals& relate it to maternal & perinatal outcomes at different gestational ages. Methods: A prospectivedescriptive cross sectional studywas conductedon women whose pregnancies complicated by severe preeclampsia and got managed at the three teaching hospitalsin Addis Ababa, Ethiopia; namely: TikurAnbesa Specialized Hospital (TASH), Ghandi Memorial Hospital (GMH), and Zewditu Memorial Hospital (ZMH) from May to July, 2014. Data was collected with a pre tested structured questionaire. Datawas entered; cleaned, coded& analyzed using Statistical package for social sciences (SPSS)version 20 and important conclusions and recommendations were generated. Results: There were a total of 3351 deliveries attended at the three teaching hospitals with prevalence of severe preeclampsia accounting for 279 (7.8%). Cases of merely severe preeclampsia were 135 (48.4%); 116 (41.6%)HELLP syndrome& 28 (10%) eclampsia. From those patients who presented at < 34 weeks; fifty two (50.5%) had their pregnancies terminated immediately while the remaining patients gained 10.1 days on average. There were 13 (26%) still births in those who presented at < 34 weeks and put under conservative management. Nineteen (37.3%) still births recorded in the same category of patients whose pregnancies were terminated immediately after admission. Risk of still birth was found to be significantly increased in those pregnancies that were conservatively managed. Conclusion: Prevalence of severe preeclampsia is progressively increasing with worsening of poor perinatal outcome especially for those presenting with sever preeclampsia remote from term that were managed conservatively. Therefore it is wise to revisit the selection criteria used for conservative management in order to improve feto-maternal outcome.

Item Type: Thesis (Masters)
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: Africana
Depositing User: Emmanuel Ndorimana
Date Deposited: 28 Nov 2018 11:07
Last Modified: 28 Nov 2018 11:07

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