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 of <0.05 was considered statistically significant. The incidence of early-onset severe preeclampsia and eclampsia at the unit was 1.0%. There was a statistically significant difference between place of dwelling and maternal complications, with urban dwellers suffering more complications. Tests of association were done between various variables and fetal survival to discharged home showed the following associations; gestational age, mother’s booking status, mother’s systolic blood pressure and diastolic blood pressure, receiving corticosteroid therapy and fetal birth weight.