FREQUENCY OF PRIMIGRAVIDA IN PATIENTS WITH ECLAMPSIA

Authors

  • Faiza Department of Obstetrics and Gynaecology, Ayub Medical College,l Abbottabad
  • Ruqqia Sultana Department of Obstetrics and Gynaecology, Ayub Medical College, Abbottabad
  • Jawaris Batool Department of Obstetrics and Gynaecology, Ayub Medical College,l Abbottabad
  • Shah Khalid Department of Neurosurgery Ayub Medical College Abbottabad
  • Abdul Majid Khan Deaprtment of Emergency Ayub Teaching Hospital, Abbottabad

DOI:

https://doi.org/10.55519/JAMC-02-11489

Keywords:

eclampsia, primigravidas.

Abstract

Background: Pregnancy-induced hypertension (PIH) occurs in about 5% of pregnancies and is a major cause of high perinatal and maternal morbidity and mortality. In several international studies, primigravidas were associated with a significantly higher incidence of eclampsia. The local studies so far have a small sample size and mainly focus on preeclampsia in all pregnant women. limited data is available on the frequency of eclampsia in primigravidas in our population. This study aims to determine the frequency of primigravidas in patients with eclampsia after 20 weeks of gestation. Methods: This descriptive Cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital Abbottabad from 7/10/2020 to 7/4/2021. A total of 134 patients were observed. Diagnosis of eclampsia was based upon obstetrical history, presence of fits or coma, raised blood pressure and presence of proteinuria on urine complete examination. Immediate management included stabilizing the patient and delivery by Induction of labour or Caesarean section. The guardians of the patients explained the purpose and the benefits of the study and informed written consent was taken. Results:  Our study shows that among 134 patients, 96(72%) patients were in the age range of 18–27 years while 38 (28%) patients were in the age range of 28–35 years. The mean age was 30 years with SD±10.94.  Eighty-two (61%) patients had a POG range ≤34 weeks while 52 (39%) patients had a POG range >34 weeks. Forty-eight (36%) patients had BMI <27 Kg/m2 while 86 (64%) patients had BMI >27 Kg/m2. Fifty-six (42%) patients had a positive history of hypertension while 78(58%) patients had a negative history of hypertension. Out of 134 patients 102(76%) were primigravidas while 32(24%) were multigravidas. Conclusion: Our study concludes that the frequency of primigravidas was 76% in patients with eclampsia after 20 weeks of gestation presenting at tertiary care hospital Abbottabad.

References

Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive Disorders of Pregnancy: ISSHP Classification, Diagnosis, and Management Recommendations for International Practice. Pregnancy Hypertensions 2018;72(1):24–43.

Luger RK, Kight BP. Hypertension in Pregnancy. StatPearls. 2022.

Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol 2013;170(1):1–7.

Berhe AK, Kassa GM, Fekadu GA, Muche AA. Prevalence of hypertensive disorders of pregnancy in Ethiopia: a systemic review and meta-analysis. BMC Pregnancy Childbirth 2018;18(1):34.

Wagnew M, Dessalegn M, Worku A, Nyagero J. Trends of preeclampsia/eclampsia and maternal and neonatal outcomes among women delivering in addisababa selected government hospitals, Ethiopia: a retrospective cross-sectional study. Pan Afr Med J 2016;25(Suppl 2):12.

Belay AS, Wudad T. Prevalence and associated factors of pre-eclampsia among pregnant women attending anti-natal care at Mettu Karl referral hospital, Ethiopia: a cross-sectional study. Clin Hypertens 2019;25(1):14.

Endeshaw G, Berhan Y. Perinatal Outcome in Women with Hypertensive Disorders of Pregnancy: A Retrospective Cohort Study. Int Sch Res Notices 2015;2015:208043.

Deepak A, Reena R, Anirudhan D. Fetal and maternal outcome following expectant management of severe preeclampsia remote from term. Int J Reprod Contracept Obstet Gynecol 2017;6(12):5420–5.

Tukur J, Umar BA, Rabi'u A. Pattern of eclampsia in a tertiary health facility situated in a semi-rural town in Northern Nigeria. Ann Afr Med 2007;6(4):164–7.

Xiong X, Demianczuk NN, Saunders LD, Wang FL, Fraser WD. Impact of preeclampsia and gestational hypertension on birth weight by gestational age. Am J Epidemiol 2002;155(3):203–9.

Muhe LM, McClure EM, Nigussie AK, Mekasha A, Worku B, Worku A, et al. Major causes of death in preterm infants in selected hospitals in Ethiopia (SIP): a prospective, cross-sectional, observational study. Lancet Glob Health 2019;7(8):e1130–8.

Thadhani R, Mutter WP, Wolf M. First trimester placental growth factor and soluble fms-like tyrosine kinase 1 and risk for preeclampsia. J Clin Endocrinol Metab 2004;89(2):770–5.

Bills V, Salmon A, Harper S. Impaired vascular permeability regulation caused by the VEGF (165) b splice variant in pre-eclampsia. BJOG 2011;118(10):1253–61.

Delmis J. Hypertension in pregnancy. Lijec Vjesn 2006;128(11-12):357–68.

Levine RJ, Lam C, Qian C. Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. N Engl J Med 2006;355(10):992–1005.

Venkatesha S, Toporsian M, Lam C, Hanai J, Mammoto T, Kim YM, et al. Soluble endoglin contributes to the pathogenesis of preeclampsia. Nat Med 2006;12(6):642–9.

Additional Files

Published

2023-04-17