Title: Morbidity and mortality associated with pre-eclampsia at two tertiary care hospitals in Sri Lanka.

POPLINE Document Number: 314471

Author(s):

Dissanayake VH
Samarasinghe HD
Morgan L
Jayasekara RW
Seneviratne HR

Source citation:

Journal of Obstetrics and Gynaecology Research, 2007 Feb;33(1):56-62.

Abstract:

The aim was to report the occurrence of morbidity and mortality associated with carefully phenotyped pre-eclampsia in a sample of nulliparous Sinhalese women with strictly defined disease. A phenotyping database of 180 nulliparous women with pre-eclampsia and 180 nulliparous normotensive pregnant women who were recruited for a study into genetics of pre-eclampsia was analyzed. Women who developed pre-eclampsia had significantly higher systolic blood pressure (SBP; P = 0.002) and diastolic blood pressure (DBP; P = 0.002) at booking (at approximately 13 weeks of gestation). 38.3%, 28.3% and 33.3% of women delivered at < 34 weeks, at 34--36 weeks, and at term, respectively. 78% required a cesarean section. Complications included SBP = 160 mmHg (75.5%); DBP = 110 mmHg (83.8%); proteinuria = 3 + (150 mg/dL) in the urine protein heat coagulation test (87%); renal failure requiring dialysis (2%); platelet counts < 100 x 10/9/L (13%); = 70 U/L in aspartate and/or alanine aminotransaminase (15%); placentalabruption (4%); eclampsia (9%); and one maternal death. Maternal complications indicative of severe disease, apart from the incidence of SBP = 160 mmHg and DBP = 110 mmHg, were not significantly different in early and late-onset pre-eclampsia; fetal outcome was better with late-onset disease. 48% of babies were small for gestational age. Only 80 of 135 babies of women with pre-eclampsia whose condition could be confirmed at 6 weeks post-partum were alive. Pre-eclampsia in Sinhalese women is associated with severe maternal morbidity and fetal morbidity and mortality, suggesting that modification of the Western diagnostic criteria and/or guidelines for medical care may be necessary. There is an urgent need to improve neonatal intensive care services in Sri Lanka. (author's)

Keywords:

Sri Lanka
Research Report
Prospective Studies
Pregnant Women
Hospitals
Mortality
Nulliparity
Gestational Age
Preeclampsia
Treatment
Blood Pressure
Morbidity
Developing Countries
Asia, Southern
Asia
Studies
Research Methodology
Population Characteristics
Demographic Factors
Population
Health Facilities
Delivery of Health Care
Health
Population Dynamics
Parity
Fertility Measurements
Fertility
Fetus
Pregnancy
Reproduction
Pregnancy Complications
Diseases
Medical Procedures
Medicine
Health Services
Hemic System
Physiology
Biology