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Peculiarities of Anesthesia-Resuscitation and the Prognostic Factors of Morbidity and Mortality of Eclampsia

DOI : https://doi.org/10.36349/easjacc.2021.v03i05.002
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Introduction: Eclampsia, a major neurological complication of pre-eclampsia, is defined by a convulsive manifestation and /or consciousness disorder occurring in a preeclampsia context and cannot be attributed to a pre-existing neurological problem. Pre‐eclampsia is a leading cause of maternal morbidity and mortality. Substandard care is often present and many deaths are preventable. Objective: To assess the peculiarities of anesthesia-resuscitation and the prognostic factors of morbidity and mortality of eclampsia. Materials and Methods: This is a retrospective, descriptive and analytical study of all patients admitted for eclampsia from January to December, 2020 in the intensive care unit of the Department of Anaesthesia, Chattogram Maa-O-Shishu Hospital Medical College, Chattogram, Bangladesh. All patients admitted to resuscitation for management of eclampsia were included. The diagnosis of eclampsia was based on the occurrence of peripartum seizures in a woman whose history and examination revealed no other cause for the convulsion. All patients with eclampsia were treated according to the management protocol, namely: stabilization (peripheral venous catheter, oxygen therapy, Guedel cannula, lateral safety position, standard monitoring), administration of 4gSMgO4 in 20 minutes then 1g/h for 48h, control of arterial hypertension/Nicardipine, childbirth by the quickest method, admission for resuscitation. All patients had blood samples analyzed for: azotemia, creatinine, blood count with platelet count, hemostasis balance (TP and INR, TCA), bilirubinemia and liver aminotransferases. Results: We collected 51 cases of eclampsia for 4550 deliveries in the study. The average age of the patients was 22.23 years. Primiparity was found in 28 patients (54.9%). Antenatal consultations were effective in 4 patients (7.8%). Consciousness was clear at admission in 42 patients (82.36%) and for one patient a Glasgow score <8 was reported (1.96%). Severe hypertension was ........

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Dr. Afroza Begum

Lecturer, Dept. of Pharmacology and Therapeutics, Shaheed Monsur Ali Medical College & Hospital, Uttara, Dhaka-1230, Bangladesh

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