exudates and Eclampsia

To ascertain the characteristics, clinical features, and maternal fetal outcome in eclampsia in a tertiary referral center with 24 000 deliveries per year.. This is a cross-sectional study, in which 50 case notes were retrieved retrospectively and data was analyzed descriptively.. Eclampsia was significant in the Malay primipara patients (n = 14, P = 0.034) and the 20-24-year-old primipara patients (n = 11, P = 0.01). Most were significantly antepartum (64%) and preterm seizures (68%), and 16% were early onset (<31 weeks). Two-thirds were booked and one-third were inpatients. Twenty per cent did not have hypertension or pre-eclampsia antenatally. Most presented with headache (66%) and hyper-reflexia (48%). Only 16% presented with all three prodromal symptoms and 14% were asymptomatic. Half had diastolic blood pressure (DBP) of <110 mmHg and the level of DBP was not significantly associated with the presence of prodromal symptoms and signs. There was increased morbidity, operative intervention, admission to intensive care and more low birth weight babies. Most babies that weighed <2.5 kg had poor Apgar score at 1 min, but most babies had good Apgar score at 5 min (16 babies >2.5 kg, 22 babies < or =2.5 kg, P = 0.006). The corrected perinatal mortality was 40/1000.. There was increased maternal and perinatal morbidity but no maternal mortality. Contributing factors are the atypical presentation, early onset of disease and the absence of risk factors. There is a need to develop new methods to identify this group of patients in an effort to further reduce the prevalence of this dangerous condition.

Topics: Adult; Apgar Score; Birth Weight; Cross-Sectional Studies; Eclampsia; Female; Hospitals, Maternity; Humans; Malaysia; Medical Records; Pregnancy; Pregnancy Outcome; Prevalence; Retrospective Studies

A review of eclampsia in Kelantan was undertaken from 1983-1988. There were 146 documented cases in the state (66 per 100,000 deliveries). Eight maternal deaths occurred. Sixty seven (45.9%) were primigravida. Six of the 79 multiparous women developed eclampsia for the first time following remarriages to new partners. The multisystem dysfunction resulting from eclampsia resulted in varied maternal complications. Fatal cerebral haemorrhage (3 cases), acute pulmonary oedema (8 cases), acute renal failure (6 cases), HELLP Syndrome (8 cases) and acute abruptio placentae were the commoner complications. The average number of convulsions per patient was 1.3. The mean gestation of mothers who delivered prematurely (28.2%) was 34.6 weeks and that for those at term (71.8%) was 39.1 weeks. The caesarean section rate was 42.5%. The perinatal mortality rate was 185.9 per 1000. The implications of this high maternal and fetal mortality and morbidity are discussed in the light of the health delivery system and patient education. A team approach to medical management of eclampsia with the need for intensive care monitoring is suggested.

Topics: Adolescent; Adult; Eclampsia; Female; Humans; Incidence; Malaysia; Pregnancy; Pregnancy Outcome; Seizures

Topics: Adolescent; Adult; Eclampsia; Female; Humans; Infant Mortality; Malaysia; Maternal Mortality; Pregnancy; Prognosis

Topics: Abortion, Septic; Adolescent; Adult; Eclampsia; Female; Health Education; Hospitals, Teaching; Humans; Malaysia; Maternal Mortality; Middle Aged; Pregnancy; Socioeconomic Factors

Topics: Adult; Africa; Asia; Australia; Body Height; Body Weight; Deficiency Diseases; Diet Therapy; Eclampsia; Edema; Epidemiologic Methods; Europe; Female; Humans; Hypertension; Israel; Jamaica; Kidney Diseases; Malaysia; Maternal Age; Maternal Mortality; New Zealand; Pre-Eclampsia; Pregnancy; Proteinuria; Racial Groups; Social Class; Socioeconomic Factors; South America; Trinidad and Tobago; United States; USSR; Warfare

Topics: Aging; Birth Weight; Cesarean Section; Delivery, Obstetric; Dystocia; Eclampsia; Female; Fetal Death; Humans; Infant; Infant Mortality; Malaysia; Maternal Mortality; Nutritional Physiological Phenomena; Nutritional Sciences; Obstetric Labor Complications; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Prenatal Care; Social Conditions; Statistics as Topic