Incidence and clinical aspects related to eclampsia at Hospital de Maternidad "Rafael Calvo" in Cartagena, Colombia 1995-2001
DOI:
https://doi.org/10.18597/rcog.641Keywords:
eclampsia, maternal mortality, HELLP syndrome, hypertension in pregnancy, premature detachment of placenta usually insertAbstract
The eclampsia is a pregnancy complication that generates some of the highest risks for the obstetric patient. The objective of this study was to identify the clinical and epidemiological characteristics associated with eclampsia at the Hospital de Maternidad "Rafael Calvo" in Cartagena, Colombia. This was a retrospective-descriptive study of patients with diagnosis of eclampsia between January 1, 1995 and June 31, 2001. A total of 73.947 childbirths were included in this analysis of those, 188 (0.25%) were diagnosed with eclampsia (1 case per 393 birth). Most of the patients were adolescents (58.5%), first-time mothers (64.4%), full term pregnancies (53.3%). Forty five percent did not have prenatal control. Positive correlation was found between the number of convulsions, patient's age, and gestational age. A great number of eclamptic women (86.2%) presented convulsions before childbirth and 89.4% among them gave birth in less than 12 hours after being admitted to the hospital (45.2%). Complications were present in 14.3% of the patients. HELLP syndrome (7%) and premature detachment of the placenta (3.1%) were the most frequent. The incidence of mortality was 2.2% and the eclampsia was the cause of 16% of all maternal deaths. Eclampsia may be prevented by good prenatal care, identification of the high-risk group, minimizing risk factors, and establishing active medical management to avoid the complications.Author Biographies
Álvaro Monterrosa Castro
Ana María Bello Trujillo
References
O'Down MJ, Philipp EE. The History of Obstetrics and Gynaecology. Eclampsia. Parthenon Publishing Group. T1; 1994.
Chesley LC. History and Epidemiology of Preeclampsia-Eclampsia. Clin Obstet Gynecol 1984;27(4) 801-20.
Chesley LC. A Short History of Eclampsia. Obstet Gynecol 1943;74:599.
Mattar F, Sibai BM. Eclampsia. VIII. Risk factors for maternal morbidity. Am J Obstet Gynecol 2000;182(2):307-12.
World Health Organization Collaborative Study of Hypertensive Disorders of Pregnancy. Geographic variation in the incidence of hypertension in pregnancy. Am J Obstet Gynecol 1988;158:80-3.
López-Lleras M. Main clinical types and subtypes of eclampsia. Am J Obstet Gynecol 1992;166:4-9.
Leitch CR. The changing pattern of eclampsia over a 60-year period. Br J Obstet Gynecol 1997;104(8):917-22.
Kirk D. Ramin MD. The prevention and management of eclampsia. Obstet Gynecol Clin North Am 1999;26(3) 489-503.
Cincotta R, Ross A. A review of eclampsia in Melbourne: 1978-1992. Aust N Z J Obstet Gynecol 1996;36(3):264-71.
Saflas AF, Olson DR, Franks AL, et al. Epidemiology and eclampsia in the United States, 1979-1986. Am J Obstet Gynecol 1990;163:460-465.
Sibai BM. Eclampsia. VI. Maternal-perinatal outcome in 245 consecutive cases. Am J Obstet Gynecol 1990;163:1049-54.
Pritchard JA, Cunningham FG, Pritchard SA. The Parkland Memorial Hospital protocol for treatment of eclampsia: evaluation of 245 cases. Am J Obstet Gynecol 1984;148:951-63.
Douglas KA, Redman CW. Eclampsia in the United Kingdom. BMJ 1994;309:1395-1400.
Monterrosa A. Eclampsia en el Hospital de Maternidad Rafael Calvo. Rev Colomb Obstet Ginecol 1989;40(3):235-44.
Duley L. Maternal mortality associated with hypertensive disorders of pregnancy in Africa, Asia, Latin America, and the Caribbean. Br J Obstet Gynecol 1992;99:547.
Cifuentes RB. Obstetricia de alto riesgo. 5ª ed. 2000. Cali: Editorial Catorce. p. 749-98.
Bautista AC. Obstetricia y ginecología. Santafé de Bogotá: Universidad Nacional, Instituto Materno Infantil Concepción Villaveces de Acosta, Editorial Lito Camargo. p. 525-32.
Chesley LC. Recognition of the long-term sequel of eclampsia. Am J Obstet Gynecol 2000;182(1 Pt 1):249-50.
Chesley LC, Cooper DW. Genetic of hypertension in pregnancy: Possible single gene control of preeclampsia and eclampsia in the descendants of eclamptic women. Br J Obstet Gynaecol 1986;93(9):898-908.
Arngrimsson R, Bjornsson S, Geirsson RT, Bjornsson H, Walker JJ, Snaedal G. Genetic and familial predisposition to eclampsia and preeclampsia in a defined population. Br J Obstet Gynecol 1990;97:762-769.
Dizon-Townsend D, Nelson I, Moline L, Easton K, Ward K. Severe Preeclampsia is associated with the factor V Leiden mutation. Am J Obstet Gynecol 1996;174:343-9.
Giraldo AC. Propuesta de manejo de la paciente con preeclampsia-eclampsia. Controversias en Gin/Ob 1998;2(7):24-34.
Bhagwanjee S, Paruk F, Moodley J, Muckart DJ. Intensive care unit morbidity and mortality from Eclampsia: an evaluation of the Acute Physiology and Chronic Health Evaluation II score and the Glasgow Coma Scale. Crit. Care Med 2000;28(1):120-4.
Arias F. Guía Práctica para el embarazo y el parto de alto riesgo. 2ª ed. Madrid: Mosby/Doyma Libro; 1994. p. 234-48.
Miles JF, Martin JN Jr, Blake PG, et al: Postpartum eclampsia: a recurring perinatal dilemma. Obstet Gynecol 1999;76:328-33.
Witlin AG, Saade GR, Mattar F, Sibai BM. Risk factors for Abruptio Placentae and eclampsia: analysis of 445 consecutively managed women with severe preeclampsia and eclampsia 1999;180(6 Pt1):1322-29.
Sheehan HL. Pathological lesions in the hypertension toxemia's of pregnancy. In: Hammond J, Browne FJ, Wolstenholme GEW, editors. Toxemia of pregnancy, human and veterinary. Philadelphia: Blakiston; 1950.
Govan ADT. The Pathogenesis of eclamptic lesions. Pathol Microbiol.1961;24:561-67.
Sibai BM, Sarinoglu C, Mercer BM. Eclampsia VII. Pregnancy outcome after eclampsia and long-term prognosis. Am J Obstet Gynecol 1992;166:1757-64.
Cunningham FG. Cerebral edema complicating eclampsia. Am J Obstet Gynecol 2000;182(1 Pt 1):94-100.
Sibai BM, Ramanathan J. The case for magnesium sulfate in preeclampsia-eclampsia. Int J Obstet Anesth 1992;1:167-74.
The Eclampsia Trial Collaborative Group: Which anticonvulsant for women with Eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet 1995;345:1455-63.
Bautista AC. Terapia hidroelectrolítica durante el curso de la toxemia del embarazo: una controversia actual. 1998;3(8): 12-19.
Cifuentes RB. Trastornos hipertensivos en el embarazo: síndrome de preeclampsia-eclampsia. Controversias en Gin/Ob 1998;1(1):31-6.
Duarte A. Manejo de la adolescente embarazada. Rev Colomb Obstet Ginecol 1990;41(1):25-30.
Pardo F, Uriza G. Estudio de embarazo en adolescente en 11 instituciones colombianas. Rev Colomb Obstet Ginecol 1991;42(2):109-121.
Sánchez P, Mendieta N. Embarazo en la adolescencia. Experiencia de la A. S. C. P. Rev Colomb Obstet Ginecol 1994;45(3):208-212.
Williams. Obstetrics. 20ª ed . Buenos Aires: Panamericana. p. 647-686.
Sibai BM. Abdella TN, Spinnato JA, et al. Eclampsia: IV. The Incidence of nonpreventable eclampsia. Am J Obstet Ginecol 1986;154:581-586.
How to Cite
Downloads
Downloads
Published
Issue
Section
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
