A hospital based cross sectional study of critical care management of eclampsia patients in a tertiary care hospital

Abstract

Introduction: Preeclampsia is a pregnancy specific hypertensive syndrome associated with significant morbidity and mortality in mother and baby. Preeclampsia-eclampsia needs intensive care antepartum, intrapartum as well as postpartum for successful pregnancy outcome. Preeclampsia leads to multiorgan system involvement if appropriate timing of delivery is delayed. Materials and Methods: The present study was a hospital based cross sectional study done in the Department of Obstetrics and Gynecology, Mahatma Gandhi Memorial Medical College and Hospital Jamshedpur, Jharkhand over a period of one year from January 2020 to December 2020. For each eligible patients for the study, information in socio-demographic characteristics (age, parity, booking/referral status, marital status, educational status and place of delivery), gestational age at the time of identification of complications, indication for ICU admission and timing of admission to ICU (antepartum or postpartum) were collected on a data collection sheet. Results: During the study period, there were a total of 9907 obstetric admission and 7365 live births. Out of 174 eclampsia patients, 72 patients were admitted to the obstetric ICU, giving an ICU admission rate of 4.8/1000 live births. The mean maternal age of the patients was 25.4+5.8 years (range 18-29 years). Out of 72 patients, 30 patients (41.3%) were nulliparous and 60.5% were uneducated. A total 1.97% (3 patients) were booked and 98.03% (69 patients) were unbooked referred emergencies. The average duration of ICU stay was 5.4+3.1 days. Conclusion: Early referral of eclampsia patients or at risk patients to a tertiary care centre may help to reduce maternal morbidity and mortality. Early diagnosis and prompt treatment through a multidisciplinary team in an ICU setting can prevent complications and reduce morbidity and mortality.