Clinical significance of singleton pregnancies complicated by placental abruption associated with histological chorioamnionitis.
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The aim of this study was to determine the perinatal outcomes of placental abruption associated with the presence of histological chorioamnionitis. We reviewed the obstetric records of 96 singleton deliveries complicated by placental abruption after 22 weeks' gestation. Of these 96 cases, 37 cases (39%) were diagnosed as having histological chorioamnionitis in the placenta. The incidence of premature delivery, preterm rupture of the membranes and low birth weight in the cases of placental abruption with chorioamnionitis were higher than in cases without chorioamnionitis. However, there were no significant differences in the incidence of other outcomes, such as fetal demise, low Apgar score, or low umbilical artery pH, between the cases of placental abruption with and without histological chorioamnionitis. Although the incidence of prematurity in the cases of placental abruption with chorioamnionitis was higher than that in cases without chorioamnionitis, there were no significant differences in fetal and neonatal conditions between the abruption cases with and without chorioamnionitis. (+info)
Risk of placental abruption in relation to migraines and headaches.
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Early onset pregnancy-induced hypertension/eclampsia in Benin City, Nigeria.
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CONTEXT: Pregnancy - induced hypertension/eclampsia is a major cause of maternal and perinatal morbidity and mortality in Nigeria. There have been very few studies focused on early onset pregnancy induced hypertension/eclampsia in Nigerian women. OBJECTIVES: To determine the incidence, clinical features and outcome of cases of early onset pregnancy-induced hypertension /eclampsia in a Nigerian tertiary hospital, and compare maternofetal outcome in early and late onset disease. Methods : A retrospective study of all cases of early onset pregnancy induced hypertension/eclampsia seen over a five-year period in a tertiary hospital. MAIN OUTCOME MEASURES: Severity of disease, rates of induction of labour, caesarean section rate, maternal mortality, abruptio placenta, still births, severe birth asphyxia and early neonatal deaths. RESULTS: Early onset pregnancy induced hypertension/eclampsia contributed 6.3% of all cases of hypertensive disorders in pregnancy with an incidence of 1:141 deliveries. Most cases presented at between 28-32 weeks gestation (78.3%) The disease was severe at presentation or rapidly progressive in 39 cases (84.8%) leading to delivery within 72 hours of presentation. Caesarean section was the mode of delivery in 58.7% of cases. The perinatal survival rate was 34.0%. Early onset pregnancy induced hypertension was associated with significantly higher risk of presenting with eclampsia, having induction of labour and worse perinatal outcome than late onset disease. CONCLUSION: Most cases of early onset pregnancy induced hypertension in the study population presented with severe and rapidly progressive disease and were associated with significantly higher risk of obstetric intervention and worse perinatal outcome than late onset disease. (+info)
Pregnancy outcome in eclamptics at the University of Abuja Teaching Hospital, Gwagwalada, Abuja: a 3 year review.
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BACKGROUND: Eclampsia remains one of the major causes of maternal morbidity and mortality especially in the developing countries. In Nigeria, it is the 3 rd commonest cause of maternal mortality. The high maternal morbidity and mortality due to eclampsia in the developing countries has been ascribed to late referral, delay in hospitalization, lack of transport, unbooked status of patients and multiple seizures prior to admission. OBJECTIVE: To review the presentation and management of eclampsia at the University of Teaching Hospital (UATH), the factors associated with it, the maternal and perinatal outcome and make recommendations on how to reduce maternal and perinatal morbidity and mortality from eclampsia. METHODOLOGY: The case notes of all the patients that had eclampsia between 1 st May 2005 and 30 th April 2008 were retrieved and analyzed. The informations sought for include age of the patients, parity, booking status, type of eclampsia and blood pressure at presentation. Other informations include level of proteinuria, anticonvulsants used, mode of delivery, maternal complications and perinatal outcome. RESULTS: There were 4471 total deliveries within the period, out of which 59 had eclampsia, giving an incidence of 13 per 1000 deliveries. There were 5 maternal deaths, giving a case fatality rate of 8.5%. Eclampsia was commonest amongst the age group of 20-24 years (34.8%). Primigravidae constituted 60.9% of the cases. Majority of the patients (89.1 %) were unbooked. Antepartum eclampsia (73.9%) was more than intra-partum (19.6%) and postpartum (2.2%) combined. Thirty two patients had severe hypertension on admission (diastolic BP= 110 mmHg) while 11 (23.9%) had mild hypertension (diastolic BP 90- < 110mmHg). Twenty patients (47.8%) were managed with diazepam alone while 19 patients (41.3%) were managed with magnesium sulphate alone. Five patients were managed with both. Thirty nine (84.8%) were delivered through caesarean section while 5 (10.8%) were delivered vaginally. Maternal complications include 6 cases of acute renal failure and one case of visual impairment. Thirty seven babies were delivered live while 8 stillbirths were recorded. Six babies (13.0%) had very low birth weight, 14 (30.4%) had low birth weight and 16 (34.8%) had normal birth weight. CONCLUSION: Eclampsia still remains a major cause of maternal morbidity and mortality in Nigeria. More awareness and enabling factors should be created for more women to access antenatal facilities. Information about danger signs of pre-eclampsia/eclampsia should be made available to antenatal clients. Government should be committed to providing emergency obstetric case facilities in our hospitals for effective management of eclampsia. (+info)
Placental bed disorders in preterm labor, preterm PROM, spontaneous abortion and abruptio placentae.
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