Online ISSN: 2515-8260

Keywords : eclampsia


STUDY AND COMPARISON OF LIVER FUNCTION TESTS IN PRE-ECLAMPSIA AND ECLAMPSIA WITH NORMAL HEALTHY PREGNANT WOMEN

Brungi Asha Jyothi, Madupathi Anil Babu

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11780-11786

Background:Preeclampsia is a multisystem disorder, which occurs only in pregnant women during the second and third trimesters of pregnancy and is associated with raised blood pressure and proteinuria. It rarely presents before 20 weeks of gestation like in hydatidformmole.Eclampsia is a syndrome with one or more episodes of convulsions in association with preeclampsia. In India, the national incidence of hypertensive disorders   is 15.2%,with incidence in nulliparous women being four times greater than in multipara.Liver Function Test (LFT) abnormalities occur in 3% of the pregnancies, and preeclampsia is the most frequent cause6.In HELLP syndrome, an elevation in liver function test results is noted7. Periportal hemorrhagic necrosis in the periphery of the liver lobule is probably the lesion that causes elevated serum liver enzymes.AIM: To Study and compare liver function tests in Pre-eclampsia and Eclampsia with normal healthy pregnant women and assess the ante-partum severity in both the diseases.
Materials and Methods: Study was conducted on 70 pregnant women admitted with pre-eclampsia and eclampsia and 35 normal pregnancy patients in between 19-26 yrs of age in third trimester of pregnancy.
Results: There is an increase in Diastolic blood pressure in mild pre-eclampsia and significant increase in severe pre-eclampsia and eclampsiapatientswhen compared to controlsThere is an increase in AST, ALT, LDH parameters in mild pre-eclampsia and significant increase in severe pre-eclampsia and eclampsia patientswhen compared to controls except for bilirubin.
Conclusion: There is a derangement of parameters of LFT in severe preeclampsia and eclampsia. But there was no significant elevation in mild pre-eclampsia.Persistant liver parameter that  increased was ALT (as it is more specific to the liver damage). These can be taken as a predictor of the disease.

A prospective study of factors affecting maternal and perinatal outcome in eclampsia at government medical college/hospital Nizamabad

Dr Neelima Singh, Dr.Mounika, Dr Badhe Rekha, Dr.N.Sreedevi, Nidhi Singh, Dr Tharani Badikela

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5124-5135

Introduction: Eclampsia is one of the commonest causes of maternal deaths. The
various factors influencing maternal and perinatal outcome were evaluated in the
present study.
Aim: To determine the factors affecting maternal and perinatal outcomein Eclampsia.
Materials and methods: Present study is a prospective observational study of factors
affecting maternal and perinatal outcome in Eclampsia for a period of 6 months.
Results: The incidence of eclampsia in 1.42%. Hypertension, oedema and proteinuria
are important signs in eclampsia. The incidence of maternal mortality in the present
study was 4% and the common causes of death were acute renal failure and pulmonary
oedema. The maternal mortality in correlation with age, parity, blood pressure,
duration of labour is not statistical significant. The perinatal mortality in the present
study was 24% and corrected perinatal mortality, excluding cases of absent FHS at
admission was 18%. Prematurity was the most important cause of neonatal deaths.
Perinatal mortality was maximum in unbooked cases (37%) and is statistically
significant. Perinatal mortality was maximum, when the number of convulsions were
maximum that is in between 6-10 (100%) and it is statistically highly significant.
Conclusions: Prompt control of convulsions and blood pressure along with steps to
initiate delivery are the cornerstone and critical in Management of eclampsia.

To Determine The MRI Brain Lesion In Eclampsia Patient

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 9752-9765

Aim: The aim of this study to determine the MRI Brain lesion in eclampsia patient
 
Methods: After ethical approval, the prospective study was done  in the Department of Obstetrics and Gynecology. 60 women with eclampsia were separated into two Category: A (patients with abnormal MRI) and B (patients with normal MRI). A thorough history was taken, and all patients underwent testing such as haemoglobin, 24 hour urine protein, and renal function tests, liver function tests, absolute platelet count, and fundoscopy.
 
Results: MR Imaging was performed on 60 eclamptic women over the course of a year. MRI results were seen in 33.333 percent (n = 20) of the patients. As a result, the study was separated into two category A ( the study group), which included patients who had MRI results, and the category B, which included patients who did not have MRI findings. The study population's average age was 23.02±3.25 years. On MRI, the most prevalent diagnosis was CVT without 'infarct (20%), followed by infarct (6.67%), PRES (5%), and HLE (1.67%). A total of 20 individuals reported neurological Problems of eclampsia, with 18 having positive MRI results and two having negative MRI findings. There were 40 patients  with no neurologic manifestation, 2 with positive MRI detection and 38 with negative MRI detection. The sensitivity, specificity, PPV, and NPV of neurological symptoms for abnormal MRI in eclampsia patients were shown to be 92.11 percent, 75.55 percent, 53.87 percent, and 97.16 percent, respectively.
 
Conclusion: We concluded that clinical, laboratory and others parameters were not remarkable associated with positive MRI detection in women with eclampsia. In the follow-up of pregnant patients with pre-eclampsia/eclampsia, symptoms such as unconsciousness, altered sensorium, headache, blurred vision, seizures, GCS 3, elevated uric acid, and serum creatinine levels should serve as a warning for possible brain lesions, whereas booking status, mean blood pressure, fundoscopy findings, platelet count, haemoglobin, and liver enzymes were not significantly associated with positive magnetic resonance imaging findings in patients with eclampsia.

To determine the MRI Brain lesion in eclampsia patient.

Kanamatha Reddy Sujana, L Pranathi Reddy, S.M. Jyothi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10065-10071

Aim: The aim of this study to determine the MRI Brain lesion in eclampsia patient
Methods: After ethical approval, the prospective study was done in the Department of
Obstetrics and Gynecology. 60 women with eclampsia were separated into two
Category: A (patients with abnormal MRI) and B (patients with normal MRI). A
thorough history was taken, and all patients underwent testing such as haemoglobin, 24
hour urine protein, and renal function tests, liver function tests, absolute platelet count,
and fundoscopy.
Results: MR Imaging was performed on 60 eclamptic women over the course of a year.
MRI results were seen in 33.333 percent (n = 20) of the patients. As a result, the study
was separated into two category A (the study group), which included patients who had
MRI results, and the category B, which included patients who did not have MRI
findings. The study population''s average age was 23.02±3.25 years. On MRI, the most
prevalent diagnosis was CVT without ''infarct (20%), followed by infarct (6.67%),
PRES (5%), and HLE (1.67%). A total of 20 individuals reported neurological
Problems of eclampsia, with 18 having positive MRI results and two having negative
MRI findings. There were 40 patients with no neurologic manifestation, 2 with positive
MRI detection and 38 with negative MRI detection. The sensitivity, specificity, PPV,
and NPV of neurological symptoms for abnormal MRI in eclampsia patients were
shown to be 92.11 percent, 75.55 percent, 53.87 percent, and 97.16 percent, respectively.
Conclusion:We concluded that clinical, laboratory and others parameters were not
remarkable associated with positive MRI detection in women with eclampsia.In the
follow-up of pregnant patients with pre-eclampsia/eclampsia, symptoms such as
unconsciousness, altered sensorium, headache, blurred vision, seizures, GCS 3, elevated
uric acid, and serum creatinine levels should serve as a warning for possible brain
lesions, whereas booking status, mean blood pressure, fundoscopy findings, platelet
count, haemoglobin, and liver enzymes were not significantly associated with positive
magnetic resonance imaging findings in patients witheclampsia.

Study and Comparison of Renal Function tests in Pre-eclampsia and Eclampsia with Normal Healthy Pregnant Women

Brungi Asha Jyothi, Madupathi Anil Babu, P.Vineela

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11693-11699

Background:Preeclampsia is a multisystem disorder, which occurs only in pregnant women during the second and third trimesters of pregnancy and is associated with raised blood pressure and proteinuria. It rarely presents before 20 weeks of gestation like in hydatidformmole.Eclampsia is a syndrome with one or more episodes of convulsions in association with preeclampsia .In India, the national incidence of hypertensive disorders   is 15.2%,with incidence in nulliparous women being four times greater than in multipara.With severe renal involvement, glomerular filtration may be impaired and the plasma creatinine concentration may begin to  rise.Elevated uric acid is another component of the preeclampsia. Although hyperuricemia does correlate with maternal morbidity, there is an even stronger association of uric acid with the risk for small birth weight infants and with overall foetal mortality. The hyperuricemia of preeclampsia has been variably suggested to be associated with lactic acidosis, altered renal functions or oxidative stress.AIM: To Study and compare renal function tests in Pre-eclampsia and Eclampsia with normal healthy pregnant women and assess the ante-partum severity in both the diseases.
Materials and Methods: Study was conducted on 70 pregnant women admitted with pre-eclampsia and eclampsia and 35 normal pregnancy patients in between 19-26 yrs of age in third trimester of pregnancy.
Results: There is a increase in Diastolic blood pressure in mild pre-eclampsia and significant increase in severe pre-eclampsia and eclampsiapatientswhen compared to controlsThere is a increase in serum uric acid in mild pre-eclampsia and significant increase in all parameters insevere pre-eclampsia and eclampsia patientswhen compared to control.
Conclusion: There is a derangement of parameters of RFT in severe preeclampsia and eclampsia.But there was no significant elevation in mild pre-eclampsia.Persistant Renal parameter that  increased was Uric acid. These can be taken as a predictor of the disease.

A Clinical Study of Maternalandperinatal Outcome in Pregnancy Induced Hypertension

Himabindu Sangabathula, Neelima V, Siddareddy Yashovardhini

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4767-4777

Background:Hypertension is a prevalent and serious disorder that can cause or
exacerbate many health issues. Blood pressure is directly associated to cardiovascular
disease and mortality. Stroke, MI, angina, heart failure, renal failure, and
cardiovascular mortality are all linked to BP. As a result, hypertension is often referred
to as "the silent killer." The study's aim is to assess maternal morbidity and mortality
in pregnant women with pregnancy-induced hypertension. Birth weight, Apgar score,
NICU admission, prenatal morbidity and mortality.
Materials and Methods: During two years, pregnant women aged 21 to 40 weeks were
studied at Govt Medical College &Hospital Nalgonda (July 2019-July 2021). An 80-
patient study. The institutional ethics committee review board approved. Each patient
had a comprehensive history, clinical examination, and proforma. In all instances, the
length of hospital stay, patient recovery, perinatal outcome (birth weight, Apgar score,
NICU admission), and perinatal morbidity and mortality were examined.
Results: he present investigation found that unbooked cases had more severe
preclampsia and eclampsia. Preeclampsia patients who had not had routine prenatal
care were 40 percent unbooked. Unbooked cases have increased maternal and perinatal
mortality. In this study, 40% of NICU admissions were due to LBW/asphyxia. Overall,
50% of newborns were born underweight. PIH was a prominent cause of iatrogenic
premature birth.
Conclusion: 100% registration of pregnant women and good quality antenatal
treatment including weight, blood pressure, and urine analysis with adequate referral
mechanism to tertiary care centres.All family physicians and medical officers need to be
advised to follow a standard management protocol in a case of preeclampsia and
eclampsia with an awareness for prompt referral of women who require to be managed
by specialist. Every tertiary care centre must have specialised expertise. Though PIH is
not preventable, adequate ANC care can slow its progression and timely intervention
can significantly improve perinatal outcomes.

To evaluate the fundus changes in patients with hypertensive disorders of pregnancy: Gestational hypertension, preeclampsia, eclampsia

Dr. Tania Sadiq, Dr.Saima Sadiq, Dr.Erum Khateeb

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 67-73

Aim: To evaluate the fundus changes in patients withGestational
hypertension,preeclampsia oreclampsia.
Methods: All the patients who fulfilled the diagnostic criteria of Gestational
hypertension, preeclampsia or eclampsia(>20 weeks of pregnancy, high arterial blood
pressure of more than or equal to 140/90 , proteinuria more than or equal to
300mg/day or protein creatinine ratio more than or equal 30 mg/mmol or evidence of
maternal organ dysfunction or uteroplacental dysfunction , convulsions or coma) were
included in this study. After taking history for any eyesymptoms, anterior segment was
examined with torch light on the bed itself. Both pupils were dilated with 1%
tropicamide eye drops and fundus examination was done by ophthalmologist with direct
ophthalmoscope in a semi dark room in the ward. Hypertensive retinopathy changes
seen in right or left or both eyes, was taken as positive findings in that patient.
Results: A total of 100 patients were examined. The mean age of patients was 31.2±6.2
years (range 20-50 years). The gestation period ranged between 25 and 41 weeks. 45
(45%) were primigravidas , 33 (33%) were multigravidas and 22(22%) were
grandmultiparas. 41(41%) had mild preeclampsia, 56(56%) had severe preeclampsia
and 3(3%) had eclampsia. Retinal changes (hypertensive retinopathy) were noted in
58(58%) patients . There was statistically significant positive association between the
presence of retinal changes and blood pressure (P =0.001), proteinuria (P=0.021) and
severity of hypertensive disorders( P=0.027). However, age(P = 0.44), race ( P=0.89) and
gravida (P =0.37 were not associated with occurrence of retinopathy in our study.
Conclusion: Fundus examination in gestational hypertension , preeclampsia and
eclampsia is important in monitoring and managing cases as it correlates with severity
as it indirectly implies severity of changes in placental micro-circulation that can help to
predict the foetal outcome and ocular morbidity.

Hypertensive disorders of pregnancy and feto-maternal outcomes in a tertiary health care centre, Koppal

Dr.Dhanalakshmi KR,Dr.Seema BN, Dr.Narayani BH

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 464-472

Background: Hypertensive disorders of pregnancy are known to cause adverse maternal and fetal complications and outcomes. In view of assessing its burden and feto-maternal complications and outcomes in the current study setting, the study was conducted.
Material and Methods: This is a retrospective study conducted among 8941 women with more than 20 weeks of gestation, admitted for delivery under the department of Obstetrics and Gynaecology at Koppal Institute of Medical Sciences during the study period of 2 years from July 2019 to June 2021. The primary outcome was assessed in terms of proportions of hypertensive disorders of pregnancy and eclampsia. Secondary outcomes were assessed in terms of feto-maternal complications and outcomes among those with hypertensive disorders of pregnancy. All the quantitative data were presented in percentages.
Results: The proportions of hypertensive disorders of pregnancy were 10.64% and eclampsia was noted to be 1.9%. Majority (63.1%) of the study subjects were between 18 to 23 years, mostly from rural areas (89.8%) and belonged to lower socio-economic status (95.1%). The highest proportion of them (87.9%) had crossed a gestational age of 34 weeks and also primigravida formed the majority (68.4%). None of them were booked and 41.7% of them underwent lower segment caesarian section. 5.3% of the study subjects had maternal complications with common complications being HELLP syndrome, renal complications, pulmonary edema and cerebral venous thrombosis. 0.7% of them died. 28.9% of neonates had complications viz., low birth weight, preterm and small for date babies. Intrauterine deaths were noted among 8.1%.
Conclusion: 1 in 10 mothers had hypertensive disorders of pregnancy and nearly 2 of such 100 hypertensive mothers landed in eclampsia. Feto-maternal complications were documented among 5.3% mothers and 28.9% neonates. Maternal mortality was reported in 0.7% and 8.1% of fetuses had intrauterine deaths contributing to perinatal deaths.

Comparative study of serum magnesium levels between low dose mgso4and Pritchard regimen in treatment of eclampsia

Dr.PeruguSravani,Dr. MahitaRaniKatasani,Dr. K. Sharada

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 736-741

tonicclonicconvulsionsunrelatedtoothermedicalconditionsinwomenwithhypertensivedisorderof
pregnancy.Although10%ofpregnanciesarecomplicatedbyhypertensivedisorders,eclampsia
continuesto occur in 0.8% of women with hypertensivedisorders.
Objectives:TocomparetheserummagnesiumlevelsinPritchardregimenandlowdose
MgSO4regimen. To compare the maternaland fetalcomplicationsin both groups.
MaterialandMethods:ThisisaProspectivestudyconductedintheDepartmentofObstetrics
andGynaecologyatTertiarycareteachinghospitaloveraperiodof1yearoneclampticpatients
whogotadmittedindepartmentofobstetricsandgynecology.Standardprinciplesof
managementofeclampsiawillbefollowed.Patientsaredividedintotwogroupsascases&
controlalternatively.Groupsarechosenbasedoninclusion&exclusioncriteria.GroupI
ControlwillfollowPritchardstandardregimen.GroupIICaseswillreceivelowdose
magnesiumsulphateregimen.
Conclusion:Theoccurrenceofeclampsiaintwogroupswasmorecommonintheagerange of 20 to
26yearsamongtheprimigravidaand with previoushistory ofPIH. Thereisnomajor
differenceintheoutcomeofmaternalandfetalinbothgroups.Nonethelessthemagnesium
levelsamonglowdosegrouparesignificantlylowerincomparisonwithstandardregimen group. In
casesand controlsthe magnesium levelsare maintained in normal therapeuticrange.
Lowdoseregimenisbetter alternative tocontrolseizuresin eclampticpatients.

Analysis of Complications for Expectant Women and Comparative Study of Maternal Mortality in India

G. Keerthi; M.S. Abirami

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 1481-1491

From the first maternal level up to the delivery, there is high risk in women's health factors. Nowadays, severe maternal problems lead to crucial health issues in pregnant women. These problems may occur either during pregnancy or delivery time or after delivery according to the women health conditions. These crucial issues will become a risk for the mother’s and baby’s life. These maternal conditions during delivery are not easy to detect at the early stage of pregnancy. In this paper, some of the important pregnancy complications are addressed with their symptoms and treatment. Based on the study, different methodologies are discussed to prevent and avoid pregnant women's complications and for childbirth. The main aim of this study is to improve the maternal and fetal outcomes irrespective of the places. In this paper, a sample dataset in India is taken to show the Maternal Mortality Rate (MMR) by considering the values from the year 2010 to 2030. More analysis of MMR can be done by considering different countries, which will be helpful to solve the occurrence of risk factors either during or after pregnancy. Consequently, this analysis may avoid pregnancy death rates. The main work is to improve the maternal and fetal outcomes by strengthening the pregnant women health. Future work will be applying different machine learning methodologies to detect the risk level of severe maternal morbidity.