Eclampsia: VI. Maternal-perinatal outcome in 254 consecutive cases
Article Abstract:
Eclampsia (puerperal convulsions) is a condition that follows preeclampsia, which is characterized by high blood pressure, edema, and other symptoms. Eclampsia is more severe than preeclampsia, involving convulsions and sometimes coma. Although it constitutes a life-threatening emergency, eclampsia can be largely prevented by appropriate medical treatment of preeclampsia. A report of treatment and outcome is provided for 254 cases of eclampsia seen at one medical center over a 12-year period; the institution, in Tennessee, receives referrals from five other states and has an eclampsia incidence of 1 in 320 deliveries. Forty percent of the eclamptic patients had received prenatal care at clinics related to the institution, while 60 percent had received no prenatal care. Two hundred of the women were black. Although eclampsia is usually diagnosed by the presence of high blood pressure, protein in the urine, and edema, these symptoms were absent or atypical in one-fifth of the patients (all had convulsions). Details regarding symptoms and their onset are presented. The patients gave birth to 263 infants, of whom 16 were born dead and 15 died soon after birth. Thus, the overall perinatal mortality was 11.8 percent. Almost half these patients delivered by cesarean section. One maternal death took place; she was in a coma when admitted to the hospital. The incidence of eclampsia in the population served by this facility has not changed in the last 30 years. Since these cases represent essentially all cases of eclampsia in the region, the figures can be used to compute the regional eclampsia incidence, which is 1 in 1,600 deliveries. This figure is comparable to rates in other developed countries. Patients with eclampsia need prompt transfer to medical centers with expertise in treating the condition. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1990
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Acute renal failure in pregnancies complicated by hemolysis, elevated liver enzymes, and low platelets
Article Abstract:
Women who have a syndrome of hemolysis, an increase in liver enzymes and low platelets in conjunction with acute kidney failure during pregnancy are at increased risk for developing preeclampsia in subsequent pregnancies. They are also at higher risk for maternal and fetal death. Preeclampsia is a condition that occurs most often during a first pregnancy and can lead to death. Hemolysis is a breakdown of red blood cells. Though acute kidney failure is rare in most pregnancies, it has been associated with the development of the above syndrome. Acute kidney failure was found in 32 out of 435 women diagnosed with preeclampsia or eclampsia and the syndrome of hemolysis, increase in liver enzymes and low platelets. In the group of 32 women, nine infants were stillborn and two died after delivery. Four of these women died and 10 needed dialysis because of kidney failure. The syndrome coupled with acute kidney failure can develop either before or after delivery.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1993
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The impact of initiating a human immunodeficiency virus screening program in an urban obstetric population
Article Abstract:
Voluntary HIV testing of all obstetric patients, regardless of risk, may increase detection and reduce costs associated with treatment of preventable cases. Researchers reviewed the records of obstetric patients at one medical center for known HIV infection at the time of delivery. Voluntary testing was offered midway in the study period. In 1993, 2031 patients were tested for HIV, and of these, 25 were HIV positive. These patients may not have been considered at high risk for HIV as the only risk factor for 23 of them was unprotected intercourse. One injected drugs. Detection of maternal HIV infection during pregnancy may prevent transmission to the fetus by starting antiviral therapy as soon as possible. Prevention of fetal HIV infection may lower overall HIV treatment costs.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1995
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- Abstracts: The effect of maternal hemodynamics on fetal growth in hypertensive pregnancies. Preeclampsia: A hyperdynamic disease model
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