Pre-Eclampsia Essay, Research Paper 13
Pre-eclampsia is a disorder peculiar to pregnant women. It may be defined as the development of hypertension (blood pressure >140/90 mm Hg) together with abnormal oedema or proteinuria or both, after the twentieth week of gestation.
Pre-eclampsia is the precursor of eclampsia. Eclampsia is characterised by epileptiform convulsions and coma supervening upon hypertensive disease in pregnancy. This greatly increases the maternal and foetal morbidity and morality. In the past, eclampsia was a frequent cause of death. However, due to improved ante-natal care and the early detection of the signs of pre-eclampsia, the prevalence has decreased greatly especially in developed countries. It must be noted that pre-eclampsia is still particularly common in tropical and developing countries where ante-natal care is limited.
All pregnant patients with a diagnosis of pre-eclampsia admitted to ward B2 of the QEH between 1992 and 1996 were identified using old case notes from the Records Department of the institution.
The results have shown that from the period 1992 to 1996 there was a significant difference in the prevalence of pre-eclampsia. In 1992 the prevalence was twenty-three (23%) percent this decreased to nineteen (19%) percent in 1993 and 1994, and seventeen (17%) percent in 1995. There was a slight increase in the prevalence in 1996 to twenty-two (22%) percent. See Graph 1.
Of the one thousand and sixty-five (1065) women used in the study, the 20-24 age group strata had the greatest number of cases reported 295 or 28%, with the 25-29 age group strata following closely with 270 cases or 25%. In contrast, the oldest age group strata (>40 years) had the least number of cases reported with 15 cases or 1%. It was noted that no cases of pre-eclampsia were recorded in the 10-14 age group strata. See Table 2 and Graph 2.
The aetiology of pre-eclampsia is unknown. Commonly it affects primigravid women but when it occurs in later pregnancies there is usually a predisposing factor such as diabetes, multiparity, antecedent hypertension, family history of pre-eclampsia and eclampsia, lower socioeconomic status and extremes of age: 35 years.
The study shows that the extremes of age: 15-19 and > 35 age group strata were the least prevalent, (18% and 10% respectively), whilst the 20-24 and 25-29 age group strata were the most prevalent with 28% and 25% respectively.
Approximately 5 to 8 percent of all pregnancies are complicated by hypertension. Therefore, to reduce the number of cases of pre-eclampsia, certain preventative measures must be implemented in all antenatal care institutions. These are:
i) Education of all health care personnel
ii) Early detection of the signs of pre-eclampsia in a conscientious antenatal care setting, and
iii) Implication of early preventative treatment.
In all cases whether mild, moderate, or severe, once the diagnosis has been established, all patients should be admitted to hospital for further management.