Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003.
OBJECTIVE
To establish the risk of serious complications from severe pre-eclampsia and eclampsia in a region using a common guideline for the management of these conditions.


METHODS
A five-year prospective study.


METHODS
Sixteen maternity units in Yorkshire.


METHODS
All women managed with severe pre-eclampsia and eclampsia.


METHODS
A common guideline was developed for the management of women with these conditions. A network of midwives prospectively collected outcome data.


METHODS
Incidence of the conditions and serious complication rates.


RESULTS
A total of 210,631 women delivered in the 16 units between 1 January 1999 and 31 December 2003. One thousand eighty-seven women were diagnosed with severe pre-eclampsia or eclampsia (5.2/1000). One hundred and fifty-one women had serious complications including 82 women (39/10,000) having eclamptic seizures and 49 women (23/10,000) requiring ICU admission. There were no maternal deaths but 54 out of 1145 babies died before discharge, giving a mortality rate of 47.2/1000. Of the 82 cases of eclampsia, 45 occurred antenatally (55%), 18 before admission to the maternity unit. Eleven cases occurred in labour (13%), including 1 during a caesarean section, and 26 cases occurred following delivery (32%). Twenty-five women developed pulmonary oedema (2.3% of cases) and six women required renal dialysis (0.55% of cases). One hundred and sixty-five (15%) required no antihypertensive therapy and 489 (53%) of the remainder required only oral therapy. Two hundred and one (18.5%) required more than one drug.


CONCLUSIONS
A regional guideline for severe pre-eclampsia and eclampsia can be developed and implemented. Its use may contribute to a low rate of serious complications.
Tuffnell
D J
DJ
Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
Jankowicz
D
D
Lindow
S W
SW
Lyons
G
G
Mason
G C
GC
Russell
I F
IF
Walker
J J
JJ
D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003422:Critical Care / Q000706:statistics & numerical data; D004461:Eclampsia / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use; D009846:Oliguria / Q000209:etiology; D011225:Pre-Eclampsia / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000209:etiology; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012307:Risk Factors
D000927:Anticonvulsants; D000959:Antihypertensive Agents; D008278:Magnesium Sulfate