Anaesthetic management of patients with pre-eclampsia/eclampsia and perinatal outcome.
OBJECTIVE
This study examined risk factors for perinatal mortality associated with anaesthesia for caesarean delivery in patients with pre-eclampsia/eclampsia. The study is apt because perinatal mortality rate is one of the indicators of health status of pregnant women, new mothers and their newborns. The information obtained may help to assess changes in public health policy and practise amongst women of child-bearing age.


OBJECTIVE
The role of anaesthesia in perinatal outcome in pre-eclamptics.


METHODS
The hospital records (cases notes, labour ward and newborn special care unit and theatre records) of patients with pre-eclampsia/eclampsia, which had caesarean delivery and their babies at the University of Nigeria Teaching hospital (UNTH), Enugu, Nigeria from July 1998 to June 2006, were retrospectively reviewed. The term perinatal mortality refers to stillbirths and neonatal deaths within 7 days of birth.


RESULTS
There were a total of 6798 deliveries and 1579 women delivered through caesarean section. Of these, 196 were patients with pre-eclampsia/eclampsia. There were a total of 19 stillbirths (9%) and 19 (9%) early neonatal deaths in the pre-eclampsia/eclampsia group going a perinatal mortality of 180/1000 births. Amongst these women, 157 delivered under general anaesthesia, 34 under spinal anaesthesia and five under epidural block. Of the 38 perinatal deaths, 30 delivered by general anaesthesia and eight by regional anaesthesia.


CONCLUSIONS
Pre-eclampsia/eclampsia continues to be a cause of foetal loss in the developing world even where essential obstetric services are available. Early onset management of severe pre-eclampsia with maintenance of adequate placental perfusion during anaesthesia may result in lower perinatal deaths.
Okafor
Ugochukwu Vincent
UV
Department of Anaesthesia, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria. uvkafor@yahoo.com
Efetie
Efena Russ
ER
Igwe
Wilson
W
Okezie
Obioma
O
D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D004461:Eclampsia / Q000628:therapy*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D009549:Nigeria / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D050497:Stillbirth / Q000453:epidemiology