title: Adverse maternal and fetal outcomes and deaths related to preeclampsia and eclampsia in Haiti.
abstract: OBJECTIVE
  The purpose of this study was to define the prevalence and clinical characteristics of preeclampsia and eclampsia at a hospital in rural Haiti.
  
  
  METHODS
  This is a retrospective review of women presenting to Hôpital Albert Schweitzer (HAS) in Deschapelles, Haiti with singleton pregnancy and diagnosis of preeclampsia or eclampsia from January 1, 2011 through December 31, 2012. Hospital charts were reviewed to obtain medical and prenatal history, hospital course, delivery information, and fetal/neonatal outcomes. The outcomes included placental abruption, antepartum eclampsia, postpartum eclampsia, maternal death, birthweight <2500g and stillbirth. Data are presented as median (quartile 1, quartile 3) or n (%) and risk ratios.
  
  
  RESULTS
  During the study period, 1743 women were admitted to the maternity service at HAS and 290 (16.6%) were diagnosed with preeclampsia or eclampsia. Only singleton pregnancies were analyzed (N=270). Nearly all (95.0%) patients admitted with preeclampsia had severe preeclampsia. There were 83 patients with eclampsia (30.7%) of which 61 (73.4%) had antepartum eclampsia. There were 48 stillbirths (17.8%) and 5 maternal deaths (1.9%). Patients with antepartum eclampsia were younger, more likely to be nulliparous and had less prenatal care compared to women with antepartum preeclampsia. Antepartum eclampsia was associated with placental abruption and maternal death.
  
  
  CONCLUSIONS
  The rates of preeclampsia and its associated complications, such as eclampsia, placental abruption, maternal death and stillbirth, are high at this facility in Haiti. Such data are essential to developing region-specific systems to prevent preeclampsia-related complications.
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States.
authors.forename: Nandini
authors.initials: N
authors.lastname: Raghuraman
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States; Division of Maternal Fetal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
authors.forename: Melissa I
authors.initials: MI
authors.lastname: March
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
authors.forename: Michele R
authors.initials: MR
authors.lastname: Hacker
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States.
authors.forename: Anna Merport
authors.initials: AM
authors.lastname: Modest
authors.affiliation: Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
authors.forename: Julia
authors.initials: J
authors.lastname: Wenger
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Albert Schweitzer, Deschapelles, Haiti.
authors.forename: Rulx
authors.initials: R
authors.lastname: Narcisse
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Albert Schweitzer, Deschapelles, Haiti.
authors.forename: Jean
authors.initials: J
authors.lastname: Louis David
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States; Division of Women's Health, Brigham and Women's Hospital, Boston, MA, United States; Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Scott
authors.affiliation: Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States; Division of Maternal Fetal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: srana1@bidmc.harvard.edu.
authors.forename: Sarosh
authors.initials: S
authors.lastname: Rana
keywords: Adverse maternal and perinatal outcomes; Eclampsia; Haiti; Preeclampsia