title: PP169. Management of fetal and maternal prognosis during severe toxemia.
abstract: BACKGROUND
  Severe gravidic toxemia gives heavy maternal and fetal morbidity and mortality.
  
  
  OBJECTIVE
  The purpose of our data is to identify bad maternal and fetal factors during severe toxemia and the outcome of pregnancy.
  
  
  METHODS
  It is a retrospective and comparative study about 200 cases of severe toxemia reported during 8 years 2004-2011 among 25,000 deliveries (control group). Toxemia is considered severe when blood pressure⩾160/100mHg, proteinuria ⩾2g/l, bad neurosensorial signs, hemostasis disorders, kidney and liver failure, some fetal tests: delay intra-uterine growth acute fetal suffering, fetal death.
  
  
  RESULTS
  Frequency of severe toxemia 8‰, primiparous 58% vs. 35% control, gestational diabetes 12% vs. 10% control, oedema 87% vs. 45% control. Maternal morbidity is dominated by hemostasis disorders: low platelet count<80,000 23% vs. 8%, hypofibrinogenemia <4g/l 13% vs. 2%, HELLP syndrome eight cases vs. 0. We raised eight cases of eclampsia crises, 22 cases of retroplacental hematoma vs. 10 control. Blood transfusion 15% vs. 10% control, inhibitors of VII factor administered in two cases vs. 0. We do not deplore any maternal mortality. Fetal prognosis is very compromised ,the delay intra uterine growth 44% vs. 18% control, prematurity 66% vs. 15% control, perinatal mortality 60‰ vs 12‰ control
  
  
  CONCLUSIONS
  More toxemia appears early during pregnancy more maternal and especially fetal prognosis is compromised. New drugs, predictive tests and preventives measurements improve maternal outcome better than fetals' one.
authors.affiliation: Military Hospital, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Radhouane
authors.affiliation: Gyn Obs, Military Hospital, Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Basly
authors.affiliation: Gyn Obs, Military Hospital, Tunis, Tunisia.
authors.forename: C
authors.initials: C
authors.lastname: Mounir
authors.affiliation: Gyn Obs, Military Hospital, Tunis, Tunisia.
authors.forename: R
authors.initials: R
authors.lastname: Rachdi