title: Trend in admissions, clinical features and outcome of preeclampsia and eclampsia as seen from the intensive care unit of the Douala General Hospital, Cameroon.
abstract: BACKGROUND
  Hypertensive disorders in pregnancy (HDP) are a major cause of maternal morbidity and mortality. We aimed at determining the trends in admission, profiles and outcomes of women admitted for preeclampsia and eclampsia to an intensive care unit (ICU) in Cameroon.
  
  
  METHODS
  A retrospective study involving 74 women admitted to the ICU of the Douala General Hospital for severe preeclampsia and eclampsia from January 2007 to December 2014. Clinical profiles and outcome data were obtained from patient records. Statistical analysis was performed using SPSS version 20.
  
  
  RESULTS
  Of the 74 women admitted to ICU (72.5% for eclampsia), mean age was 30.2years and the majority (90.5%) were aged 20-39 years. While overall trend in admission for HDP increased over the years, mortality remained stable. Mean gestational age (GA) on admission was 34.0 weeks (33.5 for preeclampsia vs 35.4 for eclampsia). Most patients presented with complications of which acute kidney injury was most frequent (66.7%). Visual problems were more common in patients with eclampsia compared to preeclampsia (p = 0.01). HELLP syndrome and acute pulmonary oedema (APO) were predominant in patients with preeclampsia, while cerebrovascular accidents (CVA) occurred more in patients with eclampsia. Overall mortality was 24.3%. Presence of APO was associated with mortality in multivariable analysis (O.R.= 0.03, p = 0,01).
  
  
  CONCLUSIONS
  Trends in admission for HDP were increasing with high but stable mortality rate. Patients presented late most of whom with complications. Interventions improving antenatal care services and multidisciplinary management approach may improve maternal outcome in patients with HDP.
authors.affiliation: Department of Obstetrics and Gynaecology, Douala General Hospital, Douala, Cameroon.
authors.forename: Eugene Belley
authors.initials: EB
authors.lastname: Priso
authors.affiliation: Department of Obstetrics and Gynaecology, Douala General Hospital, Douala, Cameroon.
authors.forename: Theophile Nana
authors.initials: TN
authors.lastname: Njamen
authors.affiliation: Department of Obstetrics and Gynaecology, Douala General Hospital, Douala, Cameroon ; Department of Surgery and Specialties, University of Douala, Douala, Cameroon.
authors.forename: Charlotte Nguefack
authors.initials: CN
authors.lastname: Tchente
authors.affiliation: General intensive care unit, Douala General Hospital, Douala, Cameroon.
authors.forename: Albert Justin
authors.initials: AJ
authors.lastname: Kana
authors.affiliation: General intensive care unit, Douala General Hospital, Douala, Cameroon.
authors.forename: Tchuenkam
authors.initials: T
authors.lastname: Landry
authors.affiliation: General intensive care unit, Douala General Hospital, Douala, Cameroon.
authors.forename: Ulrich Flore Nyaga
authors.initials: UF
authors.lastname: Tchawa
authors.affiliation: General intensive care unit, Douala General Hospital, Douala, Cameroon.
authors.forename: Romuald
authors.initials: R
authors.lastname: Hentchoya
authors.affiliation: General intensive care unit, Douala General Hospital, Douala, Cameroon.
authors.forename: Gerard
authors.initials: G
authors.lastname: Beyiha
authors.affiliation: Department of Nephrology and Hemodialysis, Douala General Hospital, Douala, Cameroon.
authors.forename: Marie Patrice
authors.initials: MP
authors.lastname: Halle
authors.affiliation: Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon.
authors.forename: Leopold
authors.initials: L
authors.lastname: Aminde
authors.affiliation: Clinical Research Education, Networking and Consultancy (CRENC), Douala, Cameroon ; Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa ; Cardiology unit, Department of Internal Medicine, Douala General Hospital and Faculty of Health Sciences, University of Buea, Buea, Cameroon.
authors.forename: Anastase
authors.initials: A
authors.lastname: Dzudie
mesh_terms: D000328:Adult; D002163:Cameroon / Q000453:epidemiology; D004461:Eclampsia / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005865:Gestational Age; D017359:HELLP Syndrome / Q000453:epidemiology* / Q000628:therapy; D006769:Hospitals, General; D006801:Humans; D007362:Intensive Care Units; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
keywords: Hypertension; intensive care; outcome; preeclampsia; pregnancy