Study of Maternal and Perinatal Outcome in Early Onset Severe Pre Eclampsia: A Hospital Based Observational Study

Background: Pre eclampsia is a multisystem pregnancy complication that is typically characterized by new onset hypertension and proteinuria after 20 weeks of gestation and affects both mother and fetus. Early onset severe pre eclampsia that develops before 34 weeks of gestation is associated with high maternal and perinatal mortality and morbidity rates and prolonged hospitalization of babies in the neonatal intensive care unit because of pre maturity. Management of early onset severe pre eclampsia requires complex decision making and involves experienced obstetrician and availability of neonatal intensive care units. Aim and Objectives: To study maternal and perinatal outcomes in early onset severe pre eclampsia. Material and Methods: Consecutive 52 cases of severe pre eclampsia were selected from pregnant women admitted in the maternity ward of Smt. Sucheta Kriplani Hospital based on inclusion and exclusion criteria and maternal and perinatal outcomes were measured. Inclusion criteria were pregnant women with singleton live pregnancy, with severe pre eclampsia, ? 24 to less than 34 weeks of gestation and exclusion criteria were known cases of medical or other obstetric complications. Result: Out of 52 cases, 11 (21.1%) had antepartum eclampsia, 9 (17.3%) had abruption, 4 (7.7%) cases went into ARF, 1 (1.9%) developed HELLP syndrome and 1 (1.9%) developed pulmonary oedema, 39 (75%) cases delivered vaginally and 13 (25%) cases had LSCS due to different indications. In the postpartum period out of 52 cases, one woman had atonic PPH and one had retained placenta. Among 52 cases, 37 (71.1%) had live birth outcomes and 15 (28.8%) cases had stillbirth. Out of 37 live babies, 30 (81.1%) shifted to NICU, only 7babies (18.9%) were directly shifted to mother. Out of 37 live babies, 23 (62.1%) had RD at the time of birth, 27(73.0%) had sepsis during course of hospital stay, out of which 13 (35.1%) had clinical sepsis, 10 (27.0%) were suspected cases and 4 (10.8%) were confirmed cases, 28 (75.7%) had hypoglycaemia, 10 (27.0%) had hypocalcaemia, 7 (18.9%) had jaundice and 4 (10.8%) had other complications, 10 babies (27.0%) expired after varying duration of hospital stay. Conclusion: Early onset severe pre eclampsia is associated with increased risk of adverse maternaloutcome and poor perinatal outcome.