scholarly journals Profil pasien preeklamsia berat dan eklamsia di ICU dan HCU RSUP Prof. Dr. R. D. Kandou Manado

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Vania Nita Patty ◽  
Diana Ch. Lalenoh ◽  
Debby D. Wuisan
Keyword(s):  
Medical Records ◽  
Hellp Syndrome ◽  
Seizure Activity ◽  
Study Data ◽  
Severe Preeclampsia ◽  
Inclusion Criteria ◽  
Median Length ◽  
Hypertension In Pregnancy ◽  
Grand Mal ◽  
New Onset

Abstract: Preeclampsia was defined as hypertension in pregnancy that occurs after 20th weeks of pregnancy meanwhile eclampsia is the new onset of a grand mal seizure activity and is one of the complications of preeclampsia. Preeclampsia and eclampsia are still the major causes of high maternal and infant mortality in Indonesia (1.5% -25%). Severe preeclampsia becomes an indication of obstetric patients to be admitted to ICU. This study was aimed to obtain the profile of patients with severe preeclampsia and eclampsia admitted to the ICU and HCU Prof. Dr. R.D. Kandou Hospital. This was a descriptive retrospective study. Data were obtained from the medical records of patients admitted to the ICU and HCU from September 2014 to August 2016. There were 33 patients that met the inclusion criteria consisted of 11 patients (33%) with severe preeclampsia and 22 patients (67%) with eclampsia. Most patients were aged ≤ 25 years and the median length of stay in this study was 2 days. HELLP syndrome was found in 9 patients (27.3%) and DIC in 1 (3%) patient. There were five patients with ventilator and three patients died due to eclampsia. Conclusion: Most patients in this study were patients with eclampsia and the mortality rate was 9.1%.Keywords: severe preeclampsia, eclampsia, ICU, HCU Abstrak: Preeklamsia didefinisikan sebagai hipertensi dalam kehamilan yang terjadi setelah minggu ke- 20 kehamilan, sedangkan eklamsia adalah onset baru aktifitas kejang grand mal dan merupakan salah satu komplikasi dari preeklamsia. Preeklamsia dan eklamsia masih menjadi penyebab utama tingginya angka kematian ibu dan bayi di Indonesia (1,5%-25%). Preeklamsia berat menjadi indikasi pasien obstetri masuk ke ICU. Penelitian ini bertujuan untuk mengetahui gambaran pasien preeklamsia berat dan eklamsia yang dirawat di ICU dan HCU RSUP Prof. Dr. R.D. Kandou. Jenis penelitian ialah deskriptif retrospektif. Data diperoleh melalui data rekam medik pasien yang dirawat di ICU dan HCU periode September 2014 - Agustus 2016 dan didapatkan sebanyak 33 pasien yang memenuhi kriteria inklusi. Total pasien preeklamsia berat ialah 11 orang (33%) dan eklamsia sebanyak 22 orang (67%). Usia ≤25 tahun ialah usia terbanyak dan median lama rawat dalam penelitian ini ialah 2 hari. Kejadian HELLP syndrome pada kasus ini sebanyak 9 orang (27,3%) dan DIC sebanyak 1 orang (3%). Pasien dengan ventilator sebanyak 5 orang dan pasien yang meninggal akibat eklamsia sebanyak 3 orang. Simpulan: Dalam penelitian ini pasien terbanyak ialah pasien eklamsia dengan angka kematian 9,1%. Kata kunci: preeklamsia berat, eklamsia, ICU, HCU

scholarly journals KARAKTERISTIK DAN LUARAN PREEKLAMPSI DI RSUP PROF. DR. R.D. KANDOU MANADO

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Wahyuni Silomba ◽  
John Wantania ◽  
Joice Kaeng
Keyword(s):  
Maternal Mortality ◽  
Medical Records ◽  
Perinatal Death ◽  
Study Data ◽  
World Health ◽  
Maternal Deaths ◽  
Perinatal Deaths ◽  
Live Births ◽  
Hypertension In Pregnancy ◽  
Mild Preeclampsia

Abstract: Maternal mortality is still one of the world health problems. It was estimated that  more than 536,000 women per year died due to labor. In 2007, Indonesia maternal mortality rate (MMR) was 248 per 100,000 live births, which was the highest among SoutheastAsia countries. The most frequent cause of maternal mortality is hypertension in pregnancy. The insidence of pre-eclampsia in Indonesia is approximately 3-10% of all cases of pregnancies, which is 23.6 per 1,000 births. This study aimed to determine the characteristics and outcomes of pre-eclampsia in Prof. Dr. R.D Kandou General Hospital Manado. This was a retrospective descriptive study. Data were obtained from the medical records of pre-eclampsia patients from January 1 until December 31, 2011 at the Department of Obstetrics Gynecology Clinic. There were 328 patients admitted to the hospital with a diagnosis of pre-eclampsia or eclampsia. The data consisted of 121patients with mild pre-eclampsia, 103 patients with severe pre-eclampsia, 86 patient with superimposed pre-eclampsia, and 18 patients with eclampsia. Maternal deaths were 11.1 %. Perinatal deaths in mild preeclampsia were 1.6%; in severe preeclampsia 3.8%; in super-imposed pre-eclampsia 3.5%; and in eclampsia 11.1%. Conclusion: The most frequent cases of pre-eclampsia were mild pre-ecxlampsia, followed by severe pre-eclampsia, super-imposed pre-eclampsia, and eclampsia respectively. Perinatal deaths were the highest in eclampsia cases. Keywords: preeclampsia, superimposed, eclampsia, maternal death, perinatal death.     Abstrak: Kematian ibu masih merupakan salah satu masalah kesehatan dunia. Diperkirakan lebih dari 536.000 ibu per tahunnya meninggal akibat persalinan.Di Indonesia Angka Kematian Ibu (AKI) tahun 2007 adalah 248 per 100.000 kelahiran hidup, yang tertinggi dibandingkan negara-negara di Asia Tenggara. Salah satu penyebab kematian ibu bersalin paling sering yaitu hipertensi dalam kehamilan. Angka kejadian preeklampsi di Indonesia sekitar 3 – 10% dari semua jumlah kehamilan yaitu 23,6 kasus per 1.000 kelahiran. Penelitian ini berttujuan untuk mengetahui karakteristik dan luaran preeklampsi (PE) di BLU RSUP Prof. Dr. R. D Kandou Manado.Penelitian ini bersifat retrospektif deskriptif dengan melihat data rekam medik pasien PE periode 1 Januari – 31 Desember 2011 di Bagian Obstetri-Ginekologi. Terdapat 328 pasien yang dirawat dengan diagnosis PE sampai eklampsi, terdiri dari 121 preeklampsi ringan (PER), 103 preeklampsi berat (PEB), 86 superimposed preeklampsi, dan 18 eklampsi. Kematian maternal sebesar 11,1%. Kematian perinatal pada PER sebanyak 1,6%, PEB sebesar 3,8%, super-imposed PE sebesar 3,5%; sedangkan eklampsi sebesar 11,1%. Simpulan: Jenis preeklamsi yang tersering ialah PER, diikuti PEB, super-imposed preeklamsi, dan eklamsi. Kematian perinatal tertinggi pada kasus eklamsi. Kata kunci : preeklampsi, superimposed, eklampsi, kematian maternal, kematian perinatal.

scholarly journals Analysis of Methyldopa Therapy on sFlt-1 Antiangiogenic Levels in Patients with Severe Preeclampsia

2018 ◽  
Vol 54 (1) ◽  
pp. 46
Author(s):  
Teri Wina Herwati ◽  
Yulistiani Yulistiani ◽  
Eddy Zarkaty M
Keyword(s):  
Cross Section ◽  
Severe Preeclampsia ◽  
Standard Protocol ◽  
Inclusion Criteria ◽  
First Line ◽  
Percentage Decrease ◽  
Protein Levels ◽  
Hypertension In Pregnancy ◽  
Before And After ◽  
A Prospective Study

Methyldopa is the first-line drugs to treat hypertension in pregnancy. It can decrease blood pressure in preeclampsia by affecting a2-adrenoreceptors in central nervous system. However, it could also act by decreasing  production of sFlt-1 antiangiogenic protein levels involved in the pathophysiology of hypertention  in preeclampsia. The purpose of this study was to analyze methyldopa therapy on sFlt-1 antiangiogenic levels in the plasma of pregnant women with severe preeclampsia at the Obstetric Departement, Haji Hospital, Surabaya. This was a prospective study with observational cross-section study design. The sFlt-1 angiogenic levels were observed before and after (48 hours) methyldopa administration in severe preeclampsia patient with or without complications in the period of August to October 2016. Patient received methyldopa 250 mg or 500 mg, three times a day for clinical indications according a standard protocol. The study was approved by the ethical committee of Haji Hospital, Surabaya. There were 19 patients with preeclampsia who met the inclusion criteria, showed a decrease in the levels of sFlt-1 before and 48 hours after methyldopa therapy. Levels of sFlt-1 before methyldopa therapy in a dose of 250 mg was 10.15±10.00 (2.55-34.70) ng/ml and after therapy 8,37±9,20 (0.72-9.20) ng/ml, with a percentage decrease 17.54%. sFlt-1 levels before methyldopa therapy in a dose of 500 mg was 8.05±7.07 (2.55-20.76) ng/ml, after  therapy 4.50±2.90 (2.19-9.95) ng/ml, with a percentage decrease 44.16%. Methyldopa therapy could decrease sFlt-1 levels of antiangiogenic factor in patients with severe preeclampsia.

scholarly journals TO COMPARE THE EFFICACY OF LABETALOL AND METHYLDOPA IN TREATMENT OF PREGNANCY INDUCED HYPERTENSION

2020 ◽  
pp. 54-55
Author(s):  
Ashish Yadav ◽  
Rohitash Kularia ◽  
Subash Chandra ◽  
Anita Sharma
Keyword(s):  
Antihypertensive Drugs ◽  
Pregnancy Induced Hypertension ◽  
Inclusion Criteria ◽  
Hypertension In Pregnancy ◽  
Induced Hypertension ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Labour Room ◽  
New Onset

Background- The present study is undertaken with limited available facilities to find out the efficacy of two oral antihypertensive drugs namely labetalol and methyldopa in management of pregnancy induced hypertension. Methods- The study consisted of 100 patients with pregnancy induced hypertension attending outpatient department and admitted in ANW, or who directly came to labour room. These patients were randomly selected on lottery basis after they fulfilled the inclusion criteria. Total 100 patients were taken for the study and divided into 2 groups of 50 patients in each group. Results- The mean SBP before treatment in methyldopa group was161.33 ± 8.97 mmHg and 160.03 ± 8.23 mmHg in labetalol group which showed a fall to 138.61 ± 6.67 mmHg (methyldopa group) and 138.08 ± 5.37 mmHg (labetalol groups) after treatment. Fall of SBP was significant in both the groups. But inter group difference was not significant (p > 0.05). The mean DBP before treatment was 106.85 ± 4.33 mmHg in methyldopa group and 105.63 ± 5.23 mmHg in labetalol group which decreased to 89.31 ± 6.51 mmHg and 89.68 ± 5.26 mmHg respectively after treatment. Fall of DBP was significant in both the groups. But inter group difference was not significant (p > 0.05). Fall of MAP was significant in Group A and Group B. But inter group difference was not significant (p > 0.05). Conclusion-Labetalol and methyldopa are equally efficacious in controlling blood pressure in new onset hypertension in pregnancy.

scholarly journals ECLAMPSIA AT 16 WEEKS GESTATION ASSOCIATED WITH PARTIAL MOLAR PREGNANCY

2021 ◽  
Vol 9 (04) ◽  
pp. 218-222
Author(s):  
Y. Aitbenkaddour ◽  
◽  
K. Elbehja ◽  
N. Louridi ◽  
H. Ouadi ◽  
...  
Keyword(s):  
Postpartum Period ◽  
Early Onset ◽  
Seizure Activity ◽  
Hydatidiform Mole ◽  
Molar Pregnancy ◽  
Placental Dysfunction ◽  
Grand Mal ◽  
Early Case ◽  
Early Onset Preeclampsia ◽  
New Onset

Eclampsia is a complication of severe preeclampsia.It’s commonly defined as new onset of grand mal seizure activity and/or unexplained coma during pregnancy or postpartum in a woman with signs or symptoms of preeclampsia. It typically occurs during or after the 20th week of gestation or in the postpartum period. [1, 2].Otherwise‚hydatidiform mole can be associated with very early-onset preeclampsia .In both pathologies ‚various maternal symptoms arise from placental abnormalities. We present a very early case of eclampsia complicating a partial molar pregnancy associated with an exceptional Presssyndrom. Keyword: pre-eclampsia, hydatiform mole‚ placental dysfunction.

scholarly journals Surgical Task Shifting Helps Reduce Neonatal Mortality in Ethiopia: A Retrospective Cohort Study

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Yihun Tariku ◽  
Tadele Gerum ◽  
Mareshet Mekonen ◽  
Haddis Takele
Keyword(s):  
Neonatal Mortality ◽  
Medical Records ◽  
Task Shifting ◽  
Study Data ◽  
Inclusion Criteria ◽  
Newborn Outcomes ◽  
Duration Of Hospitalization ◽  
Null Value ◽  
Major Factors ◽  
Improve Access

Background. To improve access to surgical service and to reduce neonatal mortality Ethiopia implemented surgical task shifting to nonphysician surgeons (NPSs). We aim at assessing surgical outcomes between NPSs and physician surgeons working in two hospitals. Methods. We collected data from two hospitals on 474 maternal medical records. Completed maternal medical records were included in this study. Data were entered into Epi Info version 7 and analyzed by SPSS version 20 software. Both descriptive and inferential statistics were done. If the 95% confidence interval values exclude the null value, the factor was considered as a significant factor. Result. Totally, 3429 mothers delivered in two hospitals. Of them, 840 (24.5%) delivered by caesarian section (CS), but 474 mothers’ records meet the inclusion criteria included in this study. Of 474 CS deliveries, the majority (82%) of them were performed by NPS. Maternal or fetal emergency conditions were the main reasons (92.0%, n=436) for CS. Task shifting does not affect immediate newborn outcomes (ARR, 1.24 (0.55, 2.78)), but duration of hospitalization (ARR: 4 (2.3, 7.5)), condition of the fetus during admission (ARR: 5.22 (2.9, 9.2)), and type of anesthesia used (ARR: 0.2 (0.1, 0.4)) significantly determine the outcome. Conclusion. Surgical task shifting to NPS does not affect the immediate newborn outcome. But general anesthesia is one of the major factors that affects the outcome.

scholarly journals Pulmonary hypertension imitating HELLP syndrome

2013 ◽  
Vol 6 (4) ◽  
pp. 169-171 ◽  
Author(s):  
Adam Morton
Keyword(s):  
Pulmonary Hypertension ◽  
Connective Tissue ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Severe Preeclampsia ◽  
Severe Pulmonary Hypertension ◽  
Connective Tissue Disorders ◽  
Hypertension In Pregnancy ◽  
Elevated Liver Enzymes ◽  
End Stage

A case of undiagnosed pulmonary hypertension in a woman with mixed connective tissue disease presenting with microangiopathic haemolysis, thrombocytopenia and elevated liver enzymes imitating severe preeclampsia (HELLP syndrome) is described. Connective tissue disorders are associated with an increased prevalence of pulmonary hypertension. Maternal mortality rates with pulmonary hypertension in pregnancy are extremely high. All women with connective tissue disorders should have pulmonary hypertension excluded by echocardiography before attempting conception. End-stage pulmonary hypertension may be associated with haemolysis and thrombocytopenia and thus may imitate severe preeclampsia in pregnant women. There may be a role for extracorporeal membrane oxygenation in the peripartum management of women with severe pulmonary hypertension.

scholarly journals PROPHYLACTIC ANTIBIOTICS IN CAESAREAN DELIVERIES IN A TERITIARY CARE TEACHING HOSPITAL

2021 ◽  
pp. 60-63
Author(s):  
RAJASREE GADDE ◽  
SAJANA GOGINENI ◽  
KANCHARLA CHANDANA SRI ◽  
JIRRA INDRAJA ◽  
MARADANI BRAHMI ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Medical Records ◽  
Prospective Observational Study ◽  
Skin Incision ◽  
Study Data ◽  
Prophylactic Antibiotics ◽  
Inclusion Criteria ◽  
Nice Guidelines ◽  
Post Surgery ◽  
Collection Form

Objective: Prophylactic antibiotics are used to prevent post-operative infections after Caesarean Section. Studies have suggested a significant role in the timing of prophylaxis. The aim of the study was to evaluate the pattern of antibiotics used and to identify the frequency of post-operative infections in patients undergoing Caesarean Section. Methods: A prospective observational study was carried out for 6 mo. A total of 120 patients who met the inclusion criteria were recruited into the study. Data collection form was prepared using NICE guidelines. A total of 120 medical records were analysed. Results: The results revealed that out of 120 study subjects, prophylactic antibiotics Cefotaxime, Metronidazole and Cefixime were used in 119 (99.17%). Conclusion: This study concludes that giving prophylactic antibiotics before skin incision reduces risk of post-operative infections in women undergoing Caesarean Section. As the patients did not produce any infections post-surgery 3rd generation Cephalosporins along with Nitro-imidazoles can be considered as an effective prophylactic therapy for use during caesarean sections.

Early-Onset Preeclampsia with Pulmonary Edema and Massive Ascites: A Rare Presentation of Severe Preeclampsia or Concomitant Diagnoses?

2020 ◽  
Vol 2020 ◽  
Author(s):  
Elizabeth St. Laurent ◽  
Rebecca Fryer-Gordon ◽  
Tom McNeilis, ◽  
Leonard B. Goldstein
Keyword(s):  
Pulmonary Edema ◽  
Early Onset ◽  
Hellp Syndrome ◽  
Disease Process ◽  
Massive Ascites ◽  
Elevated Liver Enzymes ◽  
Biophysical Profile ◽  
Patient Reported ◽  
Early Onset Preeclampsia ◽  
New Onset

Preeclampsia, eclampsia, and HELLP syndrome, are a continuum of a dangerous disease process that can occur in pregnancy. Preeclampsia is defined by new onset hypertension and proteinuria. In more severe cases, preeclampsia can be associated with pulmonary edema, oliguria, persistent headaches, and impaired liver function. These symptoms reveal maternal end organ damage which may result in danger to the fetus such as oligohydramnios, decreased fetal growth, and placental abruption. The defining difference between preeclampsia and eclampsia is the presence of new onset seizure activity. HELLP syndrome occurs when the mother experiences hemolysis, elevated liver enzymes, and low platelets. This syndrome is seen in about 0.6% of pregnancies. Each of these conditions (preeclampsia, eclampsia, and HELLP) increase both the fetal and maternal morbidity and mortality rates with the most definitive cure being delivery of child and placenta.A 28 year-old Caucasian, G1P0 female at 26w4d presented to OB triage on the recommendation of her physician due to elevated uric acid levels and a recorded blood pressure of 180/110. The patient reported rapid onset of weight gain, facial edema, diminished fetal movements, and frequent headaches. Although the patient denied labor symptoms, she complained of back pain and was admitted to the hospital at 26w4d for observation due to elevated blood pressures. The patient was diagnosed with preeclampsia with severe features. As her presentation progressed, the patient developed massive ascites and pulmonary edema along with decreasing platelet counts and increasing liver enzyme values. Due to decreasing biophysical profile (BPP) scores of the fetus and decompensating lab values of the mother, an emergency cesarean was performed for the safety of mother and baby.This case presentation demonstrates the progression of hypertensive disorders of pregnancy with a rare and severe presentation of early-onset preeclampsia with severe features, pulmonary edema, and massive ascites that ultimately led to class III HELLP syndrome and extreme prematurity of the infant.

Seizures following surgery for supratentorial extratemporal low-grade tumors in children: a multicenter retrospective study

2020 ◽  
Vol 26 (1) ◽  
pp. 27-33
Author(s):  
Jonathan Roth ◽  
Or Bercovich ◽  
Ashton Roach ◽  
Francesco T. Mangano ◽  
Arvind C. Mohan ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Brain Tumors ◽  
Seizure Control ◽  
Seizure Activity ◽  
Refractory Epilepsy ◽  
Low Grade ◽  
Refractory Seizures ◽  
Low Rate ◽  
Over Time ◽  
New Onset

OBJECTIVEResection of brain tumors may lead to new-onset seizures but may also reduce seizure rates in patients presenting with seizures. Seizures are seen at presentation in about 24% of patients with brain tumors. For lesional epilepsy in general, early resection is associated with improved seizure control. However, the literature is limited regarding the occurrence of new-onset postoperative seizures, or rates of seizure control in those presenting with seizures, following resections of extratemporal low-grade gliomas (LGGs) in children.METHODSData were collected retrospectively from 4 large tertiary centers for children (< 18 years of age) who underwent resection of a supratentorial extratemporal (STET) LGG. The patients were divided into 4 groups based on preoperative seizure history: no seizures, up to 2 seizures, more than 2 seizures, and uncontrolled or refractory epilepsy. The authors analyzed the postoperative occurrence of seizures and the need for antiepileptic drugs (AEDs) over time for the various subgroups.RESULTSThe study included 98 children. Thirty patients had no preoperative seizures, 18 had up to 2, 16 had more than 2, and 34 had refractory or uncontrolled epilepsy. The risk for future seizures was higher if the patient had seizures within 1 month of surgery. The risk for new-onset seizures among patients with no seizures prior to surgery was low. The rate of seizures decreased over time for children with uncontrolled or refractory seizures. The need for AEDs was higher in the more active preoperative seizure groups; however, it decreased with time.CONCLUSIONSThe resection of STET LGGs in children is associated with a low rate of postoperative new-onset epilepsy. For children with preoperative seizures, even with uncontrolled epilepsy, most have a significant improvement in the seizure activity, and many may be weaned off their AEDs.

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