Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003
Article first published online: 28 JAN 2005
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 112, Issue 7, pages 875–880, July 2005
How to Cite
Tuffnell, D.J., Jankowicz, D., Lindow, S.W., Lyons, G., Mason, G.C., Russell, I.F., Walker, J.J. and On behalf of the Yorkshire Obstetric Critical Care Group (2005), Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003. BJOG: An International Journal of Obstetrics & Gynaecology, 112: 875–880. doi: 10.1111/j.1471-0528.2005.00565.x
- Issue published online: 17 MAY 2005
- Article first published online: 28 JAN 2005
Objective To establish the risk of serious complications from severe pre-eclampsia and eclampsia in a region using a common guideline for the management of these conditions.
Design A five-year prospective study.
Setting Sixteen maternity units in Yorkshire.
Population All women managed with severe pre-eclampsia and eclampsia.
Methods A common guideline was developed for the management of women with these conditions. A network of midwives prospectively collected outcome data.
Main outcome measure Incidence of the conditions and serious complication rates.
Results A total of 210,631 women delivered in the 16 units between 1 January 1999 and 31 December 2003. One thousand eighty-seven women were diagnosed with severe pre-eclampsia or eclampsia (5.2/1000). One hundred and fifty-one women had serious complications including 82 women (39/10,000) having eclamptic seizures and 49 women (23/10,000) requiring ICU admission. There were no maternal deaths but 54 out of 1145 babies died before discharge, giving a mortality rate of 47.2/1000. Of the 82 cases of eclampsia, 45 occurred antenatally (55%), 18 before admission to the maternity unit. Eleven cases occurred in labour (13%), including 1 during a caesarean section, and 26 cases occurred following delivery (32%). Twenty-five women developed pulmonary oedema (2.3% of cases) and six women required renal dialysis (0.55% of cases). One hundred and sixty-five (15%) required no antihypertensive therapy and 489 (53%) of the remainder required only oral therapy. Two hundred and one (18.5%) required more than one drug.
Conclusion A regional guideline for severe pre-eclampsia and eclampsia can be developed and implemented. Its use may contribute to a low rate of serious complications.