Preeclampsia and Its Maternal and Perinatal Outcomes in Pregnant Women Managed in Bahrain's Tertiary Care Hospital

Abstract

Objective: Hypertensive disorders during pregnancy being the leading causes of maternal and fetal morbidity and mortality remains a serious health issue worldwide due to the high rate of adverse maternal outcomes and close association with neonatal morbidity and mortality. The purpose of our study was to ascertain the perinatal outcomes of preeclampsia (PE) in a tertiary care hospital in Bahrain.

Methods: A retrospective cohort study was conducted from January 2018 to December 2019 in the department of Gynecology and Obstetrics in Bahrain Defense Hospital. The process of data collection included a baseline review of all women who had delivered during the study period in order to identify those with PE. Additionally, the postdelivery records of the mothers and newborns were reviewed to identify relevant maternal and neonatal outcomes.

Results: During the research period, records revealed 142 patients with PE with a rate of 1.95%. The mean gestational age at diagnosis was 35.61 (± 3.69) weeks, ranging between 20 and 42 weeks. The mean birth weight was 2.64 ± 0.79 kg, ranging from 0.5-4.5 kg. Furthermore, most babies had an Apgar score of 9 at 5 minutes. The preterm delivery rate was (16.3%) and intrauterine growth restriction (IUGR) was seen in 19 patients (13.5%) and it was significantly higher in patients who presented between 30 and 34 gestational weeks P < 0.001. Twenty-one infants were admitted to the NICU primarily for prematurity and low birth weight. There was only one early neonatal death of a hydrops baby. One infant was stillborn with extreme prematurity at 24 weeks+4 days. Maternal complications included five abruption placentae (3.5%) cases, five HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) cases (3.5%), four eclampsia (2.8%) cases, and four patients had ICU admission. Other maternal complications included acute renal failure (ARF) in two patients (1.4%), pulmonary edema in one patient, and peripartum cardiomyopathy in one patient. Data showed that adverse pregnancy outcomes were significantly more common in those with PE as compared to other pregnant populations.

Conclusion: Preeclampsia causes a remarkable increase in adverse maternal and perinatal outcomes as compared to the normotensive pregnant population. A regular goal-oriented clinical audit into perinatal morbidity and mortality associated with this condition and an active multidisciplinary approach to the management of pre-eclampsia patients in the hospital might improve the clinical outcomes.

Keywords: pre-eclampsia; pregnancy; pregnancy complication; pregnancy induced hypertension; pregnancy outcome.