Prevalence of The Risk Factors Associated with Pre-eclampsia and Eclampsia Disorders in a Tertiary Care Hospital of Lahore, a cross sectional study

Abstract

Abstract Introduction: Pre-eclampsia (PE) is a multi-system hypertensive condition characterized by a blood pressure of greater than 140/90 mmHg recorded on two separate readings at least 4 hours apart and associated with proteinuria or end organ dysfunction. It is called Eclampsia when a patient with pre-eclampsia develops tonic-clonic seizures as well. It is thought to occur due to disordered trophoblastic invasion that causes uteroplacental hypoperfusion, leading to widespread endothelial dysfunction. Risk factors include PE in a previous pregnancy, Chronic kidney disease, diabetes mellitus, chronic hypertension or autoimmune diseases. Increased maternal age, high BMI and family history also play a role in its pathology. Pakistan has the third highest maternal mortality according to a recent global health analysis, 29% of this is contributed by hypertensive disorders. This study aims to study the predisposing risk factors in pre-eclampsia patients at a tertiary care hospital. Methods: 82 selected cases of pre-eclampsia and eclampsia were included in this cross-sectional study. Informed consent was taken from all the patients and a pre-tested questionnaire was filled out by interviewing them during their antenatal visits. Results: Most (61%) of the patients were in the third decade (20-29) of their life. The mean of the blood pressure checked at the time of interviewing was 153/95 mmHg. The majority (54.90%) of the patients were overweight (BMI=26-34.9). The most commonly identified risk factors include; raised diastolic BP at the booking visit (60%), history of pre-eclampsia in a previous pregnancy (41%), nulliparity (37%), obesity (37%) family history of pre-eclampsia (28%), GDM (21%) and chronic HTN (13%). Other less common risk factors include severe anemia (9%), a gap of more than 10 years (7%), multiple gestations (5%) and maternal age of more than 35 years (4%). Conclusion: Pre-eclampsia is a significant threat to maternal as well as fetal life. And it has a higher incidence in the developing part of the world. Various risk factors are attributed to its pathophysiology. Prompt diagnosis and proper management and monitoring can reduce the morbidity and mortality associated with pre-eclampsia.