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Risk Analysis of Intensive Care Mangement on Maternal and Fetal Outcome of Severe Preeclampsia and Eclampsia

Completed
Conditions
Hypertensive Disorder of Pregnancy
Interventions
Registration Number
NCT03412552
Lead Sponsor
Cairo University
Brief Summary

Laboratory monitoring of patients included serial measurement of complete blood cell count, liver function tests, coagulation profile, and renal function tests.

ICU management during conduction of the research study included the following:

Control of convulsions using magensium sulphate. Control of blood pressure Diastolic blood pressure above 110 mmHg, nifedipine was administered.A plasma volume expansion with saline was used in all women to maintain sufficient intravascular volume. Delivery was performed immediately after hemodynamic stabilization and clinical control of general condition .

Detailed Description

Laboratory monitoring of patients included serial measurement of complete blood cell count, liver function tests, coagulation profile, and renal function tests.

ICU management included the following:

Control of convulsions by Loading dose of magensium sulphate (4-6g I.V), given over 20 minutes in 100 ml of dextrose then Maintenance dose (4-6g) magensium sulphate in 500 cc dextrose given over 8 hours using continuous IV drip.Control of blood pressure if Diastolic blood pressure above 110 mmHg, nifedipine was administered. Delivery was performed immediately after hemodynamic stabilization and clinical control of general condition .Termination of gestation decision was based on the the presence of maternal complications, fetal distress.After delivery the patient is retrurned to ICU under clinical and careful observation of the following:Heart rate, blood pressure,every 15 min,Temperature and respiratory rate ,evey 4 hours. Duration of admission in the ICU was assessed

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
1238
Inclusion Criteria
  • women with severe preeclampsia or eclampsia or HELLP syndrome admitted to ICU
Exclusion Criteria

Non eclamptic causes of fits, including hysterical causes and epilepsy

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
eclampsia without HELLP syndromeMgSO4Eclampsia was defined as tonic-clonic seizures occurring in patient diagnosed by preeclampsia patient. Any causes for convulsion other than eclampsia were excluded
severe preeclampsia without HELLP syndromeMgSO4severe preeclampsia if they met one or more of the following criteria of The American College of Obstetricians and Gynecologists (10): systolic blood pressure \>160 mm/ Hg or diastolic blood pressure \>110 mm/Hg, headache, epigastric or right-upper-quadrant pain, visual disturbances,pulmonary edema, and proteinuria (urinary protein level \>5 g/24 h).Women with severe preeclampsia selected for analysis also met all of the following laboratory criteria: platelet count ≥150,000/ mm3, serum lactate dehydrogenase \<600 IU /dL, serum total bilirubin \<1.2 mg/dL and serum aspartate aminotransferase \<70IU/L
eclampsia with HELLP syndromeMgSO4Eclampsia was defined as tonic-clonic seizures occurring in patient diagnosed by preeclampsia patient. Any causes for convulsion other than eclampsia were excluded.HELLP syndrome was defined by the clinical presentation of PET in association with thrombocytopenia (\<150.000 cells/ul), hemolysis and elevated liver enzmes (elevated transaminases and lactic dyhydrogenases activities)
HELLP syndrome without eclampsiaMgSO4HELLP syndrome was defined by the clinical presentation of PET in association with thrombocytopenia (\<150.000 cells/ul), hemolysis and elevated liver enzmes (elevated transaminases and lactic dyhydrogenases activities)
Primary Outcome Measures
NameTimeMethod
control of blood pressure24 hours after delivery

keeping blood pressure at or below 140/90

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Kasr Alainy medical school

🇪🇬

Cairo, Egypt

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