The deviated management of preeclampsia with severe features at Maharat Nakhon Ratchasima Hospital

Abstract

          Objectives: To study the prevalence and causes of deviated management of preeclampsia with severe features and to study the complications of preeclampsia with severe features at Maharat Nakhon Ratchasima Hospital (MNRH). Patients and Methods: This retrospective descriptive study collected data from referral letters and medical records of preeclampsia with severe features and eclampsia at MNRH diagnosed and treated between 1 December 2014 and 31 October 2015. The standard management guidelines include antihypertensive treatment, MgSO₄ for convulsion prevention, termination of pregnancy; and prevention of complication. The patients were categorized into 2 groups whether there was deviated management or not. The data of two groups were expressed as percentage and compared using the Chi-Square test and if p-value was < 0.05, it would be considered statistically significant. Results: Among 186 patients with diagnosis of preeclampsia with severe features and eclampsia, deviated management was found in 154 patients (81.7 %). The top-three common deviated managements were the subtherapeutic level of MgSO₄ before delivery (61.2 %), delayed increment of MgSO₄ despite subtherapeutic level (50.7 %) and delayed laboratory test results (46.1 %). In deviated management group, 84.4 % had BMI >25 kg/m² that were significantly more than those of the usual management group. However, the pregnancy outcomes and complications among two groups were not different. Conclusion: The deviated management was found in more than 80 % of preeclampsia with severe features and eclampsia at MNRH but no serious sequelae were seen.