A study to determine association of the interval between seizure and delivery with the APGAR scores and perinatal asphyxia of the neonates of eclamptic mothers of a rural tertiary care hospital in Eastern India
DOI:
https://doi.org/10.18203/2349-3291.ijcp20202150Keywords:
Apgar scores, Eclampsia, Perinatal asphyxia, Seizure to delivery intervalAbstract
Background: Eclamptic seizure not only affects maternal health but may predispose low APGAR scores and development of perinatal asphyxia and thereby influence perinatal mortality too. This study was carried out to evaluate the correlation of the interval between the onset of seizure and delivery with the APGAR scores (at 1 minute and 5 minutes) and perinatal asphyxia of the neonates of the eclamptic mothers.
Methods: A prospective, cross-sectional, observational, epidemiological study was conducted from April, 2012 to March, 2013 at a tertiary-care Government teaching hospital catering rural population of Eastern India. The participants comprised of 100 consecutive admitted eclamptic mothers and neonates born to them.
Results: Majority of mothers were unbooked, primigravidae (86%), aged below 20 years (66 %). Significant inverse correlation was observed between seizure to delivery interval and Apgar scores (1 min and 5 minutes), while seizure to delivery interval >12 hours was found to be a significant risk factor for perinatal asphyxia (OR =16.824, 95% CI = 5.107-55.424, p <0.001).
Conclusions: Measures to minimise the interval between the onset of seizures and delivery will decrease the incidence of perinatal asphyxia and perinatal mortality of neonates of eclamptic mothers in rural areas.
References
Cipolla MJ, Kraig RP. Seizures in women with preeclampsia: mechanisms and management. Fetal Maternal Medi Rev. 2011 May;22(2):91-108.
Nobis PN, Hajong A. Eclampsia in India through the decades. J Obstetr Gynecol Ind. 2016 Oct 1;66(1):172-6.
Damsky CH, Fisher SJ. Trophoblast pseudo-vasculogenesis: faking it with endothelial adhesion receptors. Curr Opin Cell Biol. 1998;10:660-666
Zhou Y, Damsky CH, Fisher SJ. Preeclampsia is associated with failure of human cytotrophoblasts to mimic a vascular adhesion phenotype. One cause of defective endovascular invasion in this syndrome?. J Clini Investig. 1997 May 1;99(9):2152-64.
Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, eds. Williams Obstetrics. 24th ed. New York: McGraw-Hill Professional; 2014: 732-743.
Brosens IA, Robertson WB, Dixon HG. The role of the spiral arteries in the pathogenesis of preeclampsia. Obstet Gynecol Annu. 1972;1:177-91.
Benyo DF, Smarason A, Redman CW, Sims C, Conrad KP. Expression of inflammatory cytokines in placentas from women with preeclampsia. The J Clini Endocrinol Metab. 2001 Jun 1;86(6):2505-12.
Nagamatsu T, Fujii T, Kusumi M, Zou L, Yamashita T, Osuga Y, et al. Cytotrophoblasts up-regulate soluble fms-like tyrosine kinase-1 expression under reduced oxygen: an implication for the placental vascular development and the pathophysiology of preeclampsia. Endocrinology. 2004 Nov 1;145(11):4838-45.
Roberts JM, Taylor RN, Musci TJ, Rodgers GM, Hubel CA, McLaughlin MK. Preeclampsia: an endothelial cell disorder. Am J Obstet Gynecol. 1989; 161:1200-4.
Sibai BM. Diagnosis, prevention, and management of eclampsia. Obstetr Gynecol. 2005 Feb 1;105(2):402-10.
Wasseff S. Mechanisms of convulsions in eclampsia. Medi Hypoth. 2009 Jan 1;72(1):49-51.
Warrington JP. Placental ischemia increases seizure susceptibility and cerebrospinal fluid cytokines. Physiolog Rep. 2015 Nov;3(11):e12634.
Fleisher MD, Lee A. Eclampsia. In: Roizen, Michael F. Roizen, Jeffrey D, eds. Essence of Anesthesia Practice. 4th ed. Philadelphia, Pa: Elsevier Inc; 2018: 153-154.
American College of Obstetricians and Gynecologists. Diagnosis and management of preeclampsia and eclampsia. Obstet Gynecol. 2002;99:159-67.
Kumar N, Shekhar C, Kumar P, Kundu AS. Kuppuswamy's socioeconomic status scale-updating for 2007. Ind J Pediatr. 2007 Dec;74(12):1131.
Shaheen B, Hassan L, Obaid M. Eclampsia, a major cause of maternal and perinatal mortality: a prospective analysis at a tertiary care hospital of Peshawar. J Pak Medi Assoc. 2003 Aug;53(8):346-9.
George IO, Jeremiah I. Perinatal outcome of babies delivered to eclamptic mothers: a prospective study from a Nigerian tertiary hospital. Int J Biomedi Sci: IJBS. 2009 Dec;5(4):390-4.
Shahabuddin AK, Hasnat M, Hamid T, Rahman AK. Perinatal outcome in eclampsia. Banglad J Child Health. 1996;20:8-14.
Alam IP, Akhter S. Perinatal Outcome of Eclampsia in Dhaka Medical College Hospital. Banglad J Obstetr Gynaecol. 2008;23(1):20-4.
Yaliwal RG, Jaju PB, Vanishree M. Eclampsia and perinatal outcome: a retrospective study in a teaching hospital. J of Clin and Diagn Res. 2011;5(5):1056-9.