Maternal and fetal morbidity and mortality among pregnancies complicated by pre-eclampsia in Omdurman Maternity hospital, Sudan

Background: Maternal mortality and morbidity are one of the biggest problems worldwide. Every day approximately 830 women die from preventable causes related to pregnancy and child birth. Ninety nine percent of these deaths occur in developing countries of which more than half are in sub Saharan Africa and one third in South Asia. Preeclampsia may lead to prematurity, still birth, intrauterine growth retardation and perinatal death. Consequently early diagnosis of preeclampsia and close observation are imperative. Despite advances in medical practice pre-eclampsia still remains a leading cause of maternal and prenatal morbidity and mortality.This study was conducted at Omdurman Maternity Hospital (OMH) in Sudan to assess the mortality and morbidity among the pre-eclampsia mothers admitted for delivery and among the babies delivered to them Material and methods: It was a prospective cross sectional hospital based study conducted at Omdurman Maternity Hospital (OMH) in Sudan. All the pregnant women with preeclampsia who delivered during June – December 2020 in the hospital were the study population. Sample size was calculated by using this equation, N = Z2X P (1-P)\ e2, Where N = Sample Size. Z = Value 1.96., P = Prevalence. Total 97 women meeting the inclusion criteria was the sample size. Systematic sampling method was applied to collect the files of women admitted in preeclampsia ward. Data were retrieved from the files of the patients which consisted of sociodemographic information, medical and obstetric history, family history, factors associated with preeclampsia and the outcome of the treatment, maternal and prenatal morbidity and mortality. The data were entered and analyzed by using SPSS, version 21 .Descriptive statistics were presented using counts, proportions (%), and mean ± standard deviation whenever appropriate. The comparison study was done by using chi square. A p-value cut off point of 0.05 at 95% CI was used to determine statistical significance. Results: The data from the files of 97 patients with preeclampsia were retrieved for the analysis. Majority of them were in the age group of 20 years or less Almost fifty percent (N=48) were nulliparous while 20.6 %( N=20) were having 2 children, 12.4% having three children and 17.5% had 4 and more children. The gestational age of majority of the patients (64.9%) attending the hospital was between 36-38 weeks. Only 19.6% of the patients were having past history of pre-eclampsia. Ninety nine percent of the patients did not have the family history of preeclampsia. Thirty seven percent of the patients were suffering from severe hypertension at admission while thirty eight percent were suffering from moderate hypertension and only 24.7% were suffering from mild hypertension. The blood pressure at the time of delivery was recorded as normal among the 9.30% of the patients, while mild among 26.80% moderately high among 29.9% and very high among 33% of the patients. As far as the investigations are concerned the vast majority of the patients (96.9%) had 1+ to 3+ protein Urea while 3.1% were having more than 3+ protein Urea in the urine. The majority of the pregnant women (59.8%) had blood hemoglobin level higher than 11 gm. /dl while 35.1% had between 9-11 mg/dl and only 4.1% with blood hg level less than 9gm/dl. Most of the patients (84.5%) underwent caesarian section for delivery. Almost eighty nine percent of the mothers totally recovered after delivery while 9.3% suffered temporal disability and 2.1% by permanent disability. As far as the infant outcome is concerned 68% were born on term while 18.6% as preterm, 8.2% IUFD and 5.2% as term +A life. Thirty three percent of the baby born was of normal weight while majority of them (64.90%) were underweight and only 2.10% were overweight. Conclusion: As far as mortality and morbidity among the mothers and the newborn baby is concerned, though no mortality was reported among the baby and the mothers. Morbidity such as IUFD and low birth weight were reported among babies while majority of the patients with pre-eclampsia underwent caesarian section for delivery and very few mothers suffered from temporal and permanent disability. However the more investment must be made in women’s health needs to reduce the problem and health service providers need to give due attention to high-risk women.