Nandini Raghuraman1, Melissa I March2, Michele R Hacker3, Anna Merport Modest1, Julia Wenger4, Rulx Narcisse5, Jean Louis David5, Jennifer Scott6, Sarosh Rana7. 1. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States. 2. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States; Division of Maternal Fetal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. 3. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. 4. Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States. 5. Department of Obstetrics and Gynecology, Hospital Albert Schweitzer, Deschapelles, Haiti. 6. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States; Division of Women's Health, Brigham and Women's Hospital, Boston, MA, United States; Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States. 7. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, United States; Division of Maternal Fetal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: srana1@bidmc.harvard.edu.
Abstract
OBJECTIVE: The purpose of this study was to define the prevalence and clinical characteristics of preeclampsia and eclampsia at a hospital in rural Haiti. METHODS: This is a retrospective review of women presenting to Hôpital Albert Schweitzer (HAS) in Deschapelles, Haiti with singleton pregnancy and diagnosis of preeclampsia or eclampsia from January 1, 2011 through December 31, 2012. Hospital charts were reviewed to obtain medical and prenatal history, hospital course, delivery information, and fetal/neonatal outcomes. The outcomes included placental abruption, antepartum eclampsia, postpartum eclampsia, maternal death, birthweight <2500g and stillbirth. Data are presented as median (quartile 1, quartile 3) or n (%) and risk ratios. RESULTS: During the study period, 1743 women were admitted to the maternity service at HAS and 290 (16.6%) were diagnosed with preeclampsia or eclampsia. Only singleton pregnancies were analyzed (N=270). Nearly all (95.0%) patients admitted with preeclampsia had severe preeclampsia. There were 83 patients with eclampsia (30.7%) of which 61 (73.4%) had antepartum eclampsia. There were 48 stillbirths (17.8%) and 5 maternal deaths (1.9%). Patients with antepartum eclampsia were younger, more likely to be nulliparous and had less prenatal care compared to women with antepartum preeclampsia. Antepartum eclampsia was associated with placental abruption and maternal death. CONCLUSIONS: The rates of preeclampsia and its associated complications, such as eclampsia, placental abruption, maternal death and stillbirth, are high at this facility in Haiti. Such data are essential to developing region-specific systems to prevent preeclampsia-related complications.
OBJECTIVE: The purpose of this study was to define the prevalence and clinical characteristics of preeclampsia and eclampsia at a hospital in rural Haiti. METHODS: This is a retrospective review of women presenting to Hôpital Albert Schweitzer (HAS) in Deschapelles, Haiti with singleton pregnancy and diagnosis of preeclampsia or eclampsia from January 1, 2011 through December 31, 2012. Hospital charts were reviewed to obtain medical and prenatal history, hospital course, delivery information, and fetal/neonatal outcomes. The outcomes included placental abruption, antepartum eclampsia, postpartum eclampsia, maternal death, birthweight <2500g and stillbirth. Data are presented as median (quartile 1, quartile 3) or n (%) and risk ratios. RESULTS: During the study period, 1743 women were admitted to the maternity service at HAS and 290 (16.6%) were diagnosed with preeclampsia or eclampsia. Only singleton pregnancies were analyzed (N=270). Nearly all (95.0%) patients admitted with preeclampsia had severe preeclampsia. There were 83 patients with eclampsia (30.7%) of which 61 (73.4%) had antepartum eclampsia. There were 48 stillbirths (17.8%) and 5 maternal deaths (1.9%). Patients with antepartum eclampsia were younger, more likely to be nulliparous and had less prenatal care compared to women with antepartum preeclampsia. Antepartum eclampsia was associated with placental abruption and maternal death. CONCLUSIONS: The rates of preeclampsia and its associated complications, such as eclampsia, placental abruption, maternal death and stillbirth, are high at this facility in Haiti. Such data are essential to developing region-specific systems to prevent preeclampsia-related complications.
Authors: Melissa I March; Carl Geahchan; Julia Wenger; Nandini Raghuraman; Anders Berg; Hamish Haddow; Bri Ann Mckeon; Rulx Narcisse; Jean Louis David; Jennifer Scott; Ravi Thadhani; S Ananth Karumanchi; Sarosh Rana Journal: PLoS One Date: 2015-05-12 Impact factor: 3.240
Authors: Hannah L Nathan; Paul T Seed; Natasha L Hezelgrave; Annemarie De Greeff; Elodie Lawley; John Anthony; David R Hall; Wilhelm Steyn; Lucy C Chappell; Andrew H Shennan Journal: Pregnancy Hypertens Date: 2017-11-21 Impact factor: 2.899
Authors: Isabelle Malhamé; Rodney Destiné; Widmise Jacquecilien; Bidjinie H Coriolan; Wacquinn St-Loth; Marie Claudy Excellent; Benjaminel Scaide; Remy Wong; Sarah Meltzer; Eddy Jean-Baptiste; Louise Pilote; Julia E von Oettingen; Kerling Israel Journal: J Glob Health Date: 2021-04-17 Impact factor: 4.413
Authors: Hannah L Nathan; Paul T Seed; Natasha L Hezelgrave; Annemarie De Greeff; Elodie Lawley; Frances Conti-Ramsden; John Anthony; Wilhelm Steyn; David R Hall; Lucy C Chappell; Andrew H Shennan Journal: J Glob Health Date: 2018-12 Impact factor: 7.664