|
KMID : 0358419750180121021
|
|
Korean Journal of Obstetrics and Gynecology
1975 Volume.18 No. 12 p.1021 ~ p.1031
|
|
|
A Clinical Observation of Eclampsia
|
|
金顯燦/Kim, H.C
朴性九/金順愛/金聖心/崔根海/李鍾錫/朴寅緖/Park, S.K/Kim, S.A/Kim, S.S/Choi, G.H/Rhee, C.S/Park, I.S
|
|
|
Abstract
|
|
|
It is well-known that eclampsia is the central problem in the clinical management of all toxemias which have one of the leading causes of maternal and perinatal -mortality and morbidity, and also take main portion of high risk pregnancy group in the developing country.
Eclampsia makes up a baffling complex of clinical problems and the pathogenesis of which has remained obscure despite extensive investigation along many different lines.. The conflict of opinion is not limited to the question of etiology but extends to the practical problems of clinical management.
It seemed worthwhile, therefore,to attempt a clinical observation of the 272 cases of eclampsia which were experienced during the last 11 years from January, 1965 to December, 1974 with a brief review of several concerning clinical aspects:
The results obtained were as follows:
1) The incidence of eclampsia was 2.8% of all deliveries and 11.7% of all toxemias. 2) About one half (48.9%) was concentrated on the age group of 21-25 and -the average age was 25.8 years.
3) The ratio between primipara and multipara was approximately 3 : 1.
4) The m+E610ajority (92.3%) was admitted as the emergency case (the unregistered) Only 5. 1 % of all cases took antenatal care before admission.
5) As to the seasonal distribution, no remarkable variation was found. Spring was the most prevalent season (29.8%) and summer, the least (18.0%). Autumn andd winter were same (26. 1 %) .
6) Antepartum, intrapartum and postpartum eclampsia were found in 61.4%,. 29.8%, and 7.3%, respectively.
7) Regarding the laboratory findings of known cases, antepartum and postpartumanemia (Hgb.: 10. 0 gm % or less) were 19.2 % and 57. 1 10/0, respectively. Over four-fifth (84.8%) revealed low total serum protein (less than 6. 0 gm%). About one. fourth (24.5%) showed elevated serum creatinine (more than 1.4 gm%) and overthree fourth (78.5%) showed low serum bicarbonate (less than 24 mEq/L).
8) The chest X-ray findings showed no pathological findings in about four fifth(79.. 0%). Among the abnormal findings, hypertensive heart configuration with or witho-ut cardiomegaly was seen in 8.5%, pulmonary congestion with or without cardiom-egaly in 6.6 %, bronchopneumonia in 1.5 %, and atelectasis in 0.4 %, etc.
9) The clinically significant EKG finding was found in 8.3%. Among the significant.findings, left ventricular hypertrophy with strain was the most frequent one(3.7°%).
10) About one half (47.8%) showed normal fundoscopic findings. K. W. grade I was in 24.9 %, grade II in 16.2 %, grade III in 8.6 %, and grade IV in 2.5 %. The higher the grade, the fewer the number of cases.
11) Regarding the response to medical treatment, about four fifth(79. 3%) responed within the second hospital stay. About one tenth (10.3%) did not respond within. the third hospital stay. The arbitrarily choosen criteria of. response was the dropping of blood pressure by 30 mmHg in systolic or more or 15 mmHg in diastolic or more with 1, 000 ml or more urine per 241 hours.
12) The mode of delivery was principally vaginal with. or without pitocin in 95.6 %. The cesarean section rate was 4.4%. Among all vaginal deliveries about two-third (62.3%) was operative deliveries such as vacuum extraction (39.7 %); forceps (13.9%), breech extraction (7.9%), and podalic version (6.8%).
13) As to the newborn weight related to the gestational weeks, about two third(65. 5%) was 2, 500 gm. or more. In term (37-41 wks) 73.2% (15.3/209) of newborn was over 2, 500 gm.. or more. As to the newborn length related to the gestational weeks, over four fifth (82.7%) was 47 cm. or more. In term 88.1 (185/210) of newborn was over 47 cm. or more. As a consequence, it seemed that. weight was affected more than length.
14) As to the fetal complications, prematurity was found in about one third (34. 5. %) fetal distress in 14.5% neonatal death in 9.5%and stillbirth in 8.7%, etc. The perinatal death was encountered in 18.3%. About one half (47.8%).
,
was stillbirth. The other causes were prematurity in ;19.6 /, unknown- in 15: 2
asphyxia in 10.9%, brain damage in 4.3%, and ´.congenital anomaly,,, in . 2.2%. 15) As to the maternal complications, antepartum and postpartum anemia (Hgb. ; 10. 0 gm % or less) was found in over one half (54.7 %) , postartum bleeding in. 14.5%, birth canal laceration in 5.6%, urinary tract infection in 4.8%, abruptio placentae in 1.7 %, premature rupture of membranes in 1.2 % y acute renal failure in 1.1 % and heart failure in 1.1 %, respectively. The maternal death was encountered in 2.4%. Among nine cases of maternal death, three cases were acute renal failure, one case was pulmonary abscess, emphysema and cerebral edema, another one case- was cerebrovascular accident with heart failure, and four cases were undetermined.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
 
|
|
|
Listed journal information
|
|
  
|
|