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[Delivery and perinatal aspects of pregnant women with pre-eclampsia-eclampsia].

UNLABELLED
Hypertension is the most important cause of disease in the expectant mother and the fetus, and it unfavorably affects the perinatal morbidity and mortality.


AIM
To determine the method of delivery of a pregnant women with Praeeclampsia-Eclampsia (PE-E) depending upon the severity, continuity and term of appearance of hypertensive disease during pregnancy and its impact on perinatal morbidity and mortality.


MATERIAL AND METHODS
The study covers a two year period (2002-2003), during which 84 pregnant women are treated and deliver with PE-E in the Ist and IInd Obstetrics clinics. Of them 64 (76.20%) are with mild form of PE, 10 (11.90%) with mid severe form and 10 (11.90%) severe form of which 3 had Eclampsia. The pregnancies were followed using echography and cardiotocographic monitoring.


RESULTS AND DISCUSSIONS
With the severe forms of PE-E the disease started between 25-30 gestational weeks (60%), while with the mid severe the appearance was between 31-36 g.w. (50%). Persistence of PE > 4 g.w. was observed with severe PE, whereas in mild forms continuity of < 3 g.w. (73.44%) prevailed with its onset after 37 g.w. (57.81%). Normal delivery was attained with 41 pregnancies (48.81%), Caesarean section (CS) with 40 (47.62%), vacuum extraction with 1 (81.19%) and 2 (2.38%) had incomplete aborts. Frequency of CS with the severe forms of PE-E is 80%, with mid severe 50%, and with the mild forms is 42.19%. The most frequent indication of CS is fetal distress--11 (27.50%) and complicated obstetric anamnesis--9 (22.50%). With severe PE-E the most frequent indication is aggravation of symptoms and its non responsiveness to treatment. Born dead are 3 fetuses with severe retardation and body weight < 800 gm. Early gestational age hasn't given us the reason for premature delivery. Death of 1 child, born by CS with 750 gm weight is recorded. The higher rate of CS (3 times more than the median for the clinic--15.16%) can be explained to a degree by the fact that operative delivery by CS in pregnancies with PE-E reduces complications and has an aim to prevent complications to the fetus as well as the mother.