Risk factors for maternal death in patients with severe preeclampsia and eclampsia

OBJECTIVES: to determine the principal death causes in patients with severe preeclampsia/eclampsia and identify related risk factors. METHODS: a case-control study was performed comprising all cases of maternal death (n = 20) in patients with severe preeclampsia or eclampsia (n = 2.541). 80 controls (survivors) were randomly selected. The odds ratio and an estimate of maternal death relative risk were determined, and a multiple logistic regression analysis performed to determine the adjusted odds ratio. RESULTS: the basic causes for death were: acute pulmonary edema, disseminated intravascular coagulopathy, hemorrhagic shock, pulmonary embolism, acute renal failure, sepsis and three cases of undetermined causes of death. The principal risk factors were: age > 25 years old, multiparity, gestational age < 32 weeks, lack of prenatal care, diastolic pressure > 110mmHg, convulsions, chronic systemic arterial hypertension, HELLP syndrome, pulmonary edema, normally inserted abruptio placenta, disseminated intravascular coagulation, acute renal failure. Variables persistently related to maternal death were: HELLP syndrome, eclampsia, acute pulmonary edema, eclampsia, chronic hypertension and lack of prenatal care. CONCLUSIONS: the principal risk factors for death in women with preeclampsia/eclampsia are the lack of prenatal care, associated to chronic hypertension, HELLP syndrome, eclampsia and acute pulmonary edema.

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Evaluation of Maternal Complications in Severe Preeclampsia in a University Hospital in Tirana

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2016.025 ◽

2016 ◽

Vol 4 (1) ◽

pp. 102-106

Author(s):

Eriseida Ndoni ◽

Redi Hoxhallari ◽

Astrit Bimbashi

Keyword(s):

Renal Failure ◽

Caesarean Section ◽

Pulmonary Edema ◽

Postpartum Hemorrhage ◽

Hellp Syndrome ◽

Placental Abruption ◽

Severe Preeclampsia ◽

University Hospital ◽

Multisystem Disorder ◽

Maternal Complications

BACKGROUND: Preeclampsia is a hypertensive multisystem disorder of pregnancy that complicates up to 10% of pregnancies worldwide and is one of the leading causes of maternal and perinatal morbidity and mortality.AIM: To evaluate maternal complications associated with severe preeclampsia.METHODS: This is a retrospective cross-sectional study conducted in the UHOG “Koço Gliozheni”, in Tirana. Primary outcomes evaluated: maternal death, eclampsia, stroke, HELLP syndrome, and pulmonary edema. Secondary outcomes: renal failure, admission in ICU, caesarean section, placental abruption, and postpartum hemorrhage. Fisher’s exact test and Chi-squared test were used as statistical methods. RESULTS: In women with severe preeclampsia we found higher rates of complications comparing to the group with preeclampsia. Eclampsia (1.5% vs. 7.1%, P < 0.001), HELLP syndrome (2.4% vs. 11.0%; P < 0.001), stroke (0.5% vs 1.9%, P = 0.105) pulmonary edema (0.25% vs. 1.3%, P = 0.0035), renal failure (0.9% vs. 2.6%, P = 0.107), admission in ICU (19.5% vs. 71.4%, P = 0.007), caesarean section rates (55.5% vs. 77%, P = 0.508), placental abruption (4.3% vs. 7.8%, P = 0.103) and severe postpartum hemorrhage (3.2% vs. 3.9%, P = 0.628). CONCLUSION: Severe preeclampsia is associated with high rates of maternal severe morbidity and early diagnosis and timely intervention can prevent life treating complications.

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MO402ACUTE OBSTRUCTIVE RENAL FAILURE IN URGENT HEMODIALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab082.0056 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Imane Failal ◽

Sanae Ezzaki ◽

Rania Elafifi ◽

Mohamed Zamd ◽

Naoufal Mtioui ◽

...

Keyword(s):

Risk Factors ◽

Renal Failure ◽

Pulmonary Edema ◽

Creatinine Level ◽

Descriptive Study ◽

Percutaneous Nephrostomy ◽

Acute Pulmonary Edema ◽

Uremic Syndrome ◽

Cancer Of The Cervix ◽

Obstructive Renal Failure

Abstract Background and Aims Acute obstructive renal failure is secondary to obstruction of the upper excretory tract occurring bilaterally or in a single anatomical or functional kidney. It accounts for 8 to 14% of all acute renal failure in Morocco. They constitute serious conditions which can jeopardize the functional prognosis of the kidney . The objective of our study is to describe the profile of patients on emergency hemodialysis for acute obstructive renal failure (AKI), the main indications for hemodialysis and to assess the risk factors for mortality. Method It was a 2-year retrospective and descriptive study from January 2018 to December 2019; performed in the nephrology and hemodialysis department CHU IBN ROCHD CASABLANCA. Results A total of 118 patients were counted: 43 women, 75 men or 36.4%, 63.5%, with an average age of 54.3 years "+/- 10.3". The circumstances of discovery were: Oligo anuria 51.5%, hematuria 25%, AEG 24%. The obstacle was neoplastic in 67.79%; lithiasis 26.27%; on pregnancy in 0.84%; bladder malformation 0.84%, and unknown etiologies in 4.2%. The neoplastic origin was cancer of the cervix, followed by the bladder and then the prostate. The average creatinine level was 89.7mg / l. The indication for hemodialysis was: threatening hyperkalemia, uremic syndrome, acidosis and acute pulmonary edema in 56%, 25.8%, 9.6% and 10% of cases, respectively The total number of hemodialysis sessions was 227 hemodialysis sessions with an average number of 1.91. Obstacle removal was performed by percutaneous nephrostomy in 70.8% of cases, by mounting a double J probe in 10% of cases and by ureterostomy in 4.2% of cases. The course was good in 77.9% of the cases, 13.5% progressed to the IRCT. Mortality was 8.4%. Risk factors for mortality were: age, etiology of neoplasia. Conclusion A total of 118 patients were counted: 43 women, 75 men or 36.4%, 63.5%, with an average age of 54.3 years "+/- 10.3". The circumstances of discovery were: Oligo anuria 51.5%, hematuria 25%, AEG 24%. The obstacle was neoplastic in 67.79%; lithiasis 26.27%; on pregnancy in 0.84%; bladder malformation 0.84%, and unknown etiologies in 4.2%. The neoplastic origin was cancer of the cervix, followed by the bladder and then the prostate. The average creatinine level was 89.7mg / l. The indication for hemodialysis was: threatening hyperkalemia, uremic syndrome, acidosis and acute pulmonary edema in 56%, 25.8%, 9.6% and 10% of cases, respectively The total number of hemodialysis sessions was 227 hemodialysis sessions with an average number of 1.91. Obstacle removal was performed by percutaneous nephrostomy in 70.8% of cases, by mounting a double J probe in 10% of cases and by ureterostomy in 4.2% of cases. The course was good in 77.9% of the cases, 13.5% progressed to the IRCT. Mortality was 8.4%. Risk factors for mortality were: age, etiology of neoplasia.

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Acute pulmonary edema due to severe preeclampsia in advanced maternal age women

Pregnancy Hypertension ◽

10.1016/j.preghy.2021.05.019 ◽

2021 ◽

Author(s):

Maya Ram ◽

Matan Anteby ◽

Carolyn F. Weiniger ◽

Ofer Havakuk ◽

Itamar Gilboa ◽

...

Keyword(s):

Pulmonary Edema ◽

Maternal Age ◽

Advanced Maternal Age ◽

Severe Preeclampsia ◽

Acute Pulmonary Edema

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Factors Influencing Maternal Mortality from Severe Preeclampsia and Eclampsia

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v36i2.293 ◽

2016 ◽

Author(s):

Denny Khusen

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Maternal Mortality ◽

Maternal Death ◽

Gestational Age ◽

Post Partum ◽

Severe Preeclampsia ◽

Maternal Complications ◽

History Of ◽

Post Partum Bleeding

Objective: To analyze risk factor, both clinical and laboratory findings, associated with maternal mortality from severe preeclampsia and eclampsia in Atma Jaya Hospital. Methods: This was a retrospective case control study. All medical records of maternal death associated with severe preeclampsia and eclampsia between 1st January 2009 and 31st December 2011 were obtained and then information about risk factors were collected and tabulated. Risk factor analyzed were maternal age, gestational age, parity, coexisting medical illness (hypertension), antenatal examination status, maternal complications, systolic and diastolic blood pressure at admission, and admission laboratory data. Results: There were 19 maternal deaths associated with severe preeclampsia and eclampsia during period of study (Consisted of 6 cases of eclampsia and 13 cases of severe preeclampsia). Maternal mortality rate for severe preeclampsia and eclampsia were 16.7% and 33.3% respectively. Multivariate analysis identified the following risk factors associated with maternal death: gestation age <32 week, history of hypertension, thrombocyte count < 100.0000/Î¼l, post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. Conclusion: In this study, we found that gestational age, history of hypertension, and platelet count are the cause of maternal mortality. Maternal complications associated with maternal mortality are post partum bleeding, acute pulmonary edema, HELLP syndrome, and sepsis. [Indones J Obstet Gynecol 2012; 36-2: 90-4] Keywords: eclampsia, maternal mortality, preeclampsia

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Risk factors and prognostic implication of acute pulmonary edema in resuscitated out-of-hospital cardiac arrest patients

Resuscitation ◽

10.1016/j.resuscitation.2013.08.199 ◽

2013 ◽

Vol 84 ◽

pp. S78

Author(s):

Joonghee Kim ◽

Taeyun Kim ◽

Kyuseok Kim ◽

Joong Eui Rhee ◽

You Hwan Jo ◽

...

Keyword(s):

Risk Factors ◽

Cardiac Arrest ◽

Pulmonary Edema ◽

Acute Pulmonary Edema ◽

Prognostic Implication ◽

Hospital Cardiac Arrest

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Risk Factors of End Stage Renal Disease in Peshawar, Pakistan: Odds Ratio Analysis

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2016.068 ◽

2016 ◽

Vol 4 (3) ◽

pp. 381-387 ◽

Cited By ~ 1

Author(s):

Salahuddin Khan ◽

Tariq Hussain ◽

Najma Salahuddin ◽

Salahuddin Mehreen

Keyword(s):

Risk Factors ◽

Renal Failure ◽

Renal Disease ◽

End Stage Renal Disease ◽

Odds Ratio ◽

Diabetic Patients ◽

Ratio Analysis ◽

Hypertensive Patients ◽

Stage Renal Disease ◽

End Stage

AIM: The basic aim of this study was to discover the association of End Stage Renal Disease (ESRD) with various risk factors. End Stage Renal Failure is the last stage of the chronic renal failure in which kidneys become completely fail to function.MATERIALS AND METHODS: The data were collected from the patients of renal diseases from three major hospitals in Peshawar, Pakistan. Odds ratio analysis was performed to examine the relationship of ESRD (a binary response variable) with various risk factors: Gender, Diabetic, Hypertension, Glomerulonephritis, Obstructive Nephropathy, Polycystic kidney disease, Myeloma, SLE Nephritis, Heredity, Hepatitis, Excess use of Drugs, heart problem and Anemia.RESULTS: Using odds ratio analysis, the authors found that the ESRD in diabetic patients was 11.04 times more than non-diabetic patients and the ESRD were 7.29 times less in non-hypertensive patients as compared to hypertensive patients. Similarly, glomerulonephritis patients had 3.115 times more risk of having ESRD than non-glomerulonephritis. Other risk factors may also, to some extent, were causes of ESRD but turned out insignificant due to stochastic sample.CONCLUSION: The authors concluded that there is a strong association between ESRD and three risk factors, namely diabetes, hypertension and glomerulonephritis.

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Acute pulmonary edema as a complication of urinary infection in pregnant women: a case report

MedNEXT Journal of Medical and Health Sciences ◽

10.54448/mdnt21625 ◽

2021 ◽

Vol 2 (6) ◽

Author(s):

Lorena Silvestre Gabioli ◽

Katia Lara de Souza ◽

Tamara Veiga Faria

Keyword(s):

Case Report ◽

Prenatal Care ◽

Pulmonary Edema ◽

Pregnant Women ◽

Urinary Infection ◽

First Trimester ◽

Severe Form ◽

Acute Pulmonary Edema ◽

Fetal Mortality ◽

Pregnancy And Postpartum

Introduction: Urinary infection (UI) is the third most common pathology during pregnancy, affecting 10-12% of pregnant women in the first trimester. Thus, the prenatal care is important to reduce indicators of maternal-fetal mortality, promoting quality of life during pregnancy and postpartum. Objective: The aim of this study is to report the case of a pregnant woman with pyelonephritis, who evolved with acute pulmonary edema. Case report: The present study was elaborated according to the rules of CARE case report. This study was analyzed and approved by the Research Ethics Committee (CEP) according to a substantiated opinion number 4,375,418 and obtaining the patient's consent. The present study therefore highlights pyelonephritis as the most severe form of UI in pregnant women, associated with septic shock, with evolution to respiratory failure, resulting from acute pulmonary edema, and may be related to worse maternal-fetal prognoses. This clinical study contributes to the literature, emphasizing that, currently, all forms of UI during pregnancy should be considered as great potential for complications, and should be treated even in its asymptomatic form. Conclusion: It is evident the need for early intervention to minimize maternal-fetal losses, unnecessary interventions and to reduce costs in relation to additional treatments. The importance of rapid diagnosis and early treatment is emphasized in order to minimize or extinguish the damage. As well as promoting actions to encourage pregnant women to perform prenatal care.

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MO370PREGNANCY-RELATED ACUTE KIDNEY INJURY IN TUNISIA: A CLINICAL CHALLENGE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab082.0024 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Menel Msehli ◽

Hela Jbali ◽

Mami Ikram ◽

Badreddine Ben kaab ◽

Fethi Ben hamida ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Renal Failure ◽

Prenatal Care ◽

Clinical Manifestations ◽

Kidney Injury ◽

Morbidity And Mortality ◽

Renal Outcome ◽

Clinical Feature ◽

High Morbidity

Abstract Background and Aims Acute kidney injury (AKI) is a complex disorder that occurs in several clinical settings. During pregnancy, there are additional unique conditions that contribute to AKI. The clinical manifestations of Pregnancy related acute kidney injury(PRAKI) range from a minimal elevation in serum creatinine to severe renal failure requiring renal replacement therapy and may be associated with significant morbidity and mortality in young healthy women. This study aims to describe epidemiologic features, study clinical profile and outcomes of women with PRAKI and identify risk factors related to requiring hemodialysis among patients. Method We performed a retrospective study over a 5-year period (2015–2019) in a Tunisian intensive care unit. All patients presenting PRAKI were included. Results Ninety-six cases of PRAKI were listed. The rate of AKI during pregnancy-related hospitalizations was 16% .the average age was 31 ± 5 years. Most women were from urban areas (62%) but with insufficient prenatal care (57%).Seventy-eight percent underwent cesarean section delivery. PRAKI occurred in the postpartum in 79%of the cases. Oligo-anuria was the most common clinical feature of PRAKI, noted in 82% of our patients. The leading etiological causes were pre eclampsia, eclampsia, postpartum haemorrhage and sepsis respectively, in 49%, 38%, and 24% of the cases. Hemodialysis was required in 23% of cases. In the adjusted regression analysis, factors associated with dialysis were insufficient prenatal care (p=0,010 ; O Ra=24,113), HELLP syndrome (p=0,003 ; ORa=35,129), disseminated intravascular coagulation (p=0,007 ; OR=11,854), average duration of oliguria (p=0,001; ORa=3,025) , Failure stage of RIFLE criteria while admitted (p=0,009; ORa=2,09) and length of ICU stay (p=0,042 ; ORa=1,118). Renal outcome was favorable, with a complete renal function recovery for 72 patients (75%). Only four patients (4%) developed chronic renal failure. Mortality rate was 13%. Conclusion PRAKI is a dreaded complication of pregnancy with high morbidity and mortality. Prevention of PRAKI requires an improvement of the sanitary infrastructures with the implementation of an obligatory prenatal consultation in order to prompt management of the underlying risk factors

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