PDF(Pubmed)
Abstract：
UNASSIGNED: Hypertensive disorders of pregnancy (HDP) are a major cause of maternal mortality and adverse outcomes. A previous study in the intensive care unit (ICU) at King Edward VIII Hospital, Durban, South Africa, in 2000 found 10.5% mortality among eclampsia patients.
UNASSIGNED: To describe the mortality and adverse neurological outcomes associated with HDP in a tertiary ICU, compare these with results from 2000 and describe factors associated therewith.
UNASSIGNED: The data of 85 patients admitted with HDP to ICU at King Edward VIII Hospital from 2010 to 2013 were retrospectively reviewed. Mortality and adverse neurological outcome (Glasgow Coma Scale (GCS) ≤14 on discharge from ICU) were assessed. Two sets of analyses were conducted. The first compared those alive on discharge from ICU with those who died in ICU. The second compared good neurological outcome with poor outcome (adverse neurological outcome, or death).
UNASSIGNED: The mortality was 11.6%, and overall, 9% had adverse neurological outcomes. There was no significant difference in mortality between patients with eclampsia in 2010 - 2013 (11.0%) and those in 2000 (10.5%) (p=0.9). Factors associated with mortality were: intra- or postpartum onset of seizures; twins; failure to perform operative delivery when indicated; lowest GCS score <10; failure to use magnesium sulphate when indicated; respiratory failure; and lower respiratory tract infections. Factors associated with poor outcomes (adverse neurological outcome, or death) were: parity (better outcomes in primiparous patients); time of antenatal onset of hypertension (worse if earlier onset); HIV infection; failure to perform operative delivery when indicated; lowest GCS score <10; failure to use magnesium sulphate when indicated; use of anticonvulsants other than magnesium sulphate or benzodiazepines in eclampsia.
UNASSIGNED: The lack of improvement in ICU eclampsia mortality demonstrates a need to develop and implement a protocol for HDP management.
UNASSIGNED: The study provides a comparison of present mortality among eclamptic patients with hyperensive disorders of pregnancy (HDP) with the mortality of eclamptic patients described in an article from the year 2000. It further looks at adverse maternal outcomes, specifically adverse neurological outcomes.In addition, it analyses other factors that may affect outcomes in HDP patients. This information is useful in making recommendations in an attempt to improve the outcomes.
UNASSIGNED: To describe the mortality and adverse neurological outcomes associated with HDP in a tertiary ICU, compare these with results from 2000 and describe factors associated therewith.
UNASSIGNED: The data of 85 patients admitted with HDP to ICU at King Edward VIII Hospital from 2010 to 2013 were retrospectively reviewed. Mortality and adverse neurological outcome (Glasgow Coma Scale (GCS) ≤14 on discharge from ICU) were assessed. Two sets of analyses were conducted. The first compared those alive on discharge from ICU with those who died in ICU. The second compared good neurological outcome with poor outcome (adverse neurological outcome, or death).
UNASSIGNED: The mortality was 11.6%, and overall, 9% had adverse neurological outcomes. There was no significant difference in mortality between patients with eclampsia in 2010 - 2013 (11.0%) and those in 2000 (10.5%) (p=0.9). Factors associated with mortality were: intra- or postpartum onset of seizures; twins; failure to perform operative delivery when indicated; lowest GCS score <10; failure to use magnesium sulphate when indicated; respiratory failure; and lower respiratory tract infections. Factors associated with poor outcomes (adverse neurological outcome, or death) were: parity (better outcomes in primiparous patients); time of antenatal onset of hypertension (worse if earlier onset); HIV infection; failure to perform operative delivery when indicated; lowest GCS score <10; failure to use magnesium sulphate when indicated; use of anticonvulsants other than magnesium sulphate or benzodiazepines in eclampsia.
UNASSIGNED: The lack of improvement in ICU eclampsia mortality demonstrates a need to develop and implement a protocol for HDP management.
UNASSIGNED: The study provides a comparison of present mortality among eclamptic patients with hyperensive disorders of pregnancy (HDP) with the mortality of eclamptic patients described in an article from the year 2000. It further looks at adverse maternal outcomes, specifically adverse neurological outcomes.In addition, it analyses other factors that may affect outcomes in HDP patients. This information is useful in making recommendations in an attempt to improve the outcomes.
摘要：
妊娠期高血压疾病（HDP）是孕产妇死亡和不良结局的主要原因。爱德华八世国王医院重症监护病房（ICU）的先前研究，德班,南非,2000年，子痫患者的死亡率为10.5%。
为了描述三级ICU中与HDP相关的死亡率和神经系统不良结局，将这些与2000年的结果进行比较，并描述与此相关的因素。
■回顾性分析2010年至2013年爱德华八世国王医院ICU收治的85例HDP患者的资料。评估死亡率和不良神经系统转归（ICU出院时格拉斯哥昏迷量表（GCS）≤14）。进行两组分析。第一个比较了从ICU出院时活着的人与在ICU死亡的人。第二个比较了良好的神经系统结果与较差的结果（不良的神经系统结果，或死亡）。
■死亡率为11.6%,总的来说,9%有不良的神经系统结局。2010-2013年子痫患者死亡率（11.0%）与2000年（10.5%）无显著差异（p=0.9）。与死亡率相关的因素是：癫痫发作中或产后发作；双胞胎；指示时未能进行手术分娩；最低GCS评分<10；指示时未能使用硫酸镁；呼吸衰竭；和下呼吸道感染。与不良预后相关的因素（不良神经系统预后，或死亡）分别为：产次（初产妇结局更好）；高血压的产前发病时间（如果发病较早，则更差）；HIV感染；指示时未能进行手术分娩；最低GCS评分<10；指示时未能使用硫酸镁；在子痫中使用除硫酸镁或苯二氮卓类药物以外的抗惊厥药。
ICU子痫死亡率缺乏改善，表明需要制定和实施HDP管理方案。
该研究提供了患有妊娠过度疾病（HDP）的子痫患者的当前死亡率与2000年的一篇文章中描述的子痫患者的死亡率的比较。它进一步着眼于不良的产妇结局，特别是不良的神经系统结果。此外,本研究分析了可能影响HDP患者结局的其他因素.这些信息有助于提出建议，试图改善结果。
为了描述三级ICU中与HDP相关的死亡率和神经系统不良结局，将这些与2000年的结果进行比较，并描述与此相关的因素。
■回顾性分析2010年至2013年爱德华八世国王医院ICU收治的85例HDP患者的资料。评估死亡率和不良神经系统转归（ICU出院时格拉斯哥昏迷量表（GCS）≤14）。进行两组分析。第一个比较了从ICU出院时活着的人与在ICU死亡的人。第二个比较了良好的神经系统结果与较差的结果（不良的神经系统结果，或死亡）。
■死亡率为11.6%,总的来说,9%有不良的神经系统结局。2010-2013年子痫患者死亡率（11.0%）与2000年（10.5%）无显著差异（p=0.9）。与死亡率相关的因素是：癫痫发作中或产后发作；双胞胎；指示时未能进行手术分娩；最低GCS评分<10；指示时未能使用硫酸镁；呼吸衰竭；和下呼吸道感染。与不良预后相关的因素（不良神经系统预后，或死亡）分别为：产次（初产妇结局更好）；高血压的产前发病时间（如果发病较早，则更差）；HIV感染；指示时未能进行手术分娩；最低GCS评分<10；指示时未能使用硫酸镁；在子痫中使用除硫酸镁或苯二氮卓类药物以外的抗惊厥药。
ICU子痫死亡率缺乏改善，表明需要制定和实施HDP管理方案。
该研究提供了患有妊娠过度疾病（HDP）的子痫患者的当前死亡率与2000年的一篇文章中描述的子痫患者的死亡率的比较。它进一步着眼于不良的产妇结局，特别是不良的神经系统结果。此外,本研究分析了可能影响HDP患者结局的其他因素.这些信息有助于提出建议，试图改善结果。
