Severe preeclampsia and eclampsia in Kerman, Iran: complications and outcomes

Our objective was to assess the frequency, epidemiological factors, complications, and outcome of severe preeclampsia and eclampsia and compare them according to severity of the condition in Kerman, southeastern Iran.

A prospective study was performed on 200 consecutive cases of severe preeclampsia and eclampsia referred to the Kerman University Maternity Center from June 2001 to December 2002. Demographic data and complications were described and severe preeclampsia and eclampsia compared using t-student's and chi2 tests.

Severe preeclampsia occurred in 3% and eclampsia in 0.6% of deliveries during the period of study. The majority of patients were young and primigravida, especially in the eclampsia group. 72.7% of eclamptic patients suffered their first convulsion at home and not in the presence of medical help. HELLP syndrome, disseminated intravascular coagulation, acute renal failure, neurological complications, and acute respiratory distress syndrome were the main maternal complications, all occurring more frequently in eclamptic patients. The frequency of pulmonary edema, placental abruption, postpartum hemorrhage, and aspiration pneumonia was not significantly different between the two groups. More than half of patients underwent cesarean delivery. Early neonatal mortality rate was 13% in the entire cohort. All six maternal deaths during the period of the study occurred in eclamptic cases (mortality rate 18%), four relating to patients who had not received prenatal care.

Severe preeclampsia carries a high risk of maternal and neonatal morbidities and mortality in Kerman. This risk increases in the presence of eclampsia, particularly in neglected cases who have not sought prenatal care.