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Canadian Journal of Anesthesia 55:423-428 (2008)
© Canadian Anesthesiologists' Society, 2008

Reports of Original Investigation

Les éclampsies en centre hospitalier universitaire en Côte d’Ivoire: prise en charge, évolution et facteurs pronostics

[Eclampsia at a teaching hospital in Ivory Coast: management, outcome and prognostic factors]

Yapo Brouh, PhD*, Patrick Gimel Ndjeundo, MD*, Yavo Denis Tetchi, MD*, Antoine Akpo Amonkou, PhD{dagger}, Yaïch Pete, MD* and Yves Yapobi, PhD{dagger}

* Des services d’anesthésie-réanimation, CHU de Cocody, et
{dagger} CHU de Yopougon, Côte d’Ivoire.

Adresser la correspondance à : Pr Brouh Yapo, CHU de Cocody, 22 BP 1771 Abidjan 22, Côte d’Ivoire. Courriel : brouh_yapo{at}yahoo.fr

Objective: To analyze the management and evolution of eclampsia in the intensive care units of Côte d’Ivoire.

Methodology: Retrospective study undertaken in the intensive care units in the University Teaching Hospitals of Cocody and Yopougon from 2001 to 2006. Patients admitted to the intensive care unit for eclampsia were included in this study. The management and evolution (clinical condition at admission, medications used, type of delivery, type of anesthesia, mortality, sequellae, clinical evolution) were studied. Factors predicting mortality were identified with the calculation of odds ratio and confidence interval. The Chi-square of Mantel Haenszel was used with an {alpha} error = 5%.

Results: The study involved 313 patients with a mean age of 22.7 ± 6.1 yr. Diazepam was the most frequently used anticonvulsant (50.5% of cases), and dihydralazine was the preferred anti-hypertensive agent (50.2%). Cesarean delivery occurred in 58.5% of cases and vaginal delivery in 41.5%. General anesthesia with intubation was used in 79% of Cesarean deliveries and spinal anaesthesia with bupivacaine 0.5% (dose: 10 in 12.5 mg) in 21%. Treatment was not followed regularly in 31.3% of cases. Maternal and perinatal mortality was 16% and 16.1%, respectively. Risk factors for mortality were: admission from outside of a university hospital, admission delay >12 hr, Glasgow score {alpha} 8 on admission, status eclampticus and poor compliance to therapy.

Conclusion: Maternal mortality is still high in our setting. Vigorous action on the factors associated with bad prognosis should yield a reduction in mortality rate.

1 Saissy JM, Vachon F. La toxémie gravidique. Dans: Saissy JM (Ed.). Précis de Réanimation Tropicale. Paris : Arnette; 1998: 959–72.

2 Pambou O, Ekoundzola JR, Malanda JP, Buambos S. Prise en charge et pronostic de l’éclampsie au C.H.U. de Brazzaville : à propos d’une étude rétrospective de 100 cas. Méd Afr Noire 1999; 46: 508–12.

3 Beye MD, Diouf E, Kane O, et al. Prise en charge de l’éclampsie grave en réanimation en milieu tropical africain. A propos de 28 cas. Ann Fr Anesth Réanim 2003; 22: 25–9[Medline]

4 Soro L, Kouame KE, Brouh Y, Yeo T, Aye YD. Analyse de la prise en charge des éclampsies graves en réanimation au CHU de Yopougon. Rev Inter des Sciences Médicales 2000; 2: 29–34.

5 Duley L, Henderson-Smart D. Magnesium sulphate versus phenytoin for eclampsia. Database Syst Rev 2000; (2): CD000128.

6 Fujikawa DG. Anticonvulsants for eclampsia. Lancet 1995; 346: 501–2.[Medline]

7 Murray D, O’Riordan M, Geary M, Phillips R, Clarke T, McKenna P. The HELLP syndrome: maternal and perinatal outcome. Ir Med J 2001; 94: 16–8.[Medline]

8 Rugarn O, Carling Meon S, Berg G. Eclampsia at a tertiary hospital 1973–99. Acta Obstet Gynecol Scand 2004; 83: 240–5.[Medline]

9 Waisman GD, Mayorga LM, Camera MI, Vignolo CA, Martinotti A. Magnesium plus nifedipine: potentiation of hypotensive effect in preeclampsia? Am J Obstet Gynecol 1988; 159: 308–9.[Medline]

10 Tsatsaris V, Carbonne B, Cabrol D. Les nouveaux tocolytiques. Dans: Mises à jour en Gynécologie Obstétrique. Collège National des Gynécologues et Obstétriciens Français. Paris : Éditions Vigot; 2001: 183–207.

11 Edouard D. Pré éclampsie/éclampsie. Encycl Méd Chir (Paris) 2003; 36–980-A-10.

12 Gilbert WM, Towner DR, Field NT, Anthony J. The safety and utility of pulmonary artery catheterization in severe preeclampsia and eclampsia. Am J Obstet Gynecol 2000; 182: 1397–403.[Medline]

13 Fournie A, Bernadet P, Desprats R. Syndromes vas-culorénaux de la grossesse. Encycl Méd Chir (Paris). 1995; 5036-A-10: 20

14 Bouaggad A, Laraki M, Bouderka MA, et al. Maternal prognostic factors in severe eclampsia (French). Rev Fr Gynecol Obstet 1995; 90: 205–7.[Medline]

15 Jenkins SM, Head BB, Hauth JC. Severe pre- eclampsia at <25 weeks of gestation: maternal and neonatal outcomes. Am J Obstet Gynecol 2002; 186: 790–5.[Medline]

16 Cisse CT, Faye Dieme ME, Ngabo D, Mbaye M, Diagne PM, Moreau JC. Indications thérapeutiques et pronostic de l’éclampsie au CHU de Dakar. J Gynecol Obstet Biol Reprod (Paris) 2003; 32(3 Pt 1): 239–45.[Medline]

17 Mayi-Tsonga S, Akouo L, Ngou-Mve-Ngou JP, Meye JF. Facteurs de risque de l’éclampsie à Libreville (Gabon): étude castémoins. Sante 2006; 16: 197–200.[Medline]

18 Tang LC, Kwok AC, Wong AY, Lee YY, Sun KO, So AP. Critical care in obstetrical patients: an eight-year review. Chin Med J (Engl) 1997; 110: 936–41.[Medline]

19 Ben Letaifa D, Daouas N, Ben Jazia K, Slama A, Jegham H. Maternal emergencies requiring controlled ventilation: epidemiology and prognosis (French). J Gynecol Obstet Biol Reprod (Paris) 2002; 31: 256–60.[Medline]


Related articles in CJA:

Maternal mortality from eclampsia in developing countries: some progress, but still a major challenge/Mortalité maternelle due à l’éclampsie dans les pays en voie de développement : du progrès mais encore un long chemin à parcourir
Dan Benhamou
CJA 2008 55: 397-402. [Full Text]  



This article has been cited by other articles:


Home page
Canadian J. AnesthesiaHome page
D. Benhamou
Maternal mortality from eclampsia in developing countries: some progress, but still a major challenge/Mortalite maternelle due a l'eclampsie dans les pays en voie de developpement : du progres mais encore un long chemin a parcourir
Can J Anesth, July 1, 2008; 55(7): 397 - 402.
[Full Text] [PDF]




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