Early and Late Onset Pre-eclampsia – Maternal and Perinatal Outcome in Tertiary Care Hospital

Abstract

Pre-eclampsia is one of the major causes of morbidity and mortality for both mother and baby.[1] Pre-eclampsia occurs in 3-11% of all pregnancies.[2] It is categorized into early onset and late onset according to the period of gestation. Pre-eclampsia that is diagnosed before 34 weeks of gestation is early onset and when diagnosed after 34 weeks of gestation is considered as late onset. Objective: To compare maternal and perinatal outcome in early onset (EOPE) and late onset pre-eclampsia (LOPE). Methods: This is a prospective observational study which included 177 pre-eclampsia patients, who were admitted in the Department of Obstetrics and Gynecology, Rangaraya Medical College at GGH, Kakinada, from SEP-2020 to FEB-2021 (6 months). Those who developed pre-eclampsia before 34 weeks of gestational age were identified and taken as early onset pre-eclampsia. Those who developed after 34 weeks gestational age were identified as late onset pre-eclampsia. Maternal and perinatal outcome was compared between those groups. Results: Incidence of pre-eclampsia is 3.3%, of which early onset (EOPE) is 1.3% and late onset pre-eclampsia 2%. Compared with late onset pre-eclampsia (LOPE), early onset pre-eclampsia (EOPE) group has higher rates of eclampsia (43.4% vs 27.7%), abruption placenta (14.4% vs 12%), pulmonary edema (1.4 % vs 0%) and there was no intergroup difference in the composite maternal outcome. A significantly higher number of women with early onset pre-eclampsia (EOPE) developed severe features during the disease course (73.9 % vs 60%) and most of them required treatment with antihypertensive drugs like labetalol (86.4 % vs 62.9 %), nifedipine (13% vs 37%) (P value 0.005). Babies born to mother with early onset pre-eclampsia (EOPE) had significantly higher rate of NICU admissions (50.7% vs 37%) and ventilator support (37.6% vs 25%). IUDs (20.2 % vs 8.3%) are significantly higher in number in early onset pre-eclampsia (EOPE). Conclusion: The study shows that women with early onset pre-eclampsia (EOPE) had more adverse maternal and perinatal outcomes than those with late onset pre-eclampsia (LOPE). But the difference was not statistically significant. Keywords: Pre-eclampsia, early onset pre-eclampsia, late onset pre-eclampsia, maternal outcome and perinatal outcome.