Pre-Eclampsia and Eclampsia Outcomes and Their Determinants among Women Who Deliver In Nakuru Level Five Hospital, Nakuru County, Kenya
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Date
2023-05
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Kenyatta University
Abstract
Irccizl:.\mpsln and cclampsia (PET/E) are a major cause maternal, fetal and neonatal
1}101‘})|§11ly and n.\nrlnlily globally. Many studies place hypertensive disorders which include
F 'E"l /E as the lAhII'LI leading cause of maternal mortality in the world. Roughly 6,300 women
dle‘cach year in Kenya duc to pregnancy related causes. (WHO, 2016). PET/E are also the
major f:‘llology for premature births resulting in perinatal mortality and morbidity.
A_pp_rox1_nmlcly 96 stillbirths and 92 neonatal deaths occur every day in Kenya. There is
dlmmuln_/c data on Nakuru level 5 hospital (NL5H) and indeed Nakuru County as a whole
on PET/E related mortality and morbidity due to lack of rescarch in the area. The goal of
this study is to provide data that can be utilized to upgrade and ameliorate maternal and
neonatal health outcomes for pregnant women. An analytical cross sectional study was
conducted to find out the incidence, awareness level and outcomes of PET/E in the
postnatal wards at NLSH. Structured questionnaires and key informant interview guides
were used. One hundred and thirteen women were interviewed on their first postnatal day.
The data collection tools’ contents were organized systematically examined for
accomplishment, redacted for faults and omissions, and then they were encoded. The data
was subsequently arranged based on the research questions and objectives. Data was
analyzed using SPSS version 23. Chi-square and correlation was used to test for association
and logistic regression for inferential statistics. Data displayed in the form of frequency
tables, and pie charts, and then elaborations followed to clarify the context. The results
showed that the incidence of preeclampsia and eclampsia among women delivering at
NLS5H was 6.9%. A majority of the respondents (43.4%) had low level of awareness. The
most common complications to the mothers were premature labour (36%), postpartum
haemorrhage (23%) and antepartum haemorrhage (7%). The most common complications
of the newborn were prematurity (37%), low birth weight (25%) and birth asphyxia (23%).
Symptomatic presentation i.e. hypertension, proteinuria and oedema showed statistically
significant relationship with complication to both mother and the baby using person’s
chisquare. Those with more severe form of the symptoms were more likely to develop
complications as per binary logistic regression analysis. For instance severe hypertension
(odds ratio=7.7), proteinuria +++ (odds ratio=6.2) and presence of oedema (odds ratio=5.4)
were more likely to develop complications than those with mild symptoms. To the neonate,
it also showed that those with more severe proteinuria (proteinuria +++) (odds ratio=4.5)
were more likely to develop complications. In addition, those with presence of oedema
(odds ratio=3.5) were also more likely to develop complications. It was concluded that the
incidence of preeclampsia and eclampsia among mothers who deliver at NLSH is within
the national and international averages. The study also concluded that, knowledge levels
on symptoms of PET/E are low. Furthermore it was identified that premature labour,
postpartum haemorrhage and antepartum haemorrhage as the most common complication
of PET/E to the mothers. In addition prematurity, low birth weight and birth asphyxia,
neonatal jaundice and neonatal death were also identified as the most common neonatal
complications. It was also confirmed that symptomatic presentation was associated with
complication of PET/E. Those with severe symptoms were more likely to develop
complications to both the mother and neonate. The study recommends early identification,
management, referral, closely monitoring and follow up pregnant women with
preeclampsia throughout the pregnancy continuum