Clinical and Biochemical Parameters of Severe Preeclampsia in Puerperium

Open Access

Abstract

Background: Preeclampsia is a multisystem disorder that may cause persistent hypertension, proteinuria, and other clinical and biochemical abnormalities beyond delivery. Continued postpartum monitoring is therefore important for early detection and management of persistent abnormalities. Aim of the study: To observe the changes in clinical and biochemical parameters among women with severe preeclampsia during puerperium. Methods & Materials: A hospital-based cross-sectional study was conducted among 50 women with antenatal severe preeclampsia attending the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from April 2018 to September 2018. Participants were selected by purposive sampling and followed for 42 days at two separate settings. Data were collected using a structured data collection sheet through interview, clinical examination, haematological and biochemical investigations, and 24-hour urine protein assessment. Data were analyzed using SPSS, with frequency, percentage, mean±SD, and Chi-square test; p<0.05 was considered statistically significant. Result: The mean age of the participants was 24.1±3.5 years, with 70.0% aged 18-24 years, while 68.0% were from urban areas and 62.0% were primiparous. During the antenatal period, all participants had high blood pressure and proteinuria, while severe headache (78.0%), nausea or vomiting (84.0%), and epigastric pain (72.0%) were common manifestations. Thrombocytopenia was present in 76.0%, elevated SGOT in 74.0%, elevated LDH in 84.0%, and elevated serum uric acid in 62.0%. At the 5th day of puerperium, hypertension persisted in all participants and proteinuria was present in 64.0%. At the 6th week, hypertension persisted in 14.0% and proteinuria in 8.0%, while headache, sleep disturbance, and blurred vision/light sensitivity persisted in 12.0%, 12.0%, and 14.0%, respectively. Overall, 8.0% participants demonstrated persistent severe preeclampsia at the 6th week, whereas 92.0% achieved complete recovery. Conclusion: Persistent clinical and biochemical abnormalities may remain after delivery among women with severe preeclampsia. Continued postpartum follow-up and timely management may help reduce maternal complications.