Nirmala, R (2008) Evaluation of serum magnesium and calcium in the prediction of preeclampsia in at risk mothers. Masters thesis, Madras Medial College, Chennai.
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Abstract
INTRODUCTION: Preeclampsia is a disease with worldwide significance to mothers and infants and it is a leading cause of death and disability in mothers and infants.1,2 This disorder was first recognized almost 2000 years ago. Celsus described pregnant women with seizures that abated with delivery. This disorder was termed eclampsia and for 2000 years, was considered a pregnancy specific seizure disorder. In the late 1800’s the association of, initially, proteinuria and later increased blood pressure with eclampsia was recognized. It was also noted that increased blood pressure and urinary protein antedated seizures. From this came the term pre-eclampsia (Chesley, L.C. 1978). According to WHO estimates, about 510,000 maternal deaths (about 0.9 percent of total deaths) occurred globally during the year 2002, of these deaths about 1,71,000 were in South East Asian Countries.4 Most of the maternal deaths are preventable. The life-time chances of maternal death in the world as a whole is 1 in 75. It varies from region to region and from country to country. In India, the life-time risk of maternal death for mother is 1 in 61. AIM OF THE STUDY: To evaluate serum magnesium and calcium in the prediction of preeclampsia in at risk mothers. MATERIALS AND METHODS: Study Design : Prospective case control study Study place : This study was conducted in the department of obstetrics at The Institute of Social Obstetrics and Government Kasturba Gandhi Hospital, Madras Medical College, Chennai. Study period : October 2006 to September 2007. Study Population : Inclusion Criteria - 1. Pregnant women of age 18 years and above, 2. Singleton pregnancy, 3. Gestational age 28-30 weeks, 4. Roll over test positive, 5. Regular for follow up and compliant, 6. Planning to have the delivery in the same institution. Exclusion Criteria - 1. Previous preeclampsia, 2. Pregnant women with medical diseases complicating pregnancy like hypertension, diabetes, cardiac, renal, liver disorders, CCF. 3. Known eplieptic patients, 4. Multiple pregnancies, 5. Pregnant women on drugs like calcium channel blocker, diuretics, drugs containing calcium and magnesium. SUMMARY: This prospective study “Evaluation of Serum Magnesium and Calcium in the prediction of Preeclampsia in at risk mothers “was carried out at the Institute of Social Obstetrics and Government Kasturba Gandhi Hospital for women and children , Chennai during the period October 2006 to September 2007. Observations of this study includes: Most of the patients in the study group were in the age group 21-25 years. • 75.7% of the patients were primigravida. • 95.7% of the cases were booked at the Institute of Social Obstetrics and Govt Kasturba Gandhi Hospital. • 97.8% belong to class V socio economic status. • 21% developed mild preeclampsia and 12% developed severe preeclampsia. • Of those who developed preeclampsia 64.2% developed preeclampsia at 32-34 weeks of gestation, 32.6% developed preeclampsia at 35-37 weeks and 3.2% developed preeclampsia after 38 weeks. • Of those who developed preeclampsia, 41 were treated with Antihypertensives alone and 9 were treated with magnesium sulphate. • Of the 12% who developed severe preeclampsia 7 had Abruption and 1 had Eclampsia. • 69.4% were delivered via Naturalis, 28.4% by caesarean section and 2.2% by Instrumental vaginal delivery. • The mean serum magnesium levels in the study group who subsequently developed preeclampsia was 1.43 ± 0.10 mg/dl. The mean serum magnesium levels who remained normotensive (control group) was 2.27 ±0.12 mg /dl. • The mean serum calcium levels in the women who subsequently developed preeclampsia (study group) was 8.62 ± 0.30 mg/dl. The mean serum calcium levels in the women who remained normotensive (control group) was 11.02 ± 0.45 mg /dl. • Lower Serum Magnesium and Calcium levels are statistically significant in predicting Preeclampsia for at risk mothers. CONCLUSION: Preeclampsia is a multisystem disorder unique to pregnancy. • Any method which can reasonably indicate the possibility of developing Preeclampsia will be most welcome. • One such method developed is the measurement of serum magnesium and serum calcium estimation. • This study conducted at The Institute of Social Obstetrics and Govt. Kasturba Gandhi Hospital reveals estimation of serum calcium and magnesium levels to be a useful indicator for the prediction of preeclampsia. • This low cost technique is ideally suited as a screening test for women even in resource poor settings like India.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Evaluation ; serum magnesium ; d calcium ; prediction ; preeclampsia ; risk mothers. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 28 Nov 2017 03:29 |
| Last Modified: | 09 Dec 2017 04:31 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4131 |
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