Management of Eclampsia and Pre-Eclampsia in the Intensive Care Unit of N’Djamena Mother and Child University Hospital

Introduction: Severe pre-eclampsia is a condition specific to pregnancy characterized by the onset of high blood pressure with systolic blood pressure (SBP) ≥ 160 mmHg and/or diastolic blood pressure (DBP) ≥ 110 mmHg, with or without 24-hour proteinuria ≥ 300 mg/24 hours or urine dipstick ≥ 1+, occurring from the 20th week of amenorrhea (WA) in a normotensive pregnant woman, associated with maternal-foetal complications. Eclampsia is the neurological complication of PE. Objective: improve the management of PE and eclampsia. Patients and Method: This is a descriptive cross-sectional study performed during the period from October, 1st 2022 to September, 30th 2023. We conducted an exhaustive collection of the files of all patients admitted to the obstetric intensive care unit of N’djamena Mother and Child University Hospital with severe pre-eclampsia or eclampsia, regardless of when the crisis occurred. Data were collected and analyzed using SPSS and Excel software. Results: We collected 217 cases of severe pre-eclampsia (PE) and eclampsia in our series, which accounted for 8.1%. The median age was 28.1 ± 8.6 years, with extremes of 16 and 44 years. For the treatment, the antihypertensive drug based on nicardipine and magnesium sulphate was respectively used in 74.2% and 77%. The mode of delivery was predominantly caesarean section in 77.4% of cases 168) compared to 22.6% (n = 49) by vaginal delivery. On the maternal side, the prognosis was favorable in 76% and 24% had had complications. Foetal complications were dominated by prematurity at 9.7%. We reported a maternal mortality rate of 3.2% (n = 7). Conclusion: PE and eclampsia are common conditions in our setting. Antihypertensive drugs, corticosteroids and, above all, obstetric treatment involving caesarean section or vaginal delivery are widely used.