Role of Postpartum Curettage in the Control of Hypertension in Severe Preeclampsia
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 4
Abstract
Introduction: Pre-eclampsia affects 3-7% of pregnancies and is a major contributor to maternal morbidity and mortality. Termination of pregnancy is the definitive management to abate the pathophysiology of preeclampsia. However during post-partum period also patient is at risk of eclampsia, worsening of hypertension and venous thromboembolism. Post-partum curettage immediately following delivery is technically an easy procedure which will remove the trophoblast and can accelerate the recovery from the disease process. Materials and Methods: We assessed the effect of post-partum uterine curettage on the maternal recovery from pre-eclampsia. This was a case control study involving 100 patients. They were randomized and allocated to either the study arm or the control arm. Immediately following delivery gentle curettage of the uterine cavity was done to remove the trophoblast. Blood pressure was monitored 4th hourly for first 48 hours. Protienuriaand uric acid levels were also assessed before and 48 hours after delivery in both the study and control groups and the data were compared. Observations and Results: Among the patients who were curreted, 93% normalized their blood pressure to less than 140/90 mm of Hg, while in the control group only 37% had normal blood pressure on third postnatal day. Regarding the need for postpartum anti hypertensives, 32% in group 1 needed anti hypertensives compared to 98% in group 2.Regarding post-partumprotienuria, 48 hours after delivery 22% in group1 and 43% in the control group had protienuria. The mean fall in uric acid levels in group 1 was 2.4mg against 1.48mg in control group. Conclusions: We conclude in our study post-partum uterine curettage was found to accelerate the recovery from severe pre-eclampsia in post-partum period. This cost effective easy to perform intervention need to be tested in a larger sample so that the same can be considered for routine management of severe preeclampsia.
Authors and Affiliations
Dr Rajeena Babu R
Keywords
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