Route of delivery and maternal outcome in severe preeclampsia: a retrospective cohort study in two referral hospitals in Yaoundé

Abstract

Background: The hallmark of preeclampsia (PE) treatment is delivery. This study aims to investigate the relationship between mode of delivery and maternal outcome in women diagnosed with severe preeclampsia. Methodology: We employed a retrospective cohort method focused on women with severe PE who were delivered at the study two sites, from 1st June 2014 to 31st May 2024. Data were collected from medical records and exported into IBM’s SPSS version 26 for statistical analyses. Bivariate and multivariate logistic regression analyses were done. The measure of association used was the relative risk with its 95% confidence interval. The significance level was set at p-value < 0.05. Results: We recruited 349 cases of severe PE. In 42.9% of cases labour was induced, and in 16.9% of these cases, induction failed and caesarean section (CS) was indicated. The overall CS rate was 53.9%. After delivery, women who had CS were significantly more likely to have coma, eclampsia, HELLP syndrome, maternal death, acute pulmonary oedema and Intensive care unit admission than women who had VD. However, after multivariate logistic regression analyses, only acute pulmonary oedema (aRR = 1.31 [CI: 1.01 - 2.73]) and intensive care unit admission (aRR = 2.22 [CI: 1.98 - 3.45]) were independently associated with delivery by CS. Conclusion: The success rate for induction of labour was high but caesarean section was the more common mode of delivery in patients with severe preeclampsia in our context.