الفهرس 
Acknowledgement
Complicaions, outcomes of ICU and theirOnly 14 pages are availabe for public view
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Abstract
Summery and conclusion
Hypertensive disorders of pregnancy, including severe pre¬eclampsia and eclampsia, complicate up to 10% of pregnancies worldwide, constituting one of the greatest causes of maternal and perinatal morbidity and mortality worldwide. Severe preeclampsia is a risk factor for future cardiovascular disease and metabolic disease in women.
The most common indications for admission to the ICU of patients with pregnancy-induced hypertension include but are not limited to refractory hypertension, neurological dysfunction (intracranial hemorrhage, seizures, and elevated intracranial pressure), liver or kidney dysfunction, pulmonary edema, HELLP syndrome, and/or disseminated intravascular coagulation.
Anes¬thetists are frequently involved in the multi-disciplinary management of critically ill women with severe preeclampsia and eclampsia.
Materials and Methods
A retrospective analysis study included 186 cases of antena¬tal and postpartum severe preeclampsia & eclampsia patients admitted to the Intensive care unit in Assiut woman health hospital between 1/1/2015 to 31/12/2016 (24 month period ), after obtaining the written approval of the ethical com¬mittee of hospital. All patients showed signs of severe preeclampsia or eclampsia.
Data about resuscitative measures, maintaince treatment,Mechanical and invasive interventions, monitoring, complications and, discharge options were collected. We also collected the data of general information such as age, pregnancy time, first pregnancy or not, multiple births or not, admission blood pressure (mmHg), tic during transference; and data after patient in ICU such as APACHE (Acute Physiology and chronic Health Evaluation) II score, Studied data included laboratory test parameters, diagnostic and therapeutic interventions, rate of morbidity and mortality and its related factors, and the average duration of ICU stay.
Result
Median ICU stay was 4 with range between 2 and 16 days. Seventeen (9.14%) women needed mechanical ventilation, while dialysis was done in 16 (8.60%) women.
The most frequent complication in the current study was HELLP syndrome that occurred in 25 (13.44%) followed by renal impairment, cerebral hemorrhage, and pulmonary that occurred in 11 (5.91%), 10 (5.37%) and 9 (4.83%) women respectively. Unfortunately, permanent blindness affected 3 (1.61%) women in the current study and death was the outcome in 12 (6.45%) women.
Improvement occurred in 160 (86%) of cases while 6 (3.22%), 5 (2.28%) and 5 (2.68%) women were transferred to neurological ward, nephrological ward and cardiology ward respectively.
Division of Enrolled Women based on Gestational age, so Gestational age was < 34 weeks in 69 (37.1%) women, 34- 36 weeks in 75 (40.3%) women and > 36 weeks in 42 (22.6%) women. It was noticed that mean age of three groups had no significant differences (P= 0.18). Mean APCH II score was 10.11 ± 2.01, 10.52 ± 2.70 and 9.76 ± 2.34 in three groups respectively with no significant difference between the group (P= 0.56). it was notice that ICU stay was more prolonged in those women with gestational age less than 34 weeks in comparison to other two groups (P= 0.03).
According to the onset of eclampsia 80 cases had antepartum eclampsia and postpartum eclampsia presented in 20 cases of women
Conclusion and recommendations
The present study reveals that severe preeclampsia, eclampsia and their complications are the most commonly maternal indications requiring ICU admission. In our study there were maternal mortality and morbidity was reported. To reduce maternal morbidity and mortality, these patients require early admission and appropriate management in the ICU. A healthy respect for this condition, coupled with aggressive and early intervention may be able to minimize adverse maternal and perinatal events in the setting of severe preeclampsia.