International journal of women's health · 2026
Severe Antepartum Eclampsia Complicated by Intrauterine Fetal Demise and Pulmonary Edema: A Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Abdulle Abdinasir Muhidin, Hussein Abdiwali Mohamed, Adawe Mariam Mohamed Mohamud, Ibrahim Fahmo Hussein, Mudei Nasteho Mohamud, Ali Hamdi Abdi
Аннотация
BACKGROUND: Eclampsia remains a leading cause of maternal mortality in low-resource settings, particularly among adolescent primigravida with limited antenatal care. This report describes the management of severe eclampsia complicated by intrauterine fetal demise (IUFD) and multiorgan dysfunction in a 17-year-old primigravida at 35 weeks gestation in Mogadishu, Somalia.
CASE PRESENTATION: A 17-year-old primigravida presented with generalized tonic-clonic seizures, Oxygen saturation of 78% (SPO2), blood glucose of 47 mg/dL, and elevated blood pressure of 140/90 mmHg. Initial findings included generalized edema, absent fetal heart rate, proteinuria (+++), acute kidney injury (creatinine 1.76 mg/dL), borderline thrombocytopenia (platelets 152 ×109/L at admission, declining to 113 ×109/L by Day 2), and transaminitis (AST 527 U/L, ALT 370.2 U/L). Obstetric ultrasound confirmed IUFD. Following resuscitation, magnesium sulfate seizure prophylaxis, intubation, and mechanical ventilation, she underwent emergency cesarean section delivering a macerated stillborn fetus weighing 2.13 kg. Chest radiography showed bilateral pulmonary opacities consistent with pulmonary edema. Postoperative intensive care included broad-spectrum antibiotics, furosemide and gradual ventilatory weaning. She was extubated on day 5 and discharged in stable condition on day 7.
CONCLUSION: Multidisciplinary critical care enabled maternal survival despite severe physiological derangements, highlighting the need for enhanced emergency obstetric and ICU capacity in Somalia.
CASE PRESENTATION: A 17-year-old primigravida presented with generalized tonic-clonic seizures, Oxygen saturation of 78% (SPO2), blood glucose of 47 mg/dL, and elevated blood pressure of 140/90 mmHg. Initial findings included generalized edema, absent fetal heart rate, proteinuria (+++), acute kidney injury (creatinine 1.76 mg/dL), borderline thrombocytopenia (platelets 152 ×109/L at admission, declining to 113 ×109/L by Day 2), and transaminitis (AST 527 U/L, ALT 370.2 U/L). Obstetric ultrasound confirmed IUFD. Following resuscitation, magnesium sulfate seizure prophylaxis, intubation, and mechanical ventilation, she underwent emergency cesarean section delivering a macerated stillborn fetus weighing 2.13 kg. Chest radiography showed bilateral pulmonary opacities consistent with pulmonary edema. Postoperative intensive care included broad-spectrum antibiotics, furosemide and gradual ventilatory weaning. She was extubated on day 5 and discharged in stable condition on day 7.
CONCLUSION: Multidisciplinary critical care enabled maternal survival despite severe physiological derangements, highlighting the need for enhanced emergency obstetric and ICU capacity in Somalia.