Factors influencing perinatal outcome in eclampsia at a tertiary referral hospital

Chaitra Sathyanarayana, Radhamani Somanna


Background: Perinatal mortality in eclampsia still continues to be high in developing countries mainly due to prematurity and birth asphyxia. This study was conducted at a tertiary referral hospital to analyse the perinatal outcome in eclampsia and identify the associated risk factors.

Methods: A prospective study wherein 170 cases of eclampsia admitted to Cheluvamba Hospital, Mysore, India over a period of one and half years were analysed.

Results: The incidence of eclampsia was 1.08%. 88.8% of the cases were delivered vaginally and 8.2% by LSCS. Majority of the babies (48.8%) weighed between 1000-2000 gms. The perinatal mortality rate in this study was 55.3%. Prematurity (61%), SGA (55%) and birth asphyxia (55%) were the most common causes of perinatal morbidity. Birth asphyxia was the commonest cause of perinatal death (51.2%) followed by respiratory distress syndrome (20.93%), septicemia (13.95%) and meconium aspiration syndrome (6.98%). Jaundice, pulmonary hemorrhage and intracranial hemorrhage contributed to 2.33% of early neonatal deaths each. Among various probable risk factors for poor perinatal outcome, BP ≥160/110 mmHg, gestational age <28 weeks, vaginal route of delivery, antepartum eclampsia and convulsion delivery interval ≥24 hours were associated with significantly higher perinatal mortality (p < 0.05).

Conclusions: Strict fetal monitoring and prompt timely intervention may help to reduce the perinatal mortality rate. The NICU facilities have to improve especially in government hospitals so that smaller babies can be taken care of and salvaged.


Eclampsia, Perinatal morbidity, Perinatal mortality

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Chesley LC. Hypertensive disorders in pregnancy. New York: Appleton Century Crofts. 1978: 1-628.

Singhal SR, Deepika, Anshu, Nanda S. Maternal and perinatal outcome in severe pre-eclampsia and eclampsia. South Asian Federation of Obstetrics and Gynecology. 2009;1(3):25-8.

Sibai BM. Diagnosis, prevention and management of eclampsia. Obstetrics and Gynecology. 2005;105(2):402-10.

Aagaard-Tillery K, Belfort MA. Eclampsia morbidity, mortality and management. Clinical Obstetrics and Gynecology. 2005;48:12-20.

Majhi AK, Chakraborty PS. Eclampsia – Present scenario in a referral medical college hospital. J Obstet Gynecol of India. 2001;53(3):143-7.

Ndaboine EM, Kihunrwa A, Rumanyika R, Beatrice HIm, Massinde AN. Maternal and Perinatal Outcomes among Eclamptic Patients Admitted to Bugando Medical Centre, Mwanza, Tanzania. African Journal of Reproductive Health. 2012;16(1): 35-41.

Nadhkarni J, Bahl J, Parekh. Perinatal outcome in pregnancy induced hypertension. Indian Pediatrics. 2001;38:174-8.

Suman GS, Somegowda. Maternal and perinatal outcome in eclampsia in a district hospital. Journal of Obstet and Gynaecology of India. 2007;57(4):324-6.

Pritchard JA, Cunningham FG, Singe A, Pritchard RN. The Parkland Memorial Hospital protocol for treatment of eclampsia: Evaluation of 245 cases. Am Obstet Gynecol. 1984;148(7):951-63.

Rajan R. Recent advances in clinical obstetrics. New Delhi: CBS Publishers. 1997:95-105.

Khuman V, Singh RL, Singh RM, Devi UA, Kom T. Perinatal outcome in eclampsia. J Med Soc. 2015;29:12-5.

Sibai BM. Eclampsia-maternal and perinatal outcome in 254 consecutive cases. Am Journal of Obstet Gynecol. 1990;163:1079-155.

Douglas KA, Redman CWG. Eclampsia in the United Kingdom. British Medical Journal. 1994;309:1395-9.

Singh BM, Misra R. Hypertensive disorders in pregnancy. 6th ed. In: Ian Donald’s Practical obstetric problems. Misra R, ed. New Delhi: Edward Arnold Ltd. 2007:280-309.