A study on fetomaternal outcome in eclampsia in a tertiary care institute

Authors

  • Sushma V. Dev Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • Mythreyi Kadambi Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysore, Karnataka, India
  • Meghana Devakki Nagaraj Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231059

Keywords:

Eclampsia, Maternal outcome, Perinatal outcome

Abstract

Background: Eclampsia is a life threatening emergency that continues to be a major cause of maternal and perinatal mortality. The present study was undertaken to analyse the maternal and fetal outcome in patients of eclampsia and to evaluate various factors influencing this outcome.

Methods: A retrospective observational epidemiological study was undertaken in the Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysore, for a period of three years from January 2020 to December 2022. All women who presented as eclampsia or developed eclampsia during hospital stay were included in the study. Data analysed included various maternal parameters, fetal parameters, and the outcome of pregnancy.

Results: The incidence of eclampsia was 7.14% which is relatively high, attributing to the fact that being tertiary care centre many cases are referred. Higher incidence seen in primigravida (72.4%) and low maternal age (48%). Caesarean section was indicated in 50% deliveries indicating immediate action was necessary for better fetomaternal outcome. 58.6% had an uneventful maternal outcome.There was 7.65% maternal mortality most common cause of death was intracranial hemorrhage. 53% were preterm deliveries and 29.4% stillbirths, respiratory distress in the newborn was seen as the major complication (41.9%).

Conclusions: In our study, maternal complications were recorded in 41.3% of the patients with a case fatality rate of 7.65%. Respiratory distress, prematurity, growth restriction and low birth weight are the neonatal complications to be anticipated. We infer from our study that better antenatal care, early recognition of disease, timely referral, early initiation of treatment and termination of pregnancy in eclamptic women could improve maternal and fetal outcome.

References

Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Hypertensive disorders, Williams obstetric. 26th edition. 2022;1777-892.

Health E. Balancing the scales: expanding treatment for pregnant women with life-threatening hypertensive conditions in developing countries. A report on barriers and solutions to treat preeclampsia and eclampsia. Engender Health. 2007.

Bhanu BT, Amudha S, Sarojini.Clinical study of maternal complications associated with eclampsia. Int J Reprod Contracept Obstet Gynecol. 2017;6:1905-8.

Agida ET, Adika BI, Jibril KA. Pregnancy outcome in eclamptics: a 3 year review. Nig J Clin Pract. 2010;13(4):394-8.

Burton G J, Redman C W, Roberts J M, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. BMJ. 2019;366:l2381.

Katz VL, Farmer R, Kuller J. Preeclampsia into eclampsia: toward a new paradigm. Am J Obstet Gynaecol. 2000;182:1389-96.

Nobis PN, Hajong A. Eclampsia in India through the decades. J Obstet Gynecol India. 2016;66(1):172-6.

Agarwal M, Gautam A. Study of fetomaternal outcome in eclampsia. Int J Reprod Contracept Obstet Gynecol. 2020;9:4155-9.

Ugran SM, Kasturi V Donimath Correlation between neuroimaging (CT scan) and neurological presentation in antepartum and postpartum eclampsia Int J Reprod Contracept Obstet Gynecol. 2016;5(2):419-24.

Sinha M, Sinha SK. Perinatal and Maternal outcomes of Eclampsia in Darbhanga District, Bihar, India. Int J Contemp Med Res. 2018;5(2).

Kokila MS, Dwivedi AD. Correlation of Clinical and Neuroimaging Findings affecting Management in Postpartum Eclampsia: A Prospective Study. J South Asian Federation Obstet Gynaecol. 2011;3(3):125-30.

Bhanu BT, Amudha S, Sarojini. Clinical study of maternal complications associated with eclampsia. J Reprod Contracept Obstet Gynecol. 2017;6(5):1905.

Jindal MA, Gaikwad HS, Hasija BD, Vani K. Comparison of neuroimaging by CT and MRI and correlation with neurological presentation in eclampsia. Int J Reprod Contracept Obstet Gynecol. 2013;2(1):83-7.

Pannu D, Das B, Hazari P, Shilpa. Maternal and perinatal outcome in eclampsia and factors affecting the outcome: a study in North Indian population. Int J Reprod Contracept Obstet Gynecol. 2014;3(2):347-51.

Sibai BM, Sarinoglu C, Mercer BM. Eclampsia: VII. Pregnancy outcome after eclampsia and long-term prognosis. Am J Obstet Gynecol. 1992;166(6):1757-63.

Sunita TH, Desai RM, Hon N, Shinde KJ, Hashmi SI. Eclampsia in a teaching hospital: Incidence, clinical profile and response to magnesium sulfate by Zuspan’s regimen. IOSR J Dental Med Sci. 2013;4(2):1-5.

Onuh SO, Aisien AO. Maternal and fetal outcome in eclamptic patients in Benin City, Nigeria. J Obstet Gynaecol. 2004;24(7):765-8.

Efetie ER, Okafor UV. Maternal outcome in eclamptic patients in abuja, nigeria a 5 year review. Nigerian J Clin Practice. 2007;10(4):309-13.

Ndaboine EM, Kihunrwa A, Rumanyika R, Beatrice IM, Massinde AN. Maternal and Perinatal Outcomes among Eclamptic Patients Admitted to Bugando Medical Centre, Mwanza, Tanzania. Afr J Reprod Health. 2012;16(1):35-42.

Mahran A, Fares H, Elkhateeb R, Ibrahim M, Bahaa H, Sanad A, et al. Risk factors and outcome of patients with eclampsia at a tertiary hospital in Egypt. BMC Pregnancy Childbirth. 2017;17(1):435.

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Published

2023-04-18

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Original Research Articles