Maternal and perinatal outcome in severe preeclampsia and eclampsia


  • Neha Saxena Department of Obstetrics and Gynaecology, L.T.M.M.C. and L.T.M.G, Sion Hospital, Mumbai, Maharashtra, India
  • Amarjeet Kaur Bava Department of Obstetrics and Gynaecology, L.T.M.M.C. and L.T.M.G, Sion Hospital, Mumbai, Maharashtra, India
  • Yogeshwar Nandanwar Department of Obstetrics and Gynaecology, L.T.M.M.C. and L.T.M.G, Sion Hospital, Mumbai, Maharashtra, India



Pre-eclampsia, Eclampsia, Hypertension, Maternal morbidity and mortality


Background: Pre-eclampsia accounts for the majority of referrals in a tertiary care centre as it stands one of the major causes of maternal and perinatal morbidity and mortality. The objective of this study was to study the maternal and fetal outcome in patients with severe pre-eclampsia and eclampsia in a tertiary centre over a period of one year.

Methods: Total 150 women with severe eclampsia and eclampsia after 20 weeks of gestation were included. Women with medical complications like anemia, preexisting hypertension, epilepsy, diabetes, vascular or renal disease, multiple gestation, polyhydramnios were excluded. Patients were managed as per existing protocol after proper history, examination and investigations. Anti-hypertensive of choice was alphamethyl-dopa, labetalol and oral nefidipene. Magnesium sulphate was used as anti convulsant.

Results: Out of 150 cases of severe pre-eclampsia and eclampsia, majority (69%) were between 20-30 years of age and 47% were primigravida. We had 75 patients with convulsions on admission and 75 with severe pre-eclampsia of whom 11 had convulsions. Headache was most common complaint. Common mode of delivery was caesarean section in 72 (48%) women, majority in view of failed induction or non-progress. Maternal complications were noted in 59% attributed to renal dysfunction, postpartum hemorrhage, DIC, placental abruption, HELLP, pulmonary edema, pulmonary embolism and renal failure. 4 maternal deaths were recorded.

Conclusions: Maternal and perinatal complications are more in patients with eclampsia. The incidence of eclampsia can be reduced by better antenatal care, early recognition and prompt treatment of severe pre-eclampsia.


Carty DM, Delles C, Dominiczak AF. Preeclampsia and future maternal health. J Hypertens. 2010;28:1349-55.

Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33:130-7.

Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365(9461):785-99.

Tan KH, Kwek K, Yeo GS. Epidemiology of pre-eclampsia and eclampsia at the KK women's and children's hospital, Singapore. Singapore Med J. 2006;47(1):48-53.

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

Alvarez Navascués R, Marín R. Severe maternal complications associated with pre-eclampsia: an almost forgotten pathology? Nefrologia. 2001;21(6):565-73.

Roberts JM. Endothelial dysfunction in preeclampsia. Semin Reprod Endocrinol. 1998;16:5-15.

Multidisciplinary management of severe pre-eclampsia (PE) experts’ guidelines 2008. Société française d’anesthésie et de réanimation. Collège national des gynécologues et obstétriciens français. Société française de médecine périnatale. Société française de néonatalogie. Ann Fr Anesth Reanim. 2009;28:275-81.

Pottecher T, Luton D. Prise en charge multidisciplinaire de la prééclampsie. French. Issy Les Moulineaux, France: Elsevier; Masson SAS; 2009.

Minire A, Mirton M, Imri V, Lauren M, Aferdita M. Maternal complications of preeclampsia. Med Arch. 2013;67(5):339-41.

Churchill D, Perry IJ, Beevers DG. Ambulatory blood pressure in pregnancy and fetal growth. Lancet. 1997;349:7-10.

Kuklina EV, Ayala C, Callaghan WM, et al. Hypertensive disorders and severe obstetric morbidity in the United States. Obstet Gynecol. 2009;113:1299-306.

Odendaal HJ, Pattinson RC, Bam R, Grove D, Kotze JVWT. Aggressive or expectant management for patients with severe preeclampsia between 28-34 weeks' gestation: a randomized controlled trial. Obstetrics and Gynecology. 1990;76(6):1070-5.

Duley L. Pre-eclampsia and the hypertensive disorders of pregnancy. British Medical Bulletin. 2003;67:161-76.

World Health Organization Fact Sheet; 2012.

Lack of preeclampsia awareness increases risk of infant mortality, press release, preeclampsia foundation; 2008.

Singhal S, 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.

Shaikh S, Ruby AJ, Piotrowski M. Pre eclampsia related chorioretinopathy with Purtscher’s likefindings and macular ischaemia. Retina. 2003;23:247-50.

Naseer D, Ataullah K, Nudrat E. Perinatal and maternal outcome of eclamptic patients admitted in Nishtar Hospital, Multan. J Coll Physician Surg Pak. 2000;10:261-4.

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






Original Research Articles