Maternal and perinatal outcomes in eclampsia: a retrospective analysis in a referral hospital

Authors

  • Renu Jain Department of Obstetrics and Gynecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
  • Jyoti Bindal Department of Obstetrics and Gynecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20172557

Keywords:

Eclampsia, Perinatal death, Pulmonary edema

Abstract

Background: Eclampsia is defined as the development of convulsions and / or unexplained coma during pregnancy or postpartum in patients with signs and symptoms of preeclampsia. The objective of present study was to investigate the incidence of eclampsia, the clinical profile, maternal and perinatal outcomes in eclamptic patients in our hospital setting.

Methods: The retrospective analysis of case records of all eclampsia cases was done over a period of one year, in department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.

Results: The incidence of eclampsia was13.04/1000 deliveries. Eclampsia was more common in the age group 20-24 years (55.64%), primigravidae (62.90%) and patients from rural areas (76.61%). Majority (91%) of women were referred from different hospitals. 112 (90.32%) patients were unbooked. 74 (59.67%) patients developed eclampsia during antenatal period before onset of labor. 67.01% patients presented at gestational age > 37 weeks. Lower segment caesarean section was the predominant mode of delivery in 66 (68.04%) patients. 11.29% patients required ventilatory support and pulmonary edema developed in 4.83% of cases. Maternal death occurred in 7.25% of cases.with a case fatality rate of 16.07%. Pulmonary edema was the commonest cause of death. 7 (5.6%) patients presented with intrauterine death on admission. There were 5 (4.06%) perinatal deaths reported in present study.

Conclusions: Eclampsia is still a common and serious complication of pregnancy. Proper antenatal care, detection of preeclampsia with early management and timely referral of high - risk patients, administration of MgSO4 in correct doses and properly timed caesarean section in selected cases would reduce the incidence of eclampsia associated maternal and perinatal morbidity and mortality in our facility.

References

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.

Bhide A, Arulkumaran S, Damania KR, Daftary SN. Arias’ Practical guide to high risk pregnancy and delivery. 4th ed. New Delhi, Elseiver;2015:218-9.

Swain S, Singh S, Das L, Sahoo B. Maternal and perinatal outcome of eclampsia in a tertiary care center. Int J Reprod Contracept Obstet Gynecol. 2016;5(2):384-90.

Mahalakshmi G, Krishnaveni A, Nimma W, Vinusha K. The study of maternal and perinatal outcome of eclampsia in a tertiary hospital. IOSR J Dental Med Sci. 2016;15(4):123-8.

Khan A, Ghosh A, Banerjee PK, Mondal TK. Profile and outcome of eclampsia in a rural tertiary hospital. Int J Recent Trends Sci Tech. 2014;10(3):526-9.

Adamu AN, Ekele BA, Ahmed Y, Mohammed BA, Isezuo SA, Abdullahpi AA. Pregnancy outcome in women with eclampsia at a tertiary center in Northern Nigeria. Afr J Med Med Sci. 2012;41(2):211-9.

Sahara HA. A review of eclampsia in Qatar: A twenty – year study (from January 1991 – December 2009). Qatar Med J. 2012;2:7-15.

Gupte S, Wagh G. Preeclampsia- Eclampsia. J Obstet Gynaecol India. 2014 Feb;64(1):4-13.

Gawandi P, Shinde MA, Jadhav CA. Clinical study of eclampsia patients at Dr. V. M. Government medical college Solapur, India. IOSR J Dental Med Sci. 2014;13(7):10-16.

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.

Doley R, Pegu B, Hazarika D. Clinical study of eclampsia in a tertiary care hospital. Indian J Sci Tech. 2016;9(29):1-5.

Sarma HK, Talukdar B. Eclampsia: a clinical prospective study in a referral hospital. J Obstet Gynecol Barpeta. 2014;1(1):57-61.

Schreurs MP, Cipolla MJ, AI-Nasiry S, Peeters LLH, Spaanderman MEA. Formely eclamptic women have lower nonpregnant blood pressure compared with formely pre-eclamptic women: a reterospective cohort study. BJOG. 2015;122(10):1403-9.

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.

Ajah LO, Ozonu NC, Ezeonu PO, Lawani LO Obuna JA, Onwe EO. The feto- marternal outcome of preeclampsia with severe features and eclampsia in Abakaliki, South – East Nigeria. J Clin Diagn Res. 2016;10(9):QC18-QC21.

Downloads

Published

2017-06-24

Issue

Section

Original Research Articles