Feto maternal outcome in eclampsia after 28 weeks of pregnancy: vaginal delivery versus caesarean section
Keywords:Antepartum eclampsia, Caesarean section, Convulsion, Vaginal delivery
Background: Eclampsia is the occurrence of convulsions or coma unrelated to other cerebral condition with signs and symptoms of preeclampsia. Objective of present study was the comparison of maternal and fetal outcome of women with more than 28 weeks gestation complicated by antepartum eclampsia when terminated either by caesarean section or by vaginal delivery.
Methods: 200 Women with more than 28 weeks of gestation with antepartum eclampsia were studied from admission to discharge or death. Depending upon the mode of delivery, they were divided into two groups: C.D. group. Where caesarean section was performed and V.D. group, where vaginal delivery was carried out. Maternal and Perinatal outcome were studied in the two groups and compared.
Results: Of the 200 cases, caesarean section was done in 40% of the cases, while vaginal delivery was carried out in 60%. Maternal complications were seen in 15% of the cases in the C.D group and 60% of the cases in the V.D. group. Maternal deaths occurred in none of the case in the C.D group and in 33% of the cases in the V.D group. The incidence of live births, still births and neonatal deaths was 87.8%, 2.43% and 9.75% respectively in the C.D group, while it was 49.16%, 45.16% and 9.67% in the V.D group The Corrected perinatal mortality was 9.75% in the C.D group and 43.55% in the V.D group. Apgar score less than 5 at l minute was seen in 35% cases in the C.D group and 82.35% cases in the V.D group.30% of the cases in the C.D group and 76.47% of the cases in the V.D group required NICU admission.
Conclusions: Timely caesarean section reduces maternal and Perinatal mortality and improves their outcome in antepartum eclampsia, especially in women with more than 28 weeks of pregnancy.
Dutta DC. Textbook of Obstetrics, 4th Ed, Calcutta, New Central Book Agency Pvt Ltd. Chapter 17;1998:234-54.
Williams Obstetrics. 22nd Ed. McGraw Hill Co. Inc. chapter 40. 2005:761-808.
Pal B, Geeta N, Vivek P. A study of eclampsia. J Obstet Gynecol. 1996;46(1):34-39.
Bhattacharya PK, Purkayastha S, Basu M, Robinsanath M. Caesarean section in eclampsia: Still a dilemma. J Obstet Gynecol India. 1992;42(1):51-55.
Majhi AK, Chakraborty PS, Mukhopadhyay A. Eclampsia present scenario in a referral medical college hospital. J Obstet Gynecol India. 2001;51(3):143-7.
Kamilya G, Bharracharyya SK, Mukherji J. Changing trends in the management of eclampsia from a teaching hospital. J Indian Med Assoc. 2005;103(5):132-5.
Mundle S, Mullik I. Risk factors in pregnancy outcome in eclampsia. Abstracts Free Communication Papers, 42nd All India congress of Obstetrics and Gynecology. 1998.
Pritchard JA, Cunningham FG, Mason RA. Coagulation changes in frequency and pathogenesis. Am J Obstet Gynecol. 1976;124:855.
Bansal V. Maternal and perinatal outcome in Eclampsia. Abstract, free communication papers, 42nd All India Congress of Obstetrics and Gynecology. 1998.