Role of antenatal care in reducing incidence of eclampsia in eastern Uttar Pradesh, India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20191937Keywords:
Antenatal care, Eclampsia, PreeclampsiaAbstract
Background: Eclampsia is characterized by sudden onset of generalized tonic-clonic convulsions or coma in pregnancy or postpartum. It is a major cause of maternal and perinatal morbidity and mortality in developing countries. This study was conducted to determine the incidence of eclampsia and role of antenatal care in reducing the incidence.
Methods: This was a prospective study (July 2015-June 2016) conducted in labour room of department of obstetrics and Gynecology, BRD Medical college, Gorakhpur, Uttar Pradesh, India. A total no. of 141 women presenting with eclampsia were included in the study. Risk factors like antenatal care and sociodemographic status were studied for their role in increased incidence of eclampsia.
Results: There were 141 eclampsia cases out of 3536 deliveries, during the study period. The incidence of eclampsia was found to be 4%. Out of 141 eclampsia cases 35.5% did not receive any antenatal care. 56.7% received substandard care in less than 4 antenatal visits. Out of those who received antenatal care (91/141), 67% received irregular, substandard care in primary health centre of their locality. Majority of eclampsia cases were between 16-25 years of age (85.1%) and were primigravida (62.4%). Majority of eclampsia cases were uneducated (89.4%), of lower socioeconomic status (71.4%) and belonged to rural area (67.4%).
Conclusions: High incidence of eclampsia in B.R.D. Medical College reflects the status of eclampsia in eastern Uttar Pradesh, India. To prevent eclampsia our health care centres should be strengthened by well trained medical officers, other health care workers and adequate antenatal care facilities.
References
Bansal V, Kaizad R. Damania. Hypertensive disorders in Pregnancy. Arias, Practical Guide to high risk pregnancy and delivery, A South Asian Perspective, 4th Ed.; 2015:185-232.
Tranquilli AL, Brown MA, Zeeman. The definition of severe and early onset preeclampsia. Statements from the International Society for the study of Hypertension in Pregnancy (ISSHP). Pregnancy Hypertension. 2013;3(1):44.
Ducarme G, Herrnberger S. Eclampsia: retrospective study of 16 cases. Obs and gynaecology Fertility. 2009;37(1):11-7.
Matter F, Sibai BM. Eclampsia. VIII Risk factors for maternal morbidity. Am J Obstet Gynecol. 2000;182:307-12.
Sibai BM, Abdella TH, Taylor HA. Eclampsia in the first half of pregnancy: a report of three cases and review of the literature. J Reprod Med. 1982;27:706-8.
Newman RB, Eddly GL. Association of eclampsia and hydatidiform mole: case report and review of the literature. Obstet Gynecol Surv. 1988;43:185-90.
Douglas KA, Redman CW. Eclampsia in the United Kingdom. BMJ. 1994;309:1395-400.
Katz VL, Farmer R, Kuller J. Preeclampsia into eclampsia: toward a new paradigm. Am J Obstet Gynecol. 2000;182:1389-96.
World Health Organization. International Collaborative Study of Hypertensive Disorders of Pregnancy. Geographic variation in the incidence of hypertension in pregnancy. Am J Obstet Gynecol. 1988;158:80-3.
Goldenberg RL, McClure E, MacGuire ER. Lessons for low income regions following the reduction in hypertension- related maternal mortality in high income countries. Int J Gynecol Obstet. 2011;113:91-5.
Vanawalla NY, Ghamande S. A five year analysis of eclampsia. J Obstet Gynecol India. 1989;39:513-5.
Suman G, Somegowda S. Maternal and perinatal outcome in Eclampsia in a District Hospital. J Obstet Gynecol India. 2007;57:324.
Educational material for teachers of midwifery. World Health Organization, 2nd edition, 2008:1-131.
Dutta DC. Hypertensive disorders in pregnancy. Konar H, editor. Text book of obstetrics, 7th Ed.; New Central Book Agency (P) Ltd: Kolkata; 2011:2019-40.
Ghulmiyyah L, Sibai B, Maternal mortality from Preeclampsia/Eclampsia. Seminar Perinatol. 2012;36(1):56-9.
Shaikh SB. A study on maternal and perinatal out comes in cases of eclampsia admitting to government medical college and general hospital, Anantapuramu, Andhra Pradesh, India. Int J Reprod Contracept Obstet Gynecol. 2016;5(7):2146-50.
Sunita TH, Desai RM. Eclampsia in a teaching hospital: Incidence, clinical profile and response to magnesium sulphate by Zuspan’s regimen. IOSR J Dent Med Scien. 2013;4(2):1-5.
Manjusha S, Vandana N. Eclampsia: A retrospective study in a tertiary care centre. Indian J Pharma Practi. 2013;6(1):69-73.
Singh S, Behera A. Eclampsia in Eastern India: Incidence, Demographic Profile and response to three different anticonvulsant regimes of magnesium Sulphate. The Internat J Gynecol Obstet. 2010;15(2).
Babbar K. Burden of eclampsia: a persisting problem in the developing countries Int J Reprod Contracept Obstet Gynecol. 2015:4(4):1029-33.
Prabhakar G, Shinde MA, Jadhav CA. Clinical study of eclampsia patients at DR V M. Government Medical College, Sholapur, India. IOSR J Dent Medi Scien. 2015;13(7):10-6.
Jain S, Nager S. Maternal mortality from eclampsia, a critical analysis of 693 cases in two teaching hospitals in Northern India. 1998;38:256-60.
Wain S, Ojha KL. .Maternal and perinatal mortality due to Eclampsia. Indian Paedia J. 1993:30(6):771-3.
Sarma HK, Talukdar B. Eclampsia: a clinical prospective study in a referral hospital. J Obstet Gynaecol Barpeta. 2014;1(1):57-61.
Corkill TF. Experience of toxaemia control in Australia and New Zealand. Pathol Microbiol. 1961;24:428-34.
Aparna Khan. Analysis of the causes of maternal death in eclampsia. IOSR J Den Med Scien. 2014;13:7-10.
Tuffnel DJ, Jankowisz D. Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003. BJOG:An Int J Obstet Gynaecol. 2005;112(7):875-80.
Bilano VL, Ota E. Risk Factors of Pre-Eclampsia/Eclampsia and its Adverse Outcomes in Low and Middle- income Countries: A WHO Secondary Analysis. PLoS ONE. 9(3):e91198.
Gupta S, Wagh G. Preeclampsi-Eclampsia. J Obstet Gynecol India. 2014;64:1.
