Published: 2020-10-27

Maternal and perinatal outcome in severe preeclampsia and eclampsia at the Rivers State university teaching hospital, Nigeria

Peter A. Awoyesuku, Dickson H. John, Dickson H. John, Lewis B. Lebara, Lewis B. Lebara


Background: Severe preeclampsia and eclampsia remain a challenge in tropical obstetric practice. It is a major contributor to feto-maternal morbidity and mortality in developing countries. This study seeks to determine the prevalence, associated risk factors and the feto-maternal outcome of severe preeclampsia and eclampsia at the rivers state university teaching hospital (RSUTH).

Method: A retrospective study of all women who had severe preeclampsia and eclampsia and were delivered at the RSUTH in a two-year period, 1ST January 2018 to 31ST December 2019, was carried out. Data on patients’ age, parity, education, booking status, gestational age at delivery, diagnosis, complications, mode of delivery and fetal sex, birth weight and Apgar scores were retrieved using structured pro-forma. Data were analyzed using SPSS version 20.

Results: There were 4496 deliveries of which 128 had severe preeclampsia and eclampsia, giving a prevalence of 2.85%. Of these, 94 (73.4%) had severe preeclampsia and 34 (26.6%) had eclampsia. The mean age of the women ± SD was 29.84±5.44 years, median parity was para 1, and mean gestational age ± SD was 35.38±3.84 weeks. There were 10 maternal deaths giving case fatality of 7.8%. The mean birth weight ± SD was 2.61±0.91 kg and stillborn rate was 14.4%. There was significant association with maternal age, education, booking status, method of delivery and Apgar score of the baby.

Conclusion: The prevalence in this study is high with associated high maternal mortality and stillborn rates. Timely and appropriate intervention including primary management and judicious termination of pregnancy will reduce mortality of mother and fetus.


Severe preeclampsia, Eclampsia, Risk factors, Maternal outcome, Perinatal outcome

Full Text:



Gabbe SG. Obstetrics: normal and problem pregnancies. 6th ed. Philadelphia: Saunders, an imprint of Elsevier Inc. 2012.

Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet. Gynecol. 2003;102(1):181-92.

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

Reingardiene D. Preeclampsia and eclampsia. Medicina (Kaunas). 2003;39(12):1244-52.

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

Tubbergen P, Lachmeijer AM, Althuisius SM, Vlak ME, Geijn HP, Dekker GA. Change in paternity: a risk factor for preeclampsia in multiparous women? J Reprod Immunol. 1999;45(1):81-8.

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

Onwuhafua PI, Onwuhafua A, Adze J, Mairami Z. Eclampsia in Kaduna State of Nigeria. A proposal for better outcome. Niger J Med. 2001;10(2):81-84.

Okogbenin SA, Eigbefoh JO, Omorogbe F, Okonta PI, Ohihoin AG. Eclampsia in Irrua specialist teaching hospital: a five-year review. Niger J Clin Pract. 2010;13(2):149-53.

Akinola OI, Fabanwa AO, Gbagesin A, Ottun TA, Kusemiju OA. Improving the clinical outcome in cases of eclampsia: the experience at Lagos State university teaching hospital, Ikeja. Int J Third World Med. 2008;6(2):2.

Oladokun A, Okewole AI, Adewole IF, Babarinsa IA. Evaluation of cases of eclampsia in university college hospital Ibadan over a 10-year period. West Afr J Med. 2000;19(3):92-4.

Tukur J. The use of magnesium sulphate for the treatment of severe preeclampsia and eclampsia. Ann Afr Med. 2008;8:76-80.

Airede LR, Ekele BA. Adolescent maternal mortality in Sokoto, Nigeria. J Obstet. Gynaecol. 2003;23(2):163-5.

Ujah IA, Asien OA, Aisien OA, Mutihir JT, Vanderjagt DJ, Glew RH et al. Maternal mortality among adolescent women in Jos, North-Central, Nigeria. J Obstet. Gynaecol. 2005;25(1):3-6.

Awoyesuku PA, MacPepple DA, Altraide BO. Magnitude and Trends in Maternal Mortality and Causative factors: A 7-year review at a tertiary hospital in Port Harcourt, Nigeria. J Adv Med Res. 2020;32(1):103-9.

Magpie Trial Collaborative Group. Do women with pre-eclampsia and their babies benefit from magnesium sulphate? The magpie trial: a randomized placebo-controlled trial. Lancet. 2002;359:1877-90.

Onuh OS, Aisien OA. Maternal and fetal outcome in eclamptic patients in Benin City, Nigeria. J Obstet. Gynaecol. 2004;24:765-8.

Dolea C, AbouZahr C. Global burden of hypertensive disorders of pregnancy in the year 2000. GBD Working Paper, World Health Organization; Geneva. Accessed on 8/8/2020.

Abalos E, Cuesta C, Carrol G, Qureshi Z, Widmer M, Vogel JP et al. Pre-eclampsia, eclampsia, and adverse maternal and perinatal outcome: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG. 2014;121:14-24.

Ajah LO, Ozonu NC, Ezeonu PO, Lawani LO, Obuna JA, Onwe EO. The Feto-Maternal Outcome of Preeclampsia with Severe Features and Eclampsia in Abakaliki, South-East Nigeria. J Clin Diag Res. 2016;10(9):QC18-21.

Okafor UV, Ezegwu HU. Cesarean delivery in preeclampsia and seasonal variation in a tropical rainforest belt. J Postgrad Med. 2010;56:21-3.

Duley L. Pre-eclampsia and the hypertensive disorders of pregnancy. Br Med Bull. 2003;67:161-76.

Abate MM, Lakew Z. Eclampsia: A 5-year retrospective review of 216 cases managed in 2 teaching hospitals in Addis Ababa. Ethiop Med J. 2006;44(1):27-31.

Saxena N, Bava AM, Nandanwar Y. Maternal and perinatal outcome in severe preeclampsia and eclampsia. Int J Reprod Contracept Obstet Gynecol. 2016;5:2171-6.

Yasmin S, Osrin D, Paul E, Costello A. Neonatal mortality of low birth weight infants in Bangladesh. Bull WHO. 2001;79:608-14.