Maternal and perinatal outcome in severe pre-eclampsia and eclampsia: a study of 120 cases at a tertiary health care center in Western India


  • Akash J. Patel Department of Obstetrics and Gynecology, NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Babulal S. Patel Department of Obstetrics and Gynecology, NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Akshay C. Shah Department of Obstetrics and Gynecology, NHL Municipal Medical College, Ahmedabad, Gujarat, India
  • Shashwat K. Jani Department of Obstetrics and Gynecology, NHL Municipal Medical College, Ahmedabad, Gujarat, India



Preeclampsia, Eclampsia, Maternal morbidity, Maternal mortality, Perinatal morbidity, Perinatal mortality


Background: Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. Pre-eclampsia accounts for the majority of referrals in a tertiary care center as it stands one of the major causes of maternal and perinatal morbidity and mortality. It complicates 6-10% of all pregnancies. In India, they account for the third most important cause of maternal mortality. Patients with PIH are at a greater risk of abruptio placenta, cerebrovascular events, organ failure and DIC. Fetuses are at a greater risk of IUGR, preterm birth, small for gestational age and IUD. This study aimed to determine the maternal and perinatal outcomes of hospitalized pregnant cases with severe preeclampsia and eclampsia.

Methods: This was a single year retrospective study conducted in a tertiary care center of Western India from May 2019 to May 2020. Maternal and perinatal outcomes were analyzed among the severe preeclampsia and eclampsia groups.

Results: A total 52 (43.33%) of the cases were in the age group of 21-25 years, 64 (53.33%) were primigravidae and the majority were referred from peripheral hospitals. Liver function tests were deranged in 26.68% of the patients and 32.5% had abnormal renal function. Labetalol was the most commonly used antihypertensive and magnesium sulphate was the anticonvulsant used in all the cases. Lower segment caesarean section was the mode of delivery in 62 (51.67%) of the cases. Commonest maternal complication was atonic PPH (12.5%). There was one maternal mortality due to aspiration pneumonia. 85 (70.83%) of the babies needed NICU admission. There were 5 (4.16%) perinatal deaths.

Conclusions: Accessible health care and health education and awareness regarding antenatal check-ups for all women will lead to early detection of severe preeclampsia. Prompt treatment and management of its complications will certainly improve the maternal and fetal outcome.


Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367:1066-74.

World Health Organization, UNICEF, UNFPA and the World Bank. Trends in Maternal Mortality: 1990 to 2010. Geneva: World Health Organization, 2012. World Health Organization: Accessed 12 June 2013.

Govt. of India (Sample Registration System) Maternal mortality in India, 1997-2003. Trends, causes and risk factors. Registrar General of India, New Delhi in collaboration.

Berzan E, Doyle R, Brown CM. Treatment of preeclampsia: current approach and future perspectives. Curr Hypertens Rep. 2004;16(9):473.

World Health Organisation. The world health report 2005- Make every mother and child count. World Health Organization, Geneva. 2005.

Wilkins LW. Hypertensive disorders in pregnancy. In: Barton JR, et al. (Eds.), Manual of Obstetrics. 8th edn. Wolters Kluver Health, Philadelphia, USA. 2014;183-95.

Say L, Souza JP, Pattinson RC. WHO Working Group on Maternal Mortality and Morbidity Classifications. Maternal near miss-towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol. 2009;23:287-96.

Pattinson R. Near miss audit in obstetrics. Best Pract Res Clin Obstet Gynaecol. 2009;23:285-6.

Conde-Agudelo A, Villar J, Lindeheimer M. World Health Organization systematic review of screening tests for preeclampsia. Obstet Gynecol. 2004;104(6):1367-91.

National high blood pressure education program working group, report on high blood pressure in Pregnancy. Am J Obstetr Gynaecol. 1990;163:1691-712.

Liu CM, Cheng PJ, Chang SD. Maternal Complications and Perinatal Outcomes associated with Gestational Hypertension and Severe Preeclampsia in Taiwanese Women. J Formes Med Asso. 2008;107(2):129-38.

Josephine Latha P, Ganesan S. Evaluation of serum uric acid and lipid profile in gestational hypertension. Int J Pharm Bio Sci. 2013;4(2):(B)496-502.

Sibai BM, Cunningham FG. Prevention of preeclampsia and eclampsia. In: Lindheimer MD, Roberts JM, Cunningham FG, editors. Chesley’s Hypertensive Disorders of Pregnancy. 3rd Ed. New York: Elsevier. 2009;215.

Saxena S, Srivastava PC, Thimmaraju KV, Mallick AK, Dalmia K, Das B. Socio-demographic profile of pregnancy induced hypertension in a tertiary care centre. Sch J Appl Med Sci. 2014;2:3081-6.

Conde-Agudelo A, Belizán JM. Risk factors for preeclampsia in a large cohort of Latin American and Caribbean women. BJOG. 2000;107:75-83.

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

Singhal S, Deepika, Anshu, Nanda S. Maternal and perinatal outcome in severe pre-eclampsia and eclampsia. South Asian Federation Obstet Gynecol. 2009;1(3):25-8.

Tufnell DJ, Jankowicz D, Lindow SW, Lyons G, Mason GC, Russell IF et al. Outcome of severe preeclampsia/eclampsia. Yorkshire 1999/2003. Br J Obstet Gynecol. 2005;112:875-80.

Miguil M, Chekairi A. Eclampsia, study of 342 cases. Hypertens Pregnancy. 2008;27(2):103-11.

Dissanayake VH, Samarasinghe HD, Morgan L, Jayasekara RW, Seneviratne HR, Pipkin FB. Morbidity and mortality associated with preeclampsia at two tertiary care hospitals in Sri Lanka. J Obstet Gynaecol Res. 2007;33(1):56-62.

Mattar F, Sibai BM. Risk factors for maternal morbidity. Am J Obstet Gynecol. 2000;182:307-12.

Igberase GO, Ebeigbe PN. Eclampsia: ten-years of experience in a rural tertiary hospital in the Niger delta, Nigeria. J Obstet Gynecol. 2006; 26(5):414-7.






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