Maternal and perinatal outcome in women with Eclampsia: A retrospective study
Abstract
Introduction: Eclampsia continues to be a major problem particularly in developing countries, contributing significantly to high maternal & perinatal morbidity & mortality.
Methods: A retrospective study was conducted between May 2010 and April 2015 among 542 patients who presented in emergency with eclampsia and initially admitted in department of Obstetrics and Gynecology and subsequently were managed at intensive care unit of teaching hospital in Bilaspur, Chhattisgarh.
Result: Out of 14, 902 pregnancies in the 5 year period of study in our tertiary care hospital, the estimated incidence was 3.5% , 85.6% patients had not received any regular antenatal care & 70.6% were primigravida. Majority of the cases (81.8%) as antepartum/ intrapartum eclampsia in the age group of 20-24 years (66.2%).Mostly (62.4%) patients presented at term, 69.7% had vaginal delivery, while 30.3% underwent caesarean section. The main factors contributing to maternal deaths (8.4%) were puerperal sepsis (11%), oliguria (8.1%) and pulmonary edema (5.9%).
Conclusion: Eclampsia is found to cause high incidence of maternal mortality & morbidity, which is also responsible for high rates of perinatal mortality. By creating an awareness and improvement in quality of basic antenatal care can reduce the incidence of eclampsia.
Downloads
References
2. Magee LA, von Dadelszen P, Chan S, Gafni A, Gruslin A, Helewa M, Hewson S, Kavuma E, Lee SK, Logan AG, McKay D, Moutquin JM, Ohlsson A, Rey E, Ross S, Singer J, Willan AR, Hannah ME; CHIPS Pilot Trial Collaborative Group. The Control of Hypertension In Pregnancy Study pilot trial. BJOG. 2007 Jun;114(6):770, e13-20.
3. Ducarme G, Herrnberger S, Pharisien I, Carbillon L, Uzan M. [Eclampsia: retrospective study about 16 cases]. Gynecol Obstet Fertil. 2009 Jan;37(1):11-7. doi: 10.1016/j.gyobfe.2008.11.011. Epub 2008 Dec 31. [PubMed]
4. Ghulmiyyah L, Sibai B. Maternal mortality from preeclampsia/eclampsia. Semin Perinatol. 2012 Feb;36(1):56-9. doi: 10.1053/j.semperi.2011.09.011. [PubMed]
5. Gupte S, Wagh G. Preeclampsia-eclampsia. J Obstet Gynaecol India. 2014 Feb;64(1):4-13. doi: 10.1007/s13224-014-0502-y. Epub 2014 Jan 31. [PubMed]
6. Chaturvedi S, Randive B, Mistry N. Availability of treatment for eclampsia in public health institutions in Maharashtra, India. J Health Popul Nutr. 2013 Mar;31(1):86-95. [PubMed]
7. Annual Health survey 2011-2012 fact: Chhhattisgarh office of the Registrar General and Census Commission.Vital statistics division, New Delhi, India.
8. Rasaly S, Carson-Dewitt. Pre-eclampsia & eclampsia. Gale Encyclopedia of Medicine. 23-40.
9. Warden M & Euerle B. Pre eclampsia (Toxaemia of pregnancy) emergency medicine 2003, updated on April 5 2002.
10. Sheraz S, Boota M. Shahzad S. Eclampsia. Prof Med J.2006.13(1):27-31.
11. Datta MR, Pant L, Kabiraj M, Basu SB. Magnesium sulfate in elampsia: A safe, efficient and cost-effective approach. J Obst Gynecol India 2002;52(3):65-68.
12. Shaheen B, Hassan L, Obaid M. Eclampsia, a major cause of maternal and perinatal mortality: a prospective analysis at a tertiary care hospital of Peshawar. J Pak Med Assoc. 2003 Aug;53(8):346-50.
13. Choudhary P. Eclampsia: a hospital based retrospective study. Kathmandu Univ Med J (KUMJ). 2003 Oct-Dec;1(4):237-41. [PubMed]
14. Tuffnell DJ, Jankowicz D, Lindow SW, Lyons G, Mason GC, Russell IF, Walker JJ; Yorkshire Obstetric Critical Care Group. Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003. BJOG. 2005 Jul;112(7):875-80.
15. Suyajna D J, Cm V. 'Single Dose MgSo4 Regimen' for Eclampsia - A Safe Motherhood Initiative. J Clin Diagn Res. 2013 May;7(5):868-72. doi: 10.7860/JCDR/2013/5398.2961. Epub 2013 Mar 25. [PubMed]
16. Douglas KA, Redman CW. Eclampsia in the United Kingdom. BMJ. 1994 Nov 26;309(6966):1395-400. [PubMed]
17. El-Nafaty AU, Melah GS, Massa AA, Audu BM, Nelda M. The analysis of eclamptic morbidity and mortality in the Specialist Hospital Gombe, Nigeria. J Obstet Gynaecol. 2004 Feb;24(2):142-7.
18. Pradeep M.R., Lalitha Shivanna. Retrospective study of eclampsia in a Teaching Hospita. International Journal of Recent Trends in Science and Technology.2013;8(3):171-173.
19. Rajasri G. Yaliwal, P.B. Jaju, M.Vanishree. Eclampsia and Perinatal Outcome a Retrospective Study in a Teaching Hospital Journal of Clinical and Diagnostic Research.2011 Oct;5(5):1056-1059. [PubMed]
20. Mattar F, Sibai BM. Eclampsia. VIII. Risk factors for maternal morbidity. Am J Obstet Gynecol. 2000 Feb;182(2):307-12. [PubMed]
21. Gaddi SS, Somegowda. Maternal and perinatal outcome in eclampsia in a district hospital. J Obst Gyn Ind.2007:57(4):324-26.
22. Nobis PN. Maternal outcome in eclampsia. Obstet. Gynecol Asia.2002;6(1)25-28. [PubMed]
23. Registrar General and Census Commissional, 2011b, Presentation on Annual Health Survey fact Sheet Key Findings, Annual Health Survey 2010e 11, Ministry of Home Affairs Government of India, New Delhi. [PubMed]
24. Ronsmans C, Campbell O. Quantifying the fall in mortality associated with interventions related to hypertensive diseases of pregnancy. BMC Public Health. 2011 Apr 13;11 Suppl 3:S8. doi: 10.1186/1471-2458-11-S3-S8.
OAI - Open Archives Initiative
