Fetomaternal outcomes in eclampsia at a tertiary care centre: a prospective observational study

Abstract

Background: Eclampsia remains one of the most severe hypertensive disorders of pregnancy and continues to contribute substantially to maternal and perinatal morbidity and mortality, particularly in low- and middle-income countries.

Methods: This hospital-based cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology at a tertiary care centre in Nepal from July 2024 to July 2025. All women presenting with antepartum, intrapartum, or postpartum eclampsia beyond 28 weeks of gestation and up to seven days postpartum were included. Women with chronic hypertension, epilepsy, metabolic disorders, renal disease, or infectious causes of seizures were excluded. A total of 114 women were enrolled using non-probability convenient sampling. Maternal demographic details, clinical characteristics, management, and outcomes were recorded. Neonatal outcomes including birth weight, Apgar scores, NICU admission, and perinatal mortality were assessed. Data were analysed using SPSS version 25 with descriptive statistics.

Results: The incidence of eclampsia was 3.39%. Most women were young (≤20 years, 42.98%), primigravida (72%), and unbooked (94.74%). Antepartum eclampsia was the most common presentation (93.85%). Vaginal delivery occurred in 48.24% and caesarean section in 46.49% of cases. Maternal complications were observed in 38.60%, with acute renal failure being the most frequent. Two maternal deaths were reported. Among neonates, 25.43% were preterm and the perinatal mortality rate was 21.05%, with prematurity being the leading cause.

Conclusions: Strengthening antenatal surveillance, early referral, and timely management are crucial to improving outcomes in resource-limited settings.