A prospective observational study for the evaluation of maternal and fetal outcome in patient with eclampsia
Keywords:Eclampsia, Maternal mortality, Perinatal mortality
Background: Eclampsia continues to be a measure health issue in developing country. In order to get a comprehensive data on eclamptic patients we conduct a prospective observational study to address the maternal and fetal complication during pregnancy.
Methods: It is a prospective observational study conducted in a tertiary care medical college between the periods September 2016 to February 2017. During the period all patients with eclampsia admitted to the labour room were taken. Any patients with known epilepsy were excluded from the study.
Results: During the period 3780 women were admitted to the labour room, out of which 56 women had eclampsia with an incidence of 1.48%. Out this antenatal eclampsia was most common with an incidence of 91.08% followed by intra partum 4 (7.14%) and postpartum eclampsia 1 (1.78%). Majority of patients 54 (96.43%) were unbooked or inadequately supervised. Most of the patient had normalization of blood pressure after oral nifedipine 46 (82.14%), only 10 (17.86%) patient required additional injection labetalol for control of blood pressure. The maternal complications were placental abruption 8 (14.28%), HELLP 6 (10.71%), pulmonary edema 1 (1.78%), acute renal failure 1 (1.78%), DIC 1 (1.78%) and maternal death 2 (3.57%). Out of fifty six babies delivered 42 (75%) had live birth and 14 (25%) had still birth. A total of 17 (40.42%) had IUGR, 17 (40.47%) require SNCU admission post-delivery.Conclusions:Eclampsia still remains the major cause of maternal and fetal morbidity. In low resource countries improvement in health care facility, adequate antenatal supervision, and timely referral will reduce the maternal and fetal complication.
Sharara HA. A review of eclampsia in Qatar: A twenty-year study (from January1991- December 2009). Qatar Med J. 2012;2:7-15.
Agida ET, Adeka BI, Jibril KA. Pregnancy outcome in eclamptics at the University of Abuja Teaching Hospital, Gwagwalada, Abuja: A 3 year review. Niger J Clin Pract. 2010;13:394-8.
Ndaboine EM, Kihunrwa A, Rumanyika R, Beatrice HLM, Massinde AN. Maternal and perinatal outcomes among eclamptic patients admitted to Bugando Medical Centre, Mwanza, Tanzania. African J Reprod Health. 2012;16(1):35.
Adekanle DA, Akinbile TO. Eclampsia and pregnancy outcome at Lautech Teaching Hospital Osogbo, South-West, Nigeria. Clin Mother Child Health. 2012;9:1-4.
Lavanya SG, Ganitha G. A prospective study of pregnancy outcome in eclampsia. Indian J Obstet Gynecol Res. 2017;4(1):26-9.
Akinola O, Fabamwo A, Gbadegesin A, Ottun A, Kusemiju O. Improving the clinical outcome in cases of eclampsia: the experience at Lagos State University Teaching Hospital, Ikeja. Internet J Third World Med. 2007;6(2):1-5.
Chen CY, Kwek K, Tan KH, Yeo GS. Our experience with eclampsia in Singapore. Singapore Med J. 2003;44:88-93.
Jamil SN, Akhtar S, Maternal outcome in eclampsia. J Med Sci. 2005;13(2):161-4.
Altman D, Carroli G, Duley L, Farrell B, Moodley J, Neilson J, et al. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet. 2002;359(9321):1877-90.
Sibai BM. Diagnosis, prevention, and management of eclampsia. Obstet Gynecol. 2005;105:402-10.
Umans JG, Abalos E, Cunningham FG. Antihypertensive treatment. In: Taylor RN, Roberts JM, Cunningham FG, eds. Chesley’s Hypertensive Disorders in Pregnancy, 4th ed. Amsterdam, Academic Press: 2014.
Shekhar S, Chanderdeep S, Thakur S. Oral nifedipine or intravenous labetalol for hypertensive emergency in pregnancy: a randomized controlled trial. Obstet Gynecol. 2013;122(5):1057.
Muganyizi PS, Shagdara MS. Predictors of extra care among magnesium sulphate treated eclamptic patients at Muhimbili National Hospital, Tanzania. BMC Pregnancy Childbirth. 2011;11:41.
Yıldırım G, Güngördük K, Aslan H, Gül A, Bayraktar M, Ceylan Y. Comparison of perinatal and maternal outcomes of severe preeclampsia, eclampsia and HELLP syndrome. J Turkish- German Gynecol Assoc. 2011;12:90-6.
Knight M. UK Obstetric Surveillance System (UKOSS): Eclampsia in the United Kingdom 2005. BJOG. 2007;114:1072.
Zwart JJ, Richters A, Öry F. Eclampsia in the Netherlands. Obstet Gynecol. 2008;112:820.
Akkawi C, Kent E, Geary M. The incidence of eclampsia in a single defined population with a selective use of magnesium sulfate. Abstract No 798. Presented at the 29th Annual Meeting of the Society for Maternal-Fetal Medicine. 2009;(1):26-31.
Moodley J. Maternal deaths associated with eclampsia in South Africa: lessons to learn from the confidential enquiries into maternal deaths, 2005-2007. S Afr Med J. 2010;100(11):717.