Preliminary Outcome of the Management of Eclampsia at the Imo State University Teaching Hospital

Background: Eclampsia continues to be a major cause of maternal and perinatal mortality in developing countries. Early identification and management of pre-eclampsia will help reduce the mortality due to eclampsia. Aim: This study aims at determining the prevalence and management outcome of eclampsia in our centre with a view to proffering solutions for an optimal or near optimal care.Methods: A retrospective review of the case records of patients managed for eclampsia at the Imo State University Teaching Hospital (IMSUTH); Orlu from 1st October 2004 to 30th September 2009 was carried out. Data on socio-demographic characteristics as well as clinical management and outcome were extracted and analyzed.Results: The prevalence of eclampsia was 2.7of all the deliveries. The prevalence was significantly higher in the unbooked than the booked patients (p0.05). The prevalence was also significantly higher in primigravidae than in multiparae (p0.05). Twenty-eight (93.3) of the eclampsia occurred antepartum. Twenty-eight (93.3) had severe hypertension on presentation. Twenty nine (95.8) of the patients had 2-5 episodes of convulsions prior to presentation to the hospital. Twenty-six (86.7) of the patients had emergency Caesarean section was carried out; mostly for unfavourable cervix. The perinatal mortality was 6.7while maternal mortality was 3.3. Complications included acute renal failure; aspiration pneumonitis and abruptio placentae. Conclusion: The prevalence of eclampsia is unacceptably high in our centre. Early antenatal booking; antenatal care follow-up to identify the imminent signs and prompt treatment of cases of pre-eclampsia will reduce the burden of eclampsia in this environment

Management of Eclampsia at AKTH: Before and after Magnesium Sulphate

Eclampsia contributes significantly to maternal and perinatal morbidity and mortality in Nigeria. The world Health Organisation recommended Magnesium Sulphate as the most effective; safe and low cost drug for the treatment of eclamptic seizures and for prophylaxis in severe pre-eclamptic.This study is aimed to evaluate the effect of the introduction of magnesium sulphate for the management of eclamptic seizures on maternal and fetal indices in Aminu Kano Teaching Hospital [AKTH]; Kano. A retrospective study of all patients who presented with eclampsia in AKTH; Kano. The study period included 3years prior to introduction o magnesium sulphate [January 2002- December 2004] and 3years after its introduction [January 2005 - December 2007]. During the study period; the prevalence of eclampsia was1.02[1: 97 deliveries]. Sixty six [50.5] of the patients were aged 19 and below. Approximately 62of the patients were primigravida and 87were unbooked. Thirty eight [29] were treated with diazepam while ninety three[71] were treated with magnesium sulphate. 39.4of those treated with diazepam died compared to 15of those treated with magnesium sulphate. Approximately ninety percent of those that died had no antenatal care. Overall perinatal mortality rate in this study was 312 per 1000 births [41]. 368.4per 1000 births among those treated with diazepam and296.7 per 1000births in the magnesium sulphate group. Approximately nine percent of those treated with magnesium sulphate develop toxicity [85.5renal and12respiratory] This study is in support of the findings that magnesium sulphate is superior to diazepam in the reduction of maternal morbidity and mortality