ABSTRACT
To describe the presentation of eclampsia, its management and associated outcomes using magnesium sulphate [MgSO4], over a five years period at a tertiary care hospital. This descriptive study was conducted at Obstetrics and Gynecology Unit, Hayatabad Medical Complex, Peshawar from January 2004 to December 2008. Data was collected from all patients presenting with eclampsia. A total of 146 patients had eclampsia. Unbooked were 124 [84.93%]. Mean age 23 years +/- 5.3 years [range 18-38 years], primigravida were 69.17% [101 cases]. Antepartum fits in 72.6% [106 cases], intrapartum 14 [9.58%] and 27 [18.49%] postpartum. MgSO4 was used in all except 4 with oliguria, they were given diazepam. Recurrent fit occurred in only 20[13.69%]. MgSO4 toxicity occurred as respiratory depression in 9 cases, depressed tendon reflexes in 10 and decreased urine output in 13 cases Total deliveries were 23021, prevalence of eclampsia was 0.63%. Mode of delivery was Vaginal in 97 [66.43%], instrumental in 29 [19.98%] and cesarean section in 20 [13.69%] cases. There were 26[17.2%] stillbirths and 4 neonatal deaths. Complications included HELLP in 17 [11.64%], pulmonary complications in 17, renal failure in 7 [4.79%], DIC in 16[10.95%] and temporary blindness in 16 cases. Eleven [7.53%] maternal deaths occurred, causes included DIC in 1case, HELLP in 2, renal failure 1, cardiopulmonary failure in 2 and CVA [received deeply unconscious] in 5 cases. All were unbooked cases and with delay in reaching hospital. Eclampsia is common antenatally and in primigravidae, and a major cause of maternal morbidity and mortality in our region. It was effectively controlled with MgSO4, preventing recurrent fits and safe for both mother and fetus